Question for those on pain control

Hi All,

I have a question for those of you who are on pain control for migraines. I have been on the same medication for about 4 years now and it is losing its effectiveness. It does not work anymore. I have tried going off it for a while and restarting it several week later and that has not helped one bit. I have no idea what to do, as my pain dr seems reluctant to change medications.

How do I deal with this? I have a note typed out for an appointment on the 16th. Is it ok to go in and ask about another medication by name, or would I just sound like a drug seeker? I do have a couple of idea and would be willing to go back to something that worked in the past. I am having real trouble with this right now. I would love any advice.

All I know is that I can't go on like this. The fainting is out of control too and there seems to be a correlation between the pain level and the number of times I faint. I need to have one of these things under some control- for my sanity if nothing else.

Any ideas would be welcome.

Pain free days,
sailingm

Many years ago I would say about five or six, I asked about my other options of a stronger pain medication because of the same reason you are asking.

I was taking fiorinal and I also was having a bowel problem with fiorinal. The doctor gave me Lortab. I am still on it and feel it is the best pain med for me.

I am not sure how to ask for a stronger pain med so to not sound like a drug seeker but our doctors know the pain we are in daily/weekly. I would give it a try and ask for something stronger. I do not know what you are on but it is worth a try.

Looking forward to other posters replys.

From reading your situation this past year I would ask. You need some quality of life and you are not getting it with what you are on now.

All the best,

kimsmom

I have a problem with pain meds because nothing works for me except codeine, Fiorinal C1/2, and oxycodone.
But also that's all I've tried so far.
NSAID's, acetaminophen alone etc doesn't do anything for me.

Luckily for me what works, works more or less always. IF it works.
I have to increase the dose but considering I am taking it for 20 + years - T3 without caffeine I think more or less the same does 1-2 tablets every 4-6 hrs i think is not bad.
Of course it doesn't work without a triptan. I hope I am not jinxing myself!!!!

I have no idea how to talk to the dr about that.
I have bad experiences about that in the past. Myself it was always a bit of luck about getting the stuff.
I got percocet only because after close to 20 years of 'Emtec 30' only, I begged for some emergency "safety ring" while flying to Europe and that's how I got it. But when upon my return I asked for more, I got denied.
then I was switching family drs an simply asked for a new Rx for Percocet and the rest, and got it without question.
I think I don't have to tell you how my heart was skipping beats! while I was asking for it!
so juzt dumb luck with oxy so far.

Beore that I got lucky once with Fiorinal C1/2, and once with Emtec30. both times I happened upon drs who weren't skimpy with these meds.
But then one of them retired, and one them reneged on the rx saying M are caused by rebounds and one day cold turkey cut off all the meds triptans including

So I don't have a good advice. I hope you'll get what you need, though.
And don't think bad about what you need, either - you are sick and that's it.
what, are you going to have a party with your Rx? no? then please stop beat yourself about needing stronger, more medications. it's a disease we have not addiction.



Risa

Sailing.......

I have no problem asking my doctor(s) for a specific medication. It's our right as a patient to be educated about our condition and its treatments. It's only logical that we research medications that might work for us.

If a doctor calls that drug-seeking, the doctor is unrealistic. I'd find a different doctor.

How are you feeling? Wish they could get those fainting episodes figured out for you. I admire your strength and fortitude in living with them. Take care.

Becky

I'm at a loss too! I had gotten painkillers from my dentist a while back from a molar extraction and dry socket.
I used them for a few migraines and they worked great! Unfortunately i threw the bottle out.
I think they were vicodin, but i dont remember the strength.
I asked my neuro to give me vicodin and he prescribed me 5/500 and they work like crap and I feel like
i am taking way too many of them when i get a M. I usually take 3-4 pills every 5 hours!
thats like WOH! I'm blowing through a bottle that says take 1 every 4-6 hours when I took
1-2 of the ones my dentist gave me and it relieved my pain completely!
2 actually gave me that sick icky feeling i hate getting but sometimes i have to deal with in
order to relieve the pain. I have a upcoming appointment and I dont know how to confront
my doctor about it either. I don't like taking so many pills like I am because i know the tylenol
in the pills can screw my liver up, but I'm so nervous to bring it up I'm not sure if i even will!
I hate pain management, and I'm only 22 so everyone always assumes that i'm asking for these drugs because
i'm seeking not because I actually need it. It drives me up a wall. I feel like I was lucky to get the
script in the first place because of my age..

Hi All,

Thanks so much for the advice. I am not sure what to do except to go in with the typed note and ask aboiut a medication by name. I don't really have a choice right now, as nothing else seems to be working. II am going to take someone with me- eitherone of my parents or possibly my roommate who can state that the pain is constant and that nothing is working. Sometimes, it helps to have back up.

As to the fainting, it is still really bad. I fainted at least 10 times every day this week. I have left a message for my doctor about it and have asked about some other treatments. I hope we can find something soon. I am not sure what to do with either of these things. Right now, all I can do is keep getting up when I fall and keep searching for answers.

I'd love any other ideas or advice.

Pain free days,
sailingm

Like you I'm a little nervous about bringing it up to my neuro about something stronger. He was real good about increasing my vicoprofen to 60 but when I asked for more because of the effectiveness issue of being on it so long he said "if that doesn't work, we may have to look at other pain control measures". I don't like the sound of that so I'm not bringing it up!!!!!

Charlotte

I have been prescribed Fioricet with Codiene, Vicodine,Stadol,Imutrex and many others. Each time I have moved over the past 20 years I had to change doctors and they all chose to change my meds instead of staying with the previous physicians orders. Needless to say I have tried alot of meds like most of you. My doctor who prescribed the Fioricet was very liberal with handing me scripts of 30 tabs per month, while the next doctor who gave me Imutrex ,which made my heart feel like it was going to beat out of my chest, was totally against any narcotic pain med. She went ballistic when she found out that a doctor that was in practice with her had seen me at the ER for a headache which I had been suffering from for days on end. I was vomiting and could not function and he gave me morphine which ended the ordeal. She became irate at the idea, at which time I left her practice. My current doctor prescribes vicodin, but has me on a daily dose of Topamax as well. He mentioned in the beginning that the intentions were to eventually get me off the vicodin and only have to take the Topamax. He's always prescribed 30 of the 5/500 at a time with no refills. I think this is to keep things in check and make me call the office for a refill. My last appointment I just decided I would be blunt and when he asked me what I take and how they work I told him out right. I had gone into the office that day after suffering with a migraine the night before so I figured I would put him to the test and if he didn't pass I would find a new dr. I told him of my routine, wake up with a headache, take two excedrine, drink a large cup of strong coffee. An hour later it goes away, mid day it gradually comes back and by 5 o clock I take a vicodin. He asked how many days I take them and how effective they are, I told him the exact truth. He told me he thought I was being smart with the meds and he changed my Topamax. He also wrote out a new script for Vicodin with refills this time. I think it's best to be honest with your doctor by all means. But it can depend on the doctor and the patient as far as the situation you described. I have been seeing my doctor now for 7 years and I make sure he knows of all my meds and other doctors I am seeing. I even made it a point last year one time to tell him of some pain meds I was given for surgery from another doctor. I always use one pharmacy and try to keep a level of trust with my doctors. I know this is hard to do in our world today, but it will help your situation.

I'm seeing a new neurologist. I'm not sure how well her plan of attack will work, but I promised her I'd try it. She wants me weaning off of my Nubain and only using sumatriptain with aleve for my migraines. And I can only use 2 in 24 hours, no more than twice a week. I don't know what I'm supposed to do the rest of the time, or what I'm supposed to do when the suma/aleve combo doesn't work and I'm in pain for days on end. I'm really worried about it. Time will tell, I guess.

Brenda,

I would be nervous too. I tried it on my own, not taking ANYTHING for two months. It made no difference in the number of headaches, so other than being in pain for two months it was a complete wash.

But, at least the Dr. knew I tried so we were able to eliminate the "rebound" headache thing.

Charlotte

Only twice a week is harsh. I know some of us use alot more than 2 to 4 imitrex a week. Maybe not every week, but often.

I'll have some weeks where I use only 1 or 2 imitrex, and some where I use 5 or 6.

What I hate is when you're worried about something like that, the stress makes your migraines worse. And it doesn't help that you tell the dr. "I am really worried about this," and he just nods, like he is saying "yes, I understand you are," but doesn't propose an alternative to worrying. No suggestions like, "I understand. I don't want you to worry. Let's try this, and if you reach a point where you feel it isn't working, and you believe you can't go without your medication, call my office, and we'll get you in to see me right away." or something.

Hey Sailing Muffin

Sorry the fainting is still around. Real sorry.

When you see your doctor, do NOT ask for pain medication. Instead try this:

1. Describe your pain using your current medication. Tell the doctor what you use, when you take it, how often, etc. then use the old 1 to 10 scale correctly where 1 is no pain and 10 is the worst describable pain and you are passing out from the pain. I naturally assume that anyone typing on here that they are in horrible pain are likely in the 5 - 7 range ... they are able to fae a monitor and type, after all.

but 5- 7 pain is life interferring. Describe your pain in what it PREVENTS. Can you drive with this pain? Watch TV? Read a book? Eat? Cook? Take a walk? 5 - 7 pain interfers with these normal life functions and needs to be treated.

2. After describing the way you take your medication AND the level of pain, only THEN ask for "pain relief." You are requesting relief from pain that is actually and really interferring in your normal life functions.

3. After describing the way you use your medication AND describing the level of pain on the medication AND asking for adequate pain relief so you can function ... then and only then say you have heard of XXX and ask the doctor what he/she thinks of it,

Using this formula, no one can describe you as a drug seeker. You are seeking PIAN RELIEF so that you can function semi-normally as a human being.

Give this a try. It has worked for me for over a decade now.

Brenda and Charlotte,

I had a MD at a World Famous pain clinic in Chicago (easy to figure out) tell me my "headaches" were all rebounds and I needed to stop taking analgesics. So I tried it for two months; two months of HELL!

IMHO I think some MD's will draw the rebound excuse when they run out of ideas. But that's my jaded opinion. Your mileage may vary...

Thank you so much for your helpful advice. I am definitely printing this out with some answwers to take in on Wedbnesday. Meanwhile, would you mind looking over a dry run, without naming specific meds. Also, I am seeing a pain mangament dr.

1. Describe your pain using your current medication. Tell the doctor what you use, when you take it, how often, etc. then use the old 1 to 10 scale correctly where 1 is no pain and 10 is the worst describable pain and you are passing out from the pain. I naturally assume that anyone typing on here that they are in horrible pain are likely in the 5 - 7 range ... they are able to fae a monitor and type, after all.

Im currently on a daily long acting pain medication. I take it twice a day. It only takes a little bit of the edge off. On a good day, the pain level is around a 7-8. On a bad day, the pain ranges from 8-10, m aking it very diffic ult to function. The pain is life altering once it passes a 7/10. I might be talk to friends on the phone briefly, or glance at the computer. It is hard to concentrate on anything significant. It takes a huge effort to get even the simplest task accomplished. Often, when the pain reaches the level, my roommate tries to distract mein any way she can- by talking, by soft music, by putting on a short anime series. In addition, once the pain pases a 7, the number of fainting spells greatly increases. When it gets to a nine, I have to call my neurologist to set up an IV of Depakan.

but 5- 7 pain is life interferring. Describe your pain in what it PREVENTS. Can you drive with this pain? Watch TV? Read a book? Eat? Cook? Take a walk? 5 - 7 pain interfers with these normal life functions and needs to be treated.

The pain greatly intereferes with my life, There are many dasys when I am unable to do the simplest task- ie wash dishes, etc. Somedays, all I can do is take the medications and try to ride it out. This fact greatly dimishes my quality of life. It also effects those around me. I have had to miss many events due to migraine pain and fainting. I even had to leave my brother's rehearsal dinner early due to strobe lights and paid for it the next week. I understand that you can't take all the pain away, but we ould try to control it better.

2. After describing the way you take your medication AND the level of pain, only THEN ask for "pain relief." You are requesting relief from pain that is actually and really interferring in your normal life functions.

I really feel that we nay need to consider doing something else because this simply is not working. I am fighting a two front war here and something has to be under control. I need help as this is interfering with my life and everyone around me.

3. After describing the way you use your medication AND describing the level of pain on the medication AND asking for adequate pain relief so you can function ... then and only then say you have heard of XXX and ask the doctor what he/she thinks of it,

I simply can't go on in this manner. Is there any way that we could try something else, such as X or Y to control this pain?

Thanks for all the commenbts. Richard, I hope you don't mind thje fact tht I plsan to print out and use your formula. It is rational. It states the case, and I hope it works. As always, you are an inspiration to m,e.

Pain free days,
sailingm

Sounds like you need a new doctor! When I see my doctor and say my current medications are not adequate to have me functioning at a reasonable level, we will come up with a solution as to what to do, together. Only if the doctor says they don't have any other ideas will I suggest something by name that I have not tried.

We patients are not doctors, so many times my suggestions will be shot down for good reasons, but other times I end up getting a prescription and a chance for some relief. I keep going back to the doctor monthly or even weekly until we get me feeling better again. I think your long acting med should do more than take the edge off.

I was able to reduce my pain 50% and have researched this is rather typical. I can now lead 90% of my previous life. Sounds like you haven't tried a whole lot of long acting meds yet so you should have options. Also, it is expected to need to go up on doses, especially for young patients like us. Methadone is one of the only ones that patients do not build the quick tolerance to.

There is no reason that I know why it is not safe to go up on doses unless you are over treating the pain, taking a medication with Tylenol (not long acting like you are), etc. Some doctors think we are all drug seekers, or that the same dose will work for years and years, when it will not on a young patient.

When you first started this medication did it consistently get you functioning at a reasonable level? I bring in a list to my doctor's appointments and set it where we can both see it, to signal to the doctor I am not leaving until we discuss and resolve everything on it. Are your specialists communicating to each other as to how best treat you? Getting your doctors working together may work to your benefit.

Best wishes.