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Thread: Breakthrough Pain, Please Help

  1. #11
    Quote Originally Posted by metronycguy
    so fla neuropathic pain is real very real, many times it is much worse than the other real pain.
    medic i is you doctor a physitrist? a lot of your pain problems sound pretty complicated, due to the different ,unnatural , unbalanced ,stress you are putting on your body by walking with no functioning muscles.
    you need to find someone that is going to look at
    I agree with metronycguy. My regular doctor recommended seeing a physiatrist/rehab doctor when I kept on going in for pain problems. My everyday doctor is the doctor I had well before my injury...but if something is out of her realm she doesn't hesitate to refer me to someone who can help.

    I take Ultram on a daily basis...I prefer it over the other meds by far. My pain is also related to so called nerve pain, but its a combo of the two. The lidoderm patches seem to help me though, sometimes better than what I have for breakthrough pain. The physiatrist also recommended some other meds for breakthrough pain...darvocet seems to help the most, but I also have oxycodone left over that I use on occasion. I am also on cymbalta which helps with pain as well as depression etc...which may not be a problem with you. I was able to get rid of three different meds by taking cymbalta. And it doesn't have the same side effects as nuerontin and lyrica...not all of them anyway. The worst of which being the mental fogginess...since your in school thats the last thing you want.

    I guess the best advice I could give would be to prevent the pain before it starts...I take Ultram on a daily basis, and its not really a high dose. I would also recemmend seeing a physiatrist since pain is so much more complicated with sci. Even though that may not be an immediate solution...but in the mean time I hope your doctor works with you a little better.

    Hope this helps a little.

    Jennifer

  2. #12
    I totally agree with the pain doc idea,really.they DO understand every type of pain and can also offer you sooo many different tools to use to try and keep things from getting too out of hand.but as was pointed out,not taking your meds the way they were intended really doesn't help your situation either.

    from what you have stated it does appear that your pain is neuropathic and also structural.i have a combo of this too.and yes,constipation is just something we all have to deal with.almost evrry med that is even related to any sort of narcotic will,in most cases,cause constipation.quite honestly,the only thing that has helped me at all with mine is eating about a cup or so of prunes each night before i go to bed,even every other night appears to still work.there are also other things you can try.but stopping your chances for any pain relief because of the constipation isn't goingto help you at all in keeping things in any sort of control.going to a good pain clinic,well they have alist of things at mine that can help with the constipation part of things.even lying on your left side if possible really does help for some reason,it has to do with the way the GI tract is set up,but it does really help.i have to always sleep onmy back but manage to prop up my right side a bit with a pillow so i can at least be leaning a bit more to the left.massaging the lower abdomen helps too.i lost the perastaltic wave on my R side so i have to massage things every once in a while just to keep things moving.it helps too.

    but i really do think just getting to a good pain clinic where all of your seperate pain issues can be fully evaluated by someone who really knows pain would honestly be the best possible move you could make for yourself.there are many different types of meds that work best on certain types of pain,and the pain docs all know this.they can set up a treatment plan that is just much more suited to you in particular.this is really what you need.you owe it to yourself to at least give pain management a shot.no other doc(and i have seen many) gave me the attention that my pain really needed til i started at my current pain clinic.my PM is an anesthesiologist so he can do all of my blocks and other injections himself.i really trust him and he has over thirty years of experience.he just really understands MY particular needs much better than anyother specialist that i have to see.

    i really hope you will give this a try.it could be the best move you ever made as far as getting good control over your pain.i wish you lots of luck.please let us know how things are going.marcia

  3. #13
    Senior Member medic1's Avatar
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    Thank you

    Thank you to everyone for the suggestions. I am starting to take my Ultram ER regularly and increasing fiber and water intake to alleviate the side effect of the Ultram. I am trying to get it through to my Physiatrist that I need something different for pain that becomes unbareable at times. His suggestion is always pt. He use to be head of the spinal cord injuries in Ann Arbor, MI, but that was a long time ago. Here in the UP he is the guy to see for all neuro stuff. He does not specialize in SCI anymore and I wonder if he keeps up on the changing information. He was a bit resistant to sending me down to Shepherd Center in Atlanta because he felt that there was nothing I could gain from the experience. He was WAY wrong on that. Not so much on the physical aspects, but I recieved information that I had no idea about and was exposed to so much when I was there.

    Again thank you to everyones information. I am definatly going to push for a pain specialist.

  4. #14
    in regard to the prunes....i take a couple of different opiates and i can vouche that 2 or 3 prunes every night or 2 works for me.

  5. #15
    maybe start looking for a new doctor this guy is way behind the times , and is doing you no favores with your pain management.
    pt can actually increase your neuropathic pain, especially if you have a lot of scar tissue.
    cauda equina

  6. #16
    Metro is once again very right about the PT thing,espescially if the doc doesn't truely understand the reasons for your actual pain.one good rule of thumb is if it just doesn't seem "right" or is very painful,just stop what you are doing immediately and get your actual condition re evaluated.you just don't want to make things any worse.this can happen when the doc just really does not understand your reasons for pain in the first place.PT does play a big part in some conditions and does make certain things better,but it can also be a very dangerous and destructive process too.just know your body and YOUR particular limitations.good luck,marcia

  7. #17
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    I forgot to mention to you Medic....
    Do you have access to an indoor pool? Walking in water at the lake/fitness center does wonders for my hips. I didnt realize it until I did it every other day.
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  8. #18
    Senior Member medic1's Avatar
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    It is good to keep in mind that "no pain, no gain" is not very appropriate for our situations. I will go over my pain with my pt when I am evaluated.

    The difficult thing is that I live is such a rural area that this is the best it gets around here. I think I will have to force the issues though of saying my pain is not going away with pt. That it may be something that I will have to live with and I would like something that would help me cope a little better.

    The closest pool is 52 miles round trip, and is at the Y. It is difficult to get there but I imagine the low impact would be great.

  9. #19
    I can atest to just how well the water thing is,but from what my father went thru not me.he had two extremely bad knees from OA,and needed a double knee replacement(done on seperate occasions) but the one thing he was doing BEFORE the surgeries was going to the local Y and doing bicycle excercises while in their hot tub?just keeping those normally withering muscles really well toned actually cut his recovery time by almost half,mostly becaue they didn't have to start from scratch in rebuilding what m,ost other people normally would lose because of the pain and the atrophy that comes along with not being able to actually excercise those muscles.he was already halfway there by the time he was starting PT.he said if it hadn't been for the heat in that hot tub,he never would have been able to actually do any sort of real excercises.his recovery went amazingly well.

    but just doing resistance excercises under any water is really really a good low impact way to excercise.if i could tolerate the heat and the cold(they both seriously effect different areas of my seperate pain syndromes to some degree)i would do it in a heart beat,mostly becaue it just sounds sooo relaxing.and a great way to relieve stress.i definitely need to do better at relieving my built up stress.

    i know this probably seems a bit extreme medic one,but have you ever contemplated a possible move just to be closer to possible pain control tools that you don't really have access to where you currently are?i know its probably not something you really want to even think about,but when it comes to being able to live a much more comfortable peaceful life,well,you know,sometimes we need to place ourselves and the possibility of a better quality of life ahead of everything else.just a thought,nothing more.good luck.

    just curious about your name 'medic one"? were you an actual medic at one time? just wondering.Marcia

  10. #20
    Senior Member medic1's Avatar
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    From the time I have spent in the water it has been nice. I almost feel normal when in the water. I use my hot tub to do some stretching and keep things loose. I was a paramedic, still am, para medic. LOL. Actually that is how my accident happened. I was transfering a patient and my partner lost control of the ambulance. We flipped and rolled landing upright on all four tires.

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