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Hi Everyone, I've read so many 'threads' and really related to NotPerky in many ways (other than not being perky) so don't know if this is more of a new question-i'm new to the boards- or simply I can relate to so many of y'alls struggles. I have chronic back pain -spinal fusion last year- and still left w/ L4-S1 pain, left leg nerve pain, pins & needles left 'butt', leg & foot and recently found uterine fibroids. The depression, severe insomnia, lack of energy and simply miserable life lately are assumed to be from the pain but very well could be depression w/ just life itself; i am sooo down/sad /frustrated lately. So I really don't know what to ask, discuss or how to put my reply but I am really looking for some support or advice or just someone who might be going thru something similar.

I have recently started SSRI cymbalta for depression but my main issue is pain meds. I have been taking hydrocodone 10/325 for about year now and can range from 6/day to 10-12/day, most often 10/day.

Main fear, concern is they don't relieve the pain anymore and I'm sure I must be addicted to them as I have not really ever been w/out pain meds of some sort for this past year; either that or major tolerance has developed.

My pain mgmt. doc started me on fentenyl patch (sp?) 50mcg yesterday. I am adamant not to take any hydrocodone as I really want to see if these patches will work (he gave me 10 and need to change every 3 days). I am in quite a bit of pain now and guess they haven't kicked in yet - could take 24 hrs....not happy about that aspect of patch!!!!-- but really don't want to take any narcotic pills (still taking my lyrica for nerve pain, took naproxem sodium for fibroids and to see if helped my back... haaa... and ambien 12.5 for sleep..... still not working for sleep- can't lie still long enough to let it do it's job). PM doc said I could take the narco (sp?) for breakthru pain if needed but really trying to see if can go w/out. I'm scheduled for spinal steroid injection soon but wondering if this patch will help w/ pain until then and also after reading all y'all have said about patches is that they are going to be VERY hard to stop using when I want to stop them. even though I'm sure I'll have to be on SOMETHING for long future unless I have more surgery (which is what last 2 docs opinions were as fusion did not take and L4-L5 is still unstable after fusion w/ rods)as I know I can't live w/ all this pain and depression.

So other than just rambling on, can anyone relate to my situation and have any advice; what else is there other than narco and these patches. If this pain doesn't keep me from getting on w/ my life (stay-at-home-mama) my depression will...and my kids and husband need me and prob. won't put up w/ me much longer. So, Sorry to carry on so long on my 1st real description of my history but would really love to hear from someone.

Also, so sorry you're going through all you are 'notperky' .... I can understand where you're coming from in more ways than one and really feel for you.... have no real advice for you.... but hang in there. I've heard GREAT things about spinal cord stimulator (I want it but can't have it as mine still needs surgery) so I hope you read this and your consult goes good as I really think that will give you relief (like a tens unit but better ) but realistically not as much prob. as all the pain meds.... sorry to say that... hope it didn't sound rude.
take care all of you

(wow... just read all i wrote......sorry!!!!!
Hi Serenity ODAAT and welcome to the group. Not to take anything away from NotPerky, because I know she has been through a lot, but I can also relate to your problem. Currently, my cervical spine has been my demon and the sciatic pain from my lumbar spine has diminished over the last year (after the last epidural injection).

Fentenyl is very powerful and far more powerful than the hydros that you have been taking. Unfortunately, like you said, it takes a while to be absorbed and start reducing the pain. Hopefully the epidural will help with the pain as well. I have had numerous epidurals in my lower spine, plus I'm scheduled for another one in my neck next week. I think you will find the patch and the epidural will help relieve the pain. I'm not prescribing, but one step down from fentenyl is oxycontin, which is time-release oxycodone and is used for people with long-term pain issues. Talk about options with your PM doc, since each medication has its own advantage and disadvantage. Sorry to hear about all of your pain issues. I've been there! Good luck to you with your injection. Let us know how you are doing and ask questions. There's is always someone here with similar problems and experiences.
Serenity, more than anything I wish you serenity. Your pain sounds so debilitating.

I don't really have a concrete answer for your, but I do want to welcome you to the board, and offer you emotional support.

I can't really answer your question about whether or not you've developed tolerance, or addiction, but my first thought is that your situation appears to be one of tolerance as your current dose doesn't seem to be managing the pain.

Also, it's not clear to me whether or not your difficulty in coping as wife and mother is due to pain medication, or simply the deep physical (and psychological) pain you're experiencing. Perhaps after your next injection, as well as the patch kicking in, it will be easier to distinguish between the two. If the new treatments work and you find yourself able to better manage your personal life, then it would appear that it was the pain causing the family difficulties.

Furthermore, there's yet another aspect that might be considered-- just to add the mystery of it all--and that's the depression itself. We know that depression exacerbates pain, so perhaps seeing a psychiatrist for treatment of that problem might also help.

Taking the Norco (spelled with an "o", although there is a certain amount of humor to be found in calling it "narco" which usually refers to a narcotics agent) for only a year may not have been long enough to lead to a full blown addiction. However, that's how long I took it starting at 5-10 mg 2-3x day and then leading to 30 mg 2-3 x day at about month 6, and if my withdrawal is an indication of depth of addiction it would appear that I wasn't deeply into the physical addiction, although it *is* clear that in my own so- called recovery and relapse that I definitely am addicted.

As you didn't mention any cravings, that might indicate that so far you're not really addicted, at least psychologically, but more in the dependent phase.

The above statements are really only my uneducated assessment and as such are simply offered as something further to contemplate.

May you, and all of the rest of us, find more serenity and peace than yesterday.
[B]Hi Serenity,[/B] I appreciate your words of support. Yes, you and I seem to have the same types of spinal issues -- including the left leg nerve pain, hand and foot numbness, and unsuccessful surgery. I was not a candidate for a fusion because all my disks were so severely degenerated. I have looked into the spinal cord implant, but at this point I am just trying to recover from my years of oxycodone before I do anything else. Frankly, I don't have the energy to even THINK of anything else. I highly doubt whether I'll ever try another "prescription" solution though. I am so sick of dependence, withdrawal symptoms, side-effects...and nothing has ever really taken away that darn nerve pain. I want to cleanse myself of everything (except the anti-flammatory and a small dose of Welbutrin), see what my "normal" is, and start from scratch.

In your case, hopefully the Fentanyl patch will kick in soon. (That's one thing I have never tried, although my doctor did mention it. I was too interested in getting my "high"....I didn't want something that was a hassle *and* didn't give me a buzz.) I definitely built up a tolerance, though, and that was why I eventually decided to taper off the oxycodone entirely. I think I crossed the line into "addiction" because the pills became a treat, a reward, something I used to calm myself down, something I used for energy, something I hid from others, something I obsessed about, and eventually something that cut me off from family/friends and sent me into isolation and a deep depression. I can't say which came first -- the pain caused the depression, or the depression caused the pain, or what. As I write this, I am 5+ weeks' clean and still depressed. But I know it will take awhile.

So, I don't know what to advise because everyone has to deal with their pain differently. I just wanted to say that just because you've built up a tolerance, doesn't mean you're an "addict". Many, many people are able to handle narcotics and pain management without crossing the line like I did. Don't despair -- you have been through a major surgery and are still recovering. I believe the Fentanyl is a lot stronger than the hydrocodone, so hopefully you will feel relief very soon. Please keep us posted, honey.
Wow, I have never been on a site like this (actually any site at all) and it's weird, I just got on for a second to read more threads and got really surprised and excited that y'all replied; what a big help and sooo nice to hear the common feelings, etc. Other than hoping to be able to help support someone else I'm so excited to get involved w/ y'alls 'community'. Thanks to you guys soo much for the support. Off to ice-skate w/ family (or just watch them of course..... how long has it been since any of us have been able to do something like that) but wish I could respond to y'alls individual comments. This site really sounds like a really good support system. I'll check back later but thanks so much to y'all for the support. What a great help and nice to feel like I can share w/ someone (prob. more in future as well) what I KNOW I can't talk openly w/ friends and family here much.
take care and will chat later.
Serenity,

I too went from hydro to the fentenyl patch. I was on about 12 pills a day of the hydro and my doc started me out on the 25mcg patch but that did nothing for the pain so I went to the 50mcg. For me the pain meds allowed and allow me to participate in life. I don't like the hassel, but for the most part I have no side-effects. My pain was so bad I daily thought of suicide. My life had shrunk to just trying to exist. Having my pain at a manageable level has given me hope and encouragement for the future which I did not have before.

I hope the fentenyl helps and you begin to enjoy life again.

Melissa
Boxerluver you are so right! All we want t do is live a normal life and not in pain all of the time. Serenity, I think you'll find that the patch reduces you pain significantly. Keep your Pain Doc informed on how you are doing. It sounds like you have one that listens. That's good!!
Amen Denon, and God what I'd give it was from something other than narcotics!!
Welcome! As most of us here, have been or are going through the same issues you are. You are NOT alone by any means. You are certainly taking alot of the hydro. The fent patches generally will help you, but I believe you need to "detox" a bit from the hydro so that the fent can build up in your system. My doctor will not give me patches. The strongest med they will give is the hydrocodone which really sucks for me. I am also getting the spinal cord stimulator tomorrow 9/17/09 which I am looking forward to. The trial was helpful. But don't give up, we are all here to help each other, talk about what we are going through and support each other.

I was 19 when I was involved in a major high speed accident with a drunk driver. It left me with 6 herniated disks, hip pain, broke both wrists, and left me unable to walk due to spinal pressure. I was able to heal and relearn to walk again. I also live with horrible, chronic pain everyday as most of us do. I also take several medications for pain. I now am 38, but feel as if I'm 100. Over the last 10 years, my upper back has been slowly hunching over due to the pain and muscle deterioriation. I'm not to hunched over, but enough to notice. I've spend 18 weeks in physical therapy from a cervical fusion and discetomy which failed to help with my pain but it did help with the numbness and loss of motor functions of both of my arms and hands. I am not the same as I was as far as being able to function with my hands and arms but I make due. Some days are worse then others. I also went through a major depression with all of this. I do not sleep well. At best, 4 hours off an on all night. I also need to make frequent positional changes. I cannot lay down for more then a couple of hours, I have to flip flop alot. Now after doing the trial of the stimulator and also getting it installed, I am hopeful that my quality of life will improve some. I personally wish you the best.

Kelly





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