I understand how patients can be drawn in and succumb. I see a physician whose practice is limited to pain management. I need to understand his practices, and so far I do. I started with a daily dose of 75 mcg, the lowest possible.
When I broke my way up the bones on my right side, Dr. Pain said he should double my dose to see me through. In fact, pain was stinking unmanageable and my 150 mcg dose now is twice a day, twelve hours apart. Dr. Bone is quite comfortable with that.
Like Dr. Kidney and Dr. Heart, Dr. Bone is happy I see a real pain management doctor. (And those are all the doctors I see, except my primary care, which we are obliged to have, and my therapist, who helps me sort my problems.)
I maintained for two or three years, I think, on the 75 mcg dose. I wonder if I can ever go back. I hope so, and will stay on it like the duck and the June bug. My replaced shoulder is magnificent, but my broken femur is slow, slow, slow.
At some witched hour in the night, I woke from pain in my right knee and left shoulder. I considered it all, and attributed it to yesterday's three hours of sewing. I put all in a new position and went back to sleep.
At some more witched hour, but not yet eight a.m., Laura, in jammies, wakened me. For the third time this year, she and the bus did not connect.
Sigh! I got up, put the morning dose in my mouth, dressed and drove Laura to school. In two and a half months, it's over! Came home, and have literally frittered away the rest of the morning. I'm cold, and Mr. Cat feels sorry for both of us!
A warm cat leaning on my shoulder makes me sleepy. Opiods and sleepy do not mix well. I'll be off to play cards and eat Fritos soon, and that is good. Mr. Cat has been sent to find a new shoulder. And, I'm still in charge of the opiods.
Hari OM
ReplyDeleteAs one who is highly allergic to opiods (indeed most orthodox preparations beyond simple aspirin/ibuprofen), I can empathise with your desire to remain in charge! I think you are doing marvellously not to have 'upped' things more than you have and that the doctors are supportive not 'pressive'. There is no shame whatsoever in sharing shoulder space with a warm cat and a zzz or several! YAM xx
I wish I could send you some warmth as it will be 85 degrees here today in Phoenix.
ReplyDeleteI know these days doctors are really careful about prescribing medications like opioids to patients. I remember the "good old days" when you would go and have surgery and you'd be prescribed something strong for pain relief. Nowadays that rarely happens or very limited amount like up to 10 pills, no refills, and they prescribe stronger doses of Advil to take or suggest Tylenol.
I know the pain doctors I type for have their patients sign a contract that they won't get pain medicine from anyone else or they won't prescribe to them anymore. I also know a lot check the states drug enforcement base (in Florida since that's the hospital I type for is based there its called EFORCE) to make sure their patients aren't getting pain pills from anyone else (assuming of course they aren't getting them on the street). They also do random drug testing to make sure that the pain meds show up in the sample as people have been known to get the pills prescribed and then sell them on the street.
It is good that you are getting the help you need for the relief of your pain and doing it legally. I'm sure that's not the case for some out there taking opioids and that's probably why we have the crisis that we are having here in America.
betty
Yes, I signed a contract. Once a year there is a blood draw. I think that's at my next appointment. I have no problem with any of this.
DeletePlaying cards and eating Fritos sounds like a fun time. Enjoy all the pleasure you can get.
ReplyDeleteNighttime pain seems to be the worst, so TG I don't get it often. But when I do I can't sleep through it. In the daytime, I can sort of get on with other things, but not at night.
ReplyDeleteNow I can comment Jo, albeit anonymously. I just hope it warms up soon. So sick of winter this year. I hate the opioid thing. The government are just a bunch of hysterics. I know it is a problem, but many of us need them when we get older. When I had my hysterectomy et al in August, they would only give me 7 pills. I made sure they knew my displeasure. The doctor had prescribed 30, but the pharmacy said they were following CDC guidelines. The CDC decided how much pain I'd be in. Glad you are better. Donna@gather
ReplyDeleteThe pharmacies had to settle it all with the CDC. It took my pharmacy about a year to come to terms with the CDC. I remember once, years ago, cutting my dose in half to get to the next prescription. I called the CDC, saying if I really were addicted, I would be robbing the drug store. However, I wasn't addicted, I was in pain!
DeleteMy oncology doctor is comfortable with my opioid use, I'm not on a schedule but take as needed and I weigh each pill as needed.
ReplyDeleteAs you might remember I have epilepsy. Way back when I was diagnosed Barbiturates were used to control seizures then. Now there are many different medications. So for more than 50 years I have been addicted to barbiturates. I never crave more than is prescribed so I don't abuse them. They are a necessity of living for me. I am glad you are keeping track of your opiates and not letting them get away from you. And I understand what a pain it is to have to take them.
ReplyDeleteI maintain your body requires to amount to alleviate pain, which is the amount you and I use. Our bodies consume it for a purpose, and the patient does not get "high". I am such a drug coward, the only time I got "high" was on hash, back in the seventies. And I knew I was high, and if I would be required to act responsibly in the next several hours, I would not be able. That was the end of abuse, for me.
DeleteEnjoy your cards and Fritos today, Joanne! Mr Cat looks very cuddly.
ReplyDeleteSounds and looks to me as though Mr Cat understands your needs Joanne and gives comfort.
ReplyDeleteJoanne, I wish I had joined your blog sooner because I haven’t got a clue what demons you are up against. All I know is you must be some kind of super woman. It sure as hell makes my whinging and moaning seem small fry in comparison, I am suitably chastened!
ReplyDeleteLX
I love your whinging; please don't stop on my account.
DeleteI love Fritos but never get to eat them. I cannot play cards to save my life as I have no card sense and no poker face. Yesterday, at the primary care dr, we discussed my neck issues and she suggested a pain management dr. NO. Not there yet. A simple Excedrin or arthritis Tylenol will do the job for now, along with my exercises for neck and sciatica. The day may come, though, when I will gladly make that appointment.
ReplyDeleteYour doctor will keep track of your kidneys and tell you when it's time to move up from Excedrin and/or Tylenol. That's her job.
DeleteIf they work then fine. If they stop working you may want to continue anyway, but that is fine also in my opinion. We are too old to worry about addiction unless they halt the dosage. That is not fine. You don't want to be shopping on the Dark Web at your age.
ReplyDeleteTom, I could even follow that! But, what's the Dark Web?
DeleteThat's where you get the drugs which your doctor denies you, even if your name is Prince and you are willing to pay. Prince would still be alive now if Obama Care was allowed full scope... no, maybe not. We have to over-ride the NHS. You pay no matter what.
DeleteTom, why would someone continue with something that stops working? Wouldn't that someone be seeing a doctor to get something new that does work?
DeleteTom made me laugh.
ReplyDeleteYou know, I am certain, that pain in itself can become a medical problem. It wrecks havoc with BP and other health markers. So keeping it under control is important and if you need those pills, you must take them. That's all there is to it.
Some day I may write a post about the doctor responsible for my and my sister's health problems, and indirectly for our mom's early death. We learned how to take responsibility for managing health, with the mess we had to straighten out!
DeleteSo there's a back story to all this? That would be interesting reading which may possibly shine a light for other people with similar issues.
DeleteI'll see what Jan says. It's here story, too.
DeleteCan't imagine living with chronic pain, but you seem to have a firm handle on it and continue to be captain of your fate.
ReplyDeleteYou do amazingly well, Joanne. And that's one handsome cat!
ReplyDeleteWow, sorry that your femur is still bothering you after all this time. That just doesn't seem fair. But then, when was life ever fair?
ReplyDeleteIt's sad that you still have to take the drugs, but being in control is important.
ReplyDeleteCat is looking after you..good to see it xx
Hope the cards and the Fritos were good today.
ReplyDeleteThe cat will be great company when you are on your own.
After my husband's bike accident, I was tasked with picking up meds from the pharmacist. He was prescribed the lowest dosage of opiates. I don't think they ever really did the trick, but timing out the pill consumption coupled with OTC drugs helped with the pain while healing. Hubs found that the opiates made him feel ill. He said, 'I hate how these make me feel. I could never become addicted!' I suppose that is a good thing.
ReplyDeleteHear, hear for warm cats and Fritos!
and the powers that be can't understand why so many people turn to heroin. two and a half months and your life is your own! so close and yet so far.
ReplyDeleteThe cold may have something to do with the continuing pain being so bad, I've noticed I ache a lot less in summer although the heat itself is debilitating enough that I lie around like a sloth.
ReplyDeleteWith the number of injuries you've had, I wouldn't be thinking about getting back to the lowest dose as long as you are still feeling pain even with the higher dose. I would be waiting six months to a year of no pain at all, before beginning to decrease. I don't see you as being the addictive type, so it isn't something you should worry about. Get well first, then cut back.
Here's something I read years ago, a man in hospital with long term pain was seen to by a new nurse, who read his chart which had recently been retyped with a slight mistake. The nurse read his daily amount of pain killer as the amount he was supposed to receive two or three times a day. So she administered the full amount on the regular schedule and for the first time in years, the patient was pain free. Until the mistake was discovered and he once again received the reduced amount and was back to suffering.
I blame a lot on winter, too.
DeleteI wonder if anyone paid attention to that poor man's relief!
Boy as long as your pain is managed, what odds. I am aware of the addictive implications. But pain is a life stealer. I manage mine with 2 Tylenol 3s in the morning and 5 drops of CBD around lunch. But sometimes none of that works. As a recovered alcoholic I can't explore other options. Soldier on.
ReplyDeleteI love that pic of the cat and you.
XO
WWW
As others have said, it sounds like you have a great handle on things. It's a bummer that Laura missed the bus today after your bad night, but I don't think that three times in one year is much of an issue.
ReplyDeleteMy boy cat enjoys supervising me when I do my PT in the mornings, sometimes from atop of my back when I'm in a plank position. He's a good distraction from my pains, albeit temporary. I hope that beautifully plush looking creature of yours provides you comfort as well.
ReplyDeleteGood that you feel in control of your painkillers rather than the other way round. Glad to say I need no painkillers right now, but there may come a time....
ReplyDeleteI once worked as an orthopedic nurse and one of my coworkers was named Ms. Bone. True
ReplyDeleteGillibrand/Corker's bill to limit prescriptions to 7 days with refills is making my hair be on fire. I've had three escruciating nerve removals from my feet, hubs shoved his femur through his acetabulum, and yes there were mass quantities of opiates to get us through. And then when we could stand it, we stopped; our pain was acute and not chronic, but it certainly went for more than 7 days. When I took pharmacology at the UofA med school in the early 90's they taught us that when opiates are taken for pain they are not physically addicting. The word physically is important. It's my theory that the epidemic is a disease of despair and while it may start with pills, it could also start with street corner fentanyl or heroin. These blatant bans are just stupid because they never take in to account the needs of people who are not addicts and do have chronic pain. Maybe they should both go talk to someone with bone cancer.
ReplyDeleteI never knew the official literature on it, but I've always known drugs do the job they were put together for and when they don't, don't take them.
DeleteI can only tell you what my personal approach is to this general issue: along with and because of my cardiac issues I have insomnia, and only get 3 or so hours of sleep a night...feel crappy the next day. I take a xanax and can sleep in excess of 6 hours. The last think I worry about at my age is developing a dependency on the drug.
ReplyDeleteThat's pretty much my whole take on medicine these days. Another CAT scan. Why not. I won't live long enough to die from the effects.
DeleteI'm glad you are staying onn top of it. Opiods are nothing to take lightly.
ReplyDeleteDefinitely!
DeleteLiving in constant pain vs. an increased dose of opiods?. Not an easy answer there.
ReplyDeleteThe only time I was given anything similar, it made me hallucinate which was downright unpleasant. If I had to handle as much pain as you daily, I'm not sure how I'd cope.
ReplyDeleteall the best - tough decisions, hopefully the doctors work it out with you.
ReplyDeleteWe are not taking these drugs for enjoyment we are taking them to make it through the day for the pain we have. And if i need a higher dose because my other is not working give it to me. It is not as if I'm walking around all happy, drugged up and in La La land its just to survive this day and every day to just be able to tolerate the pain and get up and do something instead of having my every waking thought on the pain that is consuming me.
ReplyDeleteI'm still taking over the counter stuff. Ugh!
ReplyDeleteWell you certain have some interestingly named drs. As to my new pill and lalaland the epilepsy medicine I take for my essential tremors isn't helping and is making me loopy in lalaland and too tired to drive safely. The good news for me is that a couple of days ago I found a wonderfully thoughtful gift in the mail from you in the mail, Joanne..:)
ReplyDeleteWell, good, and you should see your doctor and revisit your dose. But you know that! Happy spring.
DeleteYou do know your meds well and are on top of all of the issues. In today's world you do really have to keep up on things and be your own advocate. Best wishes.
ReplyDeleteLove the cat picture! Former Buckeye
The pain at night can be bad. I sit too much so I'm trying to exercise my way through hip and groin pain. I'm gonna try Fritos, too. You are such a good grandma for getting that child to school. Enjoy your card game and kudos to you for staying on top of your pain.
ReplyDeleteI am glad to hear that you are in charge and I hope the healing continues in your favor. Good luck with the end of the school countdown.
ReplyDeleteThe core of my mornings are my blood pressure meds, my hormones, and my vitamins. The knee/bone office never did call me. I'm a bit frightened.
ReplyDeleteI think in the old days we just did what doctors said without question. taking an interest is much better. I don't know you in person but I don't associate you with sitting around all day. I think that missing sleep through pain and taking painkillers is going to make anyone feel tired.
ReplyDelete