We do we have to beg

[Guest guest]

I have spent the greater part of the past couple of days in more pain

than neccessary as I was running low on my pain med and my doc switched

me to one that just tore my stomach up so bad I had an IBS attack,

hadn't had one in years. Something called Toradol.

I know he wants me off Darvocet and doesn't want me addicted but I just

get frustrated trying meds that don't work or make me nauseous etc.

I was worried because against all objections I took a parttime job this

summer, just two days a week, it's be grocery and gas money. Anyway

today I was stressing that he wouldn't' call it in and I'd have to call

off work the first day and risk losing the opportunity.

I called his office twice, called the phamacist, then called another

pharmacy, finally at 5 he called it in.

Why do we have to beg? Would they make an infected person beg for

antibiotics?

It just gets so humiliating. I only have 2 weeks worth so my mission

this week is to find a pain management doctor. I just can't go through

this again.

Thanks for listening guys,

[Guest guest]

>

> than neccessary as I was running low on my pain med and my doc switched

> me to one that just tore my stomach up so bad I had an IBS attack,

> hadn't had one in years. Something called Toradol.

Toradol (generic: Ketorolac) is a *very* strong NSAID (non-steroidal

anti-inflammatory). I've found it to be extraordinarily effective

(even more than morphine) for short-term pain due to injury or

inflammation. But you really don't want to use it for more than a few

days. As you've already seen, it can really tear up your stomach.

> I know he wants me off Darvocet and doesn't want me addicted but I just

> get frustrated trying meds that don't work or make me nauseous

Why is he using Darvocet? It's a " partial agonist " opioid, and the

consensus seems to be that it just doesn't do much. Some doctors who

aren't pain specialists use it in the mistaken belief that it's less

abusable and/or causes less physical dependence. All the pain doctors

I know avoid it in favor of full agonists like oxycodone or fentanyl.

And they'll work to get you on just the right dose to give you good

pain relief without mental clouding.

I hate to jump on this but chronic pain patients, of all people,

really ought to know the difference between physical dependence and

" addiction " and not let others confuse them either. Even doctors get

it wrong. Physical dependence is NOT addiction!

Addiction, by definition, is compulsive use despite harm. Use of an

opioid under medical supervision to relieve pain and help you be more

functional is hardly harmful! True addiction is actually rather rare

in legitimate pain cases.

Yes, you *will* become physically dependent if you use an opioid for

any length of time. Guaranteed. If you are ever able to go off (e.g.,

because the pain itself got better) you will have to do it very slowly

or you will be *very* uncomfortable. So deciding to use them is a

serious decision. But if you've tried everything else and nothing

seems to work, then there's no reason to at least give them a try.

Opioids are remarkably non-toxic. Other than the risk of overdose

(which is very rare except when abused) and the strong effect on the

GI tract (which can be a real problem if you don't manage it properly)

there really is no risk to the rest of the body. Opioids are *way*

less toxic than heavy sustained use of NSAIDs or (even worse)

acetaminophen (Tylenol).

My pain doctor is fond of saying that Tylenol is one of the most

dangerous drugs on the market -- and it's available over the counter!

He sees many patients, especially the elderly with reduced liver

function, who were so petrified of opioids and " addiction " that

they've already damaged their livers with excessive Tylenol use. By

the time they see him, the damage is done.

Many otherwise well-informed family practice doctors still subscribe

to outdated myths about opioids. You really need to see a pain

specialist. He/she will work with you to find the right combination of

meds that work for you. It may take some time and trial and error. It

may be a combination of opioids and non-opioids or it may not involve

opioids at all. But this is what they do, and they get pretty good at

it.