Re: At what point do Rheumotologist start giving serious pain medication?

[Guest guest]

That's a tough situation. They sort of go in order of potentcy/drug

classification. They need several months of documented proof that the milder

things are not effective.

Some of the things you mentioned are pretty strong and are in the narcotic

family. Darvocet is one of the weaker narcotics, while vicodin is a much

stronger one. I don't know what doses you were taking. You may know this, but

I'll add it anyway...pain meds work better if they are already on board. It is

much harder to relieve severe pain if no meds have been taken for a few days

prior. Just like menstrual cramps, if you take the advil 3 days before your

period the cramps are not as bad, and the meds you take work better. So taking

it only during a flare may not be your best bet, even though you're trying to

limit what you put in your body. The next catagory of pain meds stronger than

what you mentioned are things like a fentynal patch, which is incredibly strong,

it's what they give you during surgery. It will take away 100% of your pain, but

it takes 3 days to be fully effective, and you can't drive, work, or even

sometimes walk around on that.

I take enbrel as well, and have for 8 years. I do the shot every 6 days, but I

also take 2 vicodin a day (7.5 mg each), 2 soma at night (350 mg each), 800 mg

of neurontin a day, and I still need about 3000 mg of tylenol a day. (my stomach

is trashed from years of an old rhuemy experimenting with dozens of

anti-inflammatories...which only did so much, then plaquenil, then mtx) I still

have prednisone I take as needed. The combination of the soma, vicodin, and

neurontin I take at night makes me about 80% pain free, and helps me sleep

really good. Some occassional med mj works well also. If your pain is localized

to a certain area, you could try lidoderm patches, if you haven't already. Those

work pretty well, but take several hours to seep in and start working, but then

you leave them on for 8-12 hours and it definately takes the sharp edge off, so

it brings the pain down by several numbers on the pain scale.

You need to document and be persistant with your doc, and play by their rules

for awhile. (Maybe 6 mo. to a year) After that time you can say " I have tried it

your way, and I am still in disabling pain. I need to function, and if it takes

___________ medication to do so, I will assume the risks so I can

work/parent/ " ,whatever it is you do. Remind them they do not live in your body.

Some docs just don't prescribe narcotics, so make sure your current one does.

I find on the enbrel I really have to self regulate my activity level. The

enbrel makes me really loosey goosey, and I have more energy, so what I end up

doing is over-doing it. I work too hard, stand too long, garden too long, lift

too much, clean too much, because I can and I feel good and I feel like I better

get it done before I can't move again. But once I stop, I have such severe pain

that I can't move for days. So I really have to struggle to remind myself I can

not do what other people my age can do. Even if I feel good I MUST take breaks,

lay down, put my feet up, whatever I can to rest my body. I also use a really

great heat thing, it has lots of herbs that relax the muscles and tissues, and

it has white willow bark (asprin) which improves the circulations to that area,

so I find after I take my meds if I lay on the heat pack the meds sort of work

on that area better. You can also try splitting the pills so they break down

faster and you get more relief faster.

Good luck to you, keep your chin up! and stay strong!

jules

>

> Hi all,

>

> Can anyone tell me at what point will a Rheumy start prescribing pain meds

> that work?

>

> I understand they are interested in reducing the inflammation and along

> with that, pain should subside.

>

> I'm currently using Enbrel sure click once a week. She has me taking MTX

> along with that. She said that there isn't anything else besides MTX other

> than the biologics that will work.

>

> MTX makes me sick and I don't want it injected.

>

> I am very satisfied with the Enbrel but I still do get flare ups no and

> then. I would like some kind of pain relief for these flare up because they

> hurt very bad.

>

> I'm not interested in taking more pills everyday for the pain rather I need

> them or not. Just as an as needed basis to go along with the enbrel.

> Less drugs as possible in my body is what I'm looking for.

>

> I know someone wants to tell me... so tell your doctor this. I have! I'm

> on my 3rd Rheumy and she doesn't seem to hear me any more than the last

> two.

>

> I've read some people talk about pain meds their rheumy prescribes them.

>

> I've been diagnosed since 2008. Tried many meds. Like I say, I'm happy

> with the enbrel but still get a flare up now and again that is just

> unbearable.

>

> So I'm asking anyone that can tell me please...At what point does the

> rheumy break down and start helping with the once in a while pain?

>

> I've tried darvocet,, tylenol 3, Vicodin, Tramodol, and a bunch of others.

> My last rheumy prescribed me vicodin and it didn't touch the pain during

> my flare up. I called the office while bawling in pain asking them to

> please give me something stronger than vicodin. They said not at this time.

> OMG! I couldn't believe it!

>

> The only thing all three rheumys have done so far is tell me to up my

> predisone when I get a flare up that is unbearable. The predisone is great

> after a day of taking it. But I need some immediate pain reliever when

flare

> up hits that makes me want to blow my head off. I only want pain meds for

> these situations.

>

> I'm not sure how it works and I'm asking the old timers or should I say

> long time RAers how does it usually work.

>

> Does the rheumy eventually break down and give ya something for your pain.

> Give ya some serious pain meds???

>

> Sorry if this letter sounds harsh. I appreciate everyone of you on this

> list and would like to hear what you have to say. I'm just getting fed up

> with the doctors not wanting to give anything worth a darn for pain!

>

> Remember... I'm not asking them for all the time everyday RA pain. Only

> the once in a while GOD forsaken pain. Predisone don't cut it. That only

> works in very high doses and it don't take effect until the next day.

>

> Sorry so long.

>

> Hope you all are doing okay...

>

>

>

>

>

>

>

[Guest guest]

Hi - I'm so sorry you are having so much pain. My Rheumy wouldn't give me

anything for pain - he'd say take Tylenol Arthritis - we all know that is a joke

for the really bad pain. I finally found a pain management doctor that would

work with my Rheumy. I'm thinking that is going to be your best route. I've been

seeing mine for going on a year now (I think) and he is just awesome. In

addition to the pain meds I take as needed, he is able to do injections into the

inflammed areas. Yesterday I had injections in my lower back because that and my

right hip were giving me such a tough time and nothing was touching it. I'm

happy to say the pain is ALOT cooler today than it has been in a very long time.

Last month it was my right shoulder - again, awesome relief!

Just curious, why don't you want to do the MTX injections? I switched from the

pills to the injections and my side effects were a lot less than with the pills.

Doreen

Hi all,

Can anyone tell me at what point will a Rheumy start prescribing pain meds that

work? I understand they are interested in reducing the inflammation and along

with that, pain should subside.

I'm currently using Enbrel sure click once a week. She has me taking MTX along

with that. She said that there isn't anything else besides MTX other than the

biologics that will work.

MTX makes me sick and I don't want it injected.

I am very satisfied with the Enbrel but I still do get flare ups no and then. I

would like some kind of pain relief for these flare up because they hurt very

bad. I'm not interested in taking more pills everyday for the pain rather I need

them or not. Just as an as needed basis to go along with the enbrel. Less drugs

as possible in my body is what I'm looking for.

I know someone wants to tell me... so tell your doctor this. I have! I'm on my

3rd Rheumy and she doesn't seem to hear me any more than the last two.

I've read some people talk about pain meds their rheumy prescribes them. I've

been diagnosed since 2008. Tried many meds. Like I say, I'm happy with the

enbrel but still get a flare up now and again that is just unbearable.

So I'm asking anyone that can tell me please...At what point does the rheumy

break down and start helping with the once in a while pain?

I've tried darvocet,, tylenol 3, Vicodin, Tramodol, and a bunch of others. My

last rheumy prescribed me vicodin and it didn't touch the pain during my flare

up. I called the office while bawling in pain asking them to please give me

something stronger than vicodin. They said not at this time. OMG! I couldn't

believe it!

The only thing all three rheumys have done so far is tell me to up my predisone

when I get a flare up that is unbearable. The predisone is great after a day of

taking it. But I need some immediate pain reliever when flare up hits that

makes me want to blow my head off. I only want pain meds for these situations.

I'm not sure how it works and I'm asking the old timers or should I say long

time RAers how does it usually work. Does the rheumy eventually break down and

give ya something for your pain. Give ya some serious pain meds???

Sorry if this letter sounds harsh. I appreciate everyone of you on this list

and would like to hear what you have to say. I'm just getting fed up with the

doctors not wanting to give anything worth a darn for pain!

Remember... I'm not asking them for all the time everyday RA pain. Only the

once in a while GOD forsaken pain. Predisone don't cut it. That only works in

very high doses and it don't take effect until the next day.

Sorry so long.

Hope you all are doing okay...

[Guest guest]

I read your frustration. I HATE IT when they don't listen to the patient (many

doctors fit this cetegory).

You can ask your primary care physician for a referral to a pain management

specialist, or depending on your insurance, you can ask your Rheumatologist for

one. This is what you need. Dont take no for an answer!

I alternate with Morphine and/or Dilaudid, once a day is all I needed to manage

the pain of the flares or breakthrus. At first the Morphine was 3 times per

day, but as I am coming to the right cocktails, I have lessened what I take, now

its one pill per day, unless I am flaring. When I feel I dont need it anymore,

they will taper me, very slowly, until I am off it. I can't forsee when that

will be, because RA is an ugly, wily monster that keeps outsmarting me. But i

have the best pain management doctor in the world her name is Dr. Shaiova

in NYC and god bless her, because of her I am relatively comfortable. God Bless

the specialiaty too, because many people have chronic pain.

I hope this helps. OKD