To

[Guest guest]

Hi ,

Normally when people post about concerns of addiction in

pancreatitis patients, my first response is to reassure them that

it is unlikely for this to happen...that less than 5% of people

taking pain meds for chronic pain end up getting addicted.

However, in the case that you are describing, I am thinking

differently. It does seem as if he is showing signs of

addiction....however, only his pain doctor is going to be able to

tell for sure. There is a condition known as pseudo-addiction, or

addiction-like behaviour...something like that, which is seen in

people whose pain is being under treated. Again, this is

something that his pain doc needs to address.

My best advice is for you to arrange a meeting with the pain doc

so you can talk to him about this. Tell him why you are want to

meet so he can advise you whether you should let your boyfriend

know or not, that you are talking to him. We are all sensistive to

the accusations of being an " addict " so you do not want to do

something that will make him lose trust in you or his doctor. But,

his doctor, HAS TO KNOW about this...for your boyfriends health

as well as his (the doctors) own licensing laws. It may be just a

matter of gettting the right amount or the right kind of medication

for your boyfriend. I have to say, that the meds he is on may not

be adequate for the pain. Benadryl is a anti-histamine and

anti-nausea drug and will do nothing much for pain...roxicodone,

I think, is oxycodone with tylenol which is a strong opiod but

because it is short acting, may not be doing enough to control

his pain. No doubt his behaviour at the ER, the multiple visits per

week, the " shopping around " , the anger and demands, his

over-acting out the pain and his sleepiness can be signs of

addiction...but they can also be signs of not having the pain

treated adequately. If that is the case, once the pain is

addressed in the right way, this behaviour diminshes or stops

completely.

As far as the eating thing...that is hard to determine...in my case,

I can only eat well if the pain is controlled. So, it is not unusual for

me to not feel hungry or want to eat until after I have my pain

meds in me, then I will get pangs of hunger and will be able to

eat. However, that is during my more stable days. When I am

having an active flare, I basically do what you have been advised:

that is, not eat. But that is a pretty individual thing. The relief that

is felt once the pain is gone can be so dramatic that it stimulates

the hunger response.

As far as the amylase and lipase. There is no connection

between elevations and pain. You can be in a lot of pain and

have normal or slightly elevated levels...and you can have no

pain and have tremendously elevated levels. In addition, since

the surgery, your boyfriend has lost portions of his pancreas (I

think in this procedure?), so he is not going to be making as

much enzymes anymore...because the organ that synthesizes it

has been partially removed. So even if he is in an acute flare, he

may not be showing it by elevations of the amylase and lipase.

The cells that produce these are just not there any longer in

enough quantities to cause blood levels to rise....most likely. So,

again, do not judge the validity of his pain based on enzyme

levels. They are just not going to tell you anything. Even in

people who have the entire pancreas....may not always show

elevated enzyme levels. This is a common mis-perception.

So the best thing that you can do is to contact the pain doctor,

explain to him what you wrote here, ask him how he wants you to

handle this as far as making an appointment together or

separately, whether you should tell your fiance or not then follow

his advice if it seems as if the doctor is responding to your

request for help appropriately. If the doctor seems to ignore the

situation, then I would try to contact a treatment center, explain

the situation and follow their advice. But you have to make clear

that this is an ongoing pain situation...that your fiance will need

some kind of pain control for the rest of his life, so getting " clean "

is not the only goal....but that appropriate, adequate and well

supervised pain management is. Or can his surgeon help you

out if needed?

This is going to be hard for you....but you have to make sure that

you do not betray his trust in you or his trust in the pain

management doctor.

Hope this helps some...There are no easy answers, I think.

Laurie