some thoughts on pain medications

[Guest guest]

Hi there since we having discussions on pain meds I thought I would chime

in. Actually I am in extreme pain myself at the moment and I got off of pain

medicines at home a few months ago. I only will take a prescription for a

short term or following a hospital stay where I was on strong stuff and need

to ween down. It is my choice. I live with a lot of pain daily but I have

developed a tolerance and a mind set that allows me to put it out of my mind

unless it is really bad. However, I had the TP/ICT surgery two years ago and

I am not in that horrible horrible pancreatitis pain any longer. I get

pancreatitis type pain that hurts as bad as my attacks ever did

occassionally but generally its just mild to moderate I guess. Anyhow...

The pain medicines I have used when I suffered from chronic pancreatitis

pain included these opiate/opiods also known as full agonists:

- darvocet (horrible medicine, can't be titrated up, has deadly

aceteminophen, makes me throw up, and has poor coverage. Save this for a

mild toothache)

- vicodin (only good for a brief small flare up, can't be titrated up,

has aceteminophen, and tends to make me throw up)

- lortab (basically its vicodin)

- percoset (better for a out of the blue mild flare up, but can't be

titrated up, has aceteminophen so its not good for long term use)

- oxycodone (the narcotic found in percoset without aceteminophen, can

be titrated up big time, good medicine, however after a year of fairly

consistent use it was not very effective and began to make me itch like mad)

- oxycontin (good medicine for persistent pain, its oxycodone in time

release form, has many stregnths, and can be titrated up big time, but its

oxycodone so after awhile it ceased working well for me)

- oramoprh/MS Contin (time released morphine, morphine has never been

effective for me, I have had huge shots of it and it was like a cool glass

of water, the pills come in many stregnths, and can be titrated up to a

point, then people begin to have muscle cramps, spasms, and other issues, if

morphine works for you this is a good chronic pain medicine)

- duragesic (the fentanly patch, 3 day coverage which is awesome and

bad if you need to change doses, for many people it takes an adjustment

period of sweats, sleeping big time, and itching, it worked very well as my

chief chronic pain medicine for 2 years, I got up to 100ug's which is pretty

big)

- Actiq (the fentanyl lollipop, great breakthrough pain medicine for

servere flare up, short acting, kinda nasty tasting, you can throw up if you

spin that sucker around like crazy and get too much at once because it is

very fast acting, doctors do not seem to like giving this one out)

- oral dilaudid (comes in 1, 2, and 4 mg pills, can be titrated up big

time, powerful stuff for me, did the trick as excellent breakthrough pain

medicine, no real side effects,)

- ketamine (never had it, coming into vogue now, it is a

disassociative anesthetic, given in low doses because higher doses make you

hallucinate, it is popular street drug especially amognst ravers for

tripping on, in high doses it is a total anesthetic, sleepy time)

Now some of those other medicines that are used are really for neuropathic

pain such as:

- neurotin (once thought to work via the GABA receptors now proven

false and is not well understood how it works, this would be useless say for

you first attack of pancreatitis, it is for damaged nerve pathways)

- SSRIs, tricyclic antidepressants (prozac, elavil, zoloft, celexa,

etc... they probably work by modifying serotonin which can make one more

resilient to pain, but they don't stop flare ups, they can assist other

therapies, and they can have draw backs too, or they can help with anxiety

and depression..I have been on most of the SSRIs and I won't take them

anymore, mindset works better for me)

- clonodine (a central acting agent typically used for high blood

pressure, is good for withdrawal symptoms, and seems to have a mild effect

on some kinds of neuropathic pain)

Partial Agonists/ (these drugs have some opiod like effects and because

they online partially act on the opiate receptors are considered less likely

to cause addiction)

- stadol (available as a nasal spray, or in a shot, I have had the

shot and it did jack nothing for me)

- Nubain (i know nothng about this one)

NOW please know I am NOT a doctor I am just a patient. These are my takes

on some medicines. I hope this wasn't too painful to read (but if it is

reach for you breakthrough med!!! heheh). Sorry for the legnth.

Bert

--

" What we do in life echoes in eternity. "

Maximus Decimus Meridius

" Every facet, every department of your mind is to be programmed by you and

unless you assume your rightful responsibility and begin to program your own

mind, the world will program it for you. "

attributed to Lilly

Sin lies only in hurting others unnecessarily. All other " sins " are invented

nonsense.-- Heinlein