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 Post subject: Still Struggling
PostPosted: Mon Jan 17, 2011 9:16 am 
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I am still struggling with these pain issues and what to do with myself. I am so lost inside my own head that I can't seem to figure out what to do. So I am putting it out here first and maybe some of it will get straight.

First, I have issues asking others for help and I definitely have issues asking for pain management from doctors. My mom worked in the ER most of my life and when my first medical condition came on at 16, she would tell me the doctors would think I was drug seeking all the time. I wasn't and I clearly had objective findings, but I think she just saw this behavior so often she would tell me certain behaviors would be seen as drug seeking behavior. The problem was, it seemed to me even asking for pain control would be seen as drug seeking in her eyes so how do you then get help for pain if you don't ask these days? Her comments caused me to become paranoid every time I went in to a doctor even when I wasn't asking for pain meds. I was afraid of how to even respond if they asked me if I wanted them for fear of being judged as some drug addict.

They misdiagnosed me for a very long time and part of that was because I wouldn't go in anymore since they didn't have a solution to my medical problem and in the absence of a solution they can only deal with pain and dealing with pain made me too nervous so why bother going in.

As my medical condition progressed, I finally got an accurate diagnosis and there is no cure and no effective treatment anyways. I was very undermedicated and too afraid to ask for more. I went through a short phase where I would but I did actually have a very conservative doctor and I could tell he didn't approve. Eventually, this led to a friend noticing how much pain I was in all the time and offering me oxycontin. I was in a mindset at the time that if the medical community wouldn't take care of it that I would just take care of it on my own. I decided they had no right to judge my pain anyways and I wasn't going to live my life in bed. Of course, on my own, I just got addicted to the narcotics without the proper dose and type of drug. Part of the problem with my condition is that the doctor sees only what I present with. They lack the imagination required to realize how much worse that condition will get before it gets better and that it doesn't go away. They kind of think that since I am not in their office every 3 days asking them to fix it, that it only exists when I do come in. Unfortunately, they forget that THEY CAN'T FIX THE DAMN PROBLEM SO WHY WOULD I TAKE TIME OFF WORK TO GO IN THERE?!? Furthermore, none of them outright and openly judge you. They give a look or act a certain way. If you responded you would look like a drug seeking psycho anyways. If they actually said it out loud, you could explain to them why their thought process isn't reasonable, however most doctors don't take kindly to that either so they dislike you instead. Add to this the fact that doctors don't like conditions they can't fix and when a patient has one, they often transfer that dislike onto the patient.

Fast Forward five years and I have been on suboxone over 3 now. I still have pain issues that I have brought up on this site. I have been spending a substantial amount of time unhappy and in pain. But the problem is, my head is so fucked up I don't know how to figure out what is right for me.

A) When I consider asking the doctor for more suboxone, I feel like that is just my addict mind talking and she will only see it that way anyways = I tell her the current dose is perfect
B) I am absolutely terrified of increasing the script dosage regularly
C) This all seems ridiculous to me because suboxone doesn't get me high anyways but it seems like regardless, some of the doctors and definitely the pharmacists see it that way and in turn, I kind of feel that way too
D) My current family doctor doesn't agree with the sub use and he sees it as an ongoing addiction process which also makes me feel that way
E) Any time I take enough sub so I can actually enjoy myself (quilting or shopping) I feel totally guilty. Like I run through the scenario of sitting with the doctor in my mind and them asking me why I chose to take the sub and then the doctor running through a list of other coping mechanisms (this has happened before in reality) but those coping mechanisms work great once a month or so, just not every day. i.e. I can't spend all day every day in a warm bath to ease pain so it is kind of stupid to suggest this to me (but I expect it of myself anyways)
F) I feel like I am expected to manage the pain without any help from pain meds. Like society doesn't handle pain well. They expect you to get rid of it and if you can't get rid of it, pretend it isn't there but certainly don't complain about it or mention it.
G) I don't even mention my pain to my husband most of the time because I don't want to burden him with it
H) I feel like I should learn how to just manage the pain with nothing, no help from suboxone, nothing and that maybe the doctors are right and I just need to learn to live with it
I) My last sub doc completely ignored my pain issues and if I took one extra sub for pain he freaked out
J) My current sub doc went through the typical questions of what things I had tried (they know there is no cure for crying out loud) which bugs me because........how can I ever get to a point where I just accept this is my life and this condition isn't going away if they won't? I have done everything anyone has ever suggested and guess what? I still have this condition. Guess what else? There is no cure and no effective treatment.

How can I ever figure out if I stay on sub long term or what I do when I can't seem to get through all of the issues above? In my mind, I am damned if I do and damned if I don't anyways. So I just feel frozen.

Cherie

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Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

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PostPosted: Mon Jan 17, 2011 9:45 am 
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Oh sweetie, I'm so sorry you're still struggling so much. It sounds like you're aware of what's holding you back - emotions and faulty underlying beliefs (in my opinion). Our base beliefs color and directly affect our thoughts and of course our actions. In order to change those things, we have to change the underlying beliefs first. Your beliefs are telling you that people will judge you for seeking treatment for your pain. Is it also possible that you believe that you don't deserve adequate pain relief?

You're a very intelligent and insightful woman and I believe you are capable of finding the solutions to this, but you're going to have to look deep inside yourself and that's never easy. For a pain patient, it's my opinion that you're on a pretty low dose of sub. Aren't you taking 8-12 mg a day? How many times a day do you dose? It's my opinion that you do need to increase your dosage and probably dose 3 times a day. Maybe not that much higher, but I think you have to try. And I think that it can and will give you some relief.

If you get your dose increased and still have the above issues, then you're only going to continue to feel guilty. I think you need to work on those belief systems that are affecting how you feel in order for you to be comfortable. Don't you have a therapist? Are you still seeing her/him? If not, maybe it's time to consider going back again weekly. I think that could really help you figure out what's going on and how to address those issues.

I know I haven't given you any clear answers, but I don't think this is going to be a quick fix for you. I will add that you DO deserve pain relief. We're talking about your quality of life here, after all.

I really hope you can get through this and get some relief soon.

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PostPosted: Mon Jan 17, 2011 9:31 pm 
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Thanks Hatmaker. It's one of those things where I "KNOW" I deserve pain relief, but I don't FEEL it. I don't know how to make those match. The only issue with my therapist for these things is that A) he doesn't believe in just about any medication at all what so ever except for short time frames and B) he stopped taking my insurance along with everyone else on the planet and now it costs a ton of money to go see him. I can only go once per month and you know as well as anyone that this appointment is generally reserved for dealing with all the crap my family throws at me.

I think you are right that I will not get to the bottom of it until I get some help dealing with it and figuring it out. This is a real bitch of a problem though.

Cherie

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Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


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PostPosted: Mon Jan 17, 2011 11:46 pm 
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Cherie - You're so not alone in your dilemma. Believe me. I (and many others) are struggling with the same issues, though admittedly I don't think my pain condition is as bad as yours based on what I've read on your past posts. I was big into contact sports my whole youth through college. I blew out two discs and separated my shoulder. The chronic pain started right away but really kicked into high gear in my early 30s while (foolishly) I was doing lots of weight lifting and running. Now the discs are toast, I have bone spurs lining my spine, and my shoulder is largely frozen. I can barely exercise for extended periods of time, even lightly, without pain (depressing for a former athlete).

I also don't have a solution for my pain. I can certainly get fusion surgery but all doctors have advised strongly against it given my age (40) and the potential for it to destabilize my spine (make it worse) and maybe not stop the pain anyway. They think I should wait until I am much older before considering the surgery - mostly because they might have new more effective treatments within the next 10 years (I wont hold my breath).

So they tossed pain pills at me because it's all they got. It wasn't an easy decision for me to take pain meds. I tried everything under the sun first. But I had multiple doctors who agreed that it was my best option. It worked out for a good 5 years, until it didn't anymore.

In my view, if Sub (in any dose or combination of doses) gives you the necessary pain control I wouldn't hesitate. You DESERVE pain control. And of course it's safe at higher doses. When I was researching Sub doctors I looked at pain doctors and addiction psychiatrists. The pain doctors really annoyed me. They either didn't work with Sub, or if they did, they viewed it as a medication solely for treating addiction and seemed to have the attitude that "once you go Sub, you can never go back to full agonists." Which is fine except they seemed to be trying to convince me not to go on Sub in the first place and stay on the full agonists. "Just taper down if you're having trouble at your current dose!". Absurd. Maybe the release of Butrans will change their minds a bit.

The addiction psychiatrists were much more open minded and flexible. While they didn't know much about my pain, they appreciated that Sub can be helpful with the pain without the ups and downs of the full agonists. They even threw out Methadone and a return to full agonists as an option and expressed a willingness to coordinate with a pain doctor they trusted if it helped. I liked the flexibility, even if I was not ready to take such plunges.

Sorry to ramble, but I too am confused by all this. Its confusing and stressful. I guess my perspective to share would be to find a good addiction psychiatrist who has experience with pain issues. I know that's tough to come by. I got a little lucky finding mine frankly. As you may know, my plan is to try and manage without the pain meds. I am also a little lucky that I have a non-narcotic med cocktail that's keeping me going. But it's not really that great. Frankly - I am praying for that 10 year new treatment breakthrough to come a little sooner. But barring that, if I cannot stand the pain, I might try something like Butrans when it's available as the next step.

I really wish you the best of luck with this. It's comforting to have another CP'er to share ideas with.

Matt.


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PostPosted: Tue Jan 18, 2011 9:58 pm 
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Matt

You have no idea how much I truly appreciate you sharing your story with me. I really feel like you understand where I am at in this whole mess and how difficult it can be.

Pardon me for thinking "out loud" here but when I think of taking more suboxone, I also know the more of it I take the lazier I get. At high doses, I have to really work to get my butt up off the couch. I am fine once I do, but I have to consciously keep myself busy because once I stop moving, it's all over. I like the way I FEEL on lower doses........minus the pain.

It then get's to this acceptance thing that I am really not sure how to get through. Sometimes I feel like I have finally accepted the facts of my life. That I have chronic pain conditions that cannot be effectively treated or cured. That is a huge part of it. I went through so many emotions just realizing this is it for me. I do not get the life I wanted or dreamed of for myself. Then on top of it, I get addicted. That certainly isn't the life I wanted or dreamed of. So now I am this chronic pain person with an addiction who is now on suboxone. Blah!

On top of it, I don't trust myself when it comes to any kind of pain control. Just tonight I was sitting here asking myself if I really need more suboxone for pain control or if I just THINK I do and really I am just fine. You see, my condition isn't flared today so I'm in a good mood. Today I wasn't in pain all day while I was at work so I was singing to the radio on my drive and having a good time just driving in the rain most the day. But then, when my condition flares, I will sit there and wait until I am totally MISERABLE and depressed before I take extra sub because in my mind, that is what I am SUPPOSED to be doing. Then I get resentful and angry because my life sucks and I can't do anything and when I do, I am miserable. Then I get on this kick where I will take extra suboxone when I have pain because I am determined to function and actually do something I like. Then I feel guilty and think I really didn't need to take that extra sub just so I could quilt or have sex or do something enjoyable. And when I do take it so I can do those things, I run out early (i.e. I always have 8mg per day left and have never gone without at the end, so by early I mean I have no extra for pain control for like 2 weeks and am just stuck).

Then when I think about asking for more suboxone from the doctor, it gets into all these other emotions and BS I already mentioned. I will admit that in this way, I am a total wreck and a complete psycho. What ends up happening at the doctor's appointment is NOTHING. I turn into a people pleaser and when she asks how the dose is I say "great...no problems and no concerns" because I wouldn't want to take up her time or inconvenience her or make her think I am a (god forbid) drug addict! Shocking eh?

I have to laugh a little because it is so retarded. I am retarded. (I know that's a bad word and I apologize if I offend anyone).

But really, for Matt and Hatmaker, thanks for actually responding because this is a big deal to me and I don't know anyone else I can talk to about this because no one else understands except for you guys. Your responses really do help. I have to think these things through repeatedly (and to the point of totally annoying those around me at times) in order to get to the other side. I've been trying to get to the other side of this one for a LONG time. I need to keep going until I get through it.

Cherie

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Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


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PostPosted: Wed Jan 19, 2011 2:00 pm 
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Cherie - I am glad I can be of some comfort (however little).

Some thoughts on your last post.

1) First off - it is so hard for people to relate to how devastating chronic pain can be to someone's life. My wife (as wonderful as she is) doesn't get it at all. In her mind "we all get aches and pains." Shoot even my pain doctor has used the "take your medication and get on with your life" bit on me when I've harassed him about other non-medication treatment options. I literally wanted to say "OK, do you mind if I kick you in the balls with my steel toes on my way out - I am sure that with the dizziness and pain you're feeling, you can just go right on with your day when I am gone." People who are not in chronic pain don't get it. Period. I have been searching for a good community of other CPers who discuss pain and the good, bad, and ugly of different medication options. I've had a hard time finding one. The sites I've found are either of the "don't touch my pain meds" camp or "pain meds of any sort are the devil, live with it" camp. I don't relate to either. As I feel with most things in life, there's got to be balance in there somewhere and experiences to share that work. I'll keep searching and let you know if I find any.

This all said, you have hit on an important point. Chronic pain has changed us (forget dependence/addiction). My pain doc had a point to a degree. Life goes on and we gotta find the best balance we can in life. It's the cards we were dealt. Which leads to my next point.

2) I would focus less on feeling bad about whether you need the extra dose of Sub and more on whether you can calibrate a high enough dose that resolves a lot of the pain without knocking you out. That's the key. If you can take the Sub, control your pain, and function in your daily life (without active addiction too no less), that's a blessing which you can add to the many others I am sure you have. Guilt has no place in that in my opinion as long as life is good. I quit my full agonists because life ceased to be good. For five years it improved my life, then it didn't. The dependence I developed created a roller coaster ride for me that was starting to hurt my life, not improve it. That's when I started to feel guilt, even desperation. But I don't regret the five years that life was better for me.

3) Finally, I think you need a new doctor hun. You have a complex set of items to tackle and a doctor who seems ill equipped to help you. I don't know if insurance is a factor. My first inclination is to recommend an Addiction Psychiatrist with pain experience, but I know that many don't take insurance. They're also hard to find. But I am sure there are pain doctors out
there that take insurance and have some knowledge of addiction or can refer to a counselor who does. My problem with pain docs is that they look at Sub in too black and white a fashion...

"Full agonists are for pain. If you lose control of full agonists, that's on you, not the full agonist. Then we have Sub for you. Sub is not for pain. Sub is for addiction...."

I would visit a few different pain docs who deal with Sub and the second you sniff out this perspective, move on to the next. You're the patient, you're the one in pain. You're the one who needs help with pain but needs to be mindful of addiction. You're the one who needs to be empowered to find a doctor that's right for you and not feel one bit guilty about that.

I hope this helps a little. I'm still calibrating where I think I am with my pain and life without any pain meds. I'll keep you, in particular, updated on that.


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PostPosted: Wed Jan 19, 2011 2:42 pm 
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Hi Cherie, you've gotten some great replies so there's not a lot I can add, I just wanted to offer my support. I'm hoping that writing all of this out, especially the A through J reasons has helped you get some perspective, and more importantly, helped you see how hard you are being on yourself. Yes your are an addict, and yes, you DO deserve pain relief.

I think those of us who are accustomed to beating ourselves up can relate to a lot of your reasoning. After going through a mini-relapse and realizing I had to increase my dose to 8mg/day, I felt guilty asking the doc for more Sub, like I'm "drug seeking" even though Sub doesn't get me high. Since that time I've had some pain issues and have been taking ibuprofen and sometimes 10 -12mg Sub a day, so now I'm faced with running out early, too.

In my case the pain has been somewhat related to the bad weather and shoveling snow/ice. But even without the shoveling I have more aches and pains during the winter months (like an old lady!). I'm wondering if this is true for you, too, although I know your medical issues are more severe. If the season is part of the problem maybe you can put things in perspective by making your dose increase temporary. Either way, please don't tell the Sub doc that everything is fine. Tell her you need more Sub for the pain. From everything you've said before it sounds like your doc is reasonable and trusts you, so trust yourself with your decision.
Hope you feel better,
Lilly


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PostPosted: Wed Jan 19, 2011 3:44 pm 
@Jackcrack, I know exactly what you mean about how you constantly think off all these things you have to say at your doctors appt. in order to get the correct treatment and then when the day of the appointment comes like you said you say NOTHING. I was doing that exact same thing until my last appt. and I left every appointment feeling resentful when in reality the doc had no way of knowing how I was feeling because I would just tell him "yeah everythings good". I have been struggling with social anxiety disorder and GAD for years now and its been getting worse and worse and I promised myself that at my last appt I would bring up all that and how I have been craving and things are just not going well at all. When I was waiting in the docs office I got the feeling you get when you want to do soemthing but you know you are gonna chicken out and I figured "well i guess Im gonna wuss out again" but then when the nurse came in I just started pouring out the truth to her and she was kind of caught off guard because she thought I was doing so well. Then the doc came in and I told him everything as well and he told me "Im glad you told me, I need to hear these things I dont want you to tell me everything is fine if it realy isnt. And he wrote me a script for lorazepam for anxiety and ever since that appointment my anxiety has been managable and Im able to leave the house again and be around people. I dont even take the lorazepam everyday just when i need it but just knowing that if my panic does get outta control that I have a way to take care of it makes me feel so much better pyschologicaly. I just wanted to share that because I know exactly how it is being to nervous to speak up to your doc and I thought nothing would happen except they would get mad at me but it turned out that they were more than helpful and made me feel comfortable enough that if I have problems in the future I will be able to bring it up.


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PostPosted: Wed Jan 19, 2011 5:08 pm 
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Hey - I missed that you feel you have a good relationship with your current doctor. If that's the case then disregard what I said about finding a new one. I think LillyVal and SuboxOWNED have good points about trying to speak up with your current doctor about your pain and see how he/she reacts.


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PostPosted: Thu Jan 20, 2011 12:13 am 
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I do love my doctor. She doesn't take insurance. She is the only doctor locally who prescribes although I haven't looked in a year so there could be more by now. I'm not opposed to switching doctors if I needed to. I need to see what she says first. She really is a great doctor but I think she belongs to the camp where less is more which is why I feel guilty saying anything because I already know her opinions on all of this to some extent.

Suboxowned - ......and they always wonder why my pulse is jumping and my blood pressure is high when I go in there. I swear to you I can feel it the moment I walk in the door and as soon as I walk out I go back to feeling normal again. All those things I lock in my head and don't say make my heart just race. It is kind of ridiculous.

I do know this about my doctor. She believes that most addicts suffer from some type of generalized anxiety disorder. She also believes highly in meditation and exercise and diet (she kind of harrases me every time I go in...annoying but at least she cares).

My appointment is Monday. I don't know what will actually come out of my mouth. I'm so jumbled up that I'm afraid I might cry just trying to speak. I finally said something to my husband last night because my condition acted up in the evening for about 3 hours and it was just excruciating and I had been having such a good day. So I was in pain. I don't have enough sub to spoil myself with taking more. I couldn't get comfortable in bed and just got really pissed off and ranted real quick about being miserable and that this was bullshit and I was sick of it. That was all I had to say and then I just started crying and couldn't stop it. I was quiet of course as I wouldn't want to bother my husband either. The more I thought of how much suffering in silence I do the worse it got. I did eventually sleep okay. Got up, was ok most of the day. Then my condition started to flare again. Tonight will be my last night of marginal peace and then the next 3-4 days will likely be totally miserable. I think "here we go again".

I know I am whining and I do sincerely appreciate your patience while I get through this phase. It does help to kind of walk it out on here. I just need to get to Monday.

I really appreciate all of you. You are all VERY helpful. I don't know what I would do without you guys.

Cherie

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Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


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PostPosted: Thu Jan 20, 2011 10:03 am 
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I'm sorry that I don't remember exactly what condition you are dealing with. I'm just wondering if you know that it is starting to flare and the next 3 or 4 days will be bad, is there anything you can do pre-emptively to nip it in the bud? I know after surgeries they say to stay ahead of the pain, i.e. to take analgesics before the pain starts. Do you have other meds, like neurontin, that can be increased? I honestly beleive that fear and emotional upset are the worst thing for pain and that's the state you are in now. Maybe you should not wait until Mon. and call your doc now to see if they can call you in a few xtra Subs for the week-end. Please don't sell yourself short. Do for yourself what you would do for your best friend if she were in pain.
Feel better,
Lilly


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PostPosted: Thu Jan 20, 2011 5:05 pm 
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Hi Jack, I don't have time to write much just now, just wanted to say one thing--I've had trouble on occasion telling my doctor everything. I'd wished to bring up at the appointment too, sometimes out of nervousness and other times out of actually forgetting. sometimes it helps to write down some notes, like a list, of the issues you want to be sure to bring up at your appointment. i know you are a really intelligent person, and maybe already thought of that, but I just wanted to mention, on occasion that has helped me. I don't have debilitating chronic pain myself, but....I do know it's easy for some people to look askance at anyone with a condition that they themselves have never experienced. I think maybe there's an aspect of the "pull yourself up by your own bootstraps' myth that could extend to this kind of situation too. But....to me, it seems the main thing should be about each person finding the way to make their life work best. Life is hard enough when you have a lot of good luck, in my opinion, but having severe chronic pain is NOT good luck. Anyway, I really hope you feel better, please let us know how your appointment goes.


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PostPosted: Thu Jan 20, 2011 8:32 pm 
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Well, I was uncomfortable last night but today was actually okay and I'm not too uncomfortable right now either so it may be delayed a few days before life really sucks which is totally fine with me ;-) Like I said, when life is good and I'm not in pain, it's great. When I am in pain, it really sucks. So you never know what mood you might get me in either :-)

I'm pretty used to all of this so I wouldn't really want to bother the doc again. She already gave me an appointment a couple days early so I can wait.

I agree that emotions impact pain. If I hadn't done meditation I can only imagine where I would be right now. I wish I knew how to do it well enough to not just make do but to really keep functioning. I know there are classes you can go to and you can learn to remain in excruciatingly uncomfortable positions for extended times so I imagine you can learn to tolerate pain for extended times. I have heard this takes a ton of practice (years) and you must have a very strong desire to do it. I am not sure where I am at with all that right now. I think it sounds boring and not very "me" so if I was forced to do it I would but I really don't want to drive all the way into Seattle to learn all this.

Hopefully tomorrow goes as good as today did and my appt. is Monday.

Good to see you are still around Auto. I haven't seen you in a while.

Cherie

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Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


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PostPosted: Thu Jan 20, 2011 8:41 pm 
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Oh....and I have peripheral neuropathy which is well controlled by suboxone as long as I take an average of 10mg per day. I also have stage 4 hidradenitis suppurativa - chronic. It's a nightmare. I've had more surgeries than I can count and they don't really work unfortunately. It has just disfigured me and given me a whole lot of scar tissue. I've been to the university hospitals and everything else and they have no answers. UW won't even see people with this condition because they know they can't do anything with it. Blah!

To top it off, I did something to my right elbow a couple years ago which has left me with this chronic swelling. I had surgery last Feb. and they said there was a ton of swelling. They asked if anyone in my family had rheumatoid arthritis (they don't) and I am now just stuck with it because about 2 months after surgery it just swelled right back up. Everyone seems to think it isn't a big deal. Probably because I don't complain much about it. Most of the time it doesn't hurt too bad. Sometimes it hurts something awful when I am keyboarding at work. Also, if the hidradenitis is acting up and giving me a ton of pain, I can only sleep in certain positions. Well the lesser of two evils is to sleep on the right elbow then that is what will happen. The next day it will hurt so bad I can't stand it. Can't use that arm to brush my teeth, wash my hair, open a door, not nothing. I can't even lay on the couch in a comfortable position the next day. So after a few days of extra sub for the HS, I generally will need extra sub for another 2 days for the elbow. It will go back down to normal after a couple days of leaving it alone, but you would think they could please at least fix the elbow. I am sure IT has a cure. Loose bodies in there or effusion they can debride it or something. I just got another MRI and am seeing a new surgeon as soon as I get off my ass and set an appointment. It's in Seattle though so it takes an entire day off to go there.

Anyways, that's what I got.

Cherie

_________________
Criticism may not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.

- Winston Churchill


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PostPosted: Thu Jan 20, 2011 9:31 pm 
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JackCrack: I've followed along somewhat and obviously have known you here for over a year. Forgive me if I should have already been aware of this, but something you said in your latest post really jumped out at me and I was not aware of it. I'm talking about you taking only 10 mg of Suboxone a day! I guess I was not aware of that. However, I think that it is extremely relevant to what is going on with your lack of pain control in that 10mg is very often a dosing level that people on Suboxone without pain (just needing addiction treatment) take. Hell I was on 12mg for many months and am still on 8mg now. I guess it does not surprise me that you are at pain while at the 10mg level. I clearly do not have any direct experience with taking Suboxone for pain. I just know what I have read, and what I have read from many is that Suboxone is a somewhat mediocure pain medication to start with. Second, those who do seem to get pain relief often need to take 4-8 mg every six hours or thereabouts.

I'm guessing you are already aware of this - since you are very well versed about Suboxone. I guess I would just want to reinforce to you that needing or asking for more Suboxone per day is not at all out of bounds when you are currently only at 10 mg, nor is it drug seeking or anything of the sort. It would seem to me that 16 mg is an average and good starting point when using Suboxone for pain. I get the feeling that you are almost looking at this as if you were currently on 24 mg/day and were contemplating asking for 32 mg/day. That might be something to really think about before doing it. But give yourself a break! You are clearly at the low end dose for pain. Don't beat yourself up about asking for more. Besides, if you were to be able to get better pain relief from 16mg, it is not at all likely that you'll need to increase that dose in the future. It's not like you are having issues with needing more and more due to tolerance. This seems to be a pretty clear cause and effect. The cause is too low of a dose of Suboxone and the effect is pain!

Cut yourself some slack. Asking for an increase in your 10mg/day Suboxone dose is not at all the same as asking for 80mg of Oxycontin from your current dose of 40mg (as an example). There is a really great saying that I love that goes: pain is unavoidable, but suffering is optional. How I wish I would have come up with that one. But it really is true. It really sounds like there is not much you can do regarding the source of your pain. However, there certainly is something that you can do about suffering with that pain.


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PostPosted: Sun Jan 23, 2011 10:16 pm 
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Cherie - I remembered that you have your doctors appointment tomorrow. Just wanted to wish you luck and let you know you're in my prayers. Let us know how everything goes.

Matt


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PostPosted: Mon Jan 24, 2011 11:47 pm 
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Thank you for thinking of me this morning Matt and Hatmaker. I do truly appreciate it. I saw your post this morning before work.

I went to my appointment and blurted it out when she asked how I was doing and when she asked about how the dose was working and just told her I didn't think it was enough. I told her I felt like it was going backwards to go higher but that if I didn't I would be angry about it. She was fine with an increase and I am at 10mg average per day now and she offered 12mg or 16mg and I took the 16mg because I just think I need it or I will be miserable.

The nice thing was that she didn't make me feel like a shitbag for feeling like I needed to go higher and I actually think she kind of understood my ambivalence in doing so. Even better, I think she empathized with me. I mean, I always feel like a jerk for whining about it. But she made it okay. Hands down it was the most positive experience I have ever had trying to get pain control.

At the risk of continuing to sound like a whiny fuck, I still walked away from the appointment totally depressed and not really feeling relieved at all. I am not sure what my problem is entirely. I left and just started crying and then came home and started crying and was having a hard time typing the paragraph above. I don't really know what it is that bothers me so much about this. I am so depressed lately. It took me a while to digest it tonight and I am pretty sure I will have to discuss it in therapy because increasing the suboxone kind of feels like giving up the fight or giving in. I really don't have any other option so I don't understand my problem but I may just be feeling kind of sorry for myself right now. I know that's not a good thing. Most of the time if someone says anything I am the one who can think on the bright side and say "well it isn't a death sentence and that's a good thing" or "it could be worse...I heard of XYZ disease and boy that looks awful". I mean.....usually I can think of a million reasons why I am one very lucky individual. But right now....I am not feeling it.

With that being said.......I am wondering if the chantix I am taking isn't making me depressed. I have been on it nearly 4 weeks now. I seriously hope not because I am telling you.....that stuff works pretty good. I have only had about 10 cigarettes in 2 weeks and was smoking 30 a day before and I am not even really annoyed by it that much. So I will monitor. That is it for now. Thanks for all your support. I do very much appreciate it. Like I said....you guys are the only ones who understand.

Oh....and the doc did mention one other option which I will make a separate post about and I am hoping Dr. Junig might chime in on that one.

Cherie


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PostPosted: Tue Jan 25, 2011 7:14 am 
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First, Chantix can absolutely cause depression. I think you're smart to consider that and I think it's a very strong possibility that that is what is happening.

Let's put that aside for now though. I'm really glad that your doctor was so understanding. From what you've said about her before, I was kind of expecting her to be just that way.

Remember when I said our feelings and thoughts come from our underlying beliefs? Something occurred to me about why you might be feeling so guilty for asking for pain relief. I could very well be way off base, but I do want to share my thoughts. Those underlying beliefs run very deep and sometimes we don't even realize we have them. Going back to when you were a kid, how did your parents react when you were sick or felt bad or were injured? Did they minimize your pain or feelings and just tell you to buck up? Something like that could very well be the reason that you don't feel you deserve to feel better. That's what I mean by underlying belief. That specific one has to be changed (like through your therapy) before you can feel okay asking for pain relief. I also think that could have something to do with why you never complain about it and in fact think you shouldn't complain about it.

If indeed this is the case (and again, I could be way off base), the natural outcome of this would be your head or rational brain knowing it's okay to seek pain relief while those old beliefs in you are telling you the opposite. That kind of shit makes for some serious confusion on the subject.

I'll stress again that I could be very wrong here - and even if I am, I'd bet that in some related way that is what is going on. I'm glad you have a therapist to go over this with. I really hope you can find some peace on this soon.

Thanks for the update.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Tue Jan 25, 2011 11:38 am 
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Hey Cherie

At least the doctors appointment went well. Isn't it nice having a great doctor? A definite bright side to your story.

You know - interesting about the Chantix. I have no idea about Chantix and depression, but perhaps there is a drug combo thing going on here? At one point, I was on full agonists, Lyrica, and muscle relaxers for my pain. The doctor insisted there was minimal interaction between them, but I felt AWFUL. My GI tract was a mess, I was feeling more roller coaster-y than usual, bad stuff basically. I started stripping out meds - first the lyrica and then the MR and low and behold, I felt much better. Perhaps a coincidence or in my head. But I mention this because if you are on a few different meds sometimes in combination they will do things no doctor expects they will do. I don't want to talk you into stopping meds that are providing you clear benefits, but something to keep in mind maybe?

That aside I think I know exactly how you feel. It's tough to rationalize these feelings. On the one hand, we just got what we wanted and we know it will help the pain, so what are we complaining about? On the other hand, we should be fighting the good fight against this pain. Adding more medication is taking a step backwards and we want this pain to be OVER WITH. We have the whole world telling us to get on with our lives. How can we get on with life when this pain is ever present and we have to add medication to deal with it?

It's so frustrating. I know. We all want a solution to the pain. We want to get on with our lives - more than anything. We want to listen to the voices that tell us to grin and bear it. But after a while, the pain just wears us down...

The best we can do is find a balance, for ourselves and our loved ones. We should always be seeking that solution to our pain, no matter how futile, because minimally it can empower us and give us some control back. We should educate our loved ones as best as possible so they can understand us as best they can and we can hopefully see when our pain is affecting them too. And most of all, we should use all the tools at our disposal throughout this, to control the pain and improve our quality of life day in and day out.

I think you're doing great in that regard. It's natural and reasonable to feel conflicting emotions about all this. I hope you will keep up the good fight and don't hesitate to check in to bounce ideas off us if we can be helpful.


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PostPosted: Tue Jan 25, 2011 12:20 pm 
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I'm glad your doctor was so compassionate, and I'm glad you took the 16mg. You may not always need it, but now if you are in pain you don't have to worry if you will fall short by taking more Sub.
To add to what Mel said about the negative messages from the past...It could also have brought up bad feelings of asking doctors for more pain meds when you were in active addiction. I felt badly about asking my doc for a dose increase last month, especially when I had been down to 2mg/day, but it was really what I needed to do. You did what you needed to do, too. I mean, how many other options are out there?

I don't know where you're located, but where I am it's been stormy, cloudy, cold and stormy some more, which definately doesn't help my depression. I think Chantix is an SSRI or closely related to one. If it's working for you, you'll probably want to rule out other factors before going off it. It sounds like your cutback on smoking has been HUGE. That in itself is a big life change. Probably smoking was a way of dealing with negative emotions, and now you're not using that outlet anymore.
Hang in there. You're taking a lot of positive steps.


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Fond Du Lac Psychiatry
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