Posted in aches, Arthritis, Chronic lower back pain, chronic pain, Coping with Chronic Pain, Inflammation, Knee pain, Rheumatoid Arthritis, Surgeries

Relief Options for Chronic Pain

PART 3  –  OPIOIDS

Except for Marijuana, controversy surrounds Opioids more than any of the previous medications discussed in Parts 1 and 2. Suicides, accidental overdoses, and misuse of Opioids by prominent celebrities fill the headlines and invoke a strong media reaction. This escalated attention cautions healthcare physicians to seek other options for their patients.

The American Academy of Pain Medicine, National Institutes and Health, American Chiropractic Association, and American Society of Addiction Medicine provide chronic pain and prescription opioids statistics. These statistics cover the United States only:

Chronic pain statistics indicate more people suffer from pain than the combination of diabetes, heart disease, and cancer. Excluding acute pain conditions and children suffering from pain, 50 million to 100 million adults suffer from chronic pain. Of those adults, 27% seek treatment for lower back pain, 15% for severe headaches to migraine pain, and another 15% for neck pain. Alarmingly, these numbers continue to grow daily.

Research of the prescription pain pill epidemic for 2015 shows 20,404 people died from Opioids overdoses. Prescription opioids account for substance abuse disorders by two million people. Increased national crime, pharmacy burglaries, and overdose deaths were tied to Opioids abuse.

Since the rise of prescription drug overdoses, especially prescription Opioids, views have changed among healthcare providers for prescribing Opioids for the treatment of chronic pain. However, Opioids are prescribed in cases of short-term to help patients recover from fractures or post surgery.

Your primary care physician will no longer prescribe Opioids for moderate to severe chronic pain. Instead, you’ll be referred to a Pain Management Facility where specialists evaluate and monitor prescriptions of Opioids.

Many chronic pain patients find themselves suffering more and receiving little or no assistance of treatment for their pain due to the abuse and misuse epidemic. As the fear of overdosing heightens many physicians, including specialists, seek other options to treat chronic pain. Physical therapy, minimally invasive procedures, and lifestyle changes are the preferred options. However, these options, exhausted by most chronically ill patients, bring little to no relief.

So, how do chronic pain patients find relief? If Opioids are the only option available for severe chronic pain then understanding the risks involved with these drugs is mandatory. The specialists associated with Paindoctor.com (and most pain management specialists) treat chronically ill patients using a 12-step Opioid Checklist to ensure patient safety. (You can find the risks of Opioids listed after the checklist.)

Taking Opioids is a risk. But most chronic pain sufferers take that risk to acquire a fraction of the quality of life they enjoyed prior to the onset of chronic pain.

What are Opioid medications?

As the oldest known class of drugs in the world, Opioids refer to either morphine or other opium poppy-based medications – narcotics. Opioids suppress the pain perception by reducing pain signals as they are transmitted through the nervous system.

Below are some types of Opioids (and their generics) used for chronic pain treatment. ALL of these medications require a prescription.

Hydrocodone (Hysingla ER, Zohydro ER)

-*Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)

Hydromorphone (Dilaudid, Exalgo)

Oxycodone (Oxycontin, Oxecta, Roxicodone)

-*Oxycodone and Acetaminophen (Percocdet, Endocet, Roxicet)

Oxycodone and Naloxone (Targiniq ER)

Morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)

Meperidine (Demerol)

Methadone (Dolophine, Methadose)

Fentanyl (Actiq, Duragesic, Fentora)

Codeine (only available in generic form)

(*Includes Acetaminophen in the compound. Avoid other products containing acetaminophen (ex: Tylenol) due to increased risk of liver problems.)

For pain relief all day and through the night your doctor may prescribe specific doses of your pain medication. However, there is a chance you may experience “breakthrough” pain. Breakthrough pain is a flare of pain experienced even though you receive round-the-clock pain medication.1 In this case, you may be given a prescription with “as needed” instructions.

Regular visits to the pain specialist are a requirement of care if you are prescribed Opioids. These visits include questions asked by your specialist:

          1. Are you responding to the Opioid?
          2. Are you experiencing any side effects?
          3. Have you developed a medical condition or potential interaction that may increase the risk of side effects?
          4. Are you taking the medication as directed?2

NOTE:  Never change the dosing of any Opioid medication without first checking with your physician. If your pain isn’t managed by the medication prescribed, your physician may change the dose or try another Opioid drug.

Opioids can be dangerous if taken with 1) antidepressants, 2)antihistamines, and/or 3)sleeping pills. Be sure your doctor knows all medicines you are taking. Other prescription drugs, over-the-counter drugs, and herbal supplements may cause additional problems when taken with Opioids.

When you’re ready to quit the Opioids, your pain specialist will advise a slow weaning off from the Opioids to help your body adjust to the removal of the pain medications. Withdrawal symptoms occur if you stop the Opioids abruptly.

As reviewed in Parts 1 & 2 of this series, most medications have side effects and Opioids are no different. Common side effects include:

*Constipation                       *Sedation

*Fatigue                                 *Nausea

*Vomiting                              *Confusion

*Dry Mouth                           *Constricted pupils (miosis)

*Itching (pruritis)

However, there are more serious side effects including:

**Urinary retention              **Hearing loss

**Respiratory depression    **Hallucination

**Hypothermia                       **Delirium

**Hyperalgesia (increased sensitivity to pain)

**Abnormal heartbeats (arrhythmias)

LARGE doses can induce:

***Serious respiratory problems              ***Depression

***Oxygen deprivation                                ***Unconsciousness

***Overdose                                                   ***Death

Taking Opioids for the long-term may cause tolerance, dependency, and/or addiction.

Tolerance occurs when the need for Opioids causes increasing the dosages.

Dependence is a physical or psychological effect. A physical dependency occurs when you (abruptly) stop taking your Opioid medications resulting in a withdrawal syndrome. Psychological dependency occurs as an emotional need for the drug when there is no physical need.

A small percentage of patients who use Opioids long-term may suffer from addiction.3 The characterization of addiction is a constant pattern of inappropriate Opioid use and may include the following serious problems:

    • Loss of control of using Opioids
    • A preoccupation of acquiring more Opioids even though pain relief is achieved
    • Although adverse physical, psychological, or social consequences may occur, the patient continues using Opioids
    • Overdose and death increases as an adverse effect

Should you take Opioids? If you suffer from moderate to severe pain, Opioid drugs can make a significant difference in your pain levels. However, you must take them safely and follow your doctor’s instructions carefully to avoid the negative effects of Opioids.

Next week, we’ll explore Marijuana and its treatment of chronic pain. Have a great week!

1Opioid (Narcotic) Pain Medications article, WebMD, LLC, 2017

2Opioid (Narcotic) Pain Medications article, WebMD Medical Reference, Minesh Khari,MD, April 30, 2017

3What are Opioid Medications? Article, paindoctor.com

 

.

Advertisements
Posted in Arthritis, Chronic lower back pain, chronic pain, Inflammation, Knee pain, Muscle and joint stiffness, Rheumatoid Arthritis

Options for Pain Relief

PART 2

Exploring Anticonvulsants, Muscle Relaxants, and Corticosteroids

In part one of this series of Options for Pain Relief, I wrote about NSAIDs, acetaminophen, and antidepressants. This post focuses on anticonvulsants (anti-seizure) medications, muscle relaxants, and corticosteroids. Because there is so much information regarding Opioids and Marijuana for treatment of chronic pain, I’ve decided to write two separate posts for each of these. The next post (Part 3) will be devoted to the pros, cons, and debates of Opioid use for chronic pain treatment.

Now, let’s discover how anticonvulsants, muscle relaxants, and corticosteroids are used as a relief for chronic pain.

ANTICONVULSANT (antiseizure) MEDICATIONS

Anticonvulsant medications are used for specific types of nerve pain (burning, shooting pain) and must be taken on a daily basis or as prescribed by your physician. Whether pain is experienced or not, this medication must be taken as directed for maximum results. This medication is not intended for an “as needed” dosage.

Some common side effects include sleepiness (which may improve the longer the medication is taken) and weight gain (one reason I stopped taking this medication), dizziness, and fatigue. If you suffer from kidney stones or glaucoma tell your doctor as anticonvulsants are not recommended for patients with these conditions. Newer anticonvulsant drugs do not require liver monitoring, however, if you have a kidney disease use caution when taking this medication.

Anticonvulsants are another example of a medication that is developed to treat one condition and is used to relieve the symptoms of an entirely different condition. Dual purpose anticonvulsants help patients manage their seizures while also helping chronic pain patients manage their pain. Studies provide conflicting views of treating chronic pain with anticonvulsants. Although there are studies advising other forms of treatment for chronic pain, other studies indicate that anticonvulsants are vital for managing chronic pain because of fewer long-term side effects.

Listed below are frequently prescribed Generic forms of anticonvulsants: (the brand name is noted in parenthesis)

  1. Gabapentin (Neurontin)*
  2. Carbamazepine (Tegretol)*
  3. Pregabalin (Lyrica)
  4. Phenytoin (Dilantin)
  5. Topiramate (Topomax)

*FDA approved the medication for treating chronic pain.

Many patients experience lower pain levels with anticonvulsants. Your doctor may use the trial-and-error method to find the drug form and dosage that treats your pain. Be sure to inform your doctor of side effects other than those he advised when taking anticonvulsants. Read the paperwork accompanying your medicine thoroughly, making note of any restrictions (no alcohol, etc.) while taking this medication.

*******

MUSCLE RELAXANTS

In the United States alone, an estimate of $100 Billion is spent annually for chronic pain management.  And among the numerous forms of chronic pain, one form is the Musculoskeletal pain. Its symptoms and discomfort are felt within the muscles, nerves, tendons, bones, and ligaments of the body. These symptoms may develop as an acute onset (rapidly and grow to severity quickly) or as chronic pain (slowly and long-lasting.) Like most chronic pain, Musculoskeletal pain that continues for three months or more is considered ‘chronic.’

Chronic musculoskeletal pain may be widespread or centered in one area of the body. Some of the more common parts of the body include lower back pain, myalgia (muscle pain), tendinitis, and stress fractures. The causes are as varied as the types of musculoskeletal pains – injury, overuse, poor posture, arthritis, and/or prolonged confinement.

To effectively treat the symptoms of pain and discomfort muscle relaxant medications may be used. Unlike their name, muscle relaxant drugs don’t act on the muscles themselves. Instead, the impact of the effects center on the central and peripheral nervous system.

Reported symptoms treated with muscle relaxants include:

  1. Bone Pain (dull, deep, penetrating pain)
  2. Connective Tissue Pain (felt within tendons or ligaments)
  3. Muscle Pain (less intense than Bone Pain, but causes range from injury to tumor)
  4. Tunnel Syndromes (result from compression of nerves)
  5. Joint Pain (aching, stiffness, swelling or burning within a joint(s))
  6. Fibromyalgia (ligament, tendon, muscle pain)

The most commonly prescribed muscle relaxant medications are Baclofen, Carisoprodol, and Chlorzoxazone. All three work on the central nervous system, but each is prescribed for different pain problems. Baclofen is prescribed for muscle spasticity which occurs as a result of multiple sclerosis and spinal cord injuries. Carisoprodol is more commonly prescribed for the treatment of several musculoskeletal system disorders that cause acute pain. And Chlorzoxazone is typically prescribed for lower back pain and muscle spasms. Only one of these medications have received rare reports of acute liver injury. Chlorzoxazone use may be associated with liver injury, but, again these reports are rare.

However, two muscle relaxant drugs have been associated with causing acute liver damage (severe to fatal.) If you are prescribed either of these drugs, speak to your doctor extensively regarding this warning. The drugs are:

Dantroline (for chronic spasticity)   and

Tizanidine  (for acute symptoms of muscle spasms or chronic muscle spasticity)

The normal side effects of dizziness, drowsiness, and headaches accompany most of the drugs mentioned above. As with all medications prescribed or discussed in your doctor’s office, research the side effects online if your doctor fails to discuss them with you. It is your right to know exactly what you are putting into your body and the effects that may accompany those medications.

*******

CORTICOSTEROIDS

Administered in the form of a pill, a topical cream, or an injection, another class of anti-inflammatory drugs is Corticosteroids. As a stronger drug used to control severe swelling and pain, corticosteroids are prescribed for specific pain conditions. They were created to act like the natural steroids in your body. By altering the immune system, they control inflammation that causes decreased movement and pain in most joints and muscle tissues.

These drugs are periodically administered to treat cases of acute pain or flare-ups. Another common treatment is chronic swelling in the tendons and joints. To reduce pain and escalate joint and tissues flexibility, corticosteroids are used for the following conditions:

*Osteoarthritis

*Rheumatoid arthritis

*Synovitis

*Tendonitis

Common types of corticosteroids:

**Hydrocortisone

**Prednisone

**Methylprednisone

**Cortisone

And the possible side effects include:

-Headaches

-Nausea or vomiting

-Sleep problems

-Dizziness

-Changes in the skin (acne, redness, increased hair growth)

-Mental changes (anxiety, mood swings, depression

Again, let your doctor know of any extreme side effects including hands, feet, or face swelling, eye pain or other visual changes, a rash that will not disappear, new muscle pain/weakness, and/or tarry bowel movements.

Corticosteroids do work but injections are limited to a maximum number every six to twelve months each year. Pills are given in large increments and dwindle down to nothing in a matter of six to ten days. And topical creams are usually applied as needed or per your doctor’s orders. Be sure to talk extensively with your healthcare physician to understand the side effects and the likelihood you’ll receive pain relief with corticosteroids.

Next week I will post Part 3 of Options for Pain Relief – Opioids. Thank you for your patience and I hope you enjoy reading this information!

Carolyn

 

Posted in Uncategorized

Options for Chronic Pain Relief

PART 1

Exploring NSAIDs, Acetaminophens, and Antidepressants 

If you suffer from any form of BACK PAIN, you know (or maybe you don’t) there are numerous options to help relieve your back pain. These options are placed in one of these categories:

Medications     –    Injections  –    High-Tech Treatments    –    Surgery

Because the research on these different options is extensive, I plan to cover each category over the next six to eight posts. Today, I’ll begin the first part of MEDICATIONS by talking about the first two categories: NSAIDs & Acetaminophens, and Antidepressants. These medications are used for treating pain and chronic pain in the back and other parts of the body.

Medications:

This category appears to have the highest percentage of usage for treating back pain –temporary or chronic. I found five categories of medications:

1) NSAIDs and Acetaminophen,

2) Antidepressants,

3) Anti-seizure or (Anticonvulsants),

4) Muscle Relaxers, and

5) Opioids

 

NSAIDs or Nonsteroidal Anti-inflammatory Drugs encompass a wide variety of medications that may be found OTC (over-the-counter) or may need a prescription from your doctor. In either form use caution when taking anti-inflammatory drugs. Be sure to administer the drug precisely as directed by your doctor and/or the package instructions.

There are numerous articles online for OTC Anti-Inflammatory medications and I urge you to surf the net for more information. I always look at the most recent article – try to avoid older articles because there is constant change in this industry. However, one site (Healthline.org) is beneficial and includes a guide to OTC Anti-Inflammatories.

This guide lists the common NSAIDs, how they help with pain, the side effects, and comments regarding drug interactions. Before using any of the medications listed in this post, please contact your doctor first. Your doctor needs to know your history and the drugs (you are presently taking) before deciding the best NSAID for you. Some drugs interaction with NSAIDs will make the NSAIDs less effective.

Note: If you’ve had chronic pain for more than six months, call your doctor’s office. Your pain may be chronic and this list of medicines may not be suggested by your doctor.

In the Guide to OTC Anti-Inflammatories … Aspirin (Bayer, St. Joseph), ibuprofen (Advil, Motrin, Midol) and naproxen (Aleve, Naprosyn) were noted as common NSAIDs.

 

ACETAMINOPHEN (Tylenol) is one of the most common pain medicines used for fever reduction and pain.

Acetaminophens are used for arthritis pain, common aches, or headaches. These drugs have good results except in the cases of pain lasting more than six months. If this is the case you may have ‘chronic’ pain and require a prescription for a stronger pain reliever. Check with your healthcare provider for more information.

Keep in mind acetaminophens do not reduce inflammation.

 

ANTIDEPRESSANTS

In the world of searching for drugs to help alleviate chronic pain, some drugs developed for other diseases have become the most effective and commonly used ways to treat chronic pain.

Case in point: antidepressants, which were developed for the treatment of depression. And although depression may not be a condition of the patient, antidepressants have become a pillar in the treatment of chronic pain conditions. Although it isn’t understood the connection between antidepressants and their treatment of pain; it is believed neurotransmitters in the spinal cord are increased by antidepressants which would reduce pain signals.

This type of medication must be taken daily – regardless of a low or non-existent pain level. And the relief isn’t experienced immediately. It can take several weeks to feel the effects of an antidepressant. Moderate relief has been reported by most patients who take antidepressants. If this medicine does not effectively lower your pain, your doctor may pair your antidepressant with an anticonvulsant.

There are three groups of antidepressants due to how they work and their chemical structure. Considered one of the most effective group for pain relief is the tricyclics.

A few Tricyclic Antidepressants (TCAs¹):

  • Amitriptyline
  • Amoxapine
  • Clomipramine
  • Desipramine
  • Doxepin
  • Nortriptyline

Side effects include:

Blurred vision, drowsiness, dry mouth, lightheadedness upon standing up (due to drop in blood pressure), weight gain, constipation, heart-rhythm, difficulty urinating, and difficulty thinking clearly.

To help prevent or reduce these side effects, you will begin with a lower dose and your healthcare provider will increase the dosage as needed. Ironically, the lower doses tend to be more effective for pain than the doses used for depression.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are the second group of antidepressants. Often, patients with chronic pain will develop depression. Drugs in this group help treat depression at the same dosages used for treating chronic pain.

Medicines in this group include duloxetine (Cymbalta), venlafaxine (Effexor), and milnacipran (Savella). Side effects are drowsiness, insomnia, nausea, dry mouth or elevated blood pressure. If your doctor suggests one of these medications, be sure to check the specific side effects by searching the drug online.

The third group of antidepressants, Selective serotonin reuptake inhibitors (SSRIs), include the drugs paroxetine (Paxil) and fluoxetine (Sarafem, Prozac). As medications for treating depression with chronic pain, these medications work well. However, they do not relieve pain on their own. Fluoxetine may be prescribed along with other tricyclic antidepressants to boost their painkilling agents.

Then there are antidepressants that are considered “atypical antidepressants” because they don’t fit into their own category. Atypical antidepressants are bupropion, trazodone, and mirtazapine.

Like most antidepressants, the side effects of atypical antidepressants include nausea, fatigue, dry mouth, diarrhea, nervousness, and headaches. Again, ask your healthcare provider questions about these drugs and their side effects. You can also go online and read reviews by patients who have taken or are taking these drugs.

 

(Please note: Slightly increased risk of suicidal thoughts or actions are associated with antidepressant medications. Please talk to your doctor before accepting these medications if you have entertained suicidal thoughts.)

 

[¹] Published April 13, 2016. Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ.

Posted in Chronic lower back pain, chronic pain, Uncategorized

Keeping a Pain Diary or Journal

Cheers to a rainy Friday! (Rather a rainy day where I live.)

Lately, I’ve read several articles about the need for keeping a journal or diary of chronic pain levels. At first, I skipped the articles and went to my business of writing. However, the more I read, the more I decided this activity would be beneficial in many ways.

You ask, “How will keeping a pain diary or journal help me?”

I’m glad you asked! Keeping a journal or diary of your daily pain activity chronicles your “ups and downs” with pain. For example:

  1. your pain level is higher on rainy days 
  2. your sleep is disrupted because your pain woke you up 
  3. a change in medication dosage may lower or increase your pain

These are a few of the actions you can chronicle with a pain diary. Over time, you’ll have a detailed report for your personal needs and for your doctor to review. Depending on Your pain results help your doctor manage your pain more effectively. He will see the symptoms of your pain and how it varies depending on the time of day.

There are “apps” specifically for tracking your pain levels. But after reading Jo Young’s article, “How I Started a ‘Pain Diary” (and Why I Think You Should, Too) I created my own diary with columns specific to my needs. Using Excel or a spreadsheet of your choice,  below are sample column headings you may find beneficial:

  • DATE
  • MORNING  (Pain level 1-10)
  • AFTERNOON  (Pain level 1-10)
  • NIGHT  (Pain level 1-10)
  • DOSAGE OF MED-X (Dosages and frequency can affect your pain level.)
  • DOSAGE OF MED-Y
  • DOSAGE OF MED-Z
  • WENT OUTSIDE? (Sometimes we just don’t feel like going outside, like today)
  • MENTAL STATE   (Bad, Very Bad, Neutral, Good, Very Good are some suggestions)
  • HOURS OF SLEEP  (Hours of uninterrupted sleep, not including naps.)  
  • EXERCISE   (Amount of, type, time spent)
  • NOTES:  (Put anything here as additional info for yourself or your doctor)

Your entries offer valuable information to help you cope with your pain. In addition, your pain diary helps your doctor’s decisions to manage your pain more effectively. And remember – start a pain diary if you were just diagnosed or experienced pain for years! After a few weeks, you’ll begin to see a pattern of your pain levels and what appears to affect it.

Would you mind letting me know when you start your pain diary or journal? And would you share your findings? I won’t share your personal information but may use your findings (along with other readers) in a blog post!

Thank you for stopping in to read! I appreciate your time and look forward to your comments!

Blessings sent your way,

Carolyn

webmd_rm_photo_of_pain_journal

Posted in Arthritis, Chronic lower back pain, Coping with Chronic Pain, Fatigue, Fibromyalgia, Knee pain, Muscle and joint stiffness, Rheumatoid Arthritis

More Info About “Patients Like Me”

Good morning!

If you haven’t signed up for “Patients Like Me” this post will give you more in-depth information about this unique website. As a patient with chronic back pain, Fibromyalgia, and joint inflammation and pain I have found Patients Like Me (PLM) offers a way to track my daily symptoms, conditions, and treatments. Let me explain.

The goal of PLM is to help patients become involved in the care of their conditions – Fibromyalgia, chronic pain, Rheumatoid Arthritis, Lupus, Bipolar, or any health condition that involves symptoms that the patient may be dealing with. You (the patient) gives data to PLM and they (PLM) gets that data and processes it into information for You.

You (the patient) give data (your conditions, symptoms, treatments) to PLM and (PLM) gets your data, processing your information into “data points” These data points are combined with all the conditions, symptoms, and treatments of patients in their system. This information is then available for YOU to see and explore.

If you have chronic back pain you can look up how many patients have your chronic back pain, their symptoms of chronic back pain, what medications they take for chronic back pain, and how they cope.

  1. Click on CONDITIONS at the top of your dashboard
  2. If you have listed chronic back pain in the system you can find your condition from “My Conditions” at the right of the form. Or you can “look up” chronic back pain in the space provided.
  3. Type in Chronic Back Pain.
  4. You will find Chronic Idiopathic Back Pain which is pain that lasts for 3 months or more.
  5. Below Chronic Idiopathic Back Pain are an Overview of the patients in PLM by age, sex, and the start date of this condition.
  6. Look at the table on the left and you’ll find sections on “How it affects people,” “How people treat it,” and “Compare treatments.”
  7. Click on “how people treat it”
  8. As of the date of this post, there are 79 treatments for Chronic Idiopathic Back Pain listed by patients.
  9. You can shorten the list by the “Top 10 treatments”
  10. Click on Hydrocodone (for example) and you’ll find an overview of the drug. Below is a chart of the reported purpose and perceived effectiveness
  11. 1166 patients take Hydrocodone for pain. As you scan through the chart you’ll see the other conditions Hydrocodone is taken and how effective it is for patients

You can look up your conditions and symptoms in the same manner. This information may not seem relevant, but once you are able to compare the evaluations of other patients you find you aren’t alone is this battle to cope with your condition. You can even find info about how other patients take a medication, with food or without food.

Explore the site to see if it is the right fit for you. I’ve found it’s a great way to track my progress by submitting my daily info. Charts show me if a medication is working, how my symptoms change, and a detailed chart I can take to my next appointment with my pain management doctor.

I was amazed that she wanted the info to put in my chart. She found it interesting and a great tool for her to see how I progress. Take a moment to check out PLM. It might be a good fit for you or you may feel you just don’t have the time to submit your information. But look at it this way. If you submit your information you are contributing to PLM’s research and their commitment to sharing people’s information to clinical trials, the FDA, AstraZenaca, Takeda Pharmaceuticals, and M2GEN (cancer patients research team.)

Thanks for reading and let me know if you join PLM. I wish you a day with very little pain so you can enjoy doing the things you love to do!

Warmly,

Carolyn

 

Posted in Arthritis, Chronic lower back pain, Fatigue, Fibromyalgia, Health Care, Knee pain, Muscle and joint stiffness, Rheumatoid Arthritis

Patients Like Me

Hello, and I hope you are enjoying a low pain or pain-free day!

Finally, after weeks of inflammation and burning pain in all my joints, I have started on the generic brand of Celebrex! (I took this medication years ago when it first came on the market and then was taken off the market due to symptoms of heart problems in patients.) My PA explained Celebrex was doing a great job now and thought I would have good results with it. And she was right! Within 24 hours my inflammation was down and the pain level in my joints was as low as a 2 or 3. I believe it may be helping my lower back, where I have arthritis because my back pain level has been lower, also!

Isn’t it great when you try a medicine and it actually works? There are several medications I’m on that make me wonder if they are doing anything for me. My doctors usually answer that if I were off of the medicines I would see how they are helping me. And although I consider taking myself off those meds, I don’t believe I want to go through the process of getting back on them. So far now, I’ll stick to my medication list.

Today I want to introduce you to a great site I found called Patients Like Me. I came upon this website by accident. After reading the synopsis of PLM I decided to join and see what it could do for me. Bottom line…this is a great site for anyone with hidden illnesses and any illness that impairs you with pain, discomfort, or wishing you knew somebody with the same problems.

PLM claims over 500,000 patients with over 2700 conditions on the single mission of putting patients first! And when you join you’ll understand this statement more thoroughly. PatientsLikeMe is the brainchild of Jamie Heywood, whose brother, Stephen, age 29 was diagnosed with ALS in 1998. Together with brother, Ben, Jamie tried treating his brother’s symptoms and slowing the disease even though it progressed rapidly. Jamie and Ben realized that researching for information and answers to help their brother and his disease was time-consuming and difficult.

Along with another friend, Jeff Cole, the brothers initially launched PatientsLikeMe to connect ALS patients, but it quickly expanded, and in 2011, [they] opened the website to all patients and all conditions¹. Fortunately, for us, we have the opportunity to be a part of PLM and contribute to the research of our diseases while forming relationships with patients, listing our medications, taking forms to our doctor visits, and reporting our daily symptoms. All of these items contribute to the goal of PLM: “a free website where persons share their health data to track their progress, help others, and change medicine for good!²”

I’ve been a member since March of this year and have already met so many new friends through this wonderful site. Not only do you enter your medications for your own needs, but you learn how many PLM patients are on the same medication, encounter similar symptoms, and give advice on taking the medication and how they alleviate their symptoms.

Each day you receive an email asking “how are you feeling today?” PLM is not looking for sugar-coated answers to this question. You tell it like it is. Log in, mark the face you feel at the time you log in (Very Bad, Bad, Neutral, Good, Very Good) and then you can give an explanation of your feeling. This is optional but this piece of information gives you insight into other patients’ symptoms and how their pain is affected by the weather, stress, and frustration.

Because I don’t want to bore you, I’m going to stop for now. But in a couple of days, I’ll post a follow-up to this note with more information on PatientsLikeMe. If you join, please let me know so I can start following you! My username is CNRobin62 and I believe you can search for me and follow me. Then just send me a note that you joined per my blog post. We’ll chat and before you know it you’ll have an arsenal of like disease friends who understand your feelings and frustrations.

For now, enjoy the rest of your day and I hope you have a wonderful week ahead. Thank for reading and I look forward to our next meeting!

Hugs,

Carolyn

 

 

 

Posted in Coping with Chronic Pain

Does Your Environment Increase your Chronic Pain?

Good morning!

It’s Friday, March 10th and one week from today we’ll be in our new home. It seems as though this journey has taken forever since we first moved to the NC mountains on December 1, 2016. But that is because our environment was less than normal. Living in my brother-in-law’s home was full of tension, irritation, and bad vibes. A very stressful four months.

Another aspect of tension and worry has been the present President and his administration. Whether you voted for him or not, it is clear that corruption, instability, and overspending are evident in this administration.

As a chronic pain and fibromyalgia sufferer, I’ve found that almost everything I read about the current administration inflames my pain throughout the day. Why would this person and his proposals affect me in this way?

It boils down to stress and the fact I allow my environment to stress me out. And because stress affects every aspect of our bodies – our sleep patterns, attitudes, and pain levels – it can be difficult to control.

But, I did find an article by Helen White, a contributor to the Huffington Post. Diagnosed with hypermobility syndrome of the joints (HMS), a condition that features joints that easily move beyond the normal range expected for a particular joint. It is a benign condition per medicinenet.com, Ms. White has first hand experience with chronic pain and learned ways to tolerate and cope with her pain. (You can read more about this illness when you click on the highlighted typing.)

Ms. White’s article, “5 Things Living with Chronic Pain has Taught Me”, provided me with tools to live my life a little more stress-free and I briefly share her tips here:

LISTEN to your body and PACE yourself!

Without a doubt this is the hardest thing to do! I’m getting better at it, but I’m still not at the point to stop when my body gently gives the warning signs. No, I wait until the pain is full blown. Then it takes twice as long to control the pain.

Ms. White suggests “taking frequent breaks for gentle exercise and try to take things a bit slower.” She has a morning and evening yoga routine and listens to meditation CDs.

2-Have EMPATHY for others                                                                                                                                            

If your friend suffers from a Chronic illness, please don’t make suggestions on treating their pain. This isn’t helpful because unless you experience a Chronic Illness, you have no idea what your friend is experiencing.

I went through this experience in 2013 when my world literally fell down around me. As one who loves to dance, I began walking with a cane to alleviate my back pain and help with my balance. It was devastating and my bitterness came across on FB and toward my friends and family. And especially when someone tried to give advice about my pain meds and what I should do.

Thoughts of suicide were entertained – not one of my finest moments. However, by the end of that year, I realized I didn’t like myself. I vowed in 2014 I would change my attitude about my present condition and begin accepting my “new normal.”

3-PATIENCE!

First, you know your episode of pain will eventually ease off with your pain meds. It takes my pain medicine up to 90 minutes to kick in if I’ve gone past the next recommended dosage. However, I stay on top of my pain if my medicine is taken as prescribed. Don’t be a hero! Because you are feeling better and believe you can work longer, your pain will sneak up on you. Don’t wait until it is full blown to rest and take your next dosage. It takes longer for your medicine to take effect and you’ll be miserable.

4-KINDNESS – to yourself and others

Don’t beat yourself up if you have to take a day of rest. The chores will be there tomorrow. Your body comes first and as normal humans, we feel selfish about taking rest periods throughout the day, or even taking a whole day to relax to rest our bodies. Being a “get it done” person, I throw thoughts of unpacked boxes and rooms in disarray out of my mind. I relax and stop worrying. There is no time limit on getting the house in order.

For your family and friends who experience chronic pain, surprise them with their favorite cookies, a small potted plant, or a bunch of flowers on their “low” days. All it takes is a visit to let them know you are thinking of them. When in my lowest mental state due to chronic pain and a friend stops by to visit or phones, it brings me up and helps me forget my pain for a while.

5-Live in the PRESENT

Fully enjoy the moments when your pain is under control or tolerable…while at work, home, or with others. Every second counts when you have these moments so live life to the fullest! Oh, but don’t “over-do!”

You can read Helen White’s full article by highlighting the article title above. She goes into a little more detail for each plan of action and I’m sure you’ll enjoy her writing. She writes “down to earth” and I love a writer who doesn’t infiltrate their articles with words I don’t understand!

Thank you for your patience with this blog post. Over the last few weeks I’ve had a respiratory infection and then to make things just hunky-dory, developed walking pneumonia last week (March 31st to be exact!) Our little house is coming together, but the small extra “bedroom/office” has become the holding station for any unopened box. Ms. White’s article put me to the test because I must rest to get better. Of course, every time I get up I’m back in the recliner because I’m out of breath. The extra room will get done, maybe not as quickly as I hoped, but it will!

Have a wonderful week and please contact me with ideas, suggestions, and questions on future blogs. I’d love to write what you are interested in about chronic pain.

Carolyn

 

 

 

 

 

 

 

 

Posted in Chronic lower back pain

Decision Reached – Spinal Cord Stimulator

I’m back! And I made a major decision two weeks ago with my pain management doctor. I told him I wanted the Spinal Cord Stimulator removed from my back. He looked at me intently and asked, “Why?”

Then I went through my list of prepared reasons:
1- it doesn’t work
2- my pain has increased and the SCS isn’t even touching the pain
3- the battery bothers me
4- little strikes of pain are felt along my spine

He smiled and said, “Okay.” The reason for his question, he explained, was most patients begin to give reasons for wanting the Stimulator removed and realize they don’t have a valid reason. The SCS helps them at some percentage (the best results say 50% pain is removed) and they decide to leave it in.

However, with me it’s a different story. The trial for the SCS went great. One lead was inserted in my right side and left in my back for 5 days. I had no pain on my right side. But my left side hurt continuously.

When the right lead was removed, all my pain returned and I knew this was the product for me! Finally, quality of life would return and I would dance again.

Unfortunately, after the implantation of three leads and the battery pack, and numerous reprogramming… my pain has been with me every day since the surgery. In fact, it has increased. I didn’t enjoy the relief I received from the trial. Why? Nobody knows. But it would have saved a heck of a lot of money and discomfort if that darn trial hadn’t work.

I’m not saying it doesn’t work for everybody. Just me. It works for my husband. His SCS gives him about 30% decrease in his back pain with medication. (Yes, even with the SCS most patients take medication to manage their pain.)

I’ve read countless reports of how the SCS “gave me my life back” and I did my research prior to the trial. I didn’t go into this without thorough information. Yet, it didn’t work.

How do you know if the SCS will work for you? First, I would suggest you have the same doctor perform the trial and the actual implant. (It took half a dozen doctors before I found one who agreed to do the surgery due to the instrumentation in my back.) If you have the same doctor do both procedures, and I believe in most cases that is the correct approach, then you’re ahead of the game I played.

Secondly, research, research, research! Talk to other patients who have had the SCS implanted. Try to find people with similar back problems, and ask them a ton of questions.

And lastly, depending upon the Spinal Cord Stimulator Company your doctor uses, go to their website and read the reviews, find out what to expect, and ask questions on their site. Most companies have a patient forum but if you can’t find one, Google – Spinal Cord Stimulator Patient Forums.  These are the ones I found:

http://www.spine-health.com/forum/categories/spinal-cord-stimulation

http://www.mdjunction.com/forums/spinal-cord-stimulator-discussions/general-support

forums.webmd.com/3/pain-management-exchange/forum/2961

http://www.healingwell.com/community/default.aspx?f=16&m=2687933   —  this one came up when I clicked on Boston Scientific Spinal Cord Stimulator/Right Leg
And there are many more forums listed…
As with any medication you are prescribed, you look it up, check out the side effects, and read the reviews before taking the medicine. With the proposal of a Spinal Cord Stimulator, treat it as you would a new medication.
RESEARCH IT!
I’m having the battery pack removed, not the leads because they have adhered to my spine. But when I talk to the surgeon and have the surgery, I’ll let you know how it went. Until then….
Here’s hoping you feel better today than yesterday and even better tomorrow!
God bless,
Carolyn