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12-21-2014, 07:57 PM   #1
Smokeyjameson
 
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Can't get pain management

I'm just needing to vent. Active Crohn's since 91, resectioning in 2001, was in remission until recently. I'm in so much pain and all I keep hearing is "I don't want to put you on narcotics". Allergic to remicade and humira, basically nothing works. I've had dr put me on suboxone (which I read is just as addictive as opiates) however the cost of the sub is outrageous.. What like 8$ a pill now. Opiates 15$. Why does the dr fight with me about opiates during flair? Right now I could give a shit about getting addicted I just need some relief. I'm a single mom and can't just check out. Should I get a new dr? I so angry because I feel like lecture me about addiction once my flair is in remission. Any advice for teasonably priced pain management?
Thanks
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Crohn's diagnosis 1991
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12-22-2014, 10:14 AM   #2
Clash
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Maybe you could have the doc refer you to a pain management clinic. There are some IBD'ers that are refractory and while trying to find the treatment that will help with remission they get referrals to pain management clinics. Also, you might approach your GP instead of your GI and see what options he can give.

Sorry, I don't have a lot of experience with pain meds but hopefully others may be along.
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C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
12-25-2014, 11:29 AM   #3
UnXmas
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I understand why doctors are reluctant to prescribe opioids for chronic pain for patients who are not in hospital. I've been addicted to codeine for years - I think it's one of the mildest opioids, but I get very ill if I don't take it now, and see classic addict characteristics in my thoughts and behaviour, even though I've never taken an illegal drug in my life, don't drink alcohol and have never even smoked a cigarette. Your body will become addicted to them no matter how much will power you have and even if you take them only for pain relief and not because of the effects they have on your mood. You will become tolerant - every time you take them you will need higher and higher doses to achieve the same amount of pain relief.

People typically develop some tolerance to codeine after three consecutive days of use. Taking breaks may lower tolerance again, but unless you plan to use them only for short periods (a day or two at a time) followed by weeks or months without, it will be a problem, and for some people even after months without they will still be significantly less effective.

I also had a few days of oxycodone when I was in hospital recovering from surgery. It's a much stronger painkiller than codeine. The withdrawal was so bad I wished they'd just let me go through the pain in the first place (and I have had major surgeries with no pain relief before, so I do know what that's like too!).

That's not to say I disagree with the use of opioids in any chronic situation; I have come off codeine completely a few times, and feel that I'm better off on it, even with its downsides. It's also true that they have different effects on different people, both in terms of their benefits and problems. But my situation isn't typical, and I think it's right that doctors avoid prescribing them until they have tried every other option - including seeing if the patient can cope with living with their pain. What I don't understand in your case is why your doctor would give you something that's equally addictive: can you ask your doctor about the reasons behind that decision? The only reason I can think of is that opioids affect the digestive system and can be dangerous in certain circumstances, including some cases of Crohn's.

I would make sure your doctor knows all the details of your situation, exactly how bad the pain is, the type of pain (if possible, also test results that show the cause of the pain) and all the things you've tried so far, so you know he's not refusing you purely on principle. If you feel that is the case, consider a new doctor, but keep in mind that though you don't care about addiction now, you may do later, especially if you end up addicted but still in pain because you've developed tolerance to the pain relief effects.

As for other forms of pain relief, that really depends on the cause and nature of the pain. Are you on any other medications? What type of pain do you have?

Last edited by UnXmas; 12-25-2014 at 11:55 AM.
12-25-2014, 11:50 AM   #4
UnXmas
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I'm really sorry as I realised my post is a lecture on addiction, basically exactly what you said you didn't want. Perhaps it's a slightly different lecture than what you've heard before as it's not coming from a doctor. But feel free to ignore me, and if you want to answer my question about the type of pain you have, I'll try to give you a more helpful answer.

I also just did a quick google of suboxone though, and it seems it is an opioid, so I'm really not sure of your doctor's reasoning, assuming it's the same doctor who prescribed it but refused other opiods. But if you've been having suboxone, you've been having an opioid. (The definition of "opiate" isn't quite the same as "opioid", but in terms of their effects there's not much difference.) Is there a particular medication you've asked for that your doctor has refused?

Last edited by UnXmas; 12-25-2014 at 12:12 PM.
12-27-2014, 09:20 AM   #5
my little penguin
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Have you looked into Sterlera or envizo
They work differently than Humira/remicade.

Both are relatively new

Second pain management doctors
They can do things that normal Gi can't.
Nerve block etc.....
Tens unit
Other types of meds /pain pumps
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02-15-2015, 06:37 AM   #6
sweetansassy
 
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I feel your pain believe me it is something I constantly deal with. Some doctors will try an help and some wont. Obvious reasons because narcotics can become addictive, and they also can affect your bowels even worse by slowing them down and reducing your ability to function them on your own. Not all doctors are being butt heads when they choose not to prescribe pains medications some do it for the better benefit of your condition, but it doesn't make it any less frustrating. You live in constant fear of what your going to feel like day by day and the pain of having a flare. Closely watching your diet and physical activity limitations can reduce pain also, and drinking plenty of water. My doctor suggested Tylenol an Motrin as tolerated, but usually for me that is like taking baby aspirin. Every GI doctor is different, I am currently in the process of seeing a new one. I am a mother of two myself and it is frustrating adjusting to this huge lifestyle change when I am used to being so independent an always on the move. The only time I usually get pain medication is when being discharged from hospital due to a flare, but who wants to stay in the hospital all the time you would swear I live there. Sometimes if my flare is not too bad I can make it in to my regular physician which I keep closely informed and involved with my condition and what I am going through. I suggest you try relating to your regular physician also sometimes they can be a big help outside of your GI doctor by prescribing pain meds that may help between times she your hearing an not hurting. I try to only use them when I really feel it is intolerable or about to become intolerable if I don't get it nipped in the butt. Plus they could most likely get you referred to a pain clinic if necessary. Remember though if your case is anything like mine sometimes the medication they do give you for pain even opiods only take the edge off they are not a miracle. I highly suggest.staying away from morphine though. I hope this post helped you at least a little in some way mostly I just wanted to show some support because I know how frustrating your situation can be.
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