Pain meds
Pain meds
Childbirth has caused pain that's never disappeared. Foreign body feeling and aching rectum and a prolapse op to hopefully ease pain has now caused back pain due to Central Sensitisation. That's the opinion of surgeon and pain Dr. I've been on pregablin for 3 years now and have reduced it from 600mg as I didn't feel it was helping and so I'm on 300mg now and 40mg impriamine. I've tried Cymbalta but that was no help. I feel there's nothing left for me to try. A lidocaine infusion did sod all too. Acupuncture did nothing as did CBT. I'm 37 with 2 young boys and I am determined that this will not destroy everything for me. Any suggestions very welcome
Re: Pain meds
Hi Esthome,
That sounds difficult. Have these doctors suggested any other procedures or other medications? About a year ago, I was using only ice to deal with my pain and it was tremendously difficult to manage, so I finally started experimenting with different medications and found a group of them that work pretty well together. Now I have to ice in only about 1/3 of the time (instead of all the time). So, you could try experimenting with a few more medications to see if that helps. I'm on gralise (which is extended release gabapentin), tramadol, nortriptyline, and tolterodine (along with a laxative and stool softeners). It's not an ideal long term solution, but I am grateful that I can function more normally. Have you seen a pn surgeon (e.g., Hibner)?
April
That sounds difficult. Have these doctors suggested any other procedures or other medications? About a year ago, I was using only ice to deal with my pain and it was tremendously difficult to manage, so I finally started experimenting with different medications and found a group of them that work pretty well together. Now I have to ice in only about 1/3 of the time (instead of all the time). So, you could try experimenting with a few more medications to see if that helps. I'm on gralise (which is extended release gabapentin), tramadol, nortriptyline, and tolterodine (along with a laxative and stool softeners). It's not an ideal long term solution, but I am grateful that I can function more normally. Have you seen a pn surgeon (e.g., Hibner)?
April
Re: Pain meds
Thanks for replying April. I've not seen anyone else but the consultant I saw who did prolapse op but he has been to Nantes and trained to do decompression surgery. He thinks I have Pudendal nerve irritation rather than entrapment as I don't have relief on toilet seat and my rectal pain is actually worse when I stand. I don't know why my back hurts now, and worsened again after a laraposcopy. I can't sit now as back pain comes on. I think a play on meds is the best option. I need something. Do you overcome the constipating factor with your laxative regime? Many thanks
Re: Pain meds
The stool softener and laxative do overcome the constipation. I take DocQlace docusate sodium stool softener three times a day and the Senna-S laxative once a day. Both were prescribed by my pain doctor but are over-the-counter. I get the DocQlace through my mail order pharmacy, because it is much less expensive through them than at a local drugstore, and I get the Senna-S at Walgreens. And if those two medications aren't enough, you can increase the stool softener and probably could increase the laxative as well (e.g., add a half pill). My pain doctor did reassure me that these two over-the-counter medications are safe, but if you wanted to try a non-medical route, I think others on the forum have had good luck softening their stools by taking magnesium. You could do a search for that word.
I also don't have the dramatic reduction in pain when I sit on a toilet that others have. For me, sitting is not that different from other upright positions, so sitting on a toilet doesn't change my pain much. For me, the big difference is lying down or reclining vs. all the upright positions. So I'm not sure those Nantes criteria are a perfect indicator (I also used to wake up with bladder urgency (before taking medication for it), and I still wake up with burning pain sometimes, so I don't fit that criterion either). But, as with you, I'm trying medications and other steps before I think about surgery. I do only take one 50 mg pill of tramadol a day, so it does wear off by afternoon, but that is by design. I didn't want to be on it all the time.
April
I also don't have the dramatic reduction in pain when I sit on a toilet that others have. For me, sitting is not that different from other upright positions, so sitting on a toilet doesn't change my pain much. For me, the big difference is lying down or reclining vs. all the upright positions. So I'm not sure those Nantes criteria are a perfect indicator (I also used to wake up with bladder urgency (before taking medication for it), and I still wake up with burning pain sometimes, so I don't fit that criterion either). But, as with you, I'm trying medications and other steps before I think about surgery. I do only take one 50 mg pill of tramadol a day, so it does wear off by afternoon, but that is by design. I didn't want to be on it all the time.
April
Re: Pain meds
I didn't fit the relief of pain on a toilet seat criteria or the not waking up at night criteria either.
Violet
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Pain meds
I had to go on morphine. I would not have been able to survive. If I absolutely have to go to a function I have to suffer and not take the last dose of the day for several nights and save the medication for when I have to take triple or more to sit through a function. Even though there are a lot of attacks on pain medication it still is necessary in cases of prolonged pain.
Re: Pain meds
For those of us who truly need opiates TO LIVE our government is doing a terrible disservice to us. In addition to the unrelenting Pain, the grief over losing my husband of 53 years, I also suffer from severe pain fatigue. Today for instance has been a stay in bed day with ice! Trying to get the courage to do a trial of the new drg stimulator. So afraid I could be worse but my life has been ruled by this condition for 24 years now. Doctors do not get it...I did not get it before a hysterectomy in 1994 cause a severe prolapse. Four reconstructive surgeries over the years has done nothing for me.
Currently my pain center will prescribe subutex and marijuana. The mmj does nothing for me and that may be because the subutex blocks its effect. So it has become a few good days followed by bad days for me. Need to get food...could not do it today. Just too tired. This is a road that is not traveled much...if it were...there would be better solutions by now.
I also take Effexor XR...I swear that is poison...just Miss one day and it is all over!
Currently my pain center will prescribe subutex and marijuana. The mmj does nothing for me and that may be because the subutex blocks its effect. So it has become a few good days followed by bad days for me. Need to get food...could not do it today. Just too tired. This is a road that is not traveled much...if it were...there would be better solutions by now.
I also take Effexor XR...I swear that is poison...just Miss one day and it is all over!
Re: Pain meds
Grammy,
I'm so sorry. That does sound really difficult. When do you start the stimulator trial? I think that is fairly low risk. While you are waiting for that, you could try alternating between ice and sitz baths. One of my drugs started to become ineffective this spring, so I was having to ice all the time and that was damaging my tissue. So, I started to use Violet's suggestion of alternating between ice and a stiz bath and it really does work. I had no pain in the hot sitz bath, and that time in the water helped my tissue to heal somewhat. Since then I was prescribed something new that works better, but that process helped me get through the last month or two.
April
I'm so sorry. That does sound really difficult. When do you start the stimulator trial? I think that is fairly low risk. While you are waiting for that, you could try alternating between ice and sitz baths. One of my drugs started to become ineffective this spring, so I was having to ice all the time and that was damaging my tissue. So, I started to use Violet's suggestion of alternating between ice and a stiz bath and it really does work. I had no pain in the hot sitz bath, and that time in the water helped my tissue to heal somewhat. Since then I was prescribed something new that works better, but that process helped me get through the last month or two.
April