Withdrawal or gastrointestinal?

Discuss different Pain Management Options; Medication options including side effects and Worldwide variances in names etc.
Lernica
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Joined: Fri Jan 14, 2011 10:31 pm

Withdrawal or gastrointestinal?

Post by Lernica »

Hello friends,

I've just had the worst three days of my life with horrible gastrointestinal symptoms. Nausea (but no vomiting), diarrhea, horrible pounding headache, cold sweats, shakiness, feeling of doom, etc. It started with a huge painful diarrhea on Thursday evening. I thought I would pass out from the pain.

The last two days have not been much better. The symptoms have been so severe that I began to doubt that this was strictly a gastrointestinal thing. I honestly wanted someone to put me out of my misery on several occasions. So I was wondering -- do you think it could a tolerance/dependance/withdrawal thing? I have been taking Targin twice a day (10% mg. oxycodone plus 5% mg. naloxene to help with constipation) for the last six weeks. One in the morning and one at night. Great for pain. Three weeks ago my pain doc wanted me to increase it to three times a day, but my pain levels didn't seem to me to warrant the increase then. But now I'm wondering whether he advised me to do so to avoid what I'm going through right now. My symptoms are so uncomfortable and severe that I feel like a heroin addict going cold turkey.

To be clear, I have not stopped taking the oxycodone, I am still taking 20 mg. daily but I'm wondering whether my body is craving more. Cora I believe had a similar experience with muscle pains. Today in desperation I did take an afternoon dose of the Targin and after a few hours I am now feeling much better. But I also took two regular Gravol at the same time so that could also be an explanation for why my symptoms have abated for awhile.

What do you all think? This is the first time in three days that I've felt well enough to go on the computer.

Warm regards,

Lernica
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
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Karyn
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Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: Withdrawal or gastrointestinal?

Post by Karyn »

Gosh, Lernica - that sounds horrible! I wish I knew if it was withdrawal or not. I'm leaning towards "no" because you've still got the medication in your system. I just don't know. If you're still feeling poorly tomorrow, please contact your doctor!
I hope you feel better soon!
Love,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Cora
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Re: Withdrawal or gastrointestinal?

Post by Cora »

Lernica, I just saw this so sorry for the delay. I've been off site for a while and I'll post later as to why. Some of those symptoms seem rather general and hard to say that they are related to tolerance or w/d , but there are ways to tease out that information. First of all, does it happen at a time where one dose might be most used up already, like at the tail end of the expected time of duration ? Also, are the symptoms starting out a little slowly and the build. For example- mine always happened during the night and by morning I was sweating and in bone pain. And then it was clear to me- the pain went away when I took the dose. The other time of day it happened was late at night before my bedtime does I would get symptoms and they would go away a bit when I took a vicodin. WHen you develop tolerance that is likely what you see- the interdose symptoms of withdrawal.
Cora
Onset PN/PFD/centralized pain in Oct 06 after years of athletics,nursing career and dog training. PT for two years with improvement, now go for tune-ups and pain management. Stopped Cymbalta, was on M.S. Contin, then Kadian, and briefly Methadone for pain management, now off those meds and pain is well managed with Buprenorphine. Followed my pain management specialist.
donstore
Posts: 463
Joined: Mon Nov 08, 2010 6:13 am
Location: San Francisco

Re: Withdrawal or gastrointestinal?

Post by donstore »

Lernica,
When I go 24 hours without an opiate, I get a runny nose and watery eyes. This would progress eventually into insomnia and an overall aching feeling eventually. The kind of violent illness with diarrhea that you describe sounds more like the flu and not withdrawal. You would have to stop taking the opiates altogether to progress to the kind of illness you describe. Even interdose withdrawal from increased tolerance would be much more subtle. I'm not a doctor but it sounds to me like you have a bad bug. Hope you feel better soon.

Don
Mild to moderate PN for 5 plus years, pain controlled by lyrica and opiates.
Nerve block (unguided) 9/10 Dr. Jerome Weiss - sciatica for 5 months but got numb in painful perineal/scrotal area - he diagnosed entrapment - but no more cortisone for me
Potter MRI 5/11 - rt STL entrapment of PN at Alcocks
Consult with Dr. Hibner Feb. 2012
Bilateral inguinal hernias diagnosed by dynamic ultrasound - surgery on 6/20/13
Feeling a little better, a few more months will tell
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helenlegs 11
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Location: North East England

Re: Withdrawal or gastrointestinal?

Post by helenlegs 11 »

Hope you are feeling better Lernica. Have you found out what the cause is? I guess it could be a combination of with drawl and stomach complaint as your symptoms sound too severe to be with drawl. Keep hydrated.
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
Lernica
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Joined: Fri Jan 14, 2011 10:31 pm

Re: Withdrawal or gastrointestinal?

Post by Lernica »

donstore wrote: Even interdose withdrawal from increased tolerance would be much more subtle. I'm not a doctor but it sounds to me like you have a bad bug.

Don
I think you're right. I'm feeling much better, though still a bit nauseous from time to time. But the whole ordeal was so horrendous -- the shaking, the sweating, etc. -- and nothing like what I had experienced before. Plus I had some weird depressive symptoms -- like I was losing touch with reality. I was so sick I couldn't answer simple questions my family was asking (like -- "Would you like some ginger ale"?) My daughter said later I was like "the walking dead". So since my mind was playing games with me as well as my stomach, I thought it might be the opiates.

I've been taking 20 mg. oxycodone for the past six weeks. I have quite liked the effect they've had on my pain, but my recent experience was so bad -- so much like a bad trip -- that I've decided to cut down on them. Happily I've found it surprisingly easy and I'm now taking only 10 mg. (one daily dose). The oxycodone gave me a very nice "pain holiday" for my summer vacation and I was able to be much more active with it. Which made my body stronger, which in turn has eased my various aches and pains to more tolerable levels.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
Lernica
Posts: 960
Joined: Fri Jan 14, 2011 10:31 pm

Re: Withdrawal or gastrointestinal?

Post by Lernica »

Hello friends

Three weeks of GI issues and no change. Every day I have bouts of diarrhea and an upset tummy. The diarhhea is flaring up my rectum pain big time. I'm losing weight from cutting out food like dairy, of which I usually consume alot.

I am not taking any new drugs and have been taking the same dose of oxycodone (10 mg. once daily) for the last two weeks. While this dose is good for managing my pain, I believe that my body is telling me that it wants MORE. I don't like this one bit. Where will it end?

I see my pain doc on September 21. I think I'll be asking him to take me off the oxycodone although it's been great for pain relief. Having a chronic upset tummy is no fun.

I would welcome any thoughts. Thanks.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
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helenlegs 11
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Joined: Fri Sep 17, 2010 9:39 am
Location: North East England

Re: Withdrawal or gastrointestinal?

Post by helenlegs 11 »

Goodness Lernica that's awful, so sorry you have these problems on top of everything else. Sorry I have nothing that can help,nothing you have described sound familiar to me. . . . what does your normal doctor say?
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
Lernica
Posts: 960
Joined: Fri Jan 14, 2011 10:31 pm

Re: Withdrawal or gastrointestinal?

Post by Lernica »

Helen, I have not bothered visiting my family doc since she knows nothing about opiates. I'm waiting to talk to my pain doc.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
Gusselsprouts
Posts: 20
Joined: Sun Nov 28, 2010 12:50 am

Re: Withdrawal or gastrointestinal?

Post by Gusselsprouts »

Hi Lernica,

This really may have nothing to do at all with the opiates. It just doesn't seem to fit for that. It may be that you need to have some stool cultures done to see if there is an infectious cause to your nausea and diarrhea. It really might be worth seeing your family doc and not waiting to see your pain doc, especially since you are losing weight. Had you been on an antibiotic at any time over the past 6 months or so? I could ask you so many questions, but best to leave that to your family doc who will also do a thorough exam and also check your stool for blood (even if you haven't seen any).

Just my thoughts on the whole matter as I'd certainly like to see you feeling better after all this time!

Warm wishes,

Lois
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