Cyborg Ninja

I take about 20 pills a day for chronic pain, hyperthyroidism, Crohn's disease and depression. I don't know if I'm even depressed. I don't think I am. But anyway, that's not what this topic is about. One of the meds I take is tramadol, which is a non-narcotic painkiller that has SNRI properties. It is TERRIBLE to miss a dose of it, worse than missing a dose of an antidepressant because I think tramadol has a shorter half-life. Anyway, I set up an appointment to see my primary care physician (PCP) on Tuesday. Turns out she has to cancel it for an emergency so I ended up seeing her on Friday. I called in a couple times that week to ask for my tramadol to be called in to my pharmacy. She never does. By the time I go in on Friday, I'm already going through withdrawal even with a rapid taper. The nurse tells me she told the doctor but didn't give any specifics as to why the doctor didn't call it in, except that I was already going to see her on Friday. This is NOT ok. Withdrawal makes me massively depressed, nauseous, causes me to vomit and shake, I can't sleep, my heart races. One of the worst feelings in the world. She finally did prescribe the tramadol for me -- no problem and no questions asked. But why did I have to go through all of that?

I hate knowing that I will have to depend on these doctors for the rest of my life. Other patients have gone through worse, especially with pain management practitioners. Some will force you to see them every month to get a refill, others don't call in scripts or their office is lazy on referrals and faxing records, etc. This is all fairly minor to some of the other things I've gone through, but knowing how ill I can get just because a doctor is too lazy to call something in or refuses to really worries me. The best I can do is conserve medication but sometimes even that is tricky. It's common belief among doctors that if a patient takes less of their painkillers than prescribed, then they are a drug addict. Their logic is that a patient will conserve the med in order to sustain a high when they want it, because taking it continually keeps you from getting high. Man, it's nuts. It really is. So many patients suffer because of a few bastards, but I don't blame them for all of this. I blame the DEA for frightening physicians who hand out opioids for legitimate reasons, and the physicians in turn for cowering in a corner and treating all their patients like potential criminals. While it is logical to be cautious, as a doctor you need to put the patient's needs above your own. Otherwise, you never should have gone in the field.

Sorry for the long rant. It was on my mind.

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Merlocke

perhaps being too dependent on western medicine could be a bad thing as well. Although it's fantastic for emergency prodcedures (ie: losing an arm) or for more advanced pain killers to increase quality of life, it's missing the other half - eastern medicines which actually build your systems and strengthen them with time. As for specifics, I'm not a doctor, nor a naturapath, so I've got no recommendations. It's just a suggestion in a different direction to look in. Just make sure you talk with a proper herbalist and a good doctor to make sure whatever you're mixing doesn't blow up on you

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Hyacinthe

Few suggestions

First and main one is talk to your Doctor about changing your medication - the extremity of your withdrawal is REALLY worrying me as someone who works in the health profession. Addiction to opiates is extremely dangerous and only becomes more so when you inidcated that you're going to be on the medication for an extended period (lifelong)

Secondly - start making appointments when you have a week or a week and 1/2 pain medication left. This is something I learnt when I hurt myself quite badly at work, this way if something stuffs up and you need to wait a few days for an appointment you usually have a few days spare meds.

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"Her emotions were clear waters. You could see the scarring and pockmarks at the bottom of the pool, but it was just a part of her landscape – the consequences of others’ actions in which she claimed no part."

Cyborg Ninja

I believe in allopathy, not in alternative medicine. There is nothing out there that's legal that I could take for the type of pain I have.

Calling tramadol an opiate is pushing it, though it technically is, it has more in common with SNRIs. The withdrawal was the same as an antidepressant because of the effects on serotonin reuptake, except worse because of the shorter halflife. It's considered to have little chance of addiction. It sounds like you're comparing addiction to dependence anyway. If I need to take medication for chronic pain for the rest of my life, I don't see the point in being so worried about addiction. I'd worry more about those people who receive opioids for minor, shortterm problems. They tend to the be ones who abuse painkillers, though the pain management field ignores it. It's the ones who they have to see every month that are forced to suffer.

I did make the appointment early, as soon as I got back in town, but she had an emergency and couldn't see me. Something is always going to come where I'll be in trouble. And then if I see another doctor, who knows, they might claim I'm fishing around to get a script twice.

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Hyacinthe

Calling Tramadol / Ultram an opiate is not pushing it as it reacts with the opiate receptors in the exact same way as do heroin and morphine.

Opiate withdrawal symptoms include anxiety, sweating, nausea, diarrhea, tremors, chills, hallucinations, trouble sleeping, depression or breathing problems.

You exhibited a large amount of these symptoms, the extremity of the withdrawal you're suffering because you had to go 2 maybe 3 days without the medication is not a good sign (you said your appointment was for tuesday and you couldn't get in until friday).

There are numerous medications which are legal that are the same strength if not higher then Tramadol / Ultram.

The fact that you suffer from depression and one of the main side effects from opiate withdrawal that was included on your list is an increase in that means that even if you're not addicted this was not a great choice of medication for your conditions.

sounds like severe trauma to me.

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"I want to be remembered as the girl who always smiles even when her heart is broken... and the one that could brighten up your day even if she couldnt brighten her own"

"Her emotions were clear waters. You could see the scarring and pockmarks at the bottom of the pool, but it was just a part of her landscape – the consequences of others’ actions in which she claimed no part."

Cyborg Ninja

You're twisting facts. I'll start from the bottom up. It has nothing to do with trauma, and you're clearly sensationalizing this here to fit your idea (though you don't go right out and say "Opioids are evil!") And no, it's an opioid, not an opiate. Withdrawal occurs for mainly the same reasons between opioids and antidepressants. Dependence is not addiction. There are not medications available without a prescription that are as effective as tramadol (you misread what I meant as including prescriptions). Obviously I need to be on a medication for chronic pain, so I don't know what your solution is. Tylenol? Stop fooling yourself.

Edit:
If I seem defensive, it's because I find it highly offensive when someone purports what I need for pain management, with no real suggestions, just vaguely saying that I don't need so-and-so. It appears to be a weak criticism of people who need medication for chronic pain, and the popular mentality that all narcotics are evil and have no purpose.

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Hyacinthe

Cyborg Ninja I work in palliative care, for those of you that don't know that's is the last 6 weeks before someone dies, before this I worked in terminal illness wards with cancer patients. I probably know as much about chronic pain as is possible without experiencing it as I see it almost every day of my life. I help people that are in so much pain from bowel cancer that even sitting up is an effort bathe and dress because their family / friends are coming by and they don't want to meet them in their pyjamas / gown. I help young girls get their wigs just right because they hate the fact that the chemotherapy has made all their hair fall out and I try to help them without touching because I know even the lightest touch will leave a bruise that's going to be staring me in the face tomorrow. That's my job, it's what I do and I can't imagine living any other way, believe me when I say I know about chronic pain.

If I wanted to sensationalise a drugs I would pick something more dangerous then tramadol. I didn't think I sensationalised it at all, drugs to me aren't very sensational.

Narcotics aren't evil they're wonderful things, this doesn't mean that your doctor might have selected the wrong one for your situation. I'm not saying you're mis-using it either, I believe you're doing exactly what your Dr told you to do taking it the regulated amount at the correct times. I have seen Drs over-prescribe, under-prescribe, prescribe completely the wrong drug before and will again, not because they've done something wrong but because everybody reacts differently to different medications.

Infact I never once even said you were addicted, I said you exhibit symptoms of physical withdrawal which can lead to addiction. I will admit I implied it in the last post and did everything but state it and I shouldn't have done that, it was immature and petty.

You're right there is no over the counter medication as strong as tramadol. I didn't say there was. What I said was talking to your Dr about different medications would be a good idea as I don't know the drugs available in your area. America, England and Australia have vastly different drug markets. So I didn't see the point giving you a list of the brand names I know and work with which you could state and get a blank look from your Dr who probably wouldn't recognise them.

This is going to be my last post in this thread because I can't see the point anymore. You don't want to listen and I have better things to do with my time then convince you.

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"I want to be remembered as the girl who always smiles even when her heart is broken... and the one that could brighten up your day even if she couldnt brighten her own"

"Her emotions were clear waters. You could see the scarring and pockmarks at the bottom of the pool, but it was just a part of her landscape – the consequences of others’ actions in which she claimed no part."

Ratman

I am also a sufferer of chronic pain. I have a condition that drives many to suicide by the time they are my age (43). I take a number of medications and constantly adjust things in my life to work with how I feel on any given day. I live in a country where many of the meds I prefer are not available, and must be purchased online.

You ask how can you keep living like this? Because it beats the hell out of the alternative! If this is your challenge in this life, please, rise to it. Do whatever it takes to live with what you have. I look at each day as a challenge to find a solution to whatever the pain-du-jour is, or the b.s.-du-jour whether it be work, society, the medical community, whatever, rather than a reason to withdraw. I'm not saying anything about what you have or what you take for it. I understand the hell of it, and the hoops to jump, and the bullshit involved sometimes with Dr.'s, insurance, pharmacies, and the rest when all you want is a day of peace. Whatever you do to find relief, just don't give up. Solutions are all around you, just keep driving till you find them.

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analog

"Addcited" is a dirty word to many people. It doesn't mean you're a junkie, and it doesn't mean you don't need what you're addicted to. Lots of people with chronic pain are addicted to painkillers... that has nothing to do with the perfect legitimacy of their need for them. You don't take them away, you just make sure their pain is managed effectively.

Addiction is simply a medical term which means your body needs a continual supply of something or else it has extreme withdrawal symptoms. No one is calling you a junkie if they call something an addiction, or say you're experiencing addiction-like reactions. it's just a medical term to define the severity of your condition's need and drive for pain management.

Having said that, I'll go ahead and say it straight out: you indicate, through explanation of your withdrawal symptoms, an addiction to the drug.

You're not a junkie, you're not a doper, and you're not any of the other negative connotations you think of when you see the word "addiction". Most reasonable medical professionals would see your description of the withdrawal symptoms as a traumatic physiological dependence to the drug. Again, being addicted to something doesn't mean you don't actually need it, nor does it mean everyone thinks you're just looking to get high. It's just a word.

Technically, breathing would fall under the definition of an addiction. Don't get hung up on your negative perceptions of words, just focus on your pain management.

Additional: The other reason that not taking the medicine regularly, and "saving some to take more when needed" is frowned on is because- especially in the case of reuptake inhibitors- the general issue is that it's harder to kill off intense pain once it's there... so it's usually more efficient stay on a more steady level of medication so that the pain doesn't have a chance to increase to a severe level to begin with. Because of the way reuptake inhibitors work, it's generally much more efficient and effective if taken as directed, rather than as needed.

DaveOrion

Unless you suffer from chronic pain, as I do, you cant understand what people go through. No matter how closely you're involved in the clinical process, you're still not a chronic pain patient. Its been my experience that many professionals involved with chronic pain patients become insensitive towards the patients needs. While many care, many others are apathetic and just go through the motions or are down right rude & completely uncaring. You cant see pain and it doesnt show up on an X-ray, so many patients are labeled drug seekers. Unfortunately opiates are often the only means of relief for millions of chronic pain sufferers. I say unfortunately because of the cost, the side effects, and the addiction potential, not to mention the stigma associated with it.

Anyhoo, I understand exactly how you feel Cyborg. And while tramadol may be classified as an analgesic it still works on the opiate receptors in your brain, and is addictive. I lost my insurance a few years ago, so I get my tramodol & somas online. No script needed, just a short questionnaire, over night delivery available. PM me if you'd like and I'll recommend the cheapest and most reliable OP's, if your doc cant get it together.

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