Pain Management

[MattaisX]

Hello, this is my first post on this forum, was turned to it from my GI doctor at St. Peter's in NJ. While she didn't really have much to say as she's just now been given my case after 3 years with no medical insurance, she said I may be able to get some ideas of ways normal people with Crohn's manage their pain.

I'm currently taking:

Ativan 1mg 3x daily (Anxiety issues non-pain related)
Percocet as needed
Gabapentin 600mg 3x a day for multiple issues
and Prednisonal steroids.

Just started back on pentasa again, but they're going to have to switch me to Sulfa-somethinrather since Pentasa is about 840$ a month.


Really just wanted to get some information on how everyone here manages the pain as while we all know the wonders of percocet it also has it's drawbacks. I had a problem with opiates a few years ago, so that fear of getting addicted is always in the back of my mind again.

While I do feel I'm doing pretty well with it, I do have to take 2x 5-325mg to feel any sort of relief.

Also I'm sure the stress of moving isn't helping, but it's just been a terrible experience lately.

Any sort of advice would be much appreciated, whether it be holistic, over the counter, or prescription.

 

[Warrior Girl]

Hi , MattiasX! Welcome to the forum. I'm new here, too. I'm sure you'll find lots of support and knowledge here.
I see a pain management specialist and was in Percocet(10 mg) up to 3 times a day. Just a few months ago, they switched me to fentanyl patches (50 mg). I do find the edge is taken off but, it does nothing for those acute pain moments.
It may take some trial before you're able to come up with a good solution. I've also found that just simply meditating eases my anxiety.
I don't expect to ever be 100% pain free but, it is nice to be able to participate in life here and there!

 

[Angrybird]

Hello and welcome to the forum.

Just to confirm where do you get the pain specifically and it is a sharp stabbing pain or more like an ache? Is your tum actually settled or is there active disease going on? Have you tried anything like heat pads or tummy massages? Have you tried changing what you eat to see if this helps ease things?

AB
xx

 

[MattaisX]

Hello and welcome to the forum.

Just to confirm where do you get the pain specifically and it is a sharp stabbing pain or more like an ache? Is your tum actually settled or is there active disease going on? Have you tried anything like heat pads or tummy massages? Have you tried changing what you eat to see if this helps ease things?

AB
xx

Lower right portion of my stomach (Ileum I believe), is a constant stabbing pain, but the rest seems to throb.

I've tried a lot of things, yes the massages and heating pads, but the heating pads start to actually make the throbbing worse after a while. It seems like only for a short time does it help. I do find taking a long hot shower helps if I just kind of sit in there with the water on me.

The percocet really does help, but I feel as if the constipation will most definitely cause more issues than it's going to help, also like I said in the first post I used to have a dependency issue. I feel like it won't be a problem now that I know what it's like, but still a scary thing to think about.

Also, to the second poster about Fentynyl. I'm way too scared to even touch the stuff after watching some girl on Intervention who used the pops. Stuff seems to have crazy weird side effects.

 

[Angrybird]

Do you now have insurance and that is why you have seen the doc or are you still without it? Have any tests been done recently to confirm whether you have active disease and if so how bad?

 

[Warrior Girl]

I can understand the fear of fentanyl patches-- especially when you see people who abuse it. I'm on a moderate dose and take strictly as prescribed. I don't have any side effects except some pain relief. It was definately a last resort med but, I can't seem to absorb completely oral meds very well.

 

[MattaisX]

Having a pretty terrible day again. nausea through Zofram, threw up so much last night, and no idea what to do. I feel as if the 5mg Percocets aren't doing what they should. It's getting pretty easy to imagine giving up again..

Do you now have insurance and that is why you have seen the doc or are you still without it? Have any tests been done recently to confirm whether you have active disease and if so how bad?

I'm currently on charity care at a few hospitals, I actually just got out of the hospital a few days ago. They did a colonoscopy and endoscopy pillcam. The Pillcam actually got stuck for a few days, but wasn't causing a blockage so that's all fine. The colonoscopy came back just pretty much like, "Yep you crohn's" so I really learned nothing. I won't have the actual results from the pillcam till the 4'th when my follow-up is.

I can understand the fear of fentanyl patches-- especially when you see people who abuse it. I'm on a moderate dose and take strictly as prescribed. I don't have any side effects except some pain relief. It was definately a last resort med but, I can't seem to absorb completely oral meds very well.

I definitely feel a difference when I take percocet, and I'm going to go ahead and draw a line to hopefully never have to even think about Fentanyl. I'm really having to figure out how to call this doctor tomorrow though and explain that I feel my dosage should be raised though, from what I've been reading and researching today up to 10mg can be prescribed by a doctor without much overhead. The stuff still scares me though.. I want to not need it, but then realize I need it to function during these "flare" times.

Anyone have advice on how to maybe voice this to a doctor? My fiance even has a hard time understanding, and i don't blame her, I guess it's just hard to explain to someone why you need painpills with the stigma they have.

:sign0085:

 

[Angrybird]

How long have you been on the steroids and at what dose? Based on what was said during the scope it sounds like you may have active disease and this will really contribute to the pain you have, I would hope if the tum can be settled down a lot of this should ease - I am currently doing really well and do not have any pain at all. Have you tried changing anything food wise to see if this helps ease things?When are you due to start the new med?

 

[Judith]

Hello MattaisX,
Welcome to CrohnsForum!

I am sorry you are having so much pain, anxiety and stress. You are not alone.

Treatment of Chronic [wiki]Pain[/wiki] is an extremely difficult topic to address. Unfortunately, Opioids may be effective for certain types of Acute (short term) pain, but loses its efficacy in [wiki]Chronic[/wiki] pain situations - quickly (I am speaking from personal experience). It is also a touchy subject to bring up with your doctor.... you want relief from the pain but a desperate tone seems to have the opposite response that you were looking for. Your doctor may be more likely to switch your medication than increase your Percocet dose. It is also pretty short-acting so you need to dose more often.

- Oxycontin is a similar drug but longer acting. However if you are not feeling the pain relief with Percocet, Oxycontin might not be helpful either.
- Fentanyl is a good medication and you wear it as a patch for 3 days before replacing it (always remove the old patch before adding a new one). I understand your concerns about Opioids and addiction and Fentanyl can easily be abused. Fentanyl makes me very nauseous - Tigan helped. Again, your body may require increasing your Fentanyl dose as Opioids become less effective in Chronic pain.

Here are a couple of options you might want to consider:
- [wiki=Tramadol]Ultram (Tramadol)[/wiki]- An interesting pain medication with less addictive potential. Some people have excellent results with this medication. However, everyone is different and some people have bad experiences (HERE)

- Nortriptyline - This is actually a tricyclic antidepressant used for people with Chronic Pain with excellent results. It is prescribed in much lower doses for Pain and takes a few weeks to see an effect. It is taken daily and not just when you are having symptoms. Does not create the "foggy" thought process typically seen in many Opioid-based pain treatments.

- Low Dose Naltrexone (LDN) - has a huge following on CrohnsForum. It is used as a medication to combat drug/alcohol addiction but has more recently been used as a treatment for Crohn's Disease and MS. LDN HERE

- [wiki]Medical Marijuana[/wiki] - More and more research is showing beneficial effects of MMJ on Crohn's Disease. (check your local laws)

- Fish Oil, Omega 3 Fatty Acids - their anti-Inflammatory effects can help with symptoms of Arthritis and Crohn's Disease.

- [wiki]TENS - Transcutaneous Electrical Nerve Stimulation[/wiki] - A non-medication pain treatment that uses electrical current to relieve pain. It sounds horrible but is actually quite pleasant.

* Always check with your physician(s) before starting or changing any medical treatment.

We are so pleased you have joined us. I hope you are feeling better soon.