Sunday, October 19, 2008 ken k asks

Q: opiate painreleiver are they option for ra pain?

recently diagnosed with ra  have been on a regiment of painreleivers for chronic clusterheadaches (percocet and vicodin) now prescribed mtx and enbrel for moderate ra and i find myself increasing dosage of opiate to cope with pain do rheumys typically prescribe opiates and or muscle relaxers?

 

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10/19/08 7:41pm

The Enbrel should kick in in a month or less [2 weeks for me], and eliminate need for painkiller to relieve RA pain. If it doesn't, you need to try another biologic.

I was on opiatres for 3 months before I got Enbrel, then I did not need, so, yes, they are used.  If you are on perc and vic, you may be close to being dependent.  Talk to your doc.

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8/18/10 12:32pm

I've had the same problem. I had broken my pelvis in eight locations, i had a rod placement in my back, my knee was reconnected with optical fiber as well as my elbow, mynerves and ligaments were torn all through-out my right side from my hip, down & i had other internal issues as well. 6 mths in the hospital and the whole time they had me on the morphine pump, time released and quick release. When I finally got out of the hospital, the had me on percocet and the quick and time released morphine. I winged myelf off of it because of the side-effects  was experiencing. I'd rather be in pain than having cold and hot sweats, headaches, terrible and insane dreams that seemed like reality when i awoke, and other minor things that just didn't suit me. It took me about ten minutes to realize when i woke up that my dreams were dreams. I went to the Dr and told him I was done with it and I had winged myself off of it and he was disappointed. We talked for an hour and he decided I'll still need the medication, And he prescribed the same amount to me again. It took one day for me to rebel against it and not begin taking the medication again. I know there are alternative, but I'm not sure what to suggest. Morphine isn't for me and i'm not sure how to convince my Dr to try something else. What should I suggest and how should I approach the conversation in a way my Dr would understand.? Please respond soon. I'm calling today and setting up my appointment and explaining why my medications are not for me. This problem has been going on since mid 2008, So it isn't my first rodeo. Also, He demands I take Amitriptyline HCL 75 mg and I refuse. I took it while i was in the hospital, but i didn't know how to feel. now that i'm fully aware of my nervous system, that drug is the most awful thing they've ever created. there is no way anybody could function on something that extreme. He don't believe it effects me in the way i describe, but I will not touch it anymore. I've been getting them for 2 years, and since i've been an outpatient for about a year, i've been prescribed this medicine every since and i've taken it 3 times. The next day my muscles are dead, i have no energy, i'm drained and tired, i have a headache, and i feel wothless and i just want to sit and/or sleep. I don't know how to feel and it drives me insane. Please help.

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8/19/10 7:12am

If your doc will not listen to you and negotiate, find another who will.  Be careful to pick a new doc judiciously, and avoid shopping.  You may have to compromise.  If you are willing to take some pain to get off the narcotics, you have a good start.  Try going to a Narcanon meeting for support. You can tell your story, and hear others. 

See this for comment on amitriptyline:

http://en.wikipedia.org/wiki/Amitriptyline

 

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8/19/10 11:55am

Thank you so much for your advice. I'll begin trying your suggestions today. they sound like a great idea. "Shopping" can make things look different than what they are. Because of my age (18) it's easier to find a doctor that will deal with me, but when I was 17, they sent me to atleast 12 different doctors and pain managment clinics because they would only see me once and refer me to somebody else to keep them from getting in trouble. Nobody but Vanderbilt would work with me because of my age. Now, with all my CT scans, MRI's, and exrays, they go straight to the strongest medication and they wont work with me. I did some research and my Percocet ranked a 7 and my Morphine ranked a 10. I made a list of medication that have a rank between 7 and 10 that i was going to discuss with my doctor about trying instead of taking both prescriptions because they are both effective but it's too much. I want one medication that doesn't have crazy side effects. Do you think that would be an appropriate way of approaching the conversation? I'm just hoping that the records from when I was 17 don't reflect on my records now because I didn't make the decision to keep switching, it was all the doctors i was referred to that referred me to somebody else continuously for about 6 mths before I became of age. 

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10/31/08 8:11pm

GET OFF THE VICODIN ITS BAD VERY ADDITIVE.I ALSO TAKE ENBREL 1 A WEEK I NEVER HAD TAKEN PERCOCET. TRY TO STAY AWAY FROM THE PAIN PILLS IT WILL KII YOU IN THE LONG RUN..................ANNA

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By ken k— Last Modified: 12/26/10, First Published: 10/19/08