Topic : 06/30 Addicts Transformed

My surgery was anterior discectomy and fusion. I knew before having it there was a 5% risk that it would not alleviate the pain.  I just didn't know if I was in that group. I spoke to my Primary care physician and he is going to work with the neurosugeon to help me get the pain under control. He contacted them and they are sending me to physical therapy and gave me a lidocaine patch to wear. I'm actually feeling some better today. I also was able to discuss my concerns about my pain medication and he doesn't feel I'm at risk for becoming addicted to my pain meds.  

On another note: I talked to Florida Detox. They collect their money up front. They quoted me $12000 and gave me phone numbers for two finance companies where I could borrow the money. Maybe they are legit with treatment so new its not yet recognized by insurance companies.  

But I didn't have a good feeling about it.  

PH 

PH 

I'm glad that you are feeling better and that your Doctor believes you are not at risk for addiction.  Unfortunately, pain can ruin your life.  I know that I was quiet about my pain for far too long.  It still hurts everyday but at least its at a level that I can tolerate for the most part and its not ruling my life.  You've taken the first step.  Keep the lines of communication open with your Doctor and let him or her know about changes in your pain level.  It helps to keep a pain diary and to bring it with you when you have an appointment.  Good luck and I wish you the best. 

PS: $12000 for Florida Detox.  Wow - that's a lot of money.  Nice of them to recommend some places that might finance it.  I wonder if there's a money back guarantee if it doesn't work or if it makes your pain worse.  It would be awful hard to pay that kind of money back if you end up on disability.  

-Steve 

Hi Hope, 

I haven't been on the message board in a couple of days as I was traveling and I'm sure I have a lot to catch up on, but before I went any further I just wanted you to know that if I can do it . . . anyone can!!  I'm no hero - just a human being that made a bad choice.  Thankfully, soon thereafter I made the right choice and it has made all the difference.  YOU can do it!!  The disease is what keeps making you think you are weak and you know deep down that you are not.  Good luck to you Hope! 

Funny enough, I was talking with Dennis the other day, he's an amazing nurse at Florida Detox, and we discussed this message board.  I told him how that much of the time the decision to detox comes down to money.  It was the same for me - how the heck was I going to afford $12,000???  I'm the wife of a Marine and a stay at home mom - certainly not living it up by any standards.  But, somehow, I managed to pay for my pills!!  I made SURE that my meds were paid for - no matter what.  I think it just takes that same determination to pay for treatment.  Lord knows, it saves money in the long run and it even saves your life and the lives of those that love you! 

Good luck Hope - I KNOW YOU CAN DO IT! 

-Cara 

Your post is inspiring!  Congratulations to you Simp!  I wish you and your family the best! 

Hi PH, I'm so glad to hear that you had the discussion with your doctor and things are moving forward and you are feeling better.  What a tremendous relief! 

I was glad to hear that you called Florida Detox as well.  The procedure is around $12,000 and well worth it.  I'm in communication with many patients that have detoxed and continue to live their lives in sobriety - further, many were prior chronic pain patients and now find that simple over the counter drugs can help their original pain.   

I'm sorry you got a bad feeling, but please know that Florida Detox is saving lives everyday - truly doing God's work.  The best things in life are sometimes paid for up front, so that is not necessarily a bad thing.  There are many prior patients that you can talk with that have paid up front and are glad they did!! 

Again, kudos to you for getting the help you deserve.  Best of luck to you! 

Unfortunately I know that what you say is true. I am hoping that if I withdraw from her she may get some help. 

Thanks 

Thanks to Steve and Jenoc (I hope that's correct) for your kind comments on my rather verbose post. I hoped it would shed some clinical research light on the subject along with some of my practical experience. 

Those on-line Vicodin suppliers are quite upsetting to me. I don't even like writing 90-day prescriptions for mail-in. That's too much medication to have at one time. And the real risk, unbeknownst to most people, is not the hydrocodone amount but the tylenol! The maximum safe dose per day is 4000mg. Most Vicodin or Lortab dosages contain 500mg of tylenol, regardless of the hydrocodone dose. That means the maximum number of tablets a day you should take, whether you take 5, 7.5, or 10mg of hydrocodone in the pill, is 8 tablets if the pill contains 500 mg of tylenol. Common dosages are 5/500, 7.5/500, 10/500, 7.5/750, 10/325, and 10/650.  Sometimes I will write a prescription for 10/500 with the instructions for 1/2 to 1 tablet every 4 hours rather than 5/500 with instructions for 1-2 every 4 hours if I feel the patient might need the stronger hydrocodone dose as opposed to the tylenol in it.  

There is a very real problem called "Iatrogenic pseudoaddiction". This means the doctor is underprescribing pain meds for a legitimate painful condition, causing the patient to not quite get relief. The patient then tells the doctor he/she needs a higher dose or an additional dose to be able to function normally. An astute doctor well versed in pain management will understand this is NOT a plea to "get drugs". This is a legitimate update to the doctor as to how the pain management is going. The patient's daily functioning is not quite normal, which is what the patient desires.  

In keeping good notes, I ask patients on a 1-10/10 scale, what is the worst pain without medication, the best relief with it, and at what level do they feel the need for additional medication. Also what activities can they not do because of pain. Sometimes it's not a pain medication but a muscle relaxer that is needed, so careful questioning is important. On follow-up, I ask what the patient can NOW DO given the current medication dose. If the patient says, "Doc, I'm so much better, but I'm just not quite there. I can't stand as long as I have to at work. The meds don't allow me to sleep through the night. Etc.," I'm going to take the patient at his/her word and make adjustments. Usually it means instituting a long-acting medication and filling in with a short-acting one for break-through pain, which hopefully will be only a couple of times a day when the person is most active. NOW if the person just NEVER seems to be satisfied and "that other medication" always seemed to have worked better now that we've switched, that's a red flag that the patient may be after more than just pain relief. 

My point with the above is there are too many doctors who immediately presume a patient who complains about the current dose being inadequate is wrongly labeled a drug-seeker when the problem lies with inadequate treatment. And, quite frankly my dear patients, there are far too many doctors who just don't give a damn! I'm not one of them, which is why I have a lion's share of chronic pain patients.  

I have 3 principles in my practice of medicine: Respect, Listen, and Believe. RESPECT the patient regardless of age, gender, economic station, or past history. You may be the first person to give this person a fresh start. LISTEN to what the patient (or representative if he/she is a child or quite elderly) with all your senses. It's not just the words spoken that convey the message and you might miss it if you aren't careful. BELIEVE what you are told unless you have a VERY compelling reason not to. Assure the patient that you will always be truthful AND you expect the same. Many patients have not had that experience in a doctor's office. If you haven't, tell your doctor and find someone who will follow these tenents. 

A couple of people have made the statement "I'm addicted to my antidepressant." I've got news for you--so am I! I had a problem with depression in the winter for years. When I finally realized the pattern, I did make sure I had plenty of light around. I didn't start med school until I was 33 (with kids 4, 6, and 9--and a fantastic husband who is still with me!) and I was smart enough to arrange my 3rd year schedule to have surgery during December and January with the logic being I would spend several hours a day under those bright lights in surgery. It made the rotation tolerable. The next year I knew I had residency decisions to make, and even though I was rather sure of what I planned to do, I was concerned that I'd hit one of those down periods and I didn't want that to happen. Prozac was finally commonplace then. I was started on it the first week in December. Three weeks later I felt like it was the middle of July! It was the best thing I ever did in my life. That June, I made the stupid decision to try and stop taking it--only to start bursting into tears if someone started to criticize me. Interns MUST have thick skins and "there's no crying in internship." I restarted the medication.  

The guidelines for antidepressant use are to take it for a MINIMUM of 9 MONTHS to a YEAR if this is your first episode. If this is your second or later episode of depression, you may need to take it longer, or you may even need to take it for life. This is not a sign of failure in your life. It's a neurochemical imbalance. Of course there are other possible problems you could have that might be wrong if your antidepressant doesn't seem to be working, but that's for another time. 

For those of you with chronic pain and depression, Cymbalta has been found to be an excellent medication you may want to discuss with your doctor. It hits both serotonin and norepinephrine and may even allow you to get by on less pain medication than you needed before. This is where I'll make another personal confession. I have a severe case of fibromyalgia, one of the reasons I have a great interest in chronic pain management. I started on Cymbalta over a year ago when I was in the midst of a terrible fibro flair. I was able to decrease my pain medications tremendously after starting this. Of course not everybody responds in the same way, but it was a blessing to me. 

As a family physician for the past 11 years, having come into the profession at a later age, I hope I have been helpful in passing along some practical knowledge in these subject areas.  These are tough topics. I hate for those with legitimate pain problems to be made to feel as though taking their necessary medications makes them addicts when they are nothing of the sort. I don't like needing medication. I have no "craving" for medication. I take what I need on a schedule that allows me to be a normal person, as do the overwhelming majority of chronic pain patients. Needing to get that "extra buzz" by taking increasingly higher doses is NOT what the chronic pain patient does. THAT is what the ADDICT does--however "high functioning" he or she perceives him/herself to be. There's a preoccupation with "needing that higher dose" and NOT with "needing enough". MAJOR DIFFERENCE. 

I wish you all well and I hope I have helped answer some of the questions that may have been eating at some of you.  

Blessings for now and for always, 

DocDebbee 

Hi! 

Our stories are very similar.  Ultram and Buspar did nothing for me.  I tried using NSAIDS and I developing stomach bleeding and now I am not allowed to have Tyleno, Aspirin, NSAIDS of any kind.  Plus, my anesthesiologist doesn't prescribe pain meds with Tylenol or Aspirin or NSAIDS in them as she said it can cause major damage to the stomach, kidney and/or liver if taken for months and/or years. 

I thought the NSAID I first took was so wonderful compared to taking Vicodin.  But, one day several months after being on the NSAID, I was walking through my kitchen and suddenly threw up all over the white tile.  It totally surprised me.  There was both dried blood and a small amount of red blood in the mess on the floor.  I cleaned it up (what fun...) and called my internist and he had me meet him at the ER where a gasteroneneterologist was waiting along with my anesthesiologist to do an upper GI diagnostic test.  Turned out I had a bleeding ulcers in my stomach from the medication. 

So, they put me back on the Vicodin and then my internist thought since the pain wasnt going away even with me biking 25 miles per day, yoga, and weight training that cutting back on my cycling would help.  It didn't.  (actually the cyling kept all my muscles from getting cramped) so I finally gave in and called the anesthesiologist office for an appointment.  It was easy with a referral back in 2000.  Now, if people want to get in for a consultation...they have to provide medical records for the past two years that specifically show where the doctor visit was for a painful condtition.  Two MRI's, a printout from your pharmacy for the past 6 months, and a letter of reference from the treating physician.  THEN, the pain specialist looks over all the information and decides if she is the best person to help you.  In one case, she turned away one of my friends as she said she needed an orthopaedist instead of her.  In another case, she turned it away as her instincts upon meeting her was that this woman was looking for medications even though she had MRIs, etc.  5 years later, my friends has had her 21st surgery.  She's now in a wheel chair and in the process of getting divorced. Her daughter blames her stepfather for divorcing her Mom due to all the medications and surgeries that annoyed him.  I have tried to get her to see a psychiatrist to help her deal with her chronic pain (learning things like the relaxation response, etc.) and to give her body a rest from all the surgeries, that she is just building up more and more scar tissue.  Now, she called yesterday and said they think she has Crohn's disease.  She is only 35 and I feel bad for her but she does suck all the energy out of people.  She always has an excuse for why she didn't take the exam in college that day,  etc. until finally she got arrested for missing traffic court due to a suspended license for not getting her insurance in on time.  She had to get a mug shot, fingerprints, the whole thing.  Now she can't drive until she goes back to court, goes to driving school, etc. & has a 4 year old to take care of.  She cries all the time about the pain she is in.  But, I can't get a reading on her whether she has true physical pain or whether she is just desperate for pills.  She is constantly asking me for some of mine.  I keep it locked up whenever she would come visit me in Orlando. 

Since you are in the field....what do you think?  I haven't been in the CAP program very long so I have 2 years to go and then my rotations, then after I get board certified, I will go on for my Master's.  I am getting a dual major: the other in Forensic Psychology.  But, my goal is to help women with substance abuse and domestive violence abuse get their life back. 

(and yes, I will work with men , too because I have seen a male neighbor be physically abused by his wife.  She would throw plastic chairs at him, glasses, etc.  He is a surgeon and if she hurts his hand, she'd lose her big home. So, I want to make sure men don't get ignored.) 

The migraine meds work great for me.  I was put on Topamax and Atenelol for migraine prevention and they worked but in June I left them behind in my makeup bad and I thought, well, 48 hours away from it won't hurt.  Well, I was in full withdrawal by 36 hours off of the preventive meds.  We had to leave Miami and go back to Orlando to see what to do.  I was told to take one of each med I had and givve it a little while.  Well, that came back up, too.  Then we didn't know whether to retake the meds (pain, headache, etc.)  So, the ER physician said to take one of everything except the fentanyl which is dissolved between the cheek and the tongue and they weren't sure how much my body had absorbed. 

It works the best for my pain.  Fast acting but not very long acting.  I'm using one right now.  It is the drug I've found that I have no side effects at all and can stop and start it at will.  I consider myself blessed to have that. 

I'm so sorry about your Dad's suicide.  I lost my Mom, my brother and my twin all by the time I was 2l.  So, as you know, the holidays can be really difficult.  I see a psychiatrist right now as I am getting out of a domestic violence marriage.  I didn't realize I was in one until I started studying domestic violence and found out it didn't have to be physical: it is also economical, emotional, verbal, etc.  I was text messaging my ex tonight as he has our son this weekend & I mentioned seeing him for just lunch & a movie so he and his new fiancee (they dated 4 months and got engaged & are getting married within the next 8 weeks, they aren't sure or aren't telling.  She worked for him and they claim they really did only date 4 months.  None of the four kids (two and two) have met each other.  I can only imagine what her two sons (in college in alabama think of their Mom getting engaged so quickly.  I just ignore all the rumors throughout the company.  People can be so insensitive.  If I WERE addicted and struggling really bad with it right now, I probably would be using to numb myself from the emotional pain of what he put me through.  I needed money to stay in a hotel while we were separated but went to our son's soccer game & the hotel didn't take cash only credit cards & he refused to take $100 from me and put my room on his card.  I ended up sleeping in my car in 40 degree weather. The transmission on my BMW would not go into reverse for 8 months until I gave the car back to him in the divorce (I guess he repaired it).  I'm now trying to get a car but he is fighting a divorce order to give me my assets to start over.  It was horrible with no reverse.  I'm too injured to attempt to roll a heavy car back and it aggravated my neck/back so badly I'm having to have some nerves severed and so far I have a l00% success rate in the areas where she has done this laser surgery.  It is something new and there isn't any hospital overnight, no stiches or anything.  The first week is excrutiating but after that places where I had pain up to level 10 are not pain free.   I'd love to talk more with you.  It sounds like we have a lot in common.  Actually,  I find here at this board that my story is not unique....we are all in the same situation.  People say I'm lucky about getting meds (but, I think inside...well, I'd really prefer not to NEED them, even if it is medically legit).  It's expensive, people judge you for it, my husband used my 3 hospitalizations against me in court & temporarily got the kids and we are co-parents but I would have had sole custody if he hadn't taken pictures of me at night in my OWN bed & put my medications out by the lamp and then put out 7 year old on the right side of the king size bed and then told the Judge he found our son in our room like that all the time.  He had set up the whole thing.  BUT, how could I fight pictures???  SO,, after staying home with my kids for 18 years, I had to vacate my brand new custom built home over 3,000 SF & tell my 7 year old Mommy isn't going to be coming back.  He is just now adjusting to it.  If I hadn't had taken childhood and adolescent psychology I don't know how I would have been able to help them.  They see their father for what he is now yet I just feel sad for all of us.  I even feel sad for the women he has convinced that he is so wonderful when I know how he is.  He kept a million dollars in another account in his name and then spent it on a home in another state after we were separated.  So, now I have to go back to the Judge and let her know he hid assets and I have four other cases where he committed perjury.  One of his major problems is that he gave me a towel to get sick in and it had inhalants in it and caused a brain seizure in front of him and he did nothing.  No concern at all and slept in our son's bedroom that night.  He found me in a coma the next morning and still didn't call 9ll.  I was in blood, urine, feces, and vomit & I think he was hoping I was dead.  So, now the prosecutor in the county we lived in wants to talk to me.  (so now you see why I'm seeing a psychiatrist?  Stress aggravates pain and I am having these laser surgeries every 3 weeks so it has been a rough summer into fall).  

BUT, I am taking care of myself and hopefully I'll be off all meds by January as my last surgery is in December and unless I have problems just stopping them myself (my anesthesiologist has already written out a schedule of decreasing my meds from 2 every 4 hours to nothing within 30 days so I don't anticipate problems.  BUT, even taking pills LEGITIMATELY hurt me in my divorce badly as he used them against me.  My lawyer said he hadn't seen a client be set up like me in his 30 years of practice.  And yet I look at my nightstand and there are anti-anxiety, sleep, pain, muscle relaxers, in the drawer and I dont feel any pull to take them.  Quite frankly, I think subconsciously I'm afraid my ex will come after me about them.  So, I have my lawyer call once a month for a random drug test (except surgery weeks) and so far all six have been clean.  That way I have evidence for when we go back to court. 

So, pills can be a double edged sword.  Such sweet relief after the surgery, yet, it someone like a spouse claims you have a problem, well, you do.....whether it's really having one or proving you don't.  The Judge put in my divorce decree I can take anything I want, including narcotics.  But, it took a lot of work to get that done.  And the betrayal I felt sitting in court and seeing pictures of me in my bed, asleep, with my son and my meds on the other side of the bed by me.  It was horrible.  And to think my ex put him back in his bed, put my meds back up in the drawer and then acted the next morning like nothing had happened.  So, I'm sure anyone reading this could understand how a person in my situation would be susceptible to numbing their pain but I'm too afraid to take it after what my husband did.  I don't get mammograms, etc. right now.  I've got to get past being afraid to go to the physician. 

Sorry to ramble on.  I am alone right now and have no one to talk to in the middle of the night. 

Thank you for listening.  Please email me and tell me what you are taking or trying not to take, how you are feeling, etc.  I love hearing people's stories.  I think all people are good, we all just make bad choices at times. 

Phyllis