Pain Meds Questions,....

Discussion in 'Fibromyalgia Main Forum' started by jpowell79, Nov 14, 2005.

  1. jpowell79

    jpowell79 New Member

    Hi everyone, I've been around a while, but often just lurk. I'm not so weird like that, I just have a hard time speaking my mind anymore.

    Anyhooo...I have had FMS for almost 7 years, and I'm only 26. I absolutely refused anything stronger than Motrin until after I had my son (January 2005). The pain gets worse and worse every month!! I broke down and accepted Vicodin in May. It barely took the edge off, and my doc only allowed 3/day.

    I changed docs in September, and my new doc at least believes in Fibro *YAY* He said that Vicodin does NOT work for Fibro, and switched me to Darvocet. What a JOKE, it helped for a day or so, now it doesn't do hardly anything! I also take 3 Flexeril, and Elavil.

    Now I'm gaining weigh like mad (15 lbs in under a month!) This is significant considering I had lost ALL of the baby by July-with the Fibro super flare!! And my pain is AWFUL

    So my question that I'd like to ask is what pain meds are others on, been on, and what helps the best? I'd love some suggestions before my doctor appt next Monday.

    Sorry for the rambling, but I very much appreciate any suggestions :)

  2. gidgetsmom

    gidgetsmom New Member

    Hi Jamie!
    I am also somewhat of a quiet member! The docs around here aren't comfortable with the amount (2 every 4 hours) of ultram I was taking for FM so I had to go into pain management. They allow me 3 Lortabs daily and it really isn't any better than the ultram, but it does take the edge off. I am also on 3 flexeril daily and 50 mg. elavil at night. I too have gained almost 10 pounds since they upped the elavil from 25mg to 50mg! I will be starting trigger point injections AGAIN (last ones past March) the end of this month. Hopefully they will help. Good luck with your appt!
  3. jpowell79

    jpowell79 New Member

    hopin for a few more responses :)

    **Edit I am on 5 (yes,5!)mg of Elavil and got this much weight gain...SUCKS. What is Ultram? I've only heard of people using it here...never heard of it before.[This Message was Edited on 11/15/2005]
  4. JLH

    JLH New Member

    Glad you found our board/online support group!

    I am quite a bit older than you. I'm nearing 55 and I've had fibro and systemic lupus since I was 10. I worked for 30 years with it, and had to retire at 48 because I just couldn't function any longer due to the fibro, lupus, arthritis, heart problems, diabetes, and the list goes on!

    I currently have a script for Lortab that was prescribed for my back. It helps my back pain but doesn't help the fibro too much. I have also tried Darvocet and Ultram but neither of them helped.

    My rheumy refuses to prescribe any type of pain med, even Ultram, for it because he says pain meds don't help fibro.

    He put me on 10 mg of Elavil when I first started with him, but even that small dose put me to sleep for 24 hours! I later had to cut it into fourths and take only a fourth. I eventually was taken off it and tried a dozen different meds and finally settled on Zanaflex. I now take 6 mg of it and I can wake up without any hangover effect.

    I also take Cymbalta, 60 mg, and well as Neurotin. The Cymbalta and Neurotin have helped my pain level for the fibro far better than any pain med did.

    Take care,

    Edit: On the Cymbalta .... I take 30 mg capsules, 2 x day, so it doesn't make me sleepy. When I took the entire 60 mg in the morning, I stayed so sleepy all day that I couldn't stand it!
    [This Message was Edited on 11/15/2005]
  5. Shananegans

    Shananegans New Member

    I am also 26 and have had Fibro for many years. I've tried it all including Vicoden, Darvocet and TC#3 (Tylenol with codiene) and Flexeril. The codiene worked for a while but I had to switch to Ultram.

    The Ultram alone didn't help, so I also switched my muscle relaxer to Norflex. I also take 600 mg of Ibuprofen. The combination of Norflex 100mg twice a day, Ultram 50mg every 6 hours, and Ibuprofen 600mg every 6 hours, takes most of the edge off.

    So far this is the only thing that has some what helped. Also instead of Elavil, I take Pamelor, because the Elavil gave me nightmares and a fat gut... fun times. (With Pamelor, you are likely to loose weight... not gain it YAY!)

    I hope this helps and good luck, best wishes with the little one!

    [This Message was Edited on 11/15/2005]
  6. jaltair

    jaltair New Member

    Drugs that are opium based generally are not prescribed for FMS, as narcotics really don't help the type of pain the FMSers have.

    Ultram is a synthetic, non-opium drug that works with osteoarthritis pain and has been helpful in the pain of FMS as well. One Ultram contain 50 mg of tramadol hydrochloride, and Tramadol is an effective pain reliever (analgesic), and it acts similarly as does a narcotic, and is as effective as a narcotic in relieving pain.

    There is also Ultracet, which is Ultram plus acetaminophen, a "double" analgesic. I've taken Ultracet for about 3 years, and it does help the FMS pain noticeably.

    Other types of medications that help decrease the FMS pain are the ones like antidepressants, and some anti-seizure drugs. Some of the drugs that help include: Elavil, Flexeril, Sinequan, Paxil, Serzone, Xanax and Klonopin. Also, anti-inflammatory drugs like ibuprofen may help, as might PT, acupuncture, relaxation techniques, osteopathic manipulation, chiropractic care, therapeutic massage, or mild/gentle exercise. FMS people may also have a sleep disorder called the "alpha-EEG anomaly," or possibly other sleep disorders, such as "sleep myoclonus" or "PLMS" (nighttime jerking of the arms and legs), "restless leg syndrome" and "bruxism" (teeth grinding).

    Many researchers believe that those who have FMS have lowered pain tolerance due to poor sleep patterns. Some research has found that FMS patients fall asleep, but their deep level (or "stage 4") sleep was constantly interrupted by bursts of "awake-like" brain activity. The alterations in the neurotransmitter regulation (particularly serotonin and norepinephrine, and substance P) cause problems with sleep, pain and immune system function. The antidepressants and anti-seizure drugs help FMSers get "good sleep."

    I also take Neurontin 1200 mg at bedtime and Cymbalta 60 mg in the AM. These significantly help me with sleep and I've noticed good results with decreasing pain levels.

    Hope this helps you.

  7. jfrustrated

    jfrustrated New Member

    Dear jaltair

    I'm really impresssed with your info above on pain meds. Very clear. Thanks.
  8. joanng

    joanng New Member

    Jamie, depending on what fibro issue I'm dealing, that's how I decide what to take. If it's joint pain, I take percoset (10 mgs 3-4 times a day), muscle pain, percoset and motrin and zanaflex, restless legs, I take neurontin (I don't take this all the time since my legs don't bother me all the time), I also have valium for those tough muscle spasms that won't respond to the zanaflex. I have children too and they don't understand "mommy doesn't feel good, I can't (whatever it is they want)" so it's important for me to get relief but also be awake and able to move around. Many dr's don't believe drugs like percoset help but I disagree. I get relief and I can go to work, be an active/involved mom and lead an active life. I take supplements too and I think they play a big part in how I feel. Anti-depressants didn't help with the pain but did help with the depression. I did gain weight from them but lost it after I stopped taking them (after I felt better of course, not because of the weight gain). I've taken Ultram and Ultracet. Ultracet helped more than the Ultram but it made my heart race and gave me headaches. I also use a pain patch (just started this) and it seems to help, the jury is still out on this. I use the Lidoderm patches for the muscle spasms too. I can't live without them! It will take time to figure out what works for you....I've tried Vicodin, Vicoprofen, zanax, flexeril, oxycontin, oxycodone and right now I'm happy with the percoset, zanaflex, valium, motrin and neurontin. I've had the trigger point shots, they didn't help me. It will take time, be patient with yourself and maybe you should keep a log to keep track of what's working and what's not. Good luck.

    p.s. sorry about the spelling mistakes!
    [This Message was Edited on 11/16/2005]
  9. elsa

    elsa New Member

    I Jaime,

    I'm sorry you are having such a hard time. Your doctor should have told you about the side effects of elavil and flexeril.

    They are both anti-depressants and in an older generation. They are both notoriously well known for packing on the pounds ... without you doing anything differently.

    For me, the rx has to make a difference all the way around ... ie, I had an rx for flexeril ... it helped on tight muscles, but it is not a muscle relaxer.

    It added weight and water retention. It caused blurred vision which made reading impossible. It made my life besides muscle tightness horrible. Sooo, even though it did it's job on my muscles, I still punted it because it made my live all the way around miserable.

    There are other options .... If a doc told me to take elavil I'd tell him the same thing I said about flexeril .... you take it and tell me how you stand the sied effects ... (I can be a smarty britches at times, but heck, even great doctors forget that we are the ones that have to swollow the things.)

    Have you had a sleep study? It's hallmark for CFS/FM ... and a study can pinpoint which sleep disorder you have and which sleep med to take for it.

    Also, have an integrated doc or anti aging doc test your hormones ... all of them. CFS/FM causes dysregulation ... makes our hormones turn upside down. Getting them balanced makes a big difference in how you feel ... traditional endocrinologists aren't great in treating CFS/FM hormone dysreg.

    Try tramadol for pain ... it works well for many with CFS/FM. ( of course not everyone, but worth a shot.) It is non-narcotic ... can take up to 8 50mgs tabs in 24 hour period.

    I hope this helps you some and I hope you get to feeling better soon.

    Take care,

  10. jp24

    jp24 New Member

    Hey! I'm new to the message boards but not new to trying to deal with the excruciating pain of FM. A few years ago my (FORMER) primary care doctor prescribed Lortab for the pain to help me cope well enough to keep working at my extremely ambitious career. I didn't know enough about opiates for pain management and didn't know what questions to ask. I was just grateful for some real help to keep going. It sure helped to relieve some of the pain, but over time I developed a tolerance to it and eventually needed higher doses to receive the same relief. Before long I was so physically addicted to it that I needed a 5 day stint in a detox facility to safely get off of it. I probably had some predisposed tendency to have a problem with Lortab, but nevertheless, I would be extremely careful about starting down a road that is not all that effective for chronic pain and could have the potential to create a real problem for you.
    Now I rely on Aleve, Lidocane patches (these are great!), Zanaflex (a muscle relaxant) and massage. I also have a TENS unit which sometimes helps. None of these are a magic bullet and I still have some really horrible days, but I'm in a much better place than I was. Good luck to you!
  11. TwinMa

    TwinMa New Member

    Glad you decided to not lurk anymore! You have a very cute baby!!

    There is lots of good info above. I'd like to add that you need to keep in mind that since you just had your baby in Jan, your hormones are probably still out of whack. Elsa hit on some good points.

    When you see your doc, ask for estrogen and progesterone levels as well as thyroid levels.

    How is your sleep? With a less-than-one year old, you could be sleep deprived. (Aren't we all?) Poor sleep and pain go hand in hand. There is lots of good info on the board about sleep issues.

    I felt out of whack hormone-wise and sleep-wise after the birth of my twins. I think if I would have addressed those issues sooner, I would be at least a bit healthier now.

    Good luck!