Discussion in 'General Health & Wellness' started by Metallenaspain, Aug 20, 2009.

  1. Metallenaspain

    Metallenaspain New Member

    HI, well, I've NEVER been to one of these message boards before so excuse me if I'm not doing it right! I have been in severe pain for 31 years! It all started with an escalator accident!
    The pain worsens EVERY SINGLE YEAR, but lately it is spreading faster and getting more intense every single day! My "regular" pain has been managed SOMEWHAT for the last 20?+++ years with Vicodin and then Norco. They have been saying that I have FMS, but I also have RA, 4 ruptured discs, cervical radiculopathy, spinal stenosis, and scoliosis! I have had Lymes! I also caught Strep. IN MY MUSCLES! (COULD NOT EVEN STAND WITH THAT!!!)
    Well, ANYWAY, since this past January, I have been PASSING OUT with severe chest pain!!!!!!!! (I've been reassured that it's NOT my heart!)
    I have been hospitalized 4 times this year. Finally got a diagnosis of Costochondritis!
    But see, my Dr. is not listening!!! (I'm on Medicaid, and THIS "DOCTOR" {a pain management specialist--HAH} is the ONLY one that accepts my insurance!) I finally got him to give me MS Contin for the pain WHICH DOES indeed work IF I take 2 - 30mg. tablets at a time! He prescribed me 1 - 30mg. tablet two times a day, but I figure WHY bother taking one if one wont help even a little bit!!!! I just would like to know WHAT is an adequate dosage for someone that is in severe pain??? Again remember though, I have been on Norco !0/325 for at least 15 years. I was taking 3 a day!

    ALSO PLLLLLEASE, like I said, my "doctor" is NOT listening. I have pain EVERYWHERE!
    The chest pain is the worst at this time, but I also have tingling in my hands and feet!
    I keep dropping things which only makes me angry 'cause it HURTS to bend to pick the item up!
    My EYES hurt, and it seems that my vision gets worse EVERY DAY TOO!!!!
    My Rheumatologist gave up on me after he found out that I was "DEPENDENT" on the MS Contin. Noooooo, I am dependent on PAIN RELIEF!!!! I can NOT even MOVE in the morning until about an hour after I take BOTH of my MS Contins. That leaves me crawling back to bed by 4pm!
    I am starting to think that my diagnosis' are NOT correct! Does anyone else have these symptoms??? Could you possibly give me somewhere to start?!?!? There IS SOMETHING WRONG WITH ME!!!! AND YES, the chest pain IS very, very scary even though any heart problems have been ruled out!!! ( I really don't trust too many doctors because my ears had severe pain for 12 years. They called me a drug seeker until my ears finally BURST open and bled! I now have tubes in my ears, and I am usually ok with that department!)

    Does Lymes' come back? My RA seems to hide at times because when I was in the hospital, it did hide!!!! My former rheumatologist then said that I was speckled! I am VERY CONFUSED!
    I want to make sure that I am properly diagnosed, but UNTIL that happens (This has been going on for 31 YEARS!!!!), I would really like to know what the adequate dosage of MS Contin for someone like me should be?!?!?! Is 30mg. a very low dose??? Sorry, I am at my wits end! I can't go anywhere without someone telling me to go to the ER because I am clutching my chest!!!! I forgot to mention the extreme tiredness! That's been my WHOLE life !!! Before I took ANY types of meds!!!!
    I am just TRYING to give "YOU" the WHOLE picture! I AM SUFFERING!!!! WHY???????????


  2. TwoCatDoctors

    TwoCatDoctors New Member

    As to your question about Lyme disease, I strongly suggest you go to the LYME BOARD here as they can probably give you the most information about Lyme.

    I have had strep and also Costochondritis, which by the way will pass. If I started to list everything I have had and have, it would be too much.

    If your vision is bothering you, please get in to see an opthalmalogist and be truthful about all the medication you are on. Medication can have a huge impact on your eyes. My lupus medication actually caused "medication based cataracts" in both of my eyes, even at the low dose that was to avoid damaging my eyes. The cataract that was just removed had grown quickly and was huge and that's one of the downfalls of cataracts that are due to medication, and not age related.

    I had surgeries to my shoulder and knee from an auto accident and then had back surgery which was messed up when I had an injury to my back that put me in the hospital for a week and left me permanently mobility disabled with damage to my back and I now have to use an electric scooter. When discharged from the hospital I had so much pain (and I still deal with pain), but they discharged me with so many narcotics and with anti-inflammatories. I threw all the medication away because I did not want to live my life, trying to hold on until the next pain med, and instead wanted to find an alternative to pain meds. I began to search for various ways to handle pain. The Pain Management Team did epidurals on my back and they stopped when they had no effect on the pain.

    Eventually, after searching I found that I could have my cat relax next to me in bed and with the smell of his fur, the softness, his purr, and my feeling safe and secure, I was eventually able to let my mind go (into a sort of meditation) and I could bring the pain level way down. This is a pain management technique that some use. So for more than 5 years I have not taken any pain medication (except the doctors and surgeons have to provide pain meds during surgery or during an MRI/CAT scan as my back can't last through that--and I can't calmly relax during those procedures.

  3. TwoCatDoctors

    TwoCatDoctors New Member

    Web MD
    Chronic Pain and Depression: Managing Pain When You’re Depressed

    Living with chronic pain should be enough of a burden for anybody. But pile on depression -- one of the most common problems faced by people with chronic pain -- and that burden gets even heavier.

    Depression can magnify pain, and make it harder to cope. The good news is that chronic pain and depression aren't inseparable. Effective treatments can relieve depression and make chronic pain more tolerable.

    Depression: Your Path to Recovery

    Understand the symptoms of depression, from sadness to hopelessness to headache.

    * Could You Be Depressed?
    * Do You Have These Symptoms?
    * Find the Right Doctor For You
    * What Are Your Best Treatment Options?
    * Create Your Success Plan

    Chronic Pain and Depression: A Terrible Twosome

    If you have chronic pain and depression, you've got plenty of company. That’s because chronic pain and depression are common problems that often overlap. Depression is one of the most common psychological issues facing people who suffer from chronic pain, and it often complicates the patient's conditions and treatment. Consider these statistics:

    * According to the American Pain Foundation, about 32 million people in the U.S. report pain lasting longer than one year.
    * From one-quarter to more than half of patients who complain of pain to their physicians are depressed.
    * On average, 65% of depressed people also complain of pain.
    * People whose pain limits their independence are especially likely to get depressed.

    Because depression in patients with chronic pain frequently goes undiagnosed, it often goes untreated. Pain symptoms and complaints take center stage on most doctors' visits. The result is depression, along with sleep disturbances, loss of appetite, lack of energy, and decreased physical activity which may make pain much worse.

    "Chronic pain and depression go hand in hand," says Steven Feinberg, MD, adjunct associate clinical professor at Stanford University School of Medicine. "You almost have to assume a person with chronic pain is depressed and begin there."

    Chronic Pain and Depression: A Vicious Cycle

    Pain provokes an emotional response in everyone. Anxiety, irritability, and agitation -- all these are normal feelings when we're hurting. Normally, as pain subsides, so does the stressful response.

    But what if the pain doesn't go away? Over time, the constantly activated stress response can cause multiple problems associated with depression. Those problems can include:

    * chronic anxiety
    * confused thinking
    * fatigue
    * irritability
    * sleep disturbances
    * weight gain or loss

    Some of the overlap between depression and chronic pain can be explained by biology. Depression and chronic pain share some of the same neurotransmitters -- the chemical messengers traveling between nerves. They also share some of the same nerve pathways.

    The impact of chronic pain on a person's life overall also contributes to depression.

    "The real pain comes from the losses" caused by chronic pain, according to Feinberg. "Losing a job, losing respect as a functional person, loss of sexual relations, all these make people depressed."

    Once depression sets in, it magnifies the pain that is already there. "Depression adds a double whammy to chronic pain by reducing the ability to cope," says Beverly E. Thorn, professor of psychology at the University of Alabama and author of the book Cognitive Therapy for Chronic Pain.

    Research has compared people with chronic pain and depression to those who only suffer chronic pain. Those with chronic pain and depression:

    * report more intense pain
    * feel less control of their lives
    * use more unhealthy coping strategies

    Because chronic pain and depression are so intertwined, depression and chronic pain are often treated together. In fact, some treatments can improve both chronic pain and depression.

    Treating Chronic Pain and Depression: A "Whole-Life" Approach

    Chronic pain and depression can affect a person's entire life. Consequently, an ideal treatment approach addresses all the areas of one's life affected by chronic pain and depression.

    Because of the connection between chronic pain and depression, it makes sense that their treatments overlap.


    The fact that chronic pain and depression involve the same nerves and neurotransmitters means that antidepressants can be used to improve both chronic pain and depression.

    "People hate to hear, 'it's all in your head.' But the reality is, the experience of pain is in your head," says Feinberg. "Antidepressants work on the brain to reduce the perception of pain."

    Tricyclic antidepressants (Elavil, Doxepin) have abundant evidence of effectiveness. However, because of side effects their use is often limited. Newer antidepressants known as serotonin and norepinephrine reuptake inhibitors (Cymbalta, Effexor), on the other hand, seem to work well with fewer side effects.

    Physical Activity

    Many people with chronic pain avoid exercise. "They can't differentiate chronic pain from the 'good hurt' of exercise," says Feinberg. But, the less you do, the more out of shape you become. That means you have a higher risk of injury and worsened pain.

    The key is to break this cycle. "We now know that gentle, regular physical activity is a crucial part of managing chronic pain," says Thorn. Everyone with chronic pain can and should do some kind of exercise. Consult with a physician to design an exercise plan that's safe and effective for you.

    Exercise is also proven to help depression. "Physical activity releases the same kind of brain chemicals that antidepressant medications release -- [it's] a natural antidepressant," says Thorn.

    Mental and Spiritual Health

    Chronic pain affects your ability to live, work, and play the way you're used to. This can change how you see yourself -- sometimes for the worse.

    "When somebody begins to take on the identity of a 'disabled chronic pain patient,' there is a real concern that they have sunk into the pain and become a victim," says Thorn.

    Fighting this process is a critical aspect of treatment. "People with chronic pain end up sitting around," which leads to feeling passive, says Feinberg. "The best thing is for people to get busy, take control."

    Working with a health care provider who refuses to see you as a helpless victim is part of the formula for success. The goal is to replace the victim identity with one of a "well person with pain," according to Thorn.

    Treating Chronic Pain and Depression: Cognitive Therapy for Chronic Pain

    Is there such a thing as "mind over matter"? Can you "think" your way out of feeling pain?

    It may be hard to believe, but research clearly shows that for ordinary people, certain kinds of mental training truly improve chronic pain.

    One approach is cognitive therapy. In cognitive therapy, a person learns to notice the negative "automatic thoughts" that surround the experience of chronic pain. These thoughts are often distortions of reality. Cognitive therapy can teach a person how to change these thought patterns and improve the experience of pain.

    "The whole idea is that your thoughts and emotions have a profound impact on how you cope" with chronic pain, says Thorn. "There's very good evidence that cognitive therapy can reduce the overall experience of pain."

    Cognitive therapy is also a proven treatment for depression. According to Thorn, cognitive therapy "reduces symptoms of depression and anxiety" in chronic pain patients.

    In one study Thorn conducted, at the end of a 10-week cognitive therapy program, "95% of patients felt their lives were improved, and 50% said they had less pain." She also says, "Many participants also reduced their need for medications."

    Treating Chronic Pain and Depression: How to Get Started

    The best way to approach managing chronic pain is to team up with a physician to create a treatment plan. When chronic pain and depression are combined, the need to work with a physician is even greater. Here's how to get started.

    * See your primary care physician and tell her you're interested in gaining control over your chronic pain. As you develop a plan, keep in mind that the ideal pain management plan will be multidisciplinary. That means it will address all the areas of your life affected by pain. If your physician is not trained in pain management herself, ask her to refer you to a pain specialist.

    * Empower yourself by tapping into available resources. Several reputable national organizations are devoted to helping people live full lives despite pain. See the list below for their websites.

    * Find a cognitive therapist near you with experience in the treatment of chronic pain. You can locate one by contacting the national pain organizations or cognitive therapists' professional groups listed below.

    Living With Chronic Pain and Depression: Resources You Can Use

    American Pain Foundation

    Arthritis Foundation

    American Chronic Pain Association

    Academy of Cognitive Therapy

    Association for Behavioral and Cognitive Therapies

    Beck Institute for Cognitive Therapy and Research