When is it acceptable to ask for REAL pain meds? Tylenol works for me when I ache, but days like today and yesterday, it just doesn't dent it. But I certainly don't need anything on a daily basis, or even in a regular basis. It would probably get used a few times a month, and sometimes not even that much. I'm just tired of suffering through several days in a row of misery. Do you think that's too much to ask? How do I approach the situation without sounding like a druggie??
I've started using Kelly's chart, and I think that will really help. I seem to always have the good luck of being in near perfect health when I go to see my RD. So it's sometimes really hard to convey all the things I may have dealt with in the past 3 months.
So what are your ideas?
I never ask for them... they just always gave them to me. And of course, I never filled them or even took them. This is the first year, I actually took them when RXed, because well... I am in more pain and it is getting unbareable compared to before.
Just complain about your pain, that is all I ever done. I give them descriptive complains. Like one time I told my old RD, I wanted to cut off my leg because of the pain. He RXed me Lortabs.
But before I decided to tell RDs just how bad the pain was... they mostly RXed me Ultram. It never touched my pain, even when I did not have as bad of pain as I have now. So... that is why I never filled my pain med RXs. Other than I did not want to sleep my life away even more.
Ok... my reply did not help you.
With my doctor, when I tell him I am in pain he asks if I need anything to help. If yours doesn't just tell him/her exactly what you said here, that you are in a lot of pain, but have not asked for anything cause you didn't want to seem like a druggie. They get it. Actually, that is probably a really good way for you to do it.
Good luck
I think my words were something like, "Give me pain meds now, I have survived for ten years without them and I can't do it anymore!!!!"I am about to ask for another vicodin scrip because I have used up most of what I have, because of this freaking hip... used to be a months supply lasted me a year..
Katie, I would just say to them that your pain is normally controlled by Tylenol, however you have been experiencing occasional breakthrough pain and need something to help control that. It's a perfectly reasonable request and unless your doctor is paranoid, that shouldn't come across as you being a druggie. I think for many of us, when we plan to ask for pain meds, it's a bigger deal in our minds than it is in theirs. I have now been in the position of asking for pain meds, and then asking for stronger pain meds at least twice over a period of several years, and I have not had an issue.My RD never offered them, even when the pain was extreme. I visited my counselor who also is an ARNP/MSW and she finally talked me in to taking them. I didn't think I could work if I took them, but found out I couldn't work without them. She also works for my PCP as an ARNP so I see here there too. I haven't needed any for 2 months, but as the pain got worse she changed what I had.Katie, thank you for asking this question, I've been wondering the same exact thing myself for some time now. I've only been having pain since July, and when I told my RD on my 2nd visit how much my shoulder hurt and how the Voltaren wasn't touching it, he said the only other option was a cortisone shot. I declined that because it sounded traumatic, and asked him instead about muscle relaxants, he said they don't work. Then I asked about physical therapy and he said, no, the pain is due to the arthritis so it won't help. At that point I gave up. I see here that many of you get relief from Vicodin or Flexeril, but I guess I picked the wrong RD, he doesn't seem terribly compassionate. Sometimes I wonder why certain people decide to become doctors.
Katie, if the Tylenol was working and doesn't now, you may not need anything that would even remotely label you as a "druggie." Tylenol never worked for me, but Aleve does and the RD also gave me the stronger version of it, Naproxen for really bad days. You may not need to jump to something potentially habit-forming yet. You certainly are entitled to pain relief, whatever form that takes. If it turns out you do need the really heavy hitting drugs, so be it, but maybe you could try a milder prescription drug first and then go from there. Good luck. It's awful to be in pain all the time.
My RD is somewhat skeptical about giving out stronger meds than Ultram, but when I described the pain to my GP and how it has effected by lifesytle, he immediately wrote me a RX for stronger meds. I think the lifestyle issue is important - chronic pain was limiting my work, my family and my hobbies. He watched me very closely for a year and saw that I was using it on a consistant and limited basis (I take 1/2 pill 2-3X day). Now he allows refills with a quick visit. Its all about specifics and how the chronic pain has limited your day-to-day life. Best wishes.
Katie,
I'm new here but wanted to jump in on this subject as it is one that really burns me up. The idea that is that in addition to everything else that we have to deal with this, because of this disease we didn't ask for or cause, we also obviously struggle with fear of being "mixed up" with drug seeker/abusers/ addicts...whatever.... when we are forced into needing to ask for pain control.
It just shouldn't have to be that way, so please do not let yourself feel any kind of embarrassment for needing better pain control at times. Or all the time if it ever comes to that for you as it has for me right now.
And if you are unlucky enough to have a doc or two or three that try to make you feel bad for this, try your hardest to not let them influence how you feel about yourself in this matter. Unfortunately I did some bad docs do this to me for awhile, which is why I feel so strongly about this. On the other hand, I am fortunate to have a strong supportive family that has been helping me through this and reassuring me when it was the doc that was "off" and not me!
Good luck to You!
AdeleRenee
Katie
You should not be afraid to ask for pain relief. Before my back operation I 'ate' high prescription strength co-codamol. They make me woozy and unable to function so when I'm in pain that wont be dulled by anything 'over the counter' I take one or two during the day just to take the edge off, then a double dose at bedtime.
When they stop working for me I will just move up the ladder to the next line of pain relief. I'm like you I dont suffer pain all the time and will generally make do (or wait until I'm in a lot of pain until I take something)... that in itself is not a good way to treat your pain. The pain management clinic advocate keeping something in your system so that you dont need to take mega doses to kick in quickly when you're in agony (its a bit like binge drinking controlling your pain like that). Its very difficult to go along with this if you arent in pain all the time though... as I hate having to take anything if I dont need to.
There are so many different types of pain releif on the market and it may take time to find one that suits you but it will be worth it. If you can tell your Doctor/rheumy what's not working for you then he will be able to give you something else that may. There's some sort of 'comfort' in that knowledge that you've got something in your cupboard that will do the trick as and when you need it.
I just ask. I don't use them very often so a prescription lasts me a long long time. I figure that if I was a druggie, they would expect me to go through them a lot faster. But I know how you feel, I'm always nervous about it too because of what they might think. But when I weigh that against having a flare with no pain meds, I'd rather have them question me over it (which has never happened) then go without. I did discuss possible addiction with my RD early on just because I know that can happen innocently. That is too scary to fathom. I know my doc would never prescribe them if he felt I was over doing it.Katie ~I get my pain meds from my family doc and he never has hesitated. He understands the disease and was the first to give me prednisone (i was sick for 6 months, got bed ridden and had my husband practically carry me to his office for drugs while waiting a year ofr my first rhummy appt to gte here).
So, he saw me at my worst, and never had a problem prescribing me. He is also in charge of my prenisone.
I am glad you posted this. I have never asked for pain meds and consider myself the "tough it out" type. My current meds have been working okay but I had a horrible, woke me up at two in the morning shoulder, locking flare.... I was sobbing. I ransacked the medicine cabinets in the house and found my sons rx from a month ago when he broke his wrist and was able to get some relief.
This time when I went to my RD I needed courage (because unfortunately I felt bad for asking) I typed up a list of questions for my doctor and the last one was pain meds.... He did not even bat an eye.... which made me feel stupid for waiting. He told me I should never have to go to the ER in pain from a flare and of course he would give me a script. He wrote me a script for Vicodin ES and three refills which should last me a long time (hopefully!!)
Connie
I never asked for narcotic pain medication until I started having flares in my shoulders. It is the most horrific pain! My RD gave me 45 tablets of Darvocet N. When that didn't do anything for my pain, he gave me 90 Lortab 5. A whole year later, I asked him if I could have another 90 because when I flare, even a double dosage of Relafen does absolutely nothing and the Lortab helped take the edge off. I got the speech about how they aren't anti-inflammatories and how they are addictive, blah, blah, blah. Made me feel like an addict. He did give me some more but I was pretty upset about his little speech. I didn't think my history warranted that kind of treatment.Jesse - I've reached the point where I can't take any of the NSAIDs that I've tried. They all give me TERRIBLE stomach cramps. The double over in pain kind, that's why she told me to take Tylenol for now. When she told me that last visit, I knew full well it wasn't going to cut it all the time, but I said okay anyway. I know that I won't be able to take 90% of the pills you all listed. I'd be a zombie on them, I'm such a light weight. It took me several months of taking the Flexeril every day for it to not kick my butt. Even so, it still makes me sleepy. But at least that works for my neck and shoulders. But the things with my elbows, wrists, fingers, that's not muscle - that's totally RA.My RD will not write the script for pain meds. Well, wait. She did it once but she said that was the first and last time. That was back in August and I still have those pills. She'll give me muscle relaxers and sleep aids, but that's about it. She told me I'd have to get the pain pills through my GP. I don't have a GP at this time and I'd feel weird seeing a new doctor and asking for pain killers up front. They'd probably think I was a junkie loser!
Hope everyone is having a superfantastic and comfortable day!
I sure hope you can get something to help you.
Well................back in the day when I had all my migraines, I got to "sample" lots of different pain killers. I was in and out of the ER and my docs office so much, and no one had a clue why. But it was such extreme pain, they were always saying "lets try this one!" On the pain scale, I'd go in at a 10 - I couldn't even open my eyes, or sit up on my own. They'd pump me with pain meds, and I'd knock out like I hadn't slept in days. Run all their tests, and ........ nothing.Mel-Bleh to your RD. Try seeing a pain management specialist, that's what they're there for, so you shouldn't feel funny asking up front.
Katie-You might be surprised that pain meds that kicked your butt in the past might not do so now, depending on how long ago "back in the day" was. Also, maybe the dosage was too high. And besides your charting, be sure to take photos of those missing knuckles. My RD was shocked when he saw the photos of my "softball" ankles.
Every time I see my RD I tell him about my pain. Last time he gave me another prescription for a different nsaid. I think I've tried about every one by now. I can honestly say I'm in pain from the time I wake up until I go go bed. Not all from RA I might add. I have a number of things going on, but still. I can't work. I'm so thankful I don't have to. I don't know what I'd do. My husband says I handle it well. I really don't. I internalize it. God only knows what it's doing to me.
I've been thinking about drinking again. I really don't want to. I'd have to force myself. But I have to dull the pain somehow. I have an appointment next week with my RD and I'm going to ask him for something strong. I'll just have to go from there.
Another thing you can do Katie... is call in the the office and tell them you are in pain and what kind of pain and how bad it is and they more than likely will call you in some pain meds.
That is how my last RD done it. If I was hurting and I could not take it any longer I would call his office and leave a message and then they would call me back to tell me what he RXed me. I always wanted the pred pak, but he always RXed me lortab5 15 pills at a time.
I haven't needed pain meds in weeks now but when I do, I found plain extra strength Tylenol just didn't cut it. My RD prescribed Tylenol with codeine and that did the trick. No longer on prednisone either.I'm very fortunate that I don't have any problems getting a pain medication if it's needed. My RD's really good at reading pain levels... she watches how I move and sit and checks to see if there's any puffiness and heat in my joints. If things aren't going well for me she says, " Now be honest... tell me how bad is it? What things can't you do that you could do a week ago?"
I find it helps to make a list of things I do daily and rate them on a scale of 0-10, with 10 being the worst. Show him what it's like on your good days with tylenol and what it's like when the pain's uncontrolled.
MrsAlexander, that seems kind or irresponsible of your RD. You have a right to a pain free life. It may not always be possible, given that meds don't always work or other extenuating circumstances, but for someone to tell you you can't have pain meds no matter how much pain you're in seems almost sadistic.I was thinking the same thing Gimp. I think I would have told them just how cold hearted they were. They are specially trained in this area, but don't understand the level of pain involved with the disease? Hmmmmm...slept in class alot ay?
I am also planning to ask on the 21st. Days are not too bad, but nights are killing me! I have so much leg and hand pain at night that I am awake half the night. My RD normally asks if my pain has gotten worse and if my Naproxen is taking care of it. My guess is she knows it's coming sooner or later! LOL
Dont feel bad Katie! >WE< have to live with the pain and try to have a normal life. Ask for what you need.
Kathy