I've had RA for over a year and a half. I've been through a dozen different meds - the basics - pred, mtx, arava, minocyline. All that agrees with me is Enbrel, Celebrex and minocycline. Pain management varies, but i usually take 1/2 a Vicodin EC twice a day. Seems to help take the edge off the pain so I can function. Question: how many out there take pain meds on a regular basis and how long have they worked? Do they lose their potency over time? I'm somewhat concerned about dependancy issues. I'm only 49 and I can't help but think what happens 20 years down the road.
Hi justoday
You ask a really good question and I'm interested in what the others here have to say. (I use the same drug regularly too, but only for the last 6 months.)I'm new here too and there are lots of wise people on this site, with years of experience!
I don't know what the facts are, but pain medicines can be hard on your stomach, your kidneys and your liver.
As far as Vicodin goes, either my pain is increasing which I believe it is, or the effectivenesss of the medicine for me is going down. When I first started taking Vicodin it would really hit me. Now, no so much. It still takes that edge off though. However, I take it 2-3 times a day.
I don't think long term use of pain meds is considered good by anyone. But, once you have enough damage that cannot be corrected or helped by other means, then you have to take those medicines.
Many people are on much stronger medications. The effects of the meds vary because of the difference in people's initial response to pain and to each particular medicine. For those with severe back and spine problems, I think you are going to see the strongest medications.
A lot of doctors are hesitant to prescribe any pain meds. This is old school as it has been studied and found that if a person is truly in a lot of pain, they are less likely to abuse or become addicted to their pain meds.
Still, I worry. So, I try and alternate pain solutions. I will try tylenol first, then Vicodine if that doesn't cut it. I also try not to take the pain meds at the same time every day or take more than two, less if I can make it. I have a TENS unit and will use it for hours and not have to take the pain meds during that time. Heating and ice packs can help you not use the pain meds as much. Or, just learning to rest when its appropriate.
If you have a responsible doctor, they are not going to prescribe you to the point of addiction. And for the narcotics, there are very strict laws on how much they can prescribe. If your pain increases to a point where the more general medications are not working, seeing a pain specialist can help.
Remember that pain is a warning sign. So, if you are having pain in a particular area, maybe something about that area needs attention. If your knee, for instance, is extremely painful then you need to have tests done including MRIs to make sure that damage is not occuring.
So, I guess the answer is not to take the meds lightly, be very aware of exactly what is hurting and what alternatives you have.
Taking pain meds can cause extra problems like acid reflux and bleeding ulcers. With acid reflux, they will add prevacid or Nexium. If you suddenly have bleeding, that's an emergency situation. Also, some people have been pulled off their pain meds because of liver or kidney problems.
So, you have a right to be concerned. But just be open with your doctor and discuss your pain and any side effects that you should be aware. Also, if you need to take something for pain, take it at the beginning of the pain and don't wait until it's excruciating. They are more effective then.
There's a lot of people taking different things and hopefully they will hop on with more info.
You do have the right to pain management. Neither of you are taking very much at this point.
Deanna needs sleeping pills!! And so do I!! lol I don't take them yet. I'm afraid of them. There are times (like the past two weeks), when I think it would be lovely to make the pain go away. My RD keeps telling me that with the right mix of meds, I won't need anything for the pain.At this point, the dose that you are taking is very small. But you are ahead of the game if you are thinking about the long term effects that go long with pain meds. They do lose some of their potency over time and Deanna had a good suggestion. Take the smallest dose you need to get relief and try some alternatives to go along with the pain medicine. Starting off with a non-narcotic pain reliever is also a good idea. I always take ibuprofen or tylenol first and then move on to the big guns if those and heat/cold or the TENS unit dont work. Also if you are needing to take the pain medicine more than it is perscribed or even at the perscribed rate for more than a week at a time, you need to talk to your doctor. Your RA is not under control if that becomes the situation.
Think about people with asthma, they have those rescue inhalers that they use if they start having an attack. They have preventative meds that they use every day. If they are walking around puffing on that inhaler all day, they dont have control of their asthma. That means they are walking away with an airway that keeps swelling shut. Scarey right?
If you are taking a lot of heavy pain killers (ie narcotics) for several days or more, your RA is not controlled. You are covering up the problem. You are walking around with joints that are sore because your body is attacking them and destroying them.
For anyone who has tried every RA drug with no success and is basically out of treatments to try...unfortunatly pain meds may be the only solution. But otherwise, comfort measures only is NOT treatment for RA.
There are some people who get a little defensive about the pain med issue. They are sensitive because they dont want to be labeled as an addict just because they need their pain medicine and they arent taking any more than one doctor has perscribed.
Fair enough---no thats not an addict, but that is also a situation of either poor RA management by the doctor, or disease resistance to the medications. Hopefully, all doctors will see these issues and adjust medications accordingly. But that doesnt always happen. Sometimes because we dont know to relay that info to the doctor. "hey doc, I am still consistantly having to take alot of these pain pills just to get some relief...isnt there something better we can do?" Doctors arent always receptive to that unless the pt brings it up first.
The indication for a narcotic is severe pain. Most reasonable people will agree that if someone is in severe pain for a week or more, that their condition is not being treated effectivly.
I hope this helps.
Justoday-Welcome!But when the kids used to live with me, they had a lot fun with it. They come in my room, have an entire conversation with me, I would reply to them, and the next day I would know nothing about it. Sometimes it was really important stuff. They thought I was listening, because I was speaking. Oh well.
Crunchy,
I so agree with your analysis completely (spoken by a true nurse, too) and I don't feel like my illness is under control. In fact, I think that being on the pain killer for one problem masked the development of my shoulder problems. When they have got my RA meds in balance, my pain levels have gone down immensely. But I am tapering off prednisone which is kind of a priority right now since they have already been afraid I was developing bone necrosis in my hip. I really don't want my bones to die. He said if I didn't get that down, I would really be sick.
I am kind of at that point though where they are throwing all the recommended combinations at me. Now they are saying, in order to improve, you've got to lower your work hours. My doc won't budge on that. He's a pretty stubborn individual, sweet, but stubborn. He hasn't moved on that position in over two years. When I complain that I'm just don't feel like things are working for me, he just restates, "cut down on your hours."
With this "work from home" again status, I am really frustrated. Don't they have anything else in their magic box for me?
The pain meds, I hate them. I can't go out on them, so they keep me forced at home more. They are hard on one's system. And, I do not like to feel loopy. I need no help with that anyway. I can do loopy by myself just fine.
Good question.
I tried all sorts of pills like Vicodin etc. but they didn't help, only ultram works for me. I take 4 pills a day, any less and i will have a very unhappy body.
I know i will probably take them forever which concerns me, but if I need them and have to take them daily for pain, I guess addiction wouldn't be a problem since i have to take them anway.
I worry more about the other meds we take...not much worry here about pain meds. Just wish I could find something that actually took the pain away instead of making me fall asleep.I had to resort to the pain meds over a year ago now. I didn't want to ... due to the dependency issues and with drawl. However, there is a HUGE difference in being addicted to something for a reason ... then just being addicted for recreational purposes.
I take Oxycontin and back it up with Vicodin ES on my heavy pain days. This is under control of my GP and my RD though. Without having them both involved I wouldn't have done it. I don't think that I could be 1/2 the person that I am without the help of them both.
IF you decide to pursue the pain meds remember to start on a LOW dose and work your way up. Sometimes the higher is NOT always better to start with. I have remained on the same MG's for about a year now.... Yes... you have to live with a certain amount of pain but, you can't live in pain if you can't function because of it.
Hang in there and be sure to discuss ALL your options with your doctors.
Try to think of pain meds this way. You are probably going to be in some kind of pain. The pain med is your little vacation from it. For me, it is more a mental relief than a physical relief because the pain never really goes away. But I can tell myself that when I get home, after all my responsibilities are done, if I need it, I can take something for pain.
A lot of times, I will distracted by the pure enjoyment of being home. I'll get involved in something on the computer, or watching a program or talking to a friend. And, for that time, I don't think about the pain. It's still there, but it is not where my mind is.
What I need the pain meds for the most if when I cannot work without them. Or, if the pain is keeping me awake all night and the lack of sleep is going to make my condition worse.
It is a balancing act and for the most part, I believe it is a personal journey. So many people told me that they would never take anything for pain. But then they don't have my pain.
But as Olive said, you are working with your doctor towards a reasonable solution, it is a great aid in your ability to function. The better they bring your disease under control, the less need for the pain meds. So, it isn't really a case of always needing to take these the rest of you life. It is learning how you are going to deal with your pain. Take advantage of other alternatives like physical therapy, etc. Use things in combination and alternate them. That really helps to.
Thanks for the perspectives. I sometimes wonder if the remedies are as varied as the many different faces of RA. Pain is the indicator for RA, but it can also be the throttle of life. My body seems to reject most of the ingredients of the basic RA cocktails. Therefore managing my RA to control the pain is somehow elusive. It is certainly not noble to burden the pain and thus give up your drive for life. It is a fine line. You are right, Crunchy. Just enough to soften the edge, but not enough to dull the senses. There is music. There are books. There is a good wife and a pretty child. There is so much more to life than pain.
But your body is going to bounce back. When it does, they can treat you again. At least that is what I hope for you.
Did they send you to a pulmonologist when you came down with the bronchitis? They did with me because they were afraid I had a blood clot in my lungs. It was a false alarm, but the second false alarm on the blood clot.
I have asthma, so I am always suspectible to it hitting my lungs. Bronchitis is the worst. Even people with RA can get so very sick. But I hoping you get better really quick.
There are a lot of kind people here. Suffering is such a good word for all of it. It seems like we stay in that state even at the best times. But when you get sick on top of it, I know it is so overwhelming.
Just remember to rest the best that you can, hope the most that you have and come here for people who know what it feels like.
I think JoJo has it. I've only been living with RA since last October. I still don't believe this is a lifelong disease. I'm going to wake up one day and be just fine. Every day that passes that that isn't true, I get a little more beaten down. Accepting pain is one thing for the short term. Over the long haul, though, I'll bet it gets really, really old. Crunchy, that was a wonderful analogy of pain meds. Kudos to you for it.