Changed my meds

**Cindylou** · 10-19-2010, 10:14 AM

I seem to find myself at the pain management clinic more often than your usual joe lately. Went yesterday to revisit my meds as we talked about doing right before I left for my high school reunion. We decided to stop the fentanyl patch and today will start morphine, the MS Contin at their lowest dose of 15 mg. I think that is pretty standard to have pm docs start you at the bottom and work your way up, only as necessary. We are also going to try an epidural injection in a week or two, targeted at that same area, if I don't reap the benefits of the RFA. I really don't understand how the block in the facet joints could have given me so much relief, albeit temporarily, and the actual cauterizing isn't. I just don't get that. Anyway, trying to stay hopeful on that.
I have been having some digestive issues for about a month, to compound things. Major constipation again which yesterday I finally got some relief from after feasting on Miralax, stool softners, gatorade, and finally X-lax, I believe got the job done. My PM told me yesterday to buy Propel, made by Gatorade, and take that instead of the Gatorade.....less sugar, more nutrients. And either Milk of Magnesia, which I hate, or the X-lax is fine she said to add to that. She said, oh one bottle of that Propel really hydrates you and helps you go. You probably aren't even cleaned out yet completely. So I went to the store after I left the appt., bought some, drank 3 bottles of the stuff last night and nothing. She just doesn't get my body. It never wants to poop. I eventually started producing some results (sorry, stop reading now if you can't take the info) yesterday morning before this pain management appt., after sitting on the pot for 2 solid hours cramping, in misery,

my stomach still feels like someone punched it. A month ago, on my actual birthday actually, (oh yeah, joy) I was vomiting up green bile and my husband said we have to go to the ER. Anyway, the ER doc had said I need to call my primary and schedule an upper endoscopy, (after they ruled stuff out) but I hadn't done it yet cuz I thought things would settle down, but they just haven't. I have not been able to handle any solid food for over a week, just liquids. And every time I try, BAM, my stomach goes all stupid on me again. So now I am waiting for the phone call from the Gastro folks to set up the endoscopy. I know I have Gastroparesis, which is when food just sits in your stomach way longer than it is supposed to, and some Diverticuli issues, but I just want my stomach to feel better. And then to add insult to injury, I woke up yesterday with pink eye! Geesh, for crying out loud. Cut me some slack!

I scrub my hands constantly, so am just baffled why I keep getting pink eye. I throw out my mascara, all the stuff they tell you to do, but I keep getting it. It's making me wonder if my granddaughter could be a carrier of it, but I don't even know if that is possible. Sorry for the long rant. Hopefully things will turn positive soon. Hope this wasn't too much of a downer, as I just needed to vent. I am scheduled for a massage this afternoon, so I am really looking forward to that.

CL

**KBear** · 10-19-2010, 06:27 PM

CL-
I'm sorry you are battling all of this at once. Being constipated is so miserable and then the medication to fix it makes you hurt more, at least until you get relief. I took my usual high dose of Peri-colace 2 days ago after not taking it for a week and figured out real quick that the hydrocodone was most of the constipation, now I'm the opposite end of the spectrum. I know better for next time. Another thing that helps me is V8 fusion, but it's more of a do regular thing, once you are backed up, it's too late for that. I take a pro-biotic too, but don't think it helps much. I don't think the doctors understand what kind of backed up it is on the medications and stuff. I have taken medication that says it will work in 2 to 6 hours and have absolutely nothing happen..... Hope you can get and stay regular.

I think the endoscopy is what they did to my hubby when they did the colonoscopy. They put a camera down your throat and put you to sleep, right? I hope they can find out what is wrong and help you with it. They helped hubby and he has regained all of his weight back (and the stuff they said to do is OTC fiber and prevacid). Made a huge difference for him and took his pain away.

Will be praying for you,
Kathy

**Jack-of-all-trades** · 10-19-2010, 10:47 PM

Originally Posted by Cindylou

I seem to find myself at the pain management clinic more often than your usual joe lately. Went yesterday to revisit my meds as we talked about doing right before I left for my high school reunion. We decided to stop the fentanyl patch and today will start morphine, the MS Contin at their lowest dose of 15 mg. I think that is pretty standard to have pm docs start you at the bottom and work your way up, only as necessary. We are also going to try an epidural injection in a week or two, targeted at that same area, if I don't reap the benefits of the RFA. I really don't understand how the block in the facet joints could have given me so much relief, albeit temporarily, and the actual cauterizing isn't. I just don't get that. Anyway, trying to stay hopeful on that.
I have been having some digestive issues for about a month, to compound things. Major constipation again which yesterday I finally got some relief from after feasting on Miralax, stool softners, gatorade, and finally X-lax, I believe got the job done. My PM told me yesterday to buy Propel, made by Gatorade, and take that instead of the Gatorade.....less sugar, more nutrients. And either Milk of Magnesia, which I hate, or the X-lax is fine she said to add to that. She said, oh one bottle of that Propel really hydrates you and helps you go. You probably aren't even cleaned out yet completely. So I went to the store after I left the appt., bought some, drank 3 bottles of the stuff last night and nothing. She just doesn't get my body. It never wants to poop. I eventually started producing some results (sorry, stop reading now if you can't take the info) yesterday morning before this pain management appt., after sitting on the pot for 2 solid hours cramping, in misery,

my stomach still feels like someone punched it. A month ago, on my actual birthday actually, (oh yeah, joy) I was vomiting up green bile and my husband said we have to go to the ER. Anyway, the ER doc had said I need to call my primary and schedule an upper endoscopy, (after they ruled stuff out) but I hadn't done it yet cuz I thought things would settle down, but they just haven't. I have not been able to handle any solid food for over a week, just liquids. And every time I try, BAM, my stomach goes all stupid on me again. So now I am waiting for the phone call from the Gastro folks to set up the endoscopy. I know I have Gastroparesis, which is when food just sits in your stomach way longer than it is supposed to, and some Diverticuli issues, but I just want my stomach to feel better. And then to add insult to injury, I woke up yesterday with pink eye! Geesh, for crying out loud. Cut me some slack!

I scrub my hands constantly, so am just baffled why I keep getting pink eye. I throw out my mascara, all the stuff they tell you to do, but I keep getting it. It's making me wonder if my granddaughter could be a carrier of it, but I don't even know if that is possible. Sorry for the long rant. Hopefully things will turn positive soon. Hope this wasn't too much of a downer, as I just needed to vent. I am scheduled for a massage this afternoon, so I am really looking forward to that.

CL

Part of reason is that an injection kind of spreads through interstitual spaces and may have covered the pain generator. This might help localize pain source.

I did a trial of switching from Fentanyl to Avinza. The Avinza dose was way to low and I was in withdrawal for a few weeks till things equalized. I had to use my stick back meds to cover the difference. Oral morphine seemed to slow GI motility more that fentanyl but we are all different. A heads-up just in case.

**Cindylou** · 10-20-2010, 01:03 PM

Thanks Kathy and Jack for your responses. Kathy, yes I am having an endoscopy on November 3rd. Just like what your husband had, it sounds like. I have had one or two before, when they were diagnosing my ulcer. This isn't an ulcer, I'm pretty sure. I think things just got really messed up with the constipation, and then I ate those stupid mixed nuts which just ripped me up more. One thing my pain management NP told me the other day is that it is a misnomer when folks tell you to eat more fruits and vegetables and nuts when you are already backed up. It's actually the last thing you should do. It only makes it worse. She said when you are that backed up you only should be drinking clear liquids and either Milk of Magnesia or X-Lax, one of those until you produce a bowel movement. Then you slowly begin adding the fruits and veggies etc., as tolerated to help keep you regular. And also, that taking so many pain meds, on top of my own slow motility, I have to either drink prune juice or the like, take a stool softner daily, and of course lots of fluids. Since I have never been a water drinker naturally, (I can eat a whole meal without one sip of milk or water) I think this Propel will help me, because I like the taste of it. Jack, thank-you for the heads up on the MS Contin. I appreciate it. Also, I get what you are saying about the numbing medication bathing a whole area in there, so possibly it's not my facet joints, but whatever got bathed in the medication that gave me the temporary relief. That is why they are thinking of doing an epidural in a week or so, in that same area, in case the facet joints weren't the culprit. I tell you. Finding pain generators is such a tricky business. In my perfect world, I'd like to think I could just point and say "right here." And bingo they would fix it. Oh, to dream. My pink eye is clearing up (I had some of the leftover eye drops ) so I am not as bummed. It's just when you get the multiple things going on, plus your spine issues, it can just drag ya down, ya know? Tomorrow I am going to an apple orchard about an hour west out in the country with my son, daughter-in-law, and granddaughter to pick apples. I am really looking forward to that and hoping to get some good pictures. I do love fall. Leaves are almost all down though, so I know old man winter is just around the corner. Not sure I'm ready for that yet. But like it or not, here it comes.

CL

**KBear** · 10-20-2010, 02:41 PM

CL- I think that most give the usual constipation advice, not realizing that our diets are usually not the problem. I have been told to eat more fiber and drink more water more times than I can count. I drink tons of water, at least 16 cups a day. When I was working on losing weight and tracking my food, I had the app track my fiber too and it turns out I consume almost double the recommended amount of fiber, so that's not it either. I believe diet can help, but I think it's definitely something you have to stay on top of and take the stool softeners daily too (I like peri-colace, the regular colace didn't do anything for me). I hope you stay clear and are able to find the right combination for you.

**Justin** · 10-20-2010, 04:19 PM

Hi CL, sorry for the GI issues. No fun. Have fun at the orchard with your family--that sounds like a great time. BTW, good luck with the upper endoscopy.

Here's a couple great links:

**Metalneck07** · 10-20-2010, 09:27 PM

CL Sorry to hear your still struggling so much. I wanted to share with you a medicene that combats constipation in patients with long term opiate usage.WPKAT put a link to it on my thread it's called Relistor.I'm going to ask my pm about it because I'm tired of the daily struggle to stay on top of it.One day your moving along great next day your backed up and hurting!!!! So if this new med is worth it I will be giving it a whirl.Like I said there's a direct link to the company with alot of information on my last thread.Take care ENJOY your day at the orchard.That's my favorite along with the Pumpkin farm we go every year.I love fall so much.But I imagine up in your neck of the woods winter could happen any moment.
Take care.Hope all goes well with the Upper Endoscopy.I have had that one 2 times and thank goodness that one is tolerable compared to all the spine stuff we have been thru.Your in my prayers and thoughts .

Caitlin aka Metalneck07

**Phylly** · 10-21-2010, 01:58 PM

CL,
So sorry that you have one problem on top of others. It does get you down. The only way I can combat the constipation is to drink Miralax nightly along with the colace morning and night. (or peri-colace which I will try with the advice of KBear). I try to drink enough water too so the gatoraide should be good too.

I hope the endoscopy rules out any problems. You have certainly had too many!!!!
Warmly,
Phylly

**Cindylou** · 10-21-2010, 04:52 PM

Thank-you all. Justin, great links. Thanks alot. Caitlin, keep me abreast how the Relistor works for you should you decide to have it prescribed. I hate the idea of one more prescription drug,you know what I mean? But, then again, if it works great......

Kathy, I totally hear what you are saying about always being told to drink more water, eat more fiber, albeit......it sounds like you do more of that than me to begin with anyway. My tummy is slowly taking baby steps to solids.

Today I have been able to keep down a hard-boiled egg. I still felt sick afterwards but it stayed down, so that's progress. I have also tried a few slices from an apple today too, but don't want to push my luck. Phylly, so nice to hear from you too. I hate that I came off as such a whiner. I don't want anyone to feel sorry for me. That said, I most certainly welcome all the advice. I am just starting a regime of Miralax nightly too, plus the colace. I am going to check out that other colace too, per Kathy's suggestion.

On a positive note, I am slowly beginning to feel like the RFA is giving me some relief and lowering my pain levels. This is huge. I re-read the fact sheet they gave me after my RFA this morning, and it actually says it can take 4-6 weeks for the nerves to completely heal and the lesion to form. It is the lesion that "stops the transmission of electrical impulses across the nerve or breaks the communication link to the brain." The link to the brain that says you are in pain. So this was quite encouraging to read. There's still hope. Yay! My son had to cancel our apple orchard day today, but we're hoping to reschedule it in the next few days. I actually ended up needing that extra time today, so it was all good.

CL

**KBear** · 10-21-2010, 06:09 PM

Glad you are feeling better about everything today. I always said "I just need to cry today and I will pull it together tomorrow and fight the fight again." Sometimes we just need to vent, be mad, have a pity party, etc. Then we can wake up the next day and fight the fight. As long as we don't stay in the negative, it's good (keeping in all the negative is probably just as bad as being negative all the time).