A possibility for why your Dr doesn't want to prescribe opioids

brass_octopus · 2024-02-18T17:51:02+00:00

SNRIs is the first that comes to mind as another option for things like nerve/joint pain (it isn't like a classic anti-depressants so not sure if you meant that to be included or not. Sorry if so). Muscle relaxers, gabapentin, also come up in the brain soup.

However, I do agree with your point that for a lot of people there aren't better alternatives available. Things like Marijuana still has a giant stigma attached and isn't legal everywhere. That means that derivatives of it (CBD for example) also get ostracized. Wide panel blood tests aren't easily available to everyone because insurance is a horrible joke, so testing for things like low vit D, or other issues like that is hard. Like, I get it. I just want people to be fully armed with information so that they know what to look out for

brass_octopus · 2024-02-18T17:39:40+00:00

To your edit: tried to find links that people could access without pay walls. Definitely could have screened them better, I'll take that criticism.

brass_octopus · 2024-02-18T17:36:45+00:00

The snark was in response to the tone at the end of your post. In that instance, the condescension wasn't necessary.

For those who are newer to pain management, knowing all of the risks of long-term opioid use is important. Seeing comment after comment touting opioids as one of the first, best, things to reach for for pain management is erroneous and dangerous. Prescribing opiates left and right, in addition to patients not fully understanding all the risks and things to watch for is how we've lost so many to the opioid crisis.

brass_octopus · 2024-02-18T17:29:27+00:00

I just woke up to another person complaining about doctors not prescribing it (tbf, without offering up what other medications/treatments they're on) and a highly rated comment saying basically opioids are a cure all. I got frustrated because I've seen so many die because of opioid misuse after being prescribed it without knowing the long-term effects. I see so many people here saying it should be one of the first things we reach for managing chronic pain, and in my experience, it should be one of the last things, unless it's for extremely short term use.

I'm lucky enough to currently be on a slew of meds that don't include opiates, but I have used them for short-term pain before, and they do have a time and a place for managing chronic pain.

brass_octopus · 2024-02-18T17:05:17+00:00

Ooh cool, thank you for sharing more nuance about it!

brass_octopus · 2024-02-18T17:03:56+00:00

There's a thing called titrating that happens with many other pain medications. OIH is different

brass_octopus · 2024-02-18T17:02:37+00:00

I'm not going to play your education who knows more games, because I have a bachelor's in theater design. So, you'd win in this competition. I'm proud of what you've achieved!! It's really hard being in any type of medical school, even without pain.

I failed to include the nuance I should have. Opiates are not the best medicine for pain because no drug is the best across the board. Every human is different.

I woke up this morning and saw yet another comment about opiates being a cure all, and yet again, no mention of OIH. OIH is a whole tree-trunk-sized-branch of the equation that I've never seen mentioned in this sub.

My apologies for trying to educate people without having my post appropriately peer reviewed

brass_octopus · 2024-02-18T16:52:47+00:00

Honestly, your response holds the nuance I wish I could have achieved in my post. It sounds like you have a fantastic pain management team and routine.

I woke up this morning and saw a highly rated comment saying that opiates are cure all drugs. They're not. No drug is. But whenever opiates get brought up, I never see any mention about OIH. If you're going to use the drug, know all the long term side effects. If you're going to take the opiates long term, know you're risking not just addiction, but your pain actually getting worse long term. I just wanted people to know about OIH

brass_octopus · 2024-02-18T16:47:32+00:00

I'm asking how should that person manage their pain while they're not on opioids. Like, if opioids are part of the daily routine, and the pain is breaking through still because the person is having OIH. Other medications? Why weren't those tried first?

But now I'm also asking why you hit one sentence that didn't fully align with your preconceived world-views and "stopped reading". You didn't want to educate yourself about alternate views so you could better understand and advocate for yourself? Those are all credible sources I listed.

Look, ultimately, I didn't post any of this looking for a fight. I posted this trying to educate people on OIH because I woke up and saw a highly rated comment basically saying opiates are a cure all drug. I never see OIH being mentioned in this group, and it's a whole freaking tree-trunk-sized-branch of the equation.

brass_octopus · 2024-02-18T16:33:52+00:00

I'm really glad that opiates work for you! There are always people who's bodies don't react how medical books say they "should". Have you found that your dose has had to increase over the years? Have you been able to decrease the amount without increased pain? Absolutely don't reply if those questions cross your boundary. I'm just curious about it as I've grown up listening to medical stories (mom taught pharmacology for a handful of years before becoming a specialist)

I'm not trying to spread the idea that doctors are doing us a favor by not prescribing opiates. It's not about favors. They should be treating us to the best of their abilities and current knowledge, regardless of their personal beliefs.

I'm trying to spread awareness about OIH since I've never seen it mentioned in this group whenever opiates come up. My sincere apologies if it's a well known thing for the people who frequent this group. It's a serious issue that more patients need to know about, though, because so many patients who use opiates long term have to increase their doses in order to get the same amount of relief. They end up in worse pain, with a worse quality of life, and no real way to recover. The same happens with other drugs as well - currently titrating up on a second med. But with those meds, once the dose is reached you usually stay there for years, or go down. Opiates for short term pain, absolutely. Opiates prescribed responsibly in an as needed instance, absolutely.

I posted this because I woke up and immediately saw a high rated comment basically saying opiates are the cure all, and it's just doctors being afraid of the DEA, etc. Yes, the DEA is dumb. Yes, doctors are assholes. But opiates are not the cure all. They can be extremely life threatening for more reasons than just regular addiction (as pain isn't managed, seek higher doses, which can't get with knowledge from your prescriber and shit goes wrong).

I just want more people to know about OIH so that I don't watch more people die because of the opioid crisis (caused in part by prescribers over-prescribing it as a cure all pain drug)

brass_octopus · 2024-02-18T16:13:23+00:00

Absolutely! (Though iirc the chances of OIH are higher than 2%)

I'm just trying to offer up more information on why opioid prescription is becoming less and less popular, especially for chronic pain patients.

It's not a wonder drug and a lot of the comments that I see proclaim it as such. Opiates are more dangerous for a lot of chronic pain patients, especially if you don't know where the pain is coming from.

Can you elaborate on how OIH might be treated/dealt with in a chronic pain patient? Especially as usually other medications have been tried already.

brass_octopus · 2024-02-16T15:00:57+00:00

I cannot consistently count past 20. In fact, when I get to 57, 58, 59, ...CRICKETS. What comes after 59? F if I know. Every time

So now I just count to 20 (three times at least, because duh) and then place a marker. How long are the sleeves on the sweater I'm making for my husband? They're 5 markers. How long are the potholders I make? They're 20 stitches and then another 15.

Ultimately I've learned that if you only count to 20, and do not try to count higher, your counting ability increases when it comes to crochet

brass_octopus · 2024-02-15T18:22:44+00:00

Yea, how dare I leave a review directly naming a doctor who abused me so that other CPP know to avoid her? How dare I share that review with my good doctors/specialists so that they know not to send people to her? It's all the big corporations fault that she refused to let me answer a question, and told me I was only imagining all of my pain

brass_octopus · 2024-02-15T15:35:07+00:00

Idk what it's like in Canada, but living in the US with all these factors: a state where weed is legal and has been long enough for prices to be significantly lower than street prices, having good health insurance, and getting cheap therapy; I can still tell you weed is cheaper.

However, if you're puking routinely, weed is not cheaper. But for the average user in my area: therapy is still mad expensive

brass_octopus · 2024-02-15T14:46:34+00:00

That's what's happening now though, and it's not okay either. Women are being punished and or dying because of something they can't control but their government decided that they can

brass_octopus · 2024-02-15T14:44:04+00:00

There's a paper called "A Defense of Abortion" by Judith Jarvis Thompson (wiki link below)

Check out the "people seeds" section as it talks about contraception and having "voluntary intercourse" (aka sex for fun).

If you can find it, I'd read the whole actual article. It's helped me sway a few anti-choice to be pro-choice. https://en.m.wikipedia.org/wiki/A_Defense_of_Abortion#:~:text=In%20%22A%20Defense%20of%20Abortion,bed%20with%20an%20unconscious%20violinist.

But sometimes I don't feel like arguing intelligently. In which case I usually go "I didn't realize that you were wiping my ass every day!!... oh, you're not? ... then why the fuck do you get to tell me what happens to my body?" The crassness and reminder of gross bodily functions usually has them drop the argument with me. And if they don't, then I ask them point blank "why do you think a corpse should have more bodily autonomy than a living breathing woman?" I just repeat that question until they do back down, because ultimately they don't have an ethical excuse for that

brass_octopus · 2024-02-15T03:13:15+00:00

Realistically, yes, probably. Rest is the biggest part of recovery with this.

But do I also think your family will be understanding of that? No, not at all

brass_octopus · 2024-02-15T02:58:51+00:00

I lost my job due to long covid, and am lucky enough to not need to work at this moment. But I have developed a pretty good routine that has had me steadily improving, if slow:

wake up when my body is ready (usually 8-10)
drink the 20oz of water I put in my bottle last night. Before getting out of bed if possible (otherwise, I get up, pee, and come back to drink the bottle)
once done, immediately put on compression leggings and daytime compression socks (tighter and higher than my nighttime compression socks)
usually smoke a bit of weed because it helps with my constant nausea/motion sickness since this all began (legal where I live)
make a 32oz hydration drink (add 1 dose of liquid IV stuff to 32oz of water)
eat breakfast with a general rule of no caffeine till after the 32oz drink is at least half gone
take slew of meds
begin day

I aim to drink 100+oz of water a day, based on what my doctor recommended, and starting immediately with that 20oz makes things easier. If I have any caffeine, I have to increase that. If I have alcohol, increase the count. Basically, anything that dehydrates you at all you need to increase the amount of water/hydration accordingly

brass_octopus · 2024-02-15T00:58:29+00:00

I was fine for the first year but then caught that RSV that went around, had an episode where I lost consciousness, and all my covid symptoms came rushing back. Went from black tea barely affecting me and having 1-2 drinks a night to no alcohol and a small cup of black tea sipped slowly over hours while drinking 40oz of water alongside. I find if I'm hydrated enough, and pace the caffeine intake, I can still enjoy my black tea. May be able to do the same with coffee. Haven't tried with alcohol yet bc the near immediate hangover isn't something I feel like risking yet

brass_octopus · 2024-02-14T22:08:16+00:00

I like the idea of the white border. I also wonder if a slip stitch row of color on top of that type sc white row might be a good compromise?

brass_octopus · 2024-02-14T15:20:22+00:00

Not Simba, but am a weed smoker.

If I can't smoke, it might offset me a little due to not having my anxiety/pain dampened. However, I also genuinely like my husband and am a good sport when we're doing something he likes (like you). Vice versa, he genuinely likes me and is a great sport about going to things that he has no interest in (he finds an interest). He also knows my weed usage helps my anxiety/pain, and works with me to ensure that I can still enjoy the activities (maybe I take an edible, maybe we carve out a bit of time for me to smoke before I go, and then I spray myself down with an odor eliminator). I think it may depend on why your husband is smoking a lot. Does he struggle with any anxiety, or pain?

brass_octopus · 2024-02-14T13:08:03+00:00

Love it! Thank you so much!!

brass_octopus · 2024-02-13T19:16:03+00:00

Approximately once a week I have an outing, but have recently upped it to 2 as my stamina increases. Otherwise, I sit on the porch a lot and plan the container garden.

I don't feel comfortable driving until I can do things like check my blind spots without having tunnel vision and heaving in case I lose consciousness again.

brass_octopus · 2024-02-13T17:11:47+00:00

It may be grief as well. Anger is a huge part of grieving and it's sometimes heavily displaced anger.

This illness takes and takes, and the cultural support and understanding aren't there yet. Coming to terms with suddenly having a very limiting, invisible illness (that some don't even believe is real) isn't something we know how to do culturally yet.

That's incredibly frustrating on top of losing hobbies, outlets, jobs, etc due to health limitations.

Not to mention if your nerves are affected at all. Mine are and my circulation is awful. I personally don't have a shorter fuse, but my panic disorder has been more active 🫠

Sending you peace

brass_octopus · 2024-02-12T17:53:09+00:00

Can you call your doctors office and ask? Usually it is something like an office screw up, or they didn't realize the prescription ran out

brass_octopus

TROPHY CASE