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Managing chronic pain
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I’m 66 years old, been on hydrocodone for over 15 years, take only when I
have pain, not addicted. I want to travel during my retirement, so of these travels require stays longer than 30 days. Due to current Medicare controlled drug rules, I cannot receive more that a 30 day supply at a time. No provisions in the rules for vacations or traveling. My doctor will write the scrips for more than 30 days with proof of my travel itinerary. I recently tried to get a 34 day supply of hydrocodone due to a extended travel plans, the insurance company would not fill due to the Medicare 30 day rule. Only option was to have the doctor write a separate scrip for the 4 extra days, which I had to pay out of pocket. I’m sorry for all the people who cannot read the labels and kill themselves due to overdoses. But it’s not fair to the millions of seniors who play by the rules, We are being punished for the stupidity of a miniorty group that insist on misusing the drugs. am I wrong ? Welcome comments,
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@rdonihoo wrote:I’m 66 years old, been on hydrocodone for over 15 years, take only when I
have pain, not addicted. I want to travel during my retirement, so of these travels require stays longer than 30 days. Due to current Medicare controlled drug rules, I cannot receive more that a 30 day supply at a time. No provisions in the rules for vacations or traveling. My doctor will write the scrips for more than 30 days with proof of my travel itinerary. I recently tried to get a 34 day supply of hydrocodone due to a extended travel plans, the insurance company would not fill due to the Medicare 30 day rule. Only option was to have the doctor write a separate scrip for the 4 extra days, which I had to pay out of pocket. I’m sorry for all the people who cannot read the labels and kill themselves due to overdoses. But it’s not fair to the millions of seniors who play by the rules, We are being punished for the stupidity of a miniorty group that insist on misusing the drugs. am I wrong ? Welcome comments,
Actually it is not Medicare that is making the rule changes on the prescribing of opioids - it is the CDC that issued them and since has issued some clarification but I don't think even the clarifications will help you.
I agree with aruzinsky on alternative meds - talk to your doctor. You might want to consider this because it may be only time until your doctor talks to you about it - opioids for many chronic pain reasons is being proven to not be the best option.
You may not have a psychological addiction to opioids but your body physicially has learned to rely on them and if withdrawn abruptly, your body will probably experience withdrawals and not just pain from whatever ails you.
Mayo Clinic - Tapering off opioids: When and how
If you've taken opioid medications for more than a couple of weeks, it's likely you need to stop soon — and stop slowly, to avoid severe symptoms of withdrawal.
Yes, doctors are looking for alternative treatments for various chronic pain conditions - mediation or other types of treatment. The conditions that will continue to receive opioid treatments are being limited to pretty much patients in active cancer treatment or are terminally ill with treatment being discontinued, patients experiencing acute sickle cell crises, patients experiencing post-surgical pain (limited and monitored closely) or from an extreme traumatic injury, again limited and monitored.
I am not sure how much advocacy is going to change this situation, specifically because there are other ways, scientifically proven, to treat many chronic pain issues without the use of long term opioids - other medications or other treatments -
Talk To Your Doctor - perhaps you can find another treatment and one that will free you up to travel.
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@rdonihoo wrote:I’m 66 years old, been on hydrocodone for over 15 years, take only when I
have pain, not addicted. I want to travel during my retirement, so of these travels require stays longer than 30 days. Due to current Medicare controlled drug rules, I cannot receive more that a 30 day supply at a time. No provisions in the rules for vacations or traveling. My doctor will write the scrips for more than 30 days with proof of my travel itinerary. I recently tried to get a 34 day supply of hydrocodone due to a extended travel plans, the insurance company would not fill due to the Medicare 30 day rule. Only option was to have the doctor write a separate scrip for the 4 extra days, which I had to pay out of pocket. I’m sorry for all the people who cannot read the labels and kill themselves due to overdoses. But it’s not fair to the millions of seniors who play by the rules, We are being punished for the stupidity of a miniorty group that insist on misusing the drugs. am I wrong ? Welcome comments,
Of course, they are unfair but your viewpoint is shallow in that you don't know who your enemies are and I do. The cause of the problem is overwhelming sympathy for the self inflicted injuries of drug abusers within our culture. And, the prevailing sympathizers of those with self inflicted injuries, not just drug abusers, are Liberals.
Drug abusers should not only be allowed to kill themselves, it should be encouraged. I have the opposite of sympathy for drug abusers because they and their liberal guardians decrease my quality of life.
A possible, but, unlikely solution to your problem is to switch to a Schedule IV opioid, which, depending on your state, allows a 90 day supply and 3 refills. The problem is that you have to be genetically abnormal for any Schedule IV opioid to be effective.
Some are
Tramadol
Pentazocine/naloxone
Butorphanol
I regularly take pentazocine/naloxone with good results. I have tried the other two and butorphanol is also effective for me. Tramadol has no noticeable effect on me. I reiterate, it is genetic.
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Hello all, I have been working in the field of health since 1996. I specialize in managing chronic conditions, stress management, pain management, am a 'Stepping On' falls prevention class leader, caregiver, and manage my own chronic health conditions which include dual hip replacements. Managing chronic conditions is an extra job we don't necessarily enjoy though it is required of us...in order to achieve a quality of life I am content with, I have found a number of methods that allow me a great deal of freedom, minimal medication use, provides me with sound sleep, and pain I can tolerate and minimize.
Why does our government get to choose what we put in our bodies are we not adults are we not living in a free Nation why does our government get to choose how and what we do I do not understand this I am a grown person I pay taxes I've worked almost all my life I taken care of my children they are grown tax-paying adults so why is it that when it comes to my own health I do not have the right to choose how I want to manage my health yes doctors should be able to advise us on what's good for us but as an adult we should be able to choose what we put in our mouths and how we manage our own pain I just don't get it we are not children and we're supposed to be free.
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Hello all,
Being on the "othe side of the fence"and being a patient of chronic back pain suffrer, these are my personal observations:
1. We all develop arthritis as we age. The pain can be in the hips, knees or back. This is manily due to "wearing out" of the joints and drying out of the "lubricant" that had been present all our lives.
2. Some of the aggrevating circumstances are -- old age, prior injury, surgery (yes it can make it worse in certain scenarios), and lack of exercise.
3. Pain pills have a very limited role. As one consumes thsse pills, the tolerance level starts to build up over a period of time. Hence more dosage is needed to acheive the same result. Given the fact abuse of these type of drugs resulting in death has come to the attention of law makers. Hence the laws have become a whole lot more rigid in obtaining these type of narcotics. If a doctor prescribes certain number it is automatically trasmitted to the "watch dogs" to make sure the doctor is not running a "pill mill" as seen in may cities. To add to this, there have been many high profile deaths in recent years -- Michal Jackon, Prince, Whitney Houston and her daughter Christina Brown etc.
4.The following is from the CDC site:
Recent Findings ƒ Since 2000, the age-adjusted drug-poisoning death rate more than doubled, from 6.2 per 100,000 in 2000 to 14.7 per 100,000 in 2014. ƒ In 2014, 47,055 deaths involved drug poisoning. Of these, 82% were unintentional, 12% were suicides, and 6% were of undetermined intent. ƒ In 2014, 40% of drug-poisoning deaths involved opioid analgesics (18,893 deaths). ƒ The age-adjusted rate for deaths involving opioid analgesics nearly quadrupled, from 1.5 per 100,000 in 2000 to 5.9 per 100,000 in 2014. ƒ In 2014, nearly 65% of all deaths from opioid analgesics involved natural and semisynthetic opioid analgesics, such as hydrocodone, morphine, and oxycodone. SOURCE: CDC/NCHS, National Vital Statistics System, 2000–2014.
What works:
1. Given the fact we cannot reverse the aging process, we can improve upon what we do and how we live. AARP has been advising its readers about "staying young". Many of these articles revolve around staying busy by exercising regulary, Yoga, swimming, walking, tennis, golf etc and the very last use of medicines. We can sit and keep complaining about pain or start doing any or all of the above.
2. I have read an article about consuming one ounce of Apple cider vinegar in warm water daily AM on an empty stomach. This has been tried with moderate success.
3. Yes. The use of turmeric has been repeatedly written up. One can easily get a large pack of this from any Indian grocery store for just $2.00 or $4.00 depending upon the size. This can be added in cooking (sprinkle on any food as it truely does not change the taste). This is a mainstay in Indain food. There have been multiple studies about use of Turmeric pills which show they are in no way superior to store bought powder, except pills cost a whole lot more.
4. In the Indian diet Garlic has been widely used. This also has significant "healing properties" of inflammation and pain control.
5. If one has chronic back pain, weight loss to the most ideal weight WILL do the magic. Just today I met a patient who has lost about 35 LBS and feels and looks great. She is determined to loose additional 25 LBS for the chronic back pain she USED to suffer!
Lastly, I practice what I preach. I never ever take any narcotics. This was true even after a major brain surgery.These are to be used for a short period of time for SEVERE pain only. Yoga is a must -- either early AM or in the evening. (Go to Youtube.com and see many easy to do yoga for back pain-- this is FREE).I Walk about 3 miles daily, take the Turmeric powder in warm water and the Apple cider vinegar also. Turmeric is a daily food item. At night I take one 800 mg Ibuprofen. This keeps the neck and back pain at bay early AM.
Pain is very subjective. It is mind over matter which can overcome need for such narcotics and keep pain at bay. Many physicians just refuse to write any form of Analgesic narcotics for fear of loosing his/her license. This will get a whole lot tougher as the new federal rules go into effect soon.
Hope this helps...
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"4.The following is from the CDC site:
Recent Findings ƒ Since 2000, the age-adjusted drug-poisoning death rate more than doubled, from 6.2 per 100,000 in 2000 to 14.7 per 100,000 in 2014. ƒ In 2014, 47,055 deaths involved drug poisoning. Of these, 82% were unintentional, 12% were suicides, and 6% were of undetermined intent. ƒ In 2014, 40% of drug-poisoning deaths involved opioid analgesics (18,893 deaths). ƒ The age-adjusted rate for deaths involving opioid analgesics nearly quadrupled, from 1.5 per 100,000 in 2000 to 5.9 per 100,000 in 2014. ƒ In 2014, nearly 65% of all deaths from opioid analgesics involved natural and semisynthetic opioid analgesics, such as hydrocodone, morphine, and oxycodone. SOURCE: CDC/NCHS, National Vital Statistics System, 2000–2014."
You didn't say who these people are. Are they chronic pain patients? Are they from illegal drug use? How old are they? This is what bothers me about these types of statistics.
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Are you a doctor, or even a pain management doctor? The overhanded government crackdown on doctors, pharmaceutical companies and distributors have made it impossible for many legitimate, innocent chronic pain patients to get the pain medication they need to lead a normal and productive life. The drug addicts deserve empathy as well as proper help with therapy and addiction treatment, but the legitimate chronic pain patients should be given more priority.
You haven't said anything that is helpful to me as my quality of life has been reduced to being bedridden from vertabral compression fractures from severe osteoporosis. I am unable now to attain any pain medication due to the 'opioid crisis'. My future looks bleak. There is no way I can go for walks, cook, exercise, or even shower. The only thing that has helped has been morphine and fentanyl patches that have been prescribed by professional pain management doctors; of which there are few nowadays. I now not on anything and even though I won't, I've considered trying to get them illegally out of desparation. But even if I wanted to I couldn't get out of bed to try.
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Not sure what you mean by being "on the other side of fence"? Someone in the medical field or someone who does not have chronic pain at a level that needs strong pain killers? I'm a nurse but had to go on disability 12 years ago due to fibromyalgia, spinal stenosis, migraines,and inflammatory arthritis. I'm 62 now and still miss being a nurse. I developed fibromyalgia in my late 20s but was not diagnosed until my mid 30s. I still continued to work with increasing pain until my
Late 40s. I miss the medical field and I miss the money I would have made if I could have continued to work.
There are people who have good pain tolerance. My mother never had headaches or menstruated cramps so it was hard for her to understand those who did until she developed polymyalgia rheumatica and developed severe headaches. That was a game changer. So the things you suggest are all very good
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@Jivanchich wrote:
I have a similar story, but I would like to ask is who can we write to or how can we start a grassroots movement to change this law and possibly make it easier and cheaper for seniors to get their medications without the monthly doctor visit. My expenses every month plus addition $50 every few months for a drug test added to the visit (to make sure I'm taking it and not selling it????) is money needed elsewhere. My back doctor says my spine is not fixable. I do not want to lay around in pain until I die. And making it a crime to assume and accuse someone of being an addict because they worked hard 40+ years and are paying a physical price.
Jivanchich,
It seems the FDA is already seeing this tighter control method work but at the detriment of many patients who take these reclassified pain medications.
Even back in 2013, they were told how these new pain med classifications would affect those who depend on them for relief.
New York Times 10/24/2013 F.D.A. Urging a Tighter Rein on Painkillers
from the link ~
"For years, F.D.A. officials had rejected recommendations from the D.E.A. and others for stronger prescribing controls on the drugs, saying the action would create undue hardships for patients. A number of doctors’ groups, including the American Medical Association and pharmacy organizations, have continued to fight the measure, citing the impact on patients.
In a telephone interview, Dr. Woodcock said that F.D.A. officials were aware that changing the prescribing rules would affect patients.
She said, however, that the impact on public health caused by the abuse of the drugs as well as their medical use had reached a tipping point.
“These are very difficult trade-offs that our society has to make,” she said. “The reason we approve these drugs is for people in pain. But we can’t ignore the epidemic on the other side.”
. . . . The F.D.A. recommendation is likely to have a significant impact on the availability of the drugs, as well as on how pharmacies operate and even the types of medical professionals who can prescribe the medications.
In recent years, the question of whether to tighten prescribing controls over hydrocodone-containing drugs has been the subject of intense lobbying.
Last year (2012), for example, lobbyists for druggists and chain pharmacies mobilized to derail a measure passed in the Senate that would mandate the types of restrictions that the F.D.A. is now recommending.
At the time, the lobbying arm of the American Cancer Society said that making patients see doctors more often to get prescriptions would impose added burdens and costs on them.
. . . . Dr. Woodcock, of the F.D.A., said that requiring patients with long-lasting pain to see a doctor after three months, rather than six, for a new prescription could benefit them. “If you are needing chronic therapy of this magnitude,” she said, “you should be seeing your prescriber.”
read more at the link ~
The government has spoken - in order to stop those who use these drugs illegally - we must control the substance realizing that this control puts a burden on those who need these drugs for relief.
There is a clear need for pain pills in a certain percent of medically insured people.
But people without medical coverage need help as much or more than those with health care insurance. Because they have as much pain as anyone else and they have no access to other medical treatments (back surgery etc.).
Of course they are using illegal drugs. They have no choice, because legal help is not available to them.
Our government seems to think that clamping down on prescription drugs will help reduce illegal drug use. But like prohabition did, it will only make more people find help on the blackmarket.
Making something illegal does not cure pain. And assuming that all illegal drug use is not for pain relief is not accurately assessing what is going on. I know that if the government took away my pain pills, i would go to the black market for help. Life is just not worth living if you have no joy in your life, and finding joy while you are doulbled up in pain is something I could never figure out how to do.
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Oh my, doesn't anyone remember the shake up about Fentanyl? I thought it was banned! I was on it, but I was allergic. Now, almost everything has been tried on me and nothing worked long term, so now (three years or more) I take nothing for pain. After my doctor moved away, there was no one else in my town to trust. It's very hard, but I exercise everyday and try to eat right. I do use Turmeric and Cayenne pepper powder daily. To preach to the non-choir, There is nothing, nothing you do that does not hurt. I've heard that doctors don't study about pain in medical school. Wow! I know my doctors did not understand that I didn't want to be addicted to anything. I don't want a high. What I want is the pain gone, even for a few hours per day... Friends, I know what you feel. I say hang in there. I know it feels like you're going to lose your mind. Get through it minute by minute if you must. I've done it, you can too. Maybe doctors will catch up soon.
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Here's what I do: I take meds that don't work. I exercise as much as I can. I pray. I cry. I spend sleepless nights because there's no comfortable position, so I'm tired all day. I keep telling myself I'm stronger than the pain, not looking forward to the day when the pain proves me wrong. I get on with my life the best I can. I can't get a job because I'm in constant pain. No doctors will put me on disability because they can't "name" the condition. That's how I "manage" chronic pain.
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I have been suffering from chronic pain sice 2002. In 2000 I had to have a cervical fusion that was successful then 2 years later, I began having pain again, I was then diagnosed with Fibromyalgia. I am seeing a great pain management doctor now, but due to allergies and side effects, the only things that helps my pain are opiates, MS Contin, Dilauddid. However, when I go to the ER or a new doctor, the first thing that the nurses and doctors tell me is that I have to stop the narcotics. I feel so asshamed that now I will not even go to the ER when I should. I had a milkd heart attack in October, 2014 and the resident who was taking care of me would not give me anything for pain and called me a drug seeker, then said that the doctors who prescribed the medicatios for me should not be allowed to practice medicine. I got up the next morning and left the hospital and have not been back since. Even though there have been several times that the chest pain is so bad that I have fallen to the floor in the grocery store. I am so frustrated at being treated like this and there is nothing to do. I feel sorry for the doictors that really care because now, they have to see a patient for a precription for Vicodin. The situation with the pain medication abuse is terrible, but why are we, the ones who benefit from it, are the ones suffering? I did not choose to be "Opiate Tolerant" but that is what the pain management doctor has as one of my diagnoses.
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@denvermrr wrote:I have been suffering from chronic pain sice 2002. In 2000 I had to have a cervical fusion that was successful then 2 years later, I began having pain again, I was then diagnosed with Fibromyalgia. I am seeing a great pain management doctor now, but due to allergies and side effects, the only things that helps my pain are opiates, MS Contin, Dilauddid. However, when I go to the ER or a new doctor, the first thing that the nurses and doctors tell me is that I have to stop the narcotics. I feel so asshamed that now I will not even go to the ER when I should. I had a milkd heart attack in October, 2014 and the resident who was taking care of me would not give me anything for pain and called me a drug seeker, then said that the doctors who prescribed the medicatios for me should not be allowed to practice medicine. I got up the next morning and left the hospital and have not been back since. Even though there have been several times that the chest pain is so bad that I have fallen to the floor in the grocery store. I am so frustrated at being treated like this and there is nothing to do. I feel sorry for the doictors that really care because now, they have to see a patient for a precription for Vicodin. The situation with the pain medication abuse is terrible, but why are we, the ones who benefit from it, are the ones suffering? I did not choose to be "Opiate Tolerant" but that is what the pain management doctor has as one of my diagnoses.
I have severe degenerative disc disease and was on opiods with success for 10 years. then due to some drug addicts, and the pharmaceutical companies breaking the law, I was taken off. since then i sit all day.
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Hi,
I am new to this site on AARP so I hope I am doing this right. I am so sorry to hear of your chronic pain issues. I myself have suffered from chronic pain since I wan 29 which was way back in 1989. I progressively got worse until there were days I could not get out of bed. I am disabled now due to a whole host of health issues. I see a pain management doctor every month and have had epidurals, saddle blocks, and facet injections. None of them really worked for me. In fact when I had the facet injections they made it worse. For about 10 years I was taking 30mg of morphine every 4 hours and 150mcg fentanyl patch changed every day. All that relieved the pain a little but relived the weight of my wallet a lot! Fentanyl is very expensive. I wont tell you how much I spend on all (32) my meds each month because I dont want to shock or scare you.
Anyway, what I wanted to ask you is if your doctor has suggested a Medtronic Neuro-Pain Stimulator? The couldnt operate on my back because they couldnt find anything that wouldnt be to hard that it would break down the surrounding area or to soft that it wouldnt be effective.
I have Ossteoporosis, Rheumatoid Arthritis, Fibromyalgia, Osteo Arthritis and Scoliosis along with a long list of other things, I have something wrong with every disc in my spine from the base of my skull to my tailbone, I have also broken my back 3 times. The last time I broke it I bent over a little to wipe of the seat of a chair and when I stood up I broke it in 2 places.
Back to the Neuro-Pain Stimulator, they put a temporary one in for 10 days and if it does not relieve your pain by 50% they dont do a permanent one. I have a hight tolerance for pain and also for medications so they could never give me enough meds to reduce my pain more than 20% but that atleast allowed me to get out of bed,. I couldnt do anything but I was up. When they put the temporary pump in I told them it relived about 40% of the pain and they decided that they would do it anyway because it worked better than the meds,
All I can say now is Thank You God for that decision and sending me to that doctor. My chronic pain is very bearable now and somedays I dont have any back pain at all!!! To me it was like getting granted a miracle.
If your doctor hasnt mentioned this to you, mention it to him and see what he says, Look it up on line, Medtronic Neuro--Pain Stimulator, I am sorry I dont have the actual web address but I found it by typing that in.
May God heal your pain
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HI,
I had many of the same problems, but didn't want surgery every 6 months bc nerves grow back. So I take a topical cream called Voltarin (generic) & it lasts forever. gets rid of nerve pain, fibro, arthritis and back pain (broken 3x.) $50 per tube that lasts 3 months. Perhaps someone could take advantage of this ortho cream. Beats surgery anyday & not that expensive. Just have to wait 10 minutes after shower for it to absorb. So, brush teeth, do hair, etc. Miracle for me.
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