Advice?

[Gene]

Hey guys

I was hoping for some advice, as I have posted before my Dr. put me on Nortryptiline 150mg, Effexor ER 150mg and Tramadol  100mg 3x per day.

The Nortriptyline I take before bed and it really has worked wonders in helping me sleep.
The Effexor doesn't really seem to be doing anything that I can tell.

The Tramadol has seemed to move my pain from a 9-10 to a 6-7 which is better that I have ever had for relief. 
I know a Guy at our church who is on Nucinta for a back injury and he was saying he was originally on Tramadol but found this Nucinta to be far more effective.

Since I have only been on the Tramadol for 1 month am I risking my Dr thinking I am trying to get stronger drugs for the high and so he might pull my Tramadol? 

I have never requested pain meds before and while it would be great if the new stuff dropped me even lower on the pain scale it would suck if I lost the Tramadol that works at least as well as it works. I see my doctor tomorrow so any suggestion would be appreciated.

[countryboy]

When asking the doc. about another med., be sure and make it a casual inquiry.  Let him know that you have a friend that is using that med and it works better for him than the Tramadol, and you are just curious about how it works and what the effects are.  Don't act as though you really want him to change your meds, but always looking for something better and more effective.   

[Robby]

I always say things like "I don't want anything stronger, or more often, but the Tramadol wears off and I have several hours to suffer before I can take another one".  That way I establish with them a repourt with them over me not wanting to take anything stronger, and I establish there is a problem that needs to be taken care of.

[ronr]

You have to know the doctor well but it's like already said.  Make them think you don't want it but just some info. 

That way they can be the expert in telling you all about HOW it works and make the heroic gesture of offering to let you try it.  They used to get samples from the reps that come round hounding them all the time and I'm guessing they still do but that's way better than having to pay yourself for a trial. 

[foxgrove]

That way they can be the expert in telling you all about HOW it works and make the heroic gesture of offering to let you try it.

Bingo!!!  The exact words I was thinking!!  If you leave them alone in the driver's seat and let them think they're picking the route, you can get a lot accomplished.  It will vary from doc to doc on how effective that is but it's sure a lot better than getting yelled at or told they're no longer treating you.  Quel nightmare!!!

[Robby]

That way they can be the expert in telling you all about HOW it works and make the heroic gesture of offering to let you try it.

Bingo!!!  The exact words I was thinking!!  If you leave them alone in the driver's seat and let them think they're picking the route, you can get a lot accomplished.  It will vary from doc to doc on how effective that is but it's sure a lot better than getting yelled at or told they're no longer treating you.  Quel nightmare!!!

That's about what I was thinking, I just didn't say it so clearly....

[Gene]

Thanks guys, I will let you know how it goes

[Gene]

So I met with my GP and used your advice and he said are you Freaking Crazy   No he didn't.  Actually while I did not get the response I had hoped I got better than no. He said since I had been on the Tramadol for only a month he needed me to stay on it for another 60 days.

If things did not get better then he would prescribe the Nucynta and I would need to be on that for 90 days to give it a chance to work.

He said after that if I was still in pain over a 5 he would prescribe a real optiot and go from there.

He was very honest with me that he understood how frustrating it was to have to go through this but while he wanted to do everything he could he also wanted to cover his ass.  I guess he has a family to feed to.

Anyways thanks for the advice as I think it worked great.  Hope you all are doing as well as can be today and that you find at least one blessing to ponder as you deal through the pain and fatigue.

[denny]

Fantastic gene!
Beware the poppy!
It can have many side effects the worst being bowel upset.
Getting off it is no joyride either.
Don't get me wrong,it provides a world of relife.
Just be careful.

[Lonesome George]

At least he's going to work with you, which is more than a lot of docs will do these days. It's still a crying shame that someone has to endure little pain relief and possible side effects for 90-120 days before the good stuff is prescribed because a doctor has to cover his butt.

It's possible you will get more used to this, or the next step will work, but if none of that happens, you are looking at least 180 days of more pain, all because the government has their nose so far up a doctors butt the docs are afraid to prescribe what we need.

I have never in my lifetime seen a government as intrusive as it is now. They think they know better than we do about  how much we hurt, what we can get for said pain, and how long we can take a medication.  That's just for a prescription, that's not counting every other aspect of our lives that are scrutinized every second.  I won't even get into how much sorry insurance cost.

[foxgrove]

Very good to hear he's making sure he's going to be around to help you out in the long run.  No use in getting sideways of the governing people and losing what appears to be a genuinely good doc.  Very happy you were heard without being accused or having your situation... darn it, can't think of the word... not ignored... minimized??  You know what I mean.  You were heard!!!  That's more rare than you know in this world.   

So, now you have a plan spelled out for you.  As denny said, there are some side effects to be careful of with opiates but in the long run, they work well to relieve pain.  Always remember that what's most important is getting back quality of life, not just pain relief.  I say this as one who is on opiates and still has insane pain levels but a better than poor quality of life-ish most of the time. 

Try to keep moving, try to keep active, try to keep your thinker from becoming a prune.    We got your back. 

[ronr]

The seed of a plan has been planted and he has a plan.  You can now push a little harder if he balks after 90 days.

Keep a log to look back on later.  Not that Fibro causes hazed thinking or anything.  That way you can better compare what relief you did get and any potential side effects, some of which can knock a guy for such a loop that he wishes it was only Fibro Fog.

Stronger drugs and opiates come with strings attached.  Usually it is a cocktail of different meds that we end up on which is another reason for the log.  If you can get 5% relief from one and 5% from another, the combo may get you even more but that is to be seen.

The government is afraid everyone is a Prince sort of mentality.  Multiple doctors, multiple drugs, etc. until they have too many of them  at once.  Either that or they must be selling them to grandma's at the nursing home.  Too many people with too many overdoses so they would rather just keep us all  in pain so they don't have to justify the reports.

[Gene]

Thanks for the support and feedback, Ronr I can not agree more, it is all about control and keeping the masses beholding to the parent government.

If your in pain all the time who has time to fight with those who control your access to what you need.

I guarantee if 3-4 of our politicians had what we all fight everyday they would be talking out the other side of their pie hole,  hmmm or maybe not they would just ensure they had their access to what they needed.

For now I will work with my GP and do my best to hold him to his plan. 

One question I never considered Fibro Fog to be a real issue for me.

But over the last 6 months it is getting worse with me struggling for the right words to match my thoughts and doing things like making up words because I can't just get the right one to come out.

For instance if I want the TV Remote I might say to my daughter give me the rotowheeler? What? 

and I know it wasn't what I was trying for. Do any of you have that kind of experience and does the Fog seem to get worse at times?

Thank again Guys!

[Lonesome George]

Yes on fog and not finding right words. I was trying to tell my wife something the other day, and finally had to give up because a 1 minute story turned into several minutes, most of it spent playing charades, with me trying to find the right words, and her trying to give them to me.  I finally just decided to tell her later, but by later I forget to tell her.

I remember now I was wanting to tell her something, but can't remember what.

[denny]

Yes.

[foxgrove]

One question I never considered Fibro Fog to be a real issue for me.

But over the last 6 months it is getting worse with me struggling for the right words to match my thoughts and doing things like making up words because I can't just get the right one to come out.

For instance if I want the TV Remote I might say to my daughter give me the rotowheeler? What?  confused

and I know it wasn't what I was trying for. Do any of you have that kind of experience and does the Fog seem to get worse at times?

 YES!!  Totally!!!  Welcome to the new world... here's a copy of your Fibrish Dictionary... keep it handy.  What.... whaddaya mean we don't have a dictionary???  Rats!!! Oh well...  Just keep laughing at yourself and don't let it get you down.  I sure know how frustrating it can be... just wait till someone hands you a phone and says, "You were there, you tell them what you saw."  

Lonesome George nailed it to a tee... or is that a tree... which do you nail it to?  As you can see, metaphors get kerfuffled in a big way, sayings just come out however they come out, and my wife just smiles and nods.  The charades part is a normal routine that I spin to almost immediately now interjecting any words that I think are at least closely related.  It gets to be quite hilarious if you're able to look back at the ease with which our minds play with little things like "door handle" or "breakfast" or "I have to go pee"... now THAT was a hilarious conversation, what with me dancing around and the bathroom in use and them all confused on the other side of the door.

New words shmew words... people make stuff up all the time, don't they?  Just listen in to a corporate beginning of year ra-ra session... new stupid words galore... rightsizing, vectoring, brand alignment, thought leader, paradigm shift(oooo, I hated that one!!)... I mean, come on... at least ours are funny.  

[denny]

I can't speak worth cacadodo anymore.
That may be an indication of what I'm thinking...  or not.

[ronr]

Fog seems to cycle like everything else but when we are living in our own private pain filled world it's no wonder we cannot concentrate enough to find the right word.

[countryboy]

Man what a topic.  Things change so fast these days, our minds are left way behind.  I agree that the Fibro
Fog has really done a number on me lately.  At times my clients call me back and want an explanation of what I said earlier.  That really makes you feel dumb.

With that being said, I have officially retired as of June 1st.  Don't know how this will effect some of my 30 year clients, but enough is enough.  In order to keep my license intact, I have to have 30 hours of continuing education each year.  The on line classes are getting harder and harder to comprehend a lot of the time.  Attending seminars is worse for the retention aspect of some of the subjects that we have to cover.  I am the type of person that gets more out of reading something at my own speed than to listen to someone else explaining something to me.

There are other medical reasons for my retiring, but I think the Fibro has climbed to the top of the ladder and there seems no way to remove it.   I guess time will tell if I am making the right decision, but I think that the timing is important.

Good luck to all you guys with your fight.  May the best man win and we know it isn't Fibro.