Strongest pain killer available from hospitals?

[Sheryl]

Not really. Sedatives are not pain killers. If pain is minor then yes, a strong sedative may be enough to let you sleep through it but you are complaining of more pain than that. Indeed if I understand correctly you don't have an insomnia problem per se, it is only due to pain that you cannot sleep?

 

Of course in mega doses, such as used IV in hospitals, sedatives can render you unable to feel pain but that is not something you can safely do at home (to put it mildly).

 

I find it a little odd that you have been given highly addictive benzos but told to lay off any dose of codeine - sounds like they don't think the amount of pain reported is plausible and that you instead have an anxiety issue. Be careful with  the Alprazolam....especially since it is not even helping.

 

You need to get to the bottom of whether in fact your pain cannot be explained by a spinal problem. Obviously this is the opinion of the doctors you have seen so far but you should get another before accepting it to   be the case.  (Maybe it is, but need to be sure. As mentioned i have known Thai orthos to be wrong on this count before)

[ChomDo]

7 minutes ago, Sheryl said:

Not really. Sedatives are not pain killers. If pain is minor then yes, a strong sedative may be enough to let you sleep through it but you are complaining of more pain than that. Indeed if I understand correctly you don't have an insomnia problem per se, it is only due to pain that you cannot sleep?

 

Of course in mega doses, such as used IV in hospitals, sedatives can render you unable to feel pain but that is not something you can safely do at home (to put it mildly).

 

I find it a little odd that you have been given highly addictive benzos but told to lay off any dose of codeine - sounds like they don't think the amount of pain reported is plausible and that you instead have an anxiety issue. Be careful with  the Alprazolam....especially since it is not even helping.

 

You need to get to the bottom of whether in fact your pain cannot be explained by a spinal problem. Obviously this is the opinion of the doctors you have seen so far but you should get another before accepting it to   be the case.  (Maybe it is, but need to be sure. As mentioned i have known Thai orthos to be wrong on this count before)

I have no sleep problem, normally I sleep fine and Zolam does make me fall asleep if I go to bed but still the pain is so strong in my arm that I have to get up just after 2 hours of sleep. I'm really getting a bit confused why now the pain is that bad at night and hardly any pain in the day. I will see the doc again on Tue and I'll tell him all this in detail.

 

I mean he was concerned because I had been taking codeine (hight dose according to Thai standard 100-130mg per day) for over a week. He thought that the Zolam would make me sleep fine. He gave me only 7 pills so I guess that's still no addiction risk with that.

 

He suspects I have CRPS or MPS and that's why he want's me to stop all the other pills. Just getting quite upset about it that I've been having this horrendous night pain and can't sleep trough. I'll of course let him know on Tue that it can't go on like this and something else has to be done or prescribed. Two more days to go so I can do that alright and then I'll see what the next idea from him is. He said I should take the steroid for 6 weeks if the fist week helps but it has had no effect yet so don't know about that.

 

 

[Sheryl]

I was not aware that you have hardly any pain during the day, impression from prior posts was that you had severe pain all the time.  Has this changed? Can't see where you would have needed so many doses  of the para/codein if the pain is only at night...?

 

While it is normal to be more sensitive to pain at night, it should not be the difference between virtually pain free and excrutiating.  Unless there is something in how your neck is positioned during the night that is triggering it.

 

[ChomDo]

1 hour ago, Sheryl said:

I was not aware that you have hardly any pain during the day, impression from prior posts was that you had severe pain all the time.  Has this changed? Can't see where you would have needed so many doses  of the para/codein if the pain is only at night...?

 

While it is normal to be more sensitive to pain at night, it should not be the difference between virtually pain free and excrutiating.  Unless there is something in how your neck is positioned during the night that is triggering it.

 

Sorry for the confusion Sheryl. This changed dramatically about a week ago. When I was taking the codeine I had sever pain all the time. Then it got gradually better and changed to the above described. That's what's weird about it, the daytime pain is pretty much gone but the night time pain is just as bad. Hopefully the doctor has some explanation to this. Although it was just 5 days ago that I saw this new doc at Samitivej and that time the symproms had already changed (to pain only at night). That's why I told him that I need something to be able to sleep at night. His solution was the above explained.

[ChomDo]

Hi again Sheryl and others who tried to help me out with this question. Here's a little update.

 

So since I wrote last time I have met twice with this specialist in Samitivej. This doctor is a spine surgeon and he seems to be highly appreciated (I don't have his name right now but I'll get it from the paper later). In his room he has a cabinet full of trophies and souvenirs from foreigners whom he has operated and last time I saw him he just returned from Japan where he had been operating a patient so it really seems like this doctor good one.

 

Anyway first time I met with him 2 weeks ago he did all the physical tests and said there's nothing wrong with my disk. According to MRI some degeneration but he said it's the neck muscle that's pushing my nerve. He prescribed Arcoxia 120mg once a day,  Lyrica 75mg once before bedtime + Rivotril 0.5 before bedtime and ParamaxCod when needed. During this 2 weeks nothing helped (only the codeine helped for pain). When I returned to see him yesterday he listened to my symptoms and noticed that the only thing that helps for me is opioids (that would affect my mind sending the pain signals). He also assessed my medical history of 10 years with unexplained pain in neck, upper back and lower back + morning headaches, dizziness, mood changes etc and said I have Fibromyalgia. When I read about it most things made sense to me too but I see that it is a condition that's not even recognised in many countries. It seems to be a very vague syndrome. For now he suggested moderate exercise despite the pain, stretching and meditating. For the next two weeks I'm taking one 75mg Lyrica + one Rivotril before bedtime. He said if I'm not better next time we meet in 2 weeks he would ask me to go to see a neurologist/psychologist who can give me more advice about Fibromyalgia.

[Sheryl]

If you go, I will be interested to know who that  neurologist/psychologist is, as I have had trouble finding doctors to recommend for people with fibromylagia.

[ChomDo]

1 hour ago, Sheryl said:

If you go, I will be interested to know who that  neurologist/psychologist is, as I have had trouble finding doctors to recommend for people with fibromylagia.

Ok I'll see what comes next and I will let you know. I do feel that I should probably have a second opinion to this diagnosis in my own country when I go back to visit in the summer. I agree with the doctor that many of my symptoms match with Fibromyalgia but many also don't so I'm still not so sure. 

 

Are you a doctor or a nurse if I may ask? It seems you know all this medical stuff and you just mentioned that you would need to know a good neurologists/psychologists to recommend for patients.

[rascalman]

I have neuropathy pain, very bad, I been on tramadol f or awhile. I want to get off but now it's not gonna happen. I am in a bad place! 

[Odysseus123]

I understand that.

 

Just prior to amputation of the right leg I was on a 100 mgs/ml of morphine (liquid) plus Tramadol.

 

I basically awoke after the operation and stated drowsily-I want to get off this rubbish!

It took them 4 months to successfully wean me off.

 

Never again.

[Sheryl]

Medical supervision is importnat in trying to get off (or reduce dosage of) addictive medications.\

 

There are physicians specializing in this in Thailand. This doctor in Bangkok is particularly good:

 

https://www.bumrungrad.com/doctors/Pichai-Saengcharnchai

[Odysseus123]

Just now, Sheryl said:

Medical supervision is importnat in trying to get off (or reduce dosage of) addictive medications.\

 

There are physicians specializing in this in Thailand. This doctor in Bangkok is particularly good:

 

https://www.bumrungrad.com/doctors/Pichai-Saengcharnchai

Hello Sheryl,

 

Yes, I should have emphasized that more strongly in my post.The four month weaning off period was supervised firstly on an inpatient then an outpatient basis.

 

Curiously enough it was the last 20 mgms or so that was the worst.Getting over the final psychological hurdle I expect.