Pain med question

[badback4me]

I am experiencing a great deal of pain in my back, neck, and shoulders. My original surgery was in 1989 for Scheuermann's kyphosis (108'). My curve has now moved up my spine and is quite bad where my neck meets my back. I had always taken ibuprofen for my pain, and naproxen for a little while. Well, it ended up giving me an ulcer. I cannot take ibuprofen without it extremely upsetting my stomach. When I mentioned this to my doc at my last visit, he prescribed Celebrex. Well, it is upsetting my stomach now, too. I have been taking Tylenol, which doesn't do much, and I'm afraid it will damage my liver. I was wondering what else there is to take that is non-narcotic. I teach, and I don't want anything that would impair my ability to do that.

Does anyone have any recommendations of where to go from here?

Thanks,
Allison

[trishthedish]

Some people have had luck with Arthrotec (an anti-inflammatory plus an ingredient to protect your stomach lining). There's also Daypro, a less-acidic anti-inflammatory that works well for some. For just sheer pain, no anti-inflammatory included, there's Ultram and Ultracet (Ultram with Tylenol combo, not a narcotic). Hopefully something out there will work better for you then what you've had. Being a pharmacist, I tend to wrack my brain for a solution in a pill. A non-pharmaceutical solution that I like is those stick-on Thermacare heat patches. They make them specifically for the uppper back and neck; 8-12 hours of soothing warmth all day. Biofreeze is a nice topical rub that doesn't smell funny once it dries and I get substantial relief from that.

It should be interesting to see what's worked for everybody else...suggestions, folks???

[txmarinemom]

Tiger Balm!!!!

(and great suggestions, Trish ;-)

[trishthedish]

Hubby has significant lower back pain and reflux disease; he gets by with Mobic (once-a-day generic meloxicam, $4.00 Rx at Wal-Mart) and chases it with an OTC Pepcid or Prilosec. MIL takes Relafen (another anti-inflammatory supposed to be stomach-friendly) and she does well.

Tiger Balm...I am almost out of BioFreeze, and I will definitely try that-thanks, Pam =)

[Geish]

I swear by Ultram/Ultracet. I had trouble (allergies) with celebrex and all of the other super drugs out there, except vioxx (gosh I miss vioxx)! Was on Ultram for 9 years and no problems ever. Got off of it a few months after surgery with no side effects.

I still need to try tiger balm.

[titaniumed]

Years ago I used to use infrarub. You have to be careful and wash your hands after you use this stuff. I scratched my ear, and my ear caught on fire!

Blue stuff is interesting stuff. Good product, but they keep calling you on the phone all the time for another re-order.

Ed

[txmarinemom]

... really is AWESOME stuff. It contains camphor and menthol (and stuff like cinnamon and cardamom), but it doesn't have the skin blistering heat that some other liniments have (and I've probably tried them all). It gives a slow, constant heat - and somehow seems to reach deeper than anything else I've tried. Also, I've never known anyone to experience any skin discomfort or reaction (even people with sensitive skin).

Generally, I just use the ointment (comes in a tiny jar, but goes a long way), but I've also used the patches. They work great for pulled quads from softball, and they're good for the back and neck area like the ones Trish described. If you have a back rubber in residence, the ointment is really, REALLY nice when it's massaged in.

I always crack up walking in a dugout of us old diehards who refuse to give up softball ... your eyes instantly start spurting tears because everyone is marinating in the stuff - LOL. Seriously, I keep a jar in my purse, one by my bed, and one in my softball bag!

Out of curiousity, I looked at their site (www.tigerbalm.com (http://www.tigerbalm.com/)): I've never seen most of the stuff in Walgreens, CVS, etc. And funny, I just looked at my jar and it reads "Tiger Balm Ultra Strength" which isn't even listed on their site - but it's what I always buy, and it IS available in almost every drug store.

And random factoid, it's the ointment of choice for the United States Marine Corps. It was the only one stocked in the Recruit PX. You have to imagine it's pretty good stuff if they're using it to treat the punishment of Marine Corps boot camp - LOL!

I know I sound like an ad for it, but it is soooooooo freakin' effective!

I'd completely forgotten about Relafen, Trish. My ortho rx'd it between my first and second knee surgeries when found out how much Advil I was eating before sparring and karate tournaments (the screws in my knee were actually backing out from training so much). I didn't have any problems tolerating it that I recall.

And, yeah, Geish ... a LOT of people who didn't have adverse effects to Vioxx *do* miss it :(.

Regards,
Pam

[titaniumed]

Pam

Thanx for the tiger balm info. Like Allison, Im having some mild neck issues above my fusion in my neck area. I will get some soon.

And since we are talking about drugs, here is something of interest.

http://www.msnbc.msn.com/id/27342269

I was just wondering how much they cost?????

Everyone needs to know what it is that they are taking. Most on this forum know quite a bit however, what about everyone else?

No wonder insurance rates continue to skyrocket.

Ed

[txmarinemom]

Wow.

Also, Ed, with the dawn of the $4 generic drug programs, those of us forced to purchase non-formularies (like my Adderall XR ... I pay full price, but do get reimbursed 100% on my HDMP/HSA - at least until I meet a new deductible next year) absorb a LOT of the cost.

And that cracked me up about how some docs find placebos acceptable if the patient knows. Like THAT's going to work?

Jeez.

Pam

[trishthedish]

Oh, Geish! I am still in mourning for Vioxx! I remember when they recalled it and I was actually stupid enough (well, ethical enough) to pull it off my shelf and send it back to the manufacturer. Vioxx was da bomb! *Sigh*

P.S. I have been a pharmacist for 15 years; never have I dispensed a placebo. FYI. Just sayin'...

[Geish]

Oh, Geish! I am still in mourning for Vioxx! I remember when they recalled it and I was actually stupid enough (well, ethical enough) to pull it off my shelf and send it back to the manufacturer. Vioxx was da bomb! *Sigh*

P.S. I have been a pharmacist for 15 years; never have I dispensed a placebo. FYI.

I really do miss it! you have no idea. It really was the best thing out there, at least for me. I can't take anything with sulfa so that cuts out a lot. I also can't take Lodine, my liver likes it a bit too much and it makes me a very sick girl.
~~ Moment of silence for Voixx observed~~

[Qikdraw]

Oh, Geish! I am still in mourning for Vioxx! I remember when they recalled it and I was actually stupid enough (well, ethical enough) to pull it off my shelf and send it back to the manufacturer. Vioxx was da bomb! *Sigh*

P.S. I have been a pharmacist for 15 years; never have I dispensed a placebo. FYI. Just sayin'...

My wife got really pissed at a story she read of a pharmacist that refused to give a women her birth control pills, then also refused to transfer her perscription to another pharmacy. Oh she was pissed. The dogs all ran out the door! :p

And why is there a pill that will fake what marijuana does, but medical marijuana illegal? Just boggles my mind... :confused:

Oh and do you know of a birth control pill or whatever that someone with high blood pressure can take? My wife takes Atenilol(sp??) 100mg. Although she has tried to get that lowered but her doctor is not listening, he just says its working, but since her dose got upped she's lost 40lbs, works out every day and is eating better. Things that usually lower BP I believe.

I think I'm gonna get me some Tiger Balm too! The wife can massage that into my back intead of just using massage oil. Although she is going to have to wash her hands before we do anything else. OUCH!! :D

Brad

[Carmell]

Oh and do you know of a birth control pill or whatever that someone with high blood pressure can take? My wife takes Atenilol(sp??) 100mg.

Hi Brad,

Atenolol at 100mgs is on the higher end of the dosing schedule. I'd be asking for something different... esp if her blood pressure is still high after the weight loss (GREAT for her!) and other life style adjustments. I may be mis-understanding here...

About birth control - Getting personal here... I couldn't tolerate B/C pills well, ever. When they came out with the NuvaRing - that was the BEST thing invented!!! It delivers the B/C hormones right into the "area" without having to go through your entire GI and blood system. Doesn't mess with your "normal" hormone levels. Very topical. I'm 43 now (ugh) and haven't had a real period in 3 years. Ahh... nice. Obviously, they have a website: http://www.nuvaring.com/Consumer/index.asp Maybe this is something to consider, esp for people like me with borderline high blood pressure and can't tolerate oral B/C pills.

Pam and I are NOT solicitors. Just offering suggestions based on experience... :D

[Qikdraw]

Hi Brad,

Atenolol at 100mgs is on the higher end of the dosing schedule. I'd be asking for something different... esp if her blood pressure is still high after the weight loss (GREAT for her!) and other life style adjustments. I may be mis-understanding here...

Hey Carmell,

My wife's BP is normal the last 4 or 5 times she has gone to the doctor, but he refuses to lower the dose. She used to be on a much lower dose, but it was raised because her BP was getting high, but it was also due to high stress with finances, her hating to go to a doctors, and a few other thinsg as well. We have finally got her to a point where her BP doesn't shoot up at every doctor visit, and she is doing much better healthwise as well. The doctor just keeps saying that the medication is working and he doesn't want to change it.

About birth control - Getting personal here... I couldn't tolerate B/C pills well, ever. When they came out with the NuvaRing - that was the BEST thing invented!!! It delivers the B/C hormones right into the "area" without having to go through your entire GI and blood system. Doesn't mess with your "normal" hormone levels. Very topical. I'm 43 now (ugh) and haven't had a real period in 3 years. Ahh... nice. Obviously, they have a website: http://www.nuvaring.com/Consumer/index.asp Maybe this is something to consider, esp for people like me with borderline high blood pressure and can't tolerate oral B/C pills.

I will show that to my wife and see what she thinks about it. Thank you for the link. :)

Pam and I are NOT solicitors. Just offering suggestions based on experience... :D

Thank you VERY much for your experienced opinions too! :D I'm not a huge medical knowledge type guy, I forget that kind of stuff easily, so thats why I come here to ask questions. :)

Brad

[txmarinemom]

Carmell, my daughter LOVES the Nuva-Ring, and from what I understand, there have been very few complications reported with it. Am I understanding you correctly that it can stop menstruation like continual dosage (skipping the placebo week and starting a new pack ... what I do) of the low dose pill?

I had my tubes tied at 21 (my first child was conceived while I was on the pill), and as far as I'm concerned, having 2 kids, 22 months apart was all the birth control (or incentive to undergo permanent birth control) I needed ;-).

And, Trish, your comment about "never dispensed a placebo", I *wondered* about that! Not YOU specifically (lol), but I wondered "Does the pharmacist KNOW they're giving a placebo, and how is that charged??".

Obviously your answer says there something on the prescription that basically tells you "fake pill". And this makes me even more curious, do all placebos look the same, or do they resemble the real McCoy?

Funny questions, I know - LOL!

Regards,
Pam

[Qikdraw]

Funny questions, I know - LOL!

Well here is another odd question... What if you take an Immodium and an Ex-Lax? What happens, do you explode? :D

[trishthedish]

Personally, I think the Nuvaring suggestion is a pretty good one-I have 2 nieces and and a step-daughter that are pretty happy with it.

Pam, I have actually seen a product in a catalog called "Cebocaps" and all they are is gelatin capsules filled with powdered lactose (milk sugar) They do come in different colors and sizes. I have never ordered them, stocked them, or had a script to dispense them. I can't see how a pharmacist would not know that they were dispensing a placebo, unless they were part of at least a double blind study, in which case the bottle containing the placebo would not be labeled as such, just "study drug no.1 or 2" or some such).

Most of my career has been spent in hospital pharmacy (I am the nerd that calculates your kidney function and mixes your chemo, or whatever else it is you may need), down in the basement somewhere. And I will say, I used to occasionally see plain syringes of normal saline or sterile water used as a placebo pain injection in one particular hospital, but not since the Joint Commission on Accreditation of Health Care Organizations (JCAHO) made the treatment of pain one of their main study objectives. As a result, the pain scale came about-you know, where the nurses ask you to rate your pain from 1-10. And according to JCAHO, patients' pain reporting is to be taken as genuine and treated accordingly. Most docs write their pain meds in ranges (morphine 5-10mg IM every 4-6 hours) and telling a nurse that your pain is from 1-5 will get you the lower dose in that range.

P.S. Pam, my oldest son was conceived on Lo-Ovral...what a trip!
P.S.S. Qikdraw, I know what would happen to me...with my luck, the Imodium would win, the Ex-Lax would be the placebo, and with the Norco I'm still taking, I'd need a stick of dynamite! Probably TMI...sorry, sorry!

[txmarinemom]

... Pam, I have actually seen a product in a catalog called "Cebocaps" and all they are is gelatin capsules filled with powdered lactase (milk sugar) ...

Oh, you should have known I'd have another question, Trish ... BTW, your knowledge is great to have on this forum!

What if a patient is lactose intolerant (or even hypoglycemic - would it effect them?)? Can the Cebocap cause a reaction? If it does, is that patient left to believe they had a reaction to the REAL drug?

(Me thinks my lil' brain wanders around unchaperoned FAR too often ... but how do you learn without asking questions? ;-)

... Pam, my oldest son was conceived on Lo-Ovral...what a trip! ...

I was on Triphasal-28 (which I have no idea whether they even manufacture anymore) when I got pregnant - and I swear, I never missed a dose.

Then, the ONE time I didn't use anything with my ex-husband ... *surprise!* ... my daughter was conceived.

My exceedingly ridiculous fertility definitely made my decision for tubal ligation (and, no ... my doctor did NOT want to do it - he actually wanted a note of permission from my husband. You can imagine my reaction to that!) at 21 an easy one. I was either going to become a nun - or prepare to potentially birth a baseball team (maybe with a bench warmer or two) by age 30 - LOL!

[trishthedish]

Never heard of a reaction to Cebocaps, since we didn't keep them, but I would think it could happen. Boy, would that suck, and would that doc (and R.Ph.) have some 'splaining to do.

But the article to which Ed linked was very interesting, since it discussed using legit drugs as placebos in certain conditions. Take me, for instance. I am on Cymbalta (an anti-depressant) 20mg for fibromyalgia. That is a sub-therapeutic dose for depression. And if a doc started a patient on 20mg for depression with the intention of titrating up over time, but the patient felt "better" on just the 20mg, so the doc left the patient at that dose, couldn't that be considered "the placebo effect"? Yet low doses of Cymbalta combined with Flexeril have been reported to work well for fibromyalgia, so 20mg isn't necessarily a placebo for my condition. Hmmm....Or maybe that's MY brain wandering around unsupervised =)

Oh, and...since my 2nd son was conceived the ONE time we didn't use anything, my ex had a vasectomy at age 23, and his general surgeon made me sign off on it (which I was EVER SO happy to do).

[txmarinemom]

Never heard of a reaction to Cebocaps, since we didn't keep them, but I would think it could happen. Boy, would that suck, and would that doc (and R.Ph.) have some 'splaining to do.

Yeah, that was my thought ... *Would* the doctor actually tell the patient "Well, um ... you see ... I didn't really give you a prescription for ___________ ...". I can guarantee you if a doctor EVER slipped me a placebo, they'd NEVER see me again.

And also, since many people will call the pharmacist if they experience a reaction, that puts y'all in a horrible position. Not so much one who works in a hospital setting (the "basement dwellers" - LOL), but one who works for a chain drug store - and really has little choice on what they fill. That would be SO unfair for the pharmacist to be cornered by the patient on a question that should be answered by the doctor.

Last comments on the topic of the "permission slip", but my ex was fully aware I was having surgery. I wasn't doing it behind his back, and he would have willingly signed a note. To me, it was the principle of the thing.

"You want me to have my HUSBAND give you HIS consent to what I do with MY body? You have GOT to be kidding!".

As it turned out, I just kept putting off turning in my "Pam has my permission to go on the field trip" note, and they had already placed an IV and given some pre-anesthesia happy drugs when he was flipping through his chart just before surgery and frowned (like "you bad girl!), "I don't see your note ...".

I looked at him, smiled (okay, smirked) and said, "Nope. And you won't.". What was he going to do? Unplug me and send me home?

He didn't, and I changed doctors after my brief recovery.

And too funny how similar our situations are with the two pregnancies!

Regards,
Pam

[titaniumed]

Trish and everyone,

Yes that article is interesting. Of course, Im very funky about drugs and chemicals. It all started with Karen Quinlan in NJ back in 1975. I was there. It was BIG news and set significant precedents in the New Jersey Supreme court. It developed our advanced health directives. She was in a coma for 10 years.
http://en.wikipedia.org/wiki/Karen_Quinlan

It was Alcohol and drugs.Jack and ludes. And not eating for 2 days. A deadly combo and a very sad story that I will never forget.

interject, food for thought. where was Karen? Watch it till the end.
http://www.ted.com/index.php/talks/jill_bolte_taylor_s_powerful_stroke_of_insight.htm l

Wasnt that neat? I thought so.

Now granted, some of the drugs that we have today are absolutly amazing. The NSAIDS are fantastic for pain reduction, and I would not have been able to cope with my 9 month sciatica however, after having a heart attack taking Bextra, I decided that I would go to Hawaii and do ocean therapy and it worked like a charm.

I have tons of stories like these and you can see why I feel the way that I do. (knowing what your taking)

This thread is about Allison and her neck and Im sorry you are in your situation. I feel for you. It looks like she has been around the block with all of this and is now looking for a non-narcotic or something that wont upset her stomach or destroy her liver.
And I dont blame her. Been there done that!

Running off to the Doctor and saying, "Doc, it hurts, what can you do for me" and having that person prescribe legit drugs as placebos, ( not sugar pills) Im talking about antibiotics where they are not warranted, hoping for a "placebo effect" can be very dangerous due to the development of drug-resistant strains of bacteria. "Placebo effect" does work in a lot of situations and is proof of power of being positive. Just make sure it is the right placebo.

From the article:
Most doctors used actual medicines as a placebo treatment: 41 percent used painkillers, 38 percent used vitamins, 13 percent used antibiotics, 13 percent used sedatives, 3 percent used saline injections, and 2 percent used sugar pills.

Wouldnt it be logical for a Doctor to issue a vitamin. (give it a complicated name) call it, "hopthishelpstrum" Why use a painkiller? and all the other stuff required with those painkillers. (stoolsofteners, reflux,etc) drugs rob the body of vitamins.

Being positive about your outcome really does have a lot to do with all things. Be positive even before surgery will help. Being positive about your surgery will help. Be positive about life! Give your body that chance that it needs to heal itself.

Not eating because you want to lose weight is not wise. Eat a balanced diet. Eat healthy foods. Eat proper amounts at the right times. Not eating will kill you. Overeating will kill you.

If we do not know what happens when 2 drugs or chemicals are mixed together, how would anyone know what happens when 5,10,20,or 30 drugs are mixed together? Thats right, nobody knows. So once again, I will reiterate, know what it is that you are taking, and why????

Brad, the answer is explode. And talking about exploding, after my last operation guess what? You guessed right, I swiched to Castor oil. It was a pleasant muffeled experiance, like a small firecracker in a pillow. Like a car wreck video online with the sound muted.

I promise more comedy on my next post.
Ed

[Geish]

... really is AWESOME stuff. It contains camphor and menthol (and stuff like cinnamon and cardamom), but it doesn't have the skin blistering heat that some other liniments have (and I've probably tried them all). It gives a slow, constant heat - and somehow seems to reach deeper than anything else I've tried. Also, I've never known anyone to experience any skin discomfort or reaction (even people with sensitive skin).

Generally, I just use the ointment (comes in a tiny jar, but goes a long way), but I've also used the patches. They work great for pulled quads from softball, and they're good for the back and neck area like the ones Trish described. If you have a back rubber in residence, the ointment is really, REALLY nice when it's massaged in.

I always crack up walking in a dugout of us old diehards who refuse to give up softball ... your eyes instantly start spurting tears because everyone is marinating in the stuff - LOL. Seriously, I keep a jar in my purse, one by my bed, and one in my softball bag!

Out of curiousity, I looked at their site (www.tigerbalm.com (http://www.tigerbalm.com/)): I've never seen most of the stuff in Walgreens, CVS, etc. And funny, I just looked at my jar and it reads "Tiger Balm Ultra Strength" which isn't even listed on their site - but it's what I always buy, and it IS available in almost every drug store.

And random factoid, it's the ointment of choice for the United States Marine Corps. It was the only one stocked in the Recruit PX. You have to imagine it's pretty good stuff if they're using it to treat the punishment of Marine Corps boot camp - LOL!

I know I sound like an ad for it, but it is soooooooo freakin' effective!



Okay, you have another convert here! Tiger Balm Rocks!
My youngest used it on her knee that has been hurting since she chipped part of the bone a year and a half ago. She told me her knee was "fantastic" this morning after using it overnight. The oldest used it on her back and loved it and I used it for the area between my shoulder blades that those damn rod irritate all of the time.
So I guess that means there are really 3 converts here.
Thanks Pam!!!

[trishthedish]

For those of you with access to a physical therapist trained in this technique, here is another fabulous drug-free pain therapy:

http://www.lymphnotes.com/article.php/id/215/

You may have seen kinesiotape on the volleyballers at the Olympics this past summer. All I know is, I'm presently wearing it between my shoulder blades and on my lower back, and it rocks! It activates certain muscles and relaxes others, depending on how the tape is applied.

I will try to get hubby to take a pic so I can post it on the blog (although I don't look like an Olympian volleyball player, lol!)