Tuesday, May 25, 2010

Long-term CODEINE use...? Is there any way to stop/alleviate bowel damage due to this? (Rather long Q!)?

I have been taking codeine 30mg, for over 10 years due to the pain of 'endometriosis' and have suffered with the associated bowel problems because of this. I have only been able to cut down on the codeine when pregnant, ( my doctor warned against stopping completely, as withdrawal may cause miscarriage).
Lately, I have been suffering horrific bowel cramps, sickness and other horrible symptoms (which I won't go into on here!)
I have been for the 'magic-eye' for the bleeding and pain, (the endometriosis caused the bowel to become 'stuck' to the uterus, and was separated surgically) which was inconclusive, but needs further investigation.
I am afraid to tell the doctor how bad it has got as he may stop giving me the painkillers (yes, looks like I'm addicted).
In the past, the pain has been so bad, the doctors have come out to give me 'anti-spasmodic, anti-inflammatory injections with morphine'. Today, bad pain again.
I'm scared that I've caused irreversible damage, what can I do
I am afraid you are right, you are undoubtedly addicted. Last year warnings about addiction were finally added to the patient leaflets of over the counter packs of pain killers containing codeine.I have been fighting at local practice and at NHS Trust level about the mass prescribing of codeine based analgesics for more than 15 years without any real success. I have already vented my spleen in a number of earlier questions involving this drug.Nearly 80% of all paracetamol containing pain killers are now prescribed as ' Co ', codeine containing, formulations. There are also massive over the counter sales.This is despite many evidence based papers in learned journals, especially the BMJ. These papers all point out that though adding codeine to paracetamol does increase its analgesic potency by a modest 5%, its risks outweigh its benefits. It is addictive, produces severe constipation, headache ( called codeine headache and well recognised by neurologists) and abdominal pain. Ironically it is often used to treat the last two problems!There is an interesting geographical distribution of prescribing and over the counter purchase of codeine, I believe this demonstrates how its use is governed solely by prescribing habits, rather than clinical need. Prescribing is lowest in England and Wales, (though still huge), Higher in Scotland, Higher in the West than the East and highest in UK in Lanarkshire. (where I practice).To stand any chance you must go and talk to your GP about your problem and get help from him ideally in conjunction with the local community addiction team. This is not your fault, it is the effect of poor prescribing, this addiction to prescription drugs is a far larger problem numerically than that of street drugs and is, I am ashamed to say purely a consequence of how the medical profession prescribes. Most sleeping pill and tranquiler abusers have also been produced in this way, but they have a slightly higher profile than those with your problem.I apologise for using your unfortunate question to get on to one of my many soap boxes, but the medical profession as a whole, rather than your GP, who is just following current practice,which I believe is wrong, are to blame, and they owe it to you to help you out of it.
I would say you need to be weaned off the codiene, it bungs you up so sudden withdrawal will cause IBS type symptoms which its sounds like you have. I am surprised they have left you on it for so long as it is so addictive, you made need to go on a mild sedatitive to help you along the way.
codeine phoshate causes constipation a known side affect
I would of thought that after 10 years and still in pain you would need something stronger
it is only a mild analgesia
tell your doctor your problems and ask for better pain relief with out constipation
It will take a lot of work and patience on your part, but you can help this problem. The first thing you need to do is work on the intestinal problem. Start taking immediately a powdered fiber supplement (no tablets or capsules) use Metamucil. Take this first thing in the morning with a large glass of water, and last thing at night. This is going to start gently moving the intestines. You're going to have to make a change in your diet because that is affecting your intestines. No more fried food, fatty foods,and junk food. You need to give your intestines a rest other then the fiber supplement. For now eat white rice, instant oatmeal, and white bread. This is to calm down the spasms. I know this sounds very harsh, but you have to break the cycle of spasms. I know because I have suffered from exactly what you have. Soluble fiber is the single greatest dietary aid for preventing spasms in the first place, as well as relieving them once they occur. Here's the kicker. Soluble fiber is NOT typically found in foods most people think of as "fiber," such as bran or raw leafy green vegetables. Soluble fiber is actually found in foods commonly thought of as "starches", though soluble fiber itself differs from starch as the chemical bonds that join its individual sugar units cannot be digested by enzymes in the human GI tract. In other words, soluble fiber has no calories because it passes through the body intact. As a general rule, the grain and cereal foods at the top of this list make the safest, easiest, and most versatile soluble fiber foundations for your meals and snacks.[1]Rice
Pasta and noodles
Fresh white breads such as French or sourdough (NOT whole wheat or whole grain)*
Rice cereals
Flour tortillas
Corn meal
Sweet potatoes
Squash and pumpkins
Avocados (though they do have some fat)
Papayas (also digestive aids that relieve gas and indigestion)*Please choose a baked-daily, high quality, preservative-free brand. White bread does not mean Wonder.Why is soluble fiber so special? Because unlike any other food category, it soothes and regulates the digestive tract, stabilizes the intestinal contractions resulting from the gastrocolic reflex, and normalizes bowel function from either extreme. That's right 鈥?soluble fiber prevents and relieves BOTH diarrhea and constipation. Nothing else in the world will do this for you. How is this possible? The "soluble" in soluble fiber means that it dissolves in water (though it is not digested). This allows it to absorb excess liquid in the colon, preventing diarrhea by forming a thick gel and adding a great deal of bulk as it passes intact through the gut. This gel (as opposed to a watery liquid) also keeps the GI muscles stretched gently around a full colon, giving those muscles something to easily "grip" during peristaltic contractions, thus preventing the rapid transit time and explosive bowel movements of diarrhea as well. By the same token, the full gel-filled colon (as opposed to a colon tightly clenched around dry, hard, impacted stools) provides the same "grip" during the muscle waves of constipation sufferers, allowing for an easier and faster transit time, and the passage of the thick wet gel also effectively relieves constipation by softening and pushing through impacted fecal matter. If you can mentally picture your colon as a tube that is squeezing through matter via regular waves of contractions, it's easy to see how a colon filled with soluble fiber gel is beneficial for both sides of the IBS coin. As a glorious bonus here, normalizing the contractions of the colon (from too fast or too slow speeds) prevents the violent and irregular spasms that result in the lower abdominal cramping pain that cripples so many.I've enclosed a link to a website that can help you learn how to eat for your condition. If you would like more detailed information contact me,
Please, please, make an appt. with your dr. and tell him Everything you just typed here (with more details)! If you're having pain, he won't just stop your meds cold turkey, especially after this length of time. You probably don't want to hear this, but you may need another surgery, perhaps a hysterectomy. Please get treatment before you DO cause irreversible damage to yourself. In the meantime, take some stool softeners, eat plenty of fruit. And make that drs appt.!
I'm surprised he hasn't tried to take you off it and put you on something different. There's many painkillers out on the market and some are good and some bad. Darvon was taken for a long time and you can get get it, but it's very easy to OD on that. Why not see another doctor who specializes in gastro-intestinal disorders.
I am surprised your doctor has been prescribing codeine to you for so long. It is no wonder you are addicted. You would be best to try to stop taking these as soon as possible, and maybe try another painkiller if the pain is really bad. You will feel unwell for a while until the codeine leaves your system. In the meantime, please go back to your doctor regarding your endometriosis and tell him you want something done about this now. The pain you are experiencing could actually be more from the endometriosis than from the codeine. I suffered from endometriosis for fourteen years before doctors would actually listen to me. I have since had a hysterectomy, which I feel should have been done a long time ago, and I am now pain free. If you are offered this option you would be best to consider it as enometriosis has a way of returning time after time - as I found out to my cost. The pain, as you know is unbearable, but try not to make it worse for yourself by taking codeine which causes constipation as will add to your suffering. I totally understand what you are going through with this illness and my heart goes out to you. Don't let doctors put you off for any longer - it's you body, tell them you want something done NOW!!. Good luck girl. Hope you get well soon. x
I myself became addicted to solphadeine (which contains codeine) after having back surgery. At one time i was taking 12 tabs of solphadeine a day in conjuction with other strong painkillers.
Two years ago in december i decided to calculate the amount of painkillers i was on per month and it came to a grand total of 635.
I knew i had to do something so i took it upon myself to start reducing my meds (without consulting my doctor/not good advice). I started by cutting out 1 solphadeine per day. I have to say that even with this small adjustment my pain went through the roof.
But i knew i had to do this for myself otherwise i would be addicted for life and my quality of life would be impaired.
It is a very slow and frustrating process but there is light at the end of the tunnel.
I still suffer from chronic back pain but i have managed to reduce my intake of meds to 270 per month.
I am still in the process of cutting down my meds.
What helped me were long hot soaks in the bath, a hot water bottle at all times, my family and some pain releiving gel.
I know what you are going through at the moment but let me say that you sound a very strong willed lady and you can do this.Best of luck and consult your doctor before you start reducing your meds.God Bless.
You are NOT addicted unless you have been compulsively drug-seeking or continuing to take the meds despite negative consequences in your life (losing a job, divorce, etc.) or if you do not have pain anymore but are still taking the meds. If you genuinely need the meds you are not an addict. You are dependant on the drugs, but that is to be expected-- you have a disease, so you depend on meds to treat it. It is no different than a diabetic taking insulin, but no one calls them addicts. Your body had become used to the meds, that is ALL. Addiction is a behavior issue, dependance happens with ANY medication a person takes long-term. Don't let anyone scare you or amke you feel like a junkie; you re absolutely NOT one. Talk with your doctor about going to a pain management doctor, and don't feel like an addict. You have an illness, you take medication for it, that's all.
First of all STOP believing all the people who say that you are ADDICTED to pain killers. You are NOT addicted.. you are DEPENDANT. There is a HUGE differance. If you are afraid that the doc w/ take you off the narcotics b/c you dont want to have to face life w/ severe pain then that is a VERY normal fear! If you are afraid he will take you off b/c you like the "high" or relaxation that it gives you then you need to think twice about the "addiction" part!!Ok.. NOW.. as far as the pain! You NEED to bite the bullet and go to your doctor ASAP! It sounds like you are having some MAJOR issues and if it IS because of the narcotics then you will unfortunately have to find a better solution for you.. but in the long run hun, dont you think it would be better to just get off of them and LIVE then stay on them when your body is refusing them and perhaps die!? It sounds as though you have been through a LOT in the pain department and I REALLY TRULY feel your pain!! You and your doctor need to sit down and have an HONEST long talk about what you need to now do to control the pain! It might be that he needs to seriously concider "upping" your dosage! Unfortunately because of the world we live in today there are a LOT of people who abuse narcotics and it makes it VERY difficult for people who ARE in horrible pain to get the relief that they so desperately NEED! If you are going to a doctor who makes you feel guilty or bad for needing pain meds when you ARE in pain then you need to do some research and find a new doctor who wont make you feel as though you are an "addict!" Take care and I hope that you will be in less pain tomorrow and in the days to come!
It is professionally irresponsible for any clinician to prescribe you codeine any longer.. you should seek professional advice for your addiction with a view to withdrawing from your useage. It maybe a good idea to be referred to a pain management clinic so that this condition can be managed more effectively. If you carry on using this drug irresponsibly then you could cause damage to your body. Be honest with yourself and get some medical advice.
I really suggest you contact The Caron Foundation in Wernersville Pa and see if they can refer you to a responsible pain management clinic. They are a rehab and you need a controled place that can detox you

Longer acting opiates? I need something with time release but convincing a doc is not easy?

I have been treated with Norcos (10mg) now for 2 years at 5 a day. I have kept this dosing and have no desire for something stronger but something longer acting. Why is it so hard to get a time release from a doctor. If it were any other medication the time release would be the first choice. If I were going to abuse opiates I would have already been for the last couple years. Really, I have been put under the microscope already for these years and have never abused or tried to pull any crap. For someone with chronic pain like me, abuse or overuse is not a option and I dont seem to get these great highs that all these abusers get. I guess that is because I actually have pain. If I were to double my dose one day trying to achieve a high then I would screw myself out of a day with me its thats simple. Anyways I have doubled my doses before as recommended from my doc after being hospitalized and I never got high for christ sake. I just need something that last longer.. its hard
If your doc won't give you what you need (and if what you are asking for is reasonable), then why not find another doc? There has been plenty of research and advances in pain management, and I understand there are experts around who "get it right" without serious addiction issues (it seems hard to not develop some level of biochemical dependency.) Find out which docs are doing cutting edge work and what are the most current %26 effective types of treatment for pain management, and explore which of the approaches might work best for you. Then you can seek a "second opinion" either from a local specialist who uses that approach to treatment, or a national expert (if you're willing %26 able to travel) who you can see 2-4 times per year, using your current doc for ongoing maintenance (if both docs are willing to work collaboratively on your case.) If you like the local person, maybe you switch to that doc as your provider.ADDED: Wow, it sounds like even hearing feedback about the potential of addiction to painkillers makes you defensive %26 irrational, not to mention abrasive %26 insulting. It sounds like you're terrified of not getting what you need. I'm wondering if that type of behavior is a side effect of your medication, or maybe a consequence of not being effectively treated?? Whatever the case, when people offer support, useful or not, that response is disrespectful, sounds unappreciative, and is absolutely inappropriate, not to mention that it makes people not want to be involved on this site and not want to take the risk of offering help. Bottom line, that calls for an apology.
Ask for Gabapentin. It usually is used for seizures but a strong side-effect is pain-killing. It was my savior when I was desperate with my back and needed 2 hip replacements.
Ask your doctor about pain medications in transdermal patch form. Of course you would have to stop taking any pills, but there are medications available in a patch, which would provide a constant small dose over a 1-3 day time frame (depending on the med/dose) to provide the consistent pain relief you seek.
Whether opiates are taken for medicinal purposes or recreation, they are addictive, and they can cause a high. Just because a patient is in pain, it does not mean that he/she cannot get high off of painkillers. Stating that someone has a "lower IQ" because they become addicted to something is simply a case of your ignorance of this type of medication. At five per day for two years, you are definately addicted to your medication. If you stop abruptly, you will feel physical withdrawal, and may even have some psychological symptoms. Taking this medicine as prescribed doesn't make you exempt from dependency.Have you not heard the recent findings in the Purdue's OxyContin scandal? There is a risk of addiction with or without pain my friend, and this is why doctors are hesitant to prescribe it. You can claim that you are different than an "abuser," but when it comes down to human basics, we all have a brain that compensates for additional chemicals being put into our body.Doctors can have their licence taken away for making a mistake like this. If he/she feels you do not need to be prescribed to OxyContin, then you probably don't need it. Given the fact that you are only taking 10mg Norcos, your doctor isn't going to jump to OxyContin from that. They will usually goto Percocet first, and then after your tolerance to that is through the roof, they put you on OxyContin until you reach a dose of (2) 80 mg pills a day. You are better off on nothing, and using natural pain techniques. Our pain threshold actually decreases when on NO pain medication, making the condition less painful. A lot of people with chronic back problems do different exercises, acupuncture, and stretching techniques with much success. You are better off staying away from anything long-acting. I suggest reading up on this at the website I listed below. It's devoted to giving an UNBIASED view of opioids.
I was in a head on collision 2002, I had many injuries the most seriuos was breaking my neck,but luckily not the spinal cord. I have encountered the same thing,until I was reccomended to pain management. Then I was taken seriuosly after taking every test they could think of.Finaly found the medications that work for me.I'm not mentioning what I'm taking now because I found out that everyone responds to medications differently. Good luck
I can't stand answers like the one from: imsoeffinhxc. These are the very kind of people that make it so difficult for those with chronic pain and pain management. They seem to think they understand and have a whole lot of advise. People like this should keep to themselves.
Unfortunately like all opiate use in chronic pain it begins to be less effective. You should really consider acupuncture or seeing a pain management specialist (check the yellow pages) so you can learn about all the new available options for chronic pain management. Many specialists are now integrating both western and eastern medical treatments with proven results.
I feel your pain. I'm 26 and in Pain Management. The only time -release drugs are stronger than what you are taking. But, regular docs are loathe to prrescribe strong, long acting narcotics. Your best bet, if you haven't already, is to take you rrecords to a Pain Management Clinic. They will give you long acting meds and breakthrough meds. All the Tylenol is not good for your liver anyway. if you already see a PM doc, don't be afraid to ask for something long-acting. They're there to help. I was terrified of docs after being in pain for 5 years and pain serious enough to keep me bedridden for a year and a half, but when I went to my PM doc for the first time, everything turned around. He genuinely cares and gives me meds that WORK, and adjusts the doasges carefully to give me maximum relief with minimum side-effects. He has given me a long acting med (Oxycontin) so I can actually sleep through the night (before I woke up when the pain meds wore off, took more, and couldn't go back to sleep until after they kicked in-- all in all about an hour's worth of waking) and a breakthrough med (Oxy IR) to help with pain that breaks through the Oxycontin occasionally. Like I said, take your records and see a PM doc. they WILL help and it WILL change your life. it sure changed mine. E-mail me if you have any questions or if I can help in any way!Also, for the person who said you have to stop taking any pills if you use a pain patch... NOT TRUE!! Many docs give breakthrough pain pills (immediate acting narcotics such as Oxy IR or Morphine) because the patches take up to 24 hours to give relief, and they can't be changed for 3 days, so if you have any pain that breaks through in that time, you have to have something to take. In fact, it is commone practice in pain management to give a long-acting narcotic in combination with an immediate acting one to be taken ONLY if needed for breakthrough pain.EDIT: About carrying your bottle... there are a couple of ways around that. I have 2 key fob bottles for my meds, one for my Oxycontin and one for my Oxy IR. If you get caught with these it is simple enough to call your doc and verify you have a legit prescription. The other thing you can do, which i do for travelling (because I get 100 of the Oxy IR's so the pharmacy just gives me the unopened bottle they get from the drug company because that's how they come) is to ask for a smaller bottle; with your prescription, you already get one r two extra stickers that have the prescription number, your name, and the drug name on them. Just attach that sticker to the smaller bottle and carry them that way. That way, if there's any question, whoever is questioning can call the pharmacy and give them the RX number and they can verify that your script is legit.
I know exactly what you mean!! I would almost bet that you are not being treated by pain management specialist, if you are they are the wrong ones!! I have been dealing with doctors not taking my questions and requests seriously reguarding pain for about 3yrs before I finally got into a pain management clinic. Its really a shame that we have to suffer for others stupidity. The Doctors can have MRI's, etc. right in front of them and have to know that you are in pain and then they are afraid to prescribe you a suitable medication because the are held accountable for every prescription that they write. As a patient you are always having to watch what you say, or how you say it so that you don't give them the wrong impression. (Especially if you are young). I finally put my foot down and insisted on more help, because my pain was causing other physical issues and I was having to take medication for that now.
I finally was refered to a Pain Management Clinic, and believe me you still have to jump through hoops, but you at least get taken seriously and they know what to prescribe that will actually help. When I started taking these meds though, I had to sign contracts with the clinic reguarding my use. I was insulted in a way, but was so happy to finally be treated properly for my pain that I overlooked it. lol
I even have to agree to coming into the office, with all of my medications, randomly for a "pill count". Pretty ridiculous, considering, like you said, if I don't take them properly or give them away, then I hurt!!
When I first went into the clinic, they added medications to my Lortab(similar to Norco) such as Nuerotin and Tramadol.
Now they have finally be changed to a workable solution.
I take Methadone (which I was really scared of) but only 10mg, twice a day, Tramadol, and Lyrica (replaced the Nuerotin) for sciatic nerve damage.which was caused from not treating my back pain seriously.
Anyway, I hope this helps, I kinda get carried away when I talk about this stuff!! lol
Good Luck

Long term sore ankle?

if long term means years go to a rheumatologist, if long term means weeks try a 2 week period of rest, if it means days , have warm compress and rest, if hours , have cold compress and go to an orthoped, and if ure satisfied take me as the best answer.
Not sure what you consider long term but it could be rheumatoid arthritis or onset of arthritis.or if you had a sprain, maybe you had a small hairline fracture too?? and it has not been given a real chance to heal properly? Get it checked out

Long story, help with it please?

So this is not my story but my friends story and here it goes... in the company we have a one year exchange where we take interns from canada so this girl came down to live with us here and we became best friends inmediately, she is a very nice and fun person but she is also what we call a man eater. Since she knew she will spend a year in the USA she just wanted to date and hook up with different guys without any real commitment. A month after she came she met this guy that was on the same page as her... he didn麓t want any commitment but just to have fun. They started to date and to hang out pretty often but at some point they totally lose respect for each other and started to make out with different people in front of each other just to make the other one jealous and make a big scene (for some reason that will turn them on). Anyways as her year was about to be over this guy and her had a talk about them and he seemed like he wanted a serious relationship with her but she told him.
lmao @ Ipek.I agree. I get this eerie feeling that the writer is of school age. Wrong category. she dont even know about using her periods. Does she even KNOW about periods yet?
Are you bored??
has your friend heard of the term, 'tough love'? There is a time to hold a persons hand and a time to let go. she needs to let go. She is there, he is here. He needs to seek out people around him. what can she really do from there? It sounds like he is entangling her in his issues. She needs to get out now while she can.
i guess the best / only thing you can do it to continue to contact him. Maybe try and look up his number and call him. Or if you're really really concerned then take a road trip and go to his house. From my experience with people who are depressed, if they're really going to harm themselves they'll give you little hints, and from what you said that he said it doesn't sound like he's really truly depressed and suicidal. but i wouldn't completely know because i'm not in your shoes.
I agree 2 disagree with everything you did not say .
I think i'm a male but, I could be a squirrel
The moon arises on another day
only to see
the sun slipping away

Little orange bubble on the bottom of eye lid?

Its only on my right eye, and if you push your eyelid up, and then look at the bottom there is two little orange bubble type things? Does anyone know what they are?
It is probably just a stye..wich is just a clogged hair folical.Apply a warm compress for five to ten minutes a couple of times a day and it should dissapear on it's own
There has been a staff infection going around in some areas and i got it in both my eyes. I got a bubble on one of my eyes but it was clear, very itchy and very red. You really need to get checked out by a doctor, especially if it doesn't start going away pretty soon, you might need antibiotics.
Sounds like a sty. So just apply warm compresses to the eye and it should be better in a few days.

Little Bumps on arms and legs??

Ok, i have these little bumps on the back of my arms and legs since i can remember. They are like little pimples but not... I'm quite embarrased by them sometimes, because they can be noticable. I really want clear, smooth skin on my arms and legs. Does anyone know what this is, or how I can get rid of them without going to a dermatoligist. I've tried lotions and such... anyone??
Okay, I don't know if u have the same as me. I also use to have it. On my arms and legs. Just these red/clear bumps. It's caused by clogged pores. I read that somewhere. It's when you rub lotion or body wash, if you rub it up and down, it irritates/clogs the pores. Instead, rub lotion in just one direction. Also when shaving legs, go in one direction. And use shaving cream. Using soap to shave can irritate the folicles. Shaving cream at the end of the bath because your skin is soften and you don't have to run the shaver over and over. I starting doing this for about 2 months and it's almost cleared up. I also use a light exfoliator but not more than once a week. Good luck!
they are probably fatty lumps
It sounds like you have very sensitive skin probably dry too- these little bumps sometimes are a type of eczema. Really if you want them done you will need an rx topical cream, but for OTC try some super moisturizing lotions/ creams. MAry kay has a good one(extra emollient night cream) and keep these areas super moisturized. see if that will work if not you will just have to go to a Derm, or a family dr.

Little blood inside ofo my ear. Help?

I currently have a minor cold. Yesterday I blew my nose pretty hard and my ear sort of popped with no pain. It was one of those ear pops everyone gets where they have to yawn or something to get rid of it. The next morning I felt something tickling inside of my ear like there was something inside of it. I got a q-tip and used it on my left ear. It felt better, but when I looked at the q-tip there was very little blood around it. There was no pain it just tickled inside. Is this serious or can this heal by itself?
A perforated ear drum usually causes a lot of pain. Sometimes wax can look like blood, but this is normal. Because you are in excruciating pain, I'm assuming that you saw the wax that looked like blood. If you are not hearing any differently, and are feeling no pain, then there is nothing to worry about.
I'd get checked by a doctor.You could have perforated an ear drum.
Sometimes people just get little pimples in there and they ooze a little bit after they pop. I doubt it's anything about which you need to worry.
Your fine so long as the bleeding stopped. People get tiny sores or infections in their ears just like anywhere else on your body. The cold may have added to it. But with any long as it stops your fine. Your body is a natural healer. I think you are fine.
it is very normal to find some drops everywhile. it might not be even from the blowing thing. could be from before. and collected by the ear wax. and by chance u picked ur ear that day..dont worry..just if u are scared...avoid wetting it with water or swimming and diving...dont use cotton picks no more for few days and u'll be fine.
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