Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Pain Meds

I can vouch for the osteoporosis pain. I've got a fracture at T9 and it hurts a lot...sometimes more than the AS pains.

In the late 19th and early 20th century morphine and heroin addiction were often called "the Soldier's Disease". They were the only painkillers available to early Veteran's Hospitals, and they did a great job-- at a horrible price.

All my healthcare comes from the VA, and they've been gun-shy about opiates for almost 60 years. Thus, I'm on tramadol PRN not to exceed 800 mg in 24 hrs, and gabapentin 600 mg TID, and they're usually adequate for pain control. Like Cindy, pain management is all they can do for thirty years of ignored and neglected AS.

Don't try this at home, kids, or without medical supervision; I have a HUGE tolerance for pain.

Maintaining a high fiber diet adequately controls any constipation tramadol might cause.

My PCP and I have discussed oxy and vikes. At this point I don't even want them for breakthrough. I've got many years of sobriety from alcohol, but I know I can cross-addict to anything in a New York minute. The next step up in pain control for me would be methadone, but neither of us want to go there. She (my PCP) feels that should be reserved for "palliative care" (aka dying comfortably) and I concur wholeheartedly.

All that being said...you may wish to give tramadol a trial. There's no high, it seems to be non-addictive, and the constipation fades quickly as your body adjusts.

As always, I'm not a doctor and don't even play one on TV, so these are just suggestions.

Good luck and keep us posted.

John

I have always responded well to the pred taper. I love how I feel and how much I can get done. I wonder if that is what normal is for most people? I don't think I've ever been "normal".

I will have to walk my preschooler 5 blocks each way to and from school twice each day starting in September and I'm really worried about being able to do that multiple days in a row. Especially at 8:30 am, since I do not cope well with getting going early on a regular basis.

Should I be discussing pain pills with my PCP? or my rheumatologist? They know each other and can work together. Should I call my rheumy and ask about pain management now (appt not until end of August) and if he doesn't want to address it, see my PCP?

I think most of my pain is a dull ache that I've endured for years and I don't really count it as pain unless it is sharp and and intense. But i'm starting to think this constant background pain is very wearing.

Thanks. It seems to me that many of those who use pain meds post about getting more done than I can on any given day. I'm really tired of sucking it up all the time. I think I have high pain tolerance, but it does make me irritable.

Micki, I have had that constant dull ache for years. It can really drag you down and make you so tired. My GP started me on Ultram(tramadol) back in 1998 when I first came down with UC and he wanted me off all NSAIDS. Over the years he added Vicoden and then Norco 10's to keep me comfortable. Now that I am taking Humira, I am trying to slowly cut down on the pain meds and NSAIDS. I still have some ostio so I have been breaking the Norco in half and only taking one when I really need it.

Don't hesitate to ask either Dr. about a script for pain meds. I prefer to have my GP take care of it as I feel he coordinates all my medical care. I might change a specialist Dr, but I have kept my GP for 25 years.
Donna

Micki,

In my case I would talk with my rheumatologist about pain. My PCP is useless. I need to find another PCP, but at the same time I wonder if I really need one. All he does is send me to specialists.

John

I really like my PCP. Our kids go to the same schools. He's very smart and personable, as well as a good doctor. And he's closer than the rheumy.

Thanks everyone for your responses. I've been baking tonight and it really upsets me that after 20 minutes on my feet, I have to take a rest because of back spasm. I'm going to make that banana bread before I go to bed, dammit!

Another reason I'm concerned about which meds to use is that I'm a single parent and I don't want the only adult at home to be totally loopy, or more important, so dead asleep that I can't wake up for something important.

Micki, in my case it was a discussion between my GP and my Rheumy then both convinced me this was the best course of action. My GP maintains my pain management for me but my Rheumy would have no problem with handling it either.
Cindy