Anyone doing long term pain management?

I'm returning to this site after a long absence because I am once again dealing with pelvic pain. I had my hysterectomy almost two years ago, and now it appears my endo is back or I may have adhesions. (I still have one ovary.) I'm having an ultrasound tomorrow to make sure there's no mass on the ovary (which is doubtful -- it felt normal on exam according to my surgeon).

I hate that I'm headed down this road again. I knew I was taking a chance by keeping one ovary, but early menopause runs in my family and I was hoping I'd go through menopause naturally before the endo had a chance to rear its ugly head again. No such luck.

Fortunately my pain right now only occurs after ovulation. I have maybe ten days of moderate to severe pain out of each month. I've opted for pain management at this point because I simply do not want to put hormones in my body any longer. I can't stand the side effects and I'm already worried about the long-term effects of all the hormones I put in my body during my 12 year struggle with endo (not to mention the fertility drugs I took!). I'm not ready to consider surgery at this point, either. I'm planning to hold out as long as possible.

Is anyone else here on long-term pain management? My surgeon has prescribed Vicodin for me, which seems to do the trick and it agrees with me (many painkillers don't). I worry about the addiction possibilities, though. I take it only in the evenings and during the night on the days the pain is at its worst -- at most 2 or 3 pills a day and obviously not every day. At this rate can I become addicted to it? I know it's necessary, and the lesser of the many evils that I can choose from at this point, but I hate to trade one problem (pain) for another (addiction).

Any advice would be most welcome.

Thanks!

Hi there!
I've been on pain management since before my hyst, but have been on long term for about a year now. This long term pain management included some treatments like nerve blocks and epidural steroid injections, but mostly medication. I am currently on Vicodin (short-acting) and Kadian, which is morphine (long-acting). I have found that this is the best combination for me. I also tried the Duragesic patch which was WONDERFUl for managing my pain, but unfortunately made me so tired that at one point I fell asleep at the wheel at 4 in the afternoon and had an accident - so I was taken off that medicine by my doc...too bad though, because if I could, i'd be taking that instead of the morphine! The vicodin works perfectly for me. I have been taking it for 3.5 years now regularly. I am not addicted, but I do have a much higher tolerance and unfortunately, I require a much higher dosage than before in order to control my pain. But being on something that is a constant around the clock narcotic, like morphine, allows me to not need to take as much of the Vicodin. I wouldn't worry about that. If God forbid you did get addicted, there are ways to handle that. I beleive the chance is not that great, because you are taking it for pain mgmt...not to "get high." Talk to your doc if you get to feel uncomfortable about how much or often your'e taking it, but I really wouldn't stress over that. The main issue is controlling your pain right now, IMHO.
I do have to have my liver checked periodically since I'm on all these narcotics and other meds, but I really have been handling it fine. I'm so happy that I can live a relatively normal pain-free life, as these medicines allow me to do that.
I hope this helps you in some way. I just wanted to share my experience. There's a lot of horror stories about this topic and dramatization - you only hear anecdotal evidence, and society has a certain stigma about long term pain mgmt w/narcotics, but I guess I'm here to tell you that it can be done in a positive healthy way, in my and my doctor's opinion.
But please talk to your doctor about how you feel and make sure you and him/her make the right decision for you together.
PM me anytime, I will go into more detail if you'd like.
Have a wonderful day, and may you enjoy many many pain free days!
Luv, Christina

Hi smg! I'm sorry that you are dealing with pain issues again. But, like the others, I feel that PM can be used as a long term solution without "addiction issues." I have been in PM for 1.5 years and have been taking Lortab and Soma the entire time. I was just switched to a little higher (from 5mg to 7.5mg) dose of the Lortab due to tolerance issues, but definitely do NOT feel I would have any problems stopping the meds if I was not in pain. I have also had SI injections and TP injections. My PM just added Neurontin 200 mg @ bedtime for suspected nerve damage from previous surgeries and it is working WONDERFULLY in conjuction with the other meds!! My pain level hasn't been above a 3 in a week. And what's even better...this med isn't a narcotic.

Good luck with PM and just know that there are others who are doing it successfully and safely with their doctors!

I have been on hydrocodone now for about 3 yrs part of that
time was on and off, but have been on it daily for 2 yrs
now and the times I have not had it was no problem.
I use to worry about it, but the pain is such a bigger
issue, one reason is because I have to work and it is
not an option on whether I have to have them, so that
I can work, I don't even think about it anymore, the only
time I think about it is if I have had to take more than
usual and have to ask for more, I am not in pain mgnt
yet, my primary care Dr. prescribes them for me and
she says if I need more than what I am on now she will
send me to PM, I am about there now and will evaluate
it in a couple of weeks. But I don't believe there is
a problem with me if I wasn't in pain I have no doubt
that I would be alright with out them. I have a tendency to ache anyway, like fibromyalgia, so it helps
with that also, plus gives me energy, it allows me to
have a life and enjoy my grandchildren and continue to
work hopefully for 4 more yrs until I can retire. I have
worried about organ damage, but I don't obcess about
it because I feel I have no choice, surgery is not an option for me right now, maybe later. I am just so
grateful that pain relief is available and my Dr. cared
enough to give it to me.
I wanted to ask the lady who says she is on Neurontin
if she takes the generic, because my insurance doesn't
pay for it, and wondered if it works the same.

Thanks for all your very helpful replies ladies. It's comforting to know so many of you have taken narcotics on a regular basis without becoming addicted.

I just got home from my ultrasound and there is definitely something on the ovary. The tech told me it's likely an endometrioma or a hemorraghic cyst. I'll have to wait to hear from my doctor after he receives the radiology report. I was hoping against hope that the endo hadn't returned, but it seems certain now that it has.

I don't know what I'll do at this point. Despite my distaste for hormones, I probably ought to give them another shot to see if whatever is on the ovary will go away. If not, I'm probably going to opt to have the ovary removed. As much as I hate the thought of surgically induced menopause, I just don't want to go back to where I was two years ago, when pain was a constant presence in my life. I also have this nagging fear of ovarian cancer in the back of my mind, due in large part to the fertility drugs I took in order to have my children.

I guess I'll have to see what my doctor recommends. But right now I'm sad beyond belief.

Thanks for listening.

Susan,
I've been in pain management for over 4 years now. Before the hyst I was using meds for pain, but was not in a long term pain mgmt program. If the pain meds are being used for pain control and you are on the right doseage, addiction should not happen. There is a difference between addiction and dependent. My body is dependent on the pain patch I am using.

I don't know alot about endo, but if it has returned I am not sure that you want to add hormones at this point. Estrogen feeds endo. If it is a cyst, than it's possible for the hormones to help dissolve the cyst, but if it's endo that may not be the best idea.

Do keep us posted on how you're doing and what the doctor recommends.

Hi Susan,

As far as the fear of addiction goes, I agree with all of the other gals here 100%. If you have pain you need relief. I have been on Lortab for almost a year now and my new doctor says that the 4 a day that I need to take is very minor compared to what others have done. She says if it is working use it. I am goint to PM next week to see if they have any better ideas to offer.

To address the hormone issue. If the ovary needs to come out, get it out of there. Surgical menapause is not that bad. I had my total hysterectomy at age 40 and the only thing that bugs me is the hot flashes which I use progesterone cream for. I do have the vaginal dryness, but my new doc gave me vagifem and it works great. It is an estrogen but you use it vaginally so it does not get into your blood stream and there is no danger of cancer. Also it's just a little pill, so no mess. There are lots of resources for dealing with surgical menapause this site being a great one. I encourage you to do some homework and don't be scared the sisters will see you through. Feel free to pm me anytime.

Blessings to you, Kay-tee

I am just dropping in as several things you mentioned have caught my attention!

I have endo, which was the reason for my hyst over five years ago. Starting last summer I began to have a lot of pelvic pain. Since endo was left on my bowel walls and I kept my ovaries, we starting thinking endo. I even had a DEXA scan to prepare to take Lupron, something I have not wanted to do. I have migraines terribly and any type of treatment for endo (Lupron, Depro, etc.) will affect my migraines negatively, so they are a last resort for me.

After an u/s, a cyst was found on my left ovary in September. I decided to try to tough things out awhile longer to see if once the cyst dissolved I would feel better. The cyst did not "disappear" until January. However, by then my pain was worse and we knew my gastro system was involved. I ended up having a CT scan as part of my gastro work up the first of March and a hemorrhagic cyst was found.

Once that cyst bled out, my whole system seemed to settle down. I don't know if I had a hormone imbalance for awhile and it set off a chain reaction or what. Now I have the twinges, pulls, and pain that at times takes my breath away. But it is now tolerable and not constant. Both my GYN and gastro think it is endo, adhesions, and scar tissue, so at this point, I am toughing it out since it is so much better. (I do not want my ovaries removed unless absolutely necessary due to my age and watching the horrors some go through with surgical menopause.)

So, I say all that just to let you know that it seems when you have endo, anything that "flares" up in your pelvic region seems to set off several things. So maybe if whatever is on your ovary can be treated, your system may calm down again.

As far as pain management, I have taken Vicodin for other health issues for a couple years now. The only that has happened to me is that it is no longer as affective as it was so I will be trying Demoral. Additionally, I have taken Soma and Mobic daily for a couple years as well. This may be why my endo pain is no worse than it is, but I still have endo pain even with all those meds that treat another health condition.

All those meds are prescribed to me by my neuro and he agrees that if you are in pain, you will not become addicted to medication. He also provides me with pain patches, but for whatever reason, they do not work for me. It is when you take strong pain meds but are not really in a lot of pain that you can run into issues.

in there and I hope you find solutions to your health needs! Many s and best wishes to you!

	Quote:
Surgical menapause is not that bad.

Unfortunately, that is not true for all. One only needs to read some of the posts in The Hormone Jungle Forum to know that for some, finding balance after surgical menopause is difficult and can bring on a whole new host of problems and issues.

Some women do not have a problem, but I would be remiss if I did not point out that this is not the case for every woman. Hormones are not one size fits all and there isn't a way to know in advance which side of the jungle you will fall into once you enter surgical menopause.

I would urge you to be sure and educate yourself about surgical menopause, ask questions of your doctor and make an informed decision. If you're interested, you can start by reading the articles in The Hormone Jungle and we have many resources in the Resources Section of HysterSisters.