On Pain Management

(This was written in March.  I now have 300 mg Lyrica pills, which are MASSIVE and damn near impossible to swallow for some people.  My GP lowered my oxy yet again---I am now on 15 mg/day.  Fuck.)

I'm a chronic pain patient, blah, blah, blah.  Because of my GP's irrational fear of opioids, I was given tramadol as a replacement for oxycodone while I'm away in Europe.  However, I was unable to pick up my prescription at the chemist's back in Canada before I flew, and so I came to Europe with only Celebrex and Lyrica (Neurontin on steroids).  The Lyrica does wonders for nerve pain, but nothing else (plus it makes me incredibly sleepy and doubles as a sedative).  The Celebrex is about as useful as a leather jacket on a nudist beach.

Needless to say, I was able to obtain a prescription for tramadol and the British version of Fiorinal (essentially Nembutal and Aspirin) for migraines, and I supplemented this with healthy amounts of over-the-counter kaolin and morphine syrup.  However, as I've come to realise, tramadol for chronic pain like this is absolutely ridiculous.  For me, it's about half the strength by weight of morphine.  The British version of Tramadol, which is called Mabron,  comes in 50mg capsules.  To get a complete reduction in pain, I've had to take approximately 500-600 mg of tramadol a day.  The good news: Tramadol, for an instant-release medication, is incredibly long-lasting.  A single dose lasting 12 hours is usual for me.  However, it takes 3-4 hours to register an effect.

There are a couple non-obvious downsides to tramadol therapy, though.  First of all, with taking huge doses like that, the histamine itch becomes unbearable.  So, I take a Zyrtec or two (that's Reactin to you Americans) for the itch.  As if that weren't enough, what I consider to be the most important organ in my body becomes completely non-operational.  I've asked my doctor here for Viagra and have been flatly turned down.  To top it all off, tramadol (like pethidine) becomes seizurogenic at doses above 200mg, and if I weren't taking Lyrica I'd probably be having eppies all over the place. For this reason, although it may be addictive, I got morphine and promptly discontinued the tramadol.

When I come back to Canada, I'm seeing my pain management doctor, and I am already scared.  I have a good knowledge of medical terms, and I am afraid that if I use such terms to accurately describe where the pain is and its nature, I would be thought of by a doctor that does not know me as a drug-seeker, which I am not.  I am in urgent need of oxycodone---it is the one drug that helps completely at the right dosage.  I have found that twenty milligrammes of oxycodone twice a day provides relief from pain and anxiety during my waking hours; however, my doctor has seen fit to prescribe only enough to last me a third of the day --- twenty milligrammes, with a strong possibility that this will be reduced the next time I see her.