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Unread 05-25-2009, 05:35 PM   #1
captmph
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Exclamation My body is really tense

I was wondering if anyone who was taking sub for chronic pain had any side effects that make the pain worse. I started sub 12 days ago, 8mg's and the pain is increasingly getting worse. I had a three level fusion in my neck Dec 18,2008. Not only does my neck hurt but it's like all of my muscles are clenched and I can not relax for the life of me. Is this normal for a sign of my dose being too high or too low? I also thought I might be having anxiety attacks or something like that but can't say that I'm worried about anything. I don't feel scared or worried, just pain and sadness. I do see a psychiatrist, talk therapist and the sub doctor. I just can't stand feeling so tense physically! It's painful on top of pain. Anyone, Please if you have gone through this let me know. It is getting intolerable.
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Unread 05-25-2009, 06:28 PM   #2
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In the higher dose range of Sub, above 20mg my pain got worse, in that I got rebound pain so to speak. I suppose if 8mg is too high of a dose for you, then taking it all at once say in the morning could also produce similar feelings. This is an assumption!

To get Sub to work most effectively for pain you need to use a very small dose, say 1mg or less every 4 - 6 hours or as needed.

In regard to anxiety that can be from several things but one this is for sure, it most likely in some form a byproduct of the addiction. If we suffered from it to ant degree prior to addiction, then we can expect it to be there now and most likely worse. It should be treated directly as it can help cause relapse.

The other thing to consider are other medications you might be on.

I would try taking Sub properly for pain, coupled with an over the counter pain med as well. Maybe 2mg every 5 - 6 hours and see if that makes a difference.

When you say ......... "my muscles are clenched and I can not relax"................ are you speaking about in your neck only or else where? Are you having spasms?

Are there any other health issues or medications?

what was your drug of choice when in active addiction?

Mike
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Unread 05-25-2009, 07:08 PM   #3
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Thanks for responding Ohiomike. I am taking the 8mg's throughout the day as well as motring and tylenol in between. Not too much tylenol though. My drug of choice was vicodan and it did work for my anxiety. As for where the muscle tensing is, it is all over my body. It's like my arms, legs, and stomach are clenched so tight that I'm giving myself a work out. This could be from the anxiety or fear that I took vicodan to avoid as well as the frustration with the dosing. I will tell you that on 10mg's of sub I did not have this feeling but I did feel tired and was unable to sleep. On 8mg's I am sleeping a little better and the mental cravings are not as bad as when I was taking 6mg. My doctor and other doc's have said the way my body reacts to medications is an enigma. So you can guess that I am frustrated which only increases the pain and muscle tightness.
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Unread 05-25-2009, 07:10 PM   #4
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PS other health issues are just mental. PTSD as I said earlier and low thyroid. No major physical illness.
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Unread 05-25-2009, 07:42 PM   #5
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My deal was vicodin as well. Now for pain I use about 1mg of Sub taken with at least 800mg of Motrin. I stay away from Tylenol simply because of liver issues. For pain help with Sub I would not take anymore than 2mg at a time.

If you really feel that anxiety or stress are playing into this, you might wish to ask your doctor for something to help. I had random anxiety attacks early on and cymbalta help that, but, what I found later on was, it also helps with my pain issues. Check though as it could conflict with thyroid treatment.

We are each very different and you could be experiencing the same type of rebound pain I did, but at the higher dose range. I know my wife reacts so different to nearly everything, even most supplements. If I were you though I would remove the other possibilities first like possible stress and anxiety issues, even if they are not outwardly noticeable.

I know it is frustrating, but please do not give up. The answers are out there and others should be along to join in with other suggestions and experiences.

By the way, at 800mg and above Motrin works as a anti inflammatory and that might help as well, it does for me. Keep good daily records of what you take and how you feel, physically and mentally, this will help your doctors and express to them (your doctors) that you need answers!

You may still be settling in some on that Sub though at 12 days that should be pretty much finished up and leveled out.

Hang in there and stay vigilant for the answers!

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Unread 05-25-2009, 08:08 PM   #6
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Ok First I have to try with tomorrow, taking only 2mg's in the morning instead of 4mg as I was doing. I also think that a lot of this could be self punishment for doing something good for myself. I chose to go on the sub and do feel better on the 10mg. At least I do today. I feel like it's too high and I take some of these posts so personally that you, and everyone else who has tried to support me, want me at the lower dose. I do this with my therapist as well.
I have not tried the 2mg's throughout the day which is a great suggestion. I also believe that if I did used to feel this I took vicodan right away so I wouldn't. Now I have to deal with this muscle clenched body. As for the pain, you're probably right on track with the rebound pain. I just didn't expect it to be this bad. That pain is different than the muscle tightness. It's in my neck and shoulders where my injury is. So rebound pain seems likeable.
How are you doing? You've been such a great support for me. I have in my head over and over again that less is more. So, again I can't let myself take my doctors advice and try the 12mg. I do take the 10, ok I did twice and stopped because I couldn't deal with only being tired. I have been tired like this for about 10 years. Did I just totally confuse you? I did myself.
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Unread 05-25-2009, 09:18 PM   #7
OhioMike
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Try to dose at 2mg as needed every 4 - 6 hours for pain.

You know what is really hard, it's the damn mental games! In other words, Sub works best at it's lowest effective dose, per individual. Great, but, heck we have been trained by this to disease to feel as though we always need more! This is a much tougher obstacle to get over than we might think and it is mental, so Sub only can help so much.

We have to learn to trust this new medication called Suboxone, which works best with less, instead of like vicodin, always wanting more. Not easy, but, we can do it, you can do it!

The other thing I found was this, after switching from vicodin to Suboxone more pain was revealed because I was no longer totally numb to everything. Damn, I could feel again and I felt pain as one of those feelings.

I will tell you one advantage of treating with Sub for pain, say 2mg every 4 - 6 hours, we normally end up taking less Sub per day than we would otherwise and we find out, we didn't need as much for the addiction issues. Also, please take the over the counter pain medications right before you melt your Sub so they are working together. That may help you, it has me.

Listen, make no mistake, treating addiction and pain together is tough or can be. But, we can do it, it just may take some time to find the recipe which works best for you. Also, try other things, like diet, home based physical therapy, stretching and stuff, supplements and so on. Stay hydrated and stay active.

You can do this, your answers are out there. You don't have to be a slave to addiction and you don't have to be a slave to pain. I can say this because I have been able to improve and I have watched as others have made progress.

I'm doing fine. Oh I have some really tough days at times, but, overall progress is being made. One thing I really try to do, I always try to find the good in each day. That may sound corny and on the good days it may not seem needed, but, by doing it each day and focusing on the little good things that happen all around me, well then when the bad days come I have some ways of dealing with them!

And I really meant it when I said to be demanding with your doctors. Not rude, but, demanding, let them know that you are part of the solution, that your proactive and that you expect results and progress from them too! They work for you!

Listen about your doctors advice, no doubt he/she means well, but, using Sub for pain is so much different than simply using it for addiction! Maybe you do need 12mg, but, if you do, then your going to find out once you try to treat your pain correctly, smaller more frequent dose routine. My bet is that you don't need more milligrams per day, but, a good pain treating program.

Anyway, hang in there, all we can do here is share the best suggestions and advice we know of, based on our personal experiences and those of each other. Remember, we are not doctors, so always check with your doctor and keep him/her apprised of how your feeling. If they are not sure of how to use Sub for pain or if you feel they are not, go to the educational sections here and print information to share with them. I did that and my doctor and I learned things together!

I'm glad your here and asking questions, stay after the answers and stay hungry for better health and you will make it!

Mike
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Unread 05-25-2009, 09:24 PM   #8
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Oh hey, by the way .............. water therapy has been really good for many helping out with neck pain and upper shoulder pain. I'm not sure what is available in your area, but they have these floating beds now at spa's and such, check it out!

And stay positive, our over all out look on life can mean so such, so try to focus on living life and enjoying, not your Sub dose and pain! lol haha easy to say, huh?

But, I'm serious, keep yourself up mentally and moving physically.

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Unread 05-25-2009, 09:51 PM   #9
captmph
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It really is the stupid mental games. I think I misinformed you but I know that 12mg is too high for me, it's the 10mg I think is ok. My mind is playing so many games that I even though I feel better on the 10mg, I should only be taking 8mgs. I want to please everyone. There is no way I can take people thinking I'm doing it wrong or letting my disease take over.
I have been learning that when the disease want's to grab hold tight I tend to think about the fusion failing or something that would lead to a major injury. The rebound pain is almost worse than ther original pain. My psychiatrist warned me about this so that could be why. I do see the ortho surgeon tomorrow so I'll find out if it's more stress related than anything. I do like the idea of taking 2mg every 4-6 hours. The pain I feel now is also partly due to the fact I was so numb and foggy headed. I already looked into the water therapy stuff. there is not a one around my area. I have to try to get some sleep so I'll be back tomorrow.
I know now that I do miss my vicodan. Not the obsessive thoughts that went with it but I miss the way it let me avoid issues. Now they are coming at me like a fierce hurricane or tornado.
Have a good night.
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Unread 05-25-2009, 11:16 PM   #10
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I understand. Feeling again can suck, but, the up side is, it lets us know we are alive. Of course those regained feeling just play into the mental part too, like missing our vocodin!

God what a vicious cycle, but, we can beat it and control it. Give it time, it takes time. We didn't get here over night and even with a medication like Sub, we can't reverse all of this over night. Keep in mind, my solutions with Sub for pain help me, but others here have found their own solutions as well, so as time permits browse the posts to get some more ideas.

As for how you work your program, listen, you do what is right for you! Your recovery is yours! It won't be like mine or anyone else's! There is no correct blue print for recovery and/or pain management. The goal is progression, quality of life and being able to live again. Progress at times will come in quickly and at other times it might creep along, but, so long as it is progress, your doing fine!

Best of luck at the doctors and I hope you can get some good ideas which will help.

Mike
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Unread 05-26-2009, 09:45 AM   #11
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Quote:
Your recovery is yours! It won't be like mine or anyone else's! There is no correct blue print for recovery and/or pain management. The goal is progression, quality of life and being able to live again. Progress at times will come in quickly and at other times it might creep along, but, so long as it is progress, your doing fine! By OhioMike
I do need to hear that a lot. One thing I just realized as far as getting the right dose is that I don't feel totally supported by all the people I'm working with in regards to taking the sub. I have not been told that they do not want my on it, but they have said they wish I could get clean without it. These are my doctors who have been treating my depression and anxiety for the past 15 years. So, the past four years my physical injuries have gotten worse. I never in my wildest dreams would have thought chronic pain and neck fusions would be part of my life. I have enough emotional crap to deal with let alone physical stuff and opiate dependance.
So what I think is going on is that I will not allow myself to get on the right dose because for some reason, they will support me more if I don't like it or feel good. The 10mg, I think, works best. I know for sure 12 is too much. I just feel too guilty and tell myself I should only be on 8 because that is where I still feel cravings and like the white knuckle sober. I hear the less is more and take it personally as a clue I only need 8mg.
I say all this but I don't know when my addiction is talking or when my gut instinct is talking. The pain is still there but the tightness in my body is less today. Yesterday I wound up taking 10mg. I also took 2mg this morning instead of 4. I also feel like I make no sense on these boards and am just an annoyance. Cunning, baffling and powerful; that is my mind plus my dependance. I'm driving myself nuts.
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Unread 05-26-2009, 10:15 AM   #12
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You need to learn to place their opinions on the shelf and focus on you! The correct dose is the lowest one which totally stops WD and Cravings! If that dose is 10mg, then that is your correct dose at this time. As you progress, that dose will come down, as needed.

It seems to me as if these doctors do not truly understand this disease or how Suboxone can be used as a positive tool in recovery. Also, your doctors need to be supporting you.

You are making sense, so don't feel as though your not. Further, even if you ramble at times, so what? We all do and it is just a need to let the crap out and that is fine too!

you know, I wish I didn't have to take Suboxone. But I do and I know this, I am doing it right, it is a proactive tool in my life and it is about my life being better and my enjoyment of my life, not what another person feels is correct. I don't like taking my blood pressure medication either, but, I know I feel much better with it and I am protecting my health.

Did you take any over the counter medications with your 2mg of Suboxone? Also give it time, get in a rhythm. Then begin to work on other things which can also help your pain.

Treat the anxiety so you can lift some of the stress. Cymbalta can help pain for some, but, there are other options as well, so speak with your doctors.

It does bother me that you feel as though you have to prove your treatment as such to your medical caregivers. I mean that seems very counter productive and it seems that you are learning more than they are. You need to let them know how you feel and that you need them to be proactive in this deal and supportive.

Less is more, but, each persons correct "less" dose is different and moves down at different rates. There is no standard, no right or wrong. So never feel guilty about your dose, just be well informed and then you can manage it making it correct for you!

Finally you state "I am driving myself nuts" ............ yes, you are, but, so did I for a while. Listen, stop searching for the perfect recovery, there is no such thing. Stop trying to please everyone, you only need to please yourself. Lean to focus on good things and things which bring pleasure to you. Do not accept negative, only constructive suggestions and support. You can do this, you just have to keep striving to take control of your own recovery!

Mike
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Unread 05-26-2009, 10:25 AM   #13
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And please, read others experiences here with pain, as many have found ways to help manage it. You never know what little trick another has found, might also be something to help you!

Hopefully they will chime in here and offer there experience.

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Unread 05-26-2009, 12:45 PM   #14
captmph
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I will read others experiences with pain on this board. I have tried cymbalta and it did not work at all, in fact it backfired. Right now I am on celexa and a little klonipin. That seems to work for me. As for the pain, I need to work with my doctors on that. I have tried all of the other medications that help but had severe side effects. Motrin with the sub helped this am.
I just got back from seeing my therapist and I guess I only thought she wasn't supporting my decision. She does, she just wants me to talk about the link between secrets in my past and secrets now with my vicodan and other narcotic use. She said nothing about not approving of suboxone. I may have "wanted her say that."
One thing I don't quite understand is the mental cravings. I think I am having them big time. I am a big people person and don't want to disappoint anyone. I am starting to understand that I do need to give myself time and stop punishing myself for this disease. I also would like to find a meeting that I could attend. It is ashame that there is no majic pill that will make us all better. Nothing will make us/me better except myself and my willingness to talk, take the sub and be as honest and patient with myself as I can be. I spent too many years looking for the fastest fix and the best medicine for a cure all. It's time to choose myself as part of the solution not problem.
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Unread 05-26-2009, 01:33 PM   #15
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I'm sorry the Cymbalta didn't help any. I'm not familiar with Celexa and I'm not sure how the Klonipin matches up with Sub. But, if it helps stay with it and keep searching for other options as well. I'm glad that the Sub and Motrin together helped some. It's odd, Motrin never helped me for anything, except knee swelling. Then after starting on Sub, that changed. Other people get no help at all. It is so different for each of us.

Hey, good news with the therapist! I'm glad you are mentioning this to her, as her support is important.

I don't know that I can be the best at describing the difference between mental and biological cravings, but, I'll try. For me a mental craving does not hold any physical feelings. Not physical WD symptoms, but that knotty gut feeling which comes with anxiety can be there. It is not driven by WD symptoms, but it is driven by thoughts of the past, thoughts of the numb feeling. I still get fleeting thoughts of using. They don't last long, but, they come flying by.

Right now with you early in recovery you have to protect against both and it can be hard to tell the difference. Further you seem to be under a lot of personal stress over recovery and that is not going to help you any. You need to keep working through that. As you do, it will be much easier to tell what a craving is and most importantly, why it is there and how best to handle it.

As for disappointing people, please, please, please, only worry about disappointing yourself right now! And YES, it does take time and I know how hard that can be to get settled into. We want so much to be better and to make everything better around us. We just have to trust. We have to trust that so long as we keep moving forward and focusing on the good, that those things will all come together. Sure there will be bumps in the road, but, so long as you are progressing and staying positive, you will ride right over them!

Easy to say, huh? ............. Trust, trust the process of recovery and trust your ability to heal. Trust the science behind this medication and trust your ability to take charge!

As for meetings please consider this, your medical treatment for this disease and or anything else is your business only. The peer support at meetings is to help us learn how to deal with the emotional, social and mental issues and to have a support line to talk them out with. Keep looking for a group you feel good about and understand, if it takes some time, that's OK.

You are already doing a good job of talking things out and that is a huge step forward, keep that up. Also try out the live chats here on Tue, Thu. and Sun. evenings from 7:30 - 9:30 pm. It is a great way to vent, get advice and to get to know people.

And YES, you are a part of the solution and you are the solution. You can do this! It is problem solving, not hopeless endless problems. Stand them up and knock them off one at a time!

Mike
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Unread 05-27-2009, 11:50 AM   #16
captmph
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I totally forgot about the chat last night. I was planning on tuning in. I will tomorrow. Right now I am off to the sub doctor to discuss my dose and the side effects or feelings I have been having. I will tell him the dosing every 4-5 hours helps a lot as well as motrin right after I take the sub. I am planning on letting him know I am on this site and getting lots of support.
will check in after appointment.
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Unread 05-27-2009, 05:50 PM   #17
captmph
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Well I just got back from the sub doctor. I am starting to like him. He said that my dose is fine. I should take an extra 2mg which would total 10mg for pain. As for the anxiety and tense feelings, it is more than probable that it is due to my PTSD and talking is the best answer.
He is concerned about the muscle tension and my extreme fatique. I used to be on provigil but now it is too expensive. I told him I was getting support and information from this site and he thought it was excellent. He wants me to try something called Vyvanse. It is apparently like Provigil but most people take it for ADHD.
For now, I have to give myself credit for this week. I confronted my therapist and talked through my feeling of not being supported, found the right dose and feel heard and motivated to get my recovery started. I also told him that a sign of too high dose was being very tired. He told me that I was tired before even taking the sub and thinks I have some type of fatique thing from so much anxiety. Oh well
I am going to try to post somewhere else tonight so hope to hear from anyone soon. Ohiomike, Its like there is no one else chimin in. We gotta get em over here.
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Unread 05-27-2009, 07:13 PM   #18
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Wow, I am really happy for you! ................. See, this right here is the real deal of recovery, not just having clear thinking to make choices, but, the ability to take charge and explore your choices!

Good for you!!!!!!

Yep, it's rough at times, but, if we learn to keep it real and rational and learn to problem solve, we will find solutions. Slowly you are going to find yours!

I have one question about your Sub doctor, did he/she understand why we dose with a smaller Sub dose, more frequently and also add in some over the counter medication if needed?

By the way, if you take over the counter medications with your Sub, try taking them before you melt your Sub dose. This way you will not have the need for water or anything, at least 15 min. after your Sub dose is finished.

Again, I'm really happy for you. You should give yourself credit and keep this thread handy. When things get tough come back and read it again to remind yourself that you can work through things!

Mike
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Unread 05-27-2009, 07:20 PM   #19
captmph
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I guess this is the real deal and it's not that bad right now, in this moment.
Yes my sub doc did recommend taking smaller doses throughout the day with motrin. I did not know that taking it before the dose is better. I was doing it the opposite. That's why it felt weird to wait almost 30min after taking the sub. Thanks for info. The doc is the one who first mentioned that for chronic pain taking sub in smaller doses with motrin is what works best. He seems pretty educated on it, I tend to overthink, question and doubt doctors when I do something new. cause ya know everything is everyone elses fault not mine. Just kidding. I will have to come back and read what I wrote in that last post, I probably won't believe it at times.
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Unread 05-27-2009, 07:34 PM   #20
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Hi captmph, congratulations on all the progress you've made. Hopefully dosing in smaller, more frequent doses will help with your pain.

About the provigil, please check this link out:
http://www.needymeds.org/drug_list.t...&name=Provigil

It has 2 programs for one 30-day free supply and if you scroll down, another program for free 6-months worth.

Hope it helps.

Nancy
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Unread 05-27-2009, 07:44 PM   #21
OhioMike
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Hey, you are building your own personal staircase for the future!

I am thrilled that your Sub doctor has such a good understanding of this medication, you have no idea how much that benefits you!

I am also thrilled that the Motrin helps. Clearly different things help different folks, but, for me it's cool when what I'm doing can help another.

As for taking your Motrin before your Sub please let me share this with you, it is taken from something I shared with another member.................


Quote:
Then on melting your Sub, if you want to get the absolute most out of each dose, then this is the trick, 30 min. prior do not eat, drink or smoke anything except for water! Right before taking your dose rinse your mouth out with Tap water, as hot as you can stand it, without being uncomfortable. After you feel the Sub has completely melted, wait another 3 min. before swallowing or spitting saliva. Now for the next 15 min do not eat, drink or smoke anything, not even water and you will get the absolute most out of each dose. It also helps if you are taking a full Sub tablet (8mg) to split it in half and place half on each side of your mouth.

Why do people like me suggest this? LOL ........... well not only does it save money, because you will need less Sub, but, it lets you know that you are doing all you can to take the least amount possible and in our minds that is a huge victory because we were always so use to wanting more and more and more!
Remember, we have many tools and methods to help us with this disease, it's only when we close our minds to anything that we get into trouble. For myself I have taken bits and pieces from many things to form my own recovery plan, always willing to explore and learn. The same seems to work for the pain issues, stress and so on. You have taken some very large steps here and your building a good foundation and understanding for yourself!

Mike
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Unread 05-28-2009, 12:24 AM   #22
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Hello captmph.

I had a 3 level cervical fusion as well! Do you have a titanium plate in your neck just like me? lol

Maybe my experience can help with your pain or a least understand it better.

I was taking 30 pills a day. When I started taking suboxone I did feel as if my pain was getting stronger (just like you). It wasn’t the suboxone, I honestly think that I noticed the pain more because I wasn’t “high” anymore.

After about 3 months of NO PILLS my pain levels began to go down. I discovered that my 30 pain pill a day habit was CAUSING the pain. You should expect the same thing to happen.

I also began an intensive physical therapy program. I went 3 times a week for 3 months, then once a week for another 3 months, then once a month. I do simple stretching exercises now at home that take up maybe 10 minutes.

I needed to strengthen all my muscles to support weak ones to ease the pain. Physical therapy almost eliminated the pain. I would strongly suggest that you have physical therapy as well.

Mike has spoken of "tools". Physical therapy is a "tool" we cronic pain people can use now to our advantage.

Mike is so good with people who suffer with chronic pain. He knows and understands pain because he lives with it everyday. His advice with how to take suboxone for pain is spot on.

It will take time for you to see any results. I know that stinks but you will be delighted when you start feeling good again. Relax and enjoy the new life you have given yourself.

Take care and remember you are not alone.
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Unread 05-28-2009, 01:37 AM   #23
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This is a great thread and I really can't add much to it. It seems that you are working very hard with your recovery and you should be very proud.

One thing I did want to comment on is that although I am no longer taking sub I think it is wonderful that there are Dr's who are willing to work with you regarding pain issues.When I was on sub I was trying to find different
doses etc to get the best pain relief possible. My Dr who was a psychiatrist wouldn't touch the pain issue. Everytime I brought it up she would shut me down. Her reason was that sub was for dependence and I am not taking it for pain and she was not treating my pain. She was very firm on this and it made it a very frustrating experience. I am glad to hear that not all Drs are like that and are more than willing to work so that all of your issues are addressed.

Take care,
Susan
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Unread 05-28-2009, 10:21 PM   #24
captmph
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Thanks everyone for posting tonight. Yes Cally I have a titanium plate along with donor bones and screws. I knew I would feel more pain for a little while after stopping the vicodan and narcotics but I did not know three months of it. UUUGH, EEKS. As for the motrin before taking the sub, it seems to work. I am having a hard time not swallowing for such a long time while the sub is dissolving. I have been doing the best I can and honestly think there is a difference.
Nancy I will check out the provigil site but yesterday my doc said that this new one Vyvanse has had a better outcome than Provigil although the internet has various results. I research everything on the internet.
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Unread 05-28-2009, 10:38 PM   #25
OhioMike
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Hey Capt, in chat supplements were mentioned in regard to the fatigue. Here is something I did early on which helped me when I would get sluggish in the afternoons or later in the day. Instead of taking my B12 in the morning with my other supplements I would hold it back and take it later in the day when I felt a little run down and it helped me some. Maybe that can help you. I'm not sure how much B12 you could take, so check with your doctor.

Mike
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Unread 05-29-2009, 02:55 PM   #26
theswan
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I did not do well on provigil. My brain is very sensitive to stress and anxiety and the "upper" part of the provigil became too much. I now suffer another WD because I stopped the provigil. I do not think it will be as bad as say opioids or Ambien but it sucks the same.

I went down to 8mg but went back to 10mg the next day as I want to fully recover fromthe provigil wd first.

Glen
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Unread 05-29-2009, 05:11 PM   #27
captmph
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What kind of w.ds did you get from provigil? I was only
More tired. Couldn't even get off the couch. So far I like.
Vyvanse a tad better. But I just started.
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