chronic pain and pain control

[mel1977]

I am very aware of how careful us nurses have to be when it comes to using narcotics. I know that as long as you don't abuse them and have a legal prescription then there is not a issue. But, a part of me just doesn't feel right using any narcotics at work. I have had two back surgeries and some small bulges in my neck. My main problems stem from muscle tightness and spasm. I have burning pain and general pain and these together wear me down. I have tried many things, right now I use Ultram, but I am nearing the full dose in 24 hours. But, I just can't imagine using percocet or anything. I tried Ultram ER but it hasn't helped, I can't use muscle relaxers cause I'll pass out on the med cart! The lidoderm patches only do so much. I have thought about MS CONTIN or OXYCONTIN, since they are CR, and thought maybe the effects wouldn't be as harsh compared to a fast acting percocet or something. I then could take the ultram or even ibuprofen in the mean time. I don't know if this is a bad thing, how it would be for work. I could use a little help here trying to figure this out. I am trying to figure out a plan to propose to my doc.

Heat is the best and so is lying down. But, can't do that all day!

(oh, for the most part I do okay, but I get so uncomfortable. I mean, my pain isn't horrible, but enough to interfere with daily life and make me miserable.)

thanks

[Tweety, BSN, RN]

Perhaps those dealing with chronic pain and working can tell you what they personally do, but your plan should be between you and your MD, as we don't offer medical advice.

Best of luck to you.

[sharona97, BSN, RN]

Like Tweety pointed out, I can't give you med advise but can tell you my experience.

I have chronic pain in my posterior back muscles from deterioation as a complication of S/P undiagnosed pertussis.

I find it very exhausting to deal with the ongoing pain, so I too, rest alot, sitting up and I have ice going on my back.

I tried the hard core meds and hated it, so I refuse to take them. Instead I see a doctor who does trigger point injections. My back muscle spasms and relaxation of the muscles is becoming evident after 4 years of treatment. I'm in the process of strength training for endurance. I also have Vicoden for the occasional severe muscle spasms that I use with ibuprofen.

I love my back doctor, she is an anasthesiologist that works in a back and spinal clinic. The shots at first really hurt and I had to breath deep through them, I'd get up to 6 at a time, now I hardly feel the pain, but still recognize the knotted muscle.

I wish you luck and freedom of pain if at all possible.

[ginger58, ASN, RN]

I'm so sorry for your pain. Is there a pain specialist where you live you could see, or someone in a town nearby? Have you gone to PT?

Please let us know what you decide.

[suanna]

I have chronic pain issues and also don't feel I can work with the opiate narcotics on board. What I discovered is Talwin, although a narcotic, doesn't cause the sedation effect like vicodan, percocet, MS... Not everyone can take it- it can cause hallucinations and sleep disruption, but in moderation it has kept me working for the last 2 years. I do use more when I am not doing patient care but I add an NSAID (orudis) when I work to augment my lower Talwin dose.{not as hard on the GI tract or the kidneys as motrin} A good pain managemenet doc should be able to help you find a solution that works for you.

Good Luck!

[bellcollector]

After extensive consultation with my pain management doc and the ok of my SBON I had no choice but to go on the heavy hitters. I took some time off to allow my body to become use to the drugs. Then went back with no problems. I am however a stickler about making someone witness when I give narcs or have to waste any. The fact is after you take the narcotic medication for a time it does not have a sedative affect on you. Of course it is best for everyone and even more so for those needing to work while using narcotics to use extreme caution as we are dealing with other peoples lives. At the same time we nurses are human beings as well and are entitled to the best quality life as possible. Best wishes in what you decide to do. P.S. I also get a lot of relief using those 8hr heating pks that come 2 to a pack.

[RheatherN, ASN, RN, EMT-P]

I am also not trying to dx or give med opinion. but i also have extensive med hx. i had surgery 3 months ago for a disc, and bad knee. i understand the pain. i feel fine on the meds, but i do take them at the end of the day when i know i am going home and wont be doing that. its scares me too! i know my body, but its always like "what-if". i do lots of ibu, prolly killing my liver.. but whatever it takes.

I do get lots of joy and pleasure and adren rush no matter what i am doing at clin, so i am usually good until i get to end of day or at home or on way home before i start to hurt.

-H-

If you come up with anything.. PM me please!

GL!!

[timpanzee]

I am also a chronic pain sufferer due to multiple injuries and accidents. Also just diagnosised with chiari 1 malformation. Waiting to see neuro - anyway I have been on vicodin now narco for last 12 years, take lyrica and muscle relaxers (at night) It has never affected my job, though I have lost one offer due to this (discrimination case ongoing),. anyway, see a pain management MD, get massages - these help greatly, heat, ointments, try to lower stress although in nursing I find this does not happen. We, as nurses, need to take care of ourselves first - I for one have a very hard time doing this, but it is vital to our own personal as well as professional well-being,. Be very careful at work that you don't get hurt, as this will open up huge can of worms done the road. Ask for help, take breaks (I know -- when???) but take care of yourself cause no one else will until we end up patients ourselves:)

[CITCAT]

Nurses in pain, when are we going to get involve in legislating change a no lift legislation.Let me explain in hospitals and ltcare hhc hoyerlifts ezlifts etc are not acessble or they are time consuming and ltc /hos arenot required my patient ratio to have so many why is this ladies you have the power to create change for furture nurses write your legislators write your sbon write your nurse ascociations promote change write dept labor email them you can change things and thus help your younger sisters in nursing because you are a sisterhood to prevent becoming one of the wounded healers also there are doctors out there that have hurt their backs and have chronic pain from lifting patients prn inbluemoon i am sure prayfully i will keep you all in my thoughts

[Tamela1RN]

I also have had an injury while helping to move a very large patient after her hip replacement. The pain was incredible. I eventually found a Dr. that would listen to me and had an artificial disc replacement at L4 - L5. I was lucky to find a great pain specialist. We eventually ended up with a fentanyl patch with percocet for btp. It seemed to me that after a short period of getting used to the drugs (a couple of weeks or so) I did not have that sleepy and foggy mental status. My pain was gone but I could still function. I think you really have to educate the company you are working for about new trends in pain management. I believe we must become our own advocate and fight to have the opportunities that other nurses

do. As for me, I also find heat to be very therapeutic. I use a product called therabeads. You warm it in the microwave and it supplies warm, moist heat that lasts approximately 2 hours. I hope you can find something that will work for you so you too can return to work without unrelenting pain. Good Luck...

[Kthale81]

I also have had an injury while helping to move a very large patient after her hip replacement. The pain was incredible. I eventually found a Dr. that would listen to me and had an artificial disc replacement at L4 - L5. I was lucky to find a great pain specialist. We eventually ended up with a fentanyl patch with percocet for btp. It seemed to me that after a short period of getting used to the drugs (a couple of weeks or so) I did not have that sleepy and foggy mental status. My pain was gone but I could still function. I think you really have to educate the company you are working for about new trends in pain management. I believe we must become our own advocate and fight to have the opportunities that other nurses

do. As for me, I also find heat to be very therapeutic. I use a product called therabeads. You warm it in the microwave and it supplies warm, moist heat that lasts approximately 2 hours. I hope you can find something that will work for you so you too can return to work without unrelenting pain. Good Luck...

Back pain seems to be very popular. I too have back pain/B leg pain. I just ove it when patients say that unable to move, walk, reach phone.... I often ask questions such as: do you live with family, do you have family nearby, how were you getting around before coming to the hospital. If I get answers indicationg independence, then I tell the patient to help themselves now to get ready for discharge. Why would I want to pull up, roll them over, practically carry the patient to the chair... I have gotten tired of patients acting so helpless and demanding, family members to drive nursing staff crazy. I will tell the patient that I am not able to do heavy lifting, pulling, etc. The patient will become more independent, family might help out. Just because one is in the hospital it doesn't mean that the patient needs to be completely helpless.

[aloha551]

I also deal with chronic pain. Ive tried just about everything out there .I take Ultram at night before bed and NSEDS during the day. I also work agency so that I I'm having a real bad day I can cancel. I also started teaching which is a great way to stay in Nursing and I love the students. I had to make quite a few adjustments but its all good.