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On Painkillers, addiction, and spotting a problem before it gets bad.
Fyndir
Registered User regular
Registered User regular
Lately I've been in high enough levels of pain that paracetamol is not cutting it in terms of allowing me to function on a regular day to day basis, standing still while passing urine is difficult, and walking to the gym is challenging enough, let alone actually exercising for any length of time.
Due to this I have been taking Cocodamol (pills which contain both Codeine 8mg and Paracetamol 500mg), at the maximum rate specified on the box, these eliminate most of the pain, make the day manageable, walking to the gym was no longer difficult, and I was able to exercise for some period of time before pain set in to an excessive degree, however these pills come with a strong warning that they can be addictive (presumably due to the codeine), and recommend against taking them for prolonged periods of time without consulting a doctor.
I have an appointment to see a doctor on Friday, and I'm hoping that we will be able to dispense with the catheter that I currently have, and allow me to return to something resembling normal life, or clarify if I should just continue taking the pills, or whatever, but in the meantime I was wondering if there are warning signs I should watch for, in order to try and discern genuine pain, and the requirement for relief, from potential addiction, and my body simply wanting more of the drug.
Due to this I have been taking Cocodamol (pills which contain both Codeine 8mg and Paracetamol 500mg), at the maximum rate specified on the box, these eliminate most of the pain, make the day manageable, walking to the gym was no longer difficult, and I was able to exercise for some period of time before pain set in to an excessive degree, however these pills come with a strong warning that they can be addictive (presumably due to the codeine), and recommend against taking them for prolonged periods of time without consulting a doctor.
I have an appointment to see a doctor on Friday, and I'm hoping that we will be able to dispense with the catheter that I currently have, and allow me to return to something resembling normal life, or clarify if I should just continue taking the pills, or whatever, but in the meantime I was wondering if there are warning signs I should watch for, in order to try and discern genuine pain, and the requirement for relief, from potential addiction, and my body simply wanting more of the drug.
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Chances are, if you're taking them as prescribed, it will never get to those levels of painful addiction. Doctors are verrrrrrry skeptical of prescribing this shit because of that. Your doctor is likely to cut you off before it comes to that point. Speak to your doctor though, they'll be more help than us.
Any addiction starts with feeling unwell when you don't have whatever it is you're addicted to. If you start to feel like you can't live without your pills, or if having to go a little longer than usual is making you physically sick, then there is a possible problem that isn't pain related.
I find that keeping a journal of my pill activity helps me too. This way I don't forget when I had some, how many I had, what time I had them. I can't lie to myself if I have it recorded like this.
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Still, being aware of any potential dependency that may develop is always wise. Talk with your doctor about it. If the want to put you on something stronger, it's likely that they'll be monitoring your pain management pretty closely, anyways. Most likely, they'll tell you to continue using it if they don't prescribe something different.
However, and maybe I've missed something in your posting history, but why are you exercising while you have this level of pain? With a catheter in place no less? You probably should be taking a lot easier than that. It sounds like you have some kind of urinary blockage that is causing pain? Or is it a prerenal problem like a ureter stricture or something? Regardless, having a catheter in place and being on this kind of pain medication means you should be taking it as easily as possible and resting.
Of course, since you are taking your medications as ordered you may have already cleared this with your physician and I withdraw my criticism.
Finally, addiction is defined as a pattern of behavior that interferes with the normal activities and responsibilities of daily life. This may lead to a physical dependence where your body will exhibit withdrawal symptoms if the drug is not taken (shaking, sweats, irritability). You're still taking care of yourself and it sounds like you're just in more pain now because you don't have the pain relief available.
Good luck to you.
Single ectopic kidney since birth (behind the bladder, if you're curious)
Chronic renal failure diagnosed about age 10 or so.
2011 saw a dip as low as 11% renal function, and my Nephrology / Renal consultant wants me to lose weight so that I am a better candidate for surgery, as I will need a new kidney sometime.
Urology consultant wanted a J-Stent, and after that was inserted the doctors on the aftercare ward were complaining that I pee too much / not regularly enough, so asked me to self catheterise 5 times a day.
Nurse + myself promptly agreed that they could stuff that plan (I am bad at self catheters), and I opted for a long term catheter with a valve to, in theory, allow relatively normal life.
It's worth clarifying that my painkillers are not prescription currently, they are just straight OTC and I picked them up after it became clear paracetamol wasn't doing the job, I have not yet spoken to my doctor about them, since I haven't seen any of my doctors in a little bit, will be bringing it up on Friday when I chew them out for the conflicting goals of exercise/catheter.
It's also very nice to have someone other than me realise that these two things do not ideally go together.
and @fyndir, sweetie, it's really adorable and very sensible of you to be weary to the risk of addiction, but 8 mg of codeine is like a threshold dose. any less and it woulden't even pass your brain blood barrier.
BUT WHY ARE YOU TAKING HEAPS OF ACETAMINOPHEN WITH A DAMAGED KIDNEY!!!!!!!!!??????
did you really think this through?
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OTC i have no idea.
Tylenol is like the NSAID alternative of choice for people with kidney damage, it's metabolized in the liver and no harm is caused to the kidney. Though one should be careful, there are a few drugs that are used in ESRD cases that metabolize in the liver, usually the ones used to control blood pressure that double as anti-anxiety or depression meds for instance. Propranolol comes to mind there.
But if OP is just taking a standard dose of Tylenol as recommended by the doctor then he's okay, as Hahnsoo1 said.
oh well, all the better then.
edit: quick search, yeah it's there, but not in the doses OP mentioned. my bad
It's about the only thing people with kidney damage can take, ibuprofen is like the worst thing, and aspirin can cause bleeding issues. It's kind of shitty, actually!
When I was at the point where I was taking Tylox for the pain, I had a concern about addiction. My dad was about to have knee surgery, and he said, Aesop's-Fable-like, "Sometimes I have to think about whether the pain is in my knee, or in my head."
*Regarding acupuncture for pain management, I personally don't have an opinion about whether it's the release of endorphins secondary to the tiny needle pricks or the rebalancing of chi performed by a skilled professional. For me, it worked. For you, again, definitely talk to your doctor about pain management, and good luck!
...then again they were also happy to take blood from my left arm, even after I pointed out I was meant to keep it in tip-top shape for Dialysis...
hmm
Thank you all for the comforting responses, it really does help.
Are they waiting for your graft/fistula to form for dialysis and that's why you're in pain? The pain somewhat abates once you're on it. If you're not waiting and already on dialysis, jesus christ dude what happened to cause all that pain (I didn't see a reason).
Hopefully you get a transplant pretty quickly, it makes your life so much better.
Which I would say is...one of the worst pains possible. The mind rebels against the very existence of such a thing.
I'm still at the stage where I'm getting immunised against everything under the sun so I'm all ready for dialysis at a later date, and we've started getting various family members tested to see if anyone's a match, all that good stuff.
She saw the doctor(s) regularly; specifically her rheumatologist and whoever at the pain management clinic. Lupus is a bitch.
We had to get a court order to get her ass in rehab, and they put her on Suboxone (later switched to Subutex because of certain side effects) to help get her off of that crap.
I thought as much. Good luck on your eventual transplant, again. You may opt to have the catheter removed completely and just go to the bathroom a lot. It's not like keeping it in your bladder is going to help you much, if you're in this much pain, unless there's incontinence involved or something.
@Barrakketh that seems unfortunate, I haven't met very many doctors who are that willy nilly about pain meds (especially opiates) just because you take a huge risk with your license when you prescribe them like that. Around here you have to fight with them to get more than a tylenol.
"Hey, you don't seem to be passing much urine, you know, less than 12 hours after we told you not to drink anything all morning, knocked you out, and stuffed stuff up your urethra. What gives man?"
They convinced themselves this was some massive problem, and then (having ignored my old notes and particulars of my condition) freaked out when I finally passed some urine and it was like 2 litres or so, prompting them to declare that I had to self catheterise 5 times a day, every day, indefinitely.
I'm basically just going to kick down doors and backhand some doctors on Friday, because I am pretty sick of this kind of nonsense.
Well if you're in that kind of condition maybe you should give the gym a miss for a few days? Perhaps this is not the time to be stressing your body?