My doctor had taken me off my slow release tramadol on the recommendation of a neurologist I had seen for a consultation set up by the insurance company for my short-term. He thought I was on too many medications so we cut down on a lot. And he thought the tramadol was causing rebound headaches with the migraines.
Basically with tramadol and migraine overuse headaches:
Some patients can take tramadol daily without getting into a medication overuse headache. For others, that 50mg a day could cause MOH. If the tramadol IS causing you MOH, it should be relieved when you take the tramadol. HealthCentral
And I knew I was not rebounding because a) I have rebounded on codeine before and it is pretty easy to see what That feels like and b) I was Better not worse. And I sure as hell would not have stayed on it if it was Worse for damn sure. But he put me on it initially so I was capable of exercising which was his first-line treatment for fibromyalgia and then botox for the migraines.
Off the meds
So I went off. And lately, my pain has been abnormally high. Usually, my baseline fibromyalgia is about 4-6ish aside from flares. Lately, it was 7-9 every damn day. Severe ribcage pain. Severe foot pain. Deeply painful back, shoulder, knee, wrist, hand pain. Pretty much my whole damn body hurt way more than usual. I had a hard time getting up the stairs. Walking was very painful. I could not sleep at night. The best I could do was 5 hours of fitful sleep and getting up at least twice in the night. The lack of sleep was making the vertigo and dizziness severe as it does and this made me even more completely non-functional and confused and unable to think.
I was beyond my pain endurance levels. I was at non-functional every day. And nothing to do about it. I tried cannabis. I tried muscle relaxants. I tried every pain rub in existence. I tried an NSAID cream my doc gave me for my ribs. I tried heat. I tried cold. My mood was being affected. I was angry. I was moody. Just sad as all hell for no reason. And that worried me.
So I set up an appointment with the pain clinic.
I told him the botox had not been working and with my spouse out of work I couldn’t afford it anyway. I told him my doctor took me off my painkiller and how it was affecting me.
He was peeved. Peeved she had taken me off without consulting him… who was managing my pain.
He said not being functional, not being able to do anything, not being able to exercise, would atrophy my muscles and make me feel worse and worse, the pain worse and worse, until I wouldn’t be able to do anything. I said I know. I was very aware of that. I had to rest so much my fibromyalgia was screaming at me. I told him I didn’t know if the severity of the pain was from not being able to do things for so long with the vertigo before I was put on meds, so the FM got worse, or if it is this possible MS issue I may be dealing with… but it has been severe. And my doctor refused to do anything about it.
So he put me back on Tridural (which is a slow-release tramadol brand) and said if 100mg works to stick to that, if not, to go up to 200 mg. And then begin slowly to get some exercise in. The vertigo, balance issues, and dizziness complicates this but I aim to start going for walks first, maybe try my stationary bike (I usually start at 5 min and work slowly up from there), mild stretches, physio exercises and eventually when I feel like I am more stable I want to join a Tai Chi class around here. Either way, you aim for three times a week, always with recovery time, and never push it… always go slow and steady. And it will be pretty slow to start for me after this length of time with no exercise and all this rest time.
I was glad he agreed with me. He said he was going to write a note to my doctor about it. I understand why he was irate since he is supposed to be handling my pain management and my pain has become completely out of control with my doctor’s changes. So back to square one really.
One the pain meds
It was a profound relief to be back on them. It really knocks the pain down a Lot. It is still there but it is manageable. Some days it works better than others because some days I am in more pain than other days. I need 200mgs because the first one will wear off; sometimes in the late afternoon, sometimes the evening. And always in the morning, I am in severe pain such that it is hard to walk so it is definitely gone by then. But the level of pain reduction is such a relief I can’t even describe it. It was like I was always constantly so tense and then suddenly every muscle just relaxed. Now, movement isn’t so agonizing. So I now believe I can start with some slow exercise.
- pain management is vital for our capacity to cope.
- If we want to exercise we need pain management.
- If we want to manage our mental illness (depression in my case) we need the pain managed
- If want to have the capacity to socialize we need some pain management
- If we want to get to some basic level of functionality instead of way, way worse then we need pain management.
- We need pain management to help stop suicidal ideation due to pain
- We need it for our wellbeing
- We need it for our quality of life
We are human beings. We should not be made to suffer and suffer simply because medical professionals fear opiates. That is what pain clinics are for… helping us in ALL the varied ways to manage our pain, including medications and shots.
*Keep in mind I am Canadian. There isn’t a thousand hoops to jump through to be on tramadol. No pee test. No pain medication shaming. No pharmacists denying to give it to you. No shaming. Just doctors extreme reluctance to put anyone on it now.