Lisa's in trouble... Asking for help

Oh, wow… I just checked my email after getting back from the hospital which, unfortunately, was one of the most horrendous inpatient experiences to date, although I escaped additionally injury this time around-- and having a working Mediport was a lifesaver, literally.

I’m totally beyond words at all the incredible advice, love, and caring that you’ve all sent me. “Thanks” doesn’t even start to explain how grateful I feel that so many of you wrote back so quickly and with so many great suggestions.

Unfortunately, after my post, I ended up down to barely holding in a few sips of liquid a day and getting very sick again. The pain was really, really bad and I was back to vomiting once admitted all the fun stuff that comes with CP flares and, yes, they did continually tell me that my amylase and lipase looked okay and this included the G.I. doc comments! Ugh nobody gets this horrible disease! Initially, they just wanted to discharge me right away on clears because of my Mediport and the staph infections running around the area I convinced them that this would put me right back where I was prior to the admission! Duh!

Regarding the admission, after about 5 days inpatient, the pain is now better (or at least back to its usual crappy state, but I guess I’m used to that by now), but I’m back to mostly liquids and will try to slowly progress to get some nutrition and strength back, but even clears flares things a little for now (and Ive already lost 7 lbs., having just recently gotten back to my normal weight- now I have to try not to lose more). When I finally went to the ER the pain was totally beyond description, and I didn’t have anything else I can take/do at home, so Dave and I decided it was “time" to go and I don’t think I could have made it even one more day at home, no matter how much I didn’t want to be back inpatient. I knew I would have passed out and even with 300mcg Fentanyl every ½ hour in my port in the ER, it was like getting a placebo. This is also what started the troubles on the unit with the pain management nurse totally not getting CP or my genetic Ehlers-Danlos Syndrome-Classical Type, all complicating what they would normally expect or give for pain management. Without going into all the details and horrendous decisions they made let alone false accusations and assumptions, I ended up more upset than I think I’ve been since I was very young (a long, long time ago). I never received the care you would expect with an admission, mostly due to very poor or absent communication among the medical personnel and thankfully I was always aware enough to speak up and advocate for myself (it was so great having Dave there to back what I was saying and convey his observations as well!).

On a few of your great suggestions, unfortunately, I’d had problems with Methadone years ago and then was switched to the Fentanyl patch with Dilaudid prn, but then also became allergic to the Dilaudid. With allergies to codeines and derivatives, they wouldn’t consider trying the Methadone again. Maybe something new will be developed one day that lasts longer than the Fentanyl and I’ll be able to take it if needed. For now, it’s been Fentanyl, Fentanyl, and more short-lasting Fentanyl. I just wish it could be an occasional Tylenol and nothing else! I still hold out hope that that day will come and I won’t give up believing that there will be a resolution to living with this disease like a true cure and no further need for all the special eating issues and pain meds.

As for the difference between “addiction" and dependence or tolerance and I’ve worked professionally as a social worker in the addictions population, both outpatient and inpatient settings when you’ve been on a drug/med for a while and need more to get the same benefit, that’s the tolerance your body has built up. While dependence refers to need your body develops to a med/drug so you can’t just stop it without risking withdrawal symptoms, neither of these, in itself, is “addiction." Addiction refers to wanting and needing a med/drug something you don’t necessarily want to stop taking, but might get a buzz or high from (and in some cases, may not) or that you can’t do without due to how it makes your body feel. Many who have become addicted to a med/drug “need" it to manage through the day it’s not to treat a pain or condition anymore, but like the alcoholic who may start the day with a drink to feel “normal" and then continues seeking the substance, at times at great risk to themselves or others. I hope I’ve written this clearly enough and I know this topic comes up frequently. Personally, I love when I go all day without needing my pain meds I don’t even think of it at all when the pains a little better and would NEVER take a dose if it weren’t needed and even agonize over taking those I do need. That’s NOT '“addiction" although over time I have needed some dosage increases because my bodys gotten used to the lower dose and it’s failed to work as well and needed to be increased. I hate totally HATE, taking any meds, let alone anything narcotic, and will gladly give it all back as soon as/if this disease gets in control and it’s not something I need for pain control. I’m sorry if this sounds like an angry reaction, but it’s been a week of struggling with pain management nurses taking my patches off and not replacing them, then dropping the PCA quickly, but never putting me back on my oral prns before I left so I’ve now been suffering some withdrawal symptoms, which are so hard to go through and so uncomfortable, trying to get things back to where they should have been. There was no reason for this, but all due to misunderstandings, I’m now dealing with CP pain, mild transient withdrawal, and some side-effects from the anti-emetics since they often forgot the Benzo that would have prevented it. Ugh, again and sorry for the long-winded info on this.

I know we all go through this and it’s really unfair-- but I also feel we’ll find a way to “use” this experience in some good way. We have to help make some sense of all we’re going through or have been through. One day that might help answer the question of “why" this happened to us. We can be a powerful group (when we have the energy, or if we group our energy together).

For those of you doing better, Congrats from me, too Awesome to hear!!! Maybe this can also help others. For those of you still suffering, losing weight, hurting all the time PLEASE hang in there. YOU have the choice to decide what you do with it, even when it doesn’t seem like you’re empowered at all. Keep making positive choices and never, never give up. And always know that I’m thinking of all of you all of the time on my mind and in my heart and I only wish I could find some magical way to make it better for all of us.

(A note to Durga and others who rightly were on my case for trying to do more than I “should" have been and then still feeling badly as my CP became more emergent thanks for your comments, too and I thought you’d be happy to know that when I first posted on asking for help this time around and saying I was in trouble, I started out apologizing for not being more available for everyone but I read it over and took the apology out. I’m slowly learning how to balance taking care of myself and still being there for as many others as possible, but also being more human and realizing those limits and the reality of this disease on top of all the others I already was being challenged by daily. Thanks so much for the caring I know it takes to be that honest and direct I’m learning and growing from all of it, and it’s a good change, as hard as it feels at times. Warren and others… Thanks SO much for the info on the Pyxis system and what I’ve been told again even recently. Everyone’s contributions have been SO helpful and reassuring. I just wish I could try some of the options mentioned. For now, I’ll be seeing the CP specialist again, setting up the Celiac block via EUS at Georgetown Univ. Hospital, getting the kidney/bladder infection under control, and hopefully going back to the acupuncturist. Got most of this set up in the next few weeks, and for now am doing what I can to re-engage with life and the parts that do work. Thanks again, all!)

I want to thank you all again You all make this tolerable and help me and each other to not feel so alone. It’s a scary disease to have, and there’s such a lack of understanding and information. At least we have each other, and WE get it!

I’m sending back smiles, hugs, hope for less pain, and friendship filled with love and belief and patience. Thanks again for being there in such a special way it’s meant the world to me.

Lisa

Hi Lisa and All,

I just read your post and yes there are ways to effectively treat a person that is tolerant to pain medications. And, if that is not being done, then your needs are not getting met. Your physician can give you a statement to carry with you attesting to the fact that you need certain amounts of whatever the medication may be. (I am going to do some research and see what I can come up with. I shall be back in touch.)

I would be concerned about going to the emergency room too. I was so very fortunate to have a physician for several years that was truly a patient advocate and the care I received under his guidance was super. Unfortunately, he left over 2 years ago and I have been floundering since. He would make sure my needs and all of his other patients were met. Then, he would take time to talk to the staff about why things were ordered, why so much medication was needed and really helped in getting them to a level of understanding.

You are in my prayers. Take care,

Jamie

I am sorry that you are suffering this way. I am in a similar situation. While do not have the drug allergies you do I have been on pain meds for years and my tolerance levels are unreal. So when I am in the hospital I too am constantly fighting to get pain relief.

Try to find a pain clinic. They often can find solutions for pain that other docs can’t. They are trained anesthesiologists. They are also not afraid to prescribe high does of meds.

I wish I could recommend something else for you. I know that it doesn’t really help but you are not alone in this. But when you are in pain that is all you can think about. I just got out of the hospital yesterday evening and once again my pain was not able to be controlled.

The only things that I can recommend is trying acupuncture - it has helped control my flares somewhat and reduced some of my daily pain levels. The other things are some foods that have helped me. Boiled potatoes (cooked in salted water). You have to leave the skin on. I don’t know why it helps but it does reduce my pancreatic pain. Of course you can’t put butter on it so I put Molly McButter on it for flavor. I also often put a little balsamic vinegar on them. The other thing is fresh pineapple. Of course pineapple has lots of natural enzymes. But these two things were recommended to me - I didn’t think it would help but what did I have to lose?? They do help me. Maybe they will help you??

I know of a friend with back issues who took 600 of Fentalyl every day so I am sure that you can go higher. Of course he was treated in a pain clinic.

If I come up with anything else I will let you know.

I am so sorry to hear about all of the pain that you are going through, I will keep you in my prayers. Nothing is beyond the capability of the lord, i sincerely hope that he sends some relief your way soon.
Lindia

Hi, all–

A quick update and a request for any other advice. I tried to schedule the celiac block through and EUS and the doc said that if the EUS doc goes in and doesn’t see calcification, even though the tail is still inflamed, he won’t do the block. I can’t see having this done, under anesthesia, if I won’t even get the temporary pain relief. That was the whole reason to do it. I put in a call to the EUS doc to discuss it, but he hasn’t called back.

On top of that, I’ll be having scans/tests of the kidney and bladder tomorrow to try to see what’s causing pain, bleeding, lab changes, etc. I think it’s a second kidney stone trying to get out (I think it started with sympathy for Charles-- I hate for anyone to go through stuff alone!;-)… but with an alleged family history of kidney failure, I think they want to ultrasound everything and figure out why I’m retaining so much urine and why I’m having all the other bladder and kidney pain, etc.

To top the cake, I’ve just been “urgently” set up for a colonoscopy and upper endoscopy under anesthesia next week due to some stool changes and yet other pains and problems. I’m guessing I’m close to Barrett’s esophagus again, since I have almost no voice left… and with the stool issues, they’re rushing since they want to rule out colon cancer and/or polyps (also runs in the family). I guess I’m glad someone is checking it all out-- it’s just feeling like there’s so much to go through on top of a CP flare. I’m surviving mostly on low fat ice cream, liquids, and a little bit of plain pasta. Not a good diet, and I’m really worried I’m going to end up back on TPN in the near future if the CP pain keeps going like this and gets worse with anything I take in. After the septic shock incident, I’m really too scared to do the TPN thing again. I’d rather do anything else.

Thanks to Angela and everyone who’s mentioned the resiliancy and high pain tolerance we all have. I’ve even said to my GI doc that while I wouldn’t wish CP pain on anyone, I wish all medical providers could have it for just 10 minutes to understand what it means when it’s said to be the worst pain of all. Since I still can’t get anyone, including my pain doc of over 15 years, to suggest anything or offer any solutions-- and he just gawks at how much it took to control the pain last time in the ER/hospital… It sure left me feeling I am running out of options. I tried to start yesterday just determined that I wouldn’t use my prn meds… no matter how bad it got… but then couldn’t stand the pain by mid day and went back to using them before it got out of control. It’s all about wanting it to go away and stop so badly. I’m really getting worried at what else is going on, but the pain is a sign of something and I just hope one of the docs will figure it out. For once, I’m feeling very exhausted by all of it and really want at least a piece of it to get back under control. I know many of us share that wish, too.

We all go through so much and I wish I could stop it for all of us!! It’s a very unfair disease and everyone here always has been so great. That makes it even more unfair.

I’m hoping we’ll all get a break and get through this one day-- and I won’t stop believing that will happen. I’ll be posting something I wrote recently on my site in the blog section if you’re interested. After I read it out loud a few days ago I decided I should share it. The site is at www.lisabard.com and the blog is on the last pages.

Thanks again-- You’re all SUPER!!!

Love, friendship, hugs, and many wishes for everything pain-free-- and a BIG thank you for understanding and letting me lean on you guys now and then–

Lisa

Here is a big prayer for you, Lisa. You have been quite a staple here and we are all pulling for you.

Dear God,

Please instill in Lisa’s doctors the knowledge to help your child through this time. Give them the education to find her pain free days. We know you always give at the appropriate time and this is Lisa’s time.

Best wishes to you

Teresa

Dearest Lisa, I am so, so sorry about your agony. I read your blog post and it resonated deeply with me. I now almost view my disk ruptures as “testing grounds” for the pain of our disease. The only time I have ever lost consciousness due to pain was during a flare-up. Our ability to withstand pain does seem to increase. I credit that as one of the reasons I was able to free my leg from the crushing grip of a pit bull. The only reason I even woke my wife up to take me to the hospital was because I was worried about blood loss and possible infection. (I ended up getting a soft tissue infection anyway and spent 4 nights in the hospital with four different IV antibiotics going into me.)
If there were any way that I could ease your pain even for a few minutes, I would. You have been a cornerstone here in our community. You always have kind words and encouragement. You have given unstintingly to others. You are coping with this awful disease on top of other serious health issues and medicine allergies. You are a strong, strong woman.
As for your options, I would suggest that you get some other gi opinions. It does not seem reasonable that they would deny you a non-narcotic minimally invasive procedure that might grant you a little respite from your torment. Please seek other medical advice. It might take time, but be persistent. Keep fighting the good fight- you are definitely an inspiration to the strength of the human spirit!

With love and lots of hugs,
Warren