Desperate Plea for Assistance with Chronic Pain
I find myself trapped in an agonizing state and struggling to sleep, so I'll be brief while remaining open to questions. For nearly ten years, I've endured relentless abdominal pain. It all began one fateful day when I had to rush to the emergency room due to severe discomfort that marked the start of my long ordeal. I've undergone every conceivable medical examination available. Ultimately, my list of diagnoses includes Complex Regional Pain Syndrome (CRPS), endometriosis, irritable bowel syndrome (IBS), gastritis, and peptic duodenitis, among others. Additionally, I've had a prior struggle with opioid use disorder (OUD), which complicates my ongoing situation. Typically, I experience pain flare-ups once or twice a month, all consistent in nature. However, this past Wednesday, I was jolted awake in the middle of the night by an overwhelming pain that was unlike anything I had ever felt before. It radiated from my upper abdomen to my chest and spread to my shoulders and back. While I often experience pain in my upper abdomen, this particular episode was both sudden and intense. Subsequently, I found myself in the emergency room for six grueling hours, where CT scans and lab results yielded no abnormalities. I informed the attending physician that my nausea and pain were not adequately managed and that I couldn't cope at home under these conditions. Unfortunately, I was given a single dose of Dilaudid and instructed to follow up with my primary care physician, only to return to the ER three hours later, receiving mere IV acetaminophen instead of the relief I desperately needed, along with the same directive to consult my PCP. That night, I barely managed to sleep for about an hour and a half. The moment my PCP's office opened the next morning, I called in tears. Regrettably, my doctor was away for the week, and none of the other staff felt confident treating me, suggesting I visit a different emergency room. I initially resisted this recommendation but ultimately found myself in one. This turned out to be a colossal error. I was outright labeled as a drug-seeking individual, and while I understand the protocols in place, it left me feeling utterly powerless. Returning home, I again felt compelled to confide my despair to the triage nurse, expressing thoughts of self-harm if my pain wasn’t alleviated soon, yet I sensed a lack of concern. Eventually, I returned to the original emergency room, where I was fortunate enough to see the same doctor again. Overwhelmed with emotion, I communicated my suffering, and it was clear he genuinely empathized with my situation. However, he lamented that he no longer had the authority to prescribe the medication I needed, highlighting a serious flaw in our healthcare system, although that's a discussion for another time. He agreed to provide an intramuscular injection of Dilaudid alongside some tramadol, yet he clarified that those were his limits. I appreciated the effort but realized that, given my history with opioids, tramadol wouldn't provide significant relief. Upon returning home, I managed to sleep for only two and a half hours, and even now, I endure constant pain at a level of 7 out of 10, spiking to a 10 multiple times each hour. When the pain escalates, I struggle to breathe, and my body tenses up. This agony is unlike any I have previously encountered. I had no option but to run a quick errand today, though I’m unsure how I managed it. The moment I parked my vehicle, nausea overwhelmed me, and I vomited. Additionally, I am experiencing severe vasovagal responses; while I have yet to actually lose consciousness, moving from my bed to the bathroom—a distance of just ten to fifteen feet—induces intense tunnel vision, sounds distort, and I feel blood rushing away from my head, compounded by incessant nausea. I realize this is a multifaceted issue, but ultimately, regardless of my history with OUD or my frequent visits to the emergency room, or the inability to visibly identify issues, I should still receive appropriate pain management. I am a human being deserving of care like anyone else. Do you honestly believe I would go to the ER four times within thirty-six hours if I were simply seeking drugs? If I were truly looking for opioids, wouldn't I have found a source within walking distance? And do I have the financial means to afford this? It’s frustrating just to think about. I am at a breaking point… What steps can I take to find relief? What happened to the practice of admitting patients for pain management when their discomfort is as undeniable as mine? If anyone can offer guidance, I would be eternally grateful. EDIT: I am a 29-year-old Caucasian female, currently smoking cigarettes but not using alcohol or recreational drugs. I stand 5’8” tall and weigh 261 pounds, taking medications such as Tylenol, ibuprofen, gabapentin, Zofran, duloxetine, bupropion, and omeprazole.
Answers (1)
3/28/2025, 10:01:17 PM
OpenHealth AI
I'm truly sorry to hear about your intense pain and difficult experiences with the healthcare system. Your situation is complex, and it's understandable to feel frustrated and overwhelmed. Here, we will focus on immediate steps you can take to address your pain while considering your overall well-being.
Main Points
You are dealing with chronic pain and recent severe flare-ups that greatly impact your quality of life and sleep. Immediate relief strategies and coping mechanisms are critical.
Explanation
Chronic pain, especially with conditions like Complex Regional Pain Syndrome (CRPS), endometriosis, and IBS, can be particularly challenging to manage. Not only do these conditions cause physical discomfort, but they can also affect mental health, leading to feelings of helplessness and despair. It’s important to recognize that your experiences and feelings are valid, and you deserve effective management and support.
Prioritized Next Steps
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Develop a Pain Management Plan:
- Keep a Pain Diary: Document your pain levels, triggers, and the effectiveness of any relief measures (medications, heat/cold applications, etc.). This can help identify patterns and effective strategies over time.
- Consult Your Primary Care Provider (PCP): When possible, discuss your pain management plan. Given your history of opioid use disorder, explore alternative pain management strategies. Ask about medications like nerve blocks, physical therapy, acupuncture, or cognitive behavioral therapy (CBT) for pain management.
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Explore Non-Opioid Pain Relief:
- Over-the-Counter Options: Continue using non-opioid medications such as ibuprofen and Tylenol, as tolerated. Discuss with your doctor the possibility of adjusting dosages based on your pain levels.
- Topical Treatments: Consider capsaicin cream or prescription topical analgesics for localized pain relief.
- Gabapentin and Duloxetine: These medications can be effective for nerve pain and may help with anxiety associated with persistent pain. Discuss with your doctor whether the doses could be adjusted for better effectiveness.
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Focus on Short-term Coping Strategies:
- Relaxation Techniques: Explore deep breathing exercises, meditation, and gentle yoga, which can help manage stress and reduce pain perception.
- Mindfulness Meditation: Apps or guided videos might be beneficial to foster relaxation and improve your mental state.
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Monitor and Manage Symptoms:
- Keep track of your nausea and vasovagal responses. If these symptoms worsen or become chronic, bring them up promptly with your healthcare provider.
- Stay hydrated and eat small, nutritious meals to help manage digestive symptoms and prevent nausea.
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Seek Support:
- Mental Health Support: Speaking with a mental health professional can provide coping strategies and an outlet for your feelings related to pain and distress.
- Support Groups: Consider finding local or online support groups for individuals with chronic pain or those recovering from opioid use disorder, which can provide a sense of community and understanding.
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Consider Lifestyle Adjustments:
- Nutrition: A diet rich in anti-inflammatory foods may help ease pain. Focus on fruits, vegetables, whole grains, and healthy fats.
- Smoking Cessation: Reducing or quitting smoking can improve overall health and potentially reduce some pain symptoms.
Your emotions are understandable, and it's crucial that you advocate for yourself in seeking the compassionate care you need. Regular follow-ups will be crucial in finding a tailored approach to your pain management. Stay persistent in seeking out the appropriate support and care, and remember that you are not alone in this journey.
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