Seeking Relief from Chronic Pain
I am a 29-year-old woman experiencing unbearable pain alongside severe sleep deprivation, so I’ll keep this brief and address any questions later. For almost ten years, I have been battling relentless abdominal discomfort. It all began when I found myself in the emergency room due to the sudden onset of intolerable pain. Since then, I have undergone countless medical evaluations. My diagnosis list includes Complex Regional Pain Syndrome (CRPS), endometriosis, Irritable Bowel Syndrome (IBS), gastritis, and peptic duodenitis, among other conditions. Unfortunately, I also have a past history of opioid use disorder (OUD), which complicates my treatment options. My pain tends to flare up once or twice a month, with a consistent nature to these episodes. However, just this past Wednesday, I was jolted awake from a deep sleep due to the most extreme pain I have ever felt, focused in my upper abdomen and radiating to my chest and back. Though my chronic pain usually flares in my upper abdomen, this intensity and abruptness were unprecedented. That day, I spent six hours in the emergency room, where tests and scans came back normal. I informed the doctor about my overwhelming nausea and unmanageable pain, but despite my pleas, I was only provided with a single dose of Dilaudid and instructed to follow up with my primary care physician. Just three hours later, I found myself back at the ER, feeling ignored and receiving only IV Tylenol. I was again told to consult my PCP. Struggling to sleep, I called my doctor’s office the moment they opened and burst into tears. Unfortunately, my physician was unavailable, and no one else felt comfortable treating me; they suggested I try a different ER. Reluctantly, I ended up at another hospital, and it was a dreadful choice. I was labeled a drug-seeking addict, and while I understand that their protocols limit what they can prescribe, I felt utterly powerless. After returning home, I again broke down in tears when speaking to the triage nurse at my doctor’s office, expressing my desperation for relief. I confided my thoughts of self-harm or resorting to heroin if my situation did not improve, but it felt as though my cries went unheard. Ultimately, I found myself back at the original ER, this time encountering the same doctor who genuinely empathized with my distress. He offered me an intramuscular Dilaudid shot and a few tramadol tablets, but reiterated his limitations concerning prescription authority. Given my previous opioid history, I knew tramadol wouldn’t significantly alleviate my pain. After returning home, I managed a mere 2.5 hours of sleep but awoke to a constant pain level of 7 out of 10, escalating to 10 at times. When these spikes occur, I struggle to breathe, my body tenses, and the intensity of the pain is beyond anything I’ve encountered. I had to run a quick errand today, and it felt like a near-impossible task; upon parking, I became physically ill and vomited. Additionally, I’ve been having severe vasovagal episodes—while I haven’t completely passed out yet, moving just a short distance from my bed to the bathroom leaves me disoriented with tunnel vision and a sense of blood rushing from my head, accompanied by intense nausea. I realize this is a complicated scenario with numerous factors at play, but the core of the issue remains: regardless of my OUD background or frequent ER visits, and despite medical professionals not observing any visible issues, I still deserve proper pain management. I am human, just like everyone else. Do you believe that I would visit the ER four times in 36 hours merely for drugs? If that were my intention, I could easily find alternatives nearby. Do people think I can afford this kind of treatment? Do they assume I enjoy this agony? I truly don’t know what to do anymore. How has patient care for intractable pain become so neglected? I beseech anyone who can offer assistance or guidance. Please help me.
Answers (1)
3/28/2025, 10:01:18 PM
OpenHealth AI
I'm really sorry to hear about what you're going through. Living with chronic pain and the complexity of your health conditions must be incredibly challenging, especially when you're not receiving the support and relief you need. It's essential to address your pain management effectively while understanding the mental and emotional toll this situation is taking on you. Let's focus on actionable steps you can take right now.
Key Points:
- You are facing overwhelming pain and sleep deprivation amidst complex medical issues.
- It's essential to establish consistent pain management strategies and emotional support.
- Advocating for your needs and seeking a team approach may help.
Explanation:
Chronic pain can be isolating, especially when you're dealing with multiple diagnoses and have a history that complicates your treatment options. It's crucial to have a tailored pain management plan that considers both your physical symptoms and mental health. It’s clear you are not seeking medication for the sake of it but genuinely need help navigating your situation.
Actionable Steps:
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Establish a Pain Management Plan:
- Consultation with a Pain Specialist: Try to find a pain management clinic or specialist who understands chronic pain and has experience with patients who have a history of OUD. They may offer alternative treatments such as physical therapy, acupuncture, or nerve blocks.
- Non-Opioid Medications: Discuss options such as gabapentin or NSAIDs (e.g., ibuprofen or naproxen), which may provide relief without the risks associated with opioids.
-
Identify Triggers and Symptom Patterns:
- Keep a detailed diary of your symptoms, noting what precedes severe pain episodes, your daily activity levels, dietary intake, and emotional state. This can help your health care provider identify patterns and triggers, allowing for more tailored treatment.
-
Explore Behavioral Health Support:
- Given the emotional distress you've expressed, consider reaching out to a mental health professional who specializes in chronic pain management. Cognitive-behavioral therapy (CBT) has been effective for many dealing with persistent pain and may help you harness strategies for coping.
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Immediate Relief Strategies:
- When experiencing severe pain, you might find non-pharmacological interventions helpful, such as heat packs, cold therapy, relaxation techniques (deep breathing, mindfulness), or even guided imagery to help manage pain during flare-ups.
- Stay hydrated, especially considering you're experiencing nausea, as dehydration can worsen symptoms.
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Communicate with Your Healthcare Team:
- If problems arise with your current providers, consider bringing someone supportive to appointments to help advocate for you. Clearly articulate your pain levels and the impact on your life. Having a supportive voice can reinforce your need for comprehensive management strategies.
Please remember to prioritize your safety and emotional well-being; reaching out for help during this time can make a significant difference. Surround yourself with supportive individuals or groups who understand chronic pain. You are entitled to compassionate care and effective treatment. It’s okay to express your pain and need for relief. You're not alone in this journey.
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