OpenHealth Q&A

Desperate for Relief from Unmanageable Pain

I am experiencing unbearable pain alongside severe sleep deprivation, so I will try to keep this concise while remaining open to any questions that arise. For nearly ten years, I've been grappling with continual abdominal discomfort. It all started one day when I had to rush to the emergency room due to intense abdominal pain, marking the beginning of my ongoing struggle. There is no medical investigation that I haven't undergone. I have received multiple diagnoses such as Complex Regional Pain Syndrome (CRPS), endometriosis, Irritable Bowel Syndrome (IBS), gastritis, and peptic duodenitis, among others. Tragically, I also have a short-lived history of Opioid Use Disorder (OUD), which I believe complicates my situation. Usually, I encounter flare-ups once or twice per month, and they tend to feel similar each time. However, this past Wednesday, I was abruptly awakened from a deep sleep by the worst pain imaginable. It struck my upper abdomen, radiating towards my chest and extending to my back and shoulder blades. Typically, my chronic pain does flare in the upper abdomen, but never with such sudden, intense severity. Consequently, I found myself spending six hours in the emergency room that day. My CT scan and lab tests came back normal, yet I conveyed to the attending physician that my pain and accompanying nausea were completely unmanageable and that I needed assistance beyond what I could manage at home. 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. Unfortunately, I was dismissed again and provided only with IV Tylenol. Sleep eluded me that night, giving me barely an hour and a half of rest. First thing in the morning, I called my primary care physician’s office and broke down in tears. My doctor was out for the entire week, and nobody else felt comfortable addressing my case. They suggested trying a different emergency room, an option I was initially resistant to but eventually pursued. Unfortunately, that turned out to be a grave error. I was labeled a drug-seeking addict, and although I understand the constraints faced by ER staff, I felt utterly powerless. I returned home, sobbing to the triage nurse at my PCP’s office, expressing my desperation and fear of resorting to unhealthy coping mechanisms if relief wasn’t found soon. Regrettably, I felt like my cries for help fell on deaf ears. Eventually, I returned to the first ER and was once again seen by the same doctor. Overwhelmed with emotion, I could see that he genuinely empathized with my predicament. He expressed a desire to prescribe me oxycodone but explained that he had limited discretion in prescribing what he felt was necessary. Instead, I received an intramuscular Dilaudid injection and five tramadol tablets, which I knew from past experience would provide little relief. Once home, I managed just 2.5 hours of sleep. I now contend with a persistent pain level of around 7/10, which escalates to 10/10 several times an hour, driving me to shortness of breath and causing all my muscles to tense. I find that I’ve had no choice but to run errands, each trip leaving me wondering how I made it through. Upon arriving home today, I felt so ill that I vomited all over myself as soon as I parked. Additionally, I am experiencing intense vasovagal episodes. While I haven’t fully passed out yet, even the minor action of walking from my bed to the bathroom produces tunnel vision and a sense of disconnection, along with a wave of intense nausea. I acknowledge the complexity of my situation with multiple contributing elements. However, the core reality remains: my history with OUD and recurrent ER visits should not prohibit me from accessing adequate pain management. I deserve compassion just like anyone else in distress. Is it believable that I would visit the ER four times within a span of 36 hours if I were truly seeking drugs? Do you think that if I were in search of medication I wouldn’t find alternative means locally? Do you assume I have the financial capacity for these visits? Do you think I derive any satisfaction from this struggle? I genuinely don’t know what to do… Why can’t patients be admitted for pain management when their suffering is evidently intractable, such as mine? I’m reaching out in desperation. I need help now. **Additional Information:** I am a 29-year-old white female who smokes tobacco and is currently taking Tylenol, ibuprofen, gabapentin, Zofran, duloxetine, bupropion, and omeprazole.

Answers (1)

3/28/2025, 10:01:22 PM

OpenHealth AI

I'm truly sorry to hear about the intensity of your pain and the challenges you've faced in seeking help. Your experience sounds incredibly difficult and distressing. It’s understandable to feel overwhelmed and desperate for relief, especially after so many attempts to find solutions. Let’s break down some steps you can take while emphasizing pain management and supportive strategies.

Main Points:

1. You are striving for effective pain management amidst a complex medical history.
2. Sleep deprivation is worsening your pain and overall well-being.
3. Immediate strategies and some long-term considerations to address both pain and potential barriers to treatment.

Explanation:

Chronic pain can often feel like an insurmountable obstacle, especially when compounded by a history of opioid use disorder, which can complicate your treatment options. Your symptoms, including the sudden worsening of pain and associated nausea, are distressing and suggest the need for a more cohesive pain management plan, ideally developed with a specialist.

Next Steps:

1. Contact a Pain Specialist:

   • Reach out to a pain management clinic or specialist who is experienced in handling complex pain conditions and has a proven track record of compassionate care. They can provide tailored therapy options beyond what the emergency room is equipped to offer.

2. Document Your Pain Episodes:

   • Keep a detailed pain diary. Note the intensity of your pain, its location, what alleviates or worsens it, and any accompanying symptoms (like your vasovagal episodes). This information is invaluable for healthcare providers to understand your condition better.

3. Consider Non-Pharmacologic Treatments:

   • Explore non-drug-based approaches such as physical therapy, cognitive behavioral therapy (CBT), mindfulness, or relaxation exercises. These can help manage feelings of distress and, potentially, the perception of pain.

4. Sleep Hygiene:

   • Since sleep deprivation is significantly affecting your quality of life, implement sleep hygiene techniques. This includes setting a regular sleep schedule, creating a calming bedtime routine, and limiting screen time before bed. Consider discussing melatonin or similar supplements with a healthcare provider.

5. Seek Support:

   • Reach out to pain support groups or mental health professionals who specialize in chronic pain and coping strategies. Sharing your experience with others who understand can provide considerable emotional relief.

6. Lifestyle Adjustments:

   • Reducing or quitting smoking can have a positive impact on your overall health and pain levels. Explore resources for smoking cessation as part of your long-term health plan.

7. Emergency Planning:

   • If your pain escalates again, consider having a plan in place. This could involve knowing specific hospitals that have handled your case sympathetically or having a specific person to accompany you for support.

Your fight against such enduring pain is not just valid but warrants compassion and appropriate treatment. Consider taking these steps to create a framework for improving your situation. Remember, you deserve to receive respectful and effective care. If things become critical again, do not hesitate to express that your pain is intractable and urgently needs addressing. Please stay strong, and take care of yourself; you're not alone in this.