Pain Management

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I wouldn’t say I’m great today. I woke up feeling like I was hit by a freight train. Sleeping is key in this shoulder recovery deal. And sleeping is accomplished by pain management.

I started cutting way back on the pain medication a couple days ago. I’m not sure why, probably because they are playing havoc on my insides, but also because I’m not that big on taking pills in general. I started riding indoors and it seems counter productive exercising while eating pain pills.

Anyway, I thought everything was going great. I’ve mainly been taking two pain medicines, Oxycontin and Oxycodone. Oxycontin is a long term, time release version of Oxycodone. I’d cut down to one Oxycontin a day and then 4-6 Oxycodone. I think it caught up to me last night.

It didn’t matter how many Oxycodone I took in the middle of the night, the pain was pretty unrelenting. I ran out of Oxycontin and told the doctor I didn’t want to refill the prescription. Man, was that an error.

So, this morning, I woke up feeling like I’ve taken 5 steps backwards. I have a PT appointment in a hour or so in Vail. These appointments keep the days rolling along pretty quickly, but tend to get in the way of needed rest. I could sleep all day today under the right circumstances.

Maybe after I get moving around a bit more, I’ll feel better. It’s been 6 days now, so I would assume that it would have to be close to a time when I could be completely off the pain medication. I haven’t experienced anything like this before, especially since it seems that a lot of the emphasis from the medical side is the management of pain. I’ve always thought that improving and healing was the goal. I guess that takes care of itself with time, so just getting there is the goal. It is a strange world we live in now.

They didn't have this table hanging up at the hospital or my pain numbers would have been much, much higher.

They didn’t have this table hanging up at the hospital or my pain numbers would have been much, much higher.

13 thoughts on “Pain Management

  1. Bill E

    Man, be careful with the Oxycodone. I was give that last fall for pain, after collarbone surgery. Like you, I hate taking that shit, so took it for 3 1/2 days, and stopped. For the next 6 days after that, I started having crazy symptoms like night sweats, being super achy, fatigue, feeling sick. Didn’t think anything of it for 2 days, till the wife suggested I look it up and I realized it was classic withdrawal symptoms. Super easy to see how people get addicted fast, as it worked, and I’d have much rather taken it to dull the pain. That stuff is dangerous man. Sadly, better to try and tough out the pain.

     
  2. Dan

    Steve , talk to your doc about tapering off the pain meds when you are ready I am sure there are ways to get around the withdrawal symptoms so they are not so bad.

    Peace

     
  3. Mike Neeley

    Steve,

    We have never met but I thought I would share my experience. While I am not and never have been an elite level cyclist like you I have dealt with a major injury surgery to repair it. I am 45 and turning 46 this summer. Have always been athletic and love to race mountain bikes. In the summer of 2011 I blew out my right knee playing volleyball with my nieces and nephews. Tore the ACL completely and tore the meniscus on both sides. I had surgery in November of 2011. They did a hamstring graph to replace the torn ACL and then they trimmed the torn meniscus material. I felt pretty intense pain for a couple of weeks after surgery but it slowly subsided. Rehab and recovery felt like futile at first but the knee continues to get better and stronger and I am back racing at close to the level I was before. I hope to get all the way back but know it takes time. You may hit a point where you think it will never get back to normal but it will. Keep working hard at recovery and rehab and before you know it you will be winning National and World Championships again.
    Best of luck to your speedy recovery.

    Mike Neeley

     
  4. NJRoadie

    Pain meds are a tough issue, especially when you are in lots of pain. In my shoulder crash I broke 6 ribs, punctured a lung, broke the collarbone and the scapula, and of course lots of road rash. My pain was a 10. I was in the hospital for 6 days, the first 2 on morphine. After that I was on the same protocol as you with oxycodone, oxycontin and valium. The layers of drugs were necessary as the oxycodone (percocet) in my case was the most effective drug. However, you can only take it 4 hours apart, and in my case it would wear off after 3.5 hours. You seem to have discovered, as did I, that once you are behind on the pain meds it takes a lot to get the pain back to a manageable level.

    Like you, I wanted to wean myself off of the narcotics ASAP. I managed to do so after 2 weeks and thought I had it under control. Then I stopped sleeping. The pain was bad and I could not get comfortable enough to sleep. I got insufferable to my family and was miserable. In fact, my wife and daughter had a reverse intervention where they told me I had to go back on the drugs so I could sleep, rest and heal. So I went back on the percocet but at a reduced dosage. I mainly took it at night, right before bed and then another sometime during the night.

    Bill E is also right to point out that these narcotics are addictive. From your posts, I would say that you still need the relief. If you can’t sleep or rest then the narcotics are necessary. Rest is critical to healing, which is why the medical folks are so keyed into pain management. Wean yourself over time by lessening dosages and by increasing the time between pills. Remember that you can cut the pills, so maybe now you are taking 2 every 4 hours. Cut back to 1.5 every 4 hours and see how you do. Then cut back to 1, then 1/2, lengthening the time between doses. At the end of my weaning process I was taking a half before bed. I had a hard getting off of that half. It took a sleepless night where I googled percocet addiction to stop taking the narcotics completely.

     
  5. Keith Knittle

    Hi Steve,

    One of the lesser understood principles of pain management is that you have to stay “ahead” of the pain and inflammation or it can quickly get uncontrollable. Rest and sleep are critical to healing and as you stated you are getting neither lately. I am not a Dr. but have unfortunately broken some stuff on the bike and these are the things I learned going through that mess. Sometimes the strong pain meds are necessary! That’s why we have them available. Get doped up and rest easy my friend!

    K

     
  6. John

    Steve….give J. Unruh a call. He will be able to help you immensely with some advice. You could be having some withdrawal after 6 days, but unlikely if you still have some oxycodone. Shoulders are a bitch…the worst orthopedic pain someone can experience. You have also hit PT harder and quicker than most. You should ask if they will let you take some ibuprofen. Some orthos don’t like it because it impedes inflammation, which helps new graft fuse. Best wishes, and sorry to add even more advice, but I have a bunch of experience on this. I think most of what you are dealing with is very normal….it just sucks.

     
  7. channel_zero

    As you now know, the “cold turkey” thing does not work. As posted by others, some of those drugs are crraaaazzzyyy powerful with equally crazy side effects. That’s part of the reason for the days-ago recommendation to slow usage during the day. A slow ramp off the drugs.

    In one post you mention someone telling you about X percentage of healing over Y days. Now that you are in it you better understand “healing” doesn’t mean comfortable and vaguely functional.

    Best of luck.

     
  8. DavidA

    Hey Steve, the above comments and insights are great. I think what you are doing is “Chasing” the pain by not being on top of it. Sure they are powerful and addictive, but you have to sleep in order for your body to recover and NO i dont think you will get strung out on OXY just dont chase the pain brother man.

     
  9. Jojo

    Agree. You really need to stay ahead of the pain. Also quit trying to taper off the meds if you are still in so much pain that it is hard to function. If that is the case, you probably should not be tapering yet.
    Also you may be experiencing some withdrawal symptoms. Talk with your Doc re. your dosage and when you should start tapering and how to do it. Trudi should write things down for you if need to refer to later.
    Sorry to get on a soapbox. This is a pet peeve of mine as I see this too often and you are doing yourself no favors.
    Best wishes and take care of yourself.

     
  10. catherine

    On Inga and Eddie: If Inga couldn’t figure out by herself how to get a rest day when she needed a rest day, then, that’s her problem. It doesn’t usually send a person to the hospital. Can’t blame Eddie for that.

    On the pain chart: Doesn’t really fit an athlete because they’ve already endured the “worst pain possible” and survived it without pain pills.

    That being said, the professional health care providers probably know what they are talking about when they say “stay ahead of the pain”. After a few weeks, when you’re in a more active recovery phase, you will be disciplined enough to stop the pills, start to exercise on a regular basis, and get back to a routine.

     
  11. H Luce

    discipline works only when the addiction is psychological in nature. Opiate addiction is physiological, and is far more difficult to treat. However, these drugs are useful in recovery – so instead of trying to get off early, listen to your docs and follow what they say.

     
  12. Wildcat

    The best pain medicine is likely pretty available where you are at. It’s all natural and will help you sleep too! You know what I’m talking about. It’s a shame you have to go through all of this pill crap when God provided us with the best medicine already.

     

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