Suitable Pain Meds

I've been suffering from severe headaches 5 years after my RNY surgery. I've had these headaches for 3 months now.

I know I have to avoid NSAIDs. I took a mild one and it helped with the pain. But I can't take long term obviously.

So I've been taking 50mg of Elavil with 2-4mg or Hydro Morphone a day. That just about covers the pain but occasionally need a Tylenol 3 to top it off.

Can anyone suggest an alternative pain management regimen? I really don't want to take the narcotics for a long period of time.

Thanks,

Andrew.

Do they have no idea what is causing them?

No idea at all. It's like a migraine in intensity but sound and light doesn't affect me.

• Blood tests show no infection.
• Optician shows no problems.
• CT Scan showed nothing.
• No sinus congestion.
• Stopped taking caffeine: no change.
• Walked more often: no change.
• Calcium, Iron and Vitamin D all checked and in range.
• Blood sugars are well controlled.
• Massage therapy has no effect.
• Acupuncture has no effect.
• Changed my chair and sitting position. My neck's less sore but the headaches are untouched.

I have an MRI at the end of November but I suspect it'll be the same: nothing wrong.

As my doctor says "sometime you just get headaches and we can't find the problem."

Unfortunately, once you eliminate Tylenol and NSAIDs, narcotics are pretty much all that's left. There are things for specific types of pain that are not narcotic and may help (e.g., for migraines), and for some kinds of issues people take Cymbalta, but those medications are not primarily for pain and therefore don't help in the same way as, or as much as, pain meds do. 

Many RNYers rely on Tramadol, which is a level below the hydrocodone, for pain, but the FDA just made it a scheduled narcotic because of the (alleged) potential for addiction.  I took to for 4 years and noticed absolutely no signs of psychological or physiological dependence, let alone addiction. YMMV, of course.

Lora

ETA: I didn't originally see that you're from Canada, so what the US FDA classification of Tramadol probably doesn't apply to you, although it may be similarly categorized in Canada.

Thanks Lora. My research hadn't brought up Tramadol.

Lortab: just as additctive as the hydromorphone.

Nambumetone : stomach upsets

Liboderm: topical only.

Darvocet: withdrawn from sale for being addictive.

Flector 1.3%: stomach upsets.

Ultram looks promising as it's lower risk of addiction. Have you heard of this medicine?

Ultram is Tramadol  =)

Yes, Ultram and Tramadol are the same thing.

Unfortunately -- in my experience, anyway -- it isn't nearly as effective, even at higher doses, as any of the narcotic pain meds, but it is a bit more effective than the NSAIDs would be.  I was taking it for severe arthritis in my knees, and the Tramadol/Ultram isn't a strong enough pain killer to overcome the lack of the anti-inflammatory action that the NSAIDs have.  With arthritis, reducing the inflammation is a critical part of addressing the source of the pain. 

I sure hope they find the reason for your headaches!

Lora

Have you seen a neurologist?  I did when my headaches were so bad.. I was on a daily regimen of Zonisamide... It's an anti seizure med for migraines... It worked wonders and I didn't need pain meds.  Keep in mind, the more pain meds you take the more likely you will get a rebound headache.  

Good luck. 

Neurologist is booked for December 5th.

Caffeine if they are not too bad or botox, which might be the solution if they are a permanent fixture!