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Knee And Leg Pain, Had Opoid Addiction, Took Duragesic, Didn't Help. Treatment?

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Posted on Thu, 7 Jun 2012
Question: i have a difficult situation which is not easy to diagnose and i barely have 10 bucks i need a professional oppinion cause of seen many doctors and im now broke and homeless about to go into hospital but there are some things i cant or may forget to mention its pain in my knees that started now its stretching into my legs i have mental problems and ive been through all types of abuse right now i need to know whats wrong with my knees and how to treat that then ill do dual diagnosic i am very well educated i have bsed a doctor before but now i really need to know whats goin on no bs my name is XXXXXXX krouchick im a recovering addict and i have psych issues can u help me?
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Follow up: Dr. CS Narayan (9 minutes later)
i used to have a serious opoid addiction and i also am dual diagnosic most like likely tripple but there is no help for that i cant take oxycontin or really any pain pills cause of my history so instead i was givin a patch called duragesic i was in a methadone clinic for drug treatment awile ago however methadone is a very bad drug and i went from 170mg daily to 40 in the last couple months against all doctors advices but im still standing and im ok. i have a bad horrible pain that started in both my knees my right knee is the worst whenever i get up or sit down it hurts even lying down makes it worse the only thing that helps is when i excersise the pain doesnt go away but the more i move the easier it is to deal with i think the methadone did this to me but i think im partially or all the way wrong now that pain is in my legs every mourning is unbearable i will not let my doctor prescribe me anything that could get me high or possible drug abuse so the patch helps but just takes the edge off which i can handle but its getting a worse and so are my psychiatric problems i know ive been misdiagnosed and i cant afford to pay 25 for a specialist so if this is to much for you please just concentrate on the knees and now recently me legs which has just started and also mild pain in my wrists that also just started i need a real oppinion not something read out of a doctor school book cause ive read them and tried to diagnose myself and im not a doctor if u can help please tell me how and whats happening. i will answer any question u have honestly
doctor
Answered by Dr. CS Narayan (7 minutes later)
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

After reading your words, I see that you have pain in knees.

Keeping your abuse, addiction recovery, herniated disc conditions and psychiatric issues aside - I would like you to reply me nicely point wise for these questions:
1. How long is this knee pain present ?
2. Where in the knee do you feel pain ?
3. Were you treated for the herniated disc before, any other medical history ?
4. Have you undergone any tests related to the knee yet ?
5. Have you tried any medicines for this knee pain now ?

I would be able to guide you properly if you answer them for now.

Meanwhile, just apply some cold compresses or some pain ointments, whatever is at hand. Keep some pillows below your knee when you sleep.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. CS Narayan (2 days later)
1. My knee pain has been present for about 2 years now but didnt get really bad until a few months ago however my brother did something to take down the swelling and for a couple days it didnt hurt as if he had to drain it or something but it was basically applying pressure to the swollen area and doing a message otherwise it hurts everytime i get up sit down lay down or sitting down only thing that helps is constant movement the more i move the easier it gets the worse pain is in the mourning and at night takes a few hours of me movin around in the mourning and at night before i get just a little relief. anyway next ? i feel the pain from the top part of my knee on the sides and top and i didnt realize cause i couldnt feel it but its swollen halfway down my calf muscle or whatever its called.
3. I have gone through alot of treatments such as injections cortizone shots, some weird therapy where it sends a electric shock to the nerves i think there were 2 accidents the first accident i healed ok from after 1 year of pain medicine and physical therapy then i was in another accident with the same type of impact both times i was stopped and rear ended at 52 mph first time and 55 mph second time. I also tried every pain management treatment available and didnt qualify for surgery last time i tried the second accident happened about 5-6 years after the first one first one was dec 2003 then next was december 2008 then another where i was in the passenger seet and a friend mostly hit a elk in colorado in the san XXXXXXX mountains at 0000 feet after those 2nd 2 accidents things got alot worse i went from having only 2 herniated disks in my lower right back to having 3 herniations in my lower back now on both sides not just the right and shoots down both legs to feet then months later the knees started to hurt 2 years ago i tried to physical therapy for the 4th time it was later concluded that i lost 50% of my muscle mass in my right shoulder and possibly suffer from a torn rotater cuff on my top right shoulder which is more painfull the some of my disks 5 out 6 disks in my neck are now damaged c1-c5 c6 is ok and i also get extreme pain in my middle back now and suffer from horrible headaches. the 1st few months i was off everything i became as my father and mother say a very difficult person to be around and i was constantly miserable and they were right and still are so after i saw my dr and explained that i had to go before into dual diagnosis for mostly drug treatment in the past for oxycontin addiction which was one of the worst times of my life i was on it for several years and i had a dr in colorado who i thought was a decent doctor but after i told her i know im addicted to this drug and my tolerence as getting alot higher and im afraid of serious longterm addiction and brain damage. little did i know then i was already seriously addicted and i didnt realize how bad it was until i had to go to the emergency room in denver the my old dr was redflagged the last year i was in colorado is hazy cause before the last accident she had me taking 4 oxy 80s a day 2 every 12 hours plus 3 40s a day 2 in the mourning and 1 at night also had me on oxycodone 30 mg pills at 1-2 every 4 hours for breakthrough pain and also something called opana it was way too much i didnt realize until my old dr was busted shortly after this id say 2-3 months later tops she had me up to around -6-800 mg of oxy a day and another 40 mg of opana once the dea nailed her i called my father and told him i have a serious addiction problem had to come home to philadelphia to get the right treatment for some reason the dea did something to where no dr or rehab would see me cause she was the old dr i was getting legal scripts and then i find out at the end that shes literally very crooked i believe possibly selling scripts or something theres a article about it her names dr janette XXXXXXX and it was denver colorado so i came back here and went cold XXXXXXX from almost 1000 mg a day which is a really rediculas tolerence and way too much for me to be prescribed and she had it setup to where my insurance paid for it every 23 days and not 30 anyway took years to recover and i never fully did have permanent brain damage and side effects have been clean and see my pain guy and my doctor who talk to eachother and decided what to do after i was off all of them and in such bad pain in my back and legs i would pass out from it so i told the drs about my addiction history with oxycontin refused to take percocet or morphine and pretty much any pill so they put me on 2 different meds for the last 2 years a duragesic patch every few days i change it and i believe its brand duragesic strength 75 mcg per hour and 30 mg of methadone a day. when i first came out of treatment they stuck me in a methadone clinic and i hated the drug so now in last 4 months went from almost 200 mg a day down to 30 i went to my dr and complained said this drug is really messing me up i dont wanna dip out all the time and sleep all day i couldnt live like that so heres whats going on now the headaches knee pain and back pain got much worse went from buldge to complete herniation where i was diagnosed with degenerative disk disease my doctor knows and has asked to up the duragesic to 100 mcg per hour try lower the methadone to 60 im going against his advice and take 3-40 mg a day depending on the pain now im so used to fighting the cravings and stuff for the first year that now im feeling the real pain its gotten worse and i dont want to ask for anything because im so scared they put me on something addicting so heres where im confused and not sure what to do im going into a dual diagnostic center cause im having bad psychiatric issues from my childhood and my pain in the last 3-6 months has gotten bad enough where nobody wants to be around me mom and dad say im miserable and irritable all the time my blood pressure when im in this pain averages 140-150 over 90-100 now i got a dilemma i dont wanna get addicted to anything ever again the duragesic patch does work methadone scares the crap out me because the withdrawel for that lasts 30 days and im trying to make sure im only dealing with the real pain and not just the addiction history i dont want to be judged or labeled so i undertake my medicine i dunno what i can use for breakthrough pain all i know is the patch workes good takes a day to kick in but isnt taking the edge off as much as before could be the methadone decrease i did but i dont want them assuming that im back in there for addiction when this time its for psych and also for more help on pain management every dr i see says i need to take a breakthrough pain med every over the counter doesnt work and motrin 800 works good when i take it with something else i cannot take and will never fill a prescription for oxycontin percocet or any drug like those specific ones opana makes me sick dilaudid doesnt work on me at all i wont take the lollipop version of the duragesic patch cause i dont wanna be on too much but now i cant deal with it anymore the patch takes the edge off and i can move doesnt kill the pain but i figured out a long time ago i dont need it to all i need is to take the edge off im afraid of them putting me on another addictive medicine that if they do my dad dispenses my meds by the day so i dont undertake it too much and i dont accidently take too much like forgetting a dose and doiuble dosing anyway advice would be appreciated since i dunno what to do heres ur other questions

i was never fully treated for my disks now there worse then ever and its hard to walk once i move enough its better but now its become unbearable and the disks are messed up and i have pain on my lower left, lower right, central back, upper back right shoulder and neck both legs hurt from nerves and the knee pain sometimes overpowers the rest. next question is i havent done any knee tests yet cause im not sure what could be wrong all i know is that both knees hurt and swell up the right one is worse then the left and both my ankles swell up recently my wrists also started swelling. and as far as the medicine question i believe i answered that as best i could i do also suffer from DID that is my psych problem pillows dont help cause the more i raise or lower my knee and or legs the more my lower back hurts ice helps but not for long i need more answers so ask me whatever u need to ask
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Follow up: Dr. CS Narayan (28 minutes later)
there is no easy answer to this im not a doctor or specialist but i am very well educated and know alot about conditions, diagnostics, psychiatry, psychology, and i also know a great deal about medications and there interactions heres my med list been on these psych meds for almost 13 years maybe longer have panic disorder anxiety disorder social or xanax, klonopin both were addictive highly and tried valium valium takes care of my panic attacks anxiety muscle spasms and my epilepsy seizure disorder as well and in my experience doesnt seem to have any addictive effects for me i was also on klonopin but i hated it. was started on 1mg 4 times a day for klonopin then was bumped to 2mg 4 times a day then bumped to xanax for nearly 10 years had to come off it cause it was causing more seizures then stopping cant take tegretol cause it interacts with opiod pain medications and causes wd symptoms so icant take it anymore take lexapro for depression take adderal for adhd started at 40 mg a day when on ridilin ridilin made me feel real crappy tired and like my heart would explode tried the non narcotic pills made me worse so been takin 30 mg of aderal in the mourning and 20 mg 3 hours later for the day been on same dose for several years but its starting to not work as well and i dont want the dose going up i also have bad acid reflux and i take previcid for it used to be on much more medicines but my doc always says the less the better so i minimized and deleted most of them from my life went from 3 benzos to just 1 2 different adhd meds to just 1 several pain meds down to 2 and about to come off the methadone which is XXXXXXX in my opinion all i need to figure out now is breakthrough pain meds why my knee swells up and going off and changing psych meds been misdiagnosed with bipolar 1 , 2 and 3 now its been rediagnosed with multiple personality disorder recently known as DID so i dunno doc ask away
doctor
Answered by Dr. CS Narayan (8 hours later)
Hi,

Thanks for the exhaustive replies.

Yes, indeed - answering you would not be easy in here, especially with so many medical conditions involved.

I can read that you have tried many lines of medical management already for the knee, with no relief. And you are unfit for surgery. You also say you have not done any tests yet for the knee yet.

I tried hard to read your answer and pick up all the points related to your knee against the backdrop of a plethora of conditions you wrote, but I see that analgesics are not working for you with the opioid withdrawal / methadone history.

I would like to suggest you to try alternate therapies in case insurance/money/pain medications/drug interactions/multiple medicines etc are indeed issues for you. For that you would need review from a board certified orthopedic surgeon who would need to correlate everything you wrote in here to prescribe you more powerful analgesics in the possibility you need them.

For that, you would have to prepare a time-lined medical history of yours, neatly with filing of all investigations done till date.

I would be glad to go through such a file (in order) if you can send it to me. I can then read the medical language in the doctor's point of view. This is not denying your well versed capabilities of medical vocabulary.

I will be available for further queries.

Regards





Above answer was peer-reviewed by : Dr. Radhika
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Answered by
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Dr. CS Narayan

General & Family Physician

Practicing since :2004

Answered : 546 Questions

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Knee And Leg Pain, Had Opoid Addiction, Took Duragesic, Didn't Help. Treatment?

i used to have a serious opoid addiction and i also am dual diagnosic most like likely tripple but there is no help for that i cant take oxycontin or really any pain pills cause of my history so instead i was givin a patch called duragesic i was in a methadone clinic for drug treatment awile ago however methadone is a very bad drug and i went from 170mg daily to 40 in the last couple months against all doctors advices but im still standing and im ok. i have a bad horrible pain that started in both my knees my right knee is the worst whenever i get up or sit down it hurts even lying down makes it worse the only thing that helps is when i excersise the pain doesnt go away but the more i move the easier it is to deal with i think the methadone did this to me but i think im partially or all the way wrong now that pain is in my legs every mourning is unbearable i will not let my doctor prescribe me anything that could get me high or possible drug abuse so the patch helps but just takes the edge off which i can handle but its getting a worse and so are my psychiatric problems i know ive been misdiagnosed and i cant afford to pay 25 for a specialist so if this is to much for you please just concentrate on the knees and now recently me legs which has just started and also mild pain in my wrists that also just started i need a real oppinion not something read out of a doctor school book cause ive read them and tried to diagnose myself and im not a doctor if u can help please tell me how and whats happening. i will answer any question u have honestly