I am sorry to hear that you are having pain issues for a long time. With the limited information you provided, it is appearing that you need a comprehensive multi-diciplinary pain assessment. What it means is, in addition to pain specialist, the other specialists such as psychologists are a part of the pain team. It is also very important to assess the type of pain that you are having inorder to initiate or change the pain medication. If your symptoms and signs on examination are nerve related pains, the medications are different from medications for somatic pain. It is appearing that you had/ having post radiation therapy pain as well. If you never had multi- disciplinary pain assessment, I strongly recommend you to go to a good pain clinic and get a thorough evaluation for optimizing treatment and improve your functionality.
I would not recommend to stop all the drugs until you take a proper medical assessment and advice. It may create more problems than less. The anxiety and pain are interrelated. If your anxiety is because of poor pain control, treating pain would help in reducing anxiety. If your pain is worse due to then anxiety need to be treated to get better pain control with medication. Most of the times, we need to treat these both issues simultaniously but needs full evaluation of the patient before coming up with a treatment plan. There are some new drugs with good results in the market.
Nausea side effect for pain medication is not very uncommon. However, the individual variation for the side effects for opioids is very huge. You need to find the right one. Inorder to minimize the side effects, multi-modal technique of pain control is recommended. This means, using different medications that act on pain with different mechanisms simultaneously. In addition to this, nausea can also be treated with medication by multi-modal technique with different nausea medication.
Anxiety is also known to precipitate nausea. In the same manner as pain, if the nausea is due to anxiety or pain, they need to be treated simultaneously.
All the above information might be appear to be very confusing for you. I strongly recommend you to get your pain, anxiety, nausea etc evaluated in a multi disciplinary pain clinic. Hope this is of some help for you to understand the complexity involved in your clinical condition.
Do not hesitate to contact us if further information is needed.
Krishna Boddu, M.D.
| Posted: 08 Nov 2006 09:35 AM |
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