I read it somewhere in this but you need to 1) go to a pain clinic and 2) have a medication contract that may even cover pain crisisDilaudid isn't a great chronic opiod and ideally you should be switched to methadone or buprenorphine, but again, that's something that should be discussed at the pain clinic.Also, I would reexplore with a GI your hyperactive bowels and see if you can find an alternative to opioids for it's management.
Female, 50, 5 5, 215 pounds, never smoked, seizures, chronic stomach issues like abdominal migraine and ileuses, breast cancer.I have lifelong chronic digestive issues, stemming from a major exploratory surgery when I was 5 years old. About 20 years ago, I started having major issues requiring hospitalization with NG tubes and all kinds of other fun stuff because of the adhesions from the 1974 surgery hardening and choking my intestines.Starting in 2006, after many other things failed, doctors treated both the pain and the hyperactive bowels using Dilaudid. Over the past 13 years, my tolerance has increased, through absolutely nothing but closely monitored physician prescriptions and instructions. Through all of these years, I have taken some hefty narcotics for about one week every month, and not at all the other three weeks. I have thanked God a thousand times that I don't appear prone to any type of addiction (Never smoked, drink a couple of times a year, no illegal drugs whatsoever, couldn't care less about gambling, etc. My worst vice is Amazon.)Between this and absorption/metabolic condition, I get extremely little relief from the highest oral dosage that my PCP is comfortable with: 8mg every 6 hours.I'm currently in breast cancer treatment, halfway through Herceptin infusions that are supposed to continue through September. From the very beginning, Herceptin gave me diarrhea, and it has worsened to date to the point that I am in the hospital about one out of every three weeks because such severe diarrhea that I am dehydrated, critically low on magnesium, excruciating cramps because it flares my chronic condition, and you can imagine the rest.Two weeks ago I went to the emergency room with the usual symptoms, was given my now usual dose of two milligrams IV Dilaudid immediately followed by 1 mg every 3 hours for the next 8 days inpatient. Normally, they start tapering off by spreading out doses around day 4 and I am home and much more comfortable by day 8. This time, however, they noticed significant thickening of my colon on a CT scan, so on day six, when the Dilaudid had just calmed my bowels and decreased my pain, they had me do colonoscopy prep, which not surprising brought excruciating pain back with 18 hours of non-stop diarrhea.SO... hospitalist has access to 13 years of hospital records outlining the progression of all of this, has recent records showing mastectomy, Herceptin, labs consistent with six months of diarrhea... yet still harangued me the entire visit, accusing me of being there basically faking it for the Dilaudid. I could never keep him focused enough on my actual issues to get any help from him or get any questions answered because he was so convinced that there was no illness, only addiction. He claimed he read my records. I couldn't get him to call any of my other doctors. I couldn't get him to look at the December prescription bottle the nurses took from my purse and locked up that was still half full. The day of the colonoscopy, for the first time in my life, I told them I was a 9 on a scale of 1 to 10 in pain ... I'm very conservative with those numbers. Asked if I could have just one dose of 2mg of Dilaudid to get me back on track and was denied. Then he started the discharge process that day... with renewed diarrhea every couple of hours and 9 on the pain scale AND no tapering of Dilaudid. Being on Medicare (disability on the first try, approved in 2017 in less than 90 days due to the severity of illness), I threatened to report him because I didn't believe I was ready for discharge, and he told me with hostility that I could stay one more day but then I was out.I was discharged with the same level of diarrhea I went in with, more pain that I went in with, and spent three lovely days in bed crying my way through Dilaudid withdrawal. All caused by a doctor who lectured me for 4 days on the opioid epidemic. I can't imagine how many people would have become addicted in my situation instead of just gutting out the withdrawal.How do I get this to stop? Isn't there any overarching agency or physician type or anything I can do to have it documented once and for all that there has never been an addiction problem and that there is a room full of files documenting the illness and the reason for the medication?I'm seriously considering stopping life-saving breast cancer medication because on top of all of the pain and diarrhea, I can't face another week like the week he put me through. This wasn't my first experience with a doctor so obsessed with this notion, but it was by far the worst.What the hell are people with decades of documentation, debilitating chronic illness, and zero evidence of any addiction at any time supposed to do?