From: John De Armond
Newsgroups: rec.outdoors.rv-travel
Subject: Re: Bad news for Vioxx users!
Date: Fri, 01 Oct 2004 03:25:51 -0400
Message-ID: <0m0ql01q1pg4hd97sus479htt3ap724lks@4ax.com>

On Fri, 01 Oct 2004 06:41:25 GMT, "Madeleine" <madewar@earthlink.net>
wrote:

>I've heard that the increased risk for Vioxx was 300%, whereas the increased
>risk for Celebrex was 25%.  Might be worth the risk (Celebrex) for the
>quality of life for those who really suffer severely.

If I may point out something that seems to be lost in this thread, and to
many doctors it seems, these COX 1 inhibitors are only indicated for
people who could not tolerate the other NSAIDs because of stomach upset.
When these things came out my Dr tried to push them on me to replace what
was working just fine (more on that later.)  I had no stomach upset so
after I did my research I said NO.

After proceeding down the road to knee joint replacement far enough to
have had the pre-op work done, I chickened out and decided to see if I
could find a solution.  I found a Stanford U research paper that convinced
me of the efficacy of Glucosimine.  I tried it and about 6 weeks after
starting, I woke up one morning and could walk again without too much
pain.  It appears to NOT work for about as many people as it helps so no
guarantees.

After more research and some advice from my bro who's a dentist, I found
me a doc who would write a script for what I wanted and tried a combo of
Ultram (a non-narcotic, non-addicting opiate analogue) and NSAIDS.  It
took awhile to find an NSAID that worked, in my case, Aleve (naproxin
Sodium).

One 20 mg Ultram and 3 Aleves in the AM do me for the whole day.  I'm
practically pain-free.  When  I'm going to be on my feet a lot, it's 2
Ultrams in the AM.

My doc initially would not believe that this dosing would work.
Prescribing instructions call for 2 Ultram up to 4 times a day.  For me
that was not necessary.  My doc, being a little sharper than the average
sawbones, learned from me and has told me that this combo has worked very
well for other osteo patients.  It has also worked for my 80 yr old mom
and has kept the hip replacement surgeons at bay for several years now.

I've been using this drug combo for about 6 years now with complete
success.  Now that Ultram is off-patent and available in generic form
(Tramadol) it is quite affordable.

Though my Xrays still show bone-on-bone contact in my knees, on most days
I can walk without any limp.  An amazing combo of drugs.

John

From: John De Armond
Newsgroups: misc.rural
Subject: Re: pain relievers
Date: Mon, 15 Aug 2005 04:21:38 -0400
Message-ID: <4si0g1dmqlq3refbbqmk5durn83ck83nmn@4ax.com>

On Sat, 13 Aug 2005 13:09:36 -0400, Someone <Someone@somewhere.com>
wrote:

>Neon John <no@never.com> wrote in
>news:vpgsf154d90dd5tjejr8ibr2piiod9a9i0@4ax.com:
>
>> Try Ultram (Tramadol) next time.  It's a non-narcotic, non-addicting
>> and non-sedating analgesic that has about the same pain killing
>> ability gram for gram as oral morphine.
>
>Unfortunately that's a dangerous statement.
>
>
>   "ULTRAM® may induce psychic and physical dependence of the morphine-
>    type (ì-opioid). (See WARNINGS.) Dependence and abuse,
>    including drug-seeking behavior and taking illicit actions to obtain
>    the drug are not limited to those patients with prior history of
>    opioid dependence."

Atually, a little knowledge (and a lot of ignorance) is a dangerous
thing.  The above statement is lawyer repellant and in fact is false
for everyone who does not have a history of opoid dependence.

The rest of the story is this.  In the recent past (probably >5 years
ago), the FDA opened an inquiry into an allegation that Ultram was
addictive and caused drug-seeking behavior.  At one point, with next
to no evidence, the FDA even proposed scheduling the drug. Fortunately
science won out over phobias, the allegation was not supported with
the evidence and FDA closed the inquiry.  As is necessary in many
cases these days, McNeil included that warning to repel greedy
malpractice lawyers.

The word "may" is the key.  This word can cover a huge spectrum, from
"probable" to "inconceivable but theoretically possible."  That word
makes the quoted statement technically true but in practice, false.

Unfortunately, because of the lawyers and in many cases, the FDA, drug
label and insert reading has become an art form.  It has become
necessary to look beyond the insert for the information necessary to
make judgments.  Much of the vital info is passed from the drug rep's
mouth to the doc's ears, a form that cannot be subpoenaed.  That's why
we have to include our docs in the search for information.

My bro who is a doc alerted me to this tempest in a teapot when it
first started.  I followed the matter, almost on a daily basis, and
commented frequently to FDA, because this is the only drug that I've
tried, including narcotics, that lets me go about my day more or less
normally.  I understand how the vast majority of Rezulin users, those
not affected by the side effect that caused a panicked FDA to withdraw
it, felt.

John

From: John De Armond
Newsgroups: misc.rural
Subject: Re: pain relievers
Date: Mon, 15 Aug 2005 18:22:08 -0400
Message-ID: <3052g1dm2o51lduiq73pvu7pabjhakco0n@4ax.com>

On Mon, 15 Aug 2005 09:47:37 -0800, "Christina Peterson"
<tinapetrsn@yahoo.com> wrote:


>> FYI: I find that Ultram really doesnt do anything for muscle aches and
>> pains. Aleve works much better.
>>
>
>So this is mostly for nerve pain?  My husband has myofascial syndrome, a
>variant of fibromyalgia more common in men.  Ultram was one of the better
>pain killers for him, but Workers Comp won't make it available to him on a
>long term basis.

No, not just for nerve pain.  Ultram hits the same receptors as
morphine and therefore kills pain in a similar manner.  No drug works
for everyone but for most folks, Ultram is a godsend.

I suppose I'm dependent on Ultram like I am insulin.  If I don't take
it, I can barely walk.  But I can and occasionally do stop it cold
turkey for a few days just to see how my arthritis is progressing.
Other than hurting like hell, no other effects.

Generic tramadol is now so inexpensive that most anyone can afford it
without insurance.  Unfortunately there are still many docs out there
with phobias of Tramadol.  My manager recently ran into one.  She had
a gallstone and was in great pain.  The doc-in-the-box gave her some
vicodins.  No relief but they made her sleepy and nauseous.  I gave
her a couple of tramadol.  Complete relief.  The doc-in-the-box would
not write her a script, preferring to push more ineffectual narcotics
on her instead.  Idiot.

John

From: John De Armond
Newsgroups: misc.rural
Subject: Re: pain relievers
Date: Tue, 16 Aug 2005 03:52:48 -0400
Message-ID: <bi53g15a44afjojnp4s73tl0ivl9ul9jif@4ax.com>

On Mon, 15 Aug 2005 22:06:29 -0800, "Christina Peterson"
<tinapetrsn@yahoo.com> wrote:

>Thanks for the info, John.  Do you know how it works for fibromyalgia?  That
>makes some strange changes in body chemistry.  I'll check into it,.... but
>just in case you know...

My ex had pretty bad fibro.  A combination of Ultram and Elavil gave
her the most relief.  No one including her rheumatologist knows why
Elavil works (and most/all other antidepressants don't) but it does.

I'm convinced that fibro is a manifestation of chronic high stress
levels.  Her problems started when our financial situation
deteriorated after a fire that destroyed our business.  She has no
problems now but unfortunately the "cure" required her to suffer a
nervous breakdown, followed by a compulsion to start a new life
elsewhere.  I'm glad the zeroing out of the stress cured her problem
but I sure miss her.

Anyway...  She was in a fibro support group.  I tagged along on a few
sessions and listened.  Just about everyone in the group had something
that caused severe and chronic stress.  Bad marriage, financial
troubles, etc.  That lends credence to my theory regarding stress.
That also may be why Elavil works for many people.

>
>It sounds like your attitude toward pain is like my husband's.  Get rid of
>the pain, but don't let it be so distant that you don't know what's going on
>with it.  Mustn't ignore what your body is telling you.

Yeah, pretty much.  Ultram works so well for me that I might not know
where new damage is setting in unless I let it hurt on occasion.  I'm
not sure WHY I want to know since there's nothing I can do about it
but I do.  OTOH, I don't believe it is necessary to suffer chronic
pain except in the most extreme cases.  Chronic pain does many bad
things to the body.  When I'm hurting really badly I notice that even
cuts and scrapes heal more slowly.  I can just imagine what it does
that isn't readily apparent to the naked eye.

>
>I'm dependent on anti-depressants.  I've got an organic problem (and
>actually my general mental health is better than it's ever been).  If I
>needed a hip replacement I'd get that.  Making proper use medicine is no
>worse than wearing dentures or glasses.

You got it.  Shortly after the fire which I was caught in and almost
burned up in, what I learned was chronic stress syndrome put me in the
hospital with heart malfunctions and breathing problems.  I got REAL
lucky in that I got a physician's assistant who had been through a
nasty divorce and recognized the symptoms.  I got even luckier in that
the first drug she tried worked perfectly.

Turns out I'd had the problem at one level or another all my life.  I
thought it to be normal for the flight-or-fight response to go to the
peg under even minor stress.  After the drug started working it was
like "hey, can I now go back and re-live the last 40 years like I am
now?"

The bitty-bodies and the puritan meddlers and the all-pleasure-is-bad
types get all wound up about drugs that cause pleasure, calling them
addictive but they have no idea.  Yeah, opiates and barbiturates are
addictive but frankly, nowhere near that of the mental state altering
ones.  I could get along without Ultram, though my life would not be
very pleasurable but my anti-anxiety drug is absolutely vital.  I'd
obtain my anxiety drug by whatever means necessary.  I'd NEVER go back
to the bad old days.  Fortunately I've finally found a very
enlightened doc who thinks about drug use as I do so I don't have to
worry.  Such a doc is a resource to treasure.

John