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Suggest Treatment For Chronic Pain Post Opiate Withdrawal

Posted on Tue, 13 Jan 2015

Question: Thank you for contacting me. So much confusion with two surgeries/rear ending; pain is ruling; off opiates; still in extra pain due to brain receptors; however, finally, a doctor who doesn't just address "Chronic Pain" and is doing a SPECT on 29th Dec. I'm rather unable to function a lot as the pain take over to point of not coping well. Accepting, especially this time of year, I have to limit myself and receive help, is painful in itself. I hope you continue to heal. My body has had four years of abuse - nothing but injections, surgeries gone bad, and opiates as the answer. But, my hope is this new doctor will help me get on a better path. Thank you and bless you.

Answered by Dr. Ajit Naniksingh Kukreja (14 hours later)

Brief Answer:
SPECT Will help analyse the structure and function hope for the best

Detailed Answer:
Hi

Thanks for writing in again

Apologies for being late, was not at my desk and I received a call from HCM saying there is a direct query for me and I sensed it would be you, so I took some time off and am the desk to reply

Thanks for the kind words and blessings

I can understand the agony and when you have withdrawn opiates it would be something unbearable

Let us wait for a week or so and see what comes out on the SPECT

With the Christmas on and new year approaching let us hope it start with a new ray of hope,

In the mean time why don;t you give simple Paracetamol 650mg a try ?
Or if possible an 100ml infusion of Paracetamol twice or thrice a day ?

I had a patient an elderly lady of around 81 years with bad root pains had tried all analgesics and was not responding to any of these

Worked wonders with Paracetamol infusion 100 ml thrice a day for 5 days followed by twice a day for two days and then maintenance of Paracetamol 650mg thrice a day

Wishing you a MERRY CHRISTMAS AND A HAPPY NEW YEAR AHEAD

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ajit Naniksingh Kukreja (26 hours later)

Great answer; thank you for sticking with me. Two years since colorectal surgery; I tried to address the additional pain but once "Chronic Pain" label is attached, I didn't stand much of a chance. Unfortunately, the prolapse has returned which makes me wonder - since it was attached to the sacral promentory and the prolapse is returned - what could this mean? I went to colorectal surgeon and he told me to see the surgeon who did this -- that's impossible.
I'll address the pain medication you mentioned; if I had know increased sensitivity to pain would occur, I am not sure I would have asked to get off opiates during Christmas. I think you are one of a kind; I thank you for sticking with me and giving such thoughtful advise. Bless you.

Answered by Dr. Ajit Naniksingh Kukreja (2 hours later)

Brief Answer:
Chronic Pain can also be taken care of

Detailed Answer:
Hi

Thanks for the blessings, really need them

Chronic pain can also be well managed, fortunately the pain consultant friend from US is in XXXXXXX these days, let me see if I get a chance to meet him, I will surely take time to discuss your case with him and see if there is a solution to it

Recurrent prolapse may need another surgery, do not know the extent of the prolapse, If it is around half to one inch, I would opt for a minimally invasive recto-anal repair

May be you may not wish to undergo another trauma

Do give Paracetamol a try, have been evaluating this molecule for quiet some time now in the management of postoperative pain

Keep blessing

Wishing you a really wonderful year and a Merry Christmas, just to share with you 25th December happens to be my birthday, would be more than Happy when my patients remember me in their prayers on this day......

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (11 hours later)

You most certainly are in my prayers and, Happy Birthday.
Are you suffering from past surgeries? I know you have endured a lot; still treating your patients and following people like me when time spent with a doctor here is short.
My question, since the majority of my pain was after the colorectal surgery where he capped one end of colon; cut hole in side of rectum and held it with mesh strips. Since it's falling, could remaining mesh and sutures/staples have been causing the pain all along?
More blessings your way; you are a man to be admired and I hope your Birthday is full of many blessings.

Answered by Dr. Ajit Naniksingh Kukreja (4 hours later)

Brief Answer:
With two years gone by it is very unlikely

Detailed Answer:
Hi

Thanks for all the wishes and blessings
Yes I do have residual shortening, but I have accepted it as a part of normal routine

Treating patients was a profession by choice and not compulsion so I am enjoying every moment of it

Regarding the pain being due to staples sutures or mesh it is unlikely as two years have gone by, yet let us wait for the SPECT

Thanks one again for the wishes and blessings

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Ajit Naniksingh Kukreja (18 hours later)

Smart man; impatient woman.
I'll say a Happy Birthday prayer for you and blessings for the new year. You are of the character that is rare and refreshing. I'll check with you after the scan and thanks for sticking with me.
Merry Christmas and Happy Birthday,

Answered by Dr. Ajit Naniksingh Kukreja (2 hours later)

Brief Answer:
Thanks A Lot

Detailed Answer:
Hi

Thanks a lot for the wishing

Will await your reports

Wishing you a Merry Christmas And A Happy New Year in advance

Regards

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Ajit Naniksingh Kukreja (13 hours later)

Is it Happy Birthday for you today? I don't know time change , but wishing you a peaceful one. Scan on Monday as soon as I ger, I will send. I believe I'll have two opinions on film. Too much history of overlooking. But , to you, peace and Happy Birthday and blessings.

Answered by Dr. Ajit Naniksingh Kukreja (6 hours later)

Brief Answer:
Am honored

Detailed Answer:
Yes it is the Merry Christmas day here and Beloved XXXXXXX brings lot of Birthday wishes for me

Am honored specially when my patients remember me in their prayers

Will await your reports and am confident the new year will bring lot of good health and happiness to you

Wishing you a Merry Christmas once again

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Ajit Naniksingh Kukreja (1 hour later)

Know you are being blessed, celebrating two holidays. You are on my mind.
The prolapse has, from what I've been feeling, slipping for a very long time; I reported dropping inside (colon) and knew things were changing. I carried a table and felt more slipping, The entire colon and its normal function was drastically changed. However, just relax, celebrate, and know someone in the United States thinks a lot of a man so very far away. True blessings sent your way. And, enjoy the holiday; I don't need an answer right away and SPECT will be sent soon. Two Happy Birthdays.

Answered by Dr. Ajit Naniksingh Kukreja (4 hours later)

Brief Answer:
Will Await For SPECT ?

Detailed Answer:
Thanks a lot

Though an answer is not needed we are supposed to reply to pending followup queries, hence these few line

MERRY CHRISTMAS

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Ajit Naniksingh Kukreja (2 days later)

First, I hope you were blessed on your Birthday; free of pain.
I have the same prolapse that I was told to have operated on; many problems. I reported the issues repeatedly, feeling the pulling in the area of scram; area the mesh was attached; now, it's been there for two years; prolapse, actually is harder to pull in now. Many say using mesh like this doctor did is not typical. Why would the mesh not be considered a problem when I told drs about the pulling; pain, etc and now, the prolapse. I am so complicated because of the colorectal surgery and hernia repair, it was easier to just give meds. Sacral Promontory shows inflammation. I do believe I will go nuts with pain and Tylenol and Celebrex doesn't do anything. I told the doctor about what you mentioned to take and he said that's really Tylenol..
Thank you for responding to my greeting. Busy doctor doesn't need to spend time; I just wanted you to know someone was thinking about you.

Answered by Dr. Ajit Naniksingh Kukreja (4 hours later)

Brief Answer:
Very unfortunate

Detailed Answer:
Hi

Thanks for all the kind gesture and prayers am really honored by the blessings, yes it was a blessed birthday and am much better physically also

It is unfortunate that the prolapse surgery did not work for you, rather gave you more issues

Again am sorry to learn that Paracetamol is not working in your case

For temporary relief you may try Diclofenac patch also

We would wait for the reports before we come to a conclusion

Though I am busy but I have all the time for my patients as they are my only friends, I socialize a lot with my patients and their family

Thanks once again for all the care concern and love for your doctor
Wishing you a very healthy life in the upcoming new year
Regards

Above answer was peer-reviewed by : Dr. Raju A.T