Northwest Dive Club

My doctor recently gave me a new (to me) prescription to try for my severe cronic pain. I tried Oxycodone and it screwed my job and I had withdraws and temperament issues with my wife. So can't take that! May 2013 I had my spinal cord pain stimulator installed.still works great but just causes more steady pain to cover up the random nerve pains. So with a flip of a magnet, I can turn it on and be electrified.

Now back to this new drug. I told the doctor my cronic pain levels are up!
2. Doctor gave me a 3 day pain patch.
Lowest dosage of phentonal. Been with this doc many years.
3. A possible or common side effect is respritory arrest or as one doc said "respritory Laziness"
4. First week went okay. Helped a lot with back pain but did nothingness for nerve pain.
5. After increasing to two patches total of 50mcg
Started noticing, that at times, I would take a breath in and when I let it out, I would have to take another gulp of air to feel like I'm getting enough oxygen / air into my body.
Sure would not want this feeling underwater.


With respritory laziness, I might be able to get my girl breathing on!!!

Or I could just Die underwater and become a scuba statistic

I do not want oxycodone again.
So he suggested to try this... I have taken the patches off and respritory feel okay today. Just have to deal with a little more low back pain. I'll choose a back ache over breathing any day!
Has anyone else had this problem...Respritory Arrest underwater?

Or is this the secret to girl diving air consumption?
Maybe they are just Layzy Breathers.

Maybe If I have any other problems like this, I will have to just dive nitrox all the time or get a job

That is a difficult one. Sounds like the drug put you in to Cheyne-Stokes breathing. [http://en.wikipedia.org/wiki/Cheyne%E2% ... espiration]
This is a guess based on your description. Having it is not good. Having it UW + serious drugs under pressure sounds like a very bad idea.

A couple questions:
Have you had or discussed a steroid epidural injection? Don't even know if it's a viable option for you.
Low does anti-depressants are often more effective for neurological pain than analgesics. Tried that?
Some folks have been using medical marijuana for chronic pain....seriously, not a joke. Possible option?

Lazy breathing doesn't seem like the golden path to fantastic air consumption.

fmerkel wrote:Lazy breathing doesn't seem like the golden path to fantastic air consumption.

Might do wonders for CO2 retention though :(

And if the apnea is pronounced, an embolism.

Thanks fmerkel! Yeah I get epidural injection a bout once a year. Completley eleliminates Sciatica pain. I'm going to try Cymbalta next, so you are right on track, with one if my doctors!
Glad I am not having any breathing problems now.
Just staying alert just in case there are any more.
I agree that health problems and or drug use under added pressure can be dangerous and that why I'm being cautious.
As of now. This pain stimulator is still the best non-narcotic pain reliever!
Also, I still get pain relief, below 30 fsw. But what good is pain relief if I can't breath normally. I think I'm addicted to breathing =-O Lol!

Primarily sciatic type pain?
If so, maybe even if not so, take a look at this:
https://www.youtube.com/watch?v=vqzlbHsf5rw

There's a lot of info on the net on the McKenzie Method. I've had back issues for 40 years and only learned about it 3 years ago. Sometimes the general medical establishment is WAY behind some developments, especially if it doesn't make them a ton of money. I got an epidural, lasted about 6 months and started to wear off. A new Dr. suggested I try this. Never heard of it. I was pretty skeptical. Luckily I got a persistent PT because for me it took 2-3 weeks before it 'kicked in'. The disc has been 'bulging' for a loooonnnnggg time. It takes awhile to tuck back in.

The book is simple, and cheap on Amazon. I even got it from the library to check out first.


Cymbalta? [http://www.drugs.com/comments/duloxetin ... -pain.html]
Pardon my suspicion but it seems like a Dr. pushing the newest and most expensive drug. Possibly not necessary, maybe not even advisable. I'm out of my personal expertise here. Maybe Lynn can weigh in, or someone with more personal experience.

I put [low dose antidepressants for back pain] in Google and got a lot of hits. It's probably worth your time for a bit of in depth reading and education.
http://www.spine-health.com/treatment/p ... tive-guide
http://www.webmd.com/back-pain/tricycli ... -back-pain
http://www.mayoclinic.org/pain-medications/art-20045647
http://www.webmd.boots.com/back-pain/ba ... -back-pain

As you have probably figured out, humping 100# of gear to the water is not the best therapy for your back a person can think of.

Lol! I have not started Cymbalta because even the generic brand was crazy exspensive! It was so high thr pharmacy just shook her head at me
90% of my pain is now damaged nerves from several back surgeries.
Rudiculopathy...both main nerves coming out of my back @ L-4,L-5 have collapsed. Giving me neurological foot pain in both feet. Probably like diabetic nerve pain, X10 ( I'm not diabetic). Yeah I'm thinking my dive days are numbered and not sure how much longer I can continue. But until then I am fully aware of my limitations. And there are some of those allready. I've come to a realization that commercial diving or tech diving, is not for me.
I see a hp 80 in my future!!!
And a dive sherpa (sp?) to haul my gear in and out of the water. Lol!

Already have that HP 80 for any long carry or shalllow dive....

Some of the older Tri-cyclics are dirt cheap and can be an easy first choice if the pain causes sleep issues also.

Cymbalta and the like (cue in smiling pretty female faces and butterflies)......If it's advertised on TV possibly the only thing you can guarantee is it's going to make someone very rich and you very poor. I know for a FACT that the drug companies will put out an inferior drug to supplant an effective one that is going off patent and promote it as though it'll cure damn near everything that ails you. Snake oil anyone?

Good point.

Trying hard not to respond about drug companies.

That was a rant this didn't markedly add to the discussion, except the part where the Dr. apparently thought of this as the first medication to try. I'm pretty suspicious of any physician that operates this way. They may have a very good reason. If so I'd want to hear it with support and justification.
OTOH, they may not be looking out for patient best interests as much as their own. There is pretty compelling evidence that new and ghastly expensive drugs may not have any advantage over older and less expensive medications. Sometimes they are actually worse.

This was not this docs first choice. We discussed other meds / anti- depressants that I have tried with no help with nerve pain.
Nortriptuline (sp?), Anitryptouline (sp?) and some other one I can't spell.
VA wont even supply this Cymbalta (or generic form of it) because of the cost.

I stand corrected.
For a patented drug there will be no generic form.

No, thankd for the info, it was a huge help!

What about inversion? I credit it to avoiding surgery back in 08.

As a fellow back injury person may I stick my nose in?

It appears no two back issues are the same. If the manner in which nerves are impinged varies only slightly symptoms and signs can be significantly different. Add to that physiology variance between people and finding The answer to pain can be frustratingly difficult. Each person is, in effect, a test diver.

That said, maybe my experience will be useful. I've found exercise, weights primarily, to be major league beneficial. I've also started Hatha Yoga with an instructor who is familiar with back issues. So far it has been beneficial.

At this moment I am free of all pain meds except an occasional NSAID for muscle discomfort. Actually I have been tantalizingly close to getting back in the water for some months. But walking with 60# on my back is still not up to par.

Hope this helps

Well, I tried to keep my fingers quiet. ... but couldn't do it. .. as usual.
B
Yoga and physical therapy worth professionals that understand backs in general and take the time to get to know your back in particular should be required. An amateur could really damage you. Cymbalta. .. while horribly expensive has a much lower side effect profile and less drug interactions... Depending on what else you're taking, cymbalta may have been the safest choice.

If you got relief from the back injections, it is possible to have the block done permanently. my husband had chronic, severe back pain for over 20 years of his life, when he finally let me take him to see it and interventional anesthesiologist and have an abating block done he was back pain free for the 7 years until he died.

I would encourage you to go see a pain practitioner that can do procedures and get another opinion.
.

Pilates can also be of help if you stick to it. Works way better for me than yoga. In line with what someone else said, all backs pain is different, and in my case, the stretchy-twisty without super focus on core/rehab makes me worse not better. (Pilates was designed around rehabbing bed-ridden soldiers if memory serves me but someone like Kathryn Arant could for sure explain it better)

Back to the original post: Fentanyl is a potent respiratory depressant, but it's dose dependent, so the key is to find the lowest dose that gives you acceptable pain control (not complete relief) with minimal respiratory depression. The drug WILL make you more tolerant of elevated CO2 levels while diving, which can lead to headaches or worse, markedly worsened narcosis at any given depth. I would keep diving depths conservative while using it, or switch to a helium mix at a shallower depth to decrease the nitrogen component of the narcosis. The drug also has some sedative properties, which are going to increase narcosis, although there is definite tolerance to this component of its action.

Back pain is really difficult, and cases like yours, where multiple operations have been done, are way too complex for anybody to manage on the internet. No one approach works for all comers, although increasing core strength and flexibility will help most patients. But if you have neuropathy from prior nerve damage, no amount of work on your back per se will relieve the neuropathic pain, and with the nerve stimulator and the antidepressants, it sounds as though that is the primary pain your practitioner is trying to control for you.

Good luck with it all. I live with a certain amount of back pain, just to do what I love to do, and it isn't fun -- but I'm sure it's nothing to yours.