Oxycodone related to codiene

Hey guys,
Many Reddit posts really helped me in the run up to my exam, so I want to tell you my story to ease anyone else's anxiety for their screening.
This is gonna be a long read so only read along if you're wanting every detail of this journey.
A few months ago I admitted myself to ED as I was having blood clots coming out in my stool. I have had many years of bleeding stool and hemorrhoid issues but this was the first time it had happened with blood clotting.
I was asked to stay overnight but before I left I asked for a referral for a colonoscopy so at least I went home with something moving forward.
It was in the public system so it was a few months until I could get an appointment but the run up to it I was frightened about mostly the results and the sedation.
This was in Australia so the sedation option is Midazolam and Fentanyl. It's a twilight sedation and something I've never experienced before.
In the two weeks running up to it, I expressed to my psychologist of my fears and she suggested asking my GP for quick action anxiety medication.
My GP prescribed me Diazapam and suggested I take it before I leave the house.
Fast forward to the day before. I stopped eating at 2pm and started my first PLENVU dose at 7pm. Initial bowel movements weren't so bad. Maybe went 6 times over the course of the night and it slowed down by midnight and I was able to get about 6 hours sleep.
I drank lemonade, apple juice, bone broth, sucked on Werther's originals and basically tried to keep belly full of sugar and liquids to stave off hunger.
Next morning I woke up at 7am, time for dose two. This one was much more intense when it came to bowel movements. I must have gone about over 10 times in the morning and twice more at the hospital. PLENVU isn't horrendous tasting. It's very salty and viscous but drunken cold with a straw and chasing it with lemonade, it was fine. I drank as much fluid as I could before I stopped all fluid intake at 10am. I think the worst part of the prep is not the hunger but the hours after 10am and before the procedure is the intensity of the thirst. I took my 5mg of Diazapam at 10am and this helped a lot with fighting back the anxiety and nerves.
I got to the hospital, checked in easily enough and was lucky they had a good system. I arrived at 12pm for a 1:30pm procedure.
Nurses were lovely and cannulated me with ease. I expressed my nerves and one of the assistant nurses explained I would be in a Twilight sleep on Midazolam and Fentanyl and depending on how my body reacts I could be aware of what's going on, could talk to them the whole time or go straight to sleep.
Turns out, I didn't go under basically at all. I was talking to them the whole time and they were holding my hand. I may have conked out for a second here or there with no memory but I basically watched the entire footage of the scope and at one point asked for more Midazolam as it hit a bit of a sore spot.
What a was 20-30 mins felt like 5 minutes. They then banded my hemorrhoids in the same procedure.
I didn't feel it initially but as soon as I got to recovery the pain of my bands set in but the nurse was so quick to check on my pain levels and what she initially gave as Panadol turned into Oxycodone and that helped a lot.
I'm back home now and my butt still hurts through the painkillers a bit but a banding isn't a part of every procedure but something that was given as an option to me during and I was more than happy to accept.
Turns out bleeding seems to be hemorrhoid related and that shouldn't be as big of an issue once I heal from the banding.
But yeah, I found the prep way more of a breeze than I thought and all I can say is if given the option of unsedated or sedated, choose sedation cos at least you have the option to ask for more pain relief if you remain conscious. Or if you're knocked out and propofol is your option, that would probably be even more pain free than my experience.
There really isn't much to fear and now my fear of going back to get another one is basically nil. Especially since the staff were so patient and friendly to me. They really made it everything so much smoother and calming.
I know this is a long read but I hope it helps someone heading into their upcoming procedure.

Hello
25F, 130lbs, 5’10”, no tobacco, MMJ user, hydrocodone and oxyxodone as needed, cyclobenzaprine, protonix
If you read this thank you so much because I’m absolutely desperate and my doctors are tired of me and I think they think I only want pain meds. I don’t, I just want to feel better. I have a huge stash of emergency oxycodone anyway so I barely even need them for that.
On 12/15 I fell down the stairs and hit the lower of my middle back quite hard. 12/19 I had a LEEP done, 01/06 I came down with extreme urinary issues and between then and now have been back 6 times, seen 4 specialists and have seen my PCP at least ten times for urine samples. I’ve also only been able to attend my full time job for 43 days so far this year and have no more money for copays and if it weren’t for my ADA paperwork, I’d have been fired a long time ago
Over the last two weeks, it’s been taking me up to two hours to produce urine while having a full (and very sore - mostly left side) bladder. This is infuriating. When I do end up finally feeling the need to release, I have less than 3 minutes to get to a restroom before my vision starts going spotty from the bladder pressure pain.
My urologist ordered a cystoscopy, but has been blaming my 3mm kidney stone until I begged for an ultrasound last month of my bladder. Found bladder wall thickening and bladder cyst / possible urachal remnant.
I found out what Cuada equina is today. I learned that it is very very commonly missed. I can barely walk, and at the music festival I went to over the weekend I had to use ADA for just about everything. I look completely normal so I got judged pretty hard, but I do have paperwork. I have been losing weight without much diet change and my back has been killing me as well. I feel so weak. My urine flow is so small compared to what it used to be. I had a period of time where the pain was so bad, I couldn’t feel my clitoris or labia at all so sex was pointless as well, and I thought I’d lose my relationship and be alone forever. They send me to an OB-Oncologist who said not to come back, which is why my urologist finally agreed to check my bladder.
Is it possible that all my issues are related to the cyst and thickening, or could this be cuada equina that was missed on multiple CT’s? I can’t find info on bladder cysts. using retention. When is the appropriate time to go to the hospital? I can barely walk without pain meds. I urinated about 40 times on Saturday, with my usual being 10-20 times, and some days there’s very little pain or urgency at all, but the retention is almost always there to some extent.
It almost feels like the part of my brain that controls my bladder doesn’t work anymore because no matter how hard I tell my bladder to release, it just doesn’t happen sometimes and I can’t get comfortable after that. I’ve slept a total of 4 hours since Saturday morning and I only have one hydrocodone left. Pyridium does NOTHING except for when burning pain presents, and I can’t take NSAIDS until my GI clears me due to extreme gas, constipation and bloating / belching thought to be caused by peptic ulcers. I can’t walk at this point without pain meds, but the ER always releases me with the same DX of cyst and bladder wall thickening and tells me they have no clue what that means. But I’m in so much pain I feel like there has to be something they can do other than give me fluids and monitor me for an hour or two until I can get to my cystoscopy next week.
If you have any advice for me I really appreciate it. I don’t want to die but I feel the only way out of lifelong urinary pain after 6 months now is suicide. The only time suicide doesn’t cross my mind a couple times is when I do end up having to take a pain pill. In March, I had to take oxy every day. I only take them now when I can’t walk because the effects are too strong for me to keep my life in order while taking them every day. But this weekend I have had the most trouble walking, and using the restroom, since all of these issues began.
I can’t afford any more specialists visits after my procedure, so I really wish the ER could do something for me as they’re the only ones who won’t turn me away for not having money at this point. My GI doc actually canceled my appointment because I don’t have $20 and I’ve been putting off another ultrasound because it’s $200 up front. IDK what to do but I’m pretty sure this is how a lot of people end up on fent and heroin - if I had been denied pain meds this far I would have turned to the streets, and that’s coming from someone who has chosen - on their own - to quit most drug related and extracurricular activities to better their life at a young age and is much happier for it.
I can’t even get the ER to catheterize me when I can’t urinate for 6+ hours at a time. What gives? Why won’t they run a different imaging test? They wouldn’t even give me a breath test for h pylori recently and now I’m waiting a month for an appointment I can’t even afford.
TL;DR extreme bladder pain, nobody understands why, extreme difficulty urinating, ER can’t do anything for me and awaiting surgery. Is there anything I can say or do to get proper medical attention or can the ER really not touch your bladder like they say? Is there a way I can convince them to admit me so I could see a urologist before my procedure? My urologist is unavailable until my follow-up and I don’t think the company they work for allows them to Rx narcotics and I’m against taking more than 1 oxycodone a week at this point but so far have been unsuccessful in getting something weaker like hydro or tramadol.

Title: Understanding Fentanyl: Uses, Risks, and Controversies
Introduction: Fentanyl, a potent synthetic opioid, has gained significant attention in recent years due to its role in the opioid epidemic. This article aims to provide a comprehensive overview of fentanyl, including its medical uses, associated risks, and the controversies surrounding its widespread misuse.
Medical Uses: Originally developed for managing severe pain, especially in cancer patients, fentanyl is an analgesic that is 50 to 100 times more potent than morphine. It is commonly used in medical settings for pain management during surgeries, chronic pain conditions, and palliative care.
Risk Factors: While fentanyl is effective in controlling pain when administered under medical supervision, its misuse poses serious health risks. The drug's high potency increases the likelihood of overdose, leading to respiratory depression and, in extreme cases, death. Illicitly manufactured fentanyl, often mixed with other substances, has been a major contributor to the rising number of opioid-related deaths.
Controversies and Illicit Use: The illicit use of fentanyl has sparked controversy and public health concerns. The drug is often clandestinely produced and added to other drugs, such as heroin or cocaine, without the user's knowledge. This has resulted in a surge in overdoses, as individuals may unintentionally consume lethal doses of the opioid.
Law Enforcement and Regulation: Governments and law enforcement agencies worldwide are grappling with the challenges posed by the illicit production and distribution of fentanyl. Efforts to regulate its manufacturing and distribution are ongoing, with stricter controls in place to prevent diversion into illegal channels.
Treatment and Harm Reduction: Addressing the fentanyl crisis requires a multi-faceted approach, including expanded access to addiction treatment, harm reduction strategies, and public awareness campaigns. Naloxone, an opioid receptor antagonist, has proven effective in reversing opioid overdoses and is increasingly available to first responders and the general public.
Conclusion: Fentanyl, with its remarkable pain-relieving properties, has become a double-edged sword in the realm of healthcare. While it serves a crucial role in medical settings, its misuse poses severe risks to public health. Efforts to combat the opioid epidemic must focus on education, regulation, and treatment to strike a balance between managing pain effectively and preventing the tragic consequences of its illicit use.
Narcan, also known by its generic name naloxone, is a medication used to rapidly reverse opioid overdose. It works by binding to the same receptors in the brain that opioids target, effectively reversing the life-threatening effects of opioid toxicity. Narcan is commonly administered in emergency situations where an individual is experiencing respiratory depression or unconsciousness due to opioid overdose.
Emergency responders, healthcare professionals, and even some non-professionals, such as family members of individuals at risk of opioid overdose, may carry naloxone. The medication is available in various forms, including nasal sprays and injectable formulations, making it accessible for different situations.
The prompt administration of Narcan can restore normal breathing and consciousness, providing crucial time for the affected person to receive further medical attention. It is an essential tool in harm reduction strategies aimed at preventing opioid-related deaths and is a key component of public health initiatives addressing the opioid epidemic.
Suboxone is a prescription medication used in the treatment of opioid dependence and addiction. It is a combination of two active ingredients: buprenorphine and naloxone.

Buprenorphine: This is a partial opioid agonist, meaning it binds to the same receptors in the brain that opioids bind to but with less intensity. It helps to reduce cravings and withdrawal symptoms, allowing individuals in recovery to better manage their addiction.
Naloxone: Naloxone is an opioid receptor antagonist, which means it blocks the effects of opioids. When taken as directed, naloxone remains largely inactive. However, if someone were to misuse Suboxone by injecting it, the naloxone component can counteract the opioid effects, reducing the risk of misuse.

Suboxone is often prescribed as part of medication-assisted treatment (MAT), a comprehensive approach to opioid addiction that includes counseling, therapy, and support services. It can be used in the detoxification phase as well as for long-term maintenance therapy. The goal of Suboxone treatment is to help individuals gradually reduce their dependence on opioids, manage cravings, and improve their overall quality of life during recovery.
It's important to note that Suboxone should only be used under the supervision of a qualified healthcare professional, as improper use or abrupt discontinuation can lead to withdrawal symptoms or other complications.
Precipitated withdrawal refers to the accelerated onset of withdrawal symptoms, often more severe than typical, when an opioid antagonist is introduced to the body. This occurs because the antagonist displaces the opioid from receptors, leading to a sudden and intense withdrawal reaction.
For example, if someone is currently dependent on opioids and receives a medication like naloxone or naltrexone, which are opioid antagonists, it can rapidly trigger withdrawal symptoms. This is a safety mechanism, as these medications are often used to reverse opioid overdose or as part of addiction treatment.
The term is commonly associated with medication-assisted treatment for opioid use disorder, where medications like buprenorphine (a partial opioid agonist) are used. If buprenorphine is administered before other full opioids have cleared from the system, it can displace those opioids from receptors, leading to precipitated withdrawal. This is why healthcare providers carefully time the initiation of medications like buprenorphine to avoid this intensified withdrawal reaction.
Understanding the potential for precipitated withdrawal is crucial in the context of addiction treatment to ensure safe and effective transitions between medications and to minimize discomfort for individuals in recovery.
Using Suboxone involves adherence to a specific treatment plan under the guidance of a qualified healthcare professional. Here are some key aspects related to the use of Suboxone:

Prescription and Medical Supervision: Suboxone is a prescription medication, and its use should be initiated and supervised by a qualified healthcare provider, typically in the context of medication-assisted treatment (MAT) for opioid use disorder.
Dosage: The healthcare provider will determine the appropriate dosage based on the individual's specific needs and response to the medication. It's essential to follow the prescribed dosage and not adjust it without consulting the healthcare provider.
Administration: Suboxone is often administered sublingually, meaning it is placed under the tongue and allowed to dissolve. This method allows for the absorption of the medication into the bloodstream.
Timing: The timing of Suboxone administration is crucial. It is often started when the individual is in a mild to moderate state of withdrawal to reduce the risk of precipitated withdrawal. The healthcare provider will provide guidance on the appropriate timing.
Regular Monitoring: During Suboxone treatment, individuals are regularly monitored by healthcare professionals to assess progress, manage side effects, and adjust the treatment plan as needed.
Counseling and Support: Suboxone is typically part of a comprehensive treatment plan that includes counseling, therapy, and support services. This holistic approach addresses both the physical and psychological aspects of opioid addiction.
Gradual Tapering: Depending on the treatment plan, there may be a gradual tapering of Suboxone dosage as the individual progresses in their recovery. Tapering is done under medical supervision to minimize withdrawal symptoms.
Avoiding Other Opioids: It's crucial to avoid the use of other opioids while taking Suboxone. Combining opioids can lead to dangerous interactions and diminish the effectiveness of the treatment.
Side Effects and Reporting: Like any medication, Suboxone may have side effects. Common side effects include headache, nausea, and constipation. Any unusual or severe side effects should be promptly reported to the healthcare provider.
Pregnancy Considerations: If an individual is pregnant or planning to become pregnant, it's important to discuss this with the healthcare provider, as the use of Suboxone during pregnancy requires careful consideration.

Always follow the guidance of your healthcare provider and inform them of any concerns or changes in your condition during Suboxone treatment. Successful recovery often involves a combination of medication, counseling, and support tailored to individual needs.
Suboxone, when used as prescribed under the supervision of a healthcare professional as part of medication-assisted treatment (MAT) for opioid use disorder, has a lower potential for abuse and addiction compared to full opioid agonists. This is because Suboxone contains buprenorphine, a partial opioid agonist, which has a ceiling effect on its opioid effects.
Buprenorphine's partial agonist properties mean that it activates opioid receptors in the brain to a lesser extent than full agonists like heroin or oxycodone. As a result, the euphoria and respiratory depression associated with opioid abuse are less pronounced with buprenorphine.
However, it's essential to emphasize that any medication, including Suboxone, should be taken exactly as prescribed by a healthcare professional. Misuse, such as taking larger doses or combining Suboxone with other substances, can increase the risk of dependence or addiction.
Abruptly stopping Suboxone can lead to withdrawal symptoms, emphasizing the importance of a gradual tapering plan under medical supervision when discontinuing the medication. It's crucial for individuals using Suboxone to work closely with their healthcare provider to ensure proper management of their opioid use disorder and to address any concerns or side effects during the course of treatment.
Withdrawal symptoms from Suboxone, or buprenorphine (the active ingredient in Suboxone), can occur when someone who has been using the medication for an extended period stops taking it abruptly. It's important to note that withdrawal symptoms can vary in intensity and duration based on factors such as the individual's overall health, the duration of Suboxone use, and the dosage.
Common withdrawal symptoms from Suboxone may include:

Nausea and vomiting
Diarrhea
Muscle aches and pains
Sweating
Insomnia or sleep disturbances
Anxiety
Irritability
Runny nose and teary eyes
Goosebumps (piloerection)
Dilated pupils

It's important to distinguish between withdrawal symptoms and precipitated withdrawal. Precipitated withdrawal can occur if someone takes Suboxone too soon after using a full opioid agonist, leading to a more rapid and intense onset of withdrawal symptoms.
Withdrawal from Suboxone is generally considered less severe than withdrawal from full opioid agonists, and the symptoms tend to peak within the first 72 hours after discontinuation. However, the duration and severity can vary from person to person.
If an individual is considering stopping Suboxone or adjusting their dosage, it's crucial to do so under the guidance of a healthcare professional. Tapering the medication gradually, rather than stopping abruptly, can help minimize withdrawal symptoms and increase the chances of a successful transition to recovery. Seeking support from healthcare providers, counselors, and support groups is essential during this process.
Kratom is a tropical tree native to Southeast Asia, specifically in countries like Thailand, Malaysia, Indonesia, Papua New Guinea, and Myanmar. The leaves of the Kratom tree have been traditionally used for various purposes, including as a stimulant, a pain reliever, and to manage opioid withdrawal symptoms.
The active compounds in Kratom, called alkaloids, interact with opioid receptors in the brain, producing effects that can vary depending on the strain and dosage. These effects can include:

Stimulation: At lower doses, Kratom may act as a stimulant, promoting increased energy, alertness, and sociability.
Sedation: At higher doses, Kratom may have sedative effects, leading to relaxation and pain relief.
Pain Relief: Kratom has been used traditionally for its analgesic properties, and some people use it as a natural remedy for pain.
Mood Enhancement: Some users report improved mood and reduced anxiety after consuming Kratom.

However, it's important to note that Kratom is not regulated by the U.S. Food and Drug Administration (FDA), and its safety and effectiveness for various uses have not been clinically proven. There are potential risks associated with Kratom use, including dependence, addiction, and adverse effects such as nausea, constipation, and increased heart rate.
Due to these concerns, Kratom has been a subject of regulatory scrutiny in various countries, with some regions imposing restrictions or outright bans on its sale and use. It is essential for individuals to exercise caution, seek reliable information, and consult with healthcare professionals before considering the use of Kratom, especially for medicinal purposes or to manage opioid withdrawal.
Methadone is a synthetic opioid medication used primarily in the treatment of opioid dependence, particularly in the context of medication-assisted treatment (MAT). It is a long-acting opioid agonist, meaning it activates the same opioid receptors in the brain that other opioids, like heroin or morphine, do.
Key points about Methadone include:

Opioid Dependence Treatment: Methadone is often used as a maintenance medication to help individuals reduce or quit the use of illicit opioids. It helps by reducing cravings and withdrawal symptoms.
Long-Lasting Effect: One significant advantage of methadone is its long duration of action. A single daily dose can help stabilize individuals, preventing the highs and lows associated with short-acting opioids.
Supervised Administration: In some cases, methadone is provided through supervised administration in specialized clinics to ensure proper use and minimize the risk of diversion.
Tolerance and Dependence: Like other opioids, individuals using methadone can develop tolerance and dependence. Therefore, the dosage needs to be carefully managed, and discontinuation should be done gradually under medical supervision.
Reduction of Illicit Drug Use: When used as part of a comprehensive treatment plan, methadone has been shown to reduce illicit opioid use, lower the risk of overdose, and improve overall health outcomes.
Potential Side Effects: Methadone can have side effects, including constipation, sweating, drowsiness, and changes in libido. It's important for individuals to report any adverse effects to their healthcare provider.
Regulated Use: The use of methadone is tightly regulated, and it is typically dispensed through specialized clinics or healthcare providers who are authorized to prescribe it for opioid use disorder treatment.

Methadone treatment is part of a broader approach that often includes counseling, therapy, and support services. It has been a valuable tool in harm reduction strategies aimed at addressing the opioid epidemic and helping individuals achieve and maintain recovery.
Narcotics Anonymous (NA) is a 12-step program that provides support for individuals recovering from addiction, particularly those struggling with substance abuse issues. It is important to note that NA, like other 12-step programs, does not have an official stance or opinion on specific medical treatments, including medication-assisted treatment (MAT) for withdrawal.
The approach to medication assistance in withdrawal can vary among individuals within the NA community. Some may find success and support in MAT, while others may choose alternative methods or prefer an abstinence-based approach. NA encourages individuals to share their experiences, strength, and hope, but it does not dictate specific treatment choices.
The primary focus of NA is on mutual support, fellowship, and following the 12-step principles, which include admitting powerlessness over addiction, seeking spiritual awakening, and helping others in recovery. Members of NA are encouraged to respect each other's choices and paths to recovery.
It's essential for individuals seeking support for addiction to find a treatment plan that aligns with their needs and values. Consulting with healthcare professionals, attending support groups, and considering various treatment options can be part of a comprehensive approach to recovery.
SMART Recovery (Self-Management and Recovery Training) is a science-based, secular alternative to traditional 12-step programs like Narcotics Anonymous. SMART Recovery emphasizes self-empowerment and utilizes evidence-based techniques to support individuals in overcoming addiction.
Regarding Medication-Assisted Treatment (MAT), SMART Recovery takes a neutral stance. The program acknowledges that MAT, when prescribed and monitored by healthcare professionals, can be a valid and effective part of a comprehensive approach to addiction treatment. SMART Recovery recognizes that different individuals may have unique needs, and treatment plans should be tailored to the individual's circumstances.
SMART Recovery's focus is on teaching self-reliance, coping skills, and strategies for managing urges and behaviors associated with addiction. The program encourages participants to make informed decisions about their recovery, including the consideration of medications that may be prescribed by healthcare providers.
Ultimately, SMART Recovery emphasizes a holistic and individualized approach to recovery, allowing participants to choose the methods and tools that best suit their needs and align with their values. This includes being open to the potential benefits of MAT for some individuals as part of their overall recovery plan.
Several treatment modalities are available for individuals struggling with opioid use disorder. The most effective approach often involves a combination of different strategies. Here are some key treatment modalities for opioid addiction:

Medication-Assisted Treatment (MAT): MAT involves the use of medications, such as methadone, buprenorphine (Suboxone), and naltrexone, to help manage cravings, reduce withdrawal symptoms, and support recovery. These medications are often used in combination with counseling and therapy.
Counseling and Behavioral Therapies: Various forms of counseling and behavioral therapies are crucial components of opioid addiction treatment. Cognitive-behavioral therapy (CBT), contingency management, motivational enhancement therapy, and dialectical behavior therapy (DBT) are among the approaches used to address the psychological aspects of addiction and help individuals develop coping skills.
Support Groups and 12-Step Programs: Participating in support groups like Narcotics Anonymous (NA) or 12-step programs can provide valuable peer support, encouragement, and a sense of community for individuals in recovery.
Detoxification Programs: Medically supervised detoxification programs help individuals safely manage the acute withdrawal symptoms associated with stopping opioid use. These programs often serve as the initial phase of treatment.
Residential or Inpatient Treatment: Inpatient treatment programs provide a structured and supportive environment for individuals to focus on recovery. These programs may include a combination of medical supervision, counseling, and therapeutic activities.
Outpatient Treatment: Outpatient programs allow individuals to receive treatment while living at home. This flexibility can be beneficial for those with work or family commitments. Outpatient treatment often includes counseling, therapy, and medication management.
Holistic and Alternative Therapies: Some individuals find benefit from holistic approaches, such as acupuncture, yoga, meditation, or mindfulness practices. These can complement traditional treatment modalities and contribute to overall well-being.
Peer Recovery Support Services: Peer recovery support services involve individuals with lived experience in recovery providing support, guidance, and encouragement to others going through similar challenges.

The most effective treatment plans are often individualized, taking into account the specific needs, preferences, and circumstances of each person. Collaborating with healthcare professionals to develop a comprehensive and tailored approach can significantly enhance the chances of successful recovery from opioid addiction.
The withdrawal timeline for fentanyl, a potent synthetic opioid, can vary among individuals based on factors such as the duration and intensity of use, individual metabolism, and overall health. Fentanyl withdrawal symptoms typically start shortly after the last dose and follow a general timeline:

Early Symptoms (Within a few hours): Early withdrawal symptoms may include anxiety, restlessness, sweating, and increased heart rate. Individuals may also experience muscle aches and insomnia.
Peak Intensity (24-72 hours): Withdrawal symptoms usually peak within the first 24 to 72 hours after discontinuing fentanyl. During this time, individuals may experience more intense symptoms such as nausea, vomiting, diarrhea, abdominal cramps, dilated pupils, and flu-like symptoms.
Subsiding Symptoms (5-7 days): The most acute withdrawal symptoms generally begin to subside within about five to seven days. However, some symptoms, such as insomnia, anxiety, and mood swings, may persist for a more extended period.
Post-Acute Withdrawal Syndrome (PAWS): Some individuals may experience a more prolonged period of withdrawal symptoms known as post-acute withdrawal syndrome (PAWS). This can include lingering psychological symptoms such as anxiety, depression, irritability, and difficulty concentrating. PAWS can persist for weeks or even months.

It's crucial to note that fentanyl withdrawal can be challenging, and seeking professional help is recommended to manage symptoms safely and effectively. Medical supervision can provide support through the detoxification process, and healthcare professionals may use medications to alleviate specific withdrawal symptoms and improve the overall comfort of the individual.
The withdrawal process is highly individual, and some individuals may find additional support through counseling, therapy, and participation in support groups to address the psychological aspects of recovery. Always consult with healthcare professionals for guidance on the safest and most effective approach to fentanyl withdrawal.
Xylazine is a veterinary sedative and analgesic medication. It belongs to the class of drugs known as alpha-2 adrenergic agonists. While it is primarily intended for veterinary use, xylazine has been misused in some cases for recreational purposes, particularly in combination with other substances.
In veterinary medicine, xylazine is commonly used as a sedative and muscle relaxant for various procedures, including surgery and diagnostic imaging. It is often administered to calm and immobilize animals.
However, the use of xylazine outside of veterinary settings, especially when combined with other drugs, can pose serious health risks. Misuse of xylazine has been associated with adverse effects, including respiratory depression, cardiovascular issues, and central nervous system depression.
It's important to emphasize that the use of xylazine for recreational purposes is highly dangerous and illegal. The drug is not intended for human consumption, and its effects can be unpredictable and potentially life-threatening.
If you have concerns about substance use or encounter situations involving illicit drugs, it is crucial to seek help from healthcare professionals, addiction specialists, or local support services. Misuse of veterinary drugs or any substances not prescribed for human use can have severe consequences and should be avoided.
PAWS stands for Post-Acute Withdrawal Syndrome. It refers to a set of prolonged withdrawal symptoms that some individuals may experience after the acute phase of withdrawal from substances like opioids, benzodiazepines, or alcohol. PAWS is not limited to a specific substance and can occur with various drugs.
These symptoms are generally more subtle than the acute withdrawal symptoms but can persist for weeks, months, or, in some cases, years after discontinuing substance use. PAWS can vary widely among individuals and may include symptoms such as:

Mood swings
Anxiety
Irritability
Insomnia
Fatigue
Difficulty concentrating
Memory problems
Reduced impulse control
Cravings for the substance

PAWS can be challenging for individuals in recovery, as these lingering symptoms may contribute to relapse if not effectively managed. Supportive interventions, such as counseling, therapy, and participation in support groups, can be beneficial for individuals experiencing PAWS. Healthy lifestyle choices, including regular exercise, proper nutrition, and adequate sleep, may also contribute to the overall well-being of those in recovery.
It's important to note that PAWS is not experienced by everyone in recovery, and its severity and duration can vary. Seeking guidance from healthcare professionals or addiction specialists can assist individuals in managing PAWS and maintaining long-term recovery.
Quitting substance use "cold turkey" involves stopping the use of a substance abruptly without tapering or gradually reducing the dosage. It's important to note that quitting cold turkey can be challenging, and the level of difficulty varies depending on the substance, the duration and intensity of use, and individual factors.
If you're considering quitting a substance cold turkey, here are some general recommendations:

Seek Professional Guidance: Before making the decision to quit cold turkey, it's advisable to consult with a healthcare professional or addiction specialist. They can provide guidance based on your specific situation, assess potential risks, and offer support.
Create a Support System: Inform friends, family, or a support network about your decision to quit. Having a support system in place can provide encouragement, understanding, and assistance during challenging times.
Understand Withdrawal Symptoms: Be aware of potential withdrawal symptoms associated with quitting the substance cold turkey. Withdrawal symptoms can vary depending on the substance but may include anxiety, irritability, insomnia, and other physical or psychological effects.
Stay Hydrated and Nourished: Maintaining proper hydration and nutrition is crucial during the quitting process. Stay hydrated by drinking water and consuming a balanced diet to support your overall well-being.
Exercise: Engage in regular physical activity. Exercise can help alleviate stress, improve mood, and contribute to your overall physical and mental health.
Consider Professional Treatment: Depending on the substance and the severity of dependence, professional treatment options, such as inpatient or outpatient programs, may be beneficial. Medical supervision can assist in managing withdrawal symptoms and ensuring safety.
Therapy and Counseling: Consider participating in therapy or counseling to address the underlying factors contributing to substance use and to develop coping strategies for a successful recovery.
Plan for Triggers: Identify situations, environments, or emotions that may trigger the urge to use the substance. Develop a plan to cope with these triggers without resorting to substance use.

It's essential to approach quitting any substance with a comprehensive strategy, and individual circumstances vary. Seeking professional advice ensures that you make informed decisions about the best approach for your specific situation. If you are experiencing severe withdrawal symptoms or have concerns about quitting cold turkey, it is crucial to consult with a healthcare professional for guidance and support.
Tapering refers to the gradual reduction of the dosage of a substance, typically a medication or a drug, over a specific period. Tapering is commonly used in the context of addiction treatment, where it involves slowly decreasing the amount of a substance to manage withdrawal symptoms and minimize the risks associated with abrupt discontinuation.
Key points about tapering include:

Medication-Assisted Treatment (MAT): Tapering is often part of medication-assisted treatment for substance use disorders. For example, individuals dependent on opioids might undergo a gradual tapering of medications like methadone or buprenorphine.
Reducing Dependence: Tapering is employed to reduce physical dependence on a substance by allowing the body to adjust to lower levels gradually. This helps minimize the severity of withdrawal symptoms.
Individualized Approach: Tapering plans are typically individualized based on factors such as the substance used, the duration and intensity of use, and the individual's overall health. Healthcare professionals design tapering schedules to meet the specific needs of each person.
Supervised Tapering: Tapering is ideally done under the supervision of a healthcare professional to ensure safety and effectiveness. This is particularly important in cases where abrupt discontinuation could lead to severe withdrawal symptoms or complications.
Psychological Support: Tapering is not only about physical adjustments but also addresses psychological aspects of dependence. It provides individuals with an opportunity to develop coping skills and strategies for managing life without reliance on the substance.
Preventing Relapse: Gradual tapering can help reduce the risk of relapse by easing the transition to complete abstinence. It gives individuals the time and support needed to adjust to life without the substance.

Tapering is a careful and structured process that should be guided by healthcare professionals. Abruptly stopping certain substances can lead to severe withdrawal symptoms and potential health risks. Seeking professional advice and support is crucial for a safe and successful tapering process, whether it's part of addiction treatment or the discontinuation of a prescribed medication.
Engaging in activities during withdrawal can help distract from symptoms, provide a sense of accomplishment, and contribute to overall well-being. Here are some ideas for keeping busy during withdrawal:

Reading: Escape into a good book or explore topics of interest to keep your mind occupied.
Movies or TV Shows: Watch movies or binge-watch a TV series to pass the time. Choose lighthearted or inspirational content.
Exercise: Engage in gentle exercises like walking, yoga, or stretching. Exercise can help improve mood and alleviate some withdrawal symptoms.
Creative Hobbies: Explore creative outlets such as drawing, painting, writing, or playing a musical instrument.
Mindfulness and Meditation: Practice mindfulness or meditation techniques to calm the mind and reduce stress.
Gardening: Spend time outdoors, tending to a garden or plants. Nature can have a positive impact on mood.
Puzzle Games: Solve puzzles, play Sudoku, or engage in other mentally stimulating games.
Listening to Music or Podcasts: Create playlists of your favorite music or listen to podcasts on topics of interest.
Cooking or Baking: Experiment with new recipes and treat yourself to nourishing meals.
Journaling: Write down your thoughts and feelings. Keeping a journal can be therapeutic during withdrawal.
Educational Courses: Take online courses or watch educational videos on platforms like Coursera or Khan Academy.
Board Games or Card Games: Play board games or cards with friends or family for some social interaction.
Self-Care Activities: Take relaxing baths, practice skincare routines, or indulge in other self-care activities to nurture your well-being.
Volunteering: If possible, consider volunteering for a cause you're passionate about. Helping others can be rewarding.
Stay Connected: Reach out to friends and family for support. Having a support system is crucial during withdrawal.

It's important to choose activities that align with your interests and energy levels. Remember that withdrawal is a challenging time, and it's okay to prioritize self-care. If symptoms become severe or unmanageable, seeking professional help is recommended.

I want to start by saying i am not being a baby (which is what my first FEMALE doctor called me when i expressed how painful my periods are)
I’m a semi pro boxer and have been through many abdominal injuries which do not compare to the pain i feel during my period. (broken ribs, appendicitis, bowel and pelvic inflammation)
I was tested and cleared for not having endometriosis. thrice.
I take multiple pain relief medications for my period pain but nothing, and i mean NOTHING has made the pain lessen. not even a small amount. not even oxycodone, which normally works well for pain related injuries that I come across.
When on my period the pain is horrible. terrible. it started a couple years or so after my first period. I cry, pass out randomly, (even during work which isn’t great) cannot walk without being hunched over.. and vomit about five to ten times a day every time i’m on my period. i guess i’m just lucky it only lasts 4 days. My period was never this painful the first 1-4 years i was having it but as of the last 3 or so it’s been just unbearably painful. my family, coaches and boyfriend knows it can’t be normal because i’m pretty much notorious for having a very high pain tolerance.
what could this be?? I need help.

Edit: (5-8-24 4:55) Sorry I haven't been super on top of updating you all. I have a doctors appointment with my primary care provider to have some tests run. Just to cover my bases, just in case it is something from our environment and not done super rare metabolic disorder manifesting in my husband now as an adult. He's gotten a few more tests, and they also did a liver biopsy. I will post them now. We haven't gotten the results back from the liver biopsy yet.
IR liver biopsy
Collected on May 8, 2024 3:35 PM
COMPREHENSIVE METABOLIC PANEL Collected on May 8, 2024 2:33 AM Results
Sodium View trends Normal range: 137 - 145 mmol/L Your value is 141 mmol/LNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 4.1 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 114 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 20 mmol/LThis value is LowNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 117 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 23 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 0.96 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 106 Your value is 106 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of >/= 90 is categorized as normal or high, which corresponds to Stage G1 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of >/= 90 is categorized as normal or high, which corresponds to Stage G1 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 BUN/Creatinine Ratio View trends Normal range: 6 - 22 RATIO Your value is 24 RATIOThis value is HighNormal range 6 - 22 RATIO ALT View trends Normal value: <50 U/L Value 23 Your value is 23 U/LNormal value <50 U/L AST View trends Normal range: 17 - 59 U/L Your value is 18 U/LNormal range 17 - 59 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 100 U/LNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.3 mg/dLNormal range 0.2 - 1.3 mg/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL Your value is 6.9 g/dLNormal range 6.3 - 8.2 g/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 3.8 g/dLNormal range 3.5 - 5.0 g/dL Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 8.6 mg/dLNormal range 8.4 - 10.2 mg/dL Globulin, Total View trends Normal range: 1.9 - 3.7 g/dL Your value is 3.1 g/dLNormal range 1.9 - 3.7 g/dL Albumin/Globulin Ratio View trends Normal range: 1.0 - 2.5 RATIO Your value is 1.2 RATIONormal range 1.0 - 2.5 RATIO Anion Gap View trends Normal range: 7 - 17 mmol/L Your value is 7 mmol/LNormal range 7 - 17 mmol/L Want more information about CAMMONIA Collected on May 8, 2024 2:33 AM Results
Ammonia View trends Normal range: 9 - 30 umol/L Your value is 120 umol/LThis value is HighNormal range 9 - 30 umol/L
THESE ARE ADDITIONAL TESTS I POSTED IN A COMMENT YESTERDAY. I WILL ADD THEM HERE FOR SIMPLICITY.
We've gotten back a few more tests, just in case anyone is interested.
CT liver multiphase w/iv contrast Collected on May 7, 2024 1:55 PM Results EXAM: CT THREE PHASE LIVER
INDICATION: evaluate liver function
Tech Comments: No additional history
TECHNIQUE: Low dose, multi-channel computerized tomography of the abdomen was performed with IV contrast according to the triple phase liver protocol. Multiplanar reformats were reviewed.
COMPARISON: CT chest abdomen and pelvis, 05/05/2024
FINDINGS: LOWER CHEST: Lung bases are clear. No acute findings.
LIVER: Normal morphology. No suspicious hepatic lesion.
BILIARY: No CT evidence of gallbladder abnormality. No bile duct dilatation.
PANCREAS: No evidence of mass or inflammation.
SPLEEN: Unremarkable.
ADRENALS AND KIDNEYS: Adrenal glands are normal. No suspicious renal masses. Normal enhancement bilaterally. Severe bilateral hydroureteronephrosis, similar to prior with significant thinning of the renal cortex.
GASTROINTESTINAL: Visualized bowel shows no abnormal wall thickening or obstruction.
VASCULAR: Abdominal aorta is normal in caliber. The portal venous system is patent.
LYMPH NODES: No pathologically enlarged lymph nodes.
PERITONEUM: No free air or ascites.
BODY WALL AND SOFT TISSUES: Unremarkable.
BONES: No acute or suspicious abnormality.
IMPRESSION: 1. Normal morphology of the liver. 2. Redemonstration of severe hydronephrosis bilaterally with renal cortical thinning.
Collected on May 7, 2024 2:43 PM Results
Prothrombin Time View trends Normal range: 8.8 - 11.7 s Your value is 10.9 sNormal range 8.8 - 11.7 s INR View trends Normal value: <1.14 RATIO Value 1.02 Your value is 1.02 RATIONormal value <1.14 RATIO INR View trends Normal value: <1.14 RATIO
BLOOD GAS VENOUS Collected on May 7, 2024 2:43 PM Results
pH, Ven View trends Normal range: 7.32 - 7.41 Your value is 7.43 This value is HighNormal range 7.32 - 7.41 pCO2, Ven View trends Normal range: 41 - 54 mm Hg Your value is 33 mm HgThis value is LowNormal range 41 - 54 mm Hg pO2, Ven View trends Normal range: 25 - 43 mm Hg Your value is 62 mm HgThis value is HighNormal range 25 - 43 mm Hg Bicarbonate View trends Normal range: 21 - 28 mmol/L Your value is 21 mmol/LNormal range 21 - 28 mmol/L Base Deficit (-) View trends Normal range: 0 - 3 Your value is 3 Normal range 0 - 3 O2 Saturation,Venous View trends Normal range: 60 - 85 % Your value is 92 %This value is HighNormal range 60 - 85 % O2 Intake View trends Value ROOM AIR Your value is ROOM AIR
Patient is 34, male. History of polycystic kidney disease, takes lisinopril 20mg daily for high blood pressure related to the pkd. Lactulose 40mg 3x day. Just began taking this 2 days ago. No other meds or drugs. 6'0, 200 lbs. He's a little over weight, but otherwise active and healthy.
My husband came home late Friday and was acting strange. I would ask him a question and he would just stare at me blankly instead of answering. As the night wore on I noticed his symptoms becoming more and more apparent. He was very tired, when spoken to he would either stare at you blankly, answer in one word answers or reply something totally unrelated to the question asked. He was very lethargic and dazed. His eyes were glassy and blood shot. I took him to the emergency room where he continued to get worse. He began to stare blankly all the time, he couldn't tell you what he did yesterday, he couldn't tell you where he was. From my uneducated view, he seemed to be exhibiting stroke like symptoms. The first hospital did a bunch of tests, everything came back fine. They sent us home. I wasn't satisfied so I took him to another hospital. The er did more tests, all came back within normal limits from my memory. They advised that he was having a psychological meltdown and to contact a shrink. The next morning he was almost absolutely comatose, so I took him to the er again. This time we had a PA who was willing to dig. They ended up finding that his ammonia levels were 203, when normal limits are between 9 and 30. We've been two and a half days. Poison control was contacted, they ran their own tests and couldn't find the culprit as his liver is functioning normally, and his kidneys aren't great, but they wouldn't be the cause either. I will post all the tests and there results below. I'll also post all the meds he's been given.
The whole staff at this hospital is stumped, they're all of the opinion that this might something he came into contact with, and not a product of his own body. As in they believe he has been compromised by something in our environment, but they're unable to find the culprit of the symptoms. They've had him on 40mg lactulose 3x a day and at their last test of his ammonia levels he is down to 120. At that level he is alert and conscious, but still pretty slow. As if he hasn't slept well in days and had a few beers on top.
Also, I have an obsessive stalker. I am not trying to fear monger by bringing that up, but that fact and then his sudden and intense onset of symptoms has me concerned. I have informed the hospital police about the situation. I believe our city police were also contacted when they contacted poison control. It might not be relevant, but it's better to mention it.
Here's a few short videos I took of his behavior.
https://imgur.com/gallery/WEjW3D9
His labs:
May 4th
Alcohol Bld Medical View trends Normal value: <10 mg/dL Value <10
COMPREHENSIVE METABOLIC PANEL Sodium: 147 Potassium 4.0 Chloride 115 C02 20 Glucose 111 BUN 29 Creatinine 1.04 eGFR 97 BUN/Creatinine ratio 28 ALT 44 AST 32 Alkaline Phosphatase 123 Bilirubin 0.5 Protein total 8.0 Albumin blood 4.6 Calcium 9.5 Globulin total 3.4 Albumin/Globulin ratio 1.4 Anion gap 12
CBC WITH DIFFERENTIAL
WBC 6.5 RBC 5.27 Hemoglobin 14.6 Hematocrit 43.5 MCV 82.5 MCH 27.7 MCHC 33.6 RDW 14.6 Platelets 311 MPV 9.0 Diff Method Electronic wbc differential cont Segs relative 58 Lymphocytes 30 Monocyte 9 Eosinophils 2 Basophils 1 Absolute Lymphocytes 1.95 Absolute Eosinophils 0.14 Absolute Basophils 0.03
MRI BRAIN WITH AND WITHOUT CONTRAST
INDICATION: ams, evaluate for stroke, intracranial infection
Tech Comments: AMS
TECHNIQUE: Multiplanar multisequence magnetic resonance imaging of the brain was performed with and without IV contrast.
COMPARISON: 05/03/2024.
FINDINGS: VENTRICLES AND CISTERNAL SPACES: The ventricular system and subarachnoid spaces are within acceptable limits for the patient's age.
CEREBRAL AND CEREBELLAR PARENCHYMA: There is no extra-axial fluid collection or hemorrhage. There is no mass effect or midline shift. No abnormal parenchymal gradient susceptibility signal. No diffusion restriction to suggest acute ischemia/infarct. There is no abnormal signal intensity or enhancement. The brainstem is normal in size and configuration. No abnormal signal alterations are present. The cerebellar hemispheres, vermis and tonsils are normal in size and configuration.
PITUITARY GLAND: The pituitary appears grossly unremarkable. Infundibulum is midline.
ARTERIAL FLOW VOIDS: The flow voids in the vertebrobasilar and internal carotid arterial systems are grossly normal.
DURAL VENOUS SINUSES: The dural venous sinuses appear patent.
CALVARIUM, SKULL BASE: The calvarium and skull base appear within normal limits.
PARANASAL SINUSES AND MASTOIDS: No fluid signal is identified within the paranasal sinuses or mastoids.
MISCELLANEOUS FINDINGS: None.
PROTIME-INR
Prothrombin Time View trends Normal range: 8.8 - 11.7 s Your value is 11.4 sNormal range 8.8 - 11.7 s INR View trends Normal value: <1.14 RATIO Value 1.07 Your value is 1.07 RATIONormal value <1.14 RATIO INR View trends Normal value: <1.14 RATIO
HEPATIC FUNCTION PANEL
AST View trends Normal range: 17 - 59 U/L Your value is 26 U/LNormal range 17 - 59 U/L ALT View trends Normal value: <50 U/L Value 45 Your value is 45 U/LNormal value <50 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 132 U/LThis value is HighNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.7 mg/dLNormal range 0.2 - 1.3 mg/dL Bilirubin, Direct View trends Normal range: 0.1 - 0.5 mg/dL Your value is 0.2 mg/dLNormal range 0.1 - 0.5 mg/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 4.5 g/dLNormal range 3.5 - 5.0 g/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL
C-REACTIVE PROTEIN CRP 0.7
SEDIMENTATION RATE, AUTOMATED
SED RATE 19
(Second Metabolic Panal) BASIC METABOLIC PANEL Collected on May 4, 2024 8:10 PM Sodium View trends Normal range: 137 - 145 mmol/L Your value is 145 mmol/LNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 3.7 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 111 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 21 mmol/LThis value is LowNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 108 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 32 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 1.17 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 84 Your value is 84 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 9.6 mg/dLNormal range 8.4 - 10.2 mg/dL Anion Gap View trends Normal range: 7 - 17 mmol/L
(Second cbc)
CBC WITH DIFFERENTIAL May 4, 2024 8:10 PM
E County Line Rd Indpls, IN 46227Testing by Quest Diagnostics 1402 E County Line Rd Indpls, IN 46227 WBC View trends Normal range: 3.3 - 10.5 K/CUMM Your value is 11.3 K/CUMMThis value is HighNormal range 3.3 - 10.5 K/CUMM WBC Result Comment View trends Normal range: 3.3 - 10.5 K/CUMM Value
Difference from previous result noted. Specimen appearance and label verified. High Your value is Difference from previous result noted. Specimen appearance and label verified. K/CUMMThis value is HighNormal range 3.3 - 10.5 K/CUMM RBC View trends Normal range: 4.15 - 5.75 M/CUMM Your value is 5.51 M/CUMMNormal range 4.15 - 5.75 M/CUMM Hemoglobin View trends Normal range: 12.8 - 16.9 g/dL Your value is 15.3 g/dLNormal range 12.8 - 16.9 g/dL Hematocrit View trends Normal range: 38.8 - 50.2 % Your value is 45.4 %Normal range 38.8 - 50.2 % MCV View trends Normal range: 80.0 - 100.0 fL Your value is 82.4 fLNormal range 80.0 - 100.0 fL MCH View trends Normal range: 27.0 - 34.0 pg Your value is 27.8 pgNormal range 27.0 - 34.0 pg MCHC View trends Normal range: 30.5 - 34.5 g/dL Your value is 33.7 g/dLNormal range 30.5 - 34.5 g/dL RDW View trends Normal range: 11.5 - 15.0 % Your value is 14.6 %Normal range 11.5 - 15.0 % Platelets View trends Normal range: 150 - 450 K/CUMM Your value is 326 K/CUMMNormal range 150 - 450 K/CUMM MPV View trends Normal range: 7.7 - 12.2 fL Your value is 9.5 fLNormal range 7.7 - 12.2 fL Diff Method View trends Value Electronic WBC differential count Your value is Electronic WBC differential count Segs Relative View trends % Value 73 Your value is 73 % Lymphocytes View trends % Value 17 Your value is 17 % Monocyte View trends % Value 9 Your value is 9 % Eosinophils View trends % Value 1 Your value is 1 % Basophils View trends % Value 0 Your value is 0 % Absolute Neutrophils View trends Normal range: 1.30 - 6.00 K/CUMM Your value is 8.20 K/CUMMThis value is HighNormal range 1.30 - 6.00 K/CUMM ABSOLUTE LYMPHOCYTES View trends Normal range: 1.00 - 3.50 K/CUMM Your value is 1.92 K/CUMMNormal range 1.00 - 3.50 K/CUMM Absolute Monocytes View trends Normal range: 0.00 - 1.00 K/CUMM Your value is 0.99 K/CUMMNormal range 0.00 - 1.00 K/CUMM ABSOLUTE EOSINOPHILS View trends Normal range: 0.00 - 0.70 K/CUMM Your value is 0.14 K/CUMMNormal range 0.00 - 0.70 K/CUMM ABSOLUTE BASOPHILS View trends Normal range: 0.00 - 0.10 K/CUMM Your value is 0.05 K/CUMMNormal range 0.00 - 0.10 K/CUMM
AMMONIA 203 May 4, 2024 9:40 PM
Lactic Acid 0.8 May 4, 2024 9:40 PM
RESPIRATORY PANEL PCR Collected on May 4, 2024 9:42 PM Misc Source View trends Value NASOPHARYNX Your value is NASOPHARYNX Adenovirus DNA View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus 229E View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus HKU1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus NL63 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus OC43 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED SARS COVID 2 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED METAPNEUMOVIRUS View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Human Rhinovirus / Entovirus View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED INFLUENZA A View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A H1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A H3 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A,H1N1 '09 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED INFLUENZA B View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 2 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 3 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Parainfluenza Virus 4 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED RSV RNA, QUALITATIVE PCR View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Bordetella Parapertussis View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Bordetella Pertussis View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Chlamydophilia Pneuminae View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Mycoplasma Pneumoniae View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Mycoplasma Pneumoniae Comment View trends Normal value: NOT DETECTED Value
IP CARBOCYHEMOGLOBIN Collected on May 4, 2024 10:10 PM Carboxyhemoglobin View trends Normal range: 0.0 - 1.5 % Value <1.5 Your value is <1.5 %Normal range 0.0 - 1.5 %
IP TSH WITH FT4 REFLEX Collected on May 4, 2024 10:10 PM TSH W/REFLEX TO FT4 View trends Normal range: 0.40 - 4.50 mIU/L Your value is 1.00 mIU/LNormal range 0.40 - 4.50 mIU/L TSH W/REFLEX TO FT4 View trends Normal range: 0.40 - 4.50 mIU/L
IP CPK Collected on May 4, 2024 10:46 PM CPK 52
SALICYLATE LEVEL Collected on May 4, 2024 10:46 PM
Salicylate Lvl View trends Normal value: <20.0 mg/dL Value <1.0
DICTATED DATE: 05/05/2024 12:22pm TRANSCRIBED DATE: 05/05/2024 01:06pm/modl SOUTH
PATIENT NAME: HEALTH RECORD NUMBER: BILLING NUMBER: DATE OF BIRTH:
DATE OF PROCEDURE: 05/05/2024
CLINICAL SUMMARY: Altered mental status of uncertain etiology in the setting of serum ammonia elevation. Please assess for possible epileptic activity.
TECHNICAL SUMMARY: International 10/20 electrode placement was performed in this portable digital EEG. The background activity shows a poorly regulated intermixture of predominantly delta range activity. This activity is triphasic in nature without localizing or focal features. No significant stay changes were seen. Amplitude did vary at times.
Photic stimulation resulted in no change.
Sleep was not recorded.
Hyperventilation is contraindicated.
IMPRESSION: This EEG is abnormal with evidence of nearly continuous triphasic waves. These are highly compatible with a hepatic encephalopathy. There is no evidence of seizure activity and there is no asymmetry to suggest a structural process
PROCALCITONIN. May 5, 2024 1:25 AM
Procalcitonin View trends Normal value: <0.08 ng/mL Value 0.07
IP ACUTE HEPATITIS PANEL Collected on May 5, 2024 1:25 AM Results
Hep A IgM View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hep A IgM View trends Normal value: NON REACTIVE Value NON REACTIVE
Hepatitis B Surface Ag View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hepatitis B Surface Ag Comment View trends Normal value: NON REACTIVE Value NON REACTIVE
Anti-HCV View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Anti-HCV View trends Normal value: NON REACTIVE Value (NOTE)
HCV antibody was non-reactive. There is no laboratory evidence of HCV infection. Normal value NON REACTIVE Hep B core Ab, IgM View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hep B core Ab, IgM View trends Normal value: NON REACTIVE
URINALYSIS, CULTURE IF INDICATED Collected on May 5, 2024 1:37 AM
Glucose Urine View trends Normal value: NEGATIVE mg/dL Value NEGATIVE Your value is NEGATIVE mg/dLNormal value NEGATIVE mg/dL Ketones, UA View trends Normal value: NEGATIVE mg/dL Value NEGATIVE Your value is NEGATIVE mg/dLNormal value NEGATIVE mg/dL Specific Gravity Ur View trends Normal range: 1.003 - 1.030 Your value is 1.009 Normal range 1.003 - 1.030 Occult Blood Urine View trends Normal value: NEGATIVE Value MODERATEAbnormal Your value is MODERATE This value is AbnormalNormal value NEGATIVE pH, UA View trends Normal range: 4.5 - 8.0 Your value is 8.0 Normal range 4.5 - 8.0 Protein, UA View trends Normal value: NEGATIVE mg/dL Value 30Abnormal Your value is 30 mg/dLThis value is AbnormalNormal value NEGATIVE mg/dL U Nitrites View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Leukocytes, UA View trends Normal value: NEGATIVE Value TRACEAbnormal Your value is TRACE This value is AbnormalNormal value NEGATIVE Color Urine View trends Normal value: YELLOW Value YELLOW Your value is YELLOW Normal value YELLOW APPEARANCE URINE View trends Normal value: CLEAR Value CLEAR Your value is CLEAR Normal value CLEAR WBC, UA View trends Normal range: 0 - 5 /HPF Value 11-20Abnormal Your value is 11-20 /HPFThis value is AbnormalNormal range 0 - 5 /HPF Epi Cell-Ur View trends Normal range: 0 - 5 /HPF Value 0-5 Your value is 0-5 /HPFNormal range 0 - 5 /HPF RBC, UA View trends Normal range: 0 - 3 /HPF Value 4-10Abnormal Your value is 4-10 /HPFThis value is AbnormalNormal range 0 - 3 /HPF Urine Comment Micro View trends
No Collected on May 5, 2024 1:37 AM
(note: not sure why it says no)
Cannabinoids View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Phencyclidine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Cocaine Random View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Methamphetamines View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Opiates View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Amphetamines, Urine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Benzodiazepines View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Trycyclic Antidepressants View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Methadone Metab View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Barbiturates, Urine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Oxycodone, Urine View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Buprenorphine, Urine View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Result Comment View trends Normal value: NEGATIVE
AMMONIA Collected on May 5, 2024 4:56 AM
Ammonia 134
Normal range: 9 - 30 umol/L
ETHYLENE GLYCOL Collected on May 5, 2024 12:42 PM Lab tests - Blood
Ethylene Glycol Lvl View trends mg/dL Value <10
Reference range: Negative [<10 mg/dL]
VOLATILE COMPOUNDS Collected on May 5, 2024 12:42 PM Lab tests - Blood
Methanol Lvl View trends mg/dL Value <10 Ref Range:Negative (<10 mg/dL)
VALPROIC ACID Collected on May 5, 2024 12:42 PM Results
Valproic Acid, Total View trends Normal range: 50 - 120 ug/mL Value <10Low
CT chest abdomen pelvis w IV contrast Collected on May 5, 2024 9:21 PM Results New EXAM: CT CHEST ABDOMEN AND PELVIS WITH CONTRAST
INDICATION: altered mental status, possible infection
Tech Comments: No additional history.
TECHNIQUE: Low dose, multi-channel computerized tomography of the chest, abdomen and pelvis was performed with IV contrast. Multiplanar reformats were reviewed.
COMPARISON: 12/05/2018
FINDINGS: CHEST: LUNGS: No focal consolidation. No mass. Major airways are patent.No pleural effusion or pneumothorax.
HEART AND VESSELS: Unremarkable.
MEDIASTINUM AND HILA: Unremarkable.
CHEST WALL AND SOFT TISSUES: Unremarkable.
ABDOMEN AND PELVIS: LIVER: Normal morphology. No suspicious hepatic lesion. No hepatic cysts are identified.
BILIARY: Unremarkable.
PANCREAS: No evidence of mass or inflammation. No pancreatic cysts.
SPLEEN: Unremarkable.
ADRENALS AND KIDNEYS: Adrenal glands are normal. Massively dilated renal collecting systems and ureters compatible with severe hydronephrosis is similar to although slightly progressive from 12/05/2018. Thin rind of renal parenchyma is present and enhances symmetrically. Bilateral hydroureter extends to the pelvis. There is some layering hyperdensity within the left distal ureter which may represent debris.
GASTROINTESTINAL: No evidence of abnormal bowel wall thickening or obstruction.
VASCULAR: Abdominal aorta is normal in caliber.
LYMPH NODES: No pathologically enlarged lymph nodes.
PERITONEUM: No free air or ascites.
PELVIC ORGANS AND BLADDER: Urinary bladder is distended.
BODY WALL AND SOFT TISSUES: Unremarkable.
BONES: No acute or suspicious abnormality.
IMPRESSION: 1. No acute findings. 2. Severe chronic hydroureteronephrosis is similar to although slightly increased from 12/05/2018. Urinary bladder is distended although is otherwise unremarkable. Although the morphology of the kidney is severely abnormal and mimics parenchymal cyst formation, there are no renal parenchymal or hepatic cysts to suggest autosomal dominant polycystic kidney disease. Etiology of severe hydronephrosis is uncertain possibly related to chronic reflux. 3. Thin rind of peripheral renal enhancement without focal abnormality. Small amount of nonspecific hyperdensity within the left distal ureter may represent nonspecific debris.
SODIUM, RANDOM URINE Collected on May 5, 2024 5:03 PM Results New
Sodium Urine Random View trends mmol/L Value 55 No reference range established.
OSMOLALITY,URINE Collected on May 5, 2024 5:03 PM Results New
Osmolality, Ur View trends Normal range: 50 - 1,200 mOsm/kg Your value is 304 mOsm/kgNormal range 50 - 1,200 mOsm/kg
CBC Collected on May 6, 2024 3:56 AM Results
WBC View trends Normal range: 3.3 - 10.5 K/CUMM Your value is 9.9 K/CUMMNormal range 3.3 - 10.5 K/CUMM RBC View trends Normal range: 4.15 - 5.75 M/CUMM Your value is 5.66 M/CUMMNormal range 4.15 - 5.75 M/CUMM Hemoglobin View trends Normal range: 12.8 - 16.9 g/dL Your value is 15.7 g/dLNormal range 12.8 - 16.9 g/dL Hematocrit View trends Normal range: 38.8 - 50.2 % Your value is 46.8 %Normal range 38.8 - 50.2 % MCV View trends Normal range: 80.0 - 100.0 fL Your value is 82.7 fLNormal range 80.0 - 100.0 fL MCH View trends Normal range: 27.0 - 34.0 pg Your value is 27.7 pgNormal range 27.0 - 34.0 pg MCHC View trends Normal range: 30.5 - 34.5 g/dL Your value is 33.5 g/dLNormal range 30.5 - 34.5 g/dL RDW View trends Normal range: 11.5 - 15.0 % Your value is 14.6 %Normal range 11.5 - 15.0 % Platelets View trends Normal range: 150 - 450 K/CUMM Your value is 321 K/CUMMNormal range 150 - 450 K/CUMM MPV View trends Normal range: 7.7 - 12.2 fL Your value is 9.3 fLNormal range 7.7 - 12.2 fL
COMPREHENSIVE METABOLIC PANEL Collected on May 6, 2024 3:56 AM Results New
Sodium View trends Normal range: 137 - 145 mmol/L Your value is 146 mmol/LThis value is HighNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 3.8 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 111 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 23 mmol/LNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 124 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 34 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 1.23 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 79 Your value is 79 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 BUN/Creatinine Ratio View trends Normal range: 6 - 22 RATIO Your value is 28 RATIOThis value is HighNormal range 6 - 22 RATIO ALT View trends Normal value: <50 U/L Value 34 Your value is 34 U/LNormal value <50 U/L AST View trends Normal range: 17 - 59 U/L Your value is 19 U/LNormal range 17 - 59 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 138 U/LThis value is HighNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.9 mg/dLNormal range 0.2 - 1.3 mg/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL Your value is 8.2 g/dLNormal range 6.3 - 8.2 g/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 4.6 g/dLNormal range 3.5 - 5.0 g/dL Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 9.7 mg/dLNormal range 8.4 - 10.2 mg/dL Globulin, Total View trends Normal range: 1.9 - 3.7 g/dL Your value is 3.6 g/dLNormal range 1.9 - 3.7 g/dL Albumin/Globulin Ratio View trends Normal range: 1.0 - 2.5 RATIO Your value is 1.3 RATIONormal range 1.0 - 2.5 RATIO Anion Gap View trends Normal range: 7 - 17 mmol/L Your value is 12 mmol/LNormal range 7 - 17 mmol/L
AMMONIA Collected on May 6, 2024 3:56 AM Results New
Ammonia. 124 View trends Normal range: 9 - 30 umol/L
I'm sorry you had to endure all of that, but thank you for doing so.

sorry in advance for being whiny, I’m in so much pain and losing hope of ever being normal again.
Four nights ago I had this sudden pain along my entire right leg. From my right buttcheek, around to the side of my hip, down my inner and outer thigh, my outer knee, the front of my calf, to my outer ankle, and then my first 3 toes. It was about a 5/10, and went away after an hour of being awake the following morning. But it came back that night, with 10/10 pain and it did not go away the next day like it had previously. Pain during that day went down to probably a 7/10, until the evening when it shot back up to a 10/10.
Since then, I have been in a constant state of 10/10 pain. My leg and foot are so numb, and I keep having throbbing muscle spasms. Sleeping is impossible, I cannot get comfortable no matter what I do. I can only lay on my left side with a big pillow between my legs. I can’t walk or stand for more than 2 minutes before my leg feels like it’ll buckle under me. I really only get out of bed to use the bathroom, but sitting on the toilet always makes the pain way worse. I stink, I need to shower desperately. I can’t make myself food. I haven’t been to work in 3 days and I have to go back at some point. I can’t get up to feed my pet bird. My family have been helping with the necessities like bringing me food, ice packs, and feeding my bird. But I can’t rely on them and wait every time I need something.
The only things helping are ice packs and heating pads, and some leftover oxycodone that I got RX’d for a 2nd degree burn last year (I only had 2 left, so now I’m just left with ibuprofen which does nothing for me). I called the clinic I go to for primary care, before even scheduling an appointment they tried to get me on a call with the nurse because I said my pain is a 10/10. They said I could hopefully get some pain meds prescribed without having to come in to see my PCP. But I haven’t heard back from them in hours, so not sure when/if those pain meds will be available.
I really thought this would go away. At first it just felt like a bad charlie horse, and some period cramps (I typically get those in my back and thighs). But I’m feeling hopeless right now. I keep crying both from the agonizing pain and also the realization that my life might not be normal again. Maybe I’m just freaking out and overthinking. I am 22 and female and relatively healthy, I just quit vaping after 7 years and was so excited to finally take back my life. And then boom, sciatic nerve said nope! I would just like to hear from anybody willing to tell, did anyone else feel hopeless like it would feel this way forever? I really just need support I guess.

25F Caucasian 5’10” 130lb medical marijuana user, DX kidney stone 5mm right kidney, cyclobenzaprine current Rx with oxycodone 5mg as needed Hello,
I can’t find a straight answer on google. If I had just eaten, would it make my ketones “very large” in urine?
Just wondering. I went to centra care and they didn’t say anything about it, but they referred me to the ER for something else (I didn’t go because they said it was up to me sorta - kidney stone related) so I’m wondering if they just didn’t say anything because they thought I was gonna go?
I’ve never had this before but am having kidney pain & some weird indigestion / upper left quadrant pain for a week now.
TIA.

Hi everyone, this sub reddit has been so eye opening and my heart goes to everyone feeling pain.
I've been recently diagnosed - by chance - with Fibro. For context, I do have Lupus, Sjorgen (2019) and Graves (2014 - in remission) autoimmune. Currently I'm 32(f) and ever since I hit 30s, my IBS has been very hard to manage, it started with low tolerance to sulfur, so I had to be mindful about what to eat, apple cider vinegar helped me so much.
At 31, I started having more morning stiffness and random joint pain / body pains, which I first contributed to my Lupus flaring up again, and my markers were increasing, with no pain relief in sight I opted for a cortisone shot. That too, did not give me relief and I had to push through whatever life threw at me. Until I got this debilitating jaw pain that affected my speech and chewing and I was so desperate to find a relief from it. I went to Maxillofacial doctor and prescribed me codiene + lageflex and eventually lyrica when there was little improvement from the other 2.
I was so hesitant to take Lyrica at first, but after taking it - it was a bliss. It took few days to work, but I no longer woke up with pain / no random pain / my mood got better. And I'm physically active, and I was feeling at my best again and it made me so happy. But it lasted for a month probably then I started having IBS issues again, I eat relatively healthy and it seems it was what's causing me issues, soon after I started having severe debilitating body pains. I stopped what I deemed was healthy to eat and focused on simple carbs and meats and seem to be better for now.
I do suspect I've had Fibro longer my diagnosis, probably ever since I hit my 20s or even before, difference is my body has a different threshold now. I've experienced a lot of this localised tender scalp pain that makes me want to pull my hair just to relief for as long as I remember.
My question is: does your IBS start to act up first and then you notice body pains / flare up?
Thank you for reading this far, I really appreciate you sharing your experiences with me.

Hi all,
I have a physiatry appointment in a few days, and I want to maximize our time together by being as prepared as possible.
I'm having horrible teavomit-inducing mid back pain, and the full body MRI and CT I've gotten apparently "don't explain your symptoms". I learned I have a fractured T10 vertebra of unknown origin that's since healed, and some likely age-related degeneration at C5/6 and C6/7. (I'm almost 50.) Oxycodone, gabapentin, muscle relaxers, Nortriptyline and ibuprofen/paracetamol barely, BARELY touch the pain as long as I'm not standing/sitting for more than 10 minutes.
I'm a teacher, though I haven't been able to work for 2 months now. The pain started being noticeable in November or December, and progressed until I finally had to see my doctor at the beginning of March. I spent 5 days in the hospital in April for the worsening pain.
I'm humbly looking for as many suggestions possible as to what's best write down to show the doctor, in bullet points, if it helps save time? Should I mention other general issues I'm having, such as GERD (and a currently un-inflammed gallbladder with 3x 2cm stones), right hip discomfort, and absolutely un-fun perimenopause symptoms?
Any and all thoughts appreciated. :) I wish you all well in your own back pain journeys.

Title: Understanding Fentanyl: Uses, Risks, and Controversies
Introduction: Fentanyl, a potent synthetic opioid, has gained significant attention in recent years due to its role in the opioid epidemic. This article aims to provide a comprehensive overview of fentanyl, including its medical uses, associated risks, and the controversies surrounding its widespread misuse.
Medical Uses: Originally developed for managing severe pain, especially in cancer patients, fentanyl is an analgesic that is 50 to 100 times more potent than morphine. It is commonly used in medical settings for pain management during surgeries, chronic pain conditions, and palliative care.
Risk Factors: While fentanyl is effective in controlling pain when administered under medical supervision, its misuse poses serious health risks. The drug's high potency increases the likelihood of overdose, leading to respiratory depression and, in extreme cases, death. Illicitly manufactured fentanyl, often mixed with other substances, has been a major contributor to the rising number of opioid-related deaths.
Controversies and Illicit Use: The illicit use of fentanyl has sparked controversy and public health concerns. The drug is often clandestinely produced and added to other drugs, such as heroin or cocaine, without the user's knowledge. This has resulted in a surge in overdoses, as individuals may unintentionally consume lethal doses of the opioid.
Law Enforcement and Regulation: Governments and law enforcement agencies worldwide are grappling with the challenges posed by the illicit production and distribution of fentanyl. Efforts to regulate its manufacturing and distribution are ongoing, with stricter controls in place to prevent diversion into illegal channels.
Treatment and Harm Reduction: Addressing the fentanyl crisis requires a multi-faceted approach, including expanded access to addiction treatment, harm reduction strategies, and public awareness campaigns. Naloxone, an opioid receptor antagonist, has proven effective in reversing opioid overdoses and is increasingly available to first responders and the general public.
Conclusion: Fentanyl, with its remarkable pain-relieving properties, has become a double-edged sword in the realm of healthcare. While it serves a crucial role in medical settings, its misuse poses severe risks to public health. Efforts to combat the opioid epidemic must focus on education, regulation, and treatment to strike a balance between managing pain effectively and preventing the tragic consequences of its illicit use.
Narcan, also known by its generic name naloxone, is a medication used to rapidly reverse opioid overdose. It works by binding to the same receptors in the brain that opioids target, effectively reversing the life-threatening effects of opioid toxicity. Narcan is commonly administered in emergency situations where an individual is experiencing respiratory depression or unconsciousness due to opioid overdose.
Emergency responders, healthcare professionals, and even some non-professionals, such as family members of individuals at risk of opioid overdose, may carry naloxone. The medication is available in various forms, including nasal sprays and injectable formulations, making it accessible for different situations.
The prompt administration of Narcan can restore normal breathing and consciousness, providing crucial time for the affected person to receive further medical attention. It is an essential tool in harm reduction strategies aimed at preventing opioid-related deaths and is a key component of public health initiatives addressing the opioid epidemic.
Suboxone is a prescription medication used in the treatment of opioid dependence and addiction. It is a combination of two active ingredients: buprenorphine and naloxone.

Buprenorphine: This is a partial opioid agonist, meaning it binds to the same receptors in the brain that opioids bind to but with less intensity. It helps to reduce cravings and withdrawal symptoms, allowing individuals in recovery to better manage their addiction.
Naloxone: Naloxone is an opioid receptor antagonist, which means it blocks the effects of opioids. When taken as directed, naloxone remains largely inactive. However, if someone were to misuse Suboxone by injecting it, the naloxone component can counteract the opioid effects, reducing the risk of misuse.

Suboxone is often prescribed as part of medication-assisted treatment (MAT), a comprehensive approach to opioid addiction that includes counseling, therapy, and support services. It can be used in the detoxification phase as well as for long-term maintenance therapy. The goal of Suboxone treatment is to help individuals gradually reduce their dependence on opioids, manage cravings, and improve their overall quality of life during recovery.
It's important to note that Suboxone should only be used under the supervision of a qualified healthcare professional, as improper use or abrupt discontinuation can lead to withdrawal symptoms or other complications.
Precipitated withdrawal refers to the accelerated onset of withdrawal symptoms, often more severe than typical, when an opioid antagonist is introduced to the body. This occurs because the antagonist displaces the opioid from receptors, leading to a sudden and intense withdrawal reaction.
For example, if someone is currently dependent on opioids and receives a medication like naloxone or naltrexone, which are opioid antagonists, it can rapidly trigger withdrawal symptoms. This is a safety mechanism, as these medications are often used to reverse opioid overdose or as part of addiction treatment.
The term is commonly associated with medication-assisted treatment for opioid use disorder, where medications like buprenorphine (a partial opioid agonist) are used. If buprenorphine is administered before other full opioids have cleared from the system, it can displace those opioids from receptors, leading to precipitated withdrawal. This is why healthcare providers carefully time the initiation of medications like buprenorphine to avoid this intensified withdrawal reaction.
Understanding the potential for precipitated withdrawal is crucial in the context of addiction treatment to ensure safe and effective transitions between medications and to minimize discomfort for individuals in recovery.
Using Suboxone involves adherence to a specific treatment plan under the guidance of a qualified healthcare professional. Here are some key aspects related to the use of Suboxone:

Prescription and Medical Supervision: Suboxone is a prescription medication, and its use should be initiated and supervised by a qualified healthcare provider, typically in the context of medication-assisted treatment (MAT) for opioid use disorder.
Dosage: The healthcare provider will determine the appropriate dosage based on the individual's specific needs and response to the medication. It's essential to follow the prescribed dosage and not adjust it without consulting the healthcare provider.
Administration: Suboxone is often administered sublingually, meaning it is placed under the tongue and allowed to dissolve. This method allows for the absorption of the medication into the bloodstream.
Timing: The timing of Suboxone administration is crucial. It is often started when the individual is in a mild to moderate state of withdrawal to reduce the risk of precipitated withdrawal. The healthcare provider will provide guidance on the appropriate timing.
Regular Monitoring: During Suboxone treatment, individuals are regularly monitored by healthcare professionals to assess progress, manage side effects, and adjust the treatment plan as needed.
Counseling and Support: Suboxone is typically part of a comprehensive treatment plan that includes counseling, therapy, and support services. This holistic approach addresses both the physical and psychological aspects of opioid addiction.
Gradual Tapering: Depending on the treatment plan, there may be a gradual tapering of Suboxone dosage as the individual progresses in their recovery. Tapering is done under medical supervision to minimize withdrawal symptoms.
Avoiding Other Opioids: It's crucial to avoid the use of other opioids while taking Suboxone. Combining opioids can lead to dangerous interactions and diminish the effectiveness of the treatment.
Side Effects and Reporting: Like any medication, Suboxone may have side effects. Common side effects include headache, nausea, and constipation. Any unusual or severe side effects should be promptly reported to the healthcare provider.
Pregnancy Considerations: If an individual is pregnant or planning to become pregnant, it's important to discuss this with the healthcare provider, as the use of Suboxone during pregnancy requires careful consideration.

Always follow the guidance of your healthcare provider and inform them of any concerns or changes in your condition during Suboxone treatment. Successful recovery often involves a combination of medication, counseling, and support tailored to individual needs.
Suboxone, when used as prescribed under the supervision of a healthcare professional as part of medication-assisted treatment (MAT) for opioid use disorder, has a lower potential for abuse and addiction compared to full opioid agonists. This is because Suboxone contains buprenorphine, a partial opioid agonist, which has a ceiling effect on its opioid effects.
Buprenorphine's partial agonist properties mean that it activates opioid receptors in the brain to a lesser extent than full agonists like heroin or oxycodone. As a result, the euphoria and respiratory depression associated with opioid abuse are less pronounced with buprenorphine.
However, it's essential to emphasize that any medication, including Suboxone, should be taken exactly as prescribed by a healthcare professional. Misuse, such as taking larger doses or combining Suboxone with other substances, can increase the risk of dependence or addiction.
Abruptly stopping Suboxone can lead to withdrawal symptoms, emphasizing the importance of a gradual tapering plan under medical supervision when discontinuing the medication. It's crucial for individuals using Suboxone to work closely with their healthcare provider to ensure proper management of their opioid use disorder and to address any concerns or side effects during the course of treatment.
Withdrawal symptoms from Suboxone, or buprenorphine (the active ingredient in Suboxone), can occur when someone who has been using the medication for an extended period stops taking it abruptly. It's important to note that withdrawal symptoms can vary in intensity and duration based on factors such as the individual's overall health, the duration of Suboxone use, and the dosage.
Common withdrawal symptoms from Suboxone may include:

Nausea and vomiting
Diarrhea
Muscle aches and pains
Sweating
Insomnia or sleep disturbances
Anxiety
Irritability
Runny nose and teary eyes
Goosebumps (piloerection)
Dilated pupils

It's important to distinguish between withdrawal symptoms and precipitated withdrawal. Precipitated withdrawal can occur if someone takes Suboxone too soon after using a full opioid agonist, leading to a more rapid and intense onset of withdrawal symptoms.
Withdrawal from Suboxone is generally considered less severe than withdrawal from full opioid agonists, and the symptoms tend to peak within the first 72 hours after discontinuation. However, the duration and severity can vary from person to person.
If an individual is considering stopping Suboxone or adjusting their dosage, it's crucial to do so under the guidance of a healthcare professional. Tapering the medication gradually, rather than stopping abruptly, can help minimize withdrawal symptoms and increase the chances of a successful transition to recovery. Seeking support from healthcare providers, counselors, and support groups is essential during this process.
Kratom is a tropical tree native to Southeast Asia, specifically in countries like Thailand, Malaysia, Indonesia, Papua New Guinea, and Myanmar. The leaves of the Kratom tree have been traditionally used for various purposes, including as a stimulant, a pain reliever, and to manage opioid withdrawal symptoms.
The active compounds in Kratom, called alkaloids, interact with opioid receptors in the brain, producing effects that can vary depending on the strain and dosage. These effects can include:

Stimulation: At lower doses, Kratom may act as a stimulant, promoting increased energy, alertness, and sociability.
Sedation: At higher doses, Kratom may have sedative effects, leading to relaxation and pain relief.
Pain Relief: Kratom has been used traditionally for its analgesic properties, and some people use it as a natural remedy for pain.
Mood Enhancement: Some users report improved mood and reduced anxiety after consuming Kratom.

However, it's important to note that Kratom is not regulated by the U.S. Food and Drug Administration (FDA), and its safety and effectiveness for various uses have not been clinically proven. There are potential risks associated with Kratom use, including dependence, addiction, and adverse effects such as nausea, constipation, and increased heart rate.
Due to these concerns, Kratom has been a subject of regulatory scrutiny in various countries, with some regions imposing restrictions or outright bans on its sale and use. It is essential for individuals to exercise caution, seek reliable information, and consult with healthcare professionals before considering the use of Kratom, especially for medicinal purposes or to manage opioid withdrawal.
Methadone is a synthetic opioid medication used primarily in the treatment of opioid dependence, particularly in the context of medication-assisted treatment (MAT). It is a long-acting opioid agonist, meaning it activates the same opioid receptors in the brain that other opioids, like heroin or morphine, do.
Key points about Methadone include:

Opioid Dependence Treatment: Methadone is often used as a maintenance medication to help individuals reduce or quit the use of illicit opioids. It helps by reducing cravings and withdrawal symptoms.
Long-Lasting Effect: One significant advantage of methadone is its long duration of action. A single daily dose can help stabilize individuals, preventing the highs and lows associated with short-acting opioids.
Supervised Administration: In some cases, methadone is provided through supervised administration in specialized clinics to ensure proper use and minimize the risk of diversion.
Tolerance and Dependence: Like other opioids, individuals using methadone can develop tolerance and dependence. Therefore, the dosage needs to be carefully managed, and discontinuation should be done gradually under medical supervision.
Reduction of Illicit Drug Use: When used as part of a comprehensive treatment plan, methadone has been shown to reduce illicit opioid use, lower the risk of overdose, and improve overall health outcomes.
Potential Side Effects: Methadone can have side effects, including constipation, sweating, drowsiness, and changes in libido. It's important for individuals to report any adverse effects to their healthcare provider.
Regulated Use: The use of methadone is tightly regulated, and it is typically dispensed through specialized clinics or healthcare providers who are authorized to prescribe it for opioid use disorder treatment.

Methadone treatment is part of a broader approach that often includes counseling, therapy, and support services. It has been a valuable tool in harm reduction strategies aimed at addressing the opioid epidemic and helping individuals achieve and maintain recovery.
Narcotics Anonymous (NA) is a 12-step program that provides support for individuals recovering from addiction, particularly those struggling with substance abuse issues. It is important to note that NA, like other 12-step programs, does not have an official stance or opinion on specific medical treatments, including medication-assisted treatment (MAT) for withdrawal.
The approach to medication assistance in withdrawal can vary among individuals within the NA community. Some may find success and support in MAT, while others may choose alternative methods or prefer an abstinence-based approach. NA encourages individuals to share their experiences, strength, and hope, but it does not dictate specific treatment choices.
The primary focus of NA is on mutual support, fellowship, and following the 12-step principles, which include admitting powerlessness over addiction, seeking spiritual awakening, and helping others in recovery. Members of NA are encouraged to respect each other's choices and paths to recovery.
It's essential for individuals seeking support for addiction to find a treatment plan that aligns with their needs and values. Consulting with healthcare professionals, attending support groups, and considering various treatment options can be part of a comprehensive approach to recovery.
SMART Recovery (Self-Management and Recovery Training) is a science-based, secular alternative to traditional 12-step programs like Narcotics Anonymous. SMART Recovery emphasizes self-empowerment and utilizes evidence-based techniques to support individuals in overcoming addiction.
Regarding Medication-Assisted Treatment (MAT), SMART Recovery takes a neutral stance. The program acknowledges that MAT, when prescribed and monitored by healthcare professionals, can be a valid and effective part of a comprehensive approach to addiction treatment. SMART Recovery recognizes that different individuals may have unique needs, and treatment plans should be tailored to the individual's circumstances.
SMART Recovery's focus is on teaching self-reliance, coping skills, and strategies for managing urges and behaviors associated with addiction. The program encourages participants to make informed decisions about their recovery, including the consideration of medications that may be prescribed by healthcare providers.
Ultimately, SMART Recovery emphasizes a holistic and individualized approach to recovery, allowing participants to choose the methods and tools that best suit their needs and align with their values. This includes being open to the potential benefits of MAT for some individuals as part of their overall recovery plan.
Several treatment modalities are available for individuals struggling with opioid use disorder. The most effective approach often involves a combination of different strategies. Here are some key treatment modalities for opioid addiction:

Medication-Assisted Treatment (MAT): MAT involves the use of medications, such as methadone, buprenorphine (Suboxone), and naltrexone, to help manage cravings, reduce withdrawal symptoms, and support recovery. These medications are often used in combination with counseling and therapy.
Counseling and Behavioral Therapies: Various forms of counseling and behavioral therapies are crucial components of opioid addiction treatment. Cognitive-behavioral therapy (CBT), contingency management, motivational enhancement therapy, and dialectical behavior therapy (DBT) are among the approaches used to address the psychological aspects of addiction and help individuals develop coping skills.
Support Groups and 12-Step Programs: Participating in support groups like Narcotics Anonymous (NA) or 12-step programs can provide valuable peer support, encouragement, and a sense of community for individuals in recovery.
Detoxification Programs: Medically supervised detoxification programs help individuals safely manage the acute withdrawal symptoms associated with stopping opioid use. These programs often serve as the initial phase of treatment.
Residential or Inpatient Treatment: Inpatient treatment programs provide a structured and supportive environment for individuals to focus on recovery. These programs may include a combination of medical supervision, counseling, and therapeutic activities.
Outpatient Treatment: Outpatient programs allow individuals to receive treatment while living at home. This flexibility can be beneficial for those with work or family commitments. Outpatient treatment often includes counseling, therapy, and medication management.
Holistic and Alternative Therapies: Some individuals find benefit from holistic approaches, such as acupuncture, yoga, meditation, or mindfulness practices. These can complement traditional treatment modalities and contribute to overall well-being.
Peer Recovery Support Services: Peer recovery support services involve individuals with lived experience in recovery providing support, guidance, and encouragement to others going through similar challenges.

The most effective treatment plans are often individualized, taking into account the specific needs, preferences, and circumstances of each person. Collaborating with healthcare professionals to develop a comprehensive and tailored approach can significantly enhance the chances of successful recovery from opioid addiction.
The withdrawal timeline for fentanyl, a potent synthetic opioid, can vary among individuals based on factors such as the duration and intensity of use, individual metabolism, and overall health. Fentanyl withdrawal symptoms typically start shortly after the last dose and follow a general timeline:

Early Symptoms (Within a few hours): Early withdrawal symptoms may include anxiety, restlessness, sweating, and increased heart rate. Individuals may also experience muscle aches and insomnia.
Peak Intensity (24-72 hours): Withdrawal symptoms usually peak within the first 24 to 72 hours after discontinuing fentanyl. During this time, individuals may experience more intense symptoms such as nausea, vomiting, diarrhea, abdominal cramps, dilated pupils, and flu-like symptoms.
Subsiding Symptoms (5-7 days): The most acute withdrawal symptoms generally begin to subside within about five to seven days. However, some symptoms, such as insomnia, anxiety, and mood swings, may persist for a more extended period.
Post-Acute Withdrawal Syndrome (PAWS): Some individuals may experience a more prolonged period of withdrawal symptoms known as post-acute withdrawal syndrome (PAWS). This can include lingering psychological symptoms such as anxiety, depression, irritability, and difficulty concentrating. PAWS can persist for weeks or even months.

It's crucial to note that fentanyl withdrawal can be challenging, and seeking professional help is recommended to manage symptoms safely and effectively. Medical supervision can provide support through the detoxification process, and healthcare professionals may use medications to alleviate specific withdrawal symptoms and improve the overall comfort of the individual.
The withdrawal process is highly individual, and some individuals may find additional support through counseling, therapy, and participation in support groups to address the psychological aspects of recovery. Always consult with healthcare professionals for guidance on the safest and most effective approach to fentanyl withdrawal.
Xylazine is a veterinary sedative and analgesic medication. It belongs to the class of drugs known as alpha-2 adrenergic agonists. While it is primarily intended for veterinary use, xylazine has been misused in some cases for recreational purposes, particularly in combination with other substances.
In veterinary medicine, xylazine is commonly used as a sedative and muscle relaxant for various procedures, including surgery and diagnostic imaging. It is often administered to calm and immobilize animals.
However, the use of xylazine outside of veterinary settings, especially when combined with other drugs, can pose serious health risks. Misuse of xylazine has been associated with adverse effects, including respiratory depression, cardiovascular issues, and central nervous system depression.
It's important to emphasize that the use of xylazine for recreational purposes is highly dangerous and illegal. The drug is not intended for human consumption, and its effects can be unpredictable and potentially life-threatening.
If you have concerns about substance use or encounter situations involving illicit drugs, it is crucial to seek help from healthcare professionals, addiction specialists, or local support services. Misuse of veterinary drugs or any substances not prescribed for human use can have severe consequences and should be avoided.
PAWS stands for Post-Acute Withdrawal Syndrome. It refers to a set of prolonged withdrawal symptoms that some individuals may experience after the acute phase of withdrawal from substances like opioids, benzodiazepines, or alcohol. PAWS is not limited to a specific substance and can occur with various drugs.
These symptoms are generally more subtle than the acute withdrawal symptoms but can persist for weeks, months, or, in some cases, years after discontinuing substance use. PAWS can vary widely among individuals and may include symptoms such as:

Mood swings
Anxiety
Irritability
Insomnia
Fatigue
Difficulty concentrating
Memory problems
Reduced impulse control
Cravings for the substance

PAWS can be challenging for individuals in recovery, as these lingering symptoms may contribute to relapse if not effectively managed. Supportive interventions, such as counseling, therapy, and participation in support groups, can be beneficial for individuals experiencing PAWS. Healthy lifestyle choices, including regular exercise, proper nutrition, and adequate sleep, may also contribute to the overall well-being of those in recovery.
It's important to note that PAWS is not experienced by everyone in recovery, and its severity and duration can vary. Seeking guidance from healthcare professionals or addiction specialists can assist individuals in managing PAWS and maintaining long-term recovery.
Quitting substance use "cold turkey" involves stopping the use of a substance abruptly without tapering or gradually reducing the dosage. It's important to note that quitting cold turkey can be challenging, and the level of difficulty varies depending on the substance, the duration and intensity of use, and individual factors.
If you're considering quitting a substance cold turkey, here are some general recommendations:

Seek Professional Guidance: Before making the decision to quit cold turkey, it's advisable to consult with a healthcare professional or addiction specialist. They can provide guidance based on your specific situation, assess potential risks, and offer support.
Create a Support System: Inform friends, family, or a support network about your decision to quit. Having a support system in place can provide encouragement, understanding, and assistance during challenging times.
Understand Withdrawal Symptoms: Be aware of potential withdrawal symptoms associated with quitting the substance cold turkey. Withdrawal symptoms can vary depending on the substance but may include anxiety, irritability, insomnia, and other physical or psychological effects.
Stay Hydrated and Nourished: Maintaining proper hydration and nutrition is crucial during the quitting process. Stay hydrated by drinking water and consuming a balanced diet to support your overall well-being.
Exercise: Engage in regular physical activity. Exercise can help alleviate stress, improve mood, and contribute to your overall physical and mental health.
Consider Professional Treatment: Depending on the substance and the severity of dependence, professional treatment options, such as inpatient or outpatient programs, may be beneficial. Medical supervision can assist in managing withdrawal symptoms and ensuring safety.
Therapy and Counseling: Consider participating in therapy or counseling to address the underlying factors contributing to substance use and to develop coping strategies for a successful recovery.
Plan for Triggers: Identify situations, environments, or emotions that may trigger the urge to use the substance. Develop a plan to cope with these triggers without resorting to substance use.

It's essential to approach quitting any substance with a comprehensive strategy, and individual circumstances vary. Seeking professional advice ensures that you make informed decisions about the best approach for your specific situation. If you are experiencing severe withdrawal symptoms or have concerns about quitting cold turkey, it is crucial to consult with a healthcare professional for guidance and support.
Tapering refers to the gradual reduction of the dosage of a substance, typically a medication or a drug, over a specific period. Tapering is commonly used in the context of addiction treatment, where it involves slowly decreasing the amount of a substance to manage withdrawal symptoms and minimize the risks associated with abrupt discontinuation.
Key points about tapering include:

Medication-Assisted Treatment (MAT): Tapering is often part of medication-assisted treatment for substance use disorders. For example, individuals dependent on opioids might undergo a gradual tapering of medications like methadone or buprenorphine.
Reducing Dependence: Tapering is employed to reduce physical dependence on a substance by allowing the body to adjust to lower levels gradually. This helps minimize the severity of withdrawal symptoms.
Individualized Approach: Tapering plans are typically individualized based on factors such as the substance used, the duration and intensity of use, and the individual's overall health. Healthcare professionals design tapering schedules to meet the specific needs of each person.
Supervised Tapering: Tapering is ideally done under the supervision of a healthcare professional to ensure safety and effectiveness. This is particularly important in cases where abrupt discontinuation could lead to severe withdrawal symptoms or complications.
Psychological Support: Tapering is not only about physical adjustments but also addresses psychological aspects of dependence. It provides individuals with an opportunity to develop coping skills and strategies for managing life without reliance on the substance.
Preventing Relapse: Gradual tapering can help reduce the risk of relapse by easing the transition to complete abstinence. It gives individuals the time and support needed to adjust to life without the substance.

Tapering is a careful and structured process that should be guided by healthcare professionals. Abruptly stopping certain substances can lead to severe withdrawal symptoms and potential health risks. Seeking professional advice and support is crucial for a safe and successful tapering process, whether it's part of addiction treatment or the discontinuation of a prescribed medication.
Engaging in activities during withdrawal can help distract from symptoms, provide a sense of accomplishment, and contribute to overall well-being. Here are some ideas for keeping busy during withdrawal:

Reading: Escape into a good book or explore topics of interest to keep your mind occupied.
Movies or TV Shows: Watch movies or binge-watch a TV series to pass the time. Choose lighthearted or inspirational content.
Exercise: Engage in gentle exercises like walking, yoga, or stretching. Exercise can help improve mood and alleviate some withdrawal symptoms.
Creative Hobbies: Explore creative outlets such as drawing, painting, writing, or playing a musical instrument.
Mindfulness and Meditation: Practice mindfulness or meditation techniques to calm the mind and reduce stress.
Gardening: Spend time outdoors, tending to a garden or plants. Nature can have a positive impact on mood.
Puzzle Games: Solve puzzles, play Sudoku, or engage in other mentally stimulating games.
Listening to Music or Podcasts: Create playlists of your favorite music or listen to podcasts on topics of interest.
Cooking or Baking: Experiment with new recipes and treat yourself to nourishing meals.
Journaling: Write down your thoughts and feelings. Keeping a journal can be therapeutic during withdrawal.
Educational Courses: Take online courses or watch educational videos on platforms like Coursera or Khan Academy.
Board Games or Card Games: Play board games or cards with friends or family for some social interaction.
Self-Care Activities: Take relaxing baths, practice skincare routines, or indulge in other self-care activities to nurture your well-being.
Volunteering: If possible, consider volunteering for a cause you're passionate about. Helping others can be rewarding.
Stay Connected: Reach out to friends and family for support. Having a support system is crucial during withdrawal.

It's important to choose activities that align with your interests and energy levels. Remember that withdrawal is a challenging time, and it's okay to prioritize self-care. If symptoms become severe or unmanageable, seeking professional help is recommended.

I’m a big spender I spend two to $300 on the Percocet oxycodone lean 😩

So I am prescribed oxycodone for cancer related pain. For some reason I only ever get a 12 day supply, my oncologist calls it in every 12 days. Sometimes if he’s going to be out of office he will call it in early and I will receive a message from cvs that “due to state/pharmacy limitations rx oxy is too soon to fill until (given date)”. Normally it’s just like one day early and I won’t need it until a day or two anyway and they schedule it fill it on that day everything is fine. But this time the app just says it’s on hold for “refill too soon” but it doesn’t give a date when it will be filled? And tomorrow would be the 12th day of my 12 day supply so normally they would fill it the day before. Should I call? I just don’t want to be a pain.

Hi everyone, (This will be long, apologies up front, as I'm new to this...TL;DR added at the end.)
I used to think only taller people were besieged with back issues. At 155cm/5'1", I couldn't have been more wrong! :O
I started having mid back pain on and off starting November 2023, though at that time, it wasn't anything that, as a 30-year chronic migraine sufferer, I couldn't handle at the time.
Then, at the end of February/beginning of March, it began to get more and more noticeable and markedly more uncomfortable. I went in to see my GP, both about perimenopause symptoms and the back pain, and was pretty much sent on my way; he'd discovered a breast lump that he wanted to focus on first, and said a specialist probably wouldn't take me on at the time due to that finding (and that it'd be a long wait to see a specialist, anyway). The lump was benign.
As I was waiting about 4 weeks for a mammogram/ultrasound/biopsy, in the weeks leading up I was back to the doctor with worsening pain. First time, I was prescribed the weakest Panacod (I forget the dose off the top of my head), then in a follow up call when that made no difference, to try two. It didn't touch the pain, so in my next visit, I was told to try Tramadol (5mg, I believe). He noted that was the strongest he could prescribe as a GP, but it still didn't touch the pain. Both made me seriously nauseous and constipated to the point of bleeding hemorrhoids, and the attempt at two Panacod made me super unpleasantly light-headed.
My third visit, I saw an urgent care doctor, and she spent quite a bit of time with me, asking questions, looking at my notes, doing exams and she made me feel listened-to. She gave me a referral to emergency, where I went to be seen for all the same questions and tests and was given 5mg Targiniq (Oxycodone, I believe?) every 12 hours. It maybe took my pain down from a 6/7 to a 4/5, but only on days where I didn't do anything at all physical (such as even trying to make a half-decent dinner standing at the stove).
I was told to return to emergency if that didn't help, and so back I went after 4 days. This time, I was admitted, and stayed for 5 days. I was up to 15mg every 12 hours, plus something liquid every 4 hours for breakthrough pain. I was started on Gabapentin 300mg on the third day, as I could feel tingling and pressure in my limbs. That, I could deal with, but the pain continued, and up until this point I've been having very fragmented sleep. The time in the hospital was a bit of a relief, if only because I was off my feet almost the whole time and able to sleep a bit more.
Full-body CT and MRI scans showed that I had an old, healed fracture of the T10 (30% loss of height), and some kind of node of no concern at T8. There's a bit of age-related disc degeneration in my cervical spine - I'm 49 - but the scans could not explain my ever-worsening back pain.
The ortho specialist said there was no need for surgery (thank goodness), and has referred me on to Physiatry, where I will be seen next week. I was given a 10 day schedule to ween myself off the Targiniq, which I did, and as I type this I'm having what is the worst pain I've had in my back. The ortho specialist will be calling me tomorrow morning for a follow-up and I'm thinking at this rate, I'll need to go back to the hospital. But, for what, I have no clue?! I HATE the feeling of opioid medication, and I don't want that to be the answer to my issues.
What in the world, please tell me, could be causing this much pain with an old fracture? I've lost 12kg/26 pounds in the past 7 or 8 months...could that be a factor?! Otherwise, I'm at a loss and have very little quality of life at the moment. What should I ask or be on the look-out for?
Please, if anyone has any thoughts or personal anecdotes, I'd be grateful. I'm being looked after for medical advice, but any thoughts that could help me navigate this further would be dearly appreciated. (If I've left anything out, please feel free to ask!)
TL;DR - I have an old, healed fracture of my T10, with worsening pain starting November 2023 until now, reaching a 7 or 8/10 with sharp, pulsating pain in the middle of my back. I've cried, lost control of my bowels and vomitted from the pain. Scans showed no reason for my symptoms. Help!

I had my first surgery (double incision, no nipples) on January 5th and immediately developed a hematoma on my left side. Exactly three weeks later on January 26th, I had another surgery, this time for an emergency infection on my right side (a complication that has a <1% rate). During those weeks, I was checking this subreddit a lot to see if there was anything similar and for any ideas on what to do. I figure that my experience might be helpful for people.
Here are some things I wish I had known to do.

First of all, make sure that you have the right support in place for if you run into a <1% complication.

Everyone I met on the surgical team was very optimistic about my surgery and said repeatedly that the chances of any complications were very low because I was young and healthy. I believed them and did not prepare myself for the mental reality of having to basically throw away 2 months of my life due to a rare complication. I have never wanted breasts from the moment I started developing them, but had I known that I would have such a rough recovery I would have opted against the surgery and dealt with the low level dysphoria (about a 3/10 on the average day, spiking to 7/10 occasionally) for the rest of my life. This is not to say that I am unhappy with the outcome; indeed, the surgery completely took care of my chest dysphoria. I just personally wish that someone had walked me through what the rare complications could be like, how long it would likely impair my functioning, and asked me to weigh that against my dysphoria. Instead, everyone I talked to, including my friends (2 of which were medical students), basically told me that the less than 1% chance wouldn’t happen. Unfortunately for me, it did happen. So just remember that rare complications happen to someone and try to set yourself up to catch any problems immediately as they arise.
If you have any mental hang ups about asking for help like I do, it’s really important that you ignore that feeling and “bother” people. I put things off because I felt guilty about taking time out of my sister’s day to go to appointments and I was worried that I was asking stupid questions to the surgical team. Due to my history of overreacting about small health issues, I felt embarrassed and decided to bank on being part of the 99% that do not need emergency surgeries. Don’t do that. Buy a thermometer and a pulse oximeter so you also have concrete points of reference for when you feel off. For a pulse oximeter, I got the ChoiceMMed since it has good reviews on Amazon.
Try to handle any health problems you’re aware of before your surgery. I suspected I had sleep apnea, but didn’t manage to get my results from my sleep test before my surgery. If I had done it months ago and gotten a mouthguard it would’ve made sleeping post-op easier.
Prioritize your surgical appointments above any other routine appointments. I didn’t do this and missed a chance I had to potentially treat the infection earlier.

Be prepared to send a lot of messages to your surgical team and to call the help line.

Related to the paragraph above. My surgical team had a portal online where you could send messages. Get help taking photos and send them in with the message before you call the help line so that they can see them. In the early days of recovery it also helps to take photos every day in the same position so that you can easily compare and reference how much swelling there is. Take off your binder when you take photos. It’s not very useful if they can’t see the actual incision site, and I made this error in the beginning.

If you’re prescribed Oxycodone, ask to also be prescribed Zofran and take that before. Don’t take Oxycodone on an empty stomach.

After my surgery on January 5th I felt fine and without nausea. I went home and took Tylenol and Ibuprofen. Then 9 hours after my surgery I took Oxycodone and spent hell in nausea. I didn’t realize what was happening to me and thought maybe it was delayed effects of the anesthesia, so I kept taking Oxycodone and abiding by the suggested dosage schedule. It was nearly impossible to get up and I couldn’t walk more than a few steps from all the nausea. My sister called the help line and got me prescribed Zofran, but what really helped was stopping the damn Oxycodone. Unfortunately, being nauseous during this time also made my hematoma harder to handle because I missed the window for aspiration (more on this later). Nausea on Oxycodone happens to quite a few people — one of the nurses working with me in the ER right before my hospitalization and second surgery also told me that when she had tried Oxycodone she basically blacked out.
I was already extremely wary of Oxycodone after my second surgery on January 26th, but the pain wouldn’t go away and the nurses told me they could only give me Oxy since they already gave me Tylenol. I told them that it made me super nauseous, so they gave me a Zofran and reassured me that there was also anti-nausea medication in my IV. Well, none of that was enough. I started feeling nauseous again, though thanks to being in a hospital they could give me other anti-nausea stuff. I puked twice. The nurse taking care of me in the hospital told me that you should absolutely never take Oxycodone on an empty stomach — that’s the biggest cause of nausea with this medication. I still don’t want to try this medication ever again, but if I do I will heed her advice. Don’t take Oxycodone on an empty stomach. If nurses try to give you Oxycodone and you haven’t eaten anything ask them for a snack first at least.

Strip your drains at least 3 times a day.

The handout they gave me only said once a day, but after the emergency surgery they told me I should have been doing it at least 3 times a day (you can even do 5 times a day). It’s very important to get rid of any clots in there; not stripping it enough may have contributed to me getting a hematoma on my left side. It was also very hard for me to strip my drains myself, so my sister had to help me. I also suggest watching a YouTube video on how to strip them if the nurse doesn’t demonstrate for you after your surgery (mine didn’t). Make sure that you’re stripping it with the binder off and reaching as close to the entry point you can get. It’s hard to do because it takes more force than you’d expect. You might want to apply pressure on the drain at the top against your skin while your support person figures out how to strip them without yanking it out of you or slipping and hitting you in the side.

If you know you’re allergic to adhesives, ask for something different rather than surgical tape.

There’s about 1% of people who get a rash from surgical tape. If you have eczema like I do, it’s far more likely. I’ve had bad reactions to band-aids I left on for longer than a few days, so I felt like this was a complication that might happen to me. Regardless, I had never had surgery before. After 10 days, I had a lot of red bumps that first appeared on my stomach and then continued to spread. Anti-itch cream, steroid cream, and Benadryl did nothing. I was told to take the strips off. I took one off the left side by myself, but the process made me feel so nauseous I couldn’t do the other side. The nurses are much better at taking them off and have special solutions so I would actually recommend waiting for your post-op. Regardless, by the time of my appointment the bumps on the left side looked better than the right. I was marked as having an allergy to 2-Octyl Cyanoacrylate (Dermabond), which is apparently what they use on the strips to make them stick.
After my second surgery I had the misfortune of developing more red bumps, this time starting on my chest and spreading up and down. The cause for this one was harder to tell since we had avoided the adhesive strips this time (opting for Xeroform, but they told me to stop using that too just in case). Possible culprits: the antiseptic they wash you with before they start the surgery that causes the orange residue; the leftover tape on my sides holding the drains down; antibiotics I was put on for my infection (first Bactrim, then Augmentin, then back to Bactrim after they confirmed my bacteria cultures). They cleared me to wash early to try to get the antiseptic off, but I didn’t take multiple showers since showering with two drains (they put my right one back in after the second surgery) was taxing after a hospitalization. They gave me Hydroxyzine that I was taking 4 times a day (and feeling very tired due to it) but it wasn’t doing anything on its own, so eventually I got taken off of antibiotics early. They told me that they had already gotten the infection out during the surgery and the antibiotics were just for safety.
Things I have learned from this: In terms of OTC, Benadryl is apparently stronger than Loratadine. Also, creams apparently don’t work on rashes when they’re in the early stage of popping up, so you’ll need a strong antihistamine.

Get another binder or multiple ace bandages (the wider the better). Binders that go over the shoulders offer more support.

The binder they put on me after surgery both times was from EaB Medical. This binder only goes around the chest and not over the shoulders, though they do have straps that you can attach to them. I really recommend using the straps if you have this binder since it keeps it from slipping down. Having good compression is really important in the early days. You can also use ace bandages but it can be hard to tell how tightly to bind them, and they tend to stretch out after washing. Either way, you should plan on having more than 1 binder / bandages so you can swap them and wash them. Due to my situation I ended up binding for 9 weeks.
I tried to get a binder from Underworks, but the small was too small for me and the medium was slightly too large. If you want to buy from them you may want to ask them how exactly their sizing works. After my second surgery I was a 33” circumference but couldn’t make the sizing work. If you can spend the money, it’s probably a good idea to get the $100+ ones from Marena. Maybe if I had had a binder that went over the shoulders it would’ve helped get more of the fluid out from my first hematoma.

If you notice swelling with a lot of fluid, get seen within the next day or just go to the ER.

Hematomas are more common than you would think (way more common than infection). Anywhere from something like 5~30% since there are no real comprehensive estimations. If you can push against your skin and feel fluid jiggling in there it needs to be removed. If it’s accompanied by a lot of bruising it’s a hematoma. In my case, I developed disproportionate swelling on the left side after my first surgery that just kept increasing for 3 days. It was even bruising above the binder they gave me. I wasn’t using the straps for the binder at the time, so the only feedback I got from the nurse hotline when I called was that the binder was slipping and I should pull it up.
The reason why the nurse hotline didn’t really help me was because I didn’t take photos with the binder off (partly due to the terrible nausea I was dealing with from Oxycodone). The other reason is that my first surgery was on a Friday and the surgical team was off during the weekend. If I had taken off my binder for the photos and the nurse had actually gotten ahold of the plastics team, they probably would have told me to go get it drained.
My first post-op was 4 days later, so I thought I could just wait until then. That was wrong. Despite putting out 50cc and then 55cc in the drain on the left side during the first two days, by the third day it had dropped to 5cc. Either due to not stripping the drains enough, having compression that wasn’t comprehensive enough, or just being super duper unlucky, the hematoma decided to coagulate. At my post-op, I was told that because it had solidified it couldn’t be aspirated, and thus I would have to have the drain in for “as long as possible” and that I would be dealing with this zombie-looking dried blood-filled boob (like the size of a tennis ball) for at least 3 months and it would likely take 6 months to resolve itself. There was literally nothing that could be done. Or so I was told, but during my second surgery they took the opportunity to also figure out how to aspirate it, so it disappeared and healed faster than the right side.
In short, if you are swelling with a lot of fluid you need to be seen as soon as possible before it coagulates or becomes infected. You can tell because it will be way too big and will move like liquid is in there (before it coagulates). You may have to aspirate multiple times, but I didn’t have to deal with that in my situation. But I’m also the only person I know who had the whole thing coagulate.

Fevers can be cyclical. Chills are when you can’t stop shaking.

I did not know this. I also did not have a thermometer because my family is lax about health. All I knew is that I started to feel so cold I couldn’t stop shaking and do anything but lie in bed for 2-3 hours warming myself up, and then I would feel so hot that I had to get out of bed. This was fever and a fluctuating temperature. This was also my first signs of infection on my right side and I didn’t know it. No one in my family knew fevers don’t have to be constant. If this happens to you, call your hotline right away. The shaking is different from normal shivering; it feels more violent and you can’t will yourself to stop the way you can stop smaller shivers.

If there’s a lot of redness and the area continues to increase in size it’s probably an infection.

I thought I only had my left hematoma to worry about. Well, I started experiencing the chills and fever but I didn’t know what it was. My right side was looking pretty good in comparison to my left. After the drain on that side was removed though, it started to swell. And it swelled much, much slower than my left side. It also had a spreading redness (no bruising). After a few days, pus was coming out the drain hole on the right side and it wasn’t closing. I didn’t realize for sure if it was pus or not because it didn’t smell, and even the surgical team wasn’t sure. I sent photos of the area and they told me it might just be the normal amounts of swelling that happen after the drain is removed and that the pus might not actually be pus if I didn’t have other symptoms (I did. I had a fever, but didn’t realize it). I was also unlucky enough that my next post-op appointment had been 2 weeks after the last instead of the usual 1 week, due to the doctor being out. They had offered me the chance to see another doctor that week to make up for it, but I said no (this was before it started swelling). After I sent pictures in, they offered for me to come in something like the same day to aspirate the liquid, but it was literally at the same time slot I had scheduled a phone call with my PCP to renew some of my prescriptions and I didn’t want to keep bothering my sister with a surprise visit so I said no. This was the wrong move. See point 7. Always get the fluid removed. And don’t skip weeks in post-op appointments in the early stages.
I went to urgent care instead and they confirmed it was an infection and then gave me antibiotics (Bactrim). It seemed to help initially, but after a few days on that my right incision suddenly started spewing pus. The pus still didn’t smell, but the volume was continuous. I got told to go to the ER and had to have an emergency surgery.

Go slow on tapering pain medication, especially if you still have drains in.

I ended up being on pain medication for 6.5 weeks. I had seen some people say that they stopped needing painkillers as early as 2 weeks post-op, so I tried to taper with that in mind. I started out with 2400 mg Ibuprofen + 2000 mg Tylenol a day at staggered intervals after giving up on Oxycodone, and by post-op day 8 I managed to cut out Tylenol entirely. I tried to go further by decreasing Ibuprofen by about 600 mg a day, but on post-op day 9 I was hit with a searing 8/10 pain in the left side of my chest that felt like I was being stabbed.
I had been looking at intervals of 6 hours since that’s about the window of effectiveness for Ibuprofen, so when I survived taking only 300 mg in one 6 hour interval I thought that meant that I could do that for all 6 hour blocks after that. Well I guess pain medication also has a cumulative effect since that didn’t work. And then the pain started getting worse on my right side with the growing infection, so I ended up going back up to 2400 mg Ibuprofen + 2000 mg Tylenol until I was hospitalized.
At the hospital, they stopped giving me Ibuprofen since they were worried that it can thin the blood and therefore contribute to swelling. I was on 4000 mg Tylenol at the hospital and after, and they also gave me 300 mg of Gabapentin though I stopped it after 3 days in case it was contributing to my rash. (They also gave me Oxycodone again, but I ignored it and didn’t take it.) After I stopped taking Gabapentin, I decided to decrease 250 mg of Tylenol a day, and only if I felt that I wasn’t in too much discomfort (discomfort can easily turn into pain without medication).
There had been a spot in my left chest (where I had felt the stabbing pain) that hurt more than the rest of my chest ever since my first surgery on the 5th. I had thought that this was due to the hematoma on the left side, but it persisted even after the area had been aspirated, and I felt a hard lump in the location. I thought it might be a seroma, so I made an appointment with my post-op doctor. It turned out to be the drain; something about its positioning had really made things painful (and even more so when I had the hematoma). After it was removed the pain in that area decreased drastically and I was able to slowly transition off of Tylenol 250 mg a day.
My doctors kept underestimating the amount of time I would be dealing with pain (usually by a week+). Trust your sense of pain and go slow.

Make sure you’re hydrated and have had something to eat before getting your drains pulled.

I had to get my drains pulled 3 times, twice on the right since they put the drain back in after the second surgery, and once on the left. The first two times went without incident; didn’t even feel a thing. The third time, though, was really early in the morning, and as a late waker I didn’t have water or anything to eat. My blood pressure that day was low due to this, even though it had been normal in all my other appointments. After they pulled the right drain for the second time, I started feeling extremely nauseous. They gave me a damp, cool towel to put around my neck and laid me down at an angle that had my head below my shoulders until I felt better. So just be aware that this can happen if your blood pressure is low.
That about covers the things I wish I had done differently. Below are some other random useful tips that aren’t related to hematomas and infection. Hope any of this proves useful to someone else.
Miscellaneous tips:

My surgical team had a habit of just waiting for questions from me instead of offering me information. If you need questions to ask your surgeon for pre-op, here is a link to a google doc that had my questions. If your surgeon gives you a packet of information beforehand, some of this might already be answered.
My surgeon said to take “small sips of water” up to 4 hours before my surgery, but the anesthesiologist told me to drink more because it helps to be hydrated to get the IV in. So I woke up 4 hours before to chug water for this reason as I have small veins.
If you have worries about possibly having sleep apnea, it’s probably better to get intubated for the surgery so your throat can’t constrict around the tube. I have light sleep apnea when I lay on my back. Get tested before your surgery if you’re worried about it. If it’s significant you should figure out whether you need a machine (and which one you can tolerate, since CPAP tends to be too uncomfortable for most people) since you’ll be sleeping on your back for a while and the back is the worst position for sleep apnea.
They will ask you to take a pregnancy test before surgery to make sure you aren’t pregnant. If you are sure you aren’t pregnant, you should be able to say no and sign a form saying that you neglect to pee in a cup (or have blood taken for this). They didn’t tell me this the first time I had surgery, but the nurse I had with me the second time was really nice and let me know I didn’t actually have to do this. I personally am asexual and have never had sex, so obviously this test was a waste of time for me anyway.
If you have foot pain due to something like plantar fasciitis, get a small pillow to put under your legs (I often readjust where exactly I put it while sleeping) since you have to sleep on your back for a while. I often had to move the pillow up and down to take pressure off my heels. After about 7 weeks of this I had to just start sleeping with my heels hanging off the edge of the bed in addition to the small pillow.
Advocate for yourself in hospitals. The hospital I was at didn’t coordinate their blood draws and so I was stabbed something like 5 times in a single day, mostly for single tests. After I complained to the nurse and my surgeon, the blood draws were stopped entirely since the last results looked okay. I was told by the nurse that it tends to be haphazard for the first day, after which they usually figure things out enough to group blood test requests all at the start of the day for every day after. But I was already required to be poked in both arms to even get admitted, and I had done a blood test for my surgeon earlier that day to confirm I actually had an infection, so adding 3 more to that (for a total of 6, 5 in the hospital) was really just too much. You can refuse and you can probably demand that they group the tests earlier on.

Male 24 (please scroll for other information that may or may not be needed for the advice you give me)
On day 6 of recovery from wisdom tooth extraction and I’m both confused and agitated. Today I woke up at 4 am to the feeling of my jaw on the side of extraction site vibrating but it’s painful like a “cutting the skin to bleed” type of pain
Is this normal? How can I stop it? When should I worry?
If you’re asking me if I am able to ignore it the answer is no; nothing is distracting me from this pain.
Allergies and Intolerances: Used to be midly allergic to eggs (can eat them now) Lactose Intolerance
Daily Medications: Mirtazapine 30mg AntiDepressants
Pain Meds I have been taking: 2x Co-Codamol (8mg of Codiene mixed with 500mg paracetamol in the non-coated pill form) when I wake up and before I go to bed 2x Ibuprofen 200mg liquid capsules every 4-6 hours (an hour after taking the Co-Codamol in the morning and an hour before taking the Co-Codamol for bed)
Extraction information: Bottom Jaw on the left side; tooth was growing horizontally pushing my nearest molar also called an “angular impaction”
Remedies I have been suggested to use by dentist and my personal results:
Daily salt water rinse - causes pain when the water touches the cut and hits the stitches and well as a gagging sensation opted for orthodontist and dentist approved mouthwash appropriate to use after a tooth related surgery or extraction which hasn’t caused any pain or gagging sensations
Ice pack on the site for 25 minutes on then 30 minutes before using it again - minor improvement in terms of swelling, pain management quality sub-par
Increase protein for 2 weeks to help with healing and recovery
Any of other advice you think would be helpful is appreciated.
Thank you
Edit in accordance to rules: Not a drinker, only smoke weed and use an reusable vape with regulated e-liquids. I don’t have a picture of the X-ray and not comfortable showing my face.

I had a larsoscopy in January for endometriosis. They cut my ateraty during surgery, and I bled into my pelvis and left side of my labia. I had a grade 3 hematoma for around 4 weeks. Ultrasound confirmed it had resolved. I had no physical follow up with my surgeon and was discharged whilst still suffering from pain in surgery site, back and groin whilst sitting and on return to activity post op at 2 months.
The pain developed within a week of my discharge to my groin. I developed a deep burning sensation that worsened in evening. After urine samples, swaps, and pessaries for dryness, my GP and boyfriend who is a doctor agreed it may likely be nerve injury or flare related to post op complications. I'm now on Pregabalin and doing stretches at home I've responded well too. I'm still struggling, but managing pain for meds and slowly been able to move more without pain and sit again (which was impossible before) and on some days have reduced my Pregabalin dose from 150mg per day to 125mg. I'm still very restricted on mobility and lose the ability to relieve myself (bladder always feels full) when pain is pretty bad. I've been diagnosed with suspected pudenal neuralgia.
I've had no MRI or ultrasound scan yet on area. I'm seeing a specialist gyno unit in 6 weeks and just started paying privately for pelvic floor physio. I've found the pain is worse after physio but it's helping, although today I've had difficulty opening my bowels and feel tired/fatigued all over, and have pain in my back and tail bone. Although I'm taking codiene for pain so I'm aware of constipation issues this can cause and the physio performed a massage which I know can cause pain later on. I've got reduced sensation in my left labia, inner thigh and loss of strength compared to right side. I've had this since the surgery which I put down to the hematoma. I was told it would return but it never did. My physio says they are concerned I have Cauda Equina based on urine difficulties and lower back pain and asked me to go hospital. My boyfriend performed another examination at home and disagrees with her. I've decided to wait until Monday and get my GP to make the final call, as she is overseeing my care essentially.
Should I be concerned? Im not sure whether to freak out and have just been taking it easy this weekend but again, I'm having a low pain day incase of nerve pain!

Before I start I'd like to apologize for any spelling error I might have, english isn't my first language. And also if this post feels too corny. What I aim for is to see if people here had a similar feeling as I did, which is something I can partially confirm as I've had several conversations with fans and the general consensus is that find relatable my experience.
To begin with, I would like to provide some context as to when I first saw the series. The first time I saw the series was two years ago, when I was 14 years old. At the time I was really depressed as a consequence of a low self-esteem and some circumstances regarding my family (which I won't get into). My coping mechanism at the time was spending most of the time at home and the times I went out was to get drunk and occasionally use some drugs like oxycodone and xanax. Not a great time, as one can tell.
One of those days when I was at home I decided to watch some animes for the first time, as I wasn't very knowledgeable about the medium and I felt ready to try something new. Most of the animes I watched didn't leave me a very big impression, they were just like fast food, not very bad but not great. However, after browsing around for a while I came across Re:Zero, which I had some knowledge of because I recognized Rem and Ram. I gave it a try expecting another totally unremarkable series made popular by some cute waifus. But oh boy was I wrong, it was something I didn't expect.
The first times were it really shined for me was in the episodes 7, 15 and 18 of season 1. For some reason they left a very big impression, not only were they telling an interesting story but I could feel the passion that the producers poured into the series which range from the very minor details to things like the voice acting and music (the last one being something I'll delve into later). Dialogues are something in which Re:Zero does not falter either, although some of them (especially the one in ep 11 with rem) felt cheesy. But this does not include episode 18, which has the best description I've ever of how desperation and the feeling of being secluded takes a toll on a person. It resonated with me to the very core of my being, being extremely accurate as to what I was feeling at the moment. So accurate in fact that it even got right my feeling of wanting of disapppear, on top of that with reasons quite similar to the ones I was suffering at the time (especially that of feeling useless and inadequate for the people around me). For some people this scene also plays a similar role.
The rest of the episodes (including season 2) also had some very similar moments, but I wanted to specially highlight that scene as it's the one that cemented my love for the series.
The music also plays a HUGE role overall, it describes the full range of emotions in a perfect way. From pure unadulterated happiness, epic moments, fight scenes, desperation, loneliness and uncaniness; it does its job perfectly. For me the most important are looking for the light and fantasy lied. The first one describes a moderate feeling of sadness, like something very impactful but managable at first, where as we get to the end of the song it comes clean about its feelings and relaxes. However Fantasy lied is the pure definition of loneliness, as if someone was looking at the sunset for the last time and reliving his experiences at life, coupled with a feeling of melancholy.
That's for the most part what I wanted to express, I hope I'm too overbearing or annoying. For people reading this I would like to know your experiences with the series.
PD: I promise I usually write better in english, but for some reason I find difficult when writing things to public forums. I know the format isn't very good.
Edit 1: Just a small clarification so I don't give the impression of being a meathead or other wrong vibes. At the time I used substances my family wasn't in shambles (but also not that good) and if they noticed there was something wrong with me they've have helped, but I did a good deal to conceal any of my problems. While my grades suffered a little bit I was performing well at school without doing much.

Title: Understanding Fentanyl: Uses, Risks, and Controversies
Introduction: Fentanyl, a potent synthetic opioid, has gained significant attention in recent years due to its role in the opioid epidemic. This article aims to provide a comprehensive overview of fentanyl, including its medical uses, associated risks, and the controversies surrounding its widespread misuse.
Medical Uses: Originally developed for managing severe pain, especially in cancer patients, fentanyl is an analgesic that is 50 to 100 times more potent than morphine. It is commonly used in medical settings for pain management during surgeries, chronic pain conditions, and palliative care.
Risk Factors: While fentanyl is effective in controlling pain when administered under medical supervision, its misuse poses serious health risks. The drug's high potency increases the likelihood of overdose, leading to respiratory depression and, in extreme cases, death. Illicitly manufactured fentanyl, often mixed with other substances, has been a major contributor to the rising number of opioid-related deaths.
Controversies and Illicit Use: The illicit use of fentanyl has sparked controversy and public health concerns. The drug is often clandestinely produced and added to other drugs, such as heroin or cocaine, without the user's knowledge. This has resulted in a surge in overdoses, as individuals may unintentionally consume lethal doses of the opioid.
Law Enforcement and Regulation: Governments and law enforcement agencies worldwide are grappling with the challenges posed by the illicit production and distribution of fentanyl. Efforts to regulate its manufacturing and distribution are ongoing, with stricter controls in place to prevent diversion into illegal channels.
Treatment and Harm Reduction: Addressing the fentanyl crisis requires a multi-faceted approach, including expanded access to addiction treatment, harm reduction strategies, and public awareness campaigns. Naloxone, an opioid receptor antagonist, has proven effective in reversing opioid overdoses and is increasingly available to first responders and the general public.
Conclusion: Fentanyl, with its remarkable pain-relieving properties, has become a double-edged sword in the realm of healthcare. While it serves a crucial role in medical settings, its misuse poses severe risks to public health. Efforts to combat the opioid epidemic must focus on education, regulation, and treatment to strike a balance between managing pain effectively and preventing the tragic consequences of its illicit use.
Narcan, also known by its generic name naloxone, is a medication used to rapidly reverse opioid overdose. It works by binding to the same receptors in the brain that opioids target, effectively reversing the life-threatening effects of opioid toxicity. Narcan is commonly administered in emergency situations where an individual is experiencing respiratory depression or unconsciousness due to opioid overdose.
Emergency responders, healthcare professionals, and even some non-professionals, such as family members of individuals at risk of opioid overdose, may carry naloxone. The medication is available in various forms, including nasal sprays and injectable formulations, making it accessible for different situations.
The prompt administration of Narcan can restore normal breathing and consciousness, providing crucial time for the affected person to receive further medical attention. It is an essential tool in harm reduction strategies aimed at preventing opioid-related deaths and is a key component of public health initiatives addressing the opioid epidemic.
Suboxone is a prescription medication used in the treatment of opioid dependence and addiction. It is a combination of two active ingredients: buprenorphine and naloxone.

Buprenorphine: This is a partial opioid agonist, meaning it binds to the same receptors in the brain that opioids bind to but with less intensity. It helps to reduce cravings and withdrawal symptoms, allowing individuals in recovery to better manage their addiction.
Naloxone: Naloxone is an opioid receptor antagonist, which means it blocks the effects of opioids. When taken as directed, naloxone remains largely inactive. However, if someone were to misuse Suboxone by injecting it, the naloxone component can counteract the opioid effects, reducing the risk of misuse.

Suboxone is often prescribed as part of medication-assisted treatment (MAT), a comprehensive approach to opioid addiction that includes counseling, therapy, and support services. It can be used in the detoxification phase as well as for long-term maintenance therapy. The goal of Suboxone treatment is to help individuals gradually reduce their dependence on opioids, manage cravings, and improve their overall quality of life during recovery.
It's important to note that Suboxone should only be used under the supervision of a qualified healthcare professional, as improper use or abrupt discontinuation can lead to withdrawal symptoms or other complications.
Precipitated withdrawal refers to the accelerated onset of withdrawal symptoms, often more severe than typical, when an opioid antagonist is introduced to the body. This occurs because the antagonist displaces the opioid from receptors, leading to a sudden and intense withdrawal reaction.
For example, if someone is currently dependent on opioids and receives a medication like naloxone or naltrexone, which are opioid antagonists, it can rapidly trigger withdrawal symptoms. This is a safety mechanism, as these medications are often used to reverse opioid overdose or as part of addiction treatment.
The term is commonly associated with medication-assisted treatment for opioid use disorder, where medications like buprenorphine (a partial opioid agonist) are used. If buprenorphine is administered before other full opioids have cleared from the system, it can displace those opioids from receptors, leading to precipitated withdrawal. This is why healthcare providers carefully time the initiation of medications like buprenorphine to avoid this intensified withdrawal reaction.
Understanding the potential for precipitated withdrawal is crucial in the context of addiction treatment to ensure safe and effective transitions between medications and to minimize discomfort for individuals in recovery.
Using Suboxone involves adherence to a specific treatment plan under the guidance of a qualified healthcare professional. Here are some key aspects related to the use of Suboxone:

Prescription and Medical Supervision: Suboxone is a prescription medication, and its use should be initiated and supervised by a qualified healthcare provider, typically in the context of medication-assisted treatment (MAT) for opioid use disorder.
Dosage: The healthcare provider will determine the appropriate dosage based on the individual's specific needs and response to the medication. It's essential to follow the prescribed dosage and not adjust it without consulting the healthcare provider.
Administration: Suboxone is often administered sublingually, meaning it is placed under the tongue and allowed to dissolve. This method allows for the absorption of the medication into the bloodstream.
Timing: The timing of Suboxone administration is crucial. It is often started when the individual is in a mild to moderate state of withdrawal to reduce the risk of precipitated withdrawal. The healthcare provider will provide guidance on the appropriate timing.
Regular Monitoring: During Suboxone treatment, individuals are regularly monitored by healthcare professionals to assess progress, manage side effects, and adjust the treatment plan as needed.
Counseling and Support: Suboxone is typically part of a comprehensive treatment plan that includes counseling, therapy, and support services. This holistic approach addresses both the physical and psychological aspects of opioid addiction.
Gradual Tapering: Depending on the treatment plan, there may be a gradual tapering of Suboxone dosage as the individual progresses in their recovery. Tapering is done under medical supervision to minimize withdrawal symptoms.
Avoiding Other Opioids: It's crucial to avoid the use of other opioids while taking Suboxone. Combining opioids can lead to dangerous interactions and diminish the effectiveness of the treatment.
Side Effects and Reporting: Like any medication, Suboxone may have side effects. Common side effects include headache, nausea, and constipation. Any unusual or severe side effects should be promptly reported to the healthcare provider.
Pregnancy Considerations: If an individual is pregnant or planning to become pregnant, it's important to discuss this with the healthcare provider, as the use of Suboxone during pregnancy requires careful consideration.

Always follow the guidance of your healthcare provider and inform them of any concerns or changes in your condition during Suboxone treatment. Successful recovery often involves a combination of medication, counseling, and support tailored to individual needs.
Suboxone, when used as prescribed under the supervision of a healthcare professional as part of medication-assisted treatment (MAT) for opioid use disorder, has a lower potential for abuse and addiction compared to full opioid agonists. This is because Suboxone contains buprenorphine, a partial opioid agonist, which has a ceiling effect on its opioid effects.
Buprenorphine's partial agonist properties mean that it activates opioid receptors in the brain to a lesser extent than full agonists like heroin or oxycodone. As a result, the euphoria and respiratory depression associated with opioid abuse are less pronounced with buprenorphine.
However, it's essential to emphasize that any medication, including Suboxone, should be taken exactly as prescribed by a healthcare professional. Misuse, such as taking larger doses or combining Suboxone with other substances, can increase the risk of dependence or addiction.
Abruptly stopping Suboxone can lead to withdrawal symptoms, emphasizing the importance of a gradual tapering plan under medical supervision when discontinuing the medication. It's crucial for individuals using Suboxone to work closely with their healthcare provider to ensure proper management of their opioid use disorder and to address any concerns or side effects during the course of treatment.
Withdrawal symptoms from Suboxone, or buprenorphine (the active ingredient in Suboxone), can occur when someone who has been using the medication for an extended period stops taking it abruptly. It's important to note that withdrawal symptoms can vary in intensity and duration based on factors such as the individual's overall health, the duration of Suboxone use, and the dosage.
Common withdrawal symptoms from Suboxone may include:

Nausea and vomiting
Diarrhea
Muscle aches and pains
Sweating
Insomnia or sleep disturbances
Anxiety
Irritability
Runny nose and teary eyes
Goosebumps (piloerection)
Dilated pupils

It's important to distinguish between withdrawal symptoms and precipitated withdrawal. Precipitated withdrawal can occur if someone takes Suboxone too soon after using a full opioid agonist, leading to a more rapid and intense onset of withdrawal symptoms.
Withdrawal from Suboxone is generally considered less severe than withdrawal from full opioid agonists, and the symptoms tend to peak within the first 72 hours after discontinuation. However, the duration and severity can vary from person to person.
If an individual is considering stopping Suboxone or adjusting their dosage, it's crucial to do so under the guidance of a healthcare professional. Tapering the medication gradually, rather than stopping abruptly, can help minimize withdrawal symptoms and increase the chances of a successful transition to recovery. Seeking support from healthcare providers, counselors, and support groups is essential during this process.
Kratom is a tropical tree native to Southeast Asia, specifically in countries like Thailand, Malaysia, Indonesia, Papua New Guinea, and Myanmar. The leaves of the Kratom tree have been traditionally used for various purposes, including as a stimulant, a pain reliever, and to manage opioid withdrawal symptoms.
The active compounds in Kratom, called alkaloids, interact with opioid receptors in the brain, producing effects that can vary depending on the strain and dosage. These effects can include:

Stimulation: At lower doses, Kratom may act as a stimulant, promoting increased energy, alertness, and sociability.
Sedation: At higher doses, Kratom may have sedative effects, leading to relaxation and pain relief.
Pain Relief: Kratom has been used traditionally for its analgesic properties, and some people use it as a natural remedy for pain.
Mood Enhancement: Some users report improved mood and reduced anxiety after consuming Kratom.

However, it's important to note that Kratom is not regulated by the U.S. Food and Drug Administration (FDA), and its safety and effectiveness for various uses have not been clinically proven. There are potential risks associated with Kratom use, including dependence, addiction, and adverse effects such as nausea, constipation, and increased heart rate.
Due to these concerns, Kratom has been a subject of regulatory scrutiny in various countries, with some regions imposing restrictions or outright bans on its sale and use. It is essential for individuals to exercise caution, seek reliable information, and consult with healthcare professionals before considering the use of Kratom, especially for medicinal purposes or to manage opioid withdrawal.
Methadone is a synthetic opioid medication used primarily in the treatment of opioid dependence, particularly in the context of medication-assisted treatment (MAT). It is a long-acting opioid agonist, meaning it activates the same opioid receptors in the brain that other opioids, like heroin or morphine, do.
Key points about Methadone include:

Opioid Dependence Treatment: Methadone is often used as a maintenance medication to help individuals reduce or quit the use of illicit opioids. It helps by reducing cravings and withdrawal symptoms.
Long-Lasting Effect: One significant advantage of methadone is its long duration of action. A single daily dose can help stabilize individuals, preventing the highs and lows associated with short-acting opioids.
Supervised Administration: In some cases, methadone is provided through supervised administration in specialized clinics to ensure proper use and minimize the risk of diversion.
Tolerance and Dependence: Like other opioids, individuals using methadone can develop tolerance and dependence. Therefore, the dosage needs to be carefully managed, and discontinuation should be done gradually under medical supervision.
Reduction of Illicit Drug Use: When used as part of a comprehensive treatment plan, methadone has been shown to reduce illicit opioid use, lower the risk of overdose, and improve overall health outcomes.
Potential Side Effects: Methadone can have side effects, including constipation, sweating, drowsiness, and changes in libido. It's important for individuals to report any adverse effects to their healthcare provider.
Regulated Use: The use of methadone is tightly regulated, and it is typically dispensed through specialized clinics or healthcare providers who are authorized to prescribe it for opioid use disorder treatment.

Methadone treatment is part of a broader approach that often includes counseling, therapy, and support services. It has been a valuable tool in harm reduction strategies aimed at addressing the opioid epidemic and helping individuals achieve and maintain recovery.
Narcotics Anonymous (NA) is a 12-step program that provides support for individuals recovering from addiction, particularly those struggling with substance abuse issues. It is important to note that NA, like other 12-step programs, does not have an official stance or opinion on specific medical treatments, including medication-assisted treatment (MAT) for withdrawal.
The approach to medication assistance in withdrawal can vary among individuals within the NA community. Some may find success and support in MAT, while others may choose alternative methods or prefer an abstinence-based approach. NA encourages individuals to share their experiences, strength, and hope, but it does not dictate specific treatment choices.
The primary focus of NA is on mutual support, fellowship, and following the 12-step principles, which include admitting powerlessness over addiction, seeking spiritual awakening, and helping others in recovery. Members of NA are encouraged to respect each other's choices and paths to recovery.
It's essential for individuals seeking support for addiction to find a treatment plan that aligns with their needs and values. Consulting with healthcare professionals, attending support groups, and considering various treatment options can be part of a comprehensive approach to recovery.
SMART Recovery (Self-Management and Recovery Training) is a science-based, secular alternative to traditional 12-step programs like Narcotics Anonymous. SMART Recovery emphasizes self-empowerment and utilizes evidence-based techniques to support individuals in overcoming addiction.
Regarding Medication-Assisted Treatment (MAT), SMART Recovery takes a neutral stance. The program acknowledges that MAT, when prescribed and monitored by healthcare professionals, can be a valid and effective part of a comprehensive approach to addiction treatment. SMART Recovery recognizes that different individuals may have unique needs, and treatment plans should be tailored to the individual's circumstances.
SMART Recovery's focus is on teaching self-reliance, coping skills, and strategies for managing urges and behaviors associated with addiction. The program encourages participants to make informed decisions about their recovery, including the consideration of medications that may be prescribed by healthcare providers.
Ultimately, SMART Recovery emphasizes a holistic and individualized approach to recovery, allowing participants to choose the methods and tools that best suit their needs and align with their values. This includes being open to the potential benefits of MAT for some individuals as part of their overall recovery plan.
Several treatment modalities are available for individuals struggling with opioid use disorder. The most effective approach often involves a combination of different strategies. Here are some key treatment modalities for opioid addiction:

Medication-Assisted Treatment (MAT): MAT involves the use of medications, such as methadone, buprenorphine (Suboxone), and naltrexone, to help manage cravings, reduce withdrawal symptoms, and support recovery. These medications are often used in combination with counseling and therapy.
Counseling and Behavioral Therapies: Various forms of counseling and behavioral therapies are crucial components of opioid addiction treatment. Cognitive-behavioral therapy (CBT), contingency management, motivational enhancement therapy, and dialectical behavior therapy (DBT) are among the approaches used to address the psychological aspects of addiction and help individuals develop coping skills.
Support Groups and 12-Step Programs: Participating in support groups like Narcotics Anonymous (NA) or 12-step programs can provide valuable peer support, encouragement, and a sense of community for individuals in recovery.
Detoxification Programs: Medically supervised detoxification programs help individuals safely manage the acute withdrawal symptoms associated with stopping opioid use. These programs often serve as the initial phase of treatment.
Residential or Inpatient Treatment: Inpatient treatment programs provide a structured and supportive environment for individuals to focus on recovery. These programs may include a combination of medical supervision, counseling, and therapeutic activities.
Outpatient Treatment: Outpatient programs allow individuals to receive treatment while living at home. This flexibility can be beneficial for those with work or family commitments. Outpatient treatment often includes counseling, therapy, and medication management.
Holistic and Alternative Therapies: Some individuals find benefit from holistic approaches, such as acupuncture, yoga, meditation, or mindfulness practices. These can complement traditional treatment modalities and contribute to overall well-being.
Peer Recovery Support Services: Peer recovery support services involve individuals with lived experience in recovery providing support, guidance, and encouragement to others going through similar challenges.

The most effective treatment plans are often individualized, taking into account the specific needs, preferences, and circumstances of each person. Collaborating with healthcare professionals to develop a comprehensive and tailored approach can significantly enhance the chances of successful recovery from opioid addiction.
The withdrawal timeline for fentanyl, a potent synthetic opioid, can vary among individuals based on factors such as the duration and intensity of use, individual metabolism, and overall health. Fentanyl withdrawal symptoms typically start shortly after the last dose and follow a general timeline:

Early Symptoms (Within a few hours): Early withdrawal symptoms may include anxiety, restlessness, sweating, and increased heart rate. Individuals may also experience muscle aches and insomnia.
Peak Intensity (24-72 hours): Withdrawal symptoms usually peak within the first 24 to 72 hours after discontinuing fentanyl. During this time, individuals may experience more intense symptoms such as nausea, vomiting, diarrhea, abdominal cramps, dilated pupils, and flu-like symptoms.
Subsiding Symptoms (5-7 days): The most acute withdrawal symptoms generally begin to subside within about five to seven days. However, some symptoms, such as insomnia, anxiety, and mood swings, may persist for a more extended period.
Post-Acute Withdrawal Syndrome (PAWS): Some individuals may experience a more prolonged period of withdrawal symptoms known as post-acute withdrawal syndrome (PAWS). This can include lingering psychological symptoms such as anxiety, depression, irritability, and difficulty concentrating. PAWS can persist for weeks or even months.

It's crucial to note that fentanyl withdrawal can be challenging, and seeking professional help is recommended to manage symptoms safely and effectively. Medical supervision can provide support through the detoxification process, and healthcare professionals may use medications to alleviate specific withdrawal symptoms and improve the overall comfort of the individual.
The withdrawal process is highly individual, and some individuals may find additional support through counseling, therapy, and participation in support groups to address the psychological aspects of recovery. Always consult with healthcare professionals for guidance on the safest and most effective approach to fentanyl withdrawal.
Xylazine is a veterinary sedative and analgesic medication. It belongs to the class of drugs known as alpha-2 adrenergic agonists. While it is primarily intended for veterinary use, xylazine has been misused in some cases for recreational purposes, particularly in combination with other substances.
In veterinary medicine, xylazine is commonly used as a sedative and muscle relaxant for various procedures, including surgery and diagnostic imaging. It is often administered to calm and immobilize animals.
However, the use of xylazine outside of veterinary settings, especially when combined with other drugs, can pose serious health risks. Misuse of xylazine has been associated with adverse effects, including respiratory depression, cardiovascular issues, and central nervous system depression.
It's important to emphasize that the use of xylazine for recreational purposes is highly dangerous and illegal. The drug is not intended for human consumption, and its effects can be unpredictable and potentially life-threatening.
If you have concerns about substance use or encounter situations involving illicit drugs, it is crucial to seek help from healthcare professionals, addiction specialists, or local support services. Misuse of veterinary drugs or any substances not prescribed for human use can have severe consequences and should be avoided.
PAWS stands for Post-Acute Withdrawal Syndrome. It refers to a set of prolonged withdrawal symptoms that some individuals may experience after the acute phase of withdrawal from substances like opioids, benzodiazepines, or alcohol. PAWS is not limited to a specific substance and can occur with various drugs.
These symptoms are generally more subtle than the acute withdrawal symptoms but can persist for weeks, months, or, in some cases, years after discontinuing substance use. PAWS can vary widely among individuals and may include symptoms such as:

Mood swings
Anxiety
Irritability
Insomnia
Fatigue
Difficulty concentrating
Memory problems
Reduced impulse control
Cravings for the substance

PAWS can be challenging for individuals in recovery, as these lingering symptoms may contribute to relapse if not effectively managed. Supportive interventions, such as counseling, therapy, and participation in support groups, can be beneficial for individuals experiencing PAWS. Healthy lifestyle choices, including regular exercise, proper nutrition, and adequate sleep, may also contribute to the overall well-being of those in recovery.
It's important to note that PAWS is not experienced by everyone in recovery, and its severity and duration can vary. Seeking guidance from healthcare professionals or addiction specialists can assist individuals in managing PAWS and maintaining long-term recovery.
Quitting substance use "cold turkey" involves stopping the use of a substance abruptly without tapering or gradually reducing the dosage. It's important to note that quitting cold turkey can be challenging, and the level of difficulty varies depending on the substance, the duration and intensity of use, and individual factors.
If you're considering quitting a substance cold turkey, here are some general recommendations:

Seek Professional Guidance: Before making the decision to quit cold turkey, it's advisable to consult with a healthcare professional or addiction specialist. They can provide guidance based on your specific situation, assess potential risks, and offer support.
Create a Support System: Inform friends, family, or a support network about your decision to quit. Having a support system in place can provide encouragement, understanding, and assistance during challenging times.
Understand Withdrawal Symptoms: Be aware of potential withdrawal symptoms associated with quitting the substance cold turkey. Withdrawal symptoms can vary depending on the substance but may include anxiety, irritability, insomnia, and other physical or psychological effects.
Stay Hydrated and Nourished: Maintaining proper hydration and nutrition is crucial during the quitting process. Stay hydrated by drinking water and consuming a balanced diet to support your overall well-being.
Exercise: Engage in regular physical activity. Exercise can help alleviate stress, improve mood, and contribute to your overall physical and mental health.
Consider Professional Treatment: Depending on the substance and the severity of dependence, professional treatment options, such as inpatient or outpatient programs, may be beneficial. Medical supervision can assist in managing withdrawal symptoms and ensuring safety.
Therapy and Counseling: Consider participating in therapy or counseling to address the underlying factors contributing to substance use and to develop coping strategies for a successful recovery.
Plan for Triggers: Identify situations, environments, or emotions that may trigger the urge to use the substance. Develop a plan to cope with these triggers without resorting to substance use.

It's essential to approach quitting any substance with a comprehensive strategy, and individual circumstances vary. Seeking professional advice ensures that you make informed decisions about the best approach for your specific situation. If you are experiencing severe withdrawal symptoms or have concerns about quitting cold turkey, it is crucial to consult with a healthcare professional for guidance and support.
Tapering refers to the gradual reduction of the dosage of a substance, typically a medication or a drug, over a specific period. Tapering is commonly used in the context of addiction treatment, where it involves slowly decreasing the amount of a substance to manage withdrawal symptoms and minimize the risks associated with abrupt discontinuation.
Key points about tapering include:

Medication-Assisted Treatment (MAT): Tapering is often part of medication-assisted treatment for substance use disorders. For example, individuals dependent on opioids might undergo a gradual tapering of medications like methadone or buprenorphine.
Reducing Dependence: Tapering is employed to reduce physical dependence on a substance by allowing the body to adjust to lower levels gradually. This helps minimize the severity of withdrawal symptoms.
Individualized Approach: Tapering plans are typically individualized based on factors such as the substance used, the duration and intensity of use, and the individual's overall health. Healthcare professionals design tapering schedules to meet the specific needs of each person.
Supervised Tapering: Tapering is ideally done under the supervision of a healthcare professional to ensure safety and effectiveness. This is particularly important in cases where abrupt discontinuation could lead to severe withdrawal symptoms or complications.
Psychological Support: Tapering is not only about physical adjustments but also addresses psychological aspects of dependence. It provides individuals with an opportunity to develop coping skills and strategies for managing life without reliance on the substance.
Preventing Relapse: Gradual tapering can help reduce the risk of relapse by easing the transition to complete abstinence. It gives individuals the time and support needed to adjust to life without the substance.

Tapering is a careful and structured process that should be guided by healthcare professionals. Abruptly stopping certain substances can lead to severe withdrawal symptoms and potential health risks. Seeking professional advice and support is crucial for a safe and successful tapering process, whether it's part of addiction treatment or the discontinuation of a prescribed medication.
Engaging in activities during withdrawal can help distract from symptoms, provide a sense of accomplishment, and contribute to overall well-being. Here are some ideas for keeping busy during withdrawal:

Reading: Escape into a good book or explore topics of interest to keep your mind occupied.
Movies or TV Shows: Watch movies or binge-watch a TV series to pass the time. Choose lighthearted or inspirational content.
Exercise: Engage in gentle exercises like walking, yoga, or stretching. Exercise can help improve mood and alleviate some withdrawal symptoms.
Creative Hobbies: Explore creative outlets such as drawing, painting, writing, or playing a musical instrument.
Mindfulness and Meditation: Practice mindfulness or meditation techniques to calm the mind and reduce stress.
Gardening: Spend time outdoors, tending to a garden or plants. Nature can have a positive impact on mood.
Puzzle Games: Solve puzzles, play Sudoku, or engage in other mentally stimulating games.
Listening to Music or Podcasts: Create playlists of your favorite music or listen to podcasts on topics of interest.
Cooking or Baking: Experiment with new recipes and treat yourself to nourishing meals.
Journaling: Write down your thoughts and feelings. Keeping a journal can be therapeutic during withdrawal.
Educational Courses: Take online courses or watch educational videos on platforms like Coursera or Khan Academy.
Board Games or Card Games: Play board games or cards with friends or family for some social interaction.
Self-Care Activities: Take relaxing baths, practice skincare routines, or indulge in other self-care activities to nurture your well-being.
Volunteering: If possible, consider volunteering for a cause you're passionate about. Helping others can be rewarding.
Stay Connected: Reach out to friends and family for support. Having a support system is crucial during withdrawal.

It's important to choose activities that align with your interests and energy levels. Remember that withdrawal is a challenging time, and it's okay to prioritize self-care. If symptoms become severe or unmanageable, seeking professional help is recommended.

I am not a healthy person. I've been very sick for a very long time.The first proper diagnosis of chronic pancreatitis I ever received wasn't until December 2016 but I had been suffering from what I would later find out to be what are called pancreatic flare ups. The first occurance I can recall of getting sick was on my 20th birthday in 2002. What I initially thought was just a really bad hangover was in fact the start of a 19 year battle with my pancreas. It typically starts with severe nausea and vomiting. We aren't talking about regular nausea and vomiting, I'm talking about vomiting every 10-15 minutes for what would sometimes be a single day to eventually lasting as long as up to a month. This would also be accompanied by severe abdominal pain in the upper left quadrant of my abdomen that on good days feels like someone is taking a crochette needle, hooking onto my pancreas and pulling it out of a tiny hole in my back, to where on the worst days it feels like someone is taking my pancreas and trying to wring it out like a wet rag. When I am in a flare up the latter is usually the deciding factor on whether or not I get myself to a hospital. So understand that over the last 19 years I have been to emergency rooms and have been admitted to the hospital no less than 50 times, i'm not 100% on that number but i'm definitely low balling that number because if I only go to the hospital twice in a year I consider that to be a VERY good year to there have been years when i'm going to the hospital every other month. Given all these things I have grown to know what works and what does not when it comes to treatment of my disease. There is no apparent cause or none have been found since my official diagnosis in 2016 and treatment is relegated to simply managing the symptoms i.e. pain management. The most effective treatment is as follows. Administrations of IV pain medication hydromorphone also known as Dilaudid 1.5mg every 3 hours, administration of IV nausea and vomiting medication Zofran every 6 hours as needed and constant fluid saline IV bags while NPO (nothing by mouth) no food, no water, no anything for the duration of the symptoms. If symptoms last for more than 1 week TPN (total parental nutrition) is administered. TPN is a nutrient-complete solution administered directly into veins via a central IV line and continued until I can start eating and drinking again, very slowly and gradually starting with water and chicken or beef broth and slowly advancing my diet from there. This can at times go on for several weeks, my longest flareup lasting approximately 3 weeks. Fast forward to 2019 I had been getting sick a lot more often, every couple of months and was going to the hospital all the time so I had to quit my job of 12 years to focus on my health. This is the lowest point in my entire life. I had no income and was too sick to work, if not for the pandemic and me not having to pay rent for that year I would have been not only very sick but also very homeless. I had applied several times for disability and after finally enlisting some legal assistance was finally able to be approved for a whopping $1547 a month. I have worked and paid taxes and into disability for almost 25 years but at least its something and i;m able to not be homeless so I guess i'm kinda lucky. My life is very very hard and it takes everything in me every single fucking day to not just end my miserable fucking life. I also do this alone as I cannot think to burden someone with all my shit. Nonetheless I am here, writing this letter with the hope that others who share a similar fate don't have to suffer from the embarrassment, shame, pain, and fear that I was made to feel yesterday and still feel very deeply as I write this now. Starting early Christmas morning 2023 I woke up to vomiting on myself and subsequently falling into another flareup. I do not like going to the hospital because now i'm made to feel bad because I have to ask for pain medications and with all the over correction that has been done in relation to the opioid epidemic, it is very hard to now get the proper treatment I require. Emergency rooms now no longer administer IV Dilaudid to patients and are relegated to administering IV morphine as a replacement which for me is completely ineffective in treating my pain and am forced to suffer for many hours until the decision is finally made to admit me, only then do I usually get the Dilaudid I require. So for the last 4 months I have been having flareups every month but have not gone to the hospital for these reasons. This week I had another flare and i'm almost out of the oxycodone I have left which I use to manage my everyday pain, not for breakthrough pain relief as I need during these events. Another treatment my Dr.s and i have found are Celiac Plexus nerve blocks which dampense the pain impulse I receive through that nerve which I have scheduled for this Friday at UCI medical center's GI department. I received a call from an intake nurse to answer questions prior to my procedure on Friday. I was clearly in distress because the nurse asked me if I had Dilaudid for breakthrough pain and I said no, to which her response was "If it gets too bad, please come into our emergency room so we can take care of you" She clearly knew what she was talking about and knew what I was going through because she deals with people in my exact situation on a daily basis. My abdominal pain just kept getting worse and worse as the day progressed and I couldn't take it anymore so I had my friend drive me to the ER at UCI medical center we arrive Wednesday night approximately 9pm. By the time we get there I can barely walk and need a wheelchair because I was no longer ambulatory. We get there and It's an absolute madhouse.There are patients everywhere, no open seats but at least i'm in the wheelchair and my pain level at this point is a 10/10 i'm moaning because breathing hurts so damn much. The triage nurse took one look at me and said ok we're putting you at level 2 because I can tell you're really hurting. I proceed to tell her im having a pancreatic flare, she asks me what helps? I tell her 1.5mg of dilaudid, but in my mind I know what I'm probably in store for. I get seen very quickly as my case was pretty evidently emergent. The first and only times i'm ever ALLOWED to even talk to a Dr. is at this point of the night in triage. The first Dr. a Dr. Tapia came to see me and I told him what was going on. I believe he was a resident as he was reporting to Dr. Megan E Guy a few feet away from me. She walks over and I repeat what I said to Dr. Tapia and I tell them both what treatment I typically receive when in these conditions. They say to me ok well we're gonna start with a GI cocktail and see if that helps, I'm thinking to myself and am pretty sure I said it out loud that it's not gonna help and can we please not go through this? I received no response and that was the last time I even saw Dr. Guy for the rest of the entire night. I was wheeled into another waiting room and sat and waited for about 15-20 minutes before someone came and took me for an x-ray then was returned to the waiting room. After another 20 minutes I was taken into the back to have an IV line placed and finally receive some treatment. I then met my nurse Jhay, I do not know her last name. The GI "cocktail" which was just Pepcid was given at 10:59PM along with 4mg of Morphine, before I was FORCED to take the morphine I begged her not to and that it would be ineffective and wasteful. I was told that I had to take the morphine and would only be given that 3 times at 10 minute intervals and then and ONLY then would the Dr even consider putting in an order for the Dilaudid. So for the next 2 and half hours I sat writhing and moaning in absolute fucking agony. After the third dose the nurse sent 6-7 messages to Dr. Guy requesting the Dialudid and was ignored for a really long time. I asked the nurse can I please just talk to the Dr?? I could tell i was starting to get on her nerves, and i'll be completely honest and say I wasn't the nicest but given my current condition I wasn't in the friendliest mood. I asked her was my Dr. the blonde Dr? She said, "We have many blonde Doctors" I'm thinking to myself, what the fuck? Seriously?? I ask Jhay can I please go find and talk to the Dr? To which she threatened me by saying that if I did she would call security. I was so shocked, I just sat in stunned silence and sat and waited until 1:24AM when I was finally given the Dilaudid. Within a few minutes I could FINALLY feel the pain start to subside. About 10-15 minutes later Jhay went on break and had another nurse who was covering her take me from the hallway back into the waiting room. I was confused as what usually happens next is a CT and I asked the nurse where she was taking me, to which she responded back to the waiting room, I asked WHY? She sort of chuckled and asked "Did you just say why?' in a very condescending tone, she said "cause you already got your treatment" stuck me in the waiting room and sat there for the rest of the night. After a few hours the Dilaudid started to wear off and the pain was back. Jhay is sitting at the desk and I keep asking her can I please have another round of meds i'm in a lot of pain right now. She ignored me for several hours until she finally told me that the Dr. would be out to talk to me. I waited another couple hours when they took me into the back room because i think i was causing too much of a commotion and being annoying because I kept pleading and asking for some kind of attention or treatment. I sat in the little treatment room waiting for about an hour kind of just talking to myself asking what was happening? where is the Dr?? please someone help me...A very mean, nasty, rude nurse by the name of Vanessa was cleaning up and I guess got sick of hearing me moan and ask these questions to basically anyone who would listen got fed up with me and told me "IF YOU DON'T WANT TO WAIT FOR THE DR YOU DONT HAVE TO, YOU'RE DISCHARGED" Me" WHAT? ARE YOU SERIOUS? WHAT IS HAPPENING RIGHT NOW? WHY ARE YOU DOING THIS TO ME? PLEASE CANT YOU JUST HELP ME?? I thought I was getting meds? Vanessa" No, you're getting nothing. You're discharged. Hey Jhay you have his discharge papers?" Jhay" Yeah they're right here" Me" wait, whats happening?? are you guys serious?? Please don't do this, I'm hurting so much" Vanessa" You're discharged, you can leave if you don't want to wait for the Dr" She goes to get the discharge papers and i'm so heated I don't know what to do. She sticks the papers in my face and says sign here. I grab the papers out of her hand and she says "DONT GET AGGRESSIVE!!" Me" WHAT? You're gross, how could you do this to someone?" She walks away and i'm then asked to leave the emergency room. I’m left sitting outside in the cold at 530AM for an hour waiting for my mom to come pick me up. I'm still in a LOT of pain right now. I should still be in the hospital but there's no way I can bring myself to be subjected to this. This was absolutely fucking horrifying. I'm seriously traumatized and i'm terrified of having to go back tomorrow for my procedure but I absolutely can't wait and go somewhere else to have it done. What happened to me is happening every day in every hospital in this country. People are suffering because we can't get the meds and treatment we need because of the greed of one fucking family. I blame everything that happened to me and every other person like me on them. Fuck the Sachlers. If any of them ever asks themselves what has their greed done to this wonderful fucking country and how it affects everyday Americans like me, here assholes. THIS. THIS IS WHAT YOU FUCKING DID. UCI is responsible. The Sachlers are responsible. Dr. Guy is responsible. The nurses are responsible. This isn't all of it though. I just found out that my home hospital, the only one that kind of didn't make me feel like a drug seeking sack of shit was Fountain Valley Regional hospital was just bought by UCI a few months ago and now I have nowhere to go. Nowhere where I can feel safe and taken care of. I spoke with my lawyer and said that legally there’s nothing to be done. I don’t know what to do. I’m so lost and so tired. Please anyone, this is my last resort. I have no other recourse. I have nothing.

I am working with a GI specialist and a handful of other Drs to figure out some health issues I have been dealing with. One major problem, that is becoming exponentially worse and more frequent, revolves around my stomach. I will be going along my day, feeling fine, and the upper part of my stomach, (my guess is around the fudus/ cardiac sphincter area by how it feels) starts to become painful and swollen. My stomach fills with gas and the only relief I get is when I am able to release the gas. Burping can provide quick relief, but the gas in my stomach refills. The longer this goes on the more difficult it becomes to relieve the pain and bloating. Food can make the pain worse, but if I don’t eat there is nothing in my stomach to absorb the extra acid that is creating the gas. Toast can help, but it can also hurt. During an episode I will take dicyclomine, Pantoprazole, Zofran, GasEx, Pepto, metaxalone, marijuana oxycodone and oxymorphone- all Dr approved. Yet I am still left in Intense pain, bedridden, with a hot pack on my tummy. Last night I considered going to the ER, but since I am already working with specialists I can’t imagine how another uncomfortable trip to the ER would be beneficial. All that said, and understanding this is complicated, I am looking for advice about what food I should try, to help reduce the acid and extreme bloating that seems to be causing, or is related to, much of the pain. I have determined that during an episode, I cannot eat any raw vegetables, few raw fruits, meat, most dairy, things that are fatty or acidic. Old school Campbells chicken noodle soup can be helpful, but I really need more options as, at times, this has lasted over a week. Thank you all for the advice, in advance! Let’s hope tomorrow is a better day!

Been on Wegovy since 09/10/2021 and ended up at the maintenance dosage with no symptoms. I had to stop due to kidney stones in December. I started again from beginning since it it's been a few weeks without taking it. Fast forward to 1mg dosage and I'm experiencing a pain that starts in the center of my stomach and radiates towards my lower back and sometimes on each side by the flank. It seems to happen randomly, usually late at night. Can this pain be related to my gallbladder, appendix, or pancreatitis? I've been to Emergency Care twice because of how painful it was, but both CT scans didn't find anything. I'm seeing a GI and they've ordered blood work and stool testing. It seems to be waste of time. Endo and coloscopy the soonest they can do is August. Still waiting for a HIDA scan, I've tried over the counter and ibuprofen but that is not enough to stop the pain. The only thing that works for pain is Oxycodone, which was previously prescribed for my lower back pain and when I had kidney stones in December. I only take it if the pain doesn't go away and becomes too unbearable. I'm going to look for a new GI doctor that can figure out what is going on. It has been 6 weeks since I stopped taking Wegovy, and I worry that it may be pancreatitis or gallblader. I've never had it before, and I don't know if it can go away on its own.

My Experience for those Anxious - Australian Procedure