Oxycodone equivalent to morphine er

8 Female
Admitted 6/3/24 chronic health conditions Genetic disorder Cardiac: VSD, PSA ligated, pulmonary stenosis Chronic Respiratory Failure, aspiration pneumonia, pseudomonas colonized
Went to ER Monday with increased work of breathing and sats in low 90s. Xray showed multi focal pneumonia so were admitted into PICU and started on vancomycin, flagyl, cerephim, and azythromycin via IV. They were giving bipap with 30-40% oxygen flow and ipap/epap settings of 12/6. She was getting albuterol nebs, chest pt vest, and cough assist every three hours. Unfortunately as she became more agitated she started to fight bipap so decision was made to start on presidex after no success on Ativan and Valium. Yesterday she started to have fluid build up so they added Diuril. At about 8 pm last night after chest pt vest one of her lungs collapsed and we couldn’t get her more stable on bipap alone so decision was made to intubate. Her work of breathing was high. Intubation went smoothly and was not considered emergent. Now she is resting comfortably on morphine. Labs look okay, can share more specifics but lactates have been in normal range but going up slightly, as have creatinines. She has high NA but they said its the Iv, she is switching to TPN today. Sputum cultures shows no growth so they think antibiotics are covering bacterial pneumonia. She has high c-reactive proteins.
I guess I am wondering what the prognosis is. We are preparing for worst case scenario.

I’ve (26M) struggled with depression and some suicidal ideation on and off since I was 16. It was a long road and took a lot of work on myself and countless hours of therapy, but around the end of 2023, I was in what I now consider to be the peak of my life. I was working a job I mostly liked, two semesters away from finishing my bachelor’s degree online and exercising almost every other day. After years of loneliness, I finally found a friend group I really adored spending time with, and I had a boyfriend with whom I hadn’t even realized I had fallen in love, whom I’d seen for about 6 months. For perhaps the first time, I had a generally positive outlook, I felt confident and attractive, and I had so much going for me. I had no clue that I was about to make a decision that would significantly alter that course and steer me off into the deepest, darkest depression and most relentless desire to end it all that I’ve ever felt. This is a very long and personal post about my decision to have surgery that I now, in hindsight, believe to have been unnecessary. The surgery itself has left me with chronic pain and probably lifelong negative consequences that are far worse than anything I ever experienced prior. I’ve kept most of this to myself other than sharing it with my therapist, and although I’m on the ledge, I think writing it all down and putting it out there may calm me somewhat. I haven’t spared some graphic details of some of the more sensitive changes to my body because I want this to be as detailed and accurate as possible. And anyway, why should I care? I may be dead soon anyway... My hope is that if I share my story, someone, somewhere, might benefit from it and might not make the same mistake I did that has me sincerely wanting to off myself. So here it goes.
Around NovembeDecember 2023, I started experiencing some strange stabbing pain in my upper right abdomen that would come on suddenly and then go away for no obvious reason. I also thought I saw trace amounts of blood in my stool, and this concerned me enough that I reached out to my primary care doctor at the beginning of January. My doctor is always booked for months, so they told me to go to the emergency room. The ER was packed, and I ended up sitting in the waiting room for about eight hours in between going for an ultrasound and a CT scan. I was getting very tired of waiting and was about ready to give up and leave as I had to work early in the morning the next day. Looking back, I wish I had left. Just before I was about to leave, they called me back and told me that they found something on the CT scan called an intussusception in my small bowel. This is a condition where the intestine gets caught on a “lead point” and folds in on itself, sort of like a telescope. It is most often found in infants and is very rarely found in people my age, yet I was told it is a medical emergency because the tissue of my bowel could die if left untreated, and/or the lead point could be a potentially cancerous tumor. They admitted me and told me they would scan me again in the morning because, despite the severity, there was a chance it could resolve. Hearing that I would be staying overnight shocked me, as I had never been hospitalized before, having always been in good physical health. I have never had digestive issues in the past, I’ve never been diagnosed with Crohn’s disease or ulcerative colitis or anything of the sort, and I had never heard of this condition, but every medical professional I spoke to seemed very concerned that I had it. They didn’t have a bed for me in the hospital at that point, so I had to sleep in the packed and quite chaotic ER. About an hour after I was given a bed, a man was admitted a few feet from me who was very aggressive with all of the nurses, screaming and cursing at them throughout the night. I was not allowed to eat or drink, given the possibility of surgery. I struggled to get any sleep in that environment and woke up the next morning feeling very lethargic.
The surgeon and resident came by my bed and we spoke briefly. The surgeon explained that while the condition was serious, if it continued to show up in my CT scans, they could do minimally invasive laparoscopic surgery to resect the piece of my bowel that was telescoped and stitch it back together. I feel they really downplayed the severity of this procedure. I will never forget them saying, “It’s such a small piece of your bowel, you won’t miss it.” They felt that since I was young and otherwise healthy, I should have no problem making a full recovery. I felt confident in the fact that I was speaking to the chief of surgery at the hospital, who has more than twenty years of experience in the field. Then they brought me for my second scan, and within a few hours I was told the intussusception had not resolved. I was admitted to a hospital room, and the resident came to discuss moving forward with the surgery. My first impulse was “absolutely not,” but I quickly second-guessed myself. Everything I saw in the limited research I was able to do on my phone stated that this was indeed a serious condition that warranted surgery. In that moment, it seemed like the reasons not to go through with it were somewhat vain, such as not wanting the scars and having to forgo lifting weights at the gym for some time. Though it didn’t quite make sense to me that they wanted to operate on the complete opposite side of my body from the one that was in pain and which brought me into the ER in the first place. When I asked the resident about this, he responded, “We don’t understand how referred pain works,” Okay, fair enough, I thought. More than anything, I thought that if a doctor was in front of me, telling me what was going on with my body was an emergency situation that warranted immediate surgery, I should probably listen to them. They’re the “experts,” after all. And given the state I was in, having been in the hospital for over 24 hours at that point, running on very little sleep and nothing to eat, I don’t think I really had the capacity to fully parse what was going on, but given the doctors level of concern, it seemed like I urgently had to make a decision. After about an hour of talking it over with my mother, even though I never had any pain in the area they were about to operate on, I signed the consent papers. (Biggest fucking mistake of my life) I remember they listed risks of things that could go wrong during or shortly after the surgery, such as infection, bowel perforation, etc. They did not mention the procedure’s possible long-term consequences, and neither the surgeon nor resident ever mentioned possible long-term complications, and I didn’t think to ask. I had no experience with this kind of thing whatsoever; I am not a doctor, I don’t know any doctors, and no one I know has ever had abdominal surgery… I was so naive to trust these people, but I did. In fact, I trusted them so much that I was not terribly scared of the procedure I was about to undergo. Again, I chalk that up to the reduced mental capacity I was in, given a tough overnight stay in the ER. I remember the adrenaline rush as I was wheeled down to the operating room. I was singing one of my favorite songs in my head, hyping myself up for the procedure ahead of me. The last thing I remember was one of the OR nurses telling my mother not to worry, that the surgeon was “the best,” and that they had even operated on her husband.
I woke up high as a kite. I heard one of the nurses say I had been given fentanyl, which I remember freaked me out; I had forgotten it is more than a street drug and actually has legitimate uses. The procedure had gone fine, and I was discharged only a day or two later, with my only guidance upon discharge being not to lift heavy objects and “take it easy,” I was in some pain, but it was to be expected at that point and was well controlled by combining Tylenol and Advil. The surgeon called later that week to inform me that the pathology report had come back and that the lead point was simply “some swollen lymph nodes,” I was relieved to hear that it was not cancer. At my follow-up appointment two weeks later, I reported feeling pretty much fine. I had been granted medical leave and short-term disability from my job for six weeks following the surgery. This was the full length of time after which the surgeons expected I would recover fully. I used the time off to hang out with friends and my boyfriend and to focus on finishing what would have been my final semester of school. Those were the last few weeks that I felt somewhat normal despite what I had just gone through. I had no idea what was about to come.
About 5 weeks post-op is when I first began experiencing worse pain deep in my abdomen, right where I had the surgery, plus the pain in my upper right abdomen had not gone away. This new pain is crampy, yet sometimes stabbing, and had seemed to worsen with activity; I have experienced it every single day, nearly every hour, to varying degrees, since the beginning of February. That was also when I began regularly bloating and having difficulty going to the bathroom. No matter how hard I try to push, I can’t fully evacuate my bowels. (This is a nightmare for someone who has receptive anal sex like I used to do regularly. It is now impossible). With the emergence of all these symptoms, I felt very, very scared that there was something else wrong with me. And, of course, this all happened in the week when I was set to return to work. I have a physically demanding customer service job, and I was in so much pain that I found it impossible to be nice to the customers or even stand, so I left and, thankfully, was allowed to take the rest of the week off to figure things out. I obviously called my surgeon, but it also prompted me to do deeper research into the complications that can develop following abdominal surgery. I began pouring over medical journals, trying to figure out what was going on in my body on my own. That was when I first learned about “surgical adhesions.” These are fibrous bands of scar tissue that can develop due to the incisions made during surgery and handling of the bowel. As your body heals from the trauma of surgery, this scar tissue forms and can cause your intestine to stick to other organs or structures in your body. According to medical literature, they form in 90% of all patients who undergo abdominal surgery, but not all adhesions cause complications like what I’ve experienced. They are not easy to diagnose as they are impossible to visualize on any imaging tests, they do not go away on their own (it’s scar tissue), and the only treatment is surgically cutting them apart, which is risky, given that there’s a strong chance they will just grow back and possibly be even worse. This was obviously terrifying to me, but when I asked the surgeon about this, they said, “There’s very little chance that’s what’s happening,” given that the procedure was laparoscopic, not open. I scheduled another appointment with them, wherein they seemed quite dismissive of my concerns. They said the pain was likely “incisional” (it wasn’t and isn’t) but that they would order another CT scan so we could see what was going on. They also wrote me a script for gabapentin, an anticonvulsant meant to prevent seizures that is used off-label to treat pain and anxiety, with the qualifier that they would not write a script for anything stronger, basically implying that I was seeking narcotics, which was not at all the case, and which I found extremely offensive.
My next CT scan was scheduled about a month following that appointment in early March. In the interim, I began taking the gabapentin. I used more than I was prescribed because it was the only way I was able to control the pain and allow myself to feel comfortable at work. I didn’t anticipate the changes it would cause to my mood and behavior. In addition to feeling depressed and scared, I was also becoming easily emotionally dysregulated in ways I believe I would have been able to control prior to taking the medication. But when I didn’t take it, I was in pretty bad pain almost all the time, and I didn’t understand why at that point. My boyfriend noticed these changes in my mood and decided he needed space from me to protect his emotional wellbeing. I didn’t blame him then, and I still don’t, but I miss him terribly. We were supposed to remain “friends,” and he at least pretended he wanted that for a bit of time. At that point, I became determined to ween myself off the gabapentin and continue to work on improving my mental and physical health, for myself, but also for him; as I said, I really loved him. Later that week, after we split, I had my CT scan, and the surgeon called to tell me that it looked like I was just constipated. They advised me to take Miralax daily to ease that constipation, which should hopefully make me feel better. To me, this seemed like a huge relief. I started taking the Miralax, and at that point, I started exercising and lifting weights again. I also started trying to bulk up again, which had been an important part of my fitness journey prior to the surgery.
So April rolls around, and I am still trying my best to resume my normal life, which felt possible again at that point. I did end up successfully weening myself off gabapentin. With this newfound reinvigoration, I attempted to get my boyfriend back. We would make plans, but then he would reschedule again and again. Eventually, he kept our plans, and we met up for a talk in the park. We obviously had a lot to talk about in our relationship, at which point he told me that he simply was not attracted to me anymore. This was devastating news, as that was the first time I realized it was really over. Before I had thought that if I could show him how much I was trying to get back to the place I was before the surgery, he would stick around, but that was the moment I realized it was impossible for him to see me in the light he once did. Nevertheless, I tried to push on, kept going to the gym, and kept trying to get my life back. I was still seeing my friends regularly, and I was able to push myself to get through work, even though it was painful and hard. Plus, I was still working on my degree despite not feeling able to give it my best effort and focus with everything going on. I was still motivated to keep going, and I thought things might improve from there.
Well, lo and behold, they did not. One day in early April, I was sitting on the couch, sort of mindlessly snacking on some almonds before I was set to go have drinks with friends and see a concert. Immediately afterward, I felt that pain again in my abdomen. Despite that, I was really excited to see my friends and see the show. We met at a bar, where I had three cocktails before we made our way to the venue. I drank one or two more while the opener played. But by the time the headliner came on, I ended up in so much pain that I told my friends quite regrettably that I had to leave. I walked home and ate a small snack, wrongfully thinking it might make me feel better, before popping a melatonin and heading to bed. I woke up around 2 AM in the most intense pain I have experienced both before and after the surgery. I was extremely bloated and unable to pass gas or move my bowels. I had read somewhere that this was a sign of bowel obstruction and that I needed to seek medical attention. I made the decision to go to the ER. I walked down the stairs to leave, and as I did, I felt myself begin to vomit. Thankfully I was able to make it to the sink as I puked up what I imagine was that snack I’d had before bed. Shortly after, I arrived at the ER, this time choosing a different facility from the one where the surgeon had dismissed all of my post-surgical concerns. I was quickly admitted and given another CT scan. They confirmed my bowel was obstructed and told me they would place a tube into my nose down to my stomach to try to pump some of the blockage out. I asked the ER doctor if I was going to need to have surgery, to which he replied, “It’s a strong possibility.” This was horrifying to me. Getting the tube inserted into my nose was so painful, and I was screaming in agony the entire time. Then they gave me morphine, and I passed out. The details and timeline of that hospital stay are somewhat hazy in my mind, but I ended up being there for four days, over which I was given a “gastro graph challenge” test, wherein I was instructed to drink a contrast element which would be visualized by a series of Xrays so the doctors could monitor if anything was passing through my intestines. I met with another surgeon, whom I found to be much more attentive than my prior one, or at least simply possessing superior active listening skills. In fact, I felt that all of the staff at this second hospital were a lot more sensitive to my needs than the first. I really wish I had gone there the first time, as it’s the best hospital in the city. Add that to my long list of mistakes… Anyway.
Despite her more positive demeanor, she recommended another emergency surgery, this time a laparotomy (open) surgery to resect my bowel a second time. Her hypothesis was that the anastomosis (the medical term for the connection formed between my bowel loops during the first surgery) could be too narrow to allow food to pass through properly. I asked this new surgeon if it was possible I had adhesions causing this problem, and unlike the last one, she said, “It’s possible,” especially given that these symptoms began emerging a few weeks after the first surgery. But, like I said, they don’t really know what’s going on until they cut you open and go in there. Given that I am now much more aware of the risks of surgery and the risks of having a second procedure, I was fervently against going under the knife again. I simply couldn’t handle it. So I opted for conservative management, which meant waiting it out, taking an enema, and eventually getting back on a liquid and then solid diet. Thankfully, sitting in the hospital being NPO (Latin for nil per os - “nothing by mouth”) and taking the gastro graph made it pass eventually, and I didn’t have to have a second surgery. I was discharged from the hospital with instructions to schedule another diagnostic test called a “small bowel series,” in which they use xrays to track the amount of time it takes liquid to pass through your digestive system and to start a “low residue” diet- meaning eating very little fiber. Suddenly gone from my diet are all of the fruits and vegetables I once loved, and I can’t eat nuts or seeds (It seems to me that those almonds caused the obstruction in the first place). Basically, I’m now forced to exist on a diet of the most processed foods imaginable because although they are demonstrably unhealthy, that is all that my body is now able to safely digest.
After leaving that second hospital stay, I proceeded to delve even further into research about not only long-term abdominal surgery complications such as adhesions but also the nature of adult intussusceptions in general. I once again started furiously googling, finding results from medical journals and personal accounts from Reddit. I came to the conclusion that intussusceptions in adults, while ostensibly serious, have a strong possibility of resolving on their own, especially when they present in the small bowel, in the absence of vomiting (I never vomited before going to the hospital in January), when there is no obvious lead point (they couldn’t see it on my scans) and there is no obstruction (I was never obstructed before the surgery). Furthermore, while intussusception does present with blood in the stool, it is usually described as “currant jelly stool” (something I don’t recommend you google because it looks atrocious), which is not even close to the trace amounts of blood I saw in my own stool. (But no one ever asked, so how would I know the difference?) I never experienced any pain whatsoever in the area of my small bowel before the surgery. And yet I was told by a doctor that I was experiencing a medical emergency, which might have been caused by some malignant growth, which scared the shit out of me and made me feel at the time that immediate action was necessary. At one point, I even found a paper that attributed intussusception to cannabis use, which I had engaged in that week. In these papers, the authors highlight that these intussusceptions were transient and did not require surgical intervention. And on the point of adhesions, they are not easily diagnosed, and they are not easily treatable without surgical intervention; and said intervention is a cache 22 scenario because every time you get cut open, you risk growing back even more adhesions.
With all of this knowledge, I became absolutely distraught. I was never informed that by having this procedure performed, I would be at this increased risk of experiencing bowel obstruction. Like most people, I literally had no idea what an “adhesion” even was. What made me lose hope the most was that it seems as if doctors do these surgeries and simply ignore adhesion as a consequence because they don’t have any feasible way to prevent it or treat it without potentially creating more adhesion. So, although I was released from the hospital having avoided a second surgery, I felt more lost and hopeless than ever. I simply couldn’t cope with the realization that this would be something I would deal with for the rest of my life, something I could’ve avoided had I never agreed to get the first surgery because although I had that original pain I mentioned earlier- which has still continued to this day, it wasn’t and isn’t anything close to how excruciating the obstruction was, and it wasn’t really disrupting my life in the way the post-surgical pain has. But under the guidance of doctors, I opted to permanently alter my body, and there’s no going back. I feel so incredibly stupid for being deceived by these “medical professionals” who didn’t take the time to understand what was actually going on with me and chose to take an overly aggressive course of action that has left me permanently altered, in pain, and completely diminished my quality of life.
That week after leaving the hospital was truly the most suicidal I have ever felt. As I mentioned, I’ve dealt with suicidal ideation on and off since my adolescence. I’ve always had latent thoughts about wanting to die, wanting to escape, feeling like I’m hopeless and there’s no use trying to better myself. But this time, the desire to end my life was so much more intense. I became extremely disassociated from everything in life. In that week following my second hospitalization, there was absolutely nothing that could bring me joy. Before the surgery, I used to find deep pleasure in simply walking around my neighborhood for at least an hour every day. But I couldn’t do it anymore because walking gives me time to think, and thinking is too painful. It always leads back to the realization of the way I am now. Nothing could make me smile or laugh. I couldn’t even listen to music, one of my favorite things in the world. I became completely devoid of all emotions as my research transitioned away from my various new ailments and into ways I could end my life.
The rest of April and May passed by in a blur. Over that time, I’ve had two more appointments with the surgeons I met at the second hospital, a small bowel study (a more in-depth series of x-rays tracking the transit time of liquid through the GI tract), and a colonoscopy and endoscopy. Those have not yielded any significant findings as to what is going on, making me believe even more that all of these problems are being caused by adhesions. However, the small bowel study did reveal that my stomach is slightly herniated, which I believe is the cause of the original pain that I sought care for in the first place. At my last appointment, I was told to see a “small bowel specialist” GI doctor. But that was three weeks ago, and I haven’t even been able to get an appointment with them. I’m on a waiting list, but I imagine I’m looking at many months before I can get an appointment. I don’t know what they’re going to do for me. I don’t know that there’s anything that can be done besides more surgery, and I am very fearful about that. I fear the only way that these fucking doctors who fucked me up in the first place are going to even try to help me is if I’m obstructed again. But the changes to my diet, as much as I hate them, have kept me in a more manageable amount of pain and out of the hospital for now.
It is now June, and I am shocked that I am still here and confused about what to do now. Despite the diet, I still feel pain and discomfort at some point in the day, every single day. I think about wanting this all to end all of the time. I have not attempted again, though I did pick up another nitrogen tank, and I’ve also stockpiled a 90 day supply of my antidepressant, so at least I have the option. I am drinking two bottles of wine or half a bottle of vodka nearly every night. Alcohol is the only thing that seems to quiet my thoughts enough to get through each evening. I am sitting here in a cycle where I think about doing it, but I still feel obligated to go to work, to see my friends, and to feed my cat. My life has continued, but I don’t feel like I’m living anymore; I merely exist. I feel extremely unattractive because although I look the same as I did on the outside, I’m overcome with never ending emotional pain and turmoil on the inside. I am now unable to take care of myself and be on top of my life the way I used to be. After the second hospitalization, I dropped out of school and have no plans to continue, as I won’t need a bachelor’s degree when I’m dead. I have stopped exercising altogether, as it feels like there’s no point in trying to improve or take care of a body that has been permanently broken. Through all of this, I’ve lost much of my confidence and I feel I have completely lost my identity. I miss that old me so much. I miss my boyfriend so much. Plans with my friends are sometimes the only thing that keeps me going, and I am extremely grateful for them, but despite their continued presence, I feel extremely isolated and lonely. It’s hard to explain what I’ve been through to people without the context of all that has happened. I don’t have the energy to share it with them. And I feel if I speak about what I’m going through, I will feel like a burden, killing the vibe, and I don’t want that.
I have never felt this alienated from my body and from everything in life. I cannot cope with the fact that things will never be how they were before. I feel so incredibly distraught that I threw away what was shaping up to be the best days of my life. There’s nothing I or anyone else can do to change what has happened to me. It took me such a long time to get to the place I was in before the surgery. It was a brief and beautiful couple of months, but it’s over, and there’s no way for me to return. Even if there was, I don’t have that much of a fight left in me. I feel like such a fucking idiot for allowing the doctors to do this to me. I look around at all the happy people around me and know that I am dragging them down with my depression. I am tired of feeling helpless and like a burden on everyone I love. I am a shell of the person I once was. Ending it all is the singular thing that’s in my control. It is the only way to end all of this pain and suffering and stop the concern and confusion of my loved ones. I know that my exit will be painful to them, but they will all get over it in time. But me? I don’t think I will ever get over this. I will never be able to accept this horrible choice that I made. I am so tired of living this way. I am supposed to turn 27 soon, but I really don’t want to live to see my birthday. I have nothing to celebrate. My life is completely, irreversibly fucked. I don’t know when I will go, but it will be sooner rather than later. I am so sorry to everyone. I know this will hurt. I just can’t go on living this way. To all the people I care about, know that I love you, and I am so thankful you were part of my life. I know you will all go on to do great things without me. This entire saga has been unbearable; my life has spun out of control, and suicide is the only way to end my suffering. I’m sorry. I’m signing off.
TL;DR: Doctors performed a surgery I now think was unnecessary and the complications make me want to kill myself.

Hello, more or less what I said in the title and I want to know if I should be worried or not lol. 23F, 5'5 3/4", 123lbs. No smoking, no drinking, no drugs except the ones I'm prescribed by my psychiatrist. I take up to 1000mg of tylenol (recommended dose!) on occasion for severe headaches/migraines and period cramps. I take 2 women's multivitamins every morning. I'm on 300mg of bupropion (brand name wellbutrin) extended release in the morning and 50mg of sertraline (brand name zoloft) in the evening for anxiety and depression. Had been on 40mg of atomoxetine (brand name strattera) for about a year to treat ADHD by the time I had my first pneumothorax on Jan. 15th, but am now off of the medication due to it making my heart race, which had already been a concern prior.
Both pneumos were small and in the same location (left side, lower than my breast), and both occurred when I was sitting at my computer and doing no strenuous activities. Since they were small, I didn't have to have a tube put in my chest and was instead put on continuous oxygen in the ER for several hours. When I went in for the first pneumo on the 15th, I was given an EKG since I reported sudden, continuous, and severe chest pain on my left side that would radiate from the source — no heart attack, obviously, and no abnormalities aside from an extremely elevated heart rate (was between 100-120bpm when resting). BP was normal. I was given xanax (unsure of the dose) to try and lower my heartrate and calm the tremor I have in my hands. After a couple blood tests, a chest x-ray, and a CT scan with contrast, I was given my diagnosis, put on oxygen, and given some morphine for the pain. I spent ~3 days in the hospital: one night in the ER and one night admitted for observation. Was cleared with a chest x-ray in the morning on the 17th and had followups with my pcp. I was referred to a pulmonologist for followups by my pcp.
The second time was Jan. 3st and I knew it was a pneumothorax because I felt the pop. Went to the ER immediately. I was given an EKG anyways and my heartrate was high enough (over 110bpm at rest) that the ER physician decided to put a giant AED sticker on my side just in case it was determined that I required a hard reset. Otherwise, no heart abnormalities, BP was normal, etc etc. Had the same tests done, and was confirmed to have another small pneumothorax in the same location. Put on continuous oxygen and admitted during the first night for observation, stayed for another night and was discharged on Feb. 2nd. The cardiothoracic surgeon spoke to me about my case, told me there was no need to perform any surgery (no blebs on the CT and the pneumothorax was small enough to resolve on its own) and any surgical interventions to try and prevent further pneumothoraxes would cause more harm than good. He did note that the symptoms I reported aside from the pain (crackling sensations in the chest) were more typical of a larger pneumothorax.
After being discharged, I had 2 more appointments with the pulmonologist to perform a breathing test and go over my results. All clear, no concerns. AFAIK the hospital still hasn't uploaded the CTs or x-rays to the medical portal yet so :/
Since then, I occasionally experience chest pain in the same general area and at one point it was intense enough that I considered going to the ER again (it faded eventually but still concerned me). Occasional chest pain isn't anything new to me, per se, and it typically resolves within half an hour, but, well. I've been worrying that the pneumothorax may not have totally resolved, especially since both times it was apparently too small to be noticed on the initial x-rays and was only spotted on the CT but I was discharged based on my x-rays. So, like, am I being paranoid or is there more validity to my concern? I've been freaked out enough by the incidents that even sneezing too hard makes me worry that I'll pop a lung again.

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.

1. 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.
   
2. 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:

1. 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.
   
2. 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.
   
3. 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.
   
4. 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.
   
5. 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.
   
6. 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.
   
7. 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.
   
8. 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.
   
9. 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.
   
10. 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:

1. Nausea and vomiting
2. Diarrhea
3. Muscle aches and pains
4. Sweating
5. Insomnia or sleep disturbances
6. Anxiety
7. Irritability
8. Runny nose and teary eyes
9. Goosebumps (piloerection)
10. 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:

1. Stimulation: At lower doses, Kratom may act as a stimulant, promoting increased energy, alertness, and sociability.
   
2. Sedation: At higher doses, Kratom may have sedative effects, leading to relaxation and pain relief.
   
3. Pain Relief: Kratom has been used traditionally for its analgesic properties, and some people use it as a natural remedy for pain.
   
4. 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:

1. 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.
   
2. 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.
   
3. Supervised Administration: In some cases, methadone is provided through supervised administration in specialized clinics to ensure proper use and minimize the risk of diversion.
   
4. 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.
   
5. 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.
   
6. 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.
   
7. 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:

1. 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.
   
2. 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.
   
3. 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.
   
4. 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.
   
5. 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.
   
6. 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.
   
7. 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.
   
8. 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:

1. 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.
   
2. 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.
   
3. 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.
   
4. 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:

1. Mood swings
2. Anxiety
3. Irritability
4. Insomnia
5. Fatigue
6. Difficulty concentrating
7. Memory problems
8. Reduced impulse control
9. 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:

1. 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.
   
2. 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.
   
3. 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.
   
4. 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.
   
5. Exercise: Engage in regular physical activity. Exercise can help alleviate stress, improve mood, and contribute to your overall physical and mental health.
   
6. 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.
   
7. 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.
   
8. 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:

1. 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.
   
2. 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.
   
3. 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.
   
4. 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.
   
5. 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.
   
6. 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:

1. Reading: Escape into a good book or explore topics of interest to keep your mind occupied.
   
2. Movies or TV Shows: Watch movies or binge-watch a TV series to pass the time. Choose lighthearted or inspirational content.
   
3. Exercise: Engage in gentle exercises like walking, yoga, or stretching. Exercise can help improve mood and alleviate some withdrawal symptoms.
   
4. Creative Hobbies: Explore creative outlets such as drawing, painting, writing, or playing a musical instrument.
   
5. Mindfulness and Meditation: Practice mindfulness or meditation techniques to calm the mind and reduce stress.
   
6. Gardening: Spend time outdoors, tending to a garden or plants. Nature can have a positive impact on mood.
   
7. Puzzle Games: Solve puzzles, play Sudoku, or engage in other mentally stimulating games.
   
8. Listening to Music or Podcasts: Create playlists of your favorite music or listen to podcasts on topics of interest.
   
9. Cooking or Baking: Experiment with new recipes and treat yourself to nourishing meals.
   
10. Journaling: Write down your thoughts and feelings. Keeping a journal can be therapeutic during withdrawal.
    
11. Educational Courses: Take online courses or watch educational videos on platforms like Coursera or Khan Academy.
    
12. Board Games or Card Games: Play board games or cards with friends or family for some social interaction.
    
13. Self-Care Activities: Take relaxing baths, practice skincare routines, or indulge in other self-care activities to nurture your well-being.
    
14. Volunteering: If possible, consider volunteering for a cause you're passionate about. Helping others can be rewarding.
    
15. 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.

Usually don't post on reddit, but I recently had my tonsils removed and thought I'd share my experience so far, as it has been crazy. The last few months,I had reoccurring tonsilitis, so I decided it was tiem to finally bite the bullet and have my pesky tonsils removed. Before the surgery, they mentioned there's a 4% chance of bleeding, but I didn't think much of it. I was dreading the surgery, but when I first got it, it went super smooth.
Day 1: Honestly, barely felt any pain. Instantly, I was eating popsicles and drinking a lot of water. Once I got home, I stayed on a tight schedule with my pain meds (Oxycodone, Tylenol, and Motrein). As the day continued, I barely felt any discomfort.
Day 2: Woke up on Day 2, without any pain or discomfort. It was a little sore at times, but nothing crazy. As the day continued, I waited for the swallowing glass feeling and loads of pain to happen, but it never did. By the end of the day, I still felt no pain, and I was starting to believe I had made it through dodging a bullet.
Day 3: This is when everything changed. I woke up Day 3, still with a minimal amount of pain. I honestly thought I escaped a lot of the bad side effects (boy was I wrong). I opened my mouth and noticed a lot of blood and blood clots forming on side. After cleaning my mouth, it slowly went away (temporarily), just to happen again hours later. The second time it was much worse, and I ended up throwing up a bunch of dark red blood and an entire blood clot. I wasn't sure if it was just blood I swallowed during the surgery or anything serious, so I waited, just to throw up again, only this time it was bright blood. I rushed to the ER a few hours ago, where I had to get my throat cauterized yet again. Just got home a few minutes ago, and my throat is still sore.
I'll continue to update this thread. I was wondering if anyone had any similar experiences, or any update on when it starts to get better. Near the end of Day 3, about to sleep till Day 4.
**Note: the frist 3 days, I didn't eat any actually food. Only popsicles, ice cream, and shakes.

Hey all, I have been having issues with my back all my life. Had a serious L5S1 herniation 3 years ago but managed to get out of it without surgery. Started feeling pain on the front of my left thigh 6 weeks ago, went for MRI and found L5S1 normal and L3L4 and L4L5 bulged. Two weeks ago and all of a sudden, I had a terrible onset of pain in my right leg, had to to ER for pain relief (morphine shots). I'm now in terrible pain and 24/7 on a, mattress on the floor in pain and with foot drop! Anyone experienced this?

I live in Elizabethtown, Kentucky. I'm 36 years old. I'm wondering if anyone has experienced this, not just here but anywhere. I moved here about a year ago and finally got insurance through work. I got a new PCP and went to him. I've had Fibromyalgia and CFS for 18 years and RA for 7.
I went over my entire medical history, got my records, and my PCP prescribed me my oxycodone 7.5 mg 3x daily with one refill. He said I needed to be referred to pain management though because he didn't really want to prescribe the medication. I then went to my first pain management.
Over the phone they said the first appointment would be a non-narcotic evaluation that no prescriptions would be written. I thought okay fine, I got my refill anyway. We'd go over treatment options and eventually get back to my medication. Absolutely not. When I arrived I went over my history, took a drug test, then the nurse came back in and said do you not understand what non-narcotic means? I said what? She said we will NEVER prescribe your medication no matter how long you go here. She didn't let me talk to the doctor, didn't let me request my records where I've been on the medication for 7 years or show the handfuls of other prescriptions I've tried, nothing. She said if I would've known you came to get your medication, I would've stopped you at the front door. She then walked me out like I was a drug seeker in front of everyone there.
I called my doctor and they said he doesn't want to keep writing the medication, well send you to another pain management. Today I go for my second pain management appointment at a new place. I hurt my arm at work, so I have it in a sling. I go in there and the doctor is more interested in my arm than my Fibro. He tells me he's ordering xrays and NSAIDs even though I have GERD and Barretts esophagus and I cannot take any kind of NSAID. He insists I still take them and ill be fine, which I know I won't because even an ibuprofen makes me feel like someone is stabbing me in my gut. As far as the fibro, he offers to put me on Savella which I took years ago for 6 months and did absolutely nothing for me and says well if you want your pain medicine you'll have to convince your PCP to continue writing it.
I'm just at my wits end. I feel like no matter what you say, what records you have, how many pill counts or drug tests you pass, it is impossible to get narcotic medication in Kentucky whatsoever. It's not like I'm on morphine, Dilaudid, or opana. It's oxycodone 7.5. I don't go in there begging for the medicine. I'm open to all their treatments. I did 4 years of injections, but I'll go through them again. They do help for a couple days, but with widespread pain, you can't really trigger one spot because it's all over. Life is just miserable without my medicine. I hurt all the time, I can barely get past a shift at work much less come home and do things with my family.
Its basically make it through work and come home and lay down. The past 2 months I've had my oxycodone have been life altering. I made employee of the month in June, I didn't miss a single one of my kids sporting events, I went on hikes for the first time in years, my sex life improved drastically, I mean so many positive things because my pain was tolerable with medication, but now I'm back without it for 2 weeks now and it's just been terrible. I don't know what else to do because I can't continue to live like this at all.
It's just so frustrating that doctors will not hardly write you pain medicine even with records. They don't listen. You have to go in with cancer or a life ending illness to get anything. And they bring up my age, 36, as being too young to not be in pain. What do they want? For you to continue to break down until you lose everything and you're pretty much in bed 24.7 for them to be like, oh now you're bad enough to get something instead of prescribing you so you can deal with your pain and remain active in life and somewhat live?
They bring up the opiod epidemic and how they cracked down to avoid all the misuse and overdoses. Well news to them, the overdoses have continued to rise and spike because of fentanyl nowadays. Now instead of prescribing people that need pain medicine, these people are doing the only thing they can and going to the streets and unfortunately, dying from fentanyl laced pills. Not saying hardcore drug addicts aren't in that mix too, but if you want to save even those people, I think I'd rather have them taking pharmacy backed medications than something someone makes in their bathtub.
So, my question is, has anyone else experienced this in your state where it's impossible to get any kind of narcotic or been treated like a drug seeker even when you have records to prove otherwise? Is there no way around this? Are there any good doctors left in the state of kentucky that will listen and arent terrified of the government and will treat you with medication you need? I'd love to hear your stories. Thanks for reading my rant.

My whole world is crashing down on me. It’s been 3 days since I’ve called an ambulance for my 93 year old grandma. It started out with a stomach ache, then back ache, then high blood pressure. I would have never imagined this was the end. Everything was normal, and she was so full of life leading up to this incident. She ate lunch (a hotdog) which triggered her gallbladder. And that was it. I went and saw her in the ER, she looked sad and scared. I didn’t know what to say and tried to make light of the situation because for one, no one could have anticipated how serious it would become, and I always wanted to calm her down and comfort her. I left shortly after that and told her I would be back the next day. My father was able to visit her before I could, and told me to hurry because she didn’t look well at all. He told her I was going to come and she (in her morphine induced confusion) mumbled “no I don’t want her to see me like this”. I arrived and my dad told me I need to go in there to tell her I love her. I knew it would be hard but I could have never imagined how much worse her condition had gotten. She grabbed my hand and didn’t want to let go. She mumbled “you didn’t have to come” and I told her “I wanted to come, I want to see how you’re feeling” and she said “not good and shook her head”. She didn’t look like herself, and had a terrified look on her face. I told her I love her and hugged her but she was in and out of consciousness so I don’t know if she heard me. That memory has been replaying in my head non stop. Long story short, Her condition is not improving and it’s absolutely killing me. Her prognosis is not good.
I have lived with my grandma most of my life. She took the place of my parents, and raised me, and in return, I’ve dedicated my life to take care of her. I love her so much, she has been there through everything. I don’t know how to live without out. The thought of her not returning sends me into a panic. I’ve been crying non stop, and my chest hurts, the pain is unreal. I always knew this day would come but never like this, it’s too soon.

STORY TIME! Me and my husband are long time cannabis smokers…. Like a decade at least. My husband has recently been diagnosed with with CHS (cannabinoid hyperemesis syndrome) three weeks ago.. First it started with a visit to the clinic where he was diagnosed with food poisoning..couple days ago by and his symptoms are worsening. We then go to clinic again, they do blood and urine test. Says blood test results take two days, I end up bringing him to ER and they diagnosed him with CHS. first visit they do bloodwork, urine test nothing shows up. They give him an IV as he was severely dehydrated ..He is sent home with anti nausea meds… his symptoms are excessive puking, almost like screaming puking, fever,chills, dehydration, stomach pains. Another week goes by symptoms are worsening, another visit to hospital this time all the same test as well as a MRI. doc ends up giving him some morphine for pain and better anti nausea meds. Couple days go by and seems to be on the mend until today where he had a flare up and it’s the worse it’s been the last three weeks…all symptoms listen above but to it’s extreme. Waiting in ER currently… posting this to share our experience.. not a whole lot of research done on CHS..it is a very rare syndrome that happens to 30% of people predominantly in men. Essentially you go thru with drawls of cannabis and can be quite intense and can result in hospital visits. Posting to vent..it’s been three weeks of seeing someone i love go thru this pain.

God, I don't even know where to start so I guess I'll just start typing and see where this goes. I lost my nana this morning at around 3AM. She was the kindest, most loving woman I've ever had the pleasure of knowing. We were so close. When my mom came home to tell me she was gone, my first instinct was to go over to the nursing home and give her a hug. She gave the best hugs. I made it just in time to hug her corpse, but she couldn't hug me back.
I guess it all started several months ago. In either late Feburary or early March, my nana fell, hard. She was on blood thinners. She hit her head and broke her arm. She suffered a hemorrhagic stroke and I was convinced she was going to die. My mom kept saying "she can wait until you graduate" (I graduated May 17th). The bleeding to her brain stopped and she bounced back incredibly fast. It was miraculous. Then, in early May she went into kidney failure. She had been in stage 4 CKD for almost a decade, but the trauma from the fall pushed her into renal failure. The doctors put her through a Lasix challenge as a last resort and she bounced back yet again. The nursing home took her to see me graduate, which was amazing. Then, they took her to my graduation party afterwards which was even better.
3 days ago, she was sent to the ER because she couldn't breathe. Her congestive heart failure was acting up, and her kidneys were failing again. She was given the option of dialysis or hospice, and she chose hospice. It was so fast. She went from talking while alert, to talking while sleepy, to groaning to communicate, to sleeping all the time in a matter of 2 days. I sat with her as long as I could stand it. It was so hard listening to her drown.
She started the death rattle at 1PM yesterday. Her surge started at around 3PM and ended at 5 or 6. She was on so much morphine that her surge of energy was just her getting to open her eyes. She was able to smile at us while we told her we loved her. I asked her if she could squeeze my hand and she did. I asked her if she was in pain to squeeze my hand, and she didn't. For confirmation, I asked her to squeeze my hand if she wasn't in pain and she did. I'll never forget when I started crying and I said "I'm so sorry nana. I don't mean to cry, I just love you so much" and she just looked at me and smiled.
I left that night to go eat dinner with friends. Had I known that what she was experiencing was the surge, I wouldn't have left, but I know she would have wanted me to go anyways. I came back later that night and she really started to gurgle. The surge was over by then and we knew it was only a matter of time. I expected it to be around noon today since her rattle started at 1 yesterday. I left at around 915 last night. I should have stayed, but I didn't. I slept in the floor last night. I wanted to be as uncomfortable as possible so that when my dad woke me up at 6AM, there would be no chance of me falling back asleep.
At around 3AM, aunt #1 went into another room where my mom and aunt #2 were resting their eyes to say that she needed to go leave a key under the mat at nana's house since her kids were going to be there soon. My mom said "Oh I can do that" and she went to go tell nana bye before she left. When she got in there my nana was agonally breathing. My mom asked aunt #1 "how long has she been doing that?" and she replied with "she hasn't." My mom yelled for aunt #2 that she needed to get into the room now. Aunt #2 came in and my nana took 2 more breaths, and then she died. She waited to be alone to die. I am convinced it was because she didn't want her kids to see. She was thinking about everyone but herself up until the end.
By 5AM, my mom was home and she told me. I got up, got dressed, and drove up to the nursing home. Last night I had told her that I would see her tomorrow. I had to see her. I made it just in time to give her body a hug before the funeral home people took her. There was so much I wanted to tell her, but all I could muster was "I love you so much. Goodbye." She looked so peaceful. I expected to walk in and see a corpse (I expected bodily waste, a gaping mouth, and open eyes), but they had already cleaned her up. I walked in and she had her mouth open a little bit, but her eyes were closed. She just looked as if she was sleeping.
I've been crying all day. I can't stop. I went to her house and I sat at her table across from where she always sat and I ate breakfast and drank coffee with her creamer. I would give anything to eat breakfast with her one more time. It's something that you always know is going to happen in the back of your head, but you never think it's genuinely going to happen, well, until it does. I feel so bad for my cousins. They were 6 hours away. They arrived about 4 hours after she passed. They couldn't make it in time.
I was so close with my nana. I don't know what I'm going to do without her. Despite being the youngest grandchild, I got the most time with her. She took care of me as a baby when our house flooded, and she helped raise me after my mom was diagnosed with MS. I cannot even express how much I loved her. I am devastated. I don't know how I'm going to move on. When I came out as transgender, she accepted me before my mother did. That's the kind of woman she was. She was the most incredible woman I've ever known, and I don't know what I'm going to do without her. I am heartbroken.

I've been keeping this secret for about four years. All those years ago, I was going through what was at the time the most serious and traumatic breakup. I was vulnerable. I had been through years of this toxic relationship.
I lived with my mom at the time, and she has quite the slew of back and health problems. She got prescribed Percocet and very often tried to give me them. I had tried them before but they made my stomach hurt, so I often turned her down. She continued to offer them to me.
One day I decided to take one, I was hurting from work or something. And I snorted it. It was great, my stomach didn't hurt and I felt better. She continued to give me pretty much as much pills as I wanted, and even offered some when I didn't ask.
She moved into my grandmother's house once she went to assisted living. My mother gave me her old pills too.
Now four years later I'm a "functioning" addict, as much as I can be. Nobody at work knows. And I only just realized how fucked up it is to give your child prescriptions. Idk if this is my fault or not but opioid addiction is a helluva thing. I've gone from Percocet to Oxycodone, to morphine, hydrocodone, lortabs, anything like that I will do to stave off withdrawals.
I got some fake oxycodone 30s one time and did them anyways. They were fentanyl. Coming off of that put me in the hospital. It was the worst pain I've ever felt in my life. I cried so much, and the morphine they IV'd me in the hospital barely touched the pain. Unfortunately I guess I'm so far gone that wasn't even a wakeup call for me, although I refuse to touch fake pills again.
I've lost myself so much because of my drug use, and wasted so much time. I really do want to quit and I hate that I've ever done them. If I would've known how bad they were I would've said no, never done them. But I was ignorant to the true seriousness of it until it was too late.

My Mom 70F has stage 5 CKD with GFR of 10, she's been stable for the most part and regularly does her bloodwork and visits with her nephrologist and has maintained stability in all of her labsn with no major symptoms present, so we have not felt the need to start dialysis now.
Two days ago, she started complaining of severe stomach pain, we took her to the ER and she was diagnosed with two pinhole preforations near her small intestine and stomach. Based on the surgeons initial consult with me, he said this could be a fairly easy surgery or complicated. After surgery the surgeon was extremely optimistic about the outcome, he informed me that the surgery was a success, and it was the best outcome possible, they were able to seal the holes, and removed the appendix out of caution, and also at my Moms nephrologist insistance they implanted a groin catheter incase my Mom needed emergency dialysis. (She's currently in the process of having a fistula placed next month and wanted to start dialysis when she feels it's necessary, right now she has little to no symptoms and has done a good job keeping her numbers stable)
So I was shocked to see how my Mom's nephrologist was so insistent on starting her on dialysis while visiting her yesterday. It was her first day out of surgery, she was in good spirits just a little groggy, able to converse, she kept falling asleep, so you could tell the anesthesia had not warn off yet, and the nurse had also given her morphine for pain. But the pain of the sites and nasal tube were my Moms only complaints.
Her nephrologist is insisting that she needs dialysis because she's only producing a little urine via the catheter post surgery. I checked her numbers myself, they're all basically the same as what they were before the surgery, her GFR even fluctuated and increased to an 11.
I feel that since she is still in recovery, her ckd numbers are stable, and she has a nasogastric tube that is in place to allow her stomach/intestine to heal and patch properly, shouldn't we wait to make the decision to start dialysis until the tube is removed (which will likely be today), and she's on a clear liquid diet and able to move around more freely which can stimulate more urine?
I would like to see her eat, walking around, and maybe she will produce more urine naturally. I've read online that anesthesia can take a while to wear off for older patients (she's 70) and just like with any other procedure, I think it's good that she is producing atleast SOME urine, it's just not as much as the nephrologist would like to see but I really dont understand the urgency of him wanting to begin her on dialysis right now. He's saying her potassium is a 5.6, it's been high like that before, but she's been able to bring it back down into range changing and tweaking her diet, it fluctuates but never goes above a 5.6 and she's never had an issue producing urine until post surgery, which lends me to believe that it's definetly surgery related.
Please advise and provide your professional advice?
Thank you!

i'm an 18 year old trans guy who was diagnosed with mild scoliosis just a few days ago, and i've done research to try and get more answers as well as a better understanding, but i haven't found much about my specific curve degrees or when it comes to managing the pain.
the story went; i had started having bad lower back pain that i tried taking Tylenol for, Excedrin, even using a heating pad to ease the pain.
the heating pad helped a little, but only for a few minutes. but as the week progressed, the pain started trailing up to my thoracic spine instead of just in my lumbar. it got to where it hurt to bend or twist, which is when my s/o took me to the ER.
when the doctor felt my back, he instantly told me i had a lot of muscle spasming located in the areas that hurt the most. he gave me a muscle relaxer to help and sent me for xrays. when he came back to speak to me, he informed me i had two curves; one in my thoracic at a 17 degree and another in my lumbar at a 22 degree, and the reason i was spasming and it was so painful was due to my nerves and muscles trying to adjust to the curves formed.
he gave me two injections; one of morphine, the other a stronger dose of ibuprofen. it was also my first time wearing a Lidocaine patch. he said for me to look into an orthodontist to help monitor just in case.
with the research i've done, i haven't been able to find out if a 22 degree has any chance of progressing, only that 25 degrees or higher have a high chance of it.
to put perspective, i'm 4'11 in height, or at least i was months ago, though people around me suspect i've grown some. with what i looked into, those who are still growing have a chance of the curvature worsening.
i don't know, i'm an overthinker and it just hit me at once and i didn't know where else to find answers. i'm moving here soon, therefore i'm not able to look into help just yet until after the move, so i thought this would be the next best place? if anyone has any answers, or tips, suggestions, i'd appreciate it <3

I was first diagnosed 3 years ago at age 25, with a high fever and pain. Two weeks of oral antibiotics and a total month recovery. My base line for what a diverticulitis flare up was was terrible. The pain was beyond excruciating. The fever was high. I was in no state to commute to work. I spent a lot of time howling in pain.
This infection probably never fully cleared up and I probably had a smoldering infection for the next 3 years. My flare ups were never as bad as the first one so I never went the hospital. I never had a fever, only pain. And I'd just live through the pain for two weeks. I went to a gi 3 times to get solutions. I never really felt heard about my experience or taken seriously. He tried to schedule a colonoscopy but insurance wouldn't cover it. Tried the colonoscopy twice for insurance to call the day before saying they weren't going to cover it when the previously said they would. Happened with a Ct scan too. What was the imaging going to show that I didn't already I know? I have diverticulitis. I wanted a solution not a confirmation of what I knew so the imaging being denied didn't seem that important. I wanted a better doctor. But I seemed to had finally found a diet that stopped the flare ups, pescetarian eating only fresh foods, nothing processed. Eating less in general.
Then the night sweats started. There really wasn't pain like I'd had before. I'd sweat a lot at night and had no appetite or energy. I went to an urgent care and they gave me antibiotics. I took them and started to feel better for a few days then the night sweats started again. I went back, more antibiotics. After a week I started pissing and shitting blood. They got a Ct scan. Those symptoms cleared up like 3 days which is how long it took to get the ct scan. I had an appointment with a new Gastro doc. Urgent care told me to take more antibiotics after seeing the Ct scan. I took the Ct scan to the Gastro doc and in one look he had me hospitalized. I had a 5cm abcess and a fistula like structure. I was very upset, but he was right. I needed the iv antibiotics. I felt really good after 2 weeks of that. I thought maybe this was where my recovery would truly begin. The "fistula like structure" has kept me worried. Every doctor in the er told me to get my sigmoid removed. The surgeon had me loosely scheduled in July and I thought I'd wind up canceling because I would be fine, and I could keep my colon for many more years. Two weeks after the antibiotics ran their course I started to get a sharp pain in my lower mid abdomen. Very different from the DV pain of the past. The first one was so intense I thought something popped inside me. I made an appointment with a Dr and kept monitoring my temperature frequently. If I had a fever I'd go to the er. Dr appt was 2 more days out. I had that same pain twice more that day, three times the next day, and twice on the third day. An hour from going to the Dr I went to pee and gas came out of my urethra. I freaked the fuck out. I called the Gastro surgeon and they got me a Ct scan. I went to the Dr because I was meeting a new pcp with that appointment. I went home that night shook. It was the fistula.
The Gastro surgeon scheduled me a surgery two weeks out. Standard laprisocopic resection. 3.5 hours with a simple recovery and no bag. Maybe a week on a catheter because of the fistula that had opened up.
I woke up from surgery and could immediately tell something was wrong. It had been too long. I heard them saying they were telling my mom I was out of surgery and that she'd go home, which I instantly knew meant it was dark outside and she's afraid to drive in the dark. A Dr was dressing my wounds and I managed to ask her if I had a bag, she said yes. All of this was in a major daze where. I felt so defeated because I had a bag. But I hadn't actually seen it or felt it, maybe I was wrong and just hallucinating as I was clearly having 11 different hallucinations going on at that exact moment. I got dropped off in a hospital bed still in a daze and left there. I was hitting the call button for nurses. I was too dried out to talk and they wouldn't give me water. After 5 hours I finally got them to sponge the inside of my mouth enough that I could speak. They didn't have answers for me as to what happened. It was probably another 16 hours before I encountered a doctor who could at least tell me there had been complications and I had been in surgery for 8 hours but no more real details. My mom finally came by and she had some more details that the damage to my colon was much more extreme and they had to completely open up my abdomen for the surgery and abandon the laprisocopy.
I had an ileostomy, a massive catheter, and very few answers. I had a button to administer morphine which I basically just used to sleep off the first two days. On the 2nd day I saw the surgeon and got all the details. My sigmoid colon, a portion of my bladder, a portion of my urethra, a portion of my small colon had all fused into a mass of diverticulitis and puss. It took hours to cut away the tissue and rebuild the structures. I'd have the ileostomy for 1-2 months and the catheter for two weeks. I had a massive zipper scar in my mid section. And the two laprisocopic scars were turned into drains. Those smaller scars are no problem at all but this bigger one and the ostomy site are. They hamper mobility a lot. I didn't walk for the first 3 days. I am getting out of the hospital tomorrow, for a 1 week hospitalization. I am going to make a full recovery and my situation was about as bad as it gets.
When I woke up I could immediately tell the DV was gone. Even with all the drugs in me and scars the distinctive diverticul-bullshit was clearly gone.
If you made it this far and have DV let me say what this community has made clear to me. There are two camps of diverticulitis, people with 1 episode every decade or longer, and people with recurring episodes. Recurring DV has to be resolved by resection and if you wait too long it will be worse than if you got it done sooner. I thought I was getting it done sooner but I wasn't.

So we all know the classic "patient in hospice, increasing pain due to underlying malignancy, what is next step" and without fail the answer seems to always be to escalate up the pain ladder (aka give them morphine). Has anyone ever found the answer to be "increase the dose"? I took a chance on increasing the dose of oxycodone on a practice test recently (which in itself was dumb because I know nothing about the dosing and it would have been a safer answer choice to just go with add on morphine) but I was just wondering if anyone has ever come across a question like this where the answer actually was to double the dose? I noticed Amboss says nothing about dosing information and only has info on the ladder which tells me I feel like we don't need to know dosing?

I was diagnosed about 22 years ago. I have had very good control by using diet and exercise. My last A1C was 5.2. Before that it was 5.0. I had started trying to eat cottage cheese, but this raised my A1C as you can see. But something happened in the last month. First I had an attack of acute pancreatitis. This is nasty painful. This last a few hours while in the ER and getting morphine for the pain. It went away by itself. The doctor in the ER told me he just did not know why this happened to me. He was at a loss. I had cat scans and ultrasounds and there was no pathology showing. Anyway, the doc said I might try lowering my fat intake to try and keep this from happening again. I did this. I lowered my amount of fat I eat by about 2/3s. What surprised me a lot is that this produced lower BG readings for fasting and just during the day. I do test a lot. I have always been trying to break 5 on my A1C. I think it will happen now. I cannot understand why lowering my fat intake would lower my BG levels. This makes no sense to me. But there it is. My normal BG when testing now is always below 100. The only thing I can think of to explain this is that without eating fat, my intake of protein has gone up to replace that fat part of my diet.

Yesterday I did something to my back (22F). I lifted a bin (maybe 15 pounds at most) and got severe pain in my lower back. Went to the ER after a couple hours of ice, heat, pain killers and stretching. It is extremely painful to move. Twisting, walking and sitting are all very painful for me to deal with. The pain impacts my right leg when walking as I get a lot of pain when I put weight onto it. At the ER they gave me robaxin and oxycodone which did nothing to change the pain level. They sent me home with a referral to a PT and some muscle relaxers. I am feeling very depressed and saddened at this sudden injury as I bartend to make a living. Any advice? Whether it be physical or mental advice, I just need something to keep me from feeling extremely depressed and down about this whole ordeal. It has been hard to walk more than 15 feet without help, and bending over is almost impossible. I feel like everything just flipped upside down. I just started a new job this week which makes this even more stressful as I cannot finish training in this condition.

Hi all, I am 20F and went to the ER 3 days ago for the worst pain I have ever experienced. A month ago I was vomiting and peeing blood. No pain until I went to the ER a few days ago. They gave me morphine which managed the pain while I was there. They told me I have a 5mm stone that is close to my bladder. They sent me off with Flomax and some pain/nausea meds. Since then I feel normal aside from some dull cramping in my abdomen/back. But I’m feeling so nervous for the horrible pain to come back. I have been chugging water (about 80-120oz a day) and going to work at a fairly active job. Haven’t passed it yet (to my knowledge) I’ve been peeing through the strainer. I have an urology appointment in a couple weeks. My main worry is that it is stuck or just waiting to start moving again. I would hate for the pain to amp up while I’m at work or away from home. Anybody with similar experiences when the stone is scanned close to the bladder? What can I be expecting? (Though I know these suckers are pretty unpredictable)

After a lot of testing in both practice tool and ingame, I can say that our best build is crit.
My current go to build for basically every game is:
ER>RFC>Shieldbow>LDR>Bloodthirster
Explanation:
ER after the buffs is just superior to Muramana. It might be 200g more expensive and give less AD, but the crit and extra AH just make it better. The damage amp from crit literally is just higher than the Muramana passive.
RFC is common to all builds so won't bother explaining.
Shieldbow is just superior to Shojin's right now for Smolder. The crit chance actually increases your Q damage more than full stacks Shojin's, and the shield is equivalent OR MORE lategame to the health you get, while the AD is the same. The only downside is lower ability haste, but your Q only loses about 0.5 seconds of cooldown which is insignificant.
LDR and Bloodthirster are just good 4th and 5th items. LDR having both crit chance and armor pen makes it extremely valuable lategame vs both tanks and squishies once armor growth starts to kick in. Bloodthirster lifesteal, shield, and AD are just amazing to have as both a strong offensive and defensive item in one.
Overall, the build also has MUCH better auto attack DPS due to all the crit you have vs a Shojin's/Triforce/Muramana build.
tl;dr full crit Smolder has better damage and defensive stats at the cost of VERY minimal cooldown
Edit: Forgot to mention runes and starting items. I take Fleet footwork, Absorb life, Bloodline, Cut down, and secondary Celerity and Gathering storm.
These runes give the best health sustain in lane, plus Gathering storm ensures your lategame is even more overpowered so you can 1v5 if it comes to it. Cut down is just better, between the buffs and the fact that after 225 stacks you basically only do increased damage when the enemy is below 33.5% health, so the extra damage is wasted. Just take cut down, it's good.
I use Attack speed, Adaptive power, and the +65 health rune, but all of these are up to preference imo. You could take the AH rune, you could even take movement speed/tenacity if you think it would be good.
Finally, I take Doran's Ring. Gives some survivability with base health and increased ability damage with ability power, but most importantly it gives mana regen. Since my rune build doesn't use presence of mind, it runs into low mana problems until ER, but with the Q mana buffs Doran's ring is enough until you get it, with the added benefit of having more continued utility from your rune instead of redundancy.

Failed L5-S1 ALIF surgery back in early 2021 which fixed my sciatica but not the central spine pain.
Tried tons of options but nothing has helped but meds. I’ve been on Morphine ER + Oxy IR for 3.5 years increasing over time and now up to 30mg/50mg per day respectively. Not really working well any more even after jumping up from 40mg to 50mg a few months back.
Doc wants to talk next month about options and I wanted to get your experiences/opinions of these options that are on the table:

1. Med change. Hydrocodone was talked about. Not thrilled about going down in meds to a weaker type thinking they will somehow work better. But going up to a stronger like oxymorphone but lower dose equivalent makes a bit more sense to me.
   
2. Butrans (not sure if patches or pills). This one is weird as I thought it was a drug for addicts trying to get off opiates. I read a little about some people using for pain management but I’m curious your experiences.
   
3. Pain pump implant. I think the doc is thinking trying 1 or 2 before this. I don’t know much on this one but is a pain pump that much better at slowly releasing meds vs an extended release drug that it’s worth implanting something in your body?
   
4. New procedure similar to a spinal stimulator but less invasive and focused more on central back pain vs sciatica. Not keen on this as it’s a new procedure. My luck with surgeries, I’m not confident on this. I think the device is the Medtronic Inceptiv
   

I honestly don’t know what’s best. My pain is up and down based on activity. Working my desk job, I don’t need too much relief during work. Just breaks to stretch my back. Then off work at night and weekends I’m doing things with kids and trying to get errands and work around house done. That’s when I need a lot more. Not sure a steady dose is best. Curious your thoughts on this as well.
Sorry for so much info and I very much thank you if you actually read the whole thing and would love your thoughts. Thanks!

I had one when I was 15. After the initial episodes of blinding pain that lasted about 2 days I lingered in and out of Emergency Rooms for 3 weeks. It did pass.... but I was a dumb kid on morphine and just peed into a toilet. So we just think it passed.
Now at 35 I had one that had blinding pain, lingering pain for a week, and then I got obstructed and they placed a stent.
Do people really just.... PASS these?
My friend told me a story how a friend of his had pain for one afternoon and just went to pee and it came out.
Do people really just pee these out the same day they feel the first pain?
Is that why once my pain dies down in the ER they would send me home and just tell me to deal with it? But really I want to be in a medically induced coma for a month until it passes?
I feel like my experience is not the norm for people.

I spent the day in the ER yesterday after three days of pretty awful belly pain that kept getting worse. They diagnosed me with acute Diverticulitis and dosed me with IV antibiotics and morphine and then sent me home with antibiotics, toradol and Tylenol 3. I have only been taking the antibiotics so far and ONE of the Toradol this morning. The pain is still the same. I am supposed to be on a clear liquid diet only for about 3 days then progress to a low residue bland diet. I was not instructed to follow up with anyone but it seems that you all have a GI doctor. Should I get an appointment with a GI doctor?