Secrets of dealing with pain.

What your doctor never told you, because they likely never knew.

When it comes to suffering, pain is at the top of the list for most. It’s a warning system that something is wrong and is causing pain to alert us to the problem.

All throughout our body, we have pain receptors which respond to either chemical stimuli, thermal stimuli or mechanical stimuli.

A few years ago, scientists also discovered a new pain organ underneath our skin that covers our entire body and is responsible for sensing pain from pressure.

But there are things that doctors never suggest to their patient about managing pain, that are dependent on treatment being successful.

One of those things is the different bioavailability of various opiates when taken orally and long term. The bioavailability of painkillers denotes how much of the painkiller is used by the body to help with pain, and how much is destroyed by the body.

Your doctor will likely tell you that oral painkillers like morphine and methadone are far superior to things like codeine and oxycodone, but it’s more complicated than that.

If injected, it’s a different outcome, and that’s where the power of morphine excels, but taken orally, it’s a bit of a fizzer.

I have significant personal experience in this area over the last 20 years or so, and as I wasn’t getting any suitable answers from doctors, I had to look further afield, and into the nitty gritty of how we respond to opiates, when taken orally.

The bioavailability of morphine when taken orally is under 40% and can be as low as 10%, meaning you only get 10% of the painkilling potential that it holds.

The bioavailability of morphine is also different depending on genetic variance or nationality. If you are Chinese for example, you will be less sensitive to the effects of morphine.

When it comes to codeine, the effects are entirely dependent on the patients metabolism. Those with very fast metabolisms convert almost 100% of the oral codeine into morphine once it reaches the liver. Those with very slow metabolisms may only see 10% of their oral codeine converted to morphine in the liver. It’s all dependent on the patient.

We are not all the same and we react very differently to opioids, but allopathic medicine tends to treat everyone the same.

Personally, I’ve always needed high doses of codeine and many other drugs in order for them to have the intended affect. I have gene mutations that make me an inefficient detoxer, suggesting I have a slow metabolism.

Back in 2010, my doctor decided to try me on oral morphine as it’s cleaner on the body than codeine. I picked up the script, but when I proceeded to take it, I got no pain relief at all. The doctor had used the official conversion guide between codeine and morphine so it should have worked, but it didn’t.

I believe the bioavailability of oral opiates may not be considered in this conversion.

The genetics and metabolic speed of the patient is also not taken into account by prescribing doctors. After doubling the dose I was given, and still having no effect on my pain, I returned to the doctor.

My dr asked if I wanted to try methadone to see if that worked as it’s also cleaner on the body than codeine.

Don’t worry, I didn’t have to line up at the chemist each morning with all the addicts. I was prescribed a bottle of methadone to take home with a couple of repeats.

I was very hopeful that this may be the answer, but when I took the first dose, nothing happened, and I was still in excruciating pain from the metal fragments peppered amongst the nerves in my back.

So when it was time for the next dose I doubled it, but this again led to no pain relief or any effect whatsoever. Over the next few days I increased my dose to 5 times what the doctor had prescribed but I still got no effect whatsoever from it.

I emailed my dr who told me to come in and see her immediately. I jumped in the car and drove to see her as I was not impaired in any way. When my dr saw me, she said I should have been on the floor in a coma, she was amazed. So back onto the codeine I went and I finally had some pain relief again.

I was taking 6 doses a day and was taking over 1 gram a day of codeine at one stage as I kept building up a tolerance and needing more.

I had to find a way to stop becoming tolerant to it as I was going to be on it for the rest of my life. I achieved this too.

I found that only taking 2 large doses a day led to no tolerance to it at all. It meant that my pain wasn’t covered at night, but this is why I think it didn’t cause tolerance to it.

Due to the metal fragments poking into my nerves, I could not lie down or sit down for very long without making the pain excessively worse. This was even when I was taking 6 doses per day. It made getting to sleep next to impossible, but I found an elegant solution.

As I mentioned at the start of this article, our pain receptors pick up thermal pain, mechanical pain, or chemical pain. What most are unaware of however, is that our pain receptors can only register pain from one of these pain stimuli at a time. I was suffering from mechanical pain.

This meant that if I caused pain to myself using heat, it would block the mechanical pain I was suffering. And that’s what I did.

Straight before bed each night, I would run a bath. A bath so hot that it caused a burning pain all over my body. It would take several minutes for me to lower my whole body into the hot water, but as soon as I had, the mechanical pain stopped immediately.

I would stay in the hot bath for twenty minutes, and when I got out, it would give me 20-30 minutes of being pain free. This was enough time to get into bed and get to sleep.

I need to highlight that it has to be a very hot bath to work. My wife couldn’t even put the tip of her finger into the water without feeling she was getting burned. She would have to pull it out of the water within a split second as she couldn’t tolerate the pain from the high heat.

Another benefit of codeine, is that unlike morphine, it produces neuronal excitation rather than neuronal depression like morphine does, and there’s a reason I mention this.

I had some crazy specialists who even suggested that maybe I wasnt in pain at all, because surely I would be depressed if I was indeed suffering such high levels of pain that I was reporting.

These crazy under-educated specialists obviously didnt know that codeine produces neuronal excitation and not depression. They were essentially blaming their lack of knowledge on me and calling my integrity into account, when it was their own which was lacking.

Pain is real, it is never somatic(hypochondria). When under-educated doctors, can’t or don’t want to find the cause of a patients pain, (as happens a lot with adverse events to pharmaceutical products,) they will send you to a psychiatrist for a diagnosis of a somatic disorder.

This will cause suffering and stigma for the rest of your life. I shudder to think how many suicides have been caused by such under-educated doctors.

Allopathic drs aren’t allowed to investigate cause and are scared that diagnosing an adverse event to a medical device will damage their career. This is why they completely ignored the well documented fragments of metal, peppered amongst the nerves in my back as a result of my 2008 explantation of metal lumbar hardware.

Even though I have multiple X-ray reports and letters from specialists, our government Corporation, ACC, that deals with injuries, refuse to take these facts into account. In the face of all the confirmed evidence, ACC refuses to believe I have any metal fragments in my back as a result of that explantation surgery so they don’t have to cover it. This is not unusual behaviour with ACC.

They aren’t even allowed to instruct their medical advisors to investigate, because in New Zealand, it is not legal for anyone to investigate the safety of a medical device, or parts of one. They don’t do investigations, they merely do what they call a determination. And they have determined that my multiple scans, radiology reports, and letters from specialists are all untrue, even though the scans are empirical evidence that I do have metal fragments peppered amongst the nerves in my back.

ACCs determination pushes any future doctor into denying the fragments are there, as they don’t want to get in trouble and threaten their career by disagreeing with ACC.

So they disagree with all the scans, radiology reports and specialists letters from musculoskeletal specialists and a neurosurgeon to my face, being sure to let me know I will not be getting any help or honesty from them whatsoever.

I had one doctor try to stand up to this corruption but it led to retaliation, and he told me in a very upset tone, that he now has to leave his career for good.

Pain really is a pain, but the bigger issue is the lack of knowledge our doctors have about the human body and opiates which causes ongoing suffering of the patient.

Have you come across any novel ideas for dealing with pain yourself. Without being able to rely on the knowledge, or lack thereof, of doctors, we can only depend on each other to manage the suffering we face.

Feel free to put your suggestions in the comments