thomason
06-15-2004, 03:39 PM
I've been reading this board for awhile, and am very impressed by the help / advice given on here.
Here is the situation. I had a serious injury in which I broke several bones and had hardware installed. I waited a year and the pain never went away in my leg, so I decided to have the hardware taken out. After that surgery was performed less than 3 months ago, I'm am still in extreme pain, and feel its probably going to be with me for awhile. I have been on and off opiates for pain since the original injury and have no problem stopping other than a few days of aggrevation. The fact that having to take this type of medication is irritating because of all the trouble the doctors have in prescribing it. I never ask for early refills, or do anything like having several doctors treating me at once. This brings me to my situation.
Within the last three months , following the surgery, the doctor that did the surgery was prescribing vicodin. He urged me to stop taking it, and reduced me down to 2 5/500's per day. I was struggling at that low of a dose for probably over a month. I was trying to come up with a better solution to get the meds that work for me, and take less of the liver and kidney damaging additives like tylenol and ibuprofen. The last time I called the surgeon he prescribed me darvocet, and that was it. It didn't do anything for pain. So I made an appointment to see my family doc, in which I described my situation and he gave me Lortab 10/325 which I took about 3-4 / day. I have no trouble tolerating it, and in fact that is really too low for my needs. But, the family doc said he couldn't prescribe anymore and he referred me to a PM doc. At about the same time, I learned from a friend, that his PM doc is one that is willing to do opiates. So I made an appointment with that guy and saw him today. I had also made an appointment with the PM doc that my family doc recommended, because thats the only way he would be willing to fill a script for the lortab. Anyway I saw the friend of mines PM doc today, and he said that he would need ALL of my medical records before he could treat me with narcotics, no way around it. I wasn't expecting that and getting the records will take several days. Meanwhile the other PM doc, who I have no idea how he is about prescribing, appointment is set for day after tomorrow.
Now this is where I don't want to screw up. I felt if I get the medical records for the PM doc I saw today, he is going to see that my family doc referred me to another PM doc, which I haven't seen yet but am supposed to.
I don't want this PM doc that I saw today to refuse treatment because he saw that I was supposed to go to another PM doc referred to by my family doc. I am not sure if that is grounds for refusal, or what the term doctor shopping might mean if thats what this could be considered. But I have not seen the other PM doc yet, and I'm not being prescribed anything currently by anyone. The last script was from my family doc for lortab, and he says no more until I go see that PM doc.
Anyway, I'm sorry for the long explanation, but I am really concerned about this. I don't want to do the wrong thing, I just want the meds for my condition. I feel that if I go to the PM doc my family doc referred me to, there is a chance he won't give me opiates. And I feel, if I don't go to him this PM doc I saw today will think I'm doctor shopping.
Please, can someone give me an opinion. I have to go get the medical records from all my previous treating doctors for this PM doc, and then he said after he checks it all out and makes sure I'm not doctor shopping or getting meds from more than one doctor, he can go ahead and start treating me. I don't know if he plans to call my family docs office, but if he does, I'm sure the family doc will tell him that I was referred to a different PM doc and even made an appointment with them.
So with all that, what is the thing to do here. Am I over-reacting? I am out of meds and going to be miserable, and on top of that I don't want to go through all this trouble if I'm just going to be refused treatment. If I get all the records for the PM doc I saw today, and he checks them out, I just hope that having made the appointment with the PM doc, referred to me by my family doc isn't going to interfere with this doctor treating me.
Thank you all for your time. I am not having a good day today. I hope someone can help me clear up this mess.
I wish you all well, and hang in there. Shoreline, your posts are extremely helpful , you are an asset to this board. I hope your adjusting to you pump well. I am amazed at the amount of help that is given on here, so I think someone will be able to give me some advice.
Here is the situation. I had a serious injury in which I broke several bones and had hardware installed. I waited a year and the pain never went away in my leg, so I decided to have the hardware taken out. After that surgery was performed less than 3 months ago, I'm am still in extreme pain, and feel its probably going to be with me for awhile. I have been on and off opiates for pain since the original injury and have no problem stopping other than a few days of aggrevation. The fact that having to take this type of medication is irritating because of all the trouble the doctors have in prescribing it. I never ask for early refills, or do anything like having several doctors treating me at once. This brings me to my situation.
Within the last three months , following the surgery, the doctor that did the surgery was prescribing vicodin. He urged me to stop taking it, and reduced me down to 2 5/500's per day. I was struggling at that low of a dose for probably over a month. I was trying to come up with a better solution to get the meds that work for me, and take less of the liver and kidney damaging additives like tylenol and ibuprofen. The last time I called the surgeon he prescribed me darvocet, and that was it. It didn't do anything for pain. So I made an appointment to see my family doc, in which I described my situation and he gave me Lortab 10/325 which I took about 3-4 / day. I have no trouble tolerating it, and in fact that is really too low for my needs. But, the family doc said he couldn't prescribe anymore and he referred me to a PM doc. At about the same time, I learned from a friend, that his PM doc is one that is willing to do opiates. So I made an appointment with that guy and saw him today. I had also made an appointment with the PM doc that my family doc recommended, because thats the only way he would be willing to fill a script for the lortab. Anyway I saw the friend of mines PM doc today, and he said that he would need ALL of my medical records before he could treat me with narcotics, no way around it. I wasn't expecting that and getting the records will take several days. Meanwhile the other PM doc, who I have no idea how he is about prescribing, appointment is set for day after tomorrow.
Now this is where I don't want to screw up. I felt if I get the medical records for the PM doc I saw today, he is going to see that my family doc referred me to another PM doc, which I haven't seen yet but am supposed to.
I don't want this PM doc that I saw today to refuse treatment because he saw that I was supposed to go to another PM doc referred to by my family doc. I am not sure if that is grounds for refusal, or what the term doctor shopping might mean if thats what this could be considered. But I have not seen the other PM doc yet, and I'm not being prescribed anything currently by anyone. The last script was from my family doc for lortab, and he says no more until I go see that PM doc.
Anyway, I'm sorry for the long explanation, but I am really concerned about this. I don't want to do the wrong thing, I just want the meds for my condition. I feel that if I go to the PM doc my family doc referred me to, there is a chance he won't give me opiates. And I feel, if I don't go to him this PM doc I saw today will think I'm doctor shopping.
Please, can someone give me an opinion. I have to go get the medical records from all my previous treating doctors for this PM doc, and then he said after he checks it all out and makes sure I'm not doctor shopping or getting meds from more than one doctor, he can go ahead and start treating me. I don't know if he plans to call my family docs office, but if he does, I'm sure the family doc will tell him that I was referred to a different PM doc and even made an appointment with them.
So with all that, what is the thing to do here. Am I over-reacting? I am out of meds and going to be miserable, and on top of that I don't want to go through all this trouble if I'm just going to be refused treatment. If I get all the records for the PM doc I saw today, and he checks them out, I just hope that having made the appointment with the PM doc, referred to me by my family doc isn't going to interfere with this doctor treating me.
Thank you all for your time. I am not having a good day today. I hope someone can help me clear up this mess.
I wish you all well, and hang in there. Shoreline, your posts are extremely helpful , you are an asset to this board. I hope your adjusting to you pump well. I am amazed at the amount of help that is given on here, so I think someone will be able to give me some advice.
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Shoreline
06-15-2004, 04:53 PM
Hi Tom, I would go to the PM doc that your GP recomended, At this moment, You have not doc shopped, meaning you haven't recieved the same meds from multi0ple docs at the same time. It may be that the PM doc your GP wants you to see will be willing to help with your post op pain. Surgeons are notorious for ending pain meds when they see fit, Not when you say the pain s improving. At this point, I would be looking for pain control to rehab the leg, lack of pain control will prevent you from working the leg hard for fear of having unmanageable pain afterwards. 3 months isn't a long time post op. The wholes from the screws are strting to fill in, your have adhesions from the incision that need to be broken free so asking for the best rehab PT and help manageing the pain as you rehab is a reasonable request.
The first doc you saw, may be very willing to prescribe long acting meds, There will always be that alternative should you not fully recover.
You wouldn't be able to get the records PM doc #1 is asking for and then get a script within 2 days anyway. So seeing this doc and seeing what modalities to mange your pain he has to offer may be the quickest way to obtain pain relief and get on the road to recovery. I know you've been in pain long enough to call it chronic but with multiple surgerries your also a recovering surgical patient, and 3 months isn't tha long although surgeons usually cut you off by that point once they believe they have fixed you.
If you see PM doc 2 and he is willing to manage your pain, prescribe the PT and therapy to rehab the leg, this concern may be for not. Honsestly, Even If I gave you the name of my doc and you lived next store, you couldn't get in for several months , he would ask for the same info and eventually go through the steps of finding what works. The PM doc your GP recomends can literally start that day, he has a relationship with your GP, can obtain your records and do his job.Prescribe meds and start you in PT or change the type of PT your doing, Scar management is extremely important, more important than simple strength building.
The big question would be did you sign releases for PM 1 to start rounding up your records, It would look a little funny to have 2 PM docs rounding your records up at the same time.
If it so happens that PM doc 2 doesn't use opiates and you don't click, that's reason enough. You don't have to see a doc you think is a jerk, Personalities can clash for any reason. If you see him and things don't look hopeful, than go back to your GP and explain you have a personal recomendation from a patient and you would like to see the doc your friend sees.
I do want to thank everyone for the support and extreme kindness during these last couple of weeks. I had my pump increased today and when I told tmy PM doc that was given nothing for Post op pain from the surgeon, Since I was seeing him an hour later they told me to ask him to manage the post surgical pain. On the back of every script from my PM IT says If you have a surgical or dental procedure , do not use your chronic pain medication to manage this pain, obtain pain meds from the treating physician. It seems my PM doc is trying to get most foks down to 60 unit doses of BT meds per month and that woudoesn't last long for post surgical pain. SO I did ask, and he gave me 60 10mg Percecet. I didn't want to ask when I left the hospital just to maintain my smooth flight under the radar , but it only hurt myself. I should have explained where I was in my 30 day cycle and had no extra meds for post op pain.
Good luck, Dave
The first doc you saw, may be very willing to prescribe long acting meds, There will always be that alternative should you not fully recover.
You wouldn't be able to get the records PM doc #1 is asking for and then get a script within 2 days anyway. So seeing this doc and seeing what modalities to mange your pain he has to offer may be the quickest way to obtain pain relief and get on the road to recovery. I know you've been in pain long enough to call it chronic but with multiple surgerries your also a recovering surgical patient, and 3 months isn't tha long although surgeons usually cut you off by that point once they believe they have fixed you.
If you see PM doc 2 and he is willing to manage your pain, prescribe the PT and therapy to rehab the leg, this concern may be for not. Honsestly, Even If I gave you the name of my doc and you lived next store, you couldn't get in for several months , he would ask for the same info and eventually go through the steps of finding what works. The PM doc your GP recomends can literally start that day, he has a relationship with your GP, can obtain your records and do his job.Prescribe meds and start you in PT or change the type of PT your doing, Scar management is extremely important, more important than simple strength building.
The big question would be did you sign releases for PM 1 to start rounding up your records, It would look a little funny to have 2 PM docs rounding your records up at the same time.
If it so happens that PM doc 2 doesn't use opiates and you don't click, that's reason enough. You don't have to see a doc you think is a jerk, Personalities can clash for any reason. If you see him and things don't look hopeful, than go back to your GP and explain you have a personal recomendation from a patient and you would like to see the doc your friend sees.
I do want to thank everyone for the support and extreme kindness during these last couple of weeks. I had my pump increased today and when I told tmy PM doc that was given nothing for Post op pain from the surgeon, Since I was seeing him an hour later they told me to ask him to manage the post surgical pain. On the back of every script from my PM IT says If you have a surgical or dental procedure , do not use your chronic pain medication to manage this pain, obtain pain meds from the treating physician. It seems my PM doc is trying to get most foks down to 60 unit doses of BT meds per month and that woudoesn't last long for post surgical pain. SO I did ask, and he gave me 60 10mg Percecet. I didn't want to ask when I left the hospital just to maintain my smooth flight under the radar , but it only hurt myself. I should have explained where I was in my 30 day cycle and had no extra meds for post op pain.
Good luck, Dave
thomason
06-15-2004, 05:20 PM
Hey Shoreline,
Thanks for the tips. Your idea of how to go about this is probably what I should have done, but I made a decision about an hour ago and hopefully it will be ok. Since I went to PM #1 today, and did sign some forms and started the process I feel it would probably be best to give it a shot. I do agree, now that you mention it that PM #2 would have been able to treat without delay and thats something I didn't think about, oh well.
I spoke with the previous doctors offices and if all goes well they will have my records ready to be picked up by this thursday. I'll drop them off with PM #1 on thurs and my appt is scheduled for friday. I asked him if I could just drop the records off the day before my appt, and it seemed that would be ok.
I decided to call PM #2 and cancel my appt. That way if PM #1 decides to call , he will see that I did cancel the appt. So I don't see any reason for PM #1 to not go ahead and start my treatment on Friday if all goes well. When I drop off the records on Thurs, I'll make sure that my appt the following day won't be too soon for him to find out what he needs.
I know it might be a bit longer of a delay with PM #1 , but since I went to him today, its like I already made my choice and I should at least give it till Friday. If things don't work out by early next week, then I'll just have to call PM #2 back and get in there.
I appreciate your help. I can understand how these doctors have to be careful about just prescribing to someone they know nothing about, someone just walking in off the street, so I'm not too upset about it. I just hope it moves along and there aren't any more unexpected delays.
As far as the holes filling in, your right about that. I can feel the bumps over them. They removed the rod from the knee, and I've had quite alot of pain in the knee as well. I know I'll never be pain-free, but I'd like to do things to get as close as I can to it. I did almost 3 months of PT, and didn't see alot of improvement other than a decrease in swelling.
Oh, and I don't know if I made this clear or not. The original injuries are almost 2 years old. The last surgery, which was about 3 months ago was remove the hardware in hopes to get the pain to come down. I don't know how long I'll be in this much pain, but the past 2 years have been really tough. I'd like to think that maybe in another year the pain will go down, but at this point I don't know if it will or not. The PT was stopped recently, after about 3 days/wk x 8 weeks to see if taking it easy will allow for it to heal.
Thanks for the tips. Your idea of how to go about this is probably what I should have done, but I made a decision about an hour ago and hopefully it will be ok. Since I went to PM #1 today, and did sign some forms and started the process I feel it would probably be best to give it a shot. I do agree, now that you mention it that PM #2 would have been able to treat without delay and thats something I didn't think about, oh well.
I spoke with the previous doctors offices and if all goes well they will have my records ready to be picked up by this thursday. I'll drop them off with PM #1 on thurs and my appt is scheduled for friday. I asked him if I could just drop the records off the day before my appt, and it seemed that would be ok.
I decided to call PM #2 and cancel my appt. That way if PM #1 decides to call , he will see that I did cancel the appt. So I don't see any reason for PM #1 to not go ahead and start my treatment on Friday if all goes well. When I drop off the records on Thurs, I'll make sure that my appt the following day won't be too soon for him to find out what he needs.
I know it might be a bit longer of a delay with PM #1 , but since I went to him today, its like I already made my choice and I should at least give it till Friday. If things don't work out by early next week, then I'll just have to call PM #2 back and get in there.
I appreciate your help. I can understand how these doctors have to be careful about just prescribing to someone they know nothing about, someone just walking in off the street, so I'm not too upset about it. I just hope it moves along and there aren't any more unexpected delays.
As far as the holes filling in, your right about that. I can feel the bumps over them. They removed the rod from the knee, and I've had quite alot of pain in the knee as well. I know I'll never be pain-free, but I'd like to do things to get as close as I can to it. I did almost 3 months of PT, and didn't see alot of improvement other than a decrease in swelling.
Oh, and I don't know if I made this clear or not. The original injuries are almost 2 years old. The last surgery, which was about 3 months ago was remove the hardware in hopes to get the pain to come down. I don't know how long I'll be in this much pain, but the past 2 years have been really tough. I'd like to think that maybe in another year the pain will go down, but at this point I don't know if it will or not. The PT was stopped recently, after about 3 days/wk x 8 weeks to see if taking it easy will allow for it to heal.
feelbad
06-16-2004, 09:43 AM
please do not take this the wrong way,but after reading your posts, I just have to ask you this.Are you looking at really trying to find the doc that offers the best pain control options or one that will just Rx you narcotics?i know that you have very legitimate pain issues,and it sounds like you are really truely suffering with this,but if you read your posts, you never mention trying to find the best pain control,only looking for who will Rx you opiates.Have you ever thought about this?addiction to narcotics is a very real possibility when having chronic pain in your life.Believe me, i know of which i speak.we walk a very fine line here with having to use narcotics just to get out of bed some days,and have to be always on the watch for any signs that we have become addicted to the very thing that keeps us going.I fell into this trap and i also suffer from some very excruciating pain.i just don't want to see this happen to someone else.
Believe me, i am not trying to second guess you or make you feel bad, i am only trying to convey what i read from your posts.i just thought that this needed to be pointed out to you.I truely mean nothing by it other than just being something that you maybe want to think about if you haven't already.I really hope that things work out for you thomason.Good luck and take care, marcia
Believe me, i am not trying to second guess you or make you feel bad, i am only trying to convey what i read from your posts.i just thought that this needed to be pointed out to you.I truely mean nothing by it other than just being something that you maybe want to think about if you haven't already.I really hope that things work out for you thomason.Good luck and take care, marcia
Shoreline
06-16-2004, 10:12 AM
Hey Thom, What you did seems like a perfectly legal response, Docs can make referrals to their buds, but it doesn't mean you are bound to only use the doc your GP likes.
The thing about PT is that there are so many different techniques an modalities and not a PT out there that practices them all. After my last surgery I went through round after round of different PT, Water therapy progressed into the gym and stretching and e-stim and excercise, But the first year nobody adressed the scarring. IF you placed your hand aover the incision and tried to move the skin, the skin was bound by adhesion to the fascia layer, so this became the priority of the nest PYT I saw, and seeemed to help the most by breaking up the scar tissue and adhesions and using myofacial release techniques. Being prescribed PT doesn't neccesarrily mean you will recieve the right PT.
Often like PM, PT's try to hammer every peg through the same hole, thinking that the technique they use will help anyone and everyone but may not adress specific issues another PT may find very important to address.
I;m sure you have insurance that has to aprove the PT and most have limits, want to see improvement and eventually claim you have reached maximum medical benefit and deny any further PT sesions unless you are able to pay out of pocket for neded PT.
You just want to make sure you recieved all the right and neccessarry PT that would benefit you the most.
Your PM can also prescribe additional PT, It may be an insurance battle, But if he can see something like scar management was never adressed tt may be cause for your insurance company to give you a few more vits.
A good PM doc is going to have more than one method to manage pain, obviously everyones pain and med neeeds are not the same. When it comes to PM I think of the bell curve we are graded by in HS and college. Some people on the far left of the slope may need minimal meds, or weaker meds and improve greatly from simple PT and meds like Ultram. The the center of the curve is where the bulk of people fall, they require a liitle more agressive pain management, more meds and more interventional procedures and the far right are people that have not responded to other attempts and are the higher dose patients, they may require mixed opiates, they may require more invasive therapy like nerve ablation or the pump or scs.
Everyone is different and you fall somewhere in the bell curve. Hopefully PM doc 1 is skilled and able to help folks on all locations of that bell curve. Yu really do want a doc that has more talent than the abilty to write a script, any doc can write a script, but rehabing a patient that became one of that 10% that the surgery wasn't succesful on, or needed hardware removed and more extensive pain intervention
Good luck, Dave
Sorry bout the spelling errors, I look at my fingers, not the screen. I just type faster that way but often mis some of my own errors.LOL
The thing about PT is that there are so many different techniques an modalities and not a PT out there that practices them all. After my last surgery I went through round after round of different PT, Water therapy progressed into the gym and stretching and e-stim and excercise, But the first year nobody adressed the scarring. IF you placed your hand aover the incision and tried to move the skin, the skin was bound by adhesion to the fascia layer, so this became the priority of the nest PYT I saw, and seeemed to help the most by breaking up the scar tissue and adhesions and using myofacial release techniques. Being prescribed PT doesn't neccesarrily mean you will recieve the right PT.
Often like PM, PT's try to hammer every peg through the same hole, thinking that the technique they use will help anyone and everyone but may not adress specific issues another PT may find very important to address.
I;m sure you have insurance that has to aprove the PT and most have limits, want to see improvement and eventually claim you have reached maximum medical benefit and deny any further PT sesions unless you are able to pay out of pocket for neded PT.
You just want to make sure you recieved all the right and neccessarry PT that would benefit you the most.
Your PM can also prescribe additional PT, It may be an insurance battle, But if he can see something like scar management was never adressed tt may be cause for your insurance company to give you a few more vits.
A good PM doc is going to have more than one method to manage pain, obviously everyones pain and med neeeds are not the same. When it comes to PM I think of the bell curve we are graded by in HS and college. Some people on the far left of the slope may need minimal meds, or weaker meds and improve greatly from simple PT and meds like Ultram. The the center of the curve is where the bulk of people fall, they require a liitle more agressive pain management, more meds and more interventional procedures and the far right are people that have not responded to other attempts and are the higher dose patients, they may require mixed opiates, they may require more invasive therapy like nerve ablation or the pump or scs.
Everyone is different and you fall somewhere in the bell curve. Hopefully PM doc 1 is skilled and able to help folks on all locations of that bell curve. Yu really do want a doc that has more talent than the abilty to write a script, any doc can write a script, but rehabing a patient that became one of that 10% that the surgery wasn't succesful on, or needed hardware removed and more extensive pain intervention
Good luck, Dave
Sorry bout the spelling errors, I look at my fingers, not the screen. I just type faster that way but often mis some of my own errors.LOL
sgibson
06-16-2004, 03:05 PM
Thomason,
Hi. I sort of had the same impression as feelbad when I read your posts. They had an air of desperation to them. I know how chronic pain can cause that desperation, I just wasn't sure thats what your focus was on. I do believe you have honest pain issues but if you go into a PM docs office with the same air I perceive here, then I'm afraid you will be labeled as a drug seeker. Pain Management is a crazy thing. One would think they could just sit down with their PM and be totally honest and not have to watch everything you say because you do have legitimate pain, but sometimes, heck most of the time, it just doesn't work that way.
I wish you the best of luck in finding what works for you. If you haven't tried any other forms of pain management besides opiates, perhaps it's time you give them an honest try. Good Luck.
God Bless,
Sherry :wave:
Hi. I sort of had the same impression as feelbad when I read your posts. They had an air of desperation to them. I know how chronic pain can cause that desperation, I just wasn't sure thats what your focus was on. I do believe you have honest pain issues but if you go into a PM docs office with the same air I perceive here, then I'm afraid you will be labeled as a drug seeker. Pain Management is a crazy thing. One would think they could just sit down with their PM and be totally honest and not have to watch everything you say because you do have legitimate pain, but sometimes, heck most of the time, it just doesn't work that way.
I wish you the best of luck in finding what works for you. If you haven't tried any other forms of pain management besides opiates, perhaps it's time you give them an honest try. Good Luck.
God Bless,
Sherry :wave:
sgibson
06-16-2004, 03:25 PM
Thomason,
Please disregard my first post. I am sorry. I'm feeling that same desperation that I condemned you for. No sooner than I typed that post I found out that I don't have insurance approval for my new PM appointment which is tomorrow. My surgeon has two offices and each office is saying it's the other offices responsibility to get the approval. Well the office I go to finally said, fine we'll take care of it. She gives me an approval number and I call the insurance to make sure everything is ok, well the stupid number she gave me is the approval for the physical therapy which I am currently doing. The lady at the insurance company told me I don't have approval for my appointment tomorrow. I called my PCP's office, just because I'm tired of dealing with the staff at surgeons office, the insurance lady at the PCP's office said she would try to take care of it and call me back. So here it is 2:22, their office closes early on Wed. and I don't know if I will hear anything back today or not. My surgeon is still rx'ing my pain meds and I have an appointment with him next week so I'm not worried about not having my meds. I was just ready to get on with developing a relationship with a new PM. I had a PM prior to surgery. I used him for 2 years. My surgeon says he is not the type of PM I need now. (PM uses mainly injections and tens). Surgeon says I need a PM to develop a long term medicine regimen. He says this is the guy to go to. I said OK. I trust my surgeon. I have always done everything he told me. I don't blame him for his staffs incompetence. I'm just trying to say I'm sorry. I understand being desperate. In my situation though the worst thing that can happen is I will have to reschedule my appointment until insurance approval can be gotten. I'm sorry you are having difficulty and I am sorry if I added to your anxiety in any way.
God Bless,
Sherry :wave:
Please disregard my first post. I am sorry. I'm feeling that same desperation that I condemned you for. No sooner than I typed that post I found out that I don't have insurance approval for my new PM appointment which is tomorrow. My surgeon has two offices and each office is saying it's the other offices responsibility to get the approval. Well the office I go to finally said, fine we'll take care of it. She gives me an approval number and I call the insurance to make sure everything is ok, well the stupid number she gave me is the approval for the physical therapy which I am currently doing. The lady at the insurance company told me I don't have approval for my appointment tomorrow. I called my PCP's office, just because I'm tired of dealing with the staff at surgeons office, the insurance lady at the PCP's office said she would try to take care of it and call me back. So here it is 2:22, their office closes early on Wed. and I don't know if I will hear anything back today or not. My surgeon is still rx'ing my pain meds and I have an appointment with him next week so I'm not worried about not having my meds. I was just ready to get on with developing a relationship with a new PM. I had a PM prior to surgery. I used him for 2 years. My surgeon says he is not the type of PM I need now. (PM uses mainly injections and tens). Surgeon says I need a PM to develop a long term medicine regimen. He says this is the guy to go to. I said OK. I trust my surgeon. I have always done everything he told me. I don't blame him for his staffs incompetence. I'm just trying to say I'm sorry. I understand being desperate. In my situation though the worst thing that can happen is I will have to reschedule my appointment until insurance approval can be gotten. I'm sorry you are having difficulty and I am sorry if I added to your anxiety in any way.
God Bless,
Sherry :wave:
thomason
06-17-2004, 02:38 AM
I appreciate everyones input here, and I can see how it would sound desperate. I guess that is because I am desperate for what I know works for me. Its not something I am glad to be involved in, but have had chronic pain issues for over 10 years now and I know what gives me relief. The doctors are well aware of the addiction potential of these meds and its up to them to be very careful in the manner they prescribe them. I probably come off as someone that is just seeking a script, but if you look at what I've been through and talk to me about how I feel on a daily basis, you might understand. I'm not one to be passive about what I need, and having seen many doctors I know most of them are not going to want to prescribe these meds on a long term basis unless it is truly a last resort. I like to hope there are some techniques in PT that I haven't tried. I've been to about 3 or 4 different PT clinics, and I agree they all differ greatly in how they treat their patients. I will look into finding something that will help with the scars. I've had the electrical stimulation and it didn't really do much. I pushed myself so hard in PT at one of the clinics that I think it caused a tiny fracture in my foot on the treadmill. The docs referred to it as a "marching" fracture commonly seen in the military. That made sense to me because I was really pushing my limits to get my range of motion and flexibility back. I just am left with a terrible deep pain that is constant and doesn't ever subside for the last 2 years. I have tried to stop the opiates probably 3 or 4 times and have just went to taking extremely dangerous amounts of tylenol and motrin throughout the day. I know about the 4g max, and I was right at it and still not having any relief.
The goal is to get pain relief that I can tolerate, which so far has been the opiates. I speak quite freely on here because I know most of you are familiar with the brand names, dosages, etc. So if it sounds like I am looking for specifically opiates for my treatment, that is true. Will I do other things besides that if it could possibly "heal" me, of course. I am not giving up, and just turning to the narcotics. I just know that the quality of my life is much greater when I have them. Do I think I'm dependant, yes. Do I think I could quit if I had to, yes. I just feel that if this is what works and I can tolerate the side effects, and there isn't danger of damaging my internal organs then this is what I want to do. I had to stop taking tylenol a few months ago because I got SEVERE headaches. I was taking two 500mg tylenol every 3-4 hrs and then the headaches started. I was then taking tylenol for the headaches too. It was really bad.
My body has adjusted to the opiates and obviously my tolerance has gone up. I don't know what this PM doc will want to try, but I feel that I may finally have someone willing to work with me, rather than having to call up the surgeon or family doc just trying to get a script. I want someone that is going to treat me for the long term, and develop something that will give me relief and settle my nerves in that I know I'll have the pain meds that help me.
So, thank you all for your input. I am comfortable taking the opiates, and I know about the dependance issue. I have taken myself off of them so many times, but have gone back because thats what works. If I got to a point where my pain became minimal, and I could tolerate it without meds I would be so happy.
Take care and thank you for the advice. I hope that there is another alternative that I can find along the way, and maybe I can do without the meds. I really need to try everything, because if I find something that works and takes the pain away, and I can run agian or do the things I used to do, it would be incredible.
The goal is to get pain relief that I can tolerate, which so far has been the opiates. I speak quite freely on here because I know most of you are familiar with the brand names, dosages, etc. So if it sounds like I am looking for specifically opiates for my treatment, that is true. Will I do other things besides that if it could possibly "heal" me, of course. I am not giving up, and just turning to the narcotics. I just know that the quality of my life is much greater when I have them. Do I think I'm dependant, yes. Do I think I could quit if I had to, yes. I just feel that if this is what works and I can tolerate the side effects, and there isn't danger of damaging my internal organs then this is what I want to do. I had to stop taking tylenol a few months ago because I got SEVERE headaches. I was taking two 500mg tylenol every 3-4 hrs and then the headaches started. I was then taking tylenol for the headaches too. It was really bad.
My body has adjusted to the opiates and obviously my tolerance has gone up. I don't know what this PM doc will want to try, but I feel that I may finally have someone willing to work with me, rather than having to call up the surgeon or family doc just trying to get a script. I want someone that is going to treat me for the long term, and develop something that will give me relief and settle my nerves in that I know I'll have the pain meds that help me.
So, thank you all for your input. I am comfortable taking the opiates, and I know about the dependance issue. I have taken myself off of them so many times, but have gone back because thats what works. If I got to a point where my pain became minimal, and I could tolerate it without meds I would be so happy.
Take care and thank you for the advice. I hope that there is another alternative that I can find along the way, and maybe I can do without the meds. I really need to try everything, because if I find something that works and takes the pain away, and I can run agian or do the things I used to do, it would be incredible.
feelbad
06-17-2004, 08:16 AM
Thanks for not taking that the wrong way.i am sure it was just the desperation of wanting relief and nothing else.I just felt that the tone of the post needed to be pointed out to you.Sounds like you are on top of things.Honestly, i didn't mean anything by my post other than making you aware of what I was sensing while reading it.You really do have to be aggressive in finding the proper treatment these days.i have been through this myself,along with probably just about everyone on this board.
Trying to find any relief is such a struggle.I know that my pain was not being properly addressed until i found a good pM doc.My clinic is such a caring place,I feel that they are really trying to help me live more comfortably and are dealing with all of my issues.i haven't been able to find anything that will bring my pain down to under a seven so far.Everyday it is such a struggle to just get out of bed knowing what awaits me when my feet hit the ground.
i really do understand where you are coming from now, and I really am sorry if I offended you in any way as it was not my intent.I hope your little nightmare turns out for the best for you.It sounds like you have been having to deal with all of this for way too long.Hopefully this new pM doc will be the one with the answers.Good luck to you and take care, Marcia
Trying to find any relief is such a struggle.I know that my pain was not being properly addressed until i found a good pM doc.My clinic is such a caring place,I feel that they are really trying to help me live more comfortably and are dealing with all of my issues.i haven't been able to find anything that will bring my pain down to under a seven so far.Everyday it is such a struggle to just get out of bed knowing what awaits me when my feet hit the ground.
i really do understand where you are coming from now, and I really am sorry if I offended you in any way as it was not my intent.I hope your little nightmare turns out for the best for you.It sounds like you have been having to deal with all of this for way too long.Hopefully this new pM doc will be the one with the answers.Good luck to you and take care, Marcia
thomason
06-17-2004, 01:14 PM
Thanks for not taking that the wrong way.i am sure it was just the desperation of wanting relief and nothing else.I just felt that the tone of the post needed to be pointed out to you.Sounds like you are on top of things.Honestly, i didn't mean anything by my post other than making you aware of what I was sensing while reading it.You really do have to be aggressive in finding the proper treatment these days.i have been through this myself,along with probably just about everyone on this board.
Trying to find any relief is such a struggle.I know that my pain was not being properly addressed until i found a good pM doc.My clinic is such a caring place,I feel that they are really trying to help me live more comfortably and are dealing with all of my issues.i haven't been able to find anything that will bring my pain down to under a seven so far.Everyday it is such a struggle to just get out of bed knowing what awaits me when my feet hit the ground.
i really do understand where you are coming from now, and I really am sorry if I offended you in any way as it was not my intent.I hope your little nightmare turns out for the best for you.It sounds like you have been having to deal with all of this for way too long.Hopefully this new pM doc will be the one with the answers.Good luck to you and take care, Marcia
I didn't take it the wrong way, and in fact I am greatful that you show your concern and you should continue to do so. To take these types of medications, without understanding how they can affect you is very dangerous. I figured someone might post something similar to what you wrote, as I am new here and my history isn't quite clear as to what I've been exposed to. So don't worry about posting what you feel might try and alert someone of their actions.
Many people can't really see what their lives become until its too late and somebody else needs to help them. This is why seeking this type of meds is so dangerous because everyone is going to respond differently. Most docs are very reluctant to keep people on these for the long term because of the addiction potential. I believe, and have also read on here, that there is a difference between addiction and dependance. There is nothing wrong with being dependant on a med as long as you are yourself, and it helps you overcome what you normally could not. I know my pain level is not as severe as some of you, but I do need to take some sort of medication for my pain. I don't wish to ruin my liver and kidneys by taking high doses of OTC tylenol and ibuprofen. I have found the opiates to be a good source of relief, and are much safer for those who know what to expect with them. I think many people have to live with some amount of pain, and if they are able to do so then I am happy for them. I honestly don't think I can live with my pain, which is why I continue to return to opiates for relief.
I hope that in time my condition improves, and I don't have the constant pain. I don't think I'll ever be able to do things like running and other recreational activities because of pain and because of fear that something will happen and I will be injured agian or make my injuries worse.
Life without any medication is much better, and if that day comes where I can do without it I will feel so good. The clarity and overall healthy feeling of being without meds is so desirable to me, but right now , not a possibility for me.
Thanks all for your concern, take care, and thank you very much for your kind words of advise.
Trying to find any relief is such a struggle.I know that my pain was not being properly addressed until i found a good pM doc.My clinic is such a caring place,I feel that they are really trying to help me live more comfortably and are dealing with all of my issues.i haven't been able to find anything that will bring my pain down to under a seven so far.Everyday it is such a struggle to just get out of bed knowing what awaits me when my feet hit the ground.
i really do understand where you are coming from now, and I really am sorry if I offended you in any way as it was not my intent.I hope your little nightmare turns out for the best for you.It sounds like you have been having to deal with all of this for way too long.Hopefully this new pM doc will be the one with the answers.Good luck to you and take care, Marcia
I didn't take it the wrong way, and in fact I am greatful that you show your concern and you should continue to do so. To take these types of medications, without understanding how they can affect you is very dangerous. I figured someone might post something similar to what you wrote, as I am new here and my history isn't quite clear as to what I've been exposed to. So don't worry about posting what you feel might try and alert someone of their actions.
Many people can't really see what their lives become until its too late and somebody else needs to help them. This is why seeking this type of meds is so dangerous because everyone is going to respond differently. Most docs are very reluctant to keep people on these for the long term because of the addiction potential. I believe, and have also read on here, that there is a difference between addiction and dependance. There is nothing wrong with being dependant on a med as long as you are yourself, and it helps you overcome what you normally could not. I know my pain level is not as severe as some of you, but I do need to take some sort of medication for my pain. I don't wish to ruin my liver and kidneys by taking high doses of OTC tylenol and ibuprofen. I have found the opiates to be a good source of relief, and are much safer for those who know what to expect with them. I think many people have to live with some amount of pain, and if they are able to do so then I am happy for them. I honestly don't think I can live with my pain, which is why I continue to return to opiates for relief.
I hope that in time my condition improves, and I don't have the constant pain. I don't think I'll ever be able to do things like running and other recreational activities because of pain and because of fear that something will happen and I will be injured agian or make my injuries worse.
Life without any medication is much better, and if that day comes where I can do without it I will feel so good. The clarity and overall healthy feeling of being without meds is so desirable to me, but right now , not a possibility for me.
Thanks all for your concern, take care, and thank you very much for your kind words of advise.
thomason
06-19-2004, 02:27 AM
I think this might be a good doc, even though he felt my current dosage of opiates was too high. He gave me a norco 2/day , zanaflex 2/day, and elavil once at bedtime. I had never taken zanaflex before, but it seemed to have a good effect. Nothing remarkable, but it did seem like something for about an hour after taking it, that might help, so we'll see in a week or so. I don't know what to think about the elavil (Antidepressant), as I've been VERY sensitive to these types of meds. I'm really hesitant to take the elavil.
I don't really know how I'm going to break the news to him that I have a very high tolerance for pain meds, and that I'm going to need an increase. I just don't want to waste time barely getting by on a low dose, but I also don't want to go in throwing names around like OxyC, dilaudid, MSC, etc. I just know that will throw up a red flag, and if he thinks the 4 lortab a day was too much, then that might just really shock him to hear what I think might work.
So, at least I see some good things coming from this. He told me that the goal is to get me pain free with minimal affect to my body and that was good to hear. I don't like being near the borderline of pain relief. I feel if I'm going to take the opiates, along with the annoying side affects, I should get to a therapeutic dosage so I'm actually feeling like I have a life again. I feel that I'm getting closer to my goal, and its a relief. If I can go a few hours in a day without sitting and dwelling on my pain, that would be such a good thing. Its just so aggravating when I get only 2 pills a day, and they are marginally effective for about an hour. I hate having such a huge tolerance like this, but its just how I am. I just don't know how I'm going to be able to get this doc to understand me, as he probably thinks that I should be more than fine with that dosage.
Sorry if this sounds like I'm desperate again, but I guess thats been the story of my life for the last 10 years.
I'm just so tired of being in pain, and having to deal with it. I'm sure you all know what I mean, so I'm not interested in wasting time getting to a manageable comfort level. Its as if you know your correct dosage needs is right around the corner, but you have to go through an neverending uphill battle to reach that corner. I just feel that if I don't get there soon, I'm going to be a very irritated person and have not much left in me to carry on a friendly conversation with somebody just to talk. I used to be like that, where I would talk to just about anybody, about things going on in the world, but since all this pain its like my whole life has been absorbed by trying to get relief from it. When I do feel relief, its like I can live agian and I can listen to others and just have a good conversation.
I don't really know how I'm going to break the news to him that I have a very high tolerance for pain meds, and that I'm going to need an increase. I just don't want to waste time barely getting by on a low dose, but I also don't want to go in throwing names around like OxyC, dilaudid, MSC, etc. I just know that will throw up a red flag, and if he thinks the 4 lortab a day was too much, then that might just really shock him to hear what I think might work.
So, at least I see some good things coming from this. He told me that the goal is to get me pain free with minimal affect to my body and that was good to hear. I don't like being near the borderline of pain relief. I feel if I'm going to take the opiates, along with the annoying side affects, I should get to a therapeutic dosage so I'm actually feeling like I have a life again. I feel that I'm getting closer to my goal, and its a relief. If I can go a few hours in a day without sitting and dwelling on my pain, that would be such a good thing. Its just so aggravating when I get only 2 pills a day, and they are marginally effective for about an hour. I hate having such a huge tolerance like this, but its just how I am. I just don't know how I'm going to be able to get this doc to understand me, as he probably thinks that I should be more than fine with that dosage.
Sorry if this sounds like I'm desperate again, but I guess thats been the story of my life for the last 10 years.
I'm just so tired of being in pain, and having to deal with it. I'm sure you all know what I mean, so I'm not interested in wasting time getting to a manageable comfort level. Its as if you know your correct dosage needs is right around the corner, but you have to go through an neverending uphill battle to reach that corner. I just feel that if I don't get there soon, I'm going to be a very irritated person and have not much left in me to carry on a friendly conversation with somebody just to talk. I used to be like that, where I would talk to just about anybody, about things going on in the world, but since all this pain its like my whole life has been absorbed by trying to get relief from it. When I do feel relief, its like I can live agian and I can listen to others and just have a good conversation.
Fiona_Jo_324
06-19-2004, 03:13 AM
I'm sure that others will have additional input. But my initial thoughts on this it that all PM Doctors have a starting point to work from. I think at this point, the best way to proceed would be do follow everything as directed and document what happens with your pain levels. If you've never tried a medication like Elavil; it might be worth a try. I know medications like that generally take a couple of weeks to build up in your system and for you to really notice any improvement. But, unless you start having a bad reaction to it; it is probably worth a try. Keeping documentation on how your pain level responds will help you talk in the most objective manner with your Doctor, I think the important thing for us PM patients is that relate everything that is occurring with our pain as objectively as possible. I definitely I agree with you .. you deserve to have your pain managed to a level you can live comfortably with.
I know I am never completely pain free; but I can say for the most part my pain is at a level I can deal with (though I do have those days when it seems horrible). My Doctor had me start taking Pamelor in addition to my other pain meds; it has worked well for my pain because it helps me get a bit drowsy and actully helps me fall asleep (unfortunately, there was a time that my pain levels were so high that I would be lucky if I could sleep for an hour straight), it took a while for me to notice any improvement, but after about two weeks I really felt it was helping to lower my pain levels. There was a point where I had reduced my Norco and Oxys substantially .. my Doctor was thrilled. But, unfortunately with my back injury I had to increase my dosages again (with Doctor okay). I am hoping once I get through the back problems, I will be able to lower my narcotic intake again. But, my Doctor is great about listening to me and understanding my needs. I have to say though from day one entering his office; I had everything documented in the most objective terms. I also brought a list of questions about potential meds (not implying I'm asking for those medications, just for reference information on their effectiveness). The Doctors I have worked with have always responded best when our sessions are both us working together to come up with the best med plan for my pain needs. I know others will have additional thoughts and ideas for you. Did you talk to your Doctor about your concerns about the Elavil? I really think your Doctor will be willing to work with you; and it is important to remember that today's visit was basically a starting point to work from. :angel:
Jo :wave:
I know I am never completely pain free; but I can say for the most part my pain is at a level I can deal with (though I do have those days when it seems horrible). My Doctor had me start taking Pamelor in addition to my other pain meds; it has worked well for my pain because it helps me get a bit drowsy and actully helps me fall asleep (unfortunately, there was a time that my pain levels were so high that I would be lucky if I could sleep for an hour straight), it took a while for me to notice any improvement, but after about two weeks I really felt it was helping to lower my pain levels. There was a point where I had reduced my Norco and Oxys substantially .. my Doctor was thrilled. But, unfortunately with my back injury I had to increase my dosages again (with Doctor okay). I am hoping once I get through the back problems, I will be able to lower my narcotic intake again. But, my Doctor is great about listening to me and understanding my needs. I have to say though from day one entering his office; I had everything documented in the most objective terms. I also brought a list of questions about potential meds (not implying I'm asking for those medications, just for reference information on their effectiveness). The Doctors I have worked with have always responded best when our sessions are both us working together to come up with the best med plan for my pain needs. I know others will have additional thoughts and ideas for you. Did you talk to your Doctor about your concerns about the Elavil? I really think your Doctor will be willing to work with you; and it is important to remember that today's visit was basically a starting point to work from. :angel:
Jo :wave:
thomason
06-21-2004, 01:56 PM
Well its been two full days, and my pain is not under control. I am in the same boat as others have been in here, in that I am hesistant to go back to the doctor and tell him I need an increase. I guess that is because in the beginning of my last appt, he started out saying I'm taking too much pain meds once he looked at my records. The most I had been up to was when I started seeing him, which was about 4 lortabs/day. I told him that even that dose was too low.
So now after trying his med combo out of norco, zanaflex, and elavil I can at least say that I gave it a shot. I know its only been 2 days, but if I'm having to take more than the 2 norcos/day that he prescribed, shouldn't I be calling the office to make an appt.? I've had to take 4-5 of them yesterday, and I just know 2/day is not going to cut it.
I will call and get in to see him ASAP, but I just hope that he is willing to understand how my tolerance is. I've been on/off opiates for over 10 years, and it doesn't take me long to build a tolerance to them. If I didn't take any for about 3-4 months, then 1 norco would probably do the job and relieve the pain for more than 30 mins. But after about a week of taking them it will take much more to get relief.
This is so irritating, and I'm sorry I have came on here and rambled on about my problems as they seem to be without end. I just wish that I could get something that would actually work for the pain. I am getting really desperate here, because the aching/throbbing is really discouraging me and taking the life out of me.
I used to be the type that thought I could get through anything with pure will power. That is what has made me give up meds on so many occasions. But then I just end up right back going to them, because I can handle chronic pain. I MUST try and find another way, because the meds are only going to do so much for me. I figure if my body is going to build a tolerance to the norco, it will just as easily build a tolerance to oxy or other similar meds.
Then there is the chance that I could be causing my pain to get worse. My leg is so uncomfortable that I constantly rotate my foot around, with my toes pointed out, and sometimes it will cause my ankle to crack, and also something up in my leg to crack. Its sorta like cracking your knuckles type of habit, but this is done because of aggrevation of it hurting. For some reason I think that by cracking it, it will alleviate the pain. I do the same with my back if it is stiff. So, in addition to the pain where the screws were located, and where the rod was removed at the knee.... I have pain just randomly throughout the leg. That could be from me rotating my foot, and affecting the muscles in the leg.
I'm willing to try anything. Maybe celebrex or vioxx would work, I was on those years ago. Maybe something like glucosamine(sp?) would work. I'll try anything as long as it isn't damaging to the organs like the tylenol and motrin. Maybe a heating pad and some bengay..... LOL. I am really willing to try anything as using opiates just makes me build a tolerance until they don't work anymore.
So now after trying his med combo out of norco, zanaflex, and elavil I can at least say that I gave it a shot. I know its only been 2 days, but if I'm having to take more than the 2 norcos/day that he prescribed, shouldn't I be calling the office to make an appt.? I've had to take 4-5 of them yesterday, and I just know 2/day is not going to cut it.
I will call and get in to see him ASAP, but I just hope that he is willing to understand how my tolerance is. I've been on/off opiates for over 10 years, and it doesn't take me long to build a tolerance to them. If I didn't take any for about 3-4 months, then 1 norco would probably do the job and relieve the pain for more than 30 mins. But after about a week of taking them it will take much more to get relief.
This is so irritating, and I'm sorry I have came on here and rambled on about my problems as they seem to be without end. I just wish that I could get something that would actually work for the pain. I am getting really desperate here, because the aching/throbbing is really discouraging me and taking the life out of me.
I used to be the type that thought I could get through anything with pure will power. That is what has made me give up meds on so many occasions. But then I just end up right back going to them, because I can handle chronic pain. I MUST try and find another way, because the meds are only going to do so much for me. I figure if my body is going to build a tolerance to the norco, it will just as easily build a tolerance to oxy or other similar meds.
Then there is the chance that I could be causing my pain to get worse. My leg is so uncomfortable that I constantly rotate my foot around, with my toes pointed out, and sometimes it will cause my ankle to crack, and also something up in my leg to crack. Its sorta like cracking your knuckles type of habit, but this is done because of aggrevation of it hurting. For some reason I think that by cracking it, it will alleviate the pain. I do the same with my back if it is stiff. So, in addition to the pain where the screws were located, and where the rod was removed at the knee.... I have pain just randomly throughout the leg. That could be from me rotating my foot, and affecting the muscles in the leg.
I'm willing to try anything. Maybe celebrex or vioxx would work, I was on those years ago. Maybe something like glucosamine(sp?) would work. I'll try anything as long as it isn't damaging to the organs like the tylenol and motrin. Maybe a heating pad and some bengay..... LOL. I am really willing to try anything as using opiates just makes me build a tolerance until they don't work anymore.
sgibson
06-21-2004, 03:26 PM
Hi Thomason,
I'm not sure how your doc is going to react to you increasing the meds without his approval. Especially since you are just establishing yourself with him. I feel sorry for you. I know what it's like to suffer because your meds aren't cutting it. When we are in pain management though we usually just have to suffer until we can get a hold of our docs. If your doc thinks you are already on too high of a dose, he is probably not going to be happy about you taking more of the meds than he rx'ed. I really don't know what to tell you. You are definitely in a hard spot. You mentioned celebrex and vioxx, perhaps they would be good choices for you. Keep us posted on what your doc does for you. I hope he is a understanding doc and will try to work with you to help alleviate some of your pain. I will say though that most pain management docs don't like their patients playing around with their directions for meds. Good Luck.
God Bless,
Sherry :wave:
I'm not sure how your doc is going to react to you increasing the meds without his approval. Especially since you are just establishing yourself with him. I feel sorry for you. I know what it's like to suffer because your meds aren't cutting it. When we are in pain management though we usually just have to suffer until we can get a hold of our docs. If your doc thinks you are already on too high of a dose, he is probably not going to be happy about you taking more of the meds than he rx'ed. I really don't know what to tell you. You are definitely in a hard spot. You mentioned celebrex and vioxx, perhaps they would be good choices for you. Keep us posted on what your doc does for you. I hope he is a understanding doc and will try to work with you to help alleviate some of your pain. I will say though that most pain management docs don't like their patients playing around with their directions for meds. Good Luck.
God Bless,
Sherry :wave:
thomason
06-21-2004, 11:42 PM
Well, what I may write here may not be verbatim for what I tell the doc.
I understand your point of view, but I'm just telling it how it is. If I have access to pain meds that I feel might relieve my pain, then I'll have to do what is necessary. I'll see what the doc has to say probably tomorrow.
The thing is, I will probably have to make another appt. I guess I could call and make the appt, and at the same time ask if I may increase the frequency of my doses as needed. I just don't want to lose out on a doc that might be willing to work with me with opiates. That is almost impossible to find, but they have to understand the tolerance thing. If you are going to be using opiates, whats the difference if you take 2 norcos/day verses 4 oxys/day. Sooner or later people build a tolerance, and unfortunately I had built one up before I started seeing him.
I understand your point of view, but I'm just telling it how it is. If I have access to pain meds that I feel might relieve my pain, then I'll have to do what is necessary. I'll see what the doc has to say probably tomorrow.
The thing is, I will probably have to make another appt. I guess I could call and make the appt, and at the same time ask if I may increase the frequency of my doses as needed. I just don't want to lose out on a doc that might be willing to work with me with opiates. That is almost impossible to find, but they have to understand the tolerance thing. If you are going to be using opiates, whats the difference if you take 2 norcos/day verses 4 oxys/day. Sooner or later people build a tolerance, and unfortunately I had built one up before I started seeing him.
sgibson
06-22-2004, 12:01 AM
Thomason,
I know how you feel and I'm sorry if you took my post the wrong way. It can be extremely frustrating when you are hurting so badly and it seems no one will help you. I do know that feeling. I don't sleep anymore due to my pain levels. They are steadily increasing. I haven't had a pain med increase in a long time. I wasted my time with a pain management doc the other day. (if you want to know more, the story is in the thread called hey sgibson) I go to see my surgeon tomorrow and we will discuss the other names of pain docs and see what we come up with. So I know how you feel. I just want to be able to sleep and have some low pain days. I hope you will find this doc of yours to be understanding of your plight. Good luck and keep us posted.
God Bless,
Sherry :wave:
I know how you feel and I'm sorry if you took my post the wrong way. It can be extremely frustrating when you are hurting so badly and it seems no one will help you. I do know that feeling. I don't sleep anymore due to my pain levels. They are steadily increasing. I haven't had a pain med increase in a long time. I wasted my time with a pain management doc the other day. (if you want to know more, the story is in the thread called hey sgibson) I go to see my surgeon tomorrow and we will discuss the other names of pain docs and see what we come up with. So I know how you feel. I just want to be able to sleep and have some low pain days. I hope you will find this doc of yours to be understanding of your plight. Good luck and keep us posted.
God Bless,
Sherry :wave:
Fiona_Jo_324
06-22-2004, 01:17 AM
thomason:
I agree that you need to contact your pain management Doctor ASAP and let him know what is going on with your pain levels. Hopefully, he will adjust your norcos or provide you with an alternative to help get you to the point where your pain is reasonably managed. I have to say though; elavil does take a couple of weeks in your system before you will notice anything. Just like any of medications they are now using for pain management you have to give them a little time to see if it helps or not. I take pamelor for chronic pain; I have to say it took a while for me to even realize it does help. I do agree though an adjustment with the Norcos is probably in order. I'm sorry about what you are going through. Keep us posted. :angel:
Jo
I agree that you need to contact your pain management Doctor ASAP and let him know what is going on with your pain levels. Hopefully, he will adjust your norcos or provide you with an alternative to help get you to the point where your pain is reasonably managed. I have to say though; elavil does take a couple of weeks in your system before you will notice anything. Just like any of medications they are now using for pain management you have to give them a little time to see if it helps or not. I take pamelor for chronic pain; I have to say it took a while for me to even realize it does help. I do agree though an adjustment with the Norcos is probably in order. I'm sorry about what you are going through. Keep us posted. :angel:
Jo
thomason
06-22-2004, 01:48 AM
Hi Thomason,
I'm not sure how your doc is going to react to you increasing the meds without his approval. Especially since you are just establishing yourself with him. I feel sorry for you. I know what it's like to suffer because your meds aren't cutting it. When we are in pain management though we usually just have to suffer until we can get a hold of our docs. If your doc thinks you are already on too high of a dose, he is probably not going to be happy about you taking more of the meds than he rx'ed. I really don't know what to tell you. You are definitely in a hard spot. You mentioned celebrex and vioxx, perhaps they would be good choices for you. Keep us posted on what your doc does for you. I hope he is a understanding doc and will try to work with you to help alleviate some of your pain. I will say though that most pain management docs don't like their patients playing around with their directions for meds. Good Luck.
God Bless,
Sherry :wave:
I understand your point, that going agianst what the doc has prescribed is not a good idea. Its just too difficult for me not to take the pain meds I have if my pain level requires it. I don't think he would be too happy if I called and said I was taking 2 (10/325) at a time. But I also think that I need to inform him rather soon, that the meds are not sufficient. That way he will be able to decide what the next step is.
But, like I said, I just want to make sure that he doesn't change his mind and pull me off the opiates all together. I am dependant on them, unfortunately, but not addicted. I am not going to lose control and start taking handfulls of them everyday, which may be what has happened with some of his patients. It must be very difficult for any doctor to treat with opiates, because they never know who is going to be able to keep control of things and who can't. I am fortunate to get the treatment I am getting, and don't want to push it. This just makes it all the more hard to have the will power to not take more than prescribed when you body is still in pain. I know some of you must still have pain, even while being treated with the pain meds. What keeps you from taking more if you have it in your medicine cabinet if you know you'll have a bit more relief? Maybe its different if your on the LA meds, and have seperate meds for BT. It just seems that once the norco wears off within an hour or 2, its like there is nothing there for the pain... its like I'm back to not even being on anything for pain.
I'm really not crazy about having to be on these meds, but its all that works. And because of the tolerance thing, they start to lose their theraputic effect.
I appreciate your help sgibson, and I know what its like to not be able to sleep. I really hope you can find a good solution. When I was initially injured, I can tell you I wouldn't sleep for days until my body would finally pass out from exhaustion. I have found 1/2 of a 10mg ambien works good for sleep, and you don't get all the groggy feel the following morning. Its another one of those meds that gets abused by some, so you might find that some docs are agianst it. I just thought I'd mention it, because I know how hard it is when you can't sleep due to pain. I wish you the best in getting good treatment.
I'm not sure how your doc is going to react to you increasing the meds without his approval. Especially since you are just establishing yourself with him. I feel sorry for you. I know what it's like to suffer because your meds aren't cutting it. When we are in pain management though we usually just have to suffer until we can get a hold of our docs. If your doc thinks you are already on too high of a dose, he is probably not going to be happy about you taking more of the meds than he rx'ed. I really don't know what to tell you. You are definitely in a hard spot. You mentioned celebrex and vioxx, perhaps they would be good choices for you. Keep us posted on what your doc does for you. I hope he is a understanding doc and will try to work with you to help alleviate some of your pain. I will say though that most pain management docs don't like their patients playing around with their directions for meds. Good Luck.
God Bless,
Sherry :wave:
I understand your point, that going agianst what the doc has prescribed is not a good idea. Its just too difficult for me not to take the pain meds I have if my pain level requires it. I don't think he would be too happy if I called and said I was taking 2 (10/325) at a time. But I also think that I need to inform him rather soon, that the meds are not sufficient. That way he will be able to decide what the next step is.
But, like I said, I just want to make sure that he doesn't change his mind and pull me off the opiates all together. I am dependant on them, unfortunately, but not addicted. I am not going to lose control and start taking handfulls of them everyday, which may be what has happened with some of his patients. It must be very difficult for any doctor to treat with opiates, because they never know who is going to be able to keep control of things and who can't. I am fortunate to get the treatment I am getting, and don't want to push it. This just makes it all the more hard to have the will power to not take more than prescribed when you body is still in pain. I know some of you must still have pain, even while being treated with the pain meds. What keeps you from taking more if you have it in your medicine cabinet if you know you'll have a bit more relief? Maybe its different if your on the LA meds, and have seperate meds for BT. It just seems that once the norco wears off within an hour or 2, its like there is nothing there for the pain... its like I'm back to not even being on anything for pain.
I'm really not crazy about having to be on these meds, but its all that works. And because of the tolerance thing, they start to lose their theraputic effect.
I appreciate your help sgibson, and I know what its like to not be able to sleep. I really hope you can find a good solution. When I was initially injured, I can tell you I wouldn't sleep for days until my body would finally pass out from exhaustion. I have found 1/2 of a 10mg ambien works good for sleep, and you don't get all the groggy feel the following morning. Its another one of those meds that gets abused by some, so you might find that some docs are agianst it. I just thought I'd mention it, because I know how hard it is when you can't sleep due to pain. I wish you the best in getting good treatment.
thomason
06-22-2004, 02:10 AM
thomason:
I agree that you need to contact your pain management Doctor ASAP and let him know what is going on with your pain levels. Hopefully, he will adjust your norcos or provide you with an alternative to help get you to the point where your pain is reasonably managed. I have to say though; elavil does take a couple of weeks in your system before you will notice anything. Just like any of medications they are now using for pain management you have to give them a little time to see if it helps or not. I take pamelor for chronic pain; I have to say it took a while for me to even realize it does help. I do agree though an adjustment with the Norcos is probably in order. I'm sorry about what you are going through. Keep us posted. :angel:
Jo
I will call the office tomorrow and let them know what is going on. I was looking at the elavil, and its an antidepressant. I am very hesitant with those types of meds, because I've also had many experiences with them and not all were good. If the elavil is going to help with my pain, I will be very glad, but I'm just concerned about taking so many meds. It concerns me about being on so many medications. I'm also taking Wellbutrin 150mg/day(antidepressant), xanax for anxiety, and usually a 5mg ambien at night. It just makes me nervous taking all these meds. I feel that if I can get my pain to a tolerable level, it may lower my anxiety level. I wish I could do away with all these meds, as its got to take its toll.
I agree that you need to contact your pain management Doctor ASAP and let him know what is going on with your pain levels. Hopefully, he will adjust your norcos or provide you with an alternative to help get you to the point where your pain is reasonably managed. I have to say though; elavil does take a couple of weeks in your system before you will notice anything. Just like any of medications they are now using for pain management you have to give them a little time to see if it helps or not. I take pamelor for chronic pain; I have to say it took a while for me to even realize it does help. I do agree though an adjustment with the Norcos is probably in order. I'm sorry about what you are going through. Keep us posted. :angel:
Jo
I will call the office tomorrow and let them know what is going on. I was looking at the elavil, and its an antidepressant. I am very hesitant with those types of meds, because I've also had many experiences with them and not all were good. If the elavil is going to help with my pain, I will be very glad, but I'm just concerned about taking so many meds. It concerns me about being on so many medications. I'm also taking Wellbutrin 150mg/day(antidepressant), xanax for anxiety, and usually a 5mg ambien at night. It just makes me nervous taking all these meds. I feel that if I can get my pain to a tolerable level, it may lower my anxiety level. I wish I could do away with all these meds, as its got to take its toll.
sgibson
06-22-2004, 04:35 PM
Hi Thomason,
You are right about the LA meds making a difference. I suppose I didn't really realize you weren't on a LA. The rule of thumb is if you need more than 2 BT doses a day then your LA med needs increasing. That makes the difference like you said about having the med available and needing it. My LA needs adjusting right now but I am waiting for my PM appt to address this issue. I saw my surgeon today and he apologized profusely for the screw up with his office setting me up with the wrong PM guy. They sent me to the guy that mainly uses injections. My surgeon wants me with a PM that uses opiate therapy. He says I am at the point now where they just need to manage my pain with meds. I have a wonderful surgeon who has continued to rx my meds. I have been blessed with a wonderful surgeon and if I can end up with a PM that is half as good as the surgeon then I will be even more blessed. My surgeon said the PM he is going to send me to is a member of his church. So I hope they get me in to this guy pretty quickly. I've got 3 weeks until my meds will be due again, so I hope it's before then. I would hate to have to drive 2 hours to my surgeons office just to pick up scripts. I don't know if they can mail out C2 scripts or not. Oh well, I'm not gonna borrow trouble as they say. LOL. It usually finds me without me looking for any more of it.
I really hope you can get this doc to understand about your pain levels. Have you tried showing him a pain diary? Does he use LA meds? I really think you need a LA med with maybe the norco or lortab as BT. Good luck and let us know what the PM says.
God Bless,
Sherry :wave:
You are right about the LA meds making a difference. I suppose I didn't really realize you weren't on a LA. The rule of thumb is if you need more than 2 BT doses a day then your LA med needs increasing. That makes the difference like you said about having the med available and needing it. My LA needs adjusting right now but I am waiting for my PM appt to address this issue. I saw my surgeon today and he apologized profusely for the screw up with his office setting me up with the wrong PM guy. They sent me to the guy that mainly uses injections. My surgeon wants me with a PM that uses opiate therapy. He says I am at the point now where they just need to manage my pain with meds. I have a wonderful surgeon who has continued to rx my meds. I have been blessed with a wonderful surgeon and if I can end up with a PM that is half as good as the surgeon then I will be even more blessed. My surgeon said the PM he is going to send me to is a member of his church. So I hope they get me in to this guy pretty quickly. I've got 3 weeks until my meds will be due again, so I hope it's before then. I would hate to have to drive 2 hours to my surgeons office just to pick up scripts. I don't know if they can mail out C2 scripts or not. Oh well, I'm not gonna borrow trouble as they say. LOL. It usually finds me without me looking for any more of it.
I really hope you can get this doc to understand about your pain levels. Have you tried showing him a pain diary? Does he use LA meds? I really think you need a LA med with maybe the norco or lortab as BT. Good luck and let us know what the PM says.
God Bless,
Sherry :wave:
dckatz2001
06-22-2004, 05:20 PM
sgibson - They can't mail out the scripts. I've tried having that done before because I am 100 miles away from my PM doctor but they made me come in anyway.
thomason
06-22-2004, 06:05 PM
sgibson, I called the docs offices today and left a message for him. I never got a return call, so I'm not sure what is going to happen. I think he does use the LA meds, but I don't know how he determines that they are needed. When I called I basically said that I was having difficultly, and my pain level was still quite high. I asked if they could pass the message on to him and see if he will ok me taking more than just 2 norcos / day. She asked me for my pharmacy phone number, which I gave, but also said that I haven't run out yet, just want to see what the doc would like for me to do. I basically said I was looking for his permission to take more, or to setup another appt to see what can be done.
I hope that I can be put on a LA, because trying to manage this without them is very difficult. I usually end up having to suffer for the last week or so, before a refill is due. I don't know what he will want to do, but I figured it would probably be best to tell him right away that the meds aren't sufficient. If I were to wait until my next appt, then he would probably say you've been fine for the last 4 weeks, why should we change it now.
I will update when I hear something back. Its so difficult trying to manage all this while working full time and going to school.
I hope that I can be put on a LA, because trying to manage this without them is very difficult. I usually end up having to suffer for the last week or so, before a refill is due. I don't know what he will want to do, but I figured it would probably be best to tell him right away that the meds aren't sufficient. If I were to wait until my next appt, then he would probably say you've been fine for the last 4 weeks, why should we change it now.
I will update when I hear something back. Its so difficult trying to manage all this while working full time and going to school.
smackliet
06-22-2004, 08:07 PM
I agree you should let him know early on, and keep letting him know. If he hears from you often enough he will see you are in pain and what you are taking isnt effective enough. If you are quiet and dont call he will assume what you are on is fine. Some times we have to shout to be heard. And i understand about taking the meds if you are in pain. How can we not if we are suffering and the med for releaf is right there.
thomason
06-23-2004, 01:56 AM
I agree you should let him know early on, and keep letting him know. If he hears from you often enough he will see you are in pain and what you are taking isnt effective enough. If you are quiet and dont call he will assume what you are on is fine. Some times we have to shout to be heard. And i understand about taking the meds if you are in pain. How can we not if we are suffering and the med for releaf is right there.
Well, then I'm glad I made the call today. I'll call agian tomorrow if I don't hear from them. I realize they have lots of patients to deal with, so getting to my message may not be priority #1. Thanks for the advice, and I also trying to keep track of my pain in a pain diary throughout the day. Its fairly redundant though, basically just says not getting relief from pain, even 30 mins after taking a norco. It should be fairly understandable that people build a tolerance, and the meds need to be adjusted accordingly.
Well, then I'm glad I made the call today. I'll call agian tomorrow if I don't hear from them. I realize they have lots of patients to deal with, so getting to my message may not be priority #1. Thanks for the advice, and I also trying to keep track of my pain in a pain diary throughout the day. Its fairly redundant though, basically just says not getting relief from pain, even 30 mins after taking a norco. It should be fairly understandable that people build a tolerance, and the meds need to be adjusted accordingly.
feelbad
06-23-2004, 09:12 AM
LA meds are probably the best thing to treat your pain.i didn't get any really good consistant relief until i was started on oxycontin.and you do not have those ups and downs with regard to your relief.My pain is still quite high but using the OC has really helped overall.i need to have another raise in my dosage as i have a huge knee issue that just will not relent.i still have to use BT meds as the type of pain that i have does not appear to want to stabilize.I think that given the cause and type of pain you are having to deal with that the OC would be an ideal med for you.hopefully, your doc will see this too.
With regard to sending CII rxes in the mail.My NS and my pain clinic do this all the time for me.Talk to your doc.this shouldn't be any kind of a problem.Marcia
With regard to sending CII rxes in the mail.My NS and my pain clinic do this all the time for me.Talk to your doc.this shouldn't be any kind of a problem.Marcia
thomason
06-23-2004, 12:26 PM
I called agian today, and the message was "he didn't ok anything"
Well, that doesn't really tell me anything other than he doesn't want me to take more than the 2 / day.
I know he couldn't just "ok" something over the phone, because if he wanted to start the oxy, I'd have to come in for the written script anyway.
So now I don't know what I'm supposed to do. The office said I could call back and talk to him after 4:30. I don't know if thats going to even make a difference.
I wonder if he thinks I've already run out, and was calling for a refill. That wouldn't surprise me if they screwed up the message I left for him. Why else would they say he didn't ok anything else.
Well, that doesn't really tell me anything other than he doesn't want me to take more than the 2 / day.
I know he couldn't just "ok" something over the phone, because if he wanted to start the oxy, I'd have to come in for the written script anyway.
So now I don't know what I'm supposed to do. The office said I could call back and talk to him after 4:30. I don't know if thats going to even make a difference.
I wonder if he thinks I've already run out, and was calling for a refill. That wouldn't surprise me if they screwed up the message I left for him. Why else would they say he didn't ok anything else.
sgibson
06-23-2004, 02:02 PM
Thomason,
I think a face to face with your PM is in order. Write down what you intend to say and practice it before you get there. Don't let him interrupt you or cut you off before you finish your thoughts. Please also keep in mind, this is only my opinion. Only you know your PCP and how he may react. Good luck.
God Bless,
Sherry :wave:
I think a face to face with your PM is in order. Write down what you intend to say and practice it before you get there. Don't let him interrupt you or cut you off before you finish your thoughts. Please also keep in mind, this is only my opinion. Only you know your PCP and how he may react. Good luck.
God Bless,
Sherry :wave:
dckatz2001
06-23-2004, 02:12 PM
I just moved to Northern Virginia/Washington, DC and found it impossible to find a PM doctor who works with medication management. I called just about everyone in this area. My meds ran our a while back and I was out for a week. That was a horrible time because of severe pain and major withdrawals. I eventually had to drive 100 miles (200 round trip) to my old PM doc so he could write me another script. I am so frustrated with PM's in this area that I called up a back surgeon I had seen about a year ago and told him that we absolutely had to do something for my back because, for me, medication is not a long term solution. It's way too frustrating to deal with finding a doc in this area who will treat with it. Luckily, my surgeon took over my treatment (with meds) and has scheduled a discogram (I think that's what it's called) to determine the cause of the pain and see if there's any surgical options. I've had one surgery already about 5 years ago and would like to avoid another one but I don't know if it's possible. It's unfortunate that these PM docs force us to undergo procedures we may not be ready for just because they don't feel comfortable treating with meds. Even though the meds have worked well for me over the past year. I am very angry at PM's after reading your post.
Fiona_Jo_324
06-23-2004, 06:35 PM
I agree with Sherry; I think at this point you really are going to have to talk to him directly. I really have a hard time leaving messages; because inevitably something is always lost in the translation. I'm so sorry about what you are going through. :angel:
Jo
Jo
sgibson
06-23-2004, 09:53 PM
dckatz,
I'm sure you are having a horrible time trying to find a PM in Northern VA. You do know about all the arrests up there?? They basically had a witch hunt on PM docs in the Northern VA area. Thousands of CP'ers left without docs or meds. I don't know if you are willing to drive to the Richmond area but there are some PM docs in the Richmond area who do use opiate therapy. I don't envy you your situation. I wish you luck.
God Bless,
Sherry :wave:
I'm sure you are having a horrible time trying to find a PM in Northern VA. You do know about all the arrests up there?? They basically had a witch hunt on PM docs in the Northern VA area. Thousands of CP'ers left without docs or meds. I don't know if you are willing to drive to the Richmond area but there are some PM docs in the Richmond area who do use opiate therapy. I don't envy you your situation. I wish you luck.
God Bless,
Sherry :wave:
dckatz2001
06-23-2004, 11:19 PM
sgibson,
I am exploring my options as far as surgical treatment. I have an appointment for a discogram (again, I'm not sure if that's the right term) on September 1. Until then, my surgeon will be treating my pain with opiates. If it's determined that surgery is not the best option right now I will probably have to drive to Winchester, VA (which is where my old PM is located). It's 100 miles away but it would be worth it to get the treatment I know works.
What are these PM's using to treat pain if they won't use opiates? Are they all using injections? I've had injections and I know thay don't work for me. When did this "witch hunt" take place? I've heard references to it but that's about it.
This past time when I went to the surgeon he switched my meds to MS Contin. Unfortunately I couldn't find a pharmacy that had it in stock so I could get it filled. It took about 30 calls to pharmacies to finally find a place where I could get it. Do you think this has anything to do with the other "witch hunt" situation? What are people supposed to do for their pain?
I am exploring my options as far as surgical treatment. I have an appointment for a discogram (again, I'm not sure if that's the right term) on September 1. Until then, my surgeon will be treating my pain with opiates. If it's determined that surgery is not the best option right now I will probably have to drive to Winchester, VA (which is where my old PM is located). It's 100 miles away but it would be worth it to get the treatment I know works.
What are these PM's using to treat pain if they won't use opiates? Are they all using injections? I've had injections and I know thay don't work for me. When did this "witch hunt" take place? I've heard references to it but that's about it.
This past time when I went to the surgeon he switched my meds to MS Contin. Unfortunately I couldn't find a pharmacy that had it in stock so I could get it filled. It took about 30 calls to pharmacies to finally find a place where I could get it. Do you think this has anything to do with the other "witch hunt" situation? What are people supposed to do for their pain?
sgibson
06-24-2004, 10:28 AM
dckatz,
Yes diskogram is the right term. I have had CT myleograms and a diskogram. The diskogram is what led me into surgery. If you have never had one, I will tell you to be prepared for a real uncomfortable time. It's weird, the pain levels can range from none to pure torture. Unfortunately, mine was on the latter end. The diskogram showed a tear and which level was causing most of my pain. It is a wonderful diagnostic tool, however, I will never consent to another one. The test is used to try to recreate your pain. Sometimes they can't recreate your pain. I think thats what they call a negative diskogram. Just make sure you bring your pain meds with you to the hospital. They told me to bring mine but they still ended up having to give me extra meds from their pharmacy.
As far as the "witch" hunt goes, you can type in Dr. Hurwitz in your search engine and find tons of information on it. I'd rather not say too much on the specifics because of site rules but I'm sure you can find all the info if you do that search. As far as what are the docs using if they aren't using opiates, well they use non opiate meds, injections, therapy, tens, and tons more modalities. Its when you have exhausted all of the options that opiates should be considered.
I know about having to drive long distances to get to your doctors because I live in a rural southern VA town and I either have to drive to Richmond or Raleigh NC to see specialists. It makes it really hard because riding in a vehicle for over ten minutes starts horrible muscle spasms.
I hope if you do find you can go the surgical route, that you will have a successful surgery. Keep us posted on your progress. Good luck.
Thomason,
How are you feeling? I really do feel for your situation. I hope you will get things resolved soon. I didn't want you to think we had forgotten about you! After all, this is a support board and we are here to give support to each other. We have all been through those trying times. Good luck and keep us posted on your situation.
God Bless,
Sherry :wave:
Yes diskogram is the right term. I have had CT myleograms and a diskogram. The diskogram is what led me into surgery. If you have never had one, I will tell you to be prepared for a real uncomfortable time. It's weird, the pain levels can range from none to pure torture. Unfortunately, mine was on the latter end. The diskogram showed a tear and which level was causing most of my pain. It is a wonderful diagnostic tool, however, I will never consent to another one. The test is used to try to recreate your pain. Sometimes they can't recreate your pain. I think thats what they call a negative diskogram. Just make sure you bring your pain meds with you to the hospital. They told me to bring mine but they still ended up having to give me extra meds from their pharmacy.
As far as the "witch" hunt goes, you can type in Dr. Hurwitz in your search engine and find tons of information on it. I'd rather not say too much on the specifics because of site rules but I'm sure you can find all the info if you do that search. As far as what are the docs using if they aren't using opiates, well they use non opiate meds, injections, therapy, tens, and tons more modalities. Its when you have exhausted all of the options that opiates should be considered.
I know about having to drive long distances to get to your doctors because I live in a rural southern VA town and I either have to drive to Richmond or Raleigh NC to see specialists. It makes it really hard because riding in a vehicle for over ten minutes starts horrible muscle spasms.
I hope if you do find you can go the surgical route, that you will have a successful surgery. Keep us posted on your progress. Good luck.
Thomason,
How are you feeling? I really do feel for your situation. I hope you will get things resolved soon. I didn't want you to think we had forgotten about you! After all, this is a support board and we are here to give support to each other. We have all been through those trying times. Good luck and keep us posted on your situation.
God Bless,
Sherry :wave:
thomason
06-24-2004, 11:28 AM
I'll find out Monday. I am going back in to see if we can adjust the meds.
twisten
06-24-2004, 01:25 PM
Thomason, just want to say that I sure hope your doc listens to you and helps you out better. I also have absortion issues and some days my pills (Mscontin and oxyir) don't help me a lot. They don't stay in my system long enough to help. Thank goodness I don't deal with that on a daily basis though. Have you tried the elavil? I've been on and off that for years and find the only thing it helps with me is "sometimes" it helps me sleep better but I am also on a high dose of it, 100-150 mg at night. It definitely isn't the answer for everyone. I recently saw a new GI doc and because my colonoscopy was good he took me off of all my crohns medications. The last few days I have been dealing with fevers and nothing staying with me so I have a bad idea that I'm in for another rough ride. It took 2 years to stabilize my crohns and its only been stable for maybe 6-8 months so I don't think stopping the meds was a smart idea, in fact I know it was down right stupid of the doc but what do you do?? Unfortunately we have to follow their direction. I have spoke with my old GI and he is not impressed with what this doc did so I am unsure what will happen now. The new GI does have all my records so that is not an issue. Of course my husband thinks it is good that I am off of some of the meds as some are known to cause cancer down the road but when they are the only thing that will arrest your disease you don't really have a choice unless you want to go through what I did off the start. Basically in the hospital for the better part of a year. Didn't mean to write a story just to tell you how docs can differ. I sure hope your appt on Monday has a good result for you.
thomason
06-25-2004, 02:01 AM
Thanks, I hope it goes well. Its really stressing to think about what this guy has control over. I just hope he is willing to continue my treatment with opiates, because nothing works better. I am just glad I can tolerate these meds, because some people can't. The thing that gives me some sort of hope is that, as I was ending my first appt, he said I'll see you in a month or sooner if necessary.
I just think that his total dening me to take more than just two per day, was a little strict. If he doesn't want me taking 3-4 of the norco a day, then I hope he is open to using the LA meds with me. I know its what I need. Maybe it would look bad if he just started me out on the LA stuff that is widely abused. I don't know how much doctors are monitored, but I would think they do have to be fairly cautious about who they treat with those meds. I hope that I don't go in to the appt, and he is mad that I called to get the increase and wants to totally take me off the opiates. Finally finding someone that can treat me on a regular basis with these, and someone who is willing to get me to the right level according to my tolerance would be great. I don't know how they differentiate between those who ask for an increase in meds for reasons to support a drug habit vs. those who need them for pain and need the increase so the med actually works for the pain.
Its got to be a judgement call, and I just hope that he sees what I am going through. I've made a pain diary of everyday since I started the meds. I didn't really take note of the times when I had to take an extra norco, because I don't want that to be a reason he uses to yank them completely. I'll be very descriptive with how the meds have not been sufficient and explain how I need to be pain free or as close as possible. I am just so far from that point right now.
I hate having to deal with this, because everything is just hanging in the balance. I'm at such a low dose that I barely get any type of relief, but its at least better than nothing. I'm going out of town for about 10 days, and right before I leave for that trip is my follow up, one month appt with him. If he doesn't refill me and does something like decide he doesn't want to treat me with opiates, I'm going to be miserable. I will be driving up the west coast, so several 4-6 hr driving periods. My leg hurts in everyday driving, I can't imagine what it would be like on a long trip having nothing for pain. I hate sounding so desperate for something, but its just ridiculous having to feel like this every single day.
To those of you that have good docs, I'm really am happy for you. That is worth so much to have someone that believes what you are telling them, rather than treating you like some drug addict. I guess I'm expecting the worst, but it just really scares me to have to go back to trying to find yet another doc if this one falls through.
I just think that his total dening me to take more than just two per day, was a little strict. If he doesn't want me taking 3-4 of the norco a day, then I hope he is open to using the LA meds with me. I know its what I need. Maybe it would look bad if he just started me out on the LA stuff that is widely abused. I don't know how much doctors are monitored, but I would think they do have to be fairly cautious about who they treat with those meds. I hope that I don't go in to the appt, and he is mad that I called to get the increase and wants to totally take me off the opiates. Finally finding someone that can treat me on a regular basis with these, and someone who is willing to get me to the right level according to my tolerance would be great. I don't know how they differentiate between those who ask for an increase in meds for reasons to support a drug habit vs. those who need them for pain and need the increase so the med actually works for the pain.
Its got to be a judgement call, and I just hope that he sees what I am going through. I've made a pain diary of everyday since I started the meds. I didn't really take note of the times when I had to take an extra norco, because I don't want that to be a reason he uses to yank them completely. I'll be very descriptive with how the meds have not been sufficient and explain how I need to be pain free or as close as possible. I am just so far from that point right now.
I hate having to deal with this, because everything is just hanging in the balance. I'm at such a low dose that I barely get any type of relief, but its at least better than nothing. I'm going out of town for about 10 days, and right before I leave for that trip is my follow up, one month appt with him. If he doesn't refill me and does something like decide he doesn't want to treat me with opiates, I'm going to be miserable. I will be driving up the west coast, so several 4-6 hr driving periods. My leg hurts in everyday driving, I can't imagine what it would be like on a long trip having nothing for pain. I hate sounding so desperate for something, but its just ridiculous having to feel like this every single day.
To those of you that have good docs, I'm really am happy for you. That is worth so much to have someone that believes what you are telling them, rather than treating you like some drug addict. I guess I'm expecting the worst, but it just really scares me to have to go back to trying to find yet another doc if this one falls through.
Fiona_Jo_324
06-25-2004, 05:15 AM
It sounds like you have done all the right things. He knows your health history and the level of pain you have to live with everyday. You have documented your pain levels and will provide him with concrete information regarding the pain you have had to endure. I think the important information would be: time you took the med., how long did you experience some relief and when did the pain became unbearable again. How many hours your pain level was high and weren't able to take another norco (because of limited # prescribed). My hope is that your first meeting with him was a starting point and he will be willing to adjust your medication based on your pain level need. I do believe if you stay objective and focused strictly on your pain; he shouldn't have any reason not to take a serious look at your medications and provide you with hopefully LA medication or up your Norcos. From his viewpoint since your previous session was his first time meeting with you he probably felt that was a good place to start; but since he left it open to meet anytime before your next appointment it indicates that he must be flexible. I will be thinking about you Monday, you obviously communicate very effectively, which I think does have impact when your dealing with Doctor(s). Anyway, keep us posted. :wave:
Jo :angel:
Jo :angel:
sgibson
06-25-2004, 12:17 PM
Hi Thomason,
I do hope this doc works out for you. I know this is your first PM doc but please try to hang in there for a little while with him. If you do have to find another PM you want to make sure your records from this doc show that you gave it an honest try. Unfortunately, it's not like with other specialists when we don't feel they are working for us we can just find another one. With PM docs we have to keep from looking like we are drug seekers. I'm just afraid if you give up on him too fast that the next PM will take a look at the records and draw an incorrect conclusion. Do you know what I mean? If this guy gets peeved and writes something deragatory in your file, unfortunately it's going to follow you. It really should not be this frustrating getting the help you need. I really do feel for you. I know it's not much consolation when we say we know what you are going through and how you feel, but we are here for you. I'm doing PT now and my pain meds are not cutting it either, but I do have a lot more medication than you so I feel guilty or even ashamed to be complaining about my pain levels. That is one of the drawbacks to opiate therapy, even though I am on significantly higher doses than you are, I have become tolerant to the point where it's probably not much more effective than your norcos.
I hope your doc will give you an increase before your trip. I know how painful car trips are. Just remember, if he does increase your meds, be careful driving until you know how you will react to them. :) Sorry, I can't help it, my brother is a state trooper and he is constantly telling me that, I just wanted to be able to say it to someone else. LOL.
Good Luck Thomason.
God Bless,
Sherry :wave:
I do hope this doc works out for you. I know this is your first PM doc but please try to hang in there for a little while with him. If you do have to find another PM you want to make sure your records from this doc show that you gave it an honest try. Unfortunately, it's not like with other specialists when we don't feel they are working for us we can just find another one. With PM docs we have to keep from looking like we are drug seekers. I'm just afraid if you give up on him too fast that the next PM will take a look at the records and draw an incorrect conclusion. Do you know what I mean? If this guy gets peeved and writes something deragatory in your file, unfortunately it's going to follow you. It really should not be this frustrating getting the help you need. I really do feel for you. I know it's not much consolation when we say we know what you are going through and how you feel, but we are here for you. I'm doing PT now and my pain meds are not cutting it either, but I do have a lot more medication than you so I feel guilty or even ashamed to be complaining about my pain levels. That is one of the drawbacks to opiate therapy, even though I am on significantly higher doses than you are, I have become tolerant to the point where it's probably not much more effective than your norcos.
I hope your doc will give you an increase before your trip. I know how painful car trips are. Just remember, if he does increase your meds, be careful driving until you know how you will react to them. :) Sorry, I can't help it, my brother is a state trooper and he is constantly telling me that, I just wanted to be able to say it to someone else. LOL.
Good Luck Thomason.
God Bless,
Sherry :wave:
thomason
06-25-2004, 01:37 PM
Very good point about being specific with the amount of time after the meds are taken. I was very specific the following day after he first started my treatment. The time starts out in the morning, and is basically every hour. I detail how I feel, and how I feel after I take the meds. The problem is I really never get any relief from them. I feel the meds take effect, and they do offer a tiny bit of relief, but the pain is still there and very intense. I don't know how that sounds to a doc, but that is being honest.
The pain is the type that "flairs". Its like a strong pressure, but not constant. Its also in many different areas at different times. One minute I'll be carrying on in my everyday business, whether it be sitting or standing ,then all of a sudden it will hit me. Either on one side of the leg with a throbbing type, deep pain. Or maybe on top of the ankle area, with a sharp intense feeling, like a nail is being driven in. I don't know what that signifies, but it just comes and goes.... usually every 20-30 mins. And it doesn't matter if I've taken a norco 15 minutes before it hits... the pain still comes on strong.
I agree I can communicate my situation fairly clearly, but when I'm sitting in the docs office, I get anxiety real bad and end up not saying much. Then to top it off, this doc is one of those types that cuts you off mid sentence, so thats another irratation.
Its all up to them. Doesn't matter what you do. They are going to decide what they feel is sufficient. I guess I've managed to deal with my pain, and I probably come across as someone who looks quite normal, but inside I'm being torn apart. Its like I've just given up because I know they are going to decide, no matter what you say.
I appreciate the advice on the driving. I am overly cautious, as much pain as I've been through, I don't take any chances in that department. :)
Everything you guys have been telling me helps. I hope things go well on Monday. I think it will as long as I tell him honestly what is going on, and am able to share the pain diary with him.
The pain is the type that "flairs". Its like a strong pressure, but not constant. Its also in many different areas at different times. One minute I'll be carrying on in my everyday business, whether it be sitting or standing ,then all of a sudden it will hit me. Either on one side of the leg with a throbbing type, deep pain. Or maybe on top of the ankle area, with a sharp intense feeling, like a nail is being driven in. I don't know what that signifies, but it just comes and goes.... usually every 20-30 mins. And it doesn't matter if I've taken a norco 15 minutes before it hits... the pain still comes on strong.
I agree I can communicate my situation fairly clearly, but when I'm sitting in the docs office, I get anxiety real bad and end up not saying much. Then to top it off, this doc is one of those types that cuts you off mid sentence, so thats another irratation.
Its all up to them. Doesn't matter what you do. They are going to decide what they feel is sufficient. I guess I've managed to deal with my pain, and I probably come across as someone who looks quite normal, but inside I'm being torn apart. Its like I've just given up because I know they are going to decide, no matter what you say.
I appreciate the advice on the driving. I am overly cautious, as much pain as I've been through, I don't take any chances in that department. :)
Everything you guys have been telling me helps. I hope things go well on Monday. I think it will as long as I tell him honestly what is going on, and am able to share the pain diary with him.
sgibson
06-25-2004, 02:18 PM
Thomason,
The same thing happens to me when I go to the docs office. I don't get an anxiety attack when going to see my surgeon because I am really comfortable with him, but if I have had to wait a long time, I'm usually hurting so bad that I just want to hurry up and get out of there. I can think of all the things I want to bring up before the visit, but then when I finally get to see him, all I can think about is getting home to my recliner. When my mom goes with me, she will say something like "what about" or "shouldn't you mention" or something to that effect. Maybe you should consider taking someone with you? I know it helps me. I even started making a list of things I wanted to discuss but it doesn't work as well as taking mom does. LOL.
I hate it when a doc cuts you off mid sentence. It really makes you feel like they are not only not listening but they don't care. I guess this is when we need to be a little more forceful. After all, we are paying them. Pain management is such a pain sometimes. Good luck.
God Bless,
Sherry :wave:
The same thing happens to me when I go to the docs office. I don't get an anxiety attack when going to see my surgeon because I am really comfortable with him, but if I have had to wait a long time, I'm usually hurting so bad that I just want to hurry up and get out of there. I can think of all the things I want to bring up before the visit, but then when I finally get to see him, all I can think about is getting home to my recliner. When my mom goes with me, she will say something like "what about" or "shouldn't you mention" or something to that effect. Maybe you should consider taking someone with you? I know it helps me. I even started making a list of things I wanted to discuss but it doesn't work as well as taking mom does. LOL.
I hate it when a doc cuts you off mid sentence. It really makes you feel like they are not only not listening but they don't care. I guess this is when we need to be a little more forceful. After all, we are paying them. Pain management is such a pain sometimes. Good luck.
God Bless,
Sherry :wave:
thomason
06-26-2004, 02:38 AM
At my first visit, he said our goal is to get me pain free with the least amount of negative affects to my body. I think he just didn't realize that starting me out at that low of a level, would have brought me back so quickly and demanding an adjustment. Now that I read a post by Shoreline in another thread, it makes me feel a little better about why he didn't ok the increase over the phone. It makes sense that these docs have to be very cautious in the way they practice medicene.
The goal is to be pain free, and I don't care what it takes to get there. I am willing to try anything... I MEAN ANYTHING. There is nothing worse than having something on your body that aches and hurts all day long without end. I hope that if we can get the meds balanced out, I can also work on more methods of treatment. I know that the meds aren't going to take all the pain away, but until they at least give me relief... I just feel I can't even concentrate on other methods. Its like an emergency. I think that getting the pain to a manageable level, and then working with other types of exercise I might actually reach that goal of being close to pain free. I just can't see continuing my life like it is right now, and this stress of having a doc willing to work with me is consuming me. You just get that feeling that you want something so bad, that you just can't relax and take a deep breath until you get it.
If I go to this appt and he agrees that I need an increase, I will be so happy. It will be like a miracle to me, because all the other docs I've ever had before have just been like ..... well its time we start getting you off the pain meds. I just can't take another one of those let downs. As long as I can get this guys attn and he truly listens to me, rather than just thinking he's hearing someone try and score some drugs, it will be a good thing. I really need a doc to help me get better....thats all I want in life is to feel better. Everything else is second to me right now, my pain is so overwhelming that I can't continue until I get it under control.
The goal is to be pain free, and I don't care what it takes to get there. I am willing to try anything... I MEAN ANYTHING. There is nothing worse than having something on your body that aches and hurts all day long without end. I hope that if we can get the meds balanced out, I can also work on more methods of treatment. I know that the meds aren't going to take all the pain away, but until they at least give me relief... I just feel I can't even concentrate on other methods. Its like an emergency. I think that getting the pain to a manageable level, and then working with other types of exercise I might actually reach that goal of being close to pain free. I just can't see continuing my life like it is right now, and this stress of having a doc willing to work with me is consuming me. You just get that feeling that you want something so bad, that you just can't relax and take a deep breath until you get it.
If I go to this appt and he agrees that I need an increase, I will be so happy. It will be like a miracle to me, because all the other docs I've ever had before have just been like ..... well its time we start getting you off the pain meds. I just can't take another one of those let downs. As long as I can get this guys attn and he truly listens to me, rather than just thinking he's hearing someone try and score some drugs, it will be a good thing. I really need a doc to help me get better....thats all I want in life is to feel better. Everything else is second to me right now, my pain is so overwhelming that I can't continue until I get it under control.