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Old 03-04-2009, 03:32 AM   #1
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Seeing my pain doc Fri - any advice?

I was thinking of bringing a new book I found at the library which claims that any back injury (or neck) can be helped through recognising muscle imbalances and postural alignment. I want to know what an expert's view is on this, and if he's into the idea, I want to ask him what posture type I appear to be and if he would suggest the exercises were appropriate for me.

Also I want to make it absolutely clear that I do not want to be addicted to pain meds again, and that I still haven't received all the information necessary to figure out what happened there, but I am searching so I can rectify it if I can, or so I can make sure nothing like that ever happened again.

After stating that I would state (calmly not crying my drug counsellor said) how the pain affects me and my family, what rating it is (between 2 and 8 or 9) and what limitations I have. I want to make it clear that I am trying to be proactive about my recovery (of the back injury as well as the addiction issue) and that I need help to manage the pain.

Also I have to explain the new pain from January this year, so hopefully he can refer me for an MRI to check my whole spine. And I have about twelve questions about whether I should have more children and how disabled I may become in the future and how to avoid it/plan for it (depending on inevitability).

Does that sound OK? I cannot remember my last pain clinic visit I was so sedated back then.

 
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Old 03-04-2009, 02:40 PM   #2
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Re: Seeing my pain doc Fri - any advice?

Sorespine:
That does sound very good. The best thing is to be honest with the doctor that you are a recovering addict but you have chronic pain that needs to be treated. Explain your pain using the pain scale and what kind of things your pain prevents you from doing. What makes the pain better? What makes the pain worse? What has worked in the past? What does not work? He/she should ask those questions but if not then tell the doctor about these. Tell the doc that you are not there to get pain meds but you just want to have some quality of life. There are many medications available that are non-narcotic and can help pain including

antidepressants(Cymbalta, Wellbutrin, Effexor, amitryptiline, nortriptyline),

anti-seizure meds (Lyrica, Neurontin, Trileptal, Tegretol, Topomax)

atypical opiod - Ultram(tramadol)

There is also the Buspan patch and possibly the fentanyl patch that you might be able to handle.

You might want to print this thread out and take it with you with everyone's advice. Good luck and let us know what happens.

brian

Last edited by brianpain33; 03-04-2009 at 02:41 PM.

 
Old 03-04-2009, 04:30 PM   #3
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Re: Seeing my pain doc Fri - any advice?

thanks brian
A lot's riding on this appointment, I have pretty much been living for it, knowing soon Friday will come, three more days, etc. it is like a catalyst for me. I am hoping it won't disappoint, because I'm so depressed right now, I couldn't stand to be disappointed with the only thing I imagine can help.

I need so much help, I'm struggling so much, and I am on Nortriptyline already and I figure that's why I'm still here! And I cannot use neurontin/gabapentin because it caused side effects like my leg kicking uncontrollably, perhaps it's better than feeling like this, I guess they will work that out tomorrow.

I'm going back to bed, and I'm giving up for the day. Tomorrow's got to be better. Couldn't be worse, right?

 
Old 03-04-2009, 06:35 PM   #4
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Re: Seeing my pain doc Fri - any advice?

Best of luck with your appt....I would be careful not to scare off your Doc. Your past is very relevant and you need to be honest with him/her, but I'd be careful how you present your view on meds. I'm just thinking out loud as they say....It's very plausible that you may need narcotics @ some point, and you don't want to close that door completely. Thus, I'd be careful not to come across as anti meds.

There are several good people on this site who had addiction problems and have been able to start fresh and now use pain meds responsibly. It can be done. Those who may have had problems @ one time deserve to be treated for pain, as long as they can comply with PM policies.

From the posts I've read from you, it seems that your primary problem has been a lack of understanding of PM rules / policies....Not abuse or over indulgence. Please correct me if I'm wrong. I cite this because there is a BIG difference between the two. In fact, I'd make sure I'd tell the new Doc that the previous staff never really went over the rules/regulations with you.

Best of luck to you @ your appointment!

Regards,

Ex

 
Old 03-04-2009, 08:11 PM   #5
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Re: Seeing my pain doc Fri - any advice?

Hi SS - Great advice from others. Isn't this your first visit with this doctor? I wouldn't do the book thing this time. I also wouldn't be asking questons about future pregnancies, future disability etc, the doctor is just meeting you. I would think you want to deal with the here and now, getting to know him, and getting your pain under treatment. You will greatly be complicating things by introducing a whole bunch of topics into an already very full conversation!

I think your overall approach is reasonable. I would advise to keep the more important things at the top of your list in case you run out of time, don't allow wandering into topics that are secondary and can be dealt with over time as you work with this doctor. so it's:

1. I am in too severe pain to be productive in my life..... (details you decided on about pain level, your daily ability, and how it affects you and your family).
2. I had a problem in the past. I am working to understand what happened and never let it happen again. Including being willing to put a process in place to make sure it doesn't happen again.
3. I want to explore all types of treatment that can help me. However want to be on lowest amount of medications that get me to the proper functioning level. (My personal opinion that asking for medications by name might not be a good idea because of what has previously transpired ), instead ask about what options are available for the type pain that you have.

Then see what transpires and go from there.

 
Old 03-05-2009, 03:32 AM   #6
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Re: Seeing my pain doc Fri - any advice?

thanks hey

i am pretty sure they explained the rules more than once to me, and this is not a cop-out, but i don't believe i was in any shape to be able to remember everything. my main thought was to kill the pain, and i was so sedated on the doses they had me on, and they were trying to work out a more appropriate dose when all of a sudden it was over. perhaps others can be responsible for their own pain management but i have proven i'm unable to do so. i will be telling him that and asking if my husband can be my carer and be responsible for my pain management whatever that is.

and i am going in with all the questions but i'm sure i won't have enough time, i know that, i just want to make sure i have them ready in case. you see, i've already assumed i won't be able to have another child, and i guess i'm looking for some hope that i could possibly do it and not die from the pain; because every time i see other mums holding newborns, i feel such despair. if i felt there was a way to do it, i'd be ok.

i guess there's a lot going through my head right now because i haven't seen a pain doctor in almost a year now, and i can't remember seeing one. it's like i'm meeting God! do you know what i mean?

anyway, points taken, and i will go in with an open mind and honestly talk with him about my pain and my life and how they don't go together so well. thank you all. lets hope i get some sleep tonight, nite!

 
Old 03-12-2009, 06:20 AM   #7
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Re: Seeing my pain doc Fri - any advice?

Sorespine,

I've heard that some recovering addicts can be on pain relief meds if they have a partner that keeps the meds in a locked box for which they have the key and give you the meds you need everyday. Also a support group is good, there is a recovery board here and might even be patients that are on meds. You might talk to you Dr about that.

 
Old 03-12-2009, 09:14 AM   #8
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Re: Seeing my pain doc Fri - any advice?

Reading this particulair thread has really reminded me how lucky we all are to have support such as this. Everyone really cares about you here.
I understand what your saying & I think Ex summed it up nicely, Your not completely understanding of the rules & not intentionally breaking them. You made a mistake, but it was not intentional.

I was so worried about accidently breaking a rule I ask for copies of everything. I signed & initialled so many papers it was unreal.
Neckpatient gave you much of the same advice as I would have. Being open about different treatments & so on..& at the same time informing this doctor about your quality of life here do to your pain levels & of course obtaining any tests needed.
I would focus only on whats most important to you at this appointment & save the rest for later. Brian did a great job of pointing out the differences in meds & at least you will be armed with some knowledge.
Mistakes happen & I pray that you can get second chance here. I will be thinking about you here. Sammy

 
Old 03-12-2009, 05:56 PM   #9
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Re: Seeing my pain doc Fri - any advice?

Hey SS,
I have been away from the board trying to do my best to wade through my own stuff, but wanted to chime in since I am a chronic pain patient and also a recovering addict.

It is a very thin line we walk when having oth issues. Especially when a drug of choice is meds.
Because I have been away for a while i am not up to par un your entire situation being that this is the first thread I have started to read this evening.

I wanted you to know I really understand the fears of being a CP'er and the possibility of becoming addicted to my medications and potentially abusing them. In my case my Drug of choice was something else but that does not mean that I could not switch.

So I make sure to take every precaution to do things the way the doctor instructs.

This may not always work for everyone...becasue we all have our own set of circumstances...

I am sorry that your struggling so! Just being in CP and having it effect every aspect of your life and your family's life is challenging enough but to have the other thing going on or the uncertainties of the addictions etc is very overwhelming.

Have you gone and visited the other section on HB? Only you can anser the addiction question for sure.

As for the pain ...have you ever thought of going to see a "Pain Psychologist"
Now I do'nt mean any Psychologist but one who specializes in people who live with chronic pain? I know that most all my experiences with the one I saw briefly were good and i had only wished I had found there was such a thing way back when I really could have used his expertise in the CP stuff.

It is difficult to pick up and continue on! Even today with 4 1/2 yrs of sobriety and all the injuries and surgeries I have been through I still have to ask for help. Help from others with CP and help from others who are addics and or alcoholics...

I do not know how I have managed to keep it all together....I gues it is an HP thing but this board was a huge aspect of how I learned to deal with the pain and know I was not alone....

I will be praying for you....there is always some sort of help out there and a solution...and the best part of it is that we do not have to do this thing alone!

Over the years I have found that I need the support fromothers who have come before me in both the CP as well as the other stuff.

I hope this post has gien you just at the very least a tiny bit of hope...becasue sometimes no matter how down I have been no matter how much I wished it all to go away or to wake up in another life it just kept on coming...life just keeps happening and the hope is that what matters is how I handle it...
So the fact that your being so honest is Huge!!! That is so wonderful and there is hope...
Hugs and prayers for you!

 
Old 03-13-2009, 01:01 AM   #10
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Re: Seeing my pain doc Fri - any advice?

I don't pretend to know anything about addiction. I was nervous that it could happen since I've been on Oxycodone over two years. Now on that (Percocet temp because of shortage) and the Fentanyl Patch. Neither is getting rid of the pain. At the least it takes the edge off. The answer is to increase it. I questioned the Dr about becomig addicted. He said I take the meds because I am in pain so that is not addiction. He said if I took the meds without pain then that is addiction. I guess that is a simple explanation.

What I don't understand is that if the Dr. knows you are in true pain couldn't they give you something that you could take without becoming addicted again? If not, the patient suffers. I assumed they would monitor you closely. I know it is hard for a Dr. to see pain unless it is shown in an MRI or something. You look at my test results and everything looks fine. I guess the Dr. in the end just takes my word for it. Although he can tell if swollen, tight etc. Seems like a fine line.

My mother did tell me that she thinks I am a drug addict. But that was just an ignorant remark with her not knowing any facts at all. We are close and she felt she was helping me by saying that. Needless to say, it just caused an arguement.

I wonder if some people are more prone to addiction then others. I have a family history of Alcoholism. Because of that, I purposely did not drink. Wonder if some kind of genetic component to drug addiction.

My pain meds are refilled every 12 days. I see the Dr. once a month. When I say refilled I mean I get a new prescription every 12 days.

Not sure what my point is. I guess it is that I can't see how a Dr. would give you nothing when in so much pain. That is just a general statement and not regarding anyone in this thread. I understand you can get addicted to Ultram too even though it is a non-narcotic. You can get addicted to nose spray too. I guess there is always something in it.

Last edited by hessie28; 03-13-2009 at 01:02 AM.

 
Old 03-13-2009, 08:01 PM   #11
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Re: Seeing my pain doc Fri - any advice?

Quote:
Originally Posted by hessie28 View Post

What I don't understand is that if the Dr. knows you are in true pain couldn't they give you something that you could take without becoming addicted again? If not, the patient suffers. I assumed they would monitor you closely.
They have a number of options. Not only are there some meds that are less addictive in nature (and potential), but even some of the more potent ones can be used once the patient is treated for addiction. There are several members who post regularly who can give one a first hand snapshot of how they were successfully treated for addiction issues.

Just because someone has had abuse problems in the past, doesn't mean they don't deserve humane PM treatment. Some of our own members have gone through treatment successfully and now take very potent meds and use them prudently. One shouldn't be "labeled" an addict and thus, denied humane treatment.


Quote:
My mother did tell me that she thinks I am a drug addict. But that was just an ignorant remark with her not knowing any facts at all. We are close and she felt she was helping me by saying that.
This is not all that uncommon....Many who don't know anything about PM will make crude, off the cuff remarks like this. Quite frankly, this is one of many reasons why I don't tell anyone about my PM. Even those in my family don't know....Just too many issues to explain and too many things can happen as a result. It's a "need to know" basis, and they don't need to know.


Quote:
I wonder if some people are more prone to addiction then others. I have a family history of Alcoholism. Because of that, I purposely did not drink. Wonder if some kind of genetic component to drug addiction.
Absolutely. There has been quite a bit of research lately on the topic and researchers have proven there is a genetic link. Those who have had alcoholic or drug abuse in their family history, are much more prone themselves to develop abusive behaviors....And it doesn't necessarily have to be drugs and alcohol...It can be other "addictive" behaviors such as tobacco, sex, shop lifting, risk taking, working out, and a whole list of other types of "addictions." Many medical issues run in some family gene pools, and "addiction" is just one of many possible deficiencies.

Regards,

Ex

 
Old 03-14-2009, 12:11 AM   #12
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Re: Seeing my pain doc Fri - any advice?

Quote:
Originally Posted by hessie28 View Post
What I don't understand is that if the Dr. knows you are in true pain couldn't they give you something that you could take without becoming addicted again? If not, the patient suffers. .
Unfortunately once you are an addict then you will always be "set off" by opiates/opiods. I am a recovering addict as many know on these boards but I was addicted to something else and therefore when I take opiates/opiods it does not set off those receptors in my brain responsible for my addiction. It does not mean that I could not become addicted to these medications because I am much more likely to than the average person. That is the reason that I need to be responsible and diligent to take the medications EXACTLY as prescribed and not try to play doctor.

It is true that many doctors and others in the medical field will let a recovering addict suffer, I have gone through this exact thing. I was seeing a PM doc and the strongest thing that he would give me was Ultram (like he did not know that Ultram can be addicting as well, duh). I finally saw a different doctor who was compassionate and understanding and treated me with respect. However, if I had stayed with that PM doc, I highly doubt that he would have EVER started me on the fentanyl patch. I finally have some quality of life even though I am not pain free(but I know that is not the goal of pain management). OK well enough about me, I just wanted to comment on that.

brian

 
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