long term pain management? - Pain Management Message Board

scotty12 · 06-10-2004, 11:05 AM

I was wondering if i should be considering the fusion surgery.its been well over a year now.the epidurals ive had did not help but the pain medication and antiinflamatories work well enough for me to function and work partime.

my pain dr isnt pushing me to make any changes but ive stopped seeing my ortho surgeon because i really dont want to have a 2 level fusion

i have 1 herniated and 2 bulging discs w/torn annulus and spondylolethesis L5-S1.ive been told that im not a candidate for ADR and all 3 surgeons ive seen say fusion is the answer.

im happy with the way things are although there are days when i just cant do much but most of the time the meds keep the pain levels low enough to have some quality of life.i have a job where my hours are flexible for now anyway and unlike the first few months im getting good relief from the meds.im still taking SA meds : roxi along with vioxx and elavil.

what im asking is because i have not had any surgery yet is pain management a long term solution.at some time will my pain dr want to end our relationship?is that something i should expect?

anybody have any imput? : ........................scotty

surgicaldisaster · 06-10-2004, 01:27 PM

Hi Scotty! Well, I would think that unless you cannot have surgery due to an underlying illness/reason that you will probably be asked to try it because it could possibly fix your problem. I know that before I went to pm, I had numerous surgeries(the last of which were 3 in 5 months). I have adhesion related disease which is extremely painful and cannot be cured. Also, surgery usually makes them worse and has for sure in my case. So for me, pain management is it. In your case though, if the pm Dr. was ever questioned on why he's rx'ing you meds when surgery has not even been done to possibly fix the problem, could end up in a world of trouble. Generally long term pain management that involves opiates is only used when "all else has failed". So, I think that at some point either you will have to have the surgery or possibly not be rx'd your meds. Obviously I don't know for sure, but I think I'm pretty much on the money here. Anyway, let us know how you are k? Is there a reason you do not want to try the surgery?(if it's in your post I'm sorry!) I know if I could fix my problem, I would in a heart beat, cuz a life depending on a Dr. to keep ya comfortable is not easy. Anyway, keep us posted and hope to hear from you soon. Surgical Disaster

scotty12 · 06-10-2004, 01:47 PM

surg,
thanks for your opinion.there is nothing stopping me from having the fusion.i am planning on having discography done in sept/oct and have fusion scheduled for dec.thats the only time i could take 8 weeks off from work.i drive about 3 hours on the days i do work and the surgeon told me thats a no no.i scheduled surgery with the understanding that i can only do it around december which is why i scheduled so far in advance.

my pain doc said that the disco results may aid in treatment(ie:nerve blocks) but the belief is that the slippage is causing all the pain.

i have always felt that if the pain is managable with meds and i have the ability to work partime and spend quality time with my family why risk the fusion.i know the longer i wait the more dependance will be an issue but i was dependent when i first started seeing spine surgeons.i know i cant go on like this forever yet im going to hold out as long as i can.

i think im just chicken because ive researched too much about fusion.ive learned that ADR is being done now for multi level problems but not here in the us yet.i would have had surgery if any of the surgeons ive seen offered say a laminectimy or discectimy but ive been told only fusion and frankly im scared of loosing what portion of my life ive gotten back.when my pain started the first few months i couldnt do much other than lay on ice packs.

so here i am almost 2 years later.i just feel like 80% sucess rate is too risky and i could wind up back in pain management anyway with worse pain...........

thanks again............scotty

sgibson · 06-10-2004, 06:30 PM

Hi Scotty,

I truly understand your situation. I went through pain management for a little over 2 years. I had my fusion in January and I am back off to pain management on the 17th. I have stayed on the same pain meds since surgery. I am fusing, xrays show bone growth, but I still have horrible pain. My surgeon warned me about it. He warned me several times before surgery that this was possible. At my last visit he said, Sherry, its not going to get any better, I want you to go to therapy (heat and massage) and to long term pain management.

I don't know if they would have continued to rx my pain killers if I had refused the fusion. I didn't ask. I was praying the fusion would fix my pain and I would no longer need rx's on a daily basis. My surgeon knew I was expecting too much from the surgery, thats why he kept telling me over and over not to expect to be pain free after surgery. Surgical's statement about them not continuing to rx pain meds if you don't do the surgery could be true. I'm not sure. It sounds reasonable to me. Then again, we should have the choice to not have surgery and still be treated for the pain. I don't know here. I applied for SSDI and was denied because they said I had had surgery for my back and the problem was fixed so I should be able to return to work in a years time. It made me wonder if I hadn't had the surgery would they have denied because I didn't try the surgery. I wish these idiots at SSDI would understand that even if there is a successful fusion there can still be dibilitating pain. It drives me crazy. Oh well, I am in the reconsideration process now. I know this thread had nothing to do with disability, I'm sorry I got off topic.

Anyway, think long and hard before you go through the surgery. I have been told that if the nerve has been impinged for a long time that even after they relieve the pressure, there is still pain. Something like remembered pain or something.

I really do wish you the best. Just be prepared if it doesn't happen. I have been fighting major depression because my surgery didn't work. I thought if the stupid thing fused then I wouldn't hurt like this. I guess I just wouldn't entertain the thought of hurting like this for another 30 or 40 years. I won't do it that long. If this PM can't help me, I don't know what I will do. I have become tolerant to my breakthrough meds and now I'm having some type of allergic reaction to the adhesive on my fentanyl patches. I'm breaking out and actually bleeding from the area. Life like this sucks.

God Bless,
Sherry

rlcowboy · 06-10-2004, 09:07 PM

Hey Scotty I just wanted to chime in here. I have had four back surgerys in the last year and two of them were fusions so I can relate.You said that you were allready dependant on pain meds before the spinal problem? Could part of the reason that you dont wont to have the fusion done is so you can keep getting your pain meds because that sounds a little like part of it? You said without the fusion and with taking pain meds that you are only able to work part time and only have some quality of life right now. Why would you not want to do something that could give you back the ability to work full time and have back your normal quality of life? I can go ahead and tell you that no Pain Managment doctor is going to keep giving you narcotics if there is something that can fix the problem and you refuse to do it. Long term use of pain meds are for folks that have done everything in there power in order to find a solution to thier problem. Going through life being dependant on narcotics is not a way to live unless, like surgical and gibson said, you have tried absolutley everything else to fix the problem and all else has failed.Once you have the fusion you could go through a Detox in order to help with your dependance with pain meds.