Hey Robin, Unfortunately it's even harder for young people to find effective treatment for chronic pain. The most that surgeon can do as far as black mark against you for merely asking for pain relief, is write that he believes you have a drug problem, recommends treatment or you displayed drug seeking behavior, whether you have done any of this or not. If he sends a note like that to your primary care doc “ GP” It will make things very difficlut with that GP referring you to anyone that may possibly prescribe meds or treat you himslef. He would be taking on substantially more liability treating you after such a harsh warning from your surgeon. He effectively burned bridges with your GP to the point that even if your GP knew of a group of docs that would prescribe medication and used opiates he's not gong to refer you to that group anyway because of that note/letter from the surgeon.
It's time to get outside that loop of docs that are basing their opinion from the get go, on the opinion of one doc. If you went to the Mayo clinic and they recommended LA opiates, your GP would probably still have a problem prescribing them. Should something happen, it still falls on his shoulders, saying Mayo clinic recommended it wouldn't get him out of trouble if the surgeons worst suspicions came true. Say you OD or got caught selling them.
So you really do have to pretty much start fresh with a new GP. Take radiologist reports to the new GP and tell him you need help in finding a way to manage the pain or help getting he ADR approved. I don't get why the insurance is having a problem. It is FDA approved. I would expand your search area with medtronics if you live in a small community that only has one doc certified to do pump implants. Expand it out to the next closest large city. You may have to travel a little to get outside your present network of docs that will not contradict one another or prescribe when warned not to.
You may have to try a few more modalities and a couple other pain clinics. I went through 4 that didn't use opiates at all, some were 4weeks 5 days a week, 8 hours a day. Did all the stuff you mentioned plus their big focus at the time was mind over matter, you can learn self hypnosis, Bio feedback, guided imagery, yoga or do more work hardening to prove to yourself you can function wthoutpain meds.
I'm not saying I got nothing out of any of those clinics, I still use several techniques and tricks I learned. The things that didn't work were just one more thing to cross off the list that allows you to say you have tried A through Y and all that's left is Z.
If your trapped in the comp system from a work injury it makes things even tougher to get an outside opinion but you do have rights and the abilty to go outside comp but you may have to pay yourslef if your regular insurance won't cover it. The reason I removed that info is because I don't believe there is or should be a fast track to find a doc that prescribes and trade dependence for pain relief without trying many of the other modalities. I don't think people need to go through what I went through. 7 years, 3 surgeries 4 clinics and round after round of PT and injections.
I got the same drug accusations for merely asking for help dealing with pain. One surgeon told my wife I should leave his office and go directly to rehab for drug counseling simply for asking for something for pain. I hadn't had any pain meds in 2 years since post op from the prior surgery, but I needed to hospitalized because I asked for pain medication? I was 32 at the time.
As far as finding a surgeon willing to operate, you age hurts you there too, nobody wants to be the surgeon that disables a 20 year old or a 25 year old. There is a chance that some other method will work and untill you exhaust them, they don't want to take the risk with your life. You could end up worse off than you are now. It may be hard to imagine being worse, but after each surgery I had to adjust my pain scale to fit levels of pain I had never experienced before. Not that I wasn't in severe pain and had many problems but so you don't think of things getting worse .If you can presently stand in a shower without someone holding you up, you could loose that ability.
I'm not trying to make light or diminish what your experiencing , just explain why docs are hesitant to do major open surgery on a young person who's bowels, bladder and ability to walk isn't being compromised by your present condition. BY ability to walk I mean loss of reflexes and neurologic impairment, not pain.
It absolutely sucks that your treated differently than someone 50 with the same Diagnosis and complaints, but it is the way it is.Docs don't want to turn a 20 year old into an opiate dependent patient either, but a doc that understands the difference between adiction and simple physical dependnece also knows, folks in pain don't get high from their pain meds. All fun addicts use them for is absorbed by the pain your trying to deal with when you reach that level of chronic pain.
So if opiate phob sugeon has contacted your GP and given you the "black mark" the only way to escape that is to change GP's, Leave that part out of your history. Don't use him as a previous consult and look for another GP and surgeon to get a fresh perspective and opinion from. Continue working on getting the ADR approved and remember patients willing to try anything are seen in a different light than those that simply won't participate in specific modalities.
For example, there was a lady at the last pain clinic I went too, she had DDD and few bulging discs, but would simply refuse to participate in PT or Bio feedback. Then rant and rave about not getting opiates when they were being prescribed to some of the other patients. That willingness to try anything separates the folks simply looking for a quick fix with a pill and those whose pain is truly impacting their life adversely.
I know most people have financial limits and traveling limits, but I would contact the makers of the disc, find out where the clinical trials were done, and who's the closest and foremost authority on their use and consult with them. His background and credentials, and lack of affiliation with your present loop of docs may carry enough weight to get the ADR aproved.
There is no guarantee with an ADR or any surgery, but having had surgery and if it fails also caries a little more weight than a more general problem like DDD or a bulging disc when seeking PM.. Everyone over 30 has some degree of DDD, unfortunately some people have abused that basic diagnosis and used it to abuse the system, abuse drugs and sell them. When one script is worth a thousand bucks on the street and you know the DEA is breathing down your back, docs have to be able to justify your treatment plan. Patient complains of X Y and Z is not enough to justify any treatment plan with opiates. You have a lot more and it's documanted. I would make a list of every procedure, where and when and the results. Something a PM doc can easily slip into your file and turn to if anyone questions why your taking specific meds that may be contreversial.
It’s those few bad aples that have made it so hard and plenty of addicts can come here simply to learn how to describe sciatica, radiclulopothy, migrains or any other painful condition. They use the mere fact they did have surgery of some sort in the past to complain and justify there need. Not all surgery fails and not everyone that has had back surgery needs PM or ends up on LA pain meds.
Docs don't particularly remember every patient or every surgery they do. However they do remember the one patient that stole their script pad, called in their own meds, altered a script or did some other ridiculous act, that.. they will never forget and that reinforces what the initially learned about opiates and rapid addiction. This does taint their view of all patients that ask for pain meds beyond a point after surgery the doc feels they shouldn't need them or towards treating patients that don't have an immediate surgical solution.
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