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Old 01-03-2006, 08:46 AM   #1
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rodekill4404 HB User
What is pain managment?

I posted my situation on the ostioprosis board
ostio penia at 41.
and one of my replys was lfor me to look into pain managment.
what is it ...............I have beeen in pain for so long .
All I really want is to get well.

 
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Old 01-04-2006, 04:38 AM   #2
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Re: What is pain managment?

to manage pain. There are many ways to try to manage your pain,most likely[depending on your pain,and were] shots,epiderals,nerve blocks, medication is usally last resort. Even P therapy.

 
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Old 01-04-2006, 07:12 AM   #3
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Re: What is pain managment?

HI RK, MH is right, There is no ab****e gaurente with PM. Every doc has his own phylosophy on the best way to manage a problem. It's mstly trial and erro , if a doesn't work, try B. If Bdoesn't work try C and so on. Docs that try to use one or two methods on their patients may be ble to help a few of thsose patients tthat repond to that partilualr method, but you can't alam every sqaure peg through a round hole and say this works for everyone. Just like they don't start with long acting pain meds assuming they will work for everyone. Why create a patient physically dependnet on opiates if a Tens unit and PT would have helped, Or anti seizure meds and accupuncure. It took many of us years to find what works best and even though not every doc will have the answer, hopefully you can take something useful away from every meeting with any PM doc or clinic. Look for a aractice that uses a multifaceted apraoch, meaning they have something diferent to offer everyone, is likely your best shot at finding a level of relief you can function at. Pain management is abotut managing pain and improving quality of life, very raerly dis someone abale to obliterat e all teir pain and restrore all normal function and rate their pain as a zero once pain becomes chronic or after multiple surgerries.

Realistic expectations has a lot to do with your satisfaction. If you know going in, 50% reduction in pain is what they shot for nd considered a success, you will be less dissapointed than if you expect complete pain relief of all symptoms with no side effects from anything a PM doc may do or prescribe.
Good luck, Dave

 
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Old 01-05-2006, 12:00 PM   #4
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Re: What is pain managment?

Thank you SL&MH

I think my problem is looking at my pain realisticly
i never could have realized that there are people in this kind of constant pain
and every new doctor i see,gives me false hope .......that they can cure me.
when in reality , im just going to have to deal w/ it.
I am reaching the point where I DO NOT WANT TO LIVE LIKE THIS!
selfish? I dont know......after so long friends just accept that i cant join them in fun ,and stop asking......I am so lost right now!
I used ton have a great life riding and diving all over the world.now my world is 2500 sq ft.and very lonely.thanks for you advice.I appriciate it.

 
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Old 01-05-2006, 12:54 PM   #5
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Re: What is pain managment?

Hi RK, Sorr about my spelling erros, I'm duslexic and it's time for ea new jkeyboard.

Documant everymethod you have tried, who, wahat , where wand when, how successfull was it and all the inormation to confirm, addy PH# Docs name etc.

Basically try to compact ebverything you have tried into one document that the doc can include as part of your file and use it to protect himself when it coomes to rationlizing the use of pain meds when the DEA comes a nocmin.

The DEA willtarget PM docs and groups in practice long before tehey will a GP tha as steppd up and playing PM. Based on the number of script eac h clnic or docs rights and the quantity prescribed is what draws attn to their pactice. So a doc that wants to stay n biz will dot every I and cross every T and protect himself and his continued ability to practice PM.

Tere is nothing wrong with calling ahead and asking for info packets of just ask a few questions that allows yu to explain you have tried nerve blocks and etc etc etc, what does this doc do differently. The righ answer is he treats every patient as a unique case that will reqiuire diferent measures for each patient. Rather than complain of pain, which can't be seen and is so subjectivve, try to focus on what it's doing to your life just like you di in the prior post. If you have a spouse take them along to cnfirm how this effgects yu. Being comfortable after a long day of phsysical labor is very different from having no quality of life and no choice when it comes to staying home when you know you can't stand for moe than 20minutes. THere are great dcocs out there, The trial and error and hoop jumping you have already done ggets you that much closer to an answer. If the doc knows up front what hasn't worked, he can move on to something that has showed promise. List meds and rate how they work, include prescribing doc and PH# if he wants to confirm, but your being completely up front, Give him the resource to confirm everything you say and start explaining you pain in how it effects you rather than an arbitrarty #. Iremeber waiting to check out at the clinic I go to. A little old lady was walking by with the nurse complaining of 10 pain. If I was in 10 pain I would be on my way to the ER or already there. I wouldn't be strolling down the hall describing the worst pain you can magine like your talking aon the church steps. I sweat and shake and BP goes through the roof. So the number system is very flawed and often people over rate or under rate their pain. Yuou have to pt something the doc can relatye to, like eminsished function or needs meds to manage, must lie down, legs shaking and can't catch breath.

You really willget there, It's just trial and error. IT sounds like you will have a story like mine, 12 docs and 3 clinics later I fund relief. JUst kiddng, times have changed since the 90's. More docs are willing to prescribe and something to consider is that if your GP , he he's the one doing all your referaals, you may have to get outside that loop of docs that's treating you.

It turns out the doc I have seen he last 5 yars that rund a multi faceted clinic with several other docs with various specialties, has alweays been in my own back yard. He could have been treating me since 93, But my group of docs, the GP and his partners decided I shouldn't go a route where a doc may prescribe pain meds,. This look on meds they have probably already existed but because a surgeon wrte a note to my GPO 4 weeks post op when I pitched a fit when he cut me off with no warning, > He wrote a letter to m GP suggesting I may need drug counseling. That fallows you and you never know if it's there. I saw a post it on the inside cover about possible opiate abuse and yanked it out years ago.

It wasn't untill 3 surgeries failed and I was left bed ridden , My SSD lawyer recomended this doc. My GP was like OH yeah, he runs a great clinic in the neighborring city and is in your network. Imagine that, He's always been there, He's a psychiatrist/Neurologist teamed up with an anesthesiologist/DO and several Phsysiatrist, but they never came to mind during the years between failed surgeries.

Dcs wil doink you around, if yo get labeled by ananyone at any point, It can cost you in who they are willing to refer you too. My doc knw they did pump management and used LA opaietes and evrything down to Botox, TP injections, you name it and they can do it. But some jerk had to have a reason why I was still sking for pain meds 4 weeks post op. It did turn out his set of hardware was the first too break, but it took 2 years with no fusion grown at all for the hardware to breakand show movement during flexion and extension Xrays. Docs don't like to admit faled surgery, and pain idoesn't make it a failure. If you they restored your reflexes or relieved the foot drop or numbness they are going to say it was a complete neurological succes. Your back may hurt like a #...#.... but if they fixed the reasons they went in, neurologic, it was a success by a surgeons standard.

Good luck and kep pounding doors. IF you want to list your city, someone may be able to point in the right direction.
Take care, Dave

 
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