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Old 07-19-2006, 09:57 AM   #1
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Husband having MRI and does not want referral to pain management

Hello everyone-
I touched on this briefly in my "pm doctor scares me" thread, and it's been confirmed this morning.

To give you a bit of the background story. My husband fell off of a 3 story roof on St. Patrick's Day two years ago. We live in a beach community where most of the houses are on pilings (stilts) and he fell from the 2nd story roof, but since it's on pilings, his fall was equal to falling 3 stories. When he hit the ground, he fell mainly on his face & shoulders into sand. They had to air lift him to Norfolk which is about an hour and 1/2 drive from here.

Anyway- God blessed us that day because my husband walked out of the trauma center THAT NIGHT with no broken bones and only a sprained hip and possible sprained neck. I felt like we were very fortunate because he could have been paralyzed or even killed. I still get chills when I think about it.

Since then, he has intermittant back flare ups where he can hardly walk for days. The last flare up kept him hurting for about 8 weeks and he is currently in another flare up that started on July 4th. His back problems are becoming more frequent and are lasting longer. I can make him rest for a couple of days, but as soon as he's able to walk upright, he goes back to work. We own a plumbing company and he feels guilty if he's not out there along with the guys working. Plus, he just plain gets miserable when he has to sit down. He's high energy that way.

He went back to the doctor this morning for the follow up, and I told him he really needed to request an MRI if the doctor didn't bring it up because I know there is some kind of problem that resulted from the fall. The first thing the doctor said is that it's time for an MRI. I really hope there is nothing major going on in his back, but I can't dwell on it because I will worry myself sick.

He has told me that if they do refer him to pain management he will refuse. They brought it up briefly at his last appointment. Reason for this is that he has some past issues with cocaine and alcohol, both of which he has beaten and has been totally clean. Clean from cocaine since well before we were married (well over 13 years clean) and over 2 years without drinking. He has been on pain medications with his back and never even takes the amount prescribed, but he is addimant (sp?) about not going to pm. He actually takes as little as possible and uses OTC medications before even taking the prescribed stuff. I told him that it's not always about pills and such and that there are non narcotic medications available.

I think we will wait and see what the MRI says before we discuss this further. We need to know what we are dealing with before we can make an informed decision. I just told him not to stress (I need to take my own advice too!! ) about this and that we will make a decision when we get the results and talk with the doctor. He knows of the prior issues with the cocaine and alocohol, so no problems in that regard.

Have a good day all, and take care of yourselves!!

Lezlee

Last edited by ozzybug; 07-19-2006 at 10:02 AM.

 
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Old 07-19-2006, 10:51 AM   #2
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Re: Husband having MRI and does not want referral to pain management

Hi Lezlee....as you know, I have a similar situation and I know that in my earlier days of pain meds I would not take as much as was prescribed for many of the same reasons as your husband. I am very careful with my meds and respect them greatly. I've been seeing a psychologist and he came up with a plan for me in the beginning which was not taking my meds as needed but on a regular schedule.....whether I felt that I needed them or not. Let me tell you...this was very hard with my background in sobriety. But it did help because I was no longer chasing my pain and having a very hard time catching up with it.

There is alot more to PM than just meds or even other alternative to meds at all....pain medications aren't usually a first line of defense in PM. The thing is they can't force him to take any kind of narcotic.....he can always just tell them that he's not comfortable taking them and that he'll let them know if he changes his mind.

I can definately relate to your husbands situation but also know what it's like to put off taking of the meds.

Take Care!!!

JeanneO

 
Old 07-19-2006, 02:21 PM   #3
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Re: Husband having MRI and does not want referral to pain management

Hi Lezlee - When your husband fell off the house, what tests did they do at Shock Trauma, or did he convince all the docs that he could just shake it off and skip out the door? I too have experience with family being in recovery and still having to take pain meds. It can be done, but of course your hubby has to be the one to make that decision, right? My very first injury happened when I fell out of a 2nd story window about 18 feet to the ground and landed on the only piece of concrete in the whole yard!!! I can't imagine falling 3 stories!! Thank goodness he landed on sand or he most likely would have lost his life. I wish him luck - sounds like you have a real stubborn one there!!! KathyMac

 
Old 07-19-2006, 03:06 PM   #4
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Re: Husband having MRI and does not want referral to pain management

Jeanne & KathyMac-
Thank you so much for your replies. I'm glad to see there are others who have beaten addictions and gone on to be able to make wise choices in pain care. It's comforting to know this can be done. I think my hubby is very concerned and determined to not do anything that would put him in jeopardy of becoming addicted to anything ever again. As a matter of fact, he quit smoking cold turkey over a year ago because he said any kind of an addiction puts him at risk.

Kathy- I can't imagine the thought of falling onto concrete! I'm glad you are still around to talk about it girl. For the 2 weeks following his fall, I would not go to sleep unless I was physically touching my husband. Even if it was just my hand on his shoulder or something. Before that fall, I always complained about not being able to sleep because of his horrid snoring, but after the fall- that snoring was the most welcome sound I've ever heard. Although, I must admit, that though I never want to be without my husband for any reason, the snoring does bother me now....hehe

As far as what was done at the trauma center, they were so busy that night that there were patients on cots in the hallways! The doctor did x-rays of every bone in his body and that was it!! I asked her to please do a CAT scan, MRI, something to make sure there were no injuries that wouldn't show up on the x-rays, but she looked at me with a nasty look on her face and said, "I don't think you are qualified to decide what diagnostic tests your husband needs, and we are too busy to keep your husband here any longer. We need this stretcher for other patients. He's talking and breathing and you need to stop worrying so much." I was LIVID!!! I wanted to slap her in her nasty face for that! I asked for the head doctor and she looked at me smuggly and said, "You have her in front of you." I simply said, "You know, I hear McDonalds is looking for their clown, and I think I've found her." What a capital "B" word! To add more fuel to the fire, they made me and my husband tape his clothes together so he could leave without being in nothing but his bare skin because they had cut them off in the helicopter. They wouldn't give him any scrubs to put on and cover up! I really wanted to tell this doctor what my medical background is. We own a plumbing company now, but before that I had a different career and I know I can't say what it was, but I know quite a bit more than she thought I knew. I wanted to tell her just how qualified I was to decide which diagnostic tests should be performed, but held my tongue because an ego like hers has nothing but steel walls around it. Nothing can penetrate her thick skull!

I filed a complaint the following morning with the hospital. Then, when I got the bill for the part the insurance company didn't cover (which was a tidy sum I might add) I immediately called and told them I'd be happy to pay the bill, BUT if my husband suffered any kind of harm and had any hidden injuries that were not diagnosed the night he was there I'd slap that hospital and the doctor with a law suit the likes of which they've never seen. The following day, the hospital rep called me and they totally deleted our bill. Now, I'm not a sue happy person, but I swear, I would have sued them if anything had happened. He could have had a slow internal bleed or something!

Anyway, my husband will be having MRI with and without contrast Weds. 07/26/06 and I will let ya'll know what it shows!

Thanks again!
Lezlee

Last edited by ozzybug; 07-19-2006 at 03:08 PM.

 
Old 07-19-2006, 08:33 PM   #5
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Re: Husband having MRI and does not want referral to pain management

I'm sorry to hear how horrible your husband was treat. We trust the ER to serve us and help determine if there's a major problem in a crisis such as yours.

I do understand your husbands apprehension of addiction. I suggest he find a PM who works with all the modalites and not just medications. If he up front with the doctor about his history he can avoid medications and opt for physical thereapy, TENS units, non narcotic things like Lidoderm Patches etc. The list doesn't end there. There's a vast array of things a patient can and should do as chronic pain patient outside of medication alone.

I hope his MRI goes well!
Barb

 
Old 07-19-2006, 09:12 PM   #6
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Re: Husband having MRI and does not want referral to pain management

Barb-
Thank you. I totally agree with you. I do own a TENS and my husband uses it all the time. He has opted for PT several times and has also seen the chiropractor for electric stim as well. He does everything in his power to avoid taking the narcotic medications. He is really good about these things. I am hoping that maybe some steroid injections or something, maybe some accupuncture or trigger point injections too, but we really can't make any kind of decision until we get the results of the MRI. I sometimes put the chicken before the egg so to speak so I really have to try and not stress over this and relax a little. It's just that a thousand different things are running through my head as to what could be going on in his back. I need to stop doing that now!!

Thank you again for your support and reply. I appreciate it so much!! Take care-
Lezlee

 
Old 07-19-2006, 10:12 PM   #7
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Re: Husband having MRI and does not want referral to pain management

Hey Ozzy, I didn't realize you lived so close. Ya gotta live on the outer banks by your description. I live in Va beach.. For some reason People have gotten the ideas that the only form of pain management is opiates. I've know just about every PM doc in Tidewater and would be happy to give you the name of a half dozen PM practices or PM docs alone in practie that wouldn't give your husband a Vicodin on his owrst day.

I've been in PM longer than Long acting opiates have been around and they didn't use short acting ones either. There are dozens of PM techniques that work for many people that are non narcotic. Nobodyy is entitled to opiates and the docs I can list will make that perfectly clear.

He has at least 20 methods I can think off and tried that may work for him. Not everyone needs opiates and just because they work better and faster than other methods, many people really don't want to spend the rest of their lives on them until they have ruled out every other potential method and quality of life has deteriorated to the point of disability

. Having bad days or feeling rough when there is a tropical storm a hundred mles away, doesn't require opiates for every patient and he does have other choices. Being uncomfortable isn't the same as being in chronic pain, if he doesn't want tolive on and be dependnet on pain meds, let him know PM is all about opiates. If you want to travel back up to Tidewater to avoid a room full of junkies, just ask for names that will only use non opiate modalities.

Honestly it's scary how opiates are now seen as the best option when they used to be seen aste last. Yes they work better than Iboprofen, but why go the opiate route if something else will work. Maybe not as fast or with the same opiate gaurentee of apain relief,. Not evryone wants or needs to pay the price of dependence and tolerance for some added relief that can be managed inother ways.

Dr Lisa Bar Or DR Waco at "Advanced pain management" in Va Beach will be more than happy to spend a year or two trying every method they can think of to help him larn to actually cope with his pain without narcotics. From there you can move on to any of the other methods they don't offer like acupuncture, Bio feedback, self hypnosis, counseling to learn basic coping and relaxation skills, Tens, TINS,myofacial release, trigger point injections, robaxin infusions, Lidoderm patches, lidocaine infusions.Antidepressants, anti seizure meds.etc etc etc etc.

No one doc can offer every method available, but any doc can write a script for narcoitics. I know a good chiro too and there is more than one type of PT for a bad back or neck. IT just depends on how the PT was trained. Unfortunately it's hard to go back once on opiates and expect to learn a better way to cope with pain than opiates. EVMS, right across from Sentara Norfolk has a PM dept and physical medecine program. They don't use opiates either and yet they somehow manage to help some people. Crazy isn't it

Just the idea that any old PM doc would put him on opiates at his first visit without trying anything else is so absurd ,but unfortunately there are docs that will. It doesn't make them good docs, it'smakes you depoendent on them each month. Patients want what they want and will shop untill they get what they want.

Just a different point of veiw than those that think the logical step after 6 weeks of PT and one ESI is methadone for the rest of your life.

Good luck, "Beach" Dave

 
Old 07-19-2006, 11:54 PM   #8
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Re: Husband having MRI and does not want referral to pain management

Dave-
You are quite intuitive! Yep- Outer Banks NC, that's me! Been here for 12 years and love it. Originally we are from the Newport News area. What a small world! I take it you spend time here?

I totally agree that pain medication should not be the first and only option as I am in pm now. Well, read my other thread about the scary pm. I will be seeing a new pm when the referral goes through. I'll be seeing Dr. Plotnic in VA Beach, and I hear he really is very reputable as well. Fingers crossed.

Yes, I've heard that APM uses a wide variety of treatment options there and that Dr. Su in the Chespapeake office is the same when it comes to medication. She offers accupunture, trigger point injections and prolotherapy I think too. I did mention that to my husband and he said, "I can get accupunture here at the beach." BUT- if you know anyhting about this area, and it sounds like you do, resources are limited here, and I'd be much more comfortable going in to Chesapeake and VA Beach. It's not that bad of a drive.

I do know that my husband is very strong in his determination to not succumb to the pain, but honestly, there are days and sometimes weeks on end that he almost can't walk and it scares me to death. I'm glad he is finally going to get that MRI. We really do need to know what we are dealing with here.

Well Dave, if you spend much time here, you never know, we may have crossed paths! Again- it's a small world! I was wondering about the screen name...thought maybe you lived near the ocean, or enjoy spending time on it!

Lezlee

PS- I'd love to have the names of the reputable doctors in the tidewater area- It's good to have a choice and to have information from someone who knows the practices of the doctors. Thanks!!

Last edited by ozzybug; 07-20-2006 at 12:07 AM.

 
Old 07-20-2006, 06:21 AM   #9
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Re: Husband having MRI and does not want referral to pain management

Hey Lezless or can I rename you OBC, It's been awhile since I have seen some of these docs so I would have to double chack to see if they are still around. But I don't know of anyone in V beachthat does acupuncture either, I'nm sure there is, I just don't know of them. I've heard of dr Su, but it weas Karen Bar at EVMS that I spent 6 months trying acupuncture with. She was an associate professor of physical medecine at EVMS. After an intern did the hystory and other info, she came in and the first words ouut of her mouth were, we don't treat pain with pan medecine. I said that's fine, I didn't ask for any? I've been doing this since before opiates were availabel and if you had a fusion or a hip replaced the strongest med any doc would send you home with was 5 mg percocet.

I'm trying to figure out why it rubs me so wrong when folks are sent directly to Dr pain med when the GP is tired of prescribing but at least I can live with my choices knowing I tried everything before pain meds were used. Maryveiw had a great PM program when I went through it in 2000 but it did close down for a whlile but they may have restarted things. Each director of the program had a different take on the use of pain meds. Dr Beth Winke was compassionate and only used meds on patients that had no potential of getting better, Her office was on battlefield Blvd.

If I had to change docs I woudld go back to her, or use Sentara VA beach to manage my pump. The anesthesia dept runs a tight PM program.

I guess you haven't been impressed with your new hospital down there, I haven't heard the greatest stories about the OB regional either. I am curious who the doc was that seemed to walk and quack like a duck is, The shut down old Sidney Loxley last year. but he got off with a slap on the wrist even though the 12 or so patents they watched put over 150,000 doses of the most potent opiate available on our streets in the 18 months they watched him.

The thng about acupuncture and many other techniques is that any doc can learn needle placement, but without the "touch" it's completely innefective. Then it sours the patient against acupuncture because it didn't help. But not every doc has the same skill level or the touch to do some techniques with any benefit. Like with TP injections, some docs have the touch, some docs will pepper an entire area with marcaine and never hit the spot and some believe it's the action of the needle that provides benefit and simply work a TP over with a dry needle.

There just isn't a one size fits all method for pain management. What may help you may not help your hubby,or vice versa, so try not to confuse both your cases. When you have a doc that uses the same technique on everyone, whether it's ESI or opiates it's more like the doc trying to slam every peg whether round or not through the same hole. A multi faceted aproach is what I have seen produce the best results. My wife is almost med free after TP's, occipital blocks and the greatest help has been from botox, but her problems are cervicle from a chiari malformation of the brain stem and mine are failed lumbar fusions.

Is your history and DX on another post I can check out? I don't often share the name of the clinic I go to, because I feel it will draw the wrong patient to the practice if I say my doc uses opiates and this is how you find him. All it takes is a couple patients getting cought selling these meds to close a practice and I don' want to risk my future or the hundreds of other patients that end up there after a very long road of failed efforts.

Getting in to the practice is like going through a security and background check and all 5 docs have to approve taking on a new patient. Anyone that thinks 6 weeks is a long time wouldn't want the name of my docs, plus they do drug screening, psych screening and eval, everyone takes the MMPI "Minnisota multi-phasic personality inventory" before being accepted as a patient. They don't call any meds in, because a patient burned them and called thier own in. Now everything is written and given at apt.

They have so many rules, most junkies will wash themself out at a monthly pill count or a UA if they hapen to make it in the front door. Only a patient who knows this is their only chance at functioning is going to jump through the hoops.

I gues that's why it blows me away when some doc a patient meets for the first time is willing to prescribe methadone without trying anything else first. Unfortuantely that's what many patients want and expect from PM, their job is to relieve pain so get to it.

Good luck with your search, nothing good comes easy.
Takle care, Dave

PS. yes I have lived on the water for 25 years now, Unfortuntely I can't take the beatig from boating, jet skis or surfing anymore.

 
Old 07-20-2006, 06:55 AM   #10
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Re: Husband having MRI and does not want referral to pain management

Hey Dave-
Yep, you can nickname me- no problems. I do love the OBX, except when it comes to the limited resources as far as medical care. There are some wonderful doctors here, but because there are so few, it's hard to get in to a practice. Well, I have to take part of that back. One of my locals is part of the reason I am where I am now with my pain. That's another post, and I will post a thread with my background information. You can also look at my thread about "New pm doctor- He scares me" and see the experience I just had.

My husband seems to be opening more to the idea of pain management as long as he can find a doctor who won't immediately jump to medications and isn't willing, or able to provide other options. We had a talk about it last night, and like you said in your post, different types of pain require different types of treatment, and a good doctor knows this. I never want to be treated just like every other patient who has pain, because my pain is unique to me. I'd also hate to think every other cp'er is treated the way I'm treated as well.

My husband's back is feeling a bit better today and he promised not to overdo it, but I know him well enough to know that he needs more time away from working. Sometimes he doesn't do himself any favors by overdoing it. Who knows, working even when he's in major pain may be a way he copes with it. He takes pride in providing for his family and just doesn't want to accept that he has limitations. Breaks my heart.

I've read about the condition your wife has and saw a very interesting show on the medical discovery channel about a young girl who had chiari malformation. That is a scary thing, and I think it's wonderful that your wife has shown improvement. It sounds like you are no stranger to the pm experience either. I hope you are able to keep your pain levels down and are able to keep your pain levels down to an acceptable level. I know, good days and bad days. It's always such a relief to have those good days you know? And even the bad days are good to have because it means you are alive to see another day.

I appreciate all of your information and hope you have a great day. I'll start a thread about my history. It's probably not nearly as involved as many others here, but it has landed me in the situation of being in chronic pain.

Have a great day!
Lezlee

 
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