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Old 12-11-2006, 10:01 AM   #1
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desparate need pain man advice

Well this has been a problem for three years now. I've had three lumbar surgeries over course of last 6 years. I suffer from failed back syndrome, pain in lower back and left leg, scar tissue, nerve damage, numbness in left foot, loss of sleep due to pain,and atrophy in left leg. Can't sit long, can't sleep well at all, can't walk long
can't stand long. I get some relief when I lay still and I constantly change positions as that even becomes uncomfortable. I've run out of medical treatment options and my pm doctor basically says I have to learn to live with the pain. I currently take 2 perc 7.5 per day but because I've been on it so long and I have a very high tolerance to meds it only gives me about two hours of relief every day. The problem is that this is the max amount of anything the doctor will give me for pain. I write asking you other sufferers about your experience with more meds than that because I've been trying to get my doctor to try long acting meds but he refuses to give me anything else. He says If I start taking that my tolerances will go up and I will only want more and more. He also says that he does not prescribe that for anyone unless they are dying or have a compound fracture or something more serious.
He says that he believes pain meds do not help anyone function any more than they would if they were not on pain meds. He wouldn't even give me any more medicine when I told him me and my wife finally decided to go on a long overdue vacation and I needed it to enjoy my vacation with my family. My situation is controlled by work comp and I am having a hard time getting me approved to get a second opinion. I'm also afraid that if I start seeing another doc that he might decide to give me nothing at all. I don't understand how they can say that I need next to nothing to cope even though I am considered perm disabled because of this. Please let me know if you think I should not pursue another doc and just live with the pain. Please also tell me anything positive or negative that you've experienced with long acting pain meds. I just need some support and was wondering what other pain sufferers felt about this situation. I just want to keep trying until I can live my life to the fullest

 
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Old 12-11-2006, 10:28 AM   #2
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Re: desparate need pain man advice

EJ-
I am so, so sorry for the situation you are having to deal with. You said you are seeing a PM doctor, yet he refuses anything but percocet 7.5 mgs. twice daily for your proven, chronic pain? I know there are many PM doctors that don't use any kind of narcotic unless it is an absolute last resort, but it sounds like you truly are a candidate for some of the ER medications out there.

I can't tell you what to do, but I can tell you that if I were faced with this situation, I would definately be seeking another PM specialist. You don't have to tell your current PM doctor you are even looking for another doctor, you just try finding another one, and then if you are able to get in with one have the new PM doctor request your records from your current doctor. You could even discuss this with your primary, family care physician and let him know what is going on, and that you are looking for another PM doctor who might be better equipped to handle your pain issues.

I am so sorry you are in this ordeal, and hope that you are able to find a different doctor that will help you manage your pain. Maybe a new and fresh eye on your situation will be a good change, and who knows, another PM doctor may even be able to help you with other modalities to help in coping with your pain too. Please don't give up doing what is right for you. You are your own best advocate. Keep us posted- and good luck!

 
Old 12-11-2006, 10:58 AM   #3
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Re: desparate need pain man advice

I'm definitely with Ozzybug on this one. There's no reason, whats so ever that someone in CP should be treated with two 7.5 Percosets a day! That is criminal and you need to stand up and either get things changed as far as your medication or move on to see someone who will take care of you.

I would go back to my PCP and first tell him what you've had to go through as far as the management of your pain and then ask him to either take over your medication or refer you to someone who will handle your medication and Chronic Pain care. I mention to ask your PCP to handle your meds, as that's what I do. My Primary handles my medication and has for the last 10 years or so since I first went to him with pain problems.

Good luck to you and remember, if someone asks you to get by on 2 Percs a day, it's time to find someone who will take care of you.
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Old 12-11-2006, 01:24 PM   #4
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Re: desparate need pain man advice

Sorry to hear about your situation EJ, Ben through the comp thing with back surgery and there isn't enough in the world to rep[lace what you have lost.

It bsimply boils dowwn to that docs opinion. I'm not saying owhat he says doesn't happen. There are alot of people with unrealistic expectations and whant to pain free after being mutilated by surgery. That's really not possible, but if you go into this undertanding pain meds have their limit, they can certainly change their life for the better.

If you see enough docs you will eventually find a pain anagement doc that is willing to do what it takes from high dose olong acting orals to implanted pumps that deliver pain to your spione. The guy your seeing is never gong to do that so you have nothing to loose by finding another doc. You do have the right togo outside of comp and pay for your own or apply for social security and be covered by medicare. If you have virtually no income SSD programs , local and stateprograms that base everything on household income.

With as many people on meds for nothing anywhere near what your going through. It's likely there is another doc somehwere closer than you think willing to treat your pain.
It is good comp has done all the pretesting and diagnostic testing so you can take everything to your own doc,. But when it comes to not knowing how to face the next 30 years. You do have to do what's in your best interest, not just financial.

I do think there is too much abuse of pain meds, just because a doc said it, does it mean it's gospel or even corect, but you know what you going to get from your present doc . Get outside of comp, get an outside opinion and seek treatment. That outside opinion will also be something more for comp to try to disprove aside from your complaint of pain. Help is out there but if comp gives you what you probably need, it's almost an admission of guilt or that you realy are injured.

My story is much the same, went 7 years without anything stronger than 5 mg percocet. I was bed wridden when the surgeons were generous enough to give me 30 5 mg vicodin a week. I spent years about 4 years on long acting orals and became productive around the house. That really wasn't enough at the age of 40. I had a pump put in, it took 18 months of playing with doses and meds and I eventually got enough relief and had a clear enough head to actually excercise and rebuild my body. 10 years takes a huge toll on you and I pushed myself harder than any PT or doc ever asked. I wouldn't have been able to without the meds, but I do have part of my life back now.

I still have al the same back problems, still have broken hardware and no fusion between L1 and S1, but being homebound sucks whether your on meds or not. It sucks more without, but if meds increase fnction rather than hinder, There are plenty of docs within driving distance of most anywhere.

Start a new thread and ask for a doc in your area. You might be surprised by what's in your own back yard. If your present docs don't want you on meds, they aren't going to refer you to one that prescribes them. They know who's doing what, who to go to for an implanted morphine pump or who to se if they haad their spine crushed. But you have to get outside the comp system, get an independent medical eval or opinion or just pay for your own PM doc untill you setlle with comp. You might get get extremely lucky and find a compassionate comp doc, but you would probably do much better to get outside your present loop of docs that aren't going to disagree with the way another comp doc has treated you.

I gotta lay down right now after 5 hours on my feet. Sorry abourt the typos buty I really gotta go now. Your post just sounded so familiar.
Take care, Dave

 
Old 12-11-2006, 03:48 PM   #5
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Re: desparate need pain man advice

thanks for all of your opinions. I am 39 years old and too young for this crap.
I've already been considered disabled and therefore have been given medicare, but I can't use that for any back related doctor visits. unfortunately I have to go to their work comp doctors and that is only if I get them to approve it. I'm affraid that they might send me to a doctor that they know does not prescribe anything and I will be even worse off than I am now.
I've been fighting with them for the last couple of weeks to send me to a new pm doctor but have not had any success yet.

 
Old 12-11-2006, 09:10 PM   #6
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Re: desparate need pain man advice

Ask your doctor about:

Celebrex

200mg per day, non narcotic analgesic/antiinflamatory


Nortriptyline

50mg at bedtime, antidepressant with a pain releiving action, also helps you sleep

More adequate doses of a long acting opoid or a referal to a pain management specialist.

 
Old 12-11-2006, 10:12 PM   #7
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Re: desparate need pain man advice

Hey EJ, A lifetime ago, 15 years I traveled to Duke University and opaid out of pocket for my own IME. It comflicted with all the BS comp docs told me and turned my case around. I read about going to comp IME's "INdependent medical eval" but how can it truly be independent if it's a comp doc. Docs paid by comp insurance companies have very lucrative contracts to see and manage comp patients and comp patients are treated very diifferently than say an HMO patient.

IN my state, a doc that takes medicare can't see you as a patient if he knows you have medicare. He must make a record and bill apropriately to medicare. Look into what it wouldcost focash to get your own IME and reecomendation. Even if the guy recomeds you for a pump, your s atep closer to finding an answer. Most likely a pump doc. You can get list from Medtronics of docs certified in your area and they would probably want to try LA orals before doing something as extreme as a pump. If someone from a respected University hospital has a different opinion and suggest a different treatment plan, your lawyer wil have something to work with. At this point you should have a lawyer.

It was worth every penny and the 6 hour round trip, for me.He circled every problem area in red pencil and it was pretty hard to dispute that there were visable mechanical problems. It doesn't have to be one of the biggies, Just whatever respected university hospital is close and outsode of your loop of docs. Money is always tight but it's your future that neeeds some investing in at the moment. If you have part D for prescriptions, they may go through under that carrier The reason why I needed a drug was never questioned, like any dentist would be covered. It's worth a try if you can't get help from whoever you see next.

Good luck, Dave

 
Old 12-12-2006, 10:25 AM   #8
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Re: desparate need pain man advice

Well I guess I am screwed now. Just heard back from my work comp carrier. I am perm disabled and they are supposed to take care of all back related doctor issues. I can not use medicare. They just denied me what I consider to be a second opinion. They say that I have been to three pm doctors already. I've been to one who was recomended by their work comp doctor and he was the one who treated me for epidural injection. I've been to a second work comp doctor that they sent me to and he gave me an independant medical exam which is nescassary in order to settle your work comp case. He did not treat me at all and I only went to him once because it was nescassary for his testimony on behalf of the ins company. The doctor I am seeing now is the doctor they sent me to in order to handle my pain management after settling work comp case. He is the only one in my opinion that I have been seeing long term and the only one they will allow me to see.
He is the one that thinks two percs a day is more than enough to handle my pain. He is the only one that has evaluated me and decided what I need to control my pain on a long term basis. I don't know what to do now I am at the mercy of this 35 year old inexperienced doctor and the wonderful world of work comp.

 
Old 12-12-2006, 08:52 PM   #9
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Thumbs up Re: desparate need pain man advice

find a pain management dr that takes cash and pay for it yourself and maybe later down the road you will get your money back because pain is the 5th vital sign and you don't have to just sit in pain. I was in the same boat ,my insu would only allow me to go to 1 certain dr and he would only give me 3 5mg lortabs a day,i just borrowed money and saved some up and went to see another dr. i called this dr first and explain my problem ,that i wasn't getting my pain manged (SP)? they said come here and you will,so i did and i got great results i am almost pain free all the time ,don't just do what they say speak up for yourself. good luck please let me know how this turns out ,get out the yellow pages today and start avocating(SP)? for yourself,kelsey

 
Old 12-12-2006, 10:34 PM   #10
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Re: desparate need pain man advice

i would like to add check with your local county agencies remember there are options for those going through what you are.
Many areas have county clinics that provide care on free or sliding scale, to include dental help. In a pinch when we were insuranceless we used them had good luck there acatuly very surprised at the level of care, in many cases having pharmacies on premisies that filled scripts right there.
Also look to United Way in your area that has a slew of possiblites as well as information on services that you may find useful.

 
Old 12-13-2006, 09:27 AM   #11
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Re: desparate need pain man advice

I just got done talking to my lawyer who handled and settled my work comp case. She is going to write the ins carrier to request I get another doctors opinion on pain management. If they still deny me she said I would have to file a motion in front of the judge. They are suppose to treat me for all future back medical needs. I am afraid of what kind of treatment they are going to provide in the far future. It has only been a few years and already they are trying my patience and denying me treatment. If I don't find another work comp doctor that is willing to give me the nescassary pain medicine I fear that I am going to be in big trouble. Work comp really stinks. I also would like to try other medicines like the ones they have for nerve pain issues. I havn't tried any of that and they won't do it. Isn't pain management suppose to be a trial type practice to find out what works for me.

 
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