Advice in talking with Pain Management Doctor - Pain Management Message Board

Brettman · 03-09-2007, 12:39 PM

Hello! I have 7 herniated disks in my back - from T-12 all the way down. I've recently changed PM Doctors due to my old one leaving to take a new position elsewhere.

I was taking MS-Contin, but this made me very sick. I take Vicoden for breakthrough pain. The new doc seems very nice. At least he hasn't treated me like a "drug seeker". I mean, they do have the MRI's and my history.........but anyways, I told him that the MS-Contin made me sick, and he gave me Dilaudid. I take 8mg every 12 hours. This also makes me sick to my stomach.

Should I get information regarding different pain medications and ask him to try different ones? I don't want to be treated as a "drug seeker", but have friends that have back injuries, and both have said I should try Oxycontin. I've read up on this and see that it has a bad rep. but I need meds so that I can function and relieve my pain.

Should I ask the doc about this med or would this be a strict "don't". I usually just take whatever is presecribed and shut my mouth. However, I can't take the nausea and upset stomach. I do not do good with Morphine at all. I've tried Oxycodone in the past, but asked to have it changed as I didn't like the way it made me feel. It did work good on my pain though, and at this point, I'd try to get used to the feeling to get relief.

I just need some advice on open communication with the doc. I don't want to say anything or suggest anything that would cause damage.

Is it ok for a patient to ask about certain pain meds, and ask to try them since they've heard they work? Or do I just continue to grin and bear it? Any thoughts/advice would be greatly appreciated!

Thanks!

Brettman · 03-09-2007, 01:33 PM

I did let him know that the MS-Contin made me sick, and he did switch me to Dilaudid, which I've only been taking since this last Monday. But now this is making me sick too.

So you think I can ask to try something else? that's ok? I will make sure I take all my other meds with me......I haven't taken the Dilaudid today, and I finally got rid of that sick, nasty feeling. So, I don't want to take any of them.......

ibake&pray · 03-09-2007, 02:02 PM

Sometimes it takes time for you to adjust to taking the meds also. Have you tried taking them with food/without food? Have you tried taking them before bed? Before I went in and told my PM I didn't like the ones I was on, I tried taking them all the different ways I could to see if I could tolerate them any better.

I wanted to be sure that I have given the meds a chance to get in my system and to get use to them. Sometimes it takes a couple weeks to settle in. Just a suggestion.

I would take a list of what you take, have taken, how long and how they affect you. You don't want your dr. to think that you are just shopping for the latest "in" drug to be taking.

good luck...

babs17 · 03-09-2007, 02:42 PM

I think ibake&pray just gave you some REALLY GOOD advice. That's actually good advice to talking to ANY kind of Doctor. They like to see that you used your head, and didn't just jump to a thumbs down conclusion. I am sure that many people have that reaction to Dilaudid, and your doctor probably has seen that after patients use the drug for a few weeks, the side efffects tend to subside. So, Try to take the med all different ways, and times of the day. Any Doctor wants to see that the patient gave his suggestions/scripts a good couple of rounds before its time to change.

Believe it or not, there are so many people out there that give up quickly on doctors's suggestions, or do it the wrong way when they get home....then they freak out on the doctor. You sound like you care, so this is not about you. LOL. But wow....I've seen this in action, many people try something one time and find themselves to be an expert on all the negatives about the med, or a PT experience, or a brace thay have to wear. This makes Doctors very upset... and it should. They have a degree in helping people thru educated decisions. Many people just like to undermine that authority and complain how things "don't work" all the time. All they want is to see that you are trying to make it work.

A little trivia: The #1 problem that Docotrs have with their patients is that the patient does not follow his instructions/scripts as insructed by the Doctor. #1 problem of the Patients to the Doctors were the extended time in the waiting room issue...this was a recent survery I read in a health magazine.

TraveltoSL · 03-09-2007, 02:50 PM

Hi there,

I agree with Bake/Pray that you have to be careful and just ask for just specific medicines sometimes and let the Dr. use his expertise in helping you with your pain. This is NOT to say that you shouldn't tell him about your upset tummy, but from what it sounds like, you are sensitive to most medicines like I am. That's just something I have to unfortunately live with and be very careful about having it with food, carrying crackers with me at all times, TONS of chewable Rolaids that are in my purse, kitchen, car, etc.....Again, not saying that you should always keep an eye on your tummy and keep track, with the Dr. on how much Acetamenophin (sp?) you are taking for your liver.....and make sure you don't develop an ulcer..... But again, ALL medicines have some side effects and it's really trial and error with which one's have good pain mgmt....(getting to a 4-5 for me personally is FANTASTIC!!!) and living and managing the upset tummy, fatigue, etc...that comes with the chronic pain package....

I don't think it's realistic that you will find a medicine that makes you feel all happy, energetic, warm and fuzzy, with no side effects whatsover....it's just the degree of "yuck" effects with taking such strong narcotics.....and then praying and working with your Dr. to get your level down to an acceptable level for pain and then managing and changing your lifestyle, eating habits, sleeping habits, work, life, etc. to really live a good and happy life WITH the pain....

You mention that Oxycodone didn't make you feel good...what exactly did you mean by that?.....Oxycontin is oxycodone without the Tylenol added.....

Also, I agree with others that you really have to give the medicine much more time to get used to it....a month is actually a good amount of time as I'm sure your Dr. will tell you to really work out the major "kinks" and side effects to decide what you can deal with....

You said that you stopped taking the Dilaudid and it hasn't even been 7 days on that....It might start to look bad if you keep only taking the medicine your Dr. is prescribing you for less than a week and keep asking for the next stronger thing....Again,,,,not that you don't NEED something stronger....but as we all know here with Chronic Pain....we have to really watch everything we do because in our world...we are guilty until proven innocent....it's just the lay of the land.....

So, unless you had the most awful experience ever with severe heart issues, throwing up constantly and not getting any food or water down for a day or two.....it's really not a good enough reason to stop taking a med just because it makes you naseaus...there are other meds that your Dr. can prescribe if necessary or OTC medicine that I take to help with your tummy issues and deal with it better...

You said that you take Vicoden for BT...so if that is not making you too sick then I would suggest asking for a long acting medicine with the same property of Hydrocodone....since it would be the exact same medicine minus the tylenol....

It took me awhile to find the right combination (meds plus lifestyle) to get to a 4-5 on the pain scale along with my 3rd major fusion surgery for my neck ( they went in through the front and the back this time)...and keeping healthy with my food choices, yoga, exercise, sleep, PT, stress management, drinking lots of water, etc.....

The medicine I take...after 3 surgeries in 4 years and all of the above non medicine things, is Oxycontin 20mg, one every 8 hours...Percocet 7.5/325 one to two every 4-6 hours but never more than 8 a day to keep my tylenol in check...Robaxin as my muscle relaxer, and Cymbalta for nerve pain and then Ambien to help with sleep when needed....
As Shoreline as others will say too, you also have to show your Dr. what else you are doing to manage your pain that doesn't include medicine and work with him to find a TOTAL BODY/MIND plan that will work for you instead of just asking for medicine after medicine so that you can be a participant in your pain management along with your Dr...

BTW...have you done PT, injections, shots, traction, surgery, or anything yet to maybe help fix some of the herniations? Just curious....

Hope that this can help some and that I don't come across harsh but want to be honest about what it can "look" like as you qouted in your post, sometimes when we just ask for certain meds....

I really wish you luck in finding a great pain mgmt. plan that can help you live the best life possible and I'm sure you will great some wonderful advice from others on this board as they have been so helpful to me...

Blessings,
Ingrid