new to thread, scared

[captnanny]

Hi,
I am a member of the spinal disorder posts and just had neck surgery five weeks ago. I had, have been on many different pain meds for the past three years, right now I'm on the duragesic pathc. My pm doctore says that I have never been at a level 4 before in three years so it is time to start lowering my dose. I am scared to death of the pain coming back and just not feeling good. Is this normal? I do not "conciously" want to stay on pain meds. In fact if this works I'll be so excited. Has anybody else had this experience, panic of going down on meds?

[ozzybug]

Hey Captnanny-
Welcome to the board. (I always kind of feel bad for saying that because it means there is yet another person suffering chronic pain)

I am so sorry you are facing the fact that your doctor wants to lower your meds. I just want to ask something though. You stated that in 3 years, you have never been at a level 4. Does that mean that in 3 years your pain has been below a level 4 on the 1-10 pain scale, or has it been staying above a level 4? I didn't quite understand what you meant by that.

Has the patch been keeping your pain at a managable level, or have you needed increases in it, or in any break through meds? I ask this because there is this new and very scary (for pm patients anyways) research which is telling doctors that people who are on pain management and have been taking opiates for an extended period of time are actually not in real pain, but are feeling increased pain because of the medications! They are saying that to fix this, the doctors need to take the meds away. They are calling this thing "opioid induced hyperalgesia". There is too much more to the story that I can't go in to here, sorry about that. (too many details)You can find more information about it though.

I have been in pm since Oct. 2006, and the only opiate I take (was taking) is Norco 7.5/325 mgs, and at my appt. in February, they switched me down to Norco 5/325 mgs, and started talking about this hyperalgesia. I was floored, because I have never asked for an increase in pain meds, and have never once told them my pain is increasing. Now, they are talking about doing away with using opioids all together and it scares the "you-know-what" out of me. (I won't go into all my details because this is your thread)

Please give more details (if you are comfortable with that) about your condition and how long you have been on pain meds and such so we can get a better picture of what might be happening with your doctor wanting to lower your dose.

I hope and pray that if the patch brings you relief and helps you to function a more normal life, that your doctor will NOT lower your dose. Take care sweetie.

[captnanny]

thank you,
I just had neck surgery, ACDF two level fusion with donor bone, in hard collar still. PT three times since. 4 is the lowest pain level I've been in in three years, Prior to surgery it was at a 10-12.
I've never heard about that abot doctors saying it;s the meds giving the sense of pain. What I don't understand and maybe PM doesn't understand is that I just started pt, still really fresh out of surgery and have been on some type of narcotic for three years. If she does not know that then I need to talk to her. Just talked to my psychiatrist and he does not think I am ready to go down because I am someone who freaks out very easily and he wants me to come up with a plan with pm, therapist and him for when I go down. I do want to be drug free. I am so relieved that I can actually have pain free days now. I know you can't stay on these meds forever and physiologically it is true that once you come down, you get a false sense of pain which can be treated with clonidine, motrin, heat and just knowing your body is trying to get you to go back up. Three years of vicodan, ultracet, oxycontin 40-120, comunox, tylenol #3, norco, now duragesic, I don't know what do you guys think, my pain has been at a lower level for four weeks, is it too soon?

[rayefaye]

Hi captnanny, my doctor said the same thing to me on my last visit and I was like ozzybug, I didn't ask for an increase or don't take a real strong opiate. But Thank God my husband was with me because when he started talking about taking my pain medicine away. He let the doctor know in no uncertain terms how bad I hurt everyday and some days I couldn't hardly get out of bed or even hardly walk some days. The doctor changed his tune real quick like and didn't decrease my medication. So my advice to anyone who suffers from chronic pain, next time you go see your doctor, take someone with you who witnesses your pain everyday. That what they can speak on your behalf and let the doctor know it's not all in your head.

[BrittleBones]

RayeFaye's idea of taking someone with you who can testify to your pain is an excellent idea! I know from personal experience that each time I've brought my husband to my pain management appointments the doc seems to act like I have more credibility because hubby is with me. Now, I suspect that many times male doctors tend to discount the pain complaints of women. I've experienced this situation many, many times in my life. BUT...when I've had a male with me and the doc is male....well, that's a totally different story and usually ends on a more positive note for me as the patient. I still have one doctor (my spine surgeon) who WILL NOT look me in the eye when I'm speaking to him or he is speaking to me. He constantly looks at the floor - and he has ABSOLUTELY NO bedside manner. The funny thing is, when I bring my husband with me (which is almost always), he will talk directly to my husband. Keep in mind that I'M the one asking the questions, but he won't respond to ME! He will only give the response to my husband, as if they were the only two people in the room. If he wasn't such a phenomenol surgeon, I would have switched docs long, long ago. KathyMac