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Old 05-15-2008, 04:41 AM   #1
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Round1 HB User
12 month neuro appointment - didnt have to mention pain management

Well had my 12 month appointment for my fusion of L4 L5 L5 S1.
I cannot believe that 12 months has pasted since the operation that I thought would give me back my life. Well I thought that I would have a better quality of life. My main concern was re: the pain management meds, but as suspected didnt even have to mention. It was more yes my work is okay, everything in the right place. He was really really nice and as he said his work looks fine, but unfortunately x-rays dont show pain. I said how there was little improvement since I saw him last, still struggling to stay up (cant). But I had found a new physio and was pleased with her. He told me I was fused, so be as vigourous as I needed to be and not to be afraid of the fusion.

Dont get me wrong I has glad to hear that I was fused, but to be honest I am fused but still have pain. I know if I wasnt fused it would be a concern why am I not fused at 12 months, but I suppose the pain is still there and that is what is putting a damper on things. Actually today I am quite down, I am sore and I feel today is going to be a battle to get thru.

At present I am taking 20 mg of Oxycontin and 12 hours later another 20mg.
25mg of Amytriptline at night, I have found the amytriptline is making me so tired the minute my head hits the pillow I am gone, just wondering what dose some of you are taking re the Amytriptline. I was told to increase the oxycontin to 30 mg now. But I feel the amytriptline is doing me good and need also to increase but was told to monitor it myself. I have 10mg of amytriptline so i can increase by 10mg but I am afraid that 35mg will totally zonk me !! Do just wondering what mg's some of you are taking.

Thanks for your help. Not really making much about the 12 month check-up !! Sorry yes, one good thing for all of us is he did say, its over the years you will notice your improvements and looking back you will say god I couldnt have done that 2 years ago. So he told me get moving with the physio stay active as much as I can and exercise, he did realise yes vicious circle, sore, can't exercise but do as much as you can.

thanks
round1

 
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Old 05-15-2008, 08:54 AM   #2
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Arthr Itis HB User
Re: 12 month neuro appointment - didnt have to mention pain management

Round 1, it is a good thing the surgeon did a good job and is happy with his work. I had the same thing after my c-7/t-1 fusion. He was very proud of his work. Why am I still in pain? He couldn't answer but he was very pround of his work! They even told me that I could do whatever I want that I wouldn't hurt the fusion. Why does it hurt like heck ? They don't know but he is very proud of his work!
Fred

 
Old 05-15-2008, 09:01 AM   #3
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Re: 12 month neuro appointment - didnt have to mention pain management

This is good news.

At least the guy didn't hassle you.

I really wonder about this pride in workmanship. You have to wonder what the goal is in this kind of surgery. If it isn't relief of pain, then why bother. Heck. I've got spiders in the house. So I bring Orkin out to spray. A month later I still have spiders. But the technician says "man, I did such a good job of spraying - you'll just need to take consolation in my workmanship."

This is when you know that a doc isn't treating you, he's treating the condition. I want docs that treat me, take care of me. And that means the care doesn't start with the anesthesia and stop with the recovery room.

Thanks for letting us know about your appointment. I was looking in this morning to get the update, and so glad I did.

steve

 
Old 05-15-2008, 10:01 AM   #4
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Re: 12 month neuro appointment - didnt have to mention pain management

Round1, It's good to know that you are fused and everything is in the place that he intended. That being said, like the rest, I have to agree that the surgeons don't really seem to pay attention to what goes on after, as long as they can be proud of their "work".

This is where your new PM comes in. I can't remember (I have Halfheimer's) if you have spoken to your PM about splitting your Oxycontin into 3 doses, instead of 2, but if it is an option that he is OK with, I would highly recommend it. The coverage is just so much better. Especially with the physio. You have those sessions during the day, which is that window of time where you are in between the "life" of your morning and night-time doses. Having that mid-day dose might do a lot to improve the relief you get.

It's up to you and your PM, but I just thought I'd throw it out there. Take care and I hope you can get into a routine that works for you. When I took Amytriptline, I was on 10mg. at night to help me sleep. But I had unpleasant side effects, so I stopped after about 6 months. I've found Xanax or the Klonopin that my psych doc Rx'd, to be a better sleep aid. But that's just me.

Take care friend. Is school almost over for your little man? I was looking at our photos last night, from our trip to Eire, and I would come back tomorrow, if I could. It's such a lovely place. My favorite bit, being the coastal areas that we visited. Any more news re: the AA diagnosis? I've been wondering.

Rest up when you can. Hugs to you, CMP/MM

 
Old 05-15-2008, 10:34 AM   #5
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ms_west HB User
Re: 12 month neuro appointment - didnt have to mention pain management

Round1 did he do xrays or a scan to make sure you are fused?

 
Old 05-15-2008, 11:20 AM   #6
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Re: 12 month neuro appointment - didnt have to mention pain management

Hi there, thanks,

Yes it looks like my neuro is very proud of his work and also the scar that you can barely make out !

Okay cmpgirl, yes I would love to be on a 3 times a day as I feel like the rest of you that it doesnt come anyway near the 12 hour mark. Actually I am after taking my 20mg now at 6 O'clock and it should be 8 O'clock, but I just wanted some relief for when putting my son to bed. I asked and he said no that it covers the 12 hours........... put will push again when I am due back to him I am kind of caught with the amytriptlyne as he said I can up myself and get the GP to do the scripts. So far I have a script for 25mg from him and a script for 10 mg........and 25mg from my GP !!!! Know I know i wont be taking that amount !.

I think you ment Ankylosing Spondiliies A.S. rather than A.A. that gave me a laugh .... I had the x-ray done last week, unconfirmed report that there is no A.S. in the Pelvic area. Then a friend of my sister who sounds just like the way I am complaining said that was her 10 years ago, and she has A.S. and said for her it only showed on an MRI so I really dont know what to do.
I was reading up on it and it said that early stages dont show up on x-ray but on an MRI. But to me I think I would be an advanced stage suffering 6-8 years now. So for the moment I am putting it on the long finger. But still watching out for it............. I think if I have a rhemy saying no i dont have it. My Gp telling me no way, but then surprised that I have the positive test. Dont believe him, get my PM to do an x-ray, and now saying no sorry I need an MRI, they really wont take me seriously its has if I am not happy been told I dont have it !!!. cmpgirl, No the schools here are finishing the end of june.......8 weeks off. If you do make it to Ireland again you have to give me a shout.

Diet, it was just an ordinary x-ray that it showed the fusion. Do you think it should be an MRI to see how solid ?????


So Yes Neuro proud of his work, but I feel like a toy that doesnt work after the batteries have been changed in.

 
Old 05-15-2008, 11:34 AM   #7
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ms_west HB User
Re: 12 month neuro appointment - didnt have to mention pain management

You can see fusion on an xray but it is my understanding that the best clarity comes from a CT or a CT Myleogram scan.

Does your doctor give you the 20 mg. tablet or the 10 mg tablet?

Last edited by ms_west; 05-15-2008 at 11:35 AM.

 
Old 05-15-2008, 12:47 PM   #8
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Re: 12 month neuro appointment - didnt have to mention pain management

Hi diet,

I see, no he was happy with the x-ray result, so I suppose if he needed to check it out he might have ordered a CT, was wondering what your view on it was, but like how sure can he be of it been solid solid.

I know my scripts are a bit hard to follow as very time I see a GP or P.M. I get a script.

My Rheumy guy that I went to re: A.S. gave me a 25mg script for Amytriptlyne: Got them, didnt take as I thought it was a high dose to start with.

P.M. Gave me a script to start the amytriptlyne at 10mg he said I would be blown away on 25mg. (I am tall and very thin). So I started on 10mg then increased it to 20mg. Now I am taking the 25mg. So I still have 10mgs so I can increase to 35mg......... He just said keep going up to a level that I am getting relief from. He gave me the guideline of 30mg for the oxycontin morning and night, but he wasnt saying for the amytriptlyne..........

How are you doing diet? Are you using the chair near the oven to slid your stuff into the oven?

Round1

 
Old 05-15-2008, 04:59 PM   #9
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Re: 12 month neuro appointment - didnt have to mention pain management

I am hanging in there. Still high level of pain. I can't wait to hear my results next Friday. I must admit I am a tad concerned because the amount of upper back pain and burning pain down my arms is extreme. My pain is normally nerve pain down the legs and the lumbar back. Now I have both.

Actually I am having the children put stuff in the oven and take it out but hubby has been doing more grilling and we have just been adding salad and bread to it. Nice quick easy meals. No more fancy cooking for me.

I almost think you should consider spreading your dose of meds every 8 hours versus 12 hours and I think you would notice a difference. This oxycontin does not last 12 hours. For instance if you are supposed to take 30 mg every 12 hours. You might consider taking 20 mg every 8 hours. This would keep your blood plasma levels up around the clock. Just a thought.

 
Old 05-15-2008, 05:37 PM   #10
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Re: 12 month neuro appointment - didnt have to mention pain management

round as isn't just mri's. It can be based on lab work evaulation as well as xrays and in some cases gene testing.
I understand your frustration of why the pain even after a year ( or in my case year 2 after surgery) > Well as/or any form of artihtus can appear and be anywhere. I know it was frustrating going through surgery and being no better off. Soft hugals.
By the by my 2 level fusion was 2 years ago and i was eventualy diagonsed with A S . I do feel as if the first year after surgery was some of my worst times .
I want so much to say something wonderfully encouraging to you, but at this point all i can think of is no You are not alone.........

 
Old 05-16-2008, 12:23 AM   #11
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Re: 12 month neuro appointment - didnt have to mention pain management

Nortriptyline or Protriptyline will be as helpful with the pain as amitriptyline, but wont make you so groggy. Nortriptyline is moderatly sedating, protriptyline is nonsedating, actualy it is stimulating, so would be taken in the morning, in a dose of 10mg or so.. can be pushed to 20mg (thats an antidepressant dose)

 
Old 05-16-2008, 08:34 AM   #12
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Round1 HB User
Re: 12 month neuro appointment - didnt have to mention pain management

Hi thanks for your replies.

Zoey1 - I would love to know how you were diagnoised with A.S. I have had the blood test and positive for HLAB-27 saw a rheumy guy and he didnt even entertain in. Didnt even do shuber test (might have the wrong spelling of that). I said how my range of movement and mobility is so bad. He said that was due to the fusion but it isnt as I was like that before the fusion. He told me no, its F.M. So my pain Management guy said no that is total rubbish its not F.M. so I went an got an x-ray done which should up okay for the pelvic area, but then nothing was done for the upper back....... so where do I go from here. Would you be able to advise me, or just let me know how you got diagnoised. Thanks.

Diet I really do think you are right and I know a number of you have said it on other posts about doing the meds every 8 hours. Yes I really do think I will do it. I am just going to make sure I have enough meds to last the month if i do it. I already mentioned it to be G.P. he said it made sense, but he would wouldnt change what the pain management guy ruled. I had said it to P.M. and he said no no no.......... so I will just have to go knocking again untill he listens I think.
round1

 
Old 05-16-2008, 10:00 AM   #13
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Re: 12 month neuro appointment - didnt have to mention pain management

I am not a pm doctor but I tried it based on Executors suggestion and I have to say I noticed a major difference.

 
Old 05-16-2008, 10:31 AM   #14
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Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: 12 month neuro appointment - didnt have to mention pain management

Quote:
Originally Posted by 123dietdrpepper View Post
I am not a pm doctor but I tried it based on Executors suggestion and I have to say I noticed a major difference.
Where can I send a bill (LOL).............

Ex

 
Old 05-16-2008, 10:55 AM   #15
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ms_west HB User
Re: 12 month neuro appointment - didnt have to mention pain management

You can send it to Round1. LOL

 
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