Do you have an answer for me? - Pain Management Message Board

Moldova · 06-27-2008, 10:10 AM

Hello everybody! I hope new day brings you some relieve...

I had yesterday an app at my surgeon's office with his PA. She is very knowlegable, works for many years at his office (HSS) and very nice (nice combination for a change, is in it?

)

She told me something i still think about and still confused. Maybe someone here can explain me in plain English what his means.

I will put (?) where I need help understanding.

She said that people who on narco meds for a long time have different understanding of pain (?) because if I wouldn't ever been on them I would tolerate pain better or maybe just taking Tylenol would help.
I asked her is this means that pain is in a people's head only? She said NO, this just means that body gets used to narco meds and if you take something like Advil or Tylenol will not help you anymore because your body got used to strong PK. She said this is type of addiction.

I heard that and got upset. Very nicely I asked her is she suggesting I am an addict. She said Absolutely NOT, you are not an addict. But your body got used to narco meds and she is afraid if I go off them - nothing else will help me (?). Yes, and what is she suggesting than? What does it mean?

She asked if I think I would be able to go off them and see how will I do, just as an experiment... I asked her nicely if she ever had nerve pain in her legs and feet or if she ever had spinal pains or if she ever leaved without able to walk, sit or stand .... She said NO. I said: "O, that is why you suggest me to go off them not even 6 month post second fusion.".
Plus, how does she know that my body got used to it? I still take same dose as I took 4 month ago, I try my best not increase the doses, hold to take BT as long as I can even through a lots of pain...

I don't know maybe I missunderstand something here or maybe just over reacted, but something bothers me after talking to her...

What do you think? Any advices?

Thank you in advance all...

sandim · 06-27-2008, 10:40 AM

Moldova,
I think she was suggesting that you take a "drug vacation". In other words, she wanted you to agree to go off the meds for 6 months, and to see how you do, painwise and living your life wise.
I am no fan of drug vacations. I think they are a bunch of garbage that doctors use to try to get patients off pain meds, and then if they have to go back on them, using that as a basis ( reason) to back up their prescribing.
There aren't many of us in the world of chronic pain, who like taking pills day after day, but we also have come to accept that in order to have a life, we have to take them.
Some doctors, despite their supposed enlightened perspectives toward narcotics in chronic pain, still don't like prescribing them.
If you need them Moldova, then you need them and it sounds like you do. So, don't let her force you into taking a drug vacation when you need the meds to live your life.
Sandi

Fabrashamx · 06-27-2008, 10:56 AM

I think she was talking about tolerence levels, but very badly. I also agree with Sandi that she wants you to take a 'med vacation' which is not well thought of by and large on this board lol.

I would ask her about lateral moves, such as switching from a 5 mg oxy to a 10 mg hydro (just an example) sometimes doing things like that slows down tolerence levels, and in a way where you are not thrown into pain and withdrawal, Even though it wont stop tolerence building up completely.

Even when you go off of a med, and then start again, tolerence plays a part, you would not be as tolerent as you were when taking them daily, but you would build a tolerence much faster than someone who had never taken opiate meds before.

Good luck and hang in there, I am sure you get more and better advice from the rest of the gang soon.

Your Friend, Fabby

cmpgirl · 06-27-2008, 11:05 AM

Moldova, I so agree with Sandim. I also do not believe in med vacations or holidays, as they are sometimes called. I would love to know who came up with that little euphamism! Going through withdrawl and having constant uncontrolled pain is no holiday in my book! I know there are some here on the boards who can see a positive side to this, bit I really think it depends on the person and how they tolerate pain and/or withdrawl symptoms.

If a person can set aside days weeks or months of their life to go through a transition like this, more power to them. But if I did not have my meds along with the other things that I do to assist in the management of my pain, I would be bedridden and of no use to myself or my family. I would never be willing to make that kind of sacrifice!

I don't know how your actual doctor feels about this. Is is just this PA who is suggesting the change? Or is she opening a dialog for your doctor? If this is something they are insisting on and you are not comfortable with it, I think you may want to seek out a different PM doc. I know this one is affiliated with a major hospital and has a glowing reputation, but it does not mean that he is the best physician for you and your needs. Not all doctors can be all things to every patient. It really sounds as though he is looking for some justification for prescribing narc meds. Maybe the DEA is on his back or something. Even if that is the case, I don't feel like you should have to pay the price. Just my opinion.

I'm so sorry you had to go through that. I don't blame you for being defensive and confused. I would have been too. It would have made me feel exactly like it did you and that is just not fair of this PA to make you feel this way. I hope you can have an open and honest talk with your doctor soon and let him know how this has affected you. Just because he has an MD after his name, doesn't mean he knows everything. And if he is worth the oath he took to first do no harm, he would not put you through something like that. Again, just my opinion.

I'm sorry I got on my soapbox. It's just that every time I hear of someone going through this kind of thing, it really gets my hackles up! Please know that I am here for you and keeping you in my prayers, as always. You are one of the kindest, most caring people I know and I am so sorry this is happening. Please keep us posted as to what you decide to do. I am here if you need anything. Very fondly, CMP/MM (((((Moldova)))))

Moldova · 06-27-2008, 11:20 AM

Fabby, Sandim, thank you so much for your respond.
I understood that she wants me "to try" to leave without them for a while.
I had my last MRI and ex-ray with me; when she took a look at them she said: "O, my God, I can't believe with all this you still smile". She had resident in a room and told him: this lady is very strong, she has so many post-op complications and never complains; I wouldn't be able to go through this with a smile like you always do.
And also she told me that to have a spine I have and Arachnodities -I will never leave without CP.
If any of you know - Arachnoidities is the worse case scenario for anybody after spinal surgeries because this non-curable non-treatable condition drive people to full debilitating state;stronger and more PK needed during their life because more and more nerves get severely scarred in a spine and extremedies. And on top of everything I am going now through a lots of tests because MS suspected!
How can I leave without pain meds? I wish I could, I really do. But just the thought fears me because I don't see how this possible. Dr Camissa who is my surgeon told me before my second surgery that I better have some savings because I will need pain meds for the rest of my life...
I wonder why would she even suggest such thing to me. Don't know why but for some reason it disturbed me... maybe I am just silly?