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Old 05-21-2009, 10:09 PM   #1
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Injured Myself Bad-Could I Ask My PM For an Increase?

I have a herniated disk in my neck touching the spine and my lower back has DDD, Bulging Disk, Annular Tear and Scoliosis. I finally got my meds right with the PM; taking 50mcg Fentanyl Patch and Percocets 10mg for BT 4x/day. Things have been great up until I went on vacation!!

I love to workout and have no problems doing it at home although I have a lot of aches and pains afterwards but I can handle it; feels like I've come numb to it at times. Anyway, we went to visit the in-laws and I worked out on the treadmill at their club house within their community. The first day my back hurt kind of bad but ignored it. Second day I was completely debilitated and was in tremendous pain that whole day plus another 5 days. I haven't felt this kind of pain since the beginning. My back was throbbing with pain no matter if I sat, stood or moved. I couldn't sleep or walk without such pain. We drove home from my in laws which was a 12 hour ride; it completely killed me!! Here I am 10 days later from the incident and now my neck hurts bad and have pain going down my back and can't turn my head.

What the heck did I do? I was on the treadmill for 40 min each time but I know that this treadmill had zero shock absorbancy (it was a real hard ride)whereas mine at home is one of the best shock absorbancy treadmills out there and never once had gotten an injury from it. The thing is that I've been taking more BT than prescribed and now will be short. I just got back from vacation yesterday...I've been hesitating to call the PM and explain what happened but I'm afraid they're going to tell me there's nothing they can do for me.

Two ?'s...

I see some people on here taking 15 mg Percocets; do you think that the PM would prescribe that to me since I'm taking the 10mg and they're not doing so much with this injury? Should I call my PM and request additional meds/increase before my appt which is in 2 weeks?

Second ?; did I really screw up my neck and back? It's far more worse than what I was first going to the PM. The pains aren't going away, in fact getting worse as time is going by as I said with my neck. Before I was able to function with the meds I'm on. I was still in pain before but it was bearable; but now is a whole different story. I wouldn't be able to get an MRI until next year for insurance reasons (can only get them once a year) to see if anything has shifted/changed.

Has anyone have experiences with injuries on top of your injury? What did you do? Your advice/response would be very much appreciated!!

 
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Old 05-21-2009, 10:40 PM   #2
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

Quote:
Originally Posted by cheryl810 View Post

Two ?'s...

I see some people on here taking 15 mg Percocets; do you think that the PM would prescribe that to me since I'm taking the 10mg and they're not doing so much with this injury? Should I call my PM and request additional meds/increase before my appt which is in 2 weeks?
Sorry to hear about your injury. Sounds like you are in a lot of pain. Do you have a pain contract? If so, it should spell out exactly what the protocol is. It will also depend on the relationship you have with your Doc and what type of Doc he is in terms of his rigor.

Normally, PM docs do not increase or change meds in between appointments, especially by phone. Additionally, running short could cause you to be discharged as a patient, that's why I suggest you refer to your contract. You need to be very careful with this as this situation could be perceived wrong. Both of these situations are what they call "red flags" in PM.

If you've been injured and feel that things have changed, you should seek the immediate services of the ER or your PM Doc. Some PM Docs just treat pain and don't really diagnosis. Conversely, some do it all.

If it were me, I would call my PM Doc and tell him I've injured myself severely and thus, need to come in right away....Or ask him what he recommends you do given the injury....That you can't wait for the next appointment, given your pain levels. He may or may not see you....He may refer you to the ER. If so, then you should go. Showing up at the next appt saying you didn't seek the services of a Doc for your injury, but ran short on your meds, probably wouldn't go over to well. Not seeking medical attention may be perceived that it's not that serious.


Quote:
Second ?; did I really screw up my neck and back? It's far more worse than what I was first going to the PM. The pains aren't going away, in fact getting worse as time is going by as I said with my neck. Before I was able to function with the meds I'm on. I was still in pain before but it was bearable; but now is a whole different story. I wouldn't be able to get an MRI until next year for insurance reasons (can only get them once a year) to see if anything has shifted/changed.
Unfortunately, it's impossible for any of us here to know. I don't mean to be evasive, but it could be anything. It could be a short term sprain of some type on top of your existing injury and given your sensitivity to pain due to being on meds already, it feels worse than it is. Or, it could be some very serious injury......Or a whole lot in between those two scenarios.

Regardless, you need to get it check out. And, if the pain continues on the way you describe, I would think you would need some diagnostic testing at some point. Otherwise, it's just a guessing game.

Your first step, however, is to get your PM Doc on the phone and find out how he wants you to proceed. The med you inquired about can't be called in to the pharmacy, so if you need something in that strength range, you'll need to pick up a hard copy. Most PM Docs won't write scripts without seeing the patient first. Again, I would refer to my pain contract on the Doc's protocol. Usually, the contracts spell all this type of stuff out so there isn't any misunderstanding.

Best of luck with this, and I'm sorry you were injured. Quite often in PM, if it's not one thing, it's another.

Regards,

Ex

Last edited by Executor; 05-21-2009 at 10:44 PM.

 
Old 05-22-2009, 06:46 AM   #3
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

I just think that anyone that has been on a treadmill or any kind of workout equipment should know how it can really do damage to your back and knees. Now with pre-existing injuries and running (something I didn't really consider at the time) can do double damage. It could be that my problems are worse than what the MRI results indicate. If I do any sort of exertion; my back hurts like hell. But it all started with this "old" treadmill. I felt it as I was running on it that it was such a hard contact as if I were running on the street outside. This is why I don't run outside; it's too painful for me.. Whatever it was it really messed me up and/or shifted some things. I think that to someone that doesn't have much knowledge on excercise/workout equipment would I guess think it's minor. For the "pros" or the educated in this area would understand the damages it can cause and can relate to what I'm saying... (I'm sure there's someone on these boards that workout too)
I'm not one to make something out of nothing so for me to say something is pretty big. If it's effecting me this bad than perhaps my back and neck is worse than I'm aware of...
I think I will call my PM to let them know and see what they recommend. I'm trying not to take the BT meds more than recommended but this is rough. I've never had this problem of "running out" before so I don't know what they'll do. In my mind I figured if I explain to them what happened and the fact that I was out of town to call them (forgot to bring their # w/me) they may "help". I don't know if I have a copy of the rules but I'll have to check regarding injuries. If I remember correctly it just says that if the meds were lost, stolen, etc that there's nothing they will do. I don't know what they do if you get an injury and need more help. I mean it would be pretty mean that if you sustain an injury that they'd say "sorry to hear it but there's nothing we can do". Everyone every now and again has some sort of injury and to me just because you're on meds doesn't mean that you don't hurt. Sometimes an injury is so bad that the meds you take don't compensate; such as now. I have a pretty good relationship with my PM office so I feel that I can be honest; which I would hope I can do now. I mean what's the point in suffering and hiding it just because you're afraid they may drop you. If they do that because I'm being honest about an injury and need a temporary increase then I don't think this office would be for me then. If you really hurt yourselft; you're basically screwed? That wouldn't be right!! Thanks for your input and will take it!!!

 
Old 05-22-2009, 11:29 AM   #4
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

You really need to take care of yourself. You aren't going to like what I have to say. Taking the medications does not mean to go out and beat your body up. After all- you are in pain management and if you required PM there must be something wrong with you that you shouldn't push your body so hard that you injure yourself further. If you are taking so much medication that you do this to yourself, maybe you better back your meds down a little and remind yourself that you hurt and have some pre-existing problem.

Take care, if it were me I would call the PM office tell them I am going to ER I have hurt myself exercising - give them the opportunity to ask and have you come to their office. I agree with Ex - you cannot wait two weeks then suddenly tell them you are short.

 
Old 05-22-2009, 01:51 PM   #5
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

This same thing happened to me, Except I went in to see my PM Dr. He looked at me and new that I had injured myself. He prescribed me more B/T meds to get me through the boute of pain. But the next month I was able to decrease back down to my regular amount. In the future NEVER take more B/T meds than your supposed to unless you call the Dr or the nurse and ask permission. I have always been told that if I ever get hurt or need to take an extra pill that I am to call. At this point I would not mention you took more B/T meds than your supposed to because you could loose your Pain management care. it all depends on how strict your DR is. I would suck it up until your next fill is do, and learn from this experience to call next time. Since you were on vacation and got hurt, they probably would have okayed this and refilled your meds early when you returned. Since you have already taken the meds, I would not reccomend you calling after the fact to tell them your out of meds. It will look really bad...Unless you have a great Pain Dr and you have never done this before, and you have a long good histroy with your DR, wouldn't I risk this. It's just not worth it to loose your pain managment over this. Can I ask why you didn't call the DRS office when this happened to ask if you could take an extra B/T med per day? It would have been so much better had you done this. In the mean time when is your next apt. I would call up today and get in as soon as you can so he can look at you. Maybe he can prescribe some other meds for you that arent your B/T meds as I wouldn't chance it. The DR'S are getting so strict these days that it could be grounds for dismissal and I Would hate for that to happen to you. when I hurt my neck a few months ago it was horrible so I called the office and they told me to take more meds until I could get in a few days alter. and than I went in for some treatments a few days later that helped my pain tremendously. good luck I am sorry you got hurt. I feel for you.

SS

Last edited by slipperyslope; 05-22-2009 at 01:55 PM.

 
Old 05-22-2009, 02:19 PM   #6
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

I would definitely call the PM doctor and tell them that you injured yourself while exercising. The doctor is there to treat your pain and needs to know what happened. You absolutely can not take it upon yourself to play doctor and increase your medication because you will run out early. The time to get things straightened out is NOW and not later. If they recommend that you go to the ER then go there and maybe they will at least do X-rays and maybe a CT scan. You could have done some kind of major damage and waiting could cause irreversible harm. I don't want to alarm you but this could be the case.

One other thing to mention is the fact that you need to accept the fact that you have quite a few things wrong with your back and spine and need to find some type of exercise that does not severely impact this area. You are only creating more damage and more pain. The pain meds are not a liberty to go ahead and do any type of exercise knowing you can just keep taking more pain meds to treat the pain. Your body is signaling you to STOP what you are doing because you are doing more damage. It is a very hard thing to accept chronic pain and to realize that you have more limitations than before. This is not to say that you can not work out but you may have to change what you do in terms of exercise. Ask your doctor about exercising at your next appointment and see what he thinks is appropriate.

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Old 05-22-2009, 02:22 PM   #7
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

Cheryl I wanted to mention that the treadmill is pretty high impact for someone with a spine issue. I can't tell if your neck and low back are an issue or just your neck. I one time tried the tread mill and could not handle the intense work out. us spine folks need to do real low impact excersise. the only thing I am abel to do it walk and swim. I can't do anything else or it flares up both my cervical area and my lumbar area. I have problems with both. I wouldn't do that type of excersise anymore and stick to low impact stuff. as you can see it can really injure a person who has spine problems.

good luck, SS

 
Old 05-22-2009, 03:36 PM   #8
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

Quote:
I just think that anyone that has been on a treadmill or any kind of workout equipment should know how it can really do damage to your back and knees. Now with pre-existing injuries and running (something I didn't really consider at the time) can do double damage. It could be that my problems are worse than what the MRI results indicate. If I do any sort of exertion; my back hurts like hell. But it all started with this "old" treadmill. I felt it as I was running on it that it was such a hard contact as if I were running on the street outside. This is why I don't run outside; it's too painful for me.. Whatever it was it really messed me up and/or shifted some things. I think that to someone that doesn't have much knowledge on excercise/workout equipment would I guess think it's minor. For the "pros" or the educated in this area would understand the damages it can cause and can relate to what I'm saying... (I'm sure there's someone on these boards that workout too
Sorry to hear about your injury Cheryl, I guess I'm a bit surprised to hear that someone who appears to have your level of understanding of exercise and its risks would make the decision to continue the exercise if you felt there was a possibility you might be risking injury, by using the older treadmill. As you say, the smallest things can have major consequences.

I agree with the previous posters, making the decision to take additional BT meds without asking permission could be very serious. I do know that most pain doctors find this unacceptable. Since you have a good relationship with your doctor and no previous issues, hopefully it will be acceptable this one time, but I wouldn't do it again.

I do love to hear there are cp patients out there who are able to do this type of exercise. It gives the rest of us some hope.
Feel better, and good luck. I hope you will let us know how things turn out with your doctor.
Kind regards,
Bullymom

 
Old 05-22-2009, 08:24 PM   #9
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

I guess that I'm just not use to having to limit myself down to doing practically nothing! I've had these pains for years but just increasly and suddenly got MUCH worse within the past year. The thing is that I had my last child 20 months ago and am trying to lose this weight still. Prior to being pregnant I was 30 pounds lighter (every women that has gained unwanted weight during a pregnancy can relate). I'm just so desparate to lose this weight and have been doing great with it. As I said, my treadmill at home has been pretty soft on my back which is why I continued to workout. Last month when I went to see my PM; she asked how I was feeling and all. I said that I'm doing so well now that the medications are working; I'm finally able to excerise for the first time since a year. She said that was awesome and refilled the scripts. Nothing more was said and left the office. It wasn't until the vacation that it all went down hill. Yes, I should have listened to my body on day 1 but I didn't. Day 2 I most definitely did and of course it was too late. I didn't have my PM # with me and just figured at the time that I could take "tomorrows" pill today since I don't always need to take all 4 BT pills every day. Well, a few days became 10 days and now will be short. Today is the first full day that I have been home from vacation so I DID call my PM office and explained the situation. They just said "no problem, you can come in on Tues." They didn't have anything open today and Monday is a holiday so Tues they can squeeze me in. I've NEVER had to do this prior and have had no prior problems or situations before so I don't think they look at me as a "problem". I am needing a temporary increase, not a permanent one; at least that's what I'm hoping for. Still today my neck pain is horrible and straingt down my mid back; still can't turn my neck and my back is really bad. When you're in so much pain and in another state or don't have the PM # with you, you just do what gets you through the day. I never once "played doctor", just tried to get some relief. That's why I called my PM today so they can be the doctor!! As I've said, everyone one time or another gets an injury so I took my meds and the next days. I had my family to help with the kids so I can rest; I didn't feel the need to run down to the ER. I'm not one of those people that will run down there for an ache that can be handled at home or something. To me, if I'm open and honest with the PM I feel they look at that as being a good thing. Yes, I injured myself, won't do it again, please help!! If you can't be honest then what's the point of these PM's?? You shouldn't have to feel like you have to suffer all because things didn't go as planned for the month!! Things happen and not always the right way. People make mistakes, a lesson I learned quite well!! But you know what, we're all human and if the PM can't see that I went well beyond my abilities and learned that I have to tone it down then something is wrong with people! You mean to say that you always have to just "suck it up" if things don't go well; that's ridiculous!! You should be able to have an open and honest relationship with ALL your doctors!! If you can't then they're not for me!! I understand that they're are many people that probably exaggerate to get more meds but that's not me! I need to be able to function for my kids and not be loopy on drugs!! I wish I could live the life I had before these problems; it's gets extremely frustrating when you see others doing what you use to do with no problems. I'm only 33, I have the rest of my life to feel like I'm 90; great life to live!!!! I'm suppose to be able to do many things but I can't and gets frustrating!!!!
Anyone that has tried to lose weight or is just so uncomfortable with your weight can understand the "desparate" need at times to lose even if it causes pain. I just figured that the pain would go away as it has in the past. I just did not realize the severity of my problems until now. What makes it so difficult is that I have an identical twin and we both love to excercise so we've been keeping each other sort of in check for years up until now that I can't keep up.
I can understand that it sounds stupid or something to some but this is how its' been for years and workingout it just part of my day.

I have my early/new appt on Tuesday so I'll keep everyone posted. Thank you ALL for your input; honestly it makes a difference!! All of this PM and med stuff is fairy new to me and what seems to be minimal to me is obviously a big deal to the PM; which I'm learning now... Thanks again!!!!

 
Old 05-22-2009, 11:10 PM   #10
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

Quote:
Originally Posted by neckpatient View Post

You really need to take care of yourself. You aren't going to like what I have to say. Taking the medications does not mean to go out and beat your body up. After all- you are in pain management and if you required PM there must be something wrong with you that you shouldn't push your body so hard that you injure yourself further. If you are taking so much medication that you do this to yourself, maybe you better back your meds down a little and remind yourself that you hurt and have some pre-existing problem.
I have to say that I agree. I've read posts on here before where something very similar has happened and the Docs have not taken it well.

Please be careful and don't push yourself so hard. I know it's tough sometimes to accept the life of a CPer, but you have to manage it accordingly. Sometimes, the miracle of meds can make us feel better than we really are, and when they wear off, reality hits.

Take care, and hope you're ok and haven't injured yourself too badly.

Regards,

Ex

 
Old 05-23-2009, 03:47 AM   #11
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

In case something like this happens again and your out of town without a phone number you can use the internet for the number under yellow pages or you can call " 411 " since you didn't have the number with you, it can be accessed very easily via a telephone or a computer. Just wanted to let you know! I would try and not tell the DR you didn't have there phone number handy as we all can use a telephone. Just don't bring it up.

 
Old 05-23-2009, 06:28 AM   #12
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

you're right slipperyslope; I probably could have done that. Well, a very big lesson learned here; find a way to call...
I'm learning that something so simple or ridiculous to me is a BIG deal to the PM's. It's all new to me, having all these problems so badly and just not thinking like these PMs. This is where these boards have been extremely helpful; you guys have given me so much info and make me see things in a mucher different light. I'm learning that every detail matters!! I'm not use to calling my doctors for every little thing. To me it just sounds like I'm being a pesty patient. I don't like to draw attention on myself so if I don't have to then I don't. I'm learning that you have to tell your PM everything even if it does sound ridiculous.

Well, I'll see what they say on Tuesday. I will just go in and tell them what happened, that I hurt myself working out (which many athletes end up doing at one point!) and will explain that I was feeling pretty good to workout and went too far!

It really stinks cause when I'm on the meds I was feeling so great where I felt like a normal person and back to my old self prior to these problems. For the first time in years I felt great, just what I want and need for my kids!! I guess I can't or shouldn't feel too great with the meds so it can be a reminder that I can't push and go too far!!! I guess a little pain should be a reminder to keep things in check and perspective...
When the meds are starting to wear off I feel A LOT of pain so I KNOW that I NEED the meds!!! This is not the life I signed up for but have to make it work with what I've got!! I have to look at that there are people out there far worse than me so I'll have to learn to be grateful for what I have and live with it. It's a hard lesson to learn especially when you have young children that want you to run and chase you/them or to play high interactive games with them! I love to do all of this but will have to watch it now...

 
Old 05-23-2009, 11:28 AM   #13
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

Cheryl,
Glad to hear you gave the doc a call and explained things. I have a feeling that is all that is necessary in your case. I have twin girls and exercise has always been a big part of both their lives, so I understand the passion for it. I have watched my gals keep each other in check their whole lives. I try very hard to instill in them that they are two completely different people and they both shine in their own areas. If one of the twins had to stop exercising it would throw her into a deep depression. As a matter of fact, she just had her first baby and the baby blues hit very badly. The thing that made all that go away was her doctor allowing her to exercise again. She is up every morning at 4 am off to the gym. Now that the baby is here, she has made her own workout room in her home. I MOST certainly understand your need for exercise. Just take it easy sweetie, or you will have to decrease your exercise program. Good luck on Tuesday, and I truly hope you feel better soon.
(((hugs))) to you!!
Bullymom

 
Old 05-23-2009, 09:32 PM   #14
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Re: Injured Myself Bad-Could I Ask My PM For an Increase?

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Originally Posted by cheryl810 View Post
To me, if I'm open and honest with the PM I feel they look at that as being a good thing. Yes, I injured myself, won't do it again, please help!! If you can't be honest then what's the point of these PM's?? You shouldn't have to feel like you have to suffer all because things didn't go as planned for the month!! Things happen and not always the right way. People make mistakes, a lesson I learned quite well!! But you know what, we're all human and if the PM can't see that I went well beyond my abilities and learned that I have to tone it down then something is wrong with people! You mean to say that you always have to just "suck it up" if things don't go well; that's ridiculous!! You should be able to have an open and honest relationship with ALL your doctors!! If you can't then they're not for me!! I understand that they're are many people that probably exaggerate to get more meds but that's not me! I need to be able to function for my kids and not be loopy on drugs!! I wish I could live the life I had before these problems; it's gets extremely frustrating when you see others doing what you use to do with no problems. I'm only 33, I have the rest of my life to feel like I'm 90; great life to live!!!! I'm suppose to be able to do many things but I can't and gets frustrating!!!!
Cheryl,

I am fairly new to this board too. I have learned so much about pm and am truly thankful.

I feel like you do about having to just suck it up and deal with the pain until your next appt. It is just not right. My pm, I don't think, would be that understanding. And this does bother me greatly. I have not had to call for an injury but needed to change my appt due to having two root canals done that same day. I asked to change it for the day before, earlier that same day or even the next day and it was like an act of congress. There was some confusion when the nurse called me back (i had to leave a voice mail explaining all the above) and she responded by saying that "its not time for you to come in and get more meds." I explained again the situation and she changed my appt to earlier the same day. But when I went in I was drug tested. I do not think it was coincidence, I think because I needed to change my appt was the reason why I was tested. Which it is possible that they do that if you change your appt, regardless of the reason. But I think it was because of the confusion with the nurse initially. I am going to bring my receipt from the endodontist when i go into my next appt for the pm just so there is no confusion further down the road, thanks to the advise of someone on here I am not saying you have done anything wrong, but I would not be surprised if you were tested. Do you think they may even do a pill count? I don't know, just a thought. But if they did and you have a good relationship with you pm as you said then he would probably be okay that you are short. Sorry to ramble but I am scared now to call them for anything due to the fear of being dismissed. Honestly if I got injured I would be scared to call. I know I have not done anything wrong, but there are some pm clinics out there that are not as understanding as yours and others. I am glad that your pm Dr is and I hope they figure out what has happened to you to cause you such pain.

I can also relate about being young, I am only 31 and can not do things with my kids. That in itself is depressing and with you not being happy with your weight, I know is really hard on you. I also have a 20 month old and it saddens me to not be able to pick her when my pain level is high. Of course she doesn't understand and that makes it so much harder. I also have a 9 year old who is very active in sports and some days I have to miss her games because I can not get out of bed. With us having such an active lifestyle with kids it is very hard to have to limit yourself. Sometimes you can't because you have kids to take care of. Thank GOD I have a wonderful husband and he is always there to take over when I can not!!!

I have been experiencing new issues since my last appt and go in on Tuesday as well, so I am hoping we can figure what has changed. I could have called earlier in the month when my pain started increasing but I honestly was scared due to the issue with me changing my appt. I would change pm Dr's but then that would look like I am dr shopping and then I would have to start all over with the new doc. Sometimes you just want to throw your hands up and say you give up but you are in such pain that you can not do that. I hate that I have to rely on meds so early in life and like you said I didn't sign up for this, not that anyone did It scares me what the future holds if I am already having these problems. But only GOD knows and I have to have faith!!!!

I just never knew that pm was so "serious" until I got on this board. PM is so difficult at times but what do you do? I know that people that do not need meds mess it up for those that do, but that doesn't make me feel any better. i truly hope that everything works out for you and please let us know what happens.

Sorry for this being so long. Take care of yourself and feel better soon!!

A

 
Old 05-23-2009, 10:45 PM   #15
PNo PNo is offline
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Join Date: Jan 2005
Location: USA
Posts: 1,197
PNo HB User
Re: Injured Myself Bad-Could I Ask My PM For an Increase?

Being with a PM doc is not that hard:

-Don't take any narcotics they don't prescribe.

-Don't take more than the daily limit you were prescribed.

- Don't take narcotic prescriptions from other doctors.

-If another doctor writes you a script make sure you know what it is so you don't break the rules.

-Lock up your meds.

-Any deviations clear with PM.

Besides any little rules your PM may have like fill at same pharmacy- if you follow these rules you won't have trouble. It is serious business to take medications-it really isn't hard to follow the rules, no excuses. When you take more than prescribed you risk serious consequences like overdose-just don't without clearance!

 
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