My PM Doctor put me on schedule II narcotic pain relievers the very first day I met with him. After an hour of Q and A, and an examination, he decided to put me on the long acting med.
I never requested a specific medication. Usually I ask my doctor what will work best for long term, consistent pain releif and he will bring up the different possible meds.
I have been through just about every type of procedure (blocks, epidurals, tens, pt) and have been on every form of medical thearapy (antidepressant, anticonvulsant,muscle relaxers, neurontin, ect)and am at a sort of plateu as far as the effectiveness of these treatments.
I think he is of the opinion that narcotic medication therapy is the last option available that will provide me relief and allow me to live a more normal life.
If he does bring up two or three different meds, and I have some knowledge about the meds, I will give him my opinion of what I think I might want to try.
For example. On my very first visit with my current pm doc, he prescribed methadone. I did not do well on methadone due to severe side effects, so I was switched. I did not ask for another specific med. I told the doc what good and bad effects the methadone provided and that the bad outweighed the good, so it has to go. He told me we could either try Morphine or Duragesic. I told him that I do not do well with patches of any sort and would prefer and oral medication, so he started me out on ms contin and ms ir for bt.
My point is, if you are honsest and do not come across as seeking any specific med, have tried many of the treatments recomended and have a decent pm doc, more than likely he will realize the value of the long acting, more powerful meds. You should not have to "convince" your doctor of anything, and if you do have a doctor that you feel you need to "convince" to get any type of pain relief, then maybe you should seek a different doctor.
I hope this answers your question.
[This message has been edited by savysac (edited 09-11-2003).]
I had tried over 5 years time period over 35 different medicines to prevent my headaches and nothing worked. I was in constant pain 16 hours every day. It interfered with every aspect of my life and I was on disability because of it. I was put on methadone because percacet and vicodin didn't touch the pain I was experiencing. Since being put on methadone 11 months ago I have been pain free.
I too was switched to MS Contin (from Vicodin) by my PM Doctor on the first visit. He does not like using Vicodin for CP patients. That did not work so he switched me to Methadone with Vicodin for B/T pain.
I had to learn or try every non opiate method over 10 years and 3 spine surgeries and have an erector set in my back. I had a heart attack in my 30's and the anesthesiologist that assisted in the cardiac cath later invited me to attend the PM clinic he ran.
My BP had been combined over 350 like the 210/160 range for several years while treating pain with prozac and BS methods and failed surgery after surgery. I was only 30 and no family history of heart problems and no cholesterol problem to worry about. So I would say I had to prove it. The clinic he ran didn't use opiates on everyone. Just the ones that that were not going to get better regardless of what they did.
Things have gotten better in the last 10 years but if the doc doesn't have documentation to explain the use of opiates I would think he's taking a chance and they would be harder to come by. If you have tried other methods document them and take them to your PM doctor apt so he can add them to your file to justify the use should anyone ever ask.
It does seem like a more humane option than invasive surgery but opiates aren't completely benign. There is a price we pay. It's not the same as addiction but dependence has it's own downfalls. I guess it comes down to, do they improve the quality of your life and ability to function more than they impair you with side effects and the consequences of masking a problem that may become irreversible if not treated more aggressively? Every doc has a different opinion on the use of these meds.
I would be concerned if my doc was known as a soft touch. He would be less likely to be around 5 years from now and his departure would likely be swift with no warning for you to find a new doc. Good luck, Shore
Well I have been on narcotics since I broke my back in 1985. Except for the the last year I was mainly on hydrocodone preps. Needless to say my tolerance to that med was very high. I had to detox myself every 2-3months just to get some relief which was hell in and of it self. Then a miracle happened we got a wonderful PM doc in this neck of the woods and I was finally given my first long acting med. At that time it was OxyContin then later switched to methadone and OxyIR and Dilaudid for BT. I did have 19yrs of failed methods and surgerys to back up my pain. I'm with shorline any Doc who doesn't document the need for strong opiates is just asking to go out of business. They do need to prove that all other avenues have failed and that Schedule 2 narcs are the only option. It weeds out the addicts and even then a few slip by. I am curious as to why you ask SFangel. Its an odd question.
OK, I am really getting concerned about you. Between this quesion, the crushing vicoden, the "secondary gain" issue, the stongest painkiller in the US...
And, you asked about you using Duragestic while having a xray so you are already on that, which from my understaning, is a VERY strong med.
I really think you need to evaluate why you are using these meds, talk to your doctor and get help if needed!
Oh, and I forgot about the "self abuse" post as well. I think that was you. I think you mentioned in the "secondary gain" email that you had seen a psychologist. Are you still going? Have you discussed all these things with him/her?
Am I over-reacting or is anyone else concerned?
I am just worried about you.
[This message has been edited by luv2sew (edited 09-12-2003).]
Luv2sew, I've noticed the contexts of her posts too and am also concerned. She did have explanations for the other questions she was asking although they didn't seem like very straight forward ones.
Hmm where should I begin?? Crohn's disease, sacroiilitis-crohn's related, scoliosis, spina bifida occulta, chronic myofascial pain, tmjd and migraines. Still waiting for bone scan and bone density test to tell me what else is wrong with me!! Too many surgeries to list!!
[This message has been edited by twisten (edited 09-12-2003).]
[This message has been edited by twisten (edited 09-13-2003).]
I am with you Luv2sew as well. And I think it would be wise for people to think before they respond to this poster with any information that may help a drug seeker. Tnese are the people who make it hard for legitimate chronic painers to get the help that they need. Remmeber that.
I agree with everyone else... Things are just getting more and more suspicious looking here... I also am worried. What's going on here, SFAngel? I'm not trying to judge you here, but you have been asking very strange and questions that are worrying me. I'm not calling you a drug-seeker, I'm just afraid for you. You seriously need to take a step back here and ask yourself why we would all see these red flags being thrown up when you're asking all these suspicious questions. Can you honestly say if you asked these things to your doctor, he wouldn't yank your meds instantly? You seriously need to do something with yourself if things are the way they look and seem. Perhaps you should try going to the Addiction and Recovery board. They can answer some questions for you if you need to find out how to get some help.
Please please please try to see our side here and don't think we're all judging you, we're just worried about you.
I agree with you 100%! As soon as I read this thread I thought uhoh here we go again. There are just too many threads from this person asking about stronger and stonger meds. Seems to me like this person is looking for a good high (JMO) and even if this person is a CP patient I think that they have done a great job of convincing us that he is a seeker with all these wierd question. If you're hoestly a CP patient then you should talk to your DR about you meds and your concerns over the meds you are taking cuz you are making some of us question your motives here. Mo
[This message has been edited by Mo7609 (edited 09-12-2003).]
To all of the above posters. I have to agree. SFangel. you have not been completely honest here and certainly not with your docs. And for you to have posted so many times in such a short time and the content of those posts has me very concerned...
I too have been reading along, and have to agree with all of you...we are just concerned. You say you are currenlty on meds., well were they prescribed, because if so (and I think you said it was Duragesic), why would you wonder how to "convince" a Dr. to get the other meds you mentioned? I'm totally baffled by that....my Dr. took a look at all my operative reports/CT scans, etc(too much to list!) and did an exam and that was it....documented proven chronic pain. We are just concerned, not trying to judge...please if there is a problem mixed in with true pain, there are ways to get help....we just care. Surgical Disaster
Hello Again: I am new to the boards, so maybe I'm outa
order here, but SFAngel your questions sure would raise
a red flag if I was your Doc. and I was reading them.
I work with people in recovery, and I would be quite
concerned for a person with your lines of questions.
If the Duragesic is working for You, I wouldn't rock the boat. From what I've seen Duragesic is pretty heavy
stuff. Maybe You need to check other things to do along with Your Meds. that could possibly help You besides depending soley on the Meds. for relief. I know it's an easy trap to fall into when it comes to the Meds., just take another and another, and before you know it, thats what your life becomes. After almost
3 years of meds., I still get good pain relief from one
Vicodin or Vicoprofen, and If I land in bed on my back for a week, I'll adjust that, but once I'm able to move about again I back the dosage down again or I would also be in trouble. I guess I'm very lucky I've been able to do that. I may suffer a bit that way, but I would rather do that then the other. Well that's enough out of me. Your All in My Prayers. Regard's
Unzzz! P. S...Walking,Weight Loss,Stretching, have all helped me.I have bad discs in my neck, lumbar 2 broad based herniations,2 bulging discs, pinching nerves,Scoliosis bad, Arthritis bad,Posterior, Anterior
and Retrolisthesis Steppage, Stenosis, you name it, so I can say I qualify. I drove construction vehicles for many years in pain, til the spine just said no more.
Take Care All, ta ta.