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Old 09-02-2012, 08:47 AM   #1
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Exclamation problem with pain doctors

Hi folks,

I'm new here. Suffering from chronic pain due to a whiplash/compression injury that's several years old. Several herniated discs, severe root nerve compression and spinal cord distortion. I've tried every kind of traditional and non-traditional therapies.

Decided against surgery, because I can't find anyone who's had a positive experience with disc replacement or injections over the long term. Also I fear that once they cut you, your options are limited to more cutting. I'm currently on disability, unable to work.

I'm currently prescribed 40 mg of oxycodone (immediate release) a day by my psychiatrist, plus a small amount of valium. I find I'm needing a bit more, between 45 and 50 mg per day, but my shrink, who's been a great help, won't write for more than 40 mg/day.

How can I find a pain management doctor who isn't cowed by the current anti-opiod environment? The ones I've seen so far have made me feel like a criminal for seeking opiod therapy, even though I have no history of abuse and plenty of medical documentation for my condition.

Any help is appreciated.


Last edited by Administrator; 09-02-2012 at 11:29 PM.

 
Old 09-02-2012, 01:21 PM   #2
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re: problem with pain doctors

I ran into the same problem as you did, took me almost a dozen times to find a DR that would help me, since my PCP had me on Oxycodone, every PM dr that I found wanted me off it.
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Old 09-19-2012, 08:05 AM   #3
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Re: problem with pain doctors

Gabe, sorry to hear about you situation. It happened to me too this whiplash. It's a chronic pain 24/7 in the neck ------ never stops.
There is not a whole lot to do about whiplash. (eventhough it's been around for
years----since they invented those trains).
40mg oxycontin is not enough for whiplash but doctors don't understand that.

They should have kept those carriages instead of inventing those cars. AT least whiplash cannot happen with carriages. Whiplash is such an injury no doctor can cure.
It's not just your disks....it's your muscles, tendons and ligaments.

I commiserate with you.

 
Old 09-19-2012, 09:54 AM   #4
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Re: problem with pain doctors

What you have experienced is what I go through everyday. I had a horrific car accident at 18, whiplash city. Unfortunately, I also suffered from migraines since I was an early teen. I got narcotic medication in my early twenties but it was off and on, depending on how my head was feeling. Fast forward 10-15 years and that original injury started causing some real problems for me. My PCP got tired of writing me scripts and moved me to a pain doc. I was immediately put on some powerful narcotics that took care of most of my pain but the meds were so strong it created other problems, so be very careful if you do land in the right spot.

Now, I've been on a maintenance dosage of meds for over 10 years and have been doing pretty well. The bad news is that a motorcycle accident in 95 and another terrible work related truck accident in 2002 that almost cost me and a coworker's life, have complicated my neck problems.

Today, I survive. That's what I'd call it. I honestly hope you get the care you deserve and don't have to shuffle through life like I have. It's amazing what the right docs can do. And btw, I'm in your camp in regards to surgery. I don't honestly think they can touch it and as a matter of fact, I've had no one imply they could. I still get tired of folks who say, why don't you just go see a surgeon and get that taken care of. Yeah, right! Let them cut on your neck, right next to your spinal cord and see how you like it. Oh, that sounds very dangerous, they'd reply. Yep, you bet your sweet a#* it is and that's the end of that discussion! I really wish you all the best and sorry for emoting.

 
Old 09-19-2012, 10:28 AM   #5
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Re: problem with pain doctors

Hey man, thanks for your story and support. I hope things improve for you, for all of us. It's maddening that the drugs that really help exist and have relatively few side effects, compared with many of the drugs advertised on TV! And it's ironic to know that any doc who suddenly found his/herself in chronic pain would have no problem with long-term opiod therapy. Of that I'm sure. I often feel that I've crossed a rubicon, and live in a world that only those in chronic pain can truly understand and commiserate with. To the so-called healthy world, my situation just isn't comprehended, even by those who've devoted their lives to understanding and helping people in pain. It's amazing and horrible.

May no one suffer, ever.

 
Old 09-19-2012, 10:29 AM   #6
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Re: problem with pain doctors

Quote:
Originally Posted by Whoopee View Post
What you have experienced is what I go through everyday. I had a horrific car accident at 18, whiplash city. Unfortunately, I also suffered from migraines since I was an early teen. I got narcotic medication in my early twenties but it was off and on, depending on how my head was feeling. Fast forward 10-15 years and that original injury started causing some real problems for me. My PCP got tired of writing me scripts and moved me to a pain doc. I was immediately put on some powerful narcotics that took care of most of my pain but the meds were so strong it created other problems, so be very careful if you do land in the right spot.

Now, I've been on a maintenance dosage of meds for over 10 years and have been doing pretty well. The bad news is that a motorcycle accident in 95 and another terrible work related truck accident in 2002 that almost cost me and a coworker's life, have complicated my neck problems.

Today, I survive. That's what I'd call it. I honestly hope you get the care you deserve and don't have to shuffle through life like I have. It's amazing what the right docs can do. And btw, I'm in your camp in regards to surgery. I don't honestly think they can touch it and as a matter of fact, I've had no one imply they could. I still get tired of folks who say, why don't you just go see a surgeon and get that taken care of. Yeah, right! Let them cut on your neck, right next to your spinal cord and see how you like it. Oh, that sounds very dangerous, they'd reply. Yep, you bet your sweet a#* it is and that's the end of that discussion! I really wish you all the best and sorry for emoting.
Hey man, thanks for your story and support. I hope things improve for you, for all of us. It's maddening that the drugs that really help exist and have relatively few side effects, compared with many of the drugs advertised on TV! And it's ironic to know that any doc who suddenly found his/herself in chronic pain would have no problem with long-term opiod therapy. Of that I'm sure. I often feel that I've crossed a rubicon, and live in a world that only those in chronic pain can truly understand and commiserate with. To the so-called healthy world, my situation just isn't comprehended, even by those who've devoted their lives to understanding and helping people in pain. It's amazing and horrible.

May no one suffer, ever.

 
Old 09-19-2012, 10:31 AM   #7
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Re: problem with pain doctors

Hey man, thanks for your story and support. I hope things improve for you, for all of us. It's maddening that the drugs that really help exist and have relatively few side effects, compared with many of the drugs advertised on TV! And it's ironic to know that any doc who suddenly found his/herself in chronic pain would have no problem with long-term opiod therapy. Of that I'm sure. I often feel that I've crossed a rubicon, and live in a world that only those in chronic pain can truly understand and commiserate with. To the so-called healthy world, my situation just isn't comprehended, even by those who've devoted their lives to understanding and helping people in pain. It's amazing and horrible.

May no one suffer, ever.

 
Old 09-19-2012, 03:59 PM   #8
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Re: problem with pain doctors

Hi Gabe,
The first and best place to start finding a pain management doctor is through your insurance website. They will give you a list of participating providers , who work with your insurance .
Do you have recent MRI's or CT scans of your neck damage? If you do, then you can either get a referral from your primary care doctor, or from your psychiatrist that is giving you the pain medications now. The new PM might not accept a referral from the psychiatrist though because technically, he is for mental health issues, not orthopedic/neuropathic ones but hopefully that won't be an issue for you.
As far as a new doctor continuing what your psychiatrist is giving you, that most likely won't happen. New doctors want the patient to allow them to diagnose and then come up with a treatment plan based on what they find.
They may also refer you to a surgeon to see what can and should be done surgically to treat your condition. Especially given that you say that there is severe compression in your neck. That indicates nerve injury and the longer you allow that to continue , the less likely that the nerves can recover. They may also want to put you on medications to treat the nerve issues , opiates are not necessarily the best meds for nerve compression. Injections may be something that they want to do as well to see if that helps to ease the symptoms that you are having. The other thing is that most PM clinics use long acting medications (opiates) rather than short acting. Oxycodone is a short acting medication. So , expect that they will start you on either a different medication altogether or combination of meds, and then slowly increase the dose as they feel it is needed. And then once you are stable, they will most likely put you on a long acting version of one of the opiates and possibly a short acting version taken once or twice a day if needed for breakthrough.
If there is something surgically that can be done, why would you not want to do that? Especially if it meant that the pain medications weren't necessary? You may find that a consult with a surgeon or two may give you a whole different perspective on what the results may be for your neck...
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Old 09-19-2012, 04:05 PM   #9
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Re: problem with pain doctors

Hurtz,

Thanks for the cogent ideas. It's time for me to go to sleep now; will give a full response tomorrow.

Many thanks.

 
Old 09-19-2012, 07:31 PM   #10
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Re: problem with pain doctors

Whiplash is different than degenerative disk disease. Most of the pain is from muscles, tendons and ligaments being damaged and therefore I don't see how surgery can help chronic whiplash sufferers.

No that is not amazing they don't want to prescribe you narcotic. What is amazing is even after so many years of whiplash cases (since it last happened started the train's invention) they just couldn't find a way to fix it.

I believe, they just don't have the technique to deal with soft tissue damage(muscle, tendons, ligaments-----and they wouldn't admit it!
Not only that----------I was blamed it is all IN MY HEAD!!!!!!. I was blamed I am one of a kind---------I was also blamed-----check this out-------that the pain in the neck is caused by my personality. But I see many people who had whiplash it just doesn't go away. It is not a matter of personality.
And that is the main cause of whiplash pain-----the muscular pain. Surgery cannot fix musclar pain and there is NO technique to fix for good the damaged muscles, tendons and ligaments.
Also it's called myofascial pain. Whiplash can definatelly cause it.
That is something you should look into.
Look at the good side------At least you can SLEEP at night. Did you know, many whiplash patients cannot sleep.
I can only commiserate with you but one thing is good with you. You can SLEEP.

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Old 09-19-2012, 08:16 PM   #11
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Re: problem with pain doctors

No,
Yes, I am aware that a surgeon can not address whiplash issues, but they most certainly can address the severe spinal cord compression and the nerve root compression, and possibly the disc herniations. Treating those things alone might go a long way in relieving some or most of the pain that Gabe is feeling.
I think that each patient must find out what works for them, and if it were me, and I was dealing with a severe compression of the spinal cord, especially in the cervical area or the nerve roots in the cervical area, surgery would definately be on my list of things if I were told that it might be worth investigating. Visiting a few surgeons, neuro and ortho board certified spine surgeons can't hurt Gabe, in fact, he might find that the advances made in the last 5 years in regards to cervical spine surgery and it's outcomes are better than they were before..
I would prefer that he explores all of his options in regard to resolving his pain, if that is possible, rather than just assume that because it started as a whiplash injury means that he can't do anything about it , but suffer...that's not the case.

 
Old 09-19-2012, 09:28 PM   #12
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Re: problem with pain doctors

Gabe, whiplash injury cause "intractable pain" that cannot be cured by a surgery. Means that even after a cervical surgery you will still suffer pain. If a whiplash has never occured to you, then a surgery would be an option. I am telling you. I suffer like hell. I cannot even rest my neck on the pillow--------both sides-------and that is everybody -----can you imagine living like that? and all I have is 2 bulging disks. Very minimal. Nothing for surgery. The pain is so immense.
I cannot find ANY comfortable position to lay my neck on the pillow----and that is everyday.

I have been investigating this whiplash issue for 7 years since this car accident and listen to many people. and believe what I am telling you.
A person only do a surgery when there is a chance to be disabled. It won't take away your neck pain.

You have couple of options:
1) Have you tried rubbing voltaren gel? I have started with that and it does help function better at least. It helps some.
2) There is something called myofascial release therapy that might help. I dont' have the money for that. But you can investigated with somebody about it. That is for SOFT TISSUE.
3) Maybe but maybe lyrica could help you.
4) Stay away from chiropractors.

That is all I can suggest. and I feel sorry that it has happened to you. I wish it has never happened to you.

Last edited by nochange; 09-19-2012 at 09:31 PM.

 
Old 09-20-2012, 03:46 AM   #13
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Re: problem with pain doctors

The sleep thing is iffy at this point. The last week or so I've been waking up at 3 am, unable to return to sleep b/c of pain. I attribute it to reducing my oxy doses, because I'm running out of my script early. I HOPE that's all it is.

 
Old 09-20-2012, 09:02 AM   #14
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Re: problem with pain doctors

Man on man, do I concur with the sleep problems. I need to usually sleep sitting up, either in bed or on the couch. It sucks! I was prescribed Ambien a few months ago and it does help some but when I'm really hurting, even being whacked with a sleeping medication doesn't do much for me. Sure hit nail on the head with that one!

 
Old 09-20-2012, 11:54 AM   #15
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Re: problem with pain doctors

Thanks, NoChange, for your thoughts. I'm seeing a new neurologist soon. I'm hopeful he'll take on the medication issue.

I'm open to talking about surgery ... my injury is mostly compression at C5/6 and 6/7, with herniation and spinal cord distortion. But I'll probably need to be convinced pretty thoroughly b4 letting them cut me.

I hear your pain, I feel my own. Best wishes for relief.

PS No luck w/ Lyrica, or Neurontin. Will look into the Voltaren gel, which I've heard about.

FYI I had some relief, esp. from burning feeling in my forearms, with Upper Cervical chiropractic. This is very different from normal chiros ... no cracking, a very gentle adjustment to the atlas, or C1. You can read about it here:

http://www.upcspine.com/default.asp

Last edited by gabe61; 09-20-2012 at 12:32 PM.

 
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