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    Old 12-15-2013, 05:01 PM   #1
    Sophia58
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    Advice Please -- How Do I Ask My Doctor?

    Hi All,
    I am new, and have been carrying on an in-depth conversation with tortoisegirl in another thread, where I have described my condition and my meds, and other specifics; the thread is called "Chronic TMJ Pain--Not Taken Seriously?" if anyone wants to read up on what's going on with me. Tortoisegirl has been very kind and has given me wise and compassionate advice, and I find that her help has assured me that I am seeking support in the right place by joining this community.

    I want to ask anyone who is willing to share her/his thoughts about something that I have previously brought up in the other thread I mentioned. Please excuse me if I have a hard time explaining, I am experiencing a bad flare-up and am just so worn out with pain. A quick synopsis of my situation is as follows: I have had TMJ pain for six+ years, have tried numerous medicines--narcotic and non-narcotic; tried various treatments including chiropractic, cortisone injections in both TMJ's, acupuncture, PT, yoga, massage, and more; seen specialists and a PM doctor; had several different opinions, and have seen several different doctors. I am not done trying to find a solution, but in the mean time I am taking opiate medication because otherwise I would be unable to do much of anything at all. I've been taking MS Contin for a little over four years, and have been taking Percocet for BT pain for around three years. I am a full-time (English Literature) student studying for my MA, but have been unable to finish the semester due to this flare-up that has lasted almost a month now. Because I just moved to a new town to go to graduate school, I have been seeing my newest doctor since September. On my first appointment she said that I am over-medicated and that I should titrate down.

    I guess that because I'm 31 and have often been told that I'm too young and take too much pain meds for my age, and have even been asked whether my pain is "all in my head" and because TMJ is sometimes viewed as a mild condition--well, I think I have started to think that everyone else is right and I am wrong, even though I am the one who goes through each day in pain. My head is ALWAYS throbbing, as are my jaws, face, neck, shoulders. But, anyway, I just took my new doctor's word for it and though that if she thinks I'm over-medicated, then I had better go down. So I went from 60 mg MSContin 3 x day to 30 mg 4 x day, staying at Percocet 10/325 4 x day as needed (I also take 900 mg Neurontin each day, Wellbutrin, and Lunesta. I have tried, in addition to several other meds, Amitriptyline, years ago and found it to be awful--but my doctor wants to me try again, when I told her it was not good at all for me.). When my pain came back like a safe being dropped on my head, I realized that I was NOT over-medicated, it's not all in my head (well, actually, the pain IS mostly in my head, ha, ha, ha), I may be young but that does NOT mean that I have to be in pain because society says I'm too young to take pain meds, and da**it, I deserve to have some quality of life!!! But even though I was able to convince my doctor that I simply cannot titrate at this time, and even though she has agreed to bump me back up to 60 mg of MS Contin 3 x day, I am still doing very, very badly. I think that my body has become too tolerant of the MS Contin after four years, and I would like to try a different LA medicine now.

    So, finally, my question is this: Is it unreasonable for me to want to try a different LA med for the time being? Is it okay for me to want to have some relief until I am able to find a solution to my chronic pain? And, if so, how do I go about asking my doctor for a different kind of LA med? (I will be looking for a different doctor when I can because I am not happy with this one, and I thank tortiosegirl for encouraging me to do so. Over the years I have almost developed a fear of doctors because of how I have been treated by some of them--like I want to use opiates for a good time and not for pain relief.)

    Any help would be appreciated because I just don't know how much more pain my body can take. I feel as though I will crumble beneath the weight of it sometimes. Thank you for taking the time to read this.

     
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    Old 12-15-2013, 05:33 PM   #2
    galalena
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    Re: Advice Please--How Do I Ask My Dr?

    I have read your story and understand what you are experiencing. First if all, I have no experience with TMJ. But have a very dear friend who has it. She went through the wringer, but is not suffering now. We no longer work together so i do not get daily updates. I can ask her what helped if you would like.

    As for the pain meds, you do not need to justify anything to anyone on this forum. We are all in the same boat, but our different maladies are SO different, each situation and treatment is unique.

    The people here are wonderful and will give you great advice on how to talk to the doc.

    What I want to say is that you do not have to list everything you take as no one can really evaluate that for you.

    What is important is having a doctor you can trust and one who will help you. It is very difficult in this anti- pain medication era. People have opinions too on different meds. I have learned not to discuss it with anyone but my husband and doctor.

    Anyway, you will find good support here. All that is critical is how YOU feel.

    I hope you can find some relief. From my many tearful conversations with my dear friend, I KNOW how awful tmj is!

    Last edited by galalena; 12-15-2013 at 05:43 PM.

     
    Old 12-15-2013, 08:37 PM   #3
    Sophia58
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    Re: Advice Please--How Do I Ask My Dr?

    Quote:
    Originally Posted by galalena View Post
    I have read your story and understand what you are experiencing. First if all, I have no experience with TMJ. But have a very dear friend who has it. She went through the wringer, but is not suffering now. We no longer work together so i do not get daily updates. I can ask her what helped if you would like.

    As for the pain meds, you do not need to justify anything to anyone on this forum. We are all in the same boat, but our different maladies are SO different, each situation and treatment is unique.

    The people here are wonderful and will give you great advice on how to talk to the doc.

    What I want to say is that you do not have to list everything you take as no one can really evaluate that for you.

    What is important is having a doctor you can trust and one who will help you. It is very difficult in this anti- pain medication era. People have opinions too on different meds. I have learned not to discuss it with anyone but my husband and doctor.

    Anyway, you will find good support here. All that is critical is how YOU feel.

    I hope you can find some relief. From my many tearful conversations with my dear friend, I KNOW how awful tmj is!
    Thank you so much for your response and for your understanding. If you are able to ask your friend about what helped her, I would greatly appreciate it.

    You're right, I don't have to explain or justify myself to anyone. I didn't used to feel like I have to do that, but after years of being looked at like an addict or a faker or a whatever, I have become extremely self-conscious about my pain; I almost feel guilty for having chronic pain. Just like I feel guilty for telling doctors that I need to increase or change my meds, and guilt is one thing I just do not need to pile on top of daily physical pain.

    I have learned that the world of chronic pain is very, very harsh!

     
    Old 12-15-2013, 10:48 PM   #4
    gmak
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    Re: Advice Please--How Do I Ask My Dr?

    Hi sophia, Im sorry! I started having chronic pain at your age so i understand the misunderstandings of others, the second guessingl the feelings of guilt when doing the best i could, the looks, semi rude drs, the pain hurts everyone that you love or that love you & the whole experience over 20 years. I ignore the chatter of those that arent affected but feel privy to comment. I only discuss my meds with immediate family, bff, dr or here, we all "get it",There is a thread on this board about "muggles", a term used from harry potter to describe those that dont know chronic pain & i thought it was informative & funny. i knew it wasnt all in my head, it was real & really bad & affecting everything i did & finding a pain mgmt dr so you find some relief is essential if you cant function, imho. I had been going to a pm/anes but when i found the my dr, it changed my life. My dr is a physical medicine & rehab dr, a physiatrist, & PM&R drs & his main goal is to restore functioning to the highest level achievable for that patient & about 50% of his practice is treating acute & chronic pain & 50% rehab for stroke pts, joint replacements, arthritis, etc Several things came to mind reading your posts. There are oral surgeons that are the mix of dentist/medical drs worlds & some specialize in TMJ disorders. Also, i saw in your other thread that tendonitis was what the dr saw on the MRI. Tendonitis is a different diagnosis from TMJ problems, what did the MRI show as concerning the joints themselves being out of socket or loose as you described? Because tendonitis is inflammation of the tendons in the jaw & many TMJ problems are caused by the muscles in the jaw. The splints are necessary to put your jaw muscles in a resting position & if your bite is causing the TMJ the teeth dont actually meet & cant clench either. Mine was a lower splint. If your not wearing your splint you really need one that fits & for problems this severe it can be worn all day & it is clear like invisalign braces. If i were you i would see an orthodontist, braces cured my TMJ problems but my teeth were perfectly straight except back molars had a crossbite, two people i know are wearing invisalign for TMJ now. I also trained myself to never put my teeth together ever except eating.Considering the many places that you describe pain it is really important to try to rule out any other source of the pain by seeing headache specialist, neurologist, & with pain in neck radiating to shoulder & down arms you might want to have your cervical spine checked & while an ENT dr was recommended by your dr but she said they wont treat a chronic pain patient. Well maybe not with narcotics but they will treat you to find out if cheekbone pain is from something else like sinus problems. The reason to see specialists is to get documentation of the severity of problems & to find out any other source of the pain before seeing pm dr, like migraines & fibro may be why your dr insisted on your taking amytriptyline. Do your medical records reflect without a doubt & explain why your pain is so severe? The reason i am asking is because ever since the difficulty with taking pain medicine thing has started, my dr told me that if the testing, imaging, dr reports from many specialists etc shows the severity of the problem then it is easier on the patient & the dr to treat with narcotics because then the dr can justify the need for the medicine because he has documentation of the severity of the diagnosis. For example, my condition is notorious for very severe pain & the MRI is completely diagnostic of having it but others that have the very same severe pain may not have a simple picture to tell exactly why they are hurting so much & its harder for those pain patients because they arent taken seriously sometimes. Also, have you ever been tested for temporal arteritis because my aunt was treated for TMJ for many years but she had temporal arteritis. As far as talking to the dr about changing meds i think it is best not to ask for certain medicines. Because the goal of pain management is to get the pain managed to a tolerable level & not to completely relief it & as many pain drs as exist, thats how many different theories & pain plans that can be found. Just as pain is unique by individuals so are the individual drs that treat it & the meds they like to use, treatments etc. Asking yourself what percentage of your pain is lessened when you take your long term med then how much pain is relieved by breakthrough & how often is bt being taken because if taking it everyday to the maximum prescribed dose then you no longer have anything for breakthru pain because the bt amount is now rolled in like a daily dose.My dr considers 50% pain relief optimum for me to be able to function. Of course i would like more relief but my dr explained years ago because i was only 32 that i had to be aware of tolerance & so did he because i would be needing treatment for decades because 4 surgeries didnt relieve my pain & surgery is no longer an option.I have had the same dr for 13 years but nevertheless I would tell be truthful with my dr & tell him exactly what is occuring, when, why, how it hurts & what i can & cant do,being specific & let him decide what to do. This happened to me a few times & i just said im having to take bt too often & he just took it from there but he always changes my bt, i have only had one long acting time released med for 13 years & before that only short acting. Especially if im only having a bad flare up, he may increase my bt for a month or so. Im really sorry that you are hurting & didnt get to finish the semester because of pain.I hope when you talk to the dr & tell her even with the dosage bumped back up that you are not doing well & that since she is a pcp she will start doing current testing & referrals to as needed specialists because you will need a current MRI & good documentation about how severe your problems are to make appt for pm. If i were you i wouldnt be so concerned about the la med until all other possible causes of why you are having so much pain is investigated a little bit more. Also, i would want to be on a muscle relaxer that works for me, not flexeril, & anti inflammatories since tendonitis is inflammation. I hope she can & will help you. She sounds nice even tho worried about over medicating, I understand how hard it is when you are suffering & the dr wants to decrease your meds & it can become necessary to change drs & its hard to. It takes time for a trusting relationship to be established between a dr & patient especially a
    pain mgmt dr/patient relationship. It is a hard road to travel on to
    be in pain all the time anyway & now harder still with receiving the
    medicine to help the pain but there are good pain drs out there
    that really care & it may take a few tries but the right one is out
    there!Welcome! We will be here for you.

    Last edited by gmak; 12-16-2013 at 02:38 AM. Reason: lines

     
    Old 12-16-2013, 04:07 PM   #5
    Sophia58
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    Re: Advice Please--How Do I Ask My Dr?

    Quote:
    Originally Posted by gmak View Post
    Hi sophia, Im sorry! I started having chronic pain at your age so i understand the misunderstandings of others, the second guessingl the feelings of guilt when doing the best i could, the looks, semi rude drs, the pain hurts everyone that you love or that love you & the whole experience over 20 years. I ignore the chatter of those that arent affected but feel privy to comment. I only discuss my meds with immediate family, bff, dr or here, we all "get it",There is a thread on this board about "muggles", a term used from harry potter to describe those that dont know chronic pain & i thought it was informative & funny. i knew it wasnt all in my head, it was real & really bad & affecting everything i did & finding a pain mgmt dr so you find some relief is essential if you cant function, imho. I had been going to a pm/anes but when i found the my dr, it changed my life. My dr is a physical medicine & rehab dr, a physiatrist, & PM&R drs & his main goal is to restore functioning to the highest level achievable for that patient & about 50% of his practice is treating acute & chronic pain & 50% rehab for stroke pts, joint replacements, arthritis, etc Several things came to mind reading your posts. There are oral surgeons that are the mix of dentist/medical drs worlds & some specialize in TMJ disorders. Also, i saw in your other thread that tendonitis was what the dr saw on the MRI. Tendonitis is a different diagnosis from TMJ problems, what did the MRI show as concerning the joints themselves being out of socket or loose as you described? Because tendonitis is inflammation of the tendons in the jaw & many TMJ problems are caused by the muscles in the jaw. The splints are necessary to put your jaw muscles in a resting position & if your bite is causing the TMJ the teeth dont actually meet & cant clench either. Mine was a lower splint. If your not wearing your splint you really need one that fits & for problems this severe it can be worn all day & it is clear like invisalign braces. If i were you i would see an orthodontist, braces cured my TMJ problems but my teeth were perfectly straight except back molars had a crossbite, two people i know are wearing invisalign for TMJ now. I also trained myself to never put my teeth together ever except eating.Considering the many places that you describe pain it is really important to try to rule out any other source of the pain by seeing headache specialist, neurologist, & with pain in neck radiating to shoulder & down arms you might want to have your cervical spine checked & while an ENT dr was recommended by your dr but she said they wont treat a chronic pain patient. Well maybe not with narcotics but they will treat you to find out if cheekbone pain is from something else like sinus problems. The reason to see specialists is to get documentation of the severity of problems & to find out any other source of the pain before seeing pm dr, like migraines & fibro may be why your dr insisted on your taking amytriptyline. Do your medical records reflect without a doubt & explain why your pain is so severe? The reason i am asking is because ever since the difficulty with taking pain medicine thing has started, my dr told me that if the testing, imaging, dr reports from many specialists etc shows the severity of the problem then it is easier on the patient & the dr to treat with narcotics because then the dr can justify the need for the medicine because he has documentation of the severity of the diagnosis. For example, my condition is notorious for very severe pain & the MRI is completely diagnostic of having it but others that have the very same severe pain may not have a simple picture to tell exactly why they are hurting so much & its harder for those pain patients because they arent taken seriously sometimes. Also, have you ever been tested for temporal arteritis because my aunt was treated for TMJ for many years but she had temporal arteritis. As far as talking to the dr about changing meds i think it is best not to ask for certain medicines. Because the goal of pain management is to get the pain managed to a tolerable level & not to completely relief it & as many pain drs as exist, thats how many different theories & pain plans that can be found. Just as pain is unique by individuals so are the individual drs that treat it & the meds they like to use, treatments etc. Asking yourself what percentage of your pain is lessened when you take your long term med then how much pain is relieved by breakthrough & how often is bt being taken because if taking it everyday to the maximum prescribed dose then you no longer have anything for breakthru pain because the bt amount is now rolled in like a daily dose.My dr considers 50% pain relief optimum for me to be able to function. Of course i would like more relief but my dr explained years ago because i was only 32 that i had to be aware of tolerance & so did he because i would be needing treatment for decades because 4 surgeries didnt relieve my pain & surgery is no longer an option.I have had the same dr for 13 years but nevertheless I would tell be truthful with my dr & tell him exactly what is occuring, when, why, how it hurts & what i can & cant do,being specific & let him decide what to do. This happened to me a few times & i just said im having to take bt too often & he just took it from there but he always changes my bt, i have only had one long acting time released med for 13 years & before that only short acting. Especially if im only having a bad flare up, he may increase my bt for a month or so. Im really sorry that you are hurting & didnt get to finish the semester because of pain.I hope when you talk to the dr & tell her even with the dosage bumped back up that you are not doing well & that since she is a pcp she will start doing current testing & referrals to as needed specialists because you will need a current MRI & good documentation about how severe your problems are to make appt for pm. If i were you i wouldnt be so concerned about the la med until all other possible causes of why you are having so much pain is investigated a little bit more. Also, i would want to be on a muscle relaxer that works for me, not flexeril, & anti inflammatories since tendonitis is inflammation. I hope she can & will help you. She sounds nice even tho worried about over medicating, I understand how hard it is when you are suffering & the dr wants to decrease your meds & it can become necessary to change drs & its hard to. It takes time for a trusting relationship to be established between a dr & patient especially a
    pain mgmt dr/patient relationship. It is a hard road to travel on to
    be in pain all the time anyway & now harder still with receiving the
    medicine to help the pain but there are good pain drs out there
    that really care & it may take a few tries but the right one is out
    there!Welcome! We will be here for you.
    Hello, and thank you so much for this detailed reply!

    To begin, the tendonitis that I was diagnosed with has always made me wonder...I just know that it is more than that. When I went to one of the dentists that claimed to specialize in TMJ (not the specialist who I first saw), he said that my muscles in that area are, how did he put it?--"buffed-up and bulging, like a strength trainer's muscles" and he had me clench for a second and feel my muscles--they really are very hard! And because my jaw seems to come out of the socket if I open my mouth too wide or at an odd angle, and I hear and feel pops and clicks so often, all of which is very painful, I absolutely know that I have TMJD, and that it is getting worse every year. My husband often has to cut up my food in tiny bites for me. I have had two splints, the first doing more harm than good, and the second doing nothing to help me and changing my bite in the process. I suppose I will try again, and get a new one made that I can wear during the day too.

    I have tried several muscle relaxers, including Flexeril, Baclofen, and one other that I can't remember the name of, but I seem to have a bad reaction to muscle relaxers in general. The Flexeril just made me very dizzy and woozy, doing nothing for my pain, and the Baclofen was a nightmare; it gave me the worst feeling of unease and made me very nauseous--I felt like something bad would happen at any moment--I dunno how else to explain it but I will never take it again. And you know what? My doctor refuses to try any other kind of muscle relaxer. Oh, and I have also tried Valium and Xanax (they're for anxiety, but can't they also be used to relax muscles?) and I absolutely hate the way they make me feel--dizzy, loopy, like my body is out of my control, and that scares the *bleep* out of me! And I have tried the Amitriptyline before, for at least three months, and it was awful. It made me feel terrible and like I was constantly sedated, and it did nothing for my pain. I told my doctor this, but she will not listen to me, and that makes me so, so angry because I know how my body reacts to that drug and I know that it does not ease my pain one bit. This reason alone makes me want to find a different doctor.

    Yes, my doctor referred me to an ENT doctor, and she is also having me get an MRI and an X-ray. But I was really offended at her comment about ENT's and chronic pain. She specifically said, "I'll refer you but it probably won't do any good because they usually don't want to have anything to do with chronic pain patients"--this could have been phrased much differently. She wasn't just referring to narcotics, but to even seeing chronic pain patients. I do want to see an orthodontist, and hopefully I will be able to when the new health care kicks in because right now I don't have insurance. My medical records are available to whoever sees me, and with everything I have done and with my plan to keep trying things, I just don't understand at what point it becomes apparent to my doctor that I have been doing ALL that is in my power to get proper treatment. At what point is it shown, without a shadow of a doubt, that I am trying and that there really is a reason why my pain is so severe? At what point do I pass muster with doctors so that they feel comfortable giving me the medicine that gives me the relief I deserve?? When I saw a PM doctor, he himself said that all he could do for me was the cortisone injections, and that there really isn't much else that can be done--besides the normal things like moist heat, exercises, maybe acupuncture, maybe chiropractic (I have seen at least four), perhaps a TENS (which I did for almost a year at one chiropractor's office), massage (which I start tomorrow), yoga (which I do daily), a splint (I will get a new one made as soon as I can afford it), soft foods, and...I feel like I'm forgetting something...but he also said that pain medicine can be a part of my treatment, and not just narcotics. So, I have tried many different drugs in addition to opiates, and I told my doctor this, naming the drugs to her--but what does she do? Tells me to try the Neurontin and the Amitriptyline again when I told her that neither did ANYTHING for my pain. And she says that she's not comfortable prescribing opiates for very long--well, that's nice, but Oh, and my old doctor was a D.O., and he often worked on my head and neck, having me lie down on my back while he poked and prodded in an effort to give me some relief, but to no avail.

    As for the level of pain I am living with right now, it is a daily 7-8, which is not where I should be. I feel that I have the right to be at a 5-6, and I am not there. I am not wanting to take narcotics indefinitely--who does?--but I do think that I should be given what I need to function UNTIL I find a valid long-term solution. Am I supposed to live each day wanting to die until I find an answer? Why can't I be prescribed what will give me some quality of life for now, until I am able to find it elsewhere?

    At my next appt I will tell my doctor what you advise--the how, when, what, where, of my pain levels. I went with a list last time but she barely paid attention to it. I guess I will just have to be more assertive. I try not to take my BT meds often because I don't want my body to get used to them, although lately I have been taking more. I will tell her this too, but I doubt she will do anything to help. I am fully aware of the need to see specialists and of the need for proof and what-not, and I of course don't expect specialists to prescribe narcotics. I do, however, expect my doctor to be willing to do so until the specialists can help me find a solution. I have been wondering if my cervical spine might be part of the problem, but that scares the hell out of me. When I reach back and rub the nape of my neck, if I press against my spine a bit it feels...weird, like kind of cracky or poppy, no, that's not it...I can't explain it.

    I just want my doctor to take into account all that I have done and to trust me that I will keep seeing other doctors, but that in order to be able to get out of the house and do that I need to get my pain at a functional level. I won't ask for any specific medicine, but I think it's ridiculous that I shouldn't do so. I want to get my pain at a tolerable level, that's all! I'm not asking for her to drug me up to the point that I don't feel anything, but just so that I can tolerate the pain. Is that so wrong?

    Oh, and I will look up Temporal Arthritis, definitely. I'm just so scared and confused. I want to be able to function.

    Thank you so much for listening and for giving wonderful advice. I am so thankful that I found this community. Oh, and I love Harry Potter! The "Muggle" thing is so funny!!!

     
    Old 12-17-2013, 06:22 AM   #6
    galalena
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    Re: Advice Please--How Do I Ask My Dr?

    I may be foggy on the details, but i think, think that is, that my coworker takes some kind of antiseizure medication for her tmj. It is not neurontin or gabapentin. She has been doing well after a long episode with it, seeing all those specialists, getting a guard, etc. i will have a longer conversation with her after the holidays and see if she has any insight she can provide.
    Anyway, my pcp is will not prescribe narcotics. He would for maybe a week if there was a very compelling reason, but he has been very open with me. He says they, the docs, are dragged into seminars and workshops and told repeatedly not to prescribe narcotics. It is not you personally, just the way it is today.

     
    Old 12-17-2013, 02:11 PM   #7
    Sophia58
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    Re: Advice Please--How Do I Ask My Dr?

    Quote:
    Originally Posted by galalena View Post
    I may be foggy on the details, but i think, think that is, that my coworker takes some kind of antiseizure medication for her tmj. It is not neurontin or gabapentin. She has been doing well after a long episode with it, seeing all those specialists, getting a guard, etc. i will have a longer conversation with her after the holidays and see if she has any insight she can provide.
    Anyway, my pcp is will not prescribe narcotics. He would for maybe a week if there was a very compelling reason, but he has been very open with me. He says they, the docs, are dragged into seminars and workshops and told repeatedly not to prescribe narcotics. It is not you personally, just the way it is today.
    ***Wait, I was mistaken. I realize from your other posts that you do take narcotic pain meds, but they are not prescribed by your pcp! Sorry for my obvious confusion below!! Sheesh, I feel a bit dumb! ;~B***
    Oh my gosh, I cannot believe that your doctor is unwilling to do so. Prior to joining HB I read a lot of posts, including several of yours not only because I appreciate your understanding towards others, but also because I felt that I could relate with some of your feelings about being in pain. I can see that you are genuinely dealing with pain and if you need narcotics for relief you should have the right to have them. Of course, if you prefer not to take them I respect that and would never say you should do so--I just think that you have a right to them if they provide you some much-needed relief and if nothing else is helping.

    You are right though, we are living in a time when the most prevalent attitudes towards narcotic pain medicine are negativity and suspicion. People who fake pain in order to get high have made it so that chronic pain is viewed as a thing almost akin to a criminal offence.

    I will do some research on anti-seizure medication that is/can be used for pain and/or TMJD, and will also bring it up to my doctor at my next appt. Thank you, and I am wishing you a pain-free day.

    Last edited by Sophia58; 12-17-2013 at 03:28 PM. Reason: Correction

     
    Old 12-17-2013, 03:50 PM   #8
    gmak
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    Re: Advice Please--How Do I Ask My Dr?

    Hi sophia, I hope you didnt feel like the" book" i wrote sounded judgmental or something negative because i was racking my brain trying to think of anything that may help you & im a cp patient too.. For instance, my dr,a physical medicine & rehab dr, because i didnt know if you were aware that this specialty does pain mgmt as well. I didnt include my TMJ info because it is was very long ago when i had it but it may help in some way. I thought i was having a bad ear infection & an ENT sent me to the oral surgeon who made me a splint & told me because my jaw goes out of joint if i open my mouth too wide & that if the splint did not help he could inject teflon into my tmj on both sides & this would stop pain & inflammation by permanently stopping the joint from popping out as a last resort. Things have changed so much that i dont know anyone who's pcp will give narcotic medicine on a long term basis, longer than a week or two, because now all of them refer to pain mgmt drs. Im sure there are some but the trend is pain mgmt as a resource to those physicians like pcp's that arent specially trained in pm & then they dont have to deal with narcotics at all & they can leave it all up to pm drs to prescribe to & monitor cp patients. The days of having a family dr that takes care of everything are gone for us. My friend got back pain & her pcp retired so she went to her husbands dr first visit & they treated her with nsaids, muscle relaxers & 30 hydrocodone but referred her to ortho for her back. He did an MRI & she has some stenosis & bulging discs & she got better but about 6 weeks later went in for a bladder infection & she flared her back up again at the gym so they asked about her back & she told them it was hurting again & when they brought her the prescriptions they gave her a referral to pain mgmt so she asked what is this for & they said that they would not prescribe any pain medicine again that she needs to go to pain mgmt. She didnt even ask for pain medicine, she still had some left! She just answered the question when the dr asked about how her back was feeling! Thats how quick the pcp's can be in referring to pm! I am so sorry that you are hurting so much & i felt like i got a clue how bad you are feeling when you said your
    husband helps cut your meat & i wish i knew how to help more, im hurting too & sometimes having someone else who knows what cp really is can help, because it helped me the first time i could actually talk to someone else that knew how it hurts & like me were hurting too.

    Last edited by gmak; 12-17-2013 at 05:25 PM.

     
    Old 12-17-2013, 05:18 PM   #9
    galalena
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    Re: Advice Please--How Do I Ask My Dr?

    Sophia, i do take methadone, a very minimal amount. But I get it from my pain doc, not my pcp. I am sorry if I was not clear. I just went through a very upsetting episode with the pain docs office. Not his fault. Also, my husband had to go out of town for 4 days so I had to do all the barn chores. We have 3 horses. Not a good idea, my arm and shoulder are killing me. But I do not have breakthrough meds so just have to suffer it out.

     
    Old 12-17-2013, 08:26 PM   #10
    SK59
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    Re: Advice Please -- How Do I Ask My Doctor?

    My PCP does prescribe my pain medicine but he has a very small practice so that may be the difference. When he first started me on narcotics I asked him if he would be able to continue prescribing for me and he assured me that he would.

    He also coordinates all of my specialist, makes all of my appointments for me and personally calls me with all of my tests results. He does require that I come in frequently, but it is worth it!

    SK

     
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