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  • I finally saw the PM for the first time today...

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    Old 04-29-2005, 06:39 PM   #1
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    I finally saw the PM for the first time today...

    Hi everyone,

    First off let me thank you all for your prayers regarding my appointment today with the PM. I had seen him before for my peroneal nerve root blocks but this is the first time I have seen him for regular pain management. He was even nicer in his office than at the Surgical Center and spent a good 45 minutes talking with me about my situation. I talked with him about my problems with the Ortho Dr. and he said that the ortho group here has a blanket policy of not prescribing narcotics of any kind for chronic pain. That explained a lot of the problem that I had getting the ortho doctor to do anything besides ultram. I told him that the ortho doc wouldn't refer me to a PM and he said that is because that particular ortho doctor doesn't want to deal with the narcotics issue at any level.

    So he spent quite a bit of time explaining what his plans were and what I could expect. On Tuesday I have a Diagnostic SI Joint Injection. I don't really know what it is but he said that he thinks I have some pretty bad problems in that area. In addition he has scheduled a sciatic nerve root block, peroneal nerve root block, and paraverteberal nerve root block. All told he said that he could inject anywhere from 3-6 locations. He also said that there were several options down the road that we would progress to as needed. Some of the things he mentioned were a device that uses an electromagnetic wave to block radicular pain and if that didn't work a pump that injects medicine directyl into the cerebrospinal fluid. He told me that he understood that I needed adequate pain control while we pursued these other options and put me on Darvon 65 mg 4 times a day and Lortab 7.5 mg 1-2 tablets every 6 hours as needed for breakthrough pain and Elavil 10 mg at bedtime starting at one tablet the first week and increasing by one tablet every week til I am up to 5 tablets at bedtime. He gave me a very good supply of the medication and said if I needed refills to just call his nurse or wife (she's his office manager I think) and they could handle it if I needed anything before I see him again in the office.

    Anyone who has some insight I would appreciate if you could share with me about these medicines and anything I need to be aware of. I have heard of Lortab and know it is a narcotic but don't know much about how strong it is. Darvon I don't have a clue about and Elavil he told me was to help me sleep and to help the other pain medicines work better. I intend to look all these up online this evening, but if anyone has had these medicines and has good advice on things to be aware of and if there is anything I have to watch out for with these medicines I would appreciate it. I can't tell you all how grateful I am I found these boards and all your support. When I first posted here I really didn't know what I could do and as a result of all your advice and support finally have some hope that I can get this pain under control for the first time since it began. It seems like he has a logical progression of things he wants to go through and will adjust medications as needed along the way. Regardless, I finally have a doctor who will treat the pain and is willing to work with me on things so I feel so mutch better than I did before today. Thank you all for your support and I hope everyone is having a pain free day


    Last edited by MavsFan; 04-29-2005 at 08:55 PM.

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    Old 04-30-2005, 06:50 AM   #2
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    Re: I finally saw the PM for the first time today...

    Hi Mav. I'm so happy that you had a good appointment and feel like someone is really in your corner and addressing your pain issues! I think my pain went from a 9 to a 7 just by listening to my PM doc at the first visit! My chronic pain comes from my si joints. As it was explained to me, your si joints are not designed to move. Instead of your sacral joints moving, your spine is designed to do all the moving. But, I have had my entire spine fused and as a consequence, my si joints started to move trying to compensate for my fixed vertabrae. My doc said that this only happens to about 5% of folks who undergo total spine fusion. Anyway, the pain was unbelievable. He said that fusing the si joints would give me a good chance of getting out of pain. Well, my pain went from a 9 to about a 7 on my right side and from a 9 to about a 5 on my right. It wasn't the relief I was expecting. I'm currently going to physical therapy 2 times weekly and trying to regain the muscle strength needed to stand up straight and walk without crutches. Did the doc tell you why he thinks you si joint is injured? You talked about the nerve blocks. Before I had my si joint fusions they needed to make sure that my pain was actually coming from those joints. In order to do that they injected steroids and a numbing agent directly into my joints. Although my pain only went away for a few hours, it proved that my si joints were the cause of my pain. I had 3 of these blocks. They weren't using these nerve blocks as a treatment. They were using them more as a diagnostic tool to see if my pain was really coming from my si joints. As for medication, before I went to a Pain Management doctor, my surgeon was prescribing my pain meds. I was on all the opiates. The problem was the longer I took them, the more I needed to get any pain relief. My pain manag. doc put me on methadone with loritab as a break through medication. These two meds have really improved the quality of my life tremendously! I am not dopey, drowsy, feeling buzzed or high. My pain is at a level 3 or 4 when I'm on my meds. Sorry this is so long, but it sounds like your doc is going through all the correct steps to figure out what's causing you pain. All the best Kathy Mac

    Old 05-02-2005, 11:09 AM   #3
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    Re: I finally saw the PM for the first time today...

    Glad your appointment went so well!!

    Elavil is also known as Amitriptyline. It is an antidepressant used for many different reasons.
    - nerve pain (neurogenic pain), chronic, severe pain and pain syndromes such as ciguatera, post herpetic neuralgia and neuropathic.
    It will also help you sleep.

    Darvon is a pain medicine.

    Old 05-02-2005, 10:11 PM   #4
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    Post Re: I finally saw the PM for the first time today...

    Hi, sorry to butt in:

    I was on Elavil for carpal tunnel/arthritis in my wrist & hand about 3 years ago. I gained 43 pounds. It took me 16 months beginning last Dec. to lose it. My PM doc. just prescribed Nortryptiline (sp) for my nerve pain in my back and leg. I am afraid to take it - don't want to regain the lbs. To boot, the Elavil did not help my pain, only made me sleepy.

    I don't want to steer you away from your medicine, just be aware that one side effect IS weight gain!


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