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babs17 03-30-2007 07:31 PM

Unrealistic goal for Pain Mangement???
I am not sure if I am asking for too much relief...I know that I should only expect aprox. a 70% pain decrease...and I'd love that, and would be most appreciative to my healthcare workers

BUT it seems that my meds (doubled since I started seeing my PM MD)/stretches/warm compresses,/ice/relaxation techniques/brisk walks at this point, but no matter, as soon as I increase my activity ...BAM!...the same pain comes back. So, I might experience barely any pain when I am just lounging...maybe a 4/10, but when I go to PT (for example), or food shopping, it always increases to a severe level. Does that EVER go away, or is that an unrealistic goal for pain management??? Thanks.

babs17 03-31-2007 07:34 PM

Re: Unrealistic goal for Pain Mangement???
Wow! I'm all alone on this one. I figured one of the people that are at 3000 posts would throw me a bone here. Has anybody lived a half normal life after a bad back injury + surgery? please....:wave:

Shoreline 04-01-2007 12:08 AM

Re: Unrealistic goal for Pain Mangement???
Hey Babs, People do get better or at least reach a point where they realize they have control over the quality of their life. My 3rd and last surgery was a complete revison of a failed fusion with broken hardware in 99. It took about 2 years for this set of hardware to break and I had already been through 2 month long PM programs and seen 10-12 PM docs and learned and tried every non opiate method to manage pain I have ever heard of.

I was eventualy referred to a PM clinic that did use opiates but also stressed PT, the psychology of it, the patients role in dealing with it and although I finally got relief, the only thing that seemed to change was my level of pain. I was disabled, couldn't walk or stand for more than 10-15 minutes. I would break into a sweat and turn gray while at the grocery store and life was pretty miserable although my pain was being managed to their best ability. I reached a fairly high dose of methadone or morphine and still was in pain, but at least it was tolerable.

After several years passed just living and being isolated trying to keep pain to a minimum, I realized I was going to have pain regardless of what I did. I new I had lost all my endurance, muscle tone , stamina, gained 35 lbs and really couldn't say PM did anything more than reduce my pain when I was sedentary. So I opted to have a pump. I felt like I owed to to myself and my family to try or do anything that might improve myy life.

Once you realize that's all pills can do, you have to decide how you want to live the rest of your life. If your going to hurt from sitting on the couch all day or going to hurt from walking 10 minutes a day, whayt do you have to loose by walking or finding someway to start rebuilding what being sedentary has cost. If walking hurts too much, swim, if swimking hurts, bike, if a bike hurts use a recumbent bike. Find what causes the least pain and get moving again.

I started excercising and I started very slow, 5 minutes a day on an elyptical walker I bought 16 months ago. From 5 minutes I went to 8 minutes, then 10 then 12, then 15, and so on and so on, It took 7 months to reach a point where more than 50 minutes was just too much and I wasn't able to manage the pain so I decided to break the work out into teo shorter sessions a day. I started at 15 minutes twice a day and progressed to 30-35 minutes twice a day. I had nothing but time on my hands and it's up to us what we do with it. This equated to 5-6 miles a day. It doesn't mater if you set goals for time, milage, or whatever , as long as you continue to increase at a rate that's tolerable. Even if it's just 2 more minutes a week. You may nit feel better week to week, but if it's not increasing your pain every weak to a level that you can't tolerate, you must be benefiting in some way.

I haven't had an increae in meds since I started excercising, I've lost 35 lbs and i returned to work part time last september after almost 6 years of being disabled and on SSD. It did take 2 years to get aproved for SSD and cost me our home, our credit and almost my marriage. Fortunately I decided I couldn't live like this anymore before my wife decided she couldn't. That's when things changed.

The pump certainly helped, I doubt I could have motivated or endured the side efects while excersing and returnig to work. Now I work 3 or 4, 7-10 hour days a week. I'm in the work trial perriod so I haven't lost benefits and can continue to earn up to 900 a month even after the fist 9 months.

My problem is, I would like to get out of the house more often but shorter dayse because the isolation is the worst. Despite my efforts I' not able to work full time or day after day witout a break. My trial perriod is coming to an end so I will have to cut back or I'll loose benefits. I can't work two 8 hour days in a row , and after work I hurt and the next day I hurt, but mentally I'm 100% better than where I was when I spent the days just trying to be comfortable.

Once I had the elyptical sitting in my den, I would feel guilty if I didn't do something every day to improve my position. My spine hasn't fused, the hardware hasn't been fixed, But through strengthening and endurance training that no doc or PT would have ever pushed me to excercise every day twice a day, I am able to spend 8 hours on my feet and make a couple hundred bucks a day doing it.

When you get sick of spending your life on the couch , only you can do something about it. There isn't a pill that duplicates excercise, there isn't a pill that will relieve all my pain, there isn't a drug that makes spending your life on the coach OK. Regardless of what I do, I'm going to have pain. I have the choice of spending the day on the couch or pushing myslef to do as much as I can. There isn't a pill to motivate, it's not a docs job to motivate. If sitting around getting fat and weak and loosing endurance is tolerable, you can choose to live that way. When it's no longer tolerable, you can choose to do everything in your power to change things. Despite a temp increase in pain which will come back down, the benefits of activty, having purpose and feeling usefull far outweigh the increase in pain. Not to mentuion the extra money.

Unfortunately part of meds making pain tolerable is they also make living that way tolerable. Only you can decide when living like this is no longer tolerable and decide to do something about it. What do you realy have to lose by trying to rebuild what surgery, meds and living sedentary have done to your life. 705 reduction in pain is a high goal in my docs opinion. With a pump, 50% relief is considered a sucessful trial and an obtainable goal. Some people get better relief and some don't, but my doc will keep me in the 50% range if I tell him I'm not there yet.. On my best days I'm in the 5 range, ater 8-9 hours of work, I'm in the 8-9 area, but I know I Haven't caused new inury, I'm just paying a price but the benefit outweighs the price in my mind.

Docs and meds can only do so much, the rest is up to you. I still don't sleep well, I think I have slept more than 4 hours straight 3 times in 7 years. I hurt after work and end up at 3am like now on the net, but I had a productive day. I'll hurt tomorrow too but I'll be ready to go back and do it again on monday. Or I could spend the rest of my life getting more out of shape, gaining more weight, spending my days on the couch which just make me stiff, restless and depressed.

I know when your in pain excercise is the absolute last thing you want to do, but when living that way becaomes more intolerable than the pain, you have nothing to lose by doing everything in your power to change the way you life is going. I decided years ago i wasn't going to have more surgery unless hardware came flying out of my back or I lost neruological function. Excercise has only benefited me although it does increase my level of pain, but it does come back down to what I'm used too. I'll never know a pain free day, but I never want to feel as useless and depressed as I did after spending 4 years doing nothing but trying to avoid additional pain. More drugs would just mean more side efects, less motivation, decreased sex drive, increased urinary retention and feeling impaired by the meds. The only way to go on for me was to change what had become a tolerable way to live. Prior to my back injury and first surgery, I never could have imagined just existing to avoid pain.I think the meds allowed this to hapen and getting the pump cleared my head enough to decide I wasn't going to live the rest of my life that way.

It's not that the pump relieves more pain than orals, it just doesn't cause the impairment and lack of motivation that orals do.

Part of MY PM was years of psychlogist and learning to cope and understand that pain is no longer a signal that I need to go get an Xray or a new MRI or see a doc because I'm having a flair or increase in pain. I know what my pain levels are and should be and what to expect. So I don't need to go to the ER and find out what I already know is wrong. Obviously if thnigs change and I start peeing on myself or I can't lift my legs or something major changes I would have it looked at, but an increase in pain is expected from activity. I have a 6 level failed fusion and broken hardware in my back. It crunches and grinds and squeaks, it feels like it's going to pop out of my back and go running across the floor like the movie Alien, but untill it does, I've learned to accept that this is as good as it will get and how I live my life is up to me, not the docs.

I hope this is what you were looking for. YES, you can get better, but only you can decide when living on the couch avoiding any increae in pain has cost you too many years at too great a price.

Get moving, get motivated and don't except that way of life any longer.
Good luck, Dave

babs17 04-01-2007 02:23 PM

Re: Unrealistic goal for Pain Mangement???
Thanks for your response and sharing your personal story....with your good days and bad days.... and crossroad you are at now....and your motivation techniques. You are correct all the way through your response. Thanks for that. I am currently fairly active. I do feel the Isolation though, b/c I am a very social person, and I put most of my energy into doing things to get me better. So, by the time I am done with that...I am in too much pain to see friends, or I am just too tired/stressed to be in a social environment. And by the way, all of my friends live at least an hour from me. I onlt have one very busy friend that lives 1/2 hr from me. So, I just don't know when I should expect to be healed well enough that I can start to go travel and visit people. Expect more of myself. Not by how far I can walk...but, if I can sit thru a long dinner, or make it thru a movie. I guess I am just afraid that I am going to hurt myself even more....I already did this.
When I first got injured 6 years ago...I decided 10 months of PT every day, no drugs and no surgery was a good way to go. I had to change almost eveything about myself and the way I live...but I did, and I got in happy place last year, and then I pushed it too far, and I got injured worse. This last injury kicked me in the arse really hard. Had to get surgery, and all....and my parents and loved ones are just constantly telling me to calm down and that I am doing too much. (BTW, I've never been a good couch potatoe b/c I feel like that is a waste of being alive). However, as you know, everything has a limit for people that have Chronic pain. If my doctor told me that I can start running...I would. But he did not say that. He said gentle PT for another 3 months. And I am still be treated for other parts of my back that are still injured (they are not part of the surgical area). I'm still getting Injections of all sorts every month. But no matter how much or how little I do in a day....same pain. I guess that what my original question was....No matter what procedure I have ...or how little/much activity I do....I'm going to be like I feel today. Thank God I have a healthy self esteem....I don't know how many people can self-motivate. I guess I was just looking for someone to say that it does get a bit better. I guess I can't judge my wellness til at least the 1 yr mark of the surgery. Alrighty. Take care.

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