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    Old 02-18-2013, 04:27 PM   #1
    kittkat
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    Unhappy Venting about Drs. treatment

    Hi, I have had chronic pain for over 30 yrs. I know that seems a long time, but I had been in several accidents as a teen & had twisted facet joints, surprisingly that seems to have abated somewhat, the thing is I never took meds for my pain, I was too scared...Fast forward 30 yrs.
    Christmas (2011) I took a fall down the steps leading to the driveway & slammed my head into my car door, which pushed my head backward, after a couple of weeks I started having severe pain in my neck & I can't move my neck freely anymore, it just locks up & I can't turn my head! My PCP sent me to an Orthopedic Dr. as he won't give me meds for this. I had an MRI & it showed disc damage & he said I had whiplash. The Ortho gave me trigger point injections without much success. He then scheduled me for an epidural in my neck which I later canceled as I had many fears of this & glad I did. He prescribed Hydrocodone 5mg. The last time I had this medication filled was in August, & he prescribed 10mg. Oxycodone & 5 mg. Flexeril. He said he could not renew it for me, so I have had to suffer & take it only when I am in extreme pain. I am at my wits end, because all the DRs. want to do is shoot steroids into you & I don't want that. My PCP said I have to see a PM Dr. but I am afraid they will also just want to shoot me up with steroids. I really hate the way they make me feel by not wanting to prescribe pain meds, if I was an addict I don't think I would still have some meds from August! I am very frustrated! Any suggestions?

    Last edited by kittkat; 02-18-2013 at 05:44 PM.

     
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    Old 02-18-2013, 06:25 PM   #2
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    Re: Venting about Drs. treatment

    Hi, I'm so sorry you hurt your neck it's really got to hurt. I go to a pain mgt dr for pain issues I recently just had to have injections in my ribs they hurt so bad I could not breath! It was from a bad reaction to cipro antibiotic! Unreal.

    Anyway, my pain is almost gone. I've been seeing this dr for at least 6 yrs hubby sees him to for a herniated (or used to be) disc in his lumbar region.

    Hubby is very afraid of needles, very. So the dr gives him two Xanax first and I drive and he doesn't even remember it. If he hadn't had the injection and physical therapy he probably would have had to had surgery on his back which is always your last resort.

    Why don't you give pain mgt a try? You have a very valid reason to see one. I would do some research maybe ask around and try to find a good one I think one with a phyiatry background is always good.

    If you don't want an injection they could try you on an oral dose of steroids to calm the disc down. You've got to do something, it not gonna get better on its own I don't think and I hate to see you suffer. Maybe PT would help too.

    Have you tried ice on it? Sometimes it will help with the infllamation inside.

    Well, I hope this helps. I know it's scary. Orthos just won't give you meds very long.

    Please let us know what you do, cathy

     
    Old 02-18-2013, 06:48 PM   #3
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    Re: Venting about Drs. treatment

    Thanks for your reply Cathy. It is not that I am afraid of shots, I just don't like the idea of anything getting near my spinal column & risking a more severe problem, especially since the mess with the bad drugs that were used last year in these shots, that's when I was supposed to have it done right before that happened, something just told me not to do it. I do want to try the pain management, I just hope they will give me the meds and not try & talk me into more shots. I took 5mg of Oxycodone tonight & it isn't doing anything for me except making me a little sleepy, but I am still in pain in my upper back area. I didn't want to take the whole 10mg. because I am afraid I won't be able to get anymore, so I kind of stretch the ones I have left out. I am so confused about this, I just want to find a Dr. that doesn't look at you like your crazy, you know what I mean?

    Last edited by kittkat; 02-18-2013 at 06:50 PM. Reason: spelling

     
    Old 02-18-2013, 07:04 PM   #4
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    Re: Venting about Drs. treatment

    Well if you go in there maybe with the attitude of trying physical therapy (I had a herniated c5/6 and did pt and epidural and got rid of it I could not move my head) let them know that you really aren't comfortable with the injections maybe try the oral steroids, they'll probably give you a muscle relax and pain medication.

    Btw, those shots/medication came out of a specific compounding pharmacy. I'm sure they have been shut down now.

    Do you have anyone that could go with you to the appt? I think that's always a good idea, maybe a note taker .

    One other thing, you can take a tube sock fill it with long cooking rice but make it so it bendable, tie a knot in the end and heat it up in the microwave and it's awesome!!! It lays right around your neck with moist heat for a long time.

    I think you will be ok with a PM dr they will end up being your best friend in the end! Cathy.

     
    Old 02-18-2013, 07:28 PM   #5
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    Re: Venting about Drs. treatment

    Hi KittKat!

    I completely understand your fear of the spinal injections! To give you an idea of exactly how much it scared me to get injections there? I've given birth to 4 children with no epidurals. I get horrible migraines, and I was more afraid of getting spinal headaches than I was of the pain of giving birth

    That being said, I have since had several nerve blocks and epidurals done in my spine ... they hurt like hell, though nothing to be afraid of. I understand they do help some people tremendously, and the optical nerve block I had done to help my migraines actually did help a bit. I had all of these injections during the time frame that the "bad drugs" were being distributed. I'm fortunate that my former pain management doctor didn't use that distributor.

    I will say that I've had several cortisone shots done, and those have worked better on the back pain and muscular pain I've had over the years ... but they cause me a great deal of pain for several days before they work. On the other hand, you need to find a pain management doctor that will work with you (my previous one only wanted to do injections, not talk to me or discuss other options .. he just wanted to bill my insurance). My current pain management doctor is Korean and spends at least an hour with me on every visit. He does a full examination every visit. He does acupuncture, spinal manipulation and physical therapy in-house. He doesn't do epidurals or nerve blocks (those require specialized machinery to do safely), but he does do cortisone and trigger point injections. He is also willing to work with me on my medication regimen.

    I'm very fortunate that I can trust him, and he trusts me. I have never felt like he looks at me like he doesn't believe me, and I've never felt that he thinks I'm just there for narcotics. I hope that you can find a doctor that works with you as well as mine does with me.

    And most importantly, I hope you have some pain-free moments in between the bad times!

     
    Old 02-18-2013, 07:53 PM   #6
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    Re: Venting about Drs. treatment

    I think the right type of PM doc could be very helpful. I understand the hesitation with certain injections, but do let the doctor explain the risks vs. benefits so you can make an educated decision. I agree to have an open mind to trying various treatments. If you say you only want to try pain meds, that will put up a red flag in their eyes. A good PM doc will try you on a combo of pt, injections, meds, etc, which may or may not include narcotics.

    Some do just offer one type of treatment (such as injections), so you'll want to avoid those. Treat the first appointment as an interview. Just an fyi: it is common to need to sign a contract and do a drug test on first appointments, sometimes even if they don't prescribe meds. I'd bring in the bottles of any pain meds you take, and a list of all your meds/doses/doctors. Good luck! Best wishes.
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    Old 02-18-2013, 08:07 PM   #7
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    Re: Venting about Drs. treatment

    Oh and a copy of any tests you've had done already mine prefers it on cd. I've heard a lot require a contract but mine hasn't yet not that I would mind. I keep him informed if every little thing, like hubby has to take a few meds before he gets a crown now due to panic attacks I emailed him right away and made sure it was ok with him before we eve took the scripts to the pharmacy. He just said he would annotate it in his chart. (I guess you know he's a patient as well lol)

    Cathy

     
    Old 02-19-2013, 02:35 PM   #8
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    Re: Venting about Drs. treatment

    Thanks for your reply's!
    I have already had numerous trigger point injections & they really did nothing for me, & one time it gave me a severe headache! I refuse to have the epidural, I don't care what they say. I know I have to go in with an open mind but I think I know what works for me. I don't really like the idea of being on a daily, throughout the day regime of drugs, I take care of my two year old Grandson & I have to be alert! Why is it not possible to only take them as needed, instead of every so many hours? I think this is what causes people to become addicted. It really stinks, so many Drs. are now refusing to treat someone with meds because of all the addicts out there & people like me who only want relief can't get the meds to take when truly needed. I guess they would rather create more addicts to keep the drug companies in business.

     
    Old 02-19-2013, 02:42 PM   #9
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    Re: Venting about Drs. treatment

    All my pain meds are written as PRN my nerve pain meds I have to take everyday because that is how it works. Cathy

     
    Old 02-19-2013, 04:25 PM   #10
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    Re: Venting about Drs. treatment

    Quote:
    Originally Posted by no34evr View Post
    All my pain meds are written as PRN my nerve pain meds I have to take everyday because that is how it works. Cathy
    Cathy, what does PRN stand for? Also can you explain what what the term "breakthrough meds" means, I have seen that term on here many times.

     
    Old 02-19-2013, 04:44 PM   #11
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    Re: Venting about Drs. treatment

    Prn is take as needed, breakthru meds are for when your pain is so bad your regular meds aren't strong enough at that time and you need a something little extra to help you manage the pain. They aren't normally taken all the time
    depending upon the individual and the amount of pain they are dealing with.

    I usually have to have them when my shoulder is really bad or my fibro is flaring. Cathy

     
    Old 02-19-2013, 04:53 PM   #12
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    Re: Venting about Drs. treatment

    I see, thank you Cathy. I also have Fibro. I guess I have been using my meds as a "breakthrough" med, I can now understand why these meds are prescribed as they are.

     
    Old 02-19-2013, 07:47 PM   #13
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    Re: Venting about Drs. treatment

    They usually would start a patient on pain meds as needed (such as the typical Vicodin or Percocet). However, for chronic/constant pain that doesn't respond to non-narcotic treatments, it will usually best be managed with a long acting plus short acting med combo. This is as when using short term meds to manage constant pain, you get a lot of ups & downs.

    Short acting meds are actually more likely to cause tolerance to build faster (requiring dose escalation), as well as being more likely to cause a patient to have that "high" feeling. Addicts would want short acting meds. So, some doctors would think its a red flag if someone has constant pain that hasn't responded to non-narcotic treatments but refuses a long acting pain med.

    Although if you could get by with only taking a small amount of meds, then maybe I could see that as a possibility. If a long acting med & dose is appropriate for you, it shouldn't make you feel drugged or impaired. However, some do feel that its not the best idea to continue driving, etc. I can say that I've never felt impaired and continue to drive, work, etc. If a medication impairs you, then likely either you need to give it a bit of time for the effect to subside, the dose is too strong, or its not a good med for you.

    Although I agree that as patients we often know what is going to work best for us, that will work against us if we refuse treatments we haven't tried. Sometimes a doctor may even want to re-try something...hopefully this is because they think it will be different the second time around. For example, using imaging guidance on injections, or trying an adjunct med for two months instead of two weeks.

    Its impossible to predict how someone will react to a medication, so I like to always start a new med at home when I don't need to be anywhere that day. Most of the adjunct type meds do need to be taken daily, and some have the potential for impairing effects such as drowsiness, but that should be apparent from the start. Hopefully this new doctor will have plenty of ideas you haven't yet tried.

    I know its tough to be patient while waiting for appointments and trying new treatments, but have hope that you will find a good treatment plan. Often what seems like the easiest route (pain meds) isn't so, as they can cause more problems long term. I wish I had delayed starting them even longer, as now I have such tolerance that I can't get relief anymore, as my dose requirement is so high that doctors aren't comfortable raising it more. Best wishes.
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    Old 02-19-2013, 08:38 PM   #14
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    Re: Venting about Drs. treatment

    Quote:
    Originally Posted by tortoisegirl View Post
    They usually would start a patient on pain meds as needed (such as the typical Vicodin or Percocet). However, for chronic/constant pain that doesn't respond to non-narcotic treatments, it will usually best be managed with a long acting plus short acting med combo. This is as when using short term meds to manage constant pain, you get a lot of ups & downs.

    Short acting meds are actually more likely to cause tolerance to build faster (requiring dose escalation), as well as being more likely to cause a patient to have that "high" feeling. Addicts would want short acting meds. So, some doctors would think its a red flag if someone has constant pain that hasn't responded to non-narcotic treatments but refuses a long acting pain med.

    Although if you could get by with only taking a small amount of meds, then maybe I could see that as a possibility. If a long acting med & dose is appropriate for you, it shouldn't make you feel drugged or impaired. However, some do feel that its not the best idea to continue driving, etc. I can say that I've never felt impaired and continue to drive, work, etc. If a medication impairs you, then likely either you need to give it a bit of time for the effect to subside, the dose is too strong, or its not a good med for you.

    Although I agree that as patients we often know what is going to work best for us, that will work against us if we refuse treatments we haven't tried. Sometimes a doctor may even want to re-try something...hopefully this is because they think it will be different the second time around. For example, using imaging guidance on injections, or trying an adjunct med for two months instead of two weeks.

    Its impossible to predict how someone will react to a medication, so I like to always start a new med at home when I don't need to be anywhere that day. Most of the adjunct type meds do need to be taken daily, and some have the potential for impairing effects such as drowsiness, but that should be apparent from the start. Hopefully this new doctor will have plenty of ideas you haven't yet tried.

    I know its tough to be patient while waiting for appointments and trying new treatments, but have hope that you will find a good treatment plan. Often what seems like the easiest route (pain meds) isn't so, as they can cause more problems long term. I wish I had delayed starting them even longer, as now I have such tolerance that I can't get relief anymore, as my dose requirement is so high that doctors aren't comfortable raising it more. Best wishes.

    Just wanted to say not all opioids have highs and lows such as Opana for instance, it comes in short and long acting too! It's a great med! Cathy

     
    Old 02-20-2013, 07:36 PM   #15
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    Re: Venting about Drs. treatment

    I was referring to short acting pain meds having highs & lows (for most folks), and at least compared to long acting pain meds.
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