It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board

  • new to pain management

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 03-11-2013, 08:34 PM   #1
    WVman
    Newbie
    (male)
     
    WVman's Avatar
     
    Join Date: Mar 2013
    Location: branchland wv
    Posts: 8
    WVman HB User
    new to pain management

    a few years ago i had an accident. went to hospital, took an x-ray, said i just sprained it. went back to work 3 days later in awful pain and have worked since. i do construction work. about 2 years ago i got a pcp and he ordered x-ray..the results - chronic-appearing scaphoid fracture, sclerosis, and possible osteonecrosis, mri may be of further benefit. doc ordered mri the results- non-united scaphoid fracture with avascular necrosis and osteoarthritis. he prescribed hydrocodone 5/500 3per day..that was after tramadol, t3s, and otcs. he left that job. clinic he worked for said i needed to choose another dr. from there so i did. he called in my 5/500 3/day for 3 months and went i went to see him he cut them down to 2/day then 1/day then 20 for the month then 10 for the month, then none. i told him that they were helping me a decent amount except when i worked construction for 8-10 hrs a day constantly using my hands and bearing heavy loads. he said there was no data "out there" that supports my condition should be painful. this was upsetting, i told him i am the data :/ .. anyway i called a pm clinic and told them my conditions and the receptionist said i could be treated there for that. i was wanderin if anyone would know if a pm doctor would see that i could very well be in pain or say no u cant be in pain..i do hear this dr. is a passionate dr..any insight plz and i also talked with an orthopedic dr. and she said where the injury is several yrs old and the bone has died and fragmented there isnt much can be done. she said i could have diff types of surgery but there is a very high chance that it will not work and could be worse than before and would take up 2 a yr+ immobilised to c if it would even heal..i have to work so that is not an option anyhow

    Last edited by WVman; 03-11-2013 at 08:38 PM.

     
    Sponsors Lightbulb
       
    Old 03-12-2013, 01:49 AM   #2
    gmak
    Senior Veteran
    (female)
     
    Join Date: Oct 2012
    Location: USA
    Posts: 2,649
    gmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB User
    Re: new to pain management

    Dear WVman, Im so sorry that you are having this bad pain, i have pain everyday & i can relate! I also had an injury that no dr told me about & while waiting to see what happened i missed the realm of time where it could have been repaired. My dr explained what happened with second PCP & it is a new pain mgmt guideline
    called "evidence based medicine".

    Evidence based medicine means if your condition has no study or isnt proved to cause pain it does not exist or require narcotic pain medicine because their is no evidence that this unstudied diagnosis causes pain.Studies or research is done by pharmaceutical companies, by drs in large teaching hospitals, etc & they provide the evidence, with providing the study that shows that the diagnosis, that has been studied & trials done causes pain & with the study often the results come with a medication recommendation that they, the researchers, have found effective to treat this determined to cause pain diagnosis,along with the dosage sometimes & if the diagnosis is rare,not affecting the "masses", uncommon or not considered important enough to be studied then there is no study & therefore no evidence that this condition causes pain & therefore does not warrant narcotic pain medication. According to my dr if no evidence, in other words, no study, then this diagnosis does not exist, there is no proof that it causes pain so the prescribing dr is not covered if the DEA comes to review all their patients records, Like me & many others you are probably used to the dr treating the symptoms that you have or they have the MRI as proof enough that you are in pain & give medication based on my drs statement these days are dwindling away.

    My dr told me if a dr is investigated they will not look to see what my MRI shows as justification for giving narcotics, but will only look for the practice of evidence based medicine by that physician. For instance, my condition has been written about by drs in medical journals, articles, publications but has not been studied in controlled groups(although it has) that are done to make a recommendation to drs about which medicine works the best or the studies are not part of the documentation
    that is included in the evidence. My dr told me that Pain mgmt is a God send to regular physicians that dont want to stick their necks out for pain patients & have to take the risk of being red flagged & then investigated.

    Pain mgmt is not hard, in my opinion, you just tell the truth, do all that they say to do exactly how they say to do it & keep them informed, updated, keep appts, keep pain contract etc the hardest part is finding one who listens, believes you & comes up with a treatment plan that works& cooperate with drug testing
    to make certain that the meds prescribed to you are taken by you, in my opinion & it is worth it to keep a dr who helps me function! Thank God that the PM is already known to be compassionate!

    Last edited by Administrator; 03-12-2013 at 11:10 AM. Reason: typos

     
    Old 03-12-2013, 10:09 AM   #3
    WVman
    Newbie
    (male)
     
    WVman's Avatar
     
    Join Date: Mar 2013
    Location: branchland wv
    Posts: 8
    WVman HB User
    Re: new to pain management

    thank you for your input..it just doesn't make sense for example a panel to get together and say, we have 100 cases of the same condition and 75 of them say it does not cause them pain and the other 25 says it does.the 25% must be crazy or cry babies..lol..i think its unfair..it happens tho'..i dont quite understand this dr. he says, u r only 29 and if you keep takin these meds u will need hydrocodone 7.5s then the 10s and after that you will need percocet. i know u can grow a tolerance to meds, but i thought i was managing pretty good on hydrocodone 5s for 2 yrs. then he says, there is no data, which i've done research and have found a lot of scholarly data, but it wont do any good to show this to him as i think he doesnt give a flyin' fiddle anyhow..i have worked for a roofing co. since i was 19. this type of work requires you to bear a lot of weight most of the day. and when i aquired this so called sprain, i went back to this work 3 days later and for the next few yrs it put my wrist through hell and messed it up beyond repair. he said well, these meds only mask the pain. i said, i know this, and thats what i want to do, since it cant be fixed and i can be more productive at work. i have an appt. with him sometime in april. i will then let him know, that i am going to go to a pain clinic, and see if i can keep him for other things like heartburn meds. etc.

     
    Old 03-12-2013, 01:20 PM   #4
    backhurtz
    Senior Veteran
    (female)
     
    backhurtz's Avatar
     
    Join Date: Oct 2008
    Location: NY, USA
    Posts: 818
    backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
    Re: new to pain management

    WV mn,
    Osteonecrosis is the death of a bone- it can be in any joint, but in the wrist it is called Keinbock's Disease. I also have it in my wrist and it is painful, especially when the bone fragments and I move it wrong or lift something that I shouldn't. Depending on the stage of the osteonecrosis, determines it's treatment- surgery can be done, that can restore most of the function of the wrist but may fuse part of the flexibility. And it can completely reduce the pain associated with it...
    As far as pain goes, treating it can be done, but unless you treat the condition, it can cause further problems down the road, arthritis throughout the wrist /hand and eventually cause the loss of the use down the road, depending on how fast it progresses.
    Seeing a pain management doctor would be a good decision for you, and if you can also find a physiatrist, he can help direct you to the right doctors to have your condition evaluated by the right doctors who are familiar with the condition. Most regular ortho's are not equipped to treat osteonecrosis, I've found...you may need to see an other who specializes in treating this condition....or check the ortho hand surgeons' website on the internet for one near you.
    __________________
    Back surgery x2

     
    Old 03-12-2013, 08:02 PM   #5
    WVman
    Newbie
    (male)
     
    WVman's Avatar
     
    Join Date: Mar 2013
    Location: branchland wv
    Posts: 8
    WVman HB User
    Re: new to pain management

    i have heard of keinbock's disease, i didn't know that that is what osteonecrosis is called if in the wrist..yea, thats what mine does when i rotate it; is crackle, pop and grind and very painful depending on the activity. im not sure of the stage it is in, but i do know that the initial injury is about 6 yrs old and i have worked the entire time roofing..which was 6 yrs of bearing heavy loads on it and twisting and turning in all different directions. i talked to an ortho about it, but im not sure if that was her specialty or not..it has been awhile back and it seems that there was mention of a bone graft or fusion maybe..and a good chance that it may not work or it could have a very long period of immobilisation..i have some motion in it (it's my left hand), but if i try and turn it toward the right it has none what-so-ever, like it is completely locked up..and if im working or doing something that puts pressure on it pushing toward the right it will bring me to my knees..i know ur not a dr. but i am goin to try and explain the pain to you and see if urs is like mine. i feel as i have trouble explaing my pain and explaing it to the dr. as well..most of the time (when not doing anything) i have "almost" constant shooting pain going from wrist toward my elbow and it is intense enough to cause an anxiety type of feeling in my stomach and/or chest along with a deep ache. i can rid it of the deep ache with lodine or some other type of nsaid but not the shooting pain. when i am working and using my hands the shooting pain will increase from an anxeity feeling in my stomach to being nauseous and it takes awhile to calm back down after i start resting (without pain meds). and it takes while for me to go to sleep..around 2 yrs ago another issue arose in the injured wrist..just right above my elbow, i get a terrible burning sensation that lasts for 2-3 hrs at a time. i have tried the nsaids, otcs, and tramadol and it doesnt work. i can take 1 1/2 hydrocodone 5mg and after about 30min it quits. i really never knew just how hard it was to explain pain to a doctor or anyone for that matter..if you wouldn't mind could u tell me if this has any relation to the pain u feel.. thanks

     
    Closed Thread




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 07:52 PM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!