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    Old 02-01-2014, 02:20 AM   #1
    OutdoorMan
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    Need pain management help/advice

    Hey everyone and thanks for reading my post. Honestly I just hope there is some advice out there that will get me help I'm begging for.
    To start out this is my first post, I've gotten to the point I need help and this seems like a good place to start.

    I'm 28 I've had chronic pain for the last 4 years. It's affected my life in many ways which is true for any chronic pain patient I'm guessing.
    I work as a Millwright and heavy equipment operator, and due to my pain I often loose or have to turn down work. My pain takes away from being able to do the things I love like hunting, fishing, hiking, and things like that. Sometimes I hurt so bad I can't even go to church, (I have faith but also go more now for the ore wedding stuff)

    I'm also worried how my pain is interfering with my relationship with friends, family, and most important to me my new fiancée. Because more often then not I hurt to much to wanna go out and do stuff with them.
    (Sorry to give my intro on here)

    My problem is getting help. I live in rural northern minnesota and can't seem to get help for pain. Despite my obvious pain I'm told by old doc I'm too young to be on pain meds for chronic pain because he says "I don't wanna be on them for my whole life." What the hell I would rather be on then and have managed pain then, off them and have no real life at all except misery.
    I recently switched doctors but don't even know how to start the pain management convo so I don't get shafted again.
    I've taken perc Vicodin, oxy, and methadone after surgeries and for awhile when I had the one doctor that started to help me but moved. It was great I had a doc that wanted to help and had a life that I got a lot accomplished for 7 months, after he left my new doctor just cut me off leaving me with some horrid withdrawals.

    So how do I talk to my new doc. Show him I'm not a druggy. I don't want the high of drugs but the high of having a life. Explain my struggle and goals. Get my life back, I wanna work regular again. Yes the stronger meds like Perc and oxy worked great but I have to take them all day, the pain wakes me up and I even end up taking them at night. Recently though I had an accident and went to the ER in a different town visiting family. The doc gave me muscle relaxers, fentanyl patches 50mcg, and some perc for breakthrough pain. It was amazing I loved the patches. They didn't get me "high" no buzz but I was pain free. Then the percs help when the pain would get a bit heavy. This is the best I have felt in years. I know I wasn't 100% pain free but I was living life.

    So how do I try to get this treatment plan from my new doc? Explain I don't want to be high. And that this has worked. I feel that if I tell him exactly what I want then it will make me look even more like a drug seeker.
    Thanks for reading all this and helping if you can.

     
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    Old 02-01-2014, 11:44 AM   #2
    LadyBassPlayer
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    Re: Need pain management help/advice

    Hello Outdoorman and welcome to the board.
    I'm sorry you are having so much pain and problems finding the right kind of medical help. You didn't mention the nature (source) of your chronic pain so it's hard to know whether to try and suggest other treatment modalities like physical therapy, TENS unit, etc...or maybe you have tried those.
    As far as finding a new doc....you may have to travel a bit. Can any of the docs you have seen give you a referral or suggestion? Is there a regional hospital with a physician referral service?
    One thing I will suggest is to write up your history of pain and meds you have tried and the response you had. If you go in asking for a certain narcotic, that's bound to be a big red flag for the doc, but if he can see what you have tried in the past, he can best determine what to do to help you.
    On a side note...I'm extremely surprised that an ER doc gave you Fentanyl patches. Having worked about 10 years in the ER, I never saw that done. Especially at that dose of 50 MCG/hr. That kind of med and dose would only be reserved for someone who is opiate dependent at a fairly high dose already. Anyway, just surprised at that.
    Best wishes for finding a new doc and getting stabilized on a good pain management regimen. Keep us posted!
    ~~~LadyBassPlayer~~~

    Last edited by LadyBassPlayer; 02-01-2014 at 11:47 AM.

     
    Old 02-03-2014, 06:47 AM   #3
    Shoreline
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    Re: Need pain management help/advice

    Hi Ouitdoor man, Yes it is more difficult when your young. My first back surgery failed when I was 28, back in the early 90's they simply didn't treat chronic pain with opiates, almost every med they use today didn't even exist back then. From my first surgery at 16, wisdomt teeth to the last 6 level revision of my failed fusion I was given 5mg percocet for pain. So nothing I was ever given would have given me the tolerance for a 50 mcgh patch. Im not judging you based on that , Im just courious what is your source of pain, you claim your obviously in pain, Im not sure what that means. I have a nephew that was hit by train, broke over 50 bones, had a brain injury and was in hospital for 4 months who looks like a walking Frankenstein of scars but at 18 I have never once heard him complain of pain. He walks with a cane and a limp and calls it his pimp walk. So there really is no such thing as obvious pain despite scars and dissformity. I have broken both my arms so many times both are limited in range of motion by 50% but they don't cause me any pain, I have broken more bones than I can count and none of them cause me pain, Now the failed back surgery which cant be seen by anyone is what makes getting through the day tough and just standing in one place for 30 minutes completely impossible.

    I can imagine finding a doc in a rural area being difficult but I would also imagine finding any type of medical help difficult, What other methods aside from pain meds have you tried to help you pain, PT, PM clinics where your taught to learn to live with pain, using bio feedback, self hypnosis, guided imagery,stretching and core stabilization methods What interventional procedures have you tried, Trigger point injections, TENS, TINS, nerve blocks and cortisone injections. Just because opiates are available doesn't make them the first line in treating chronic pain, Doctors that have given you meds although they work, have done you a disservice if they haven't given you any other tools to manage the pain. All they have done is taught you this works and whats the point of trying something if it doesn't come with the same guaranteed relief.

    Things are changing because there isnt much data that supports long term opiate use is more successful than any other treatment. The latest studies pretty much lean towards resetting your pain threshold through work hardening. Everything you have been told to not to due to avoid discomfort they force you to due and after about 6 weeks you body becomes accustomed to functioning in high degrees of pain making things like walking or hunting and fishing nothing compared to what you did during the work hardening program.,

    I actually did one of these back in the early 90's and although it didn't cure my pain it did teach e that I can get through just about anything one hour or 4 hours at a time. I am disabled by the multiple failed attempts to fuse my spine but I still work part time because I can get through a couple 6 hour shifts a week and survive, I do pay for it and I I would be considered a high dose opiate patient, But I know without hesitation hat I have tried anything and everything ever asked of me before opiates were even offered or 10 mg percocet was even available. Part of learning to cope is learning that we are a lot tougher than we think, you already know the consequences of running out of meds, Most of us in PM have contracts and pill counts and do UA's and running out early will get you discharged, being short on a pill count will get you discharged, and when you live in an area that is prone to severe weather, a snow day can turn into 5 days of extreme withdrawal if that is the soonest they can get you back into a rescheduled apt. They cant call in Class 11 drugs. Things like hunting and fishing arent really quality of life issues. No doc is going to make it his goal for you to be comfy in a deer stand for 8 hours or make it more uncomfortable to carry a dressed deer carcass 7 miles out of the brush.

    When you are in pain your in pain everywhere all the time, once you realize that you can start making some sacrifices for your fiance or she likely will leave. Are you not just as uncomfortable sitting on the couch as you would be sitting in a movie theater, so you take your fiance to dinner and movie, You have to eat anyway and you would be just as miserable sitting on the couch watching CSI as you would in at a movie. Avoiding all activity that might cause pain will turn you into a home bound recluse and you don't have ties to any woman other than your mom, that is going to put up with that crap for any length of time, When I say you dont have ties I mean you haven't been married for years, don't have kids, don't share financial responsibility, so yes, your girl didn't sign up for Mr grumpy and that is something that is up to you to change whether you have a fentanyl patch on or not. I decided along tme ago that my wife wasn't going to go to bed alone every night just because I cant sleep, I will go to bed, cuddle, love and rub her back untill she falls asleep and then get back up if I am too miserable to sleep, but sending her to bed alone is a choice, I can be selfish and say there is no point or I can understand my wife deserves to have her husband come to bed with her every night.

    I do wish you luck and I have strong suspicion you have a long ways to go as far as trial and error before any doc is gong to say opiates are your only choice. If you keep them in the forefront of you thought process and dont want to hear about any alternative treatment or modality, you wont have much luck and you do you know the price you pay for being dependent on these meds to get through the day. Just as I am curious as to what is wrong, how did it happen, how is it different from anyone else that broke a bone or had surgery, they also want to know what other methods have you tried in order to justify prescribing these mesds. They should be last resort and that hasn't been the case the last 12 years for many people and the outcome hasn't been all that positive for many people. You will need to be able to justify the use at some point and knowing that you have tried everything else and really dont have a choice is the only thing that makes the whole mess as far as using opiates every day make sense. I do wish you luck but i don't know nor would i give advice to take a shortcut to opiates and avoid everything else that may be useful without the cost of being dependent on opiates. Welcome and good Luck, Dave

     
    The Following 7 Users Say Thank You to Shoreline For This Useful Post:
    BB07 (02-03-2014),ferd144 (02-03-2014),LadyBassPlayer (02-05-2014),Pandie (02-03-2014),PhilliesFan20 (02-03-2014),tortoisegirl (02-04-2014)
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