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    Old 08-01-2014, 09:14 PM   #1
    AWildHeir
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    Question New to Board and somewhat new to PM have questions

    Hello everyone. I have been in PM FOR A LITTLE OVER A YEAR NOW. I came to PM after many attempts to manage my herniated disks in my neck. I started on 5/325 hydrocodone 4x day, mobic 7.5 1x day, and flexeril 10 3x day. This worked for a while until I did something to aggravate it and also was diagnosed with arthritis in all of my lumbar spine. We bumped it up to 7.5 hydro with everything else stayed the same. I am significantly visually impaired and a lady didn't look before she pulled out so I was then hit by a car and ended up with 5 stress fractures in my knee and a bulging disk in my lumbar spine. The hydrocodone was raised to 10/325 4x day. This works as long as I am not up on crutches and my other leg that has referred pain and my foot goes numb from the disk if I'm up for more than a few minutes. I got an epidural a week ago that worked for a few days but is totally gone now. At the end of the day the pain is pretty bad especially if I have been up on my leg for a bit that day. I wake up in quite a bit of pain. I have expressed this to my doctor the last two times I saw him. The pain in my lower back leg and numb foot goes right through my medication. I have also expressed this to my doctor. He told me lady visit that I am maxed out on the hydrocodone and that I am too young for the long acting stuff. Any thoughts or suggestions. I just don't want to hurt. I just want to be able to go about my life and be productive in as little pain as possible. I want to be able to lay down and go to sleep waking up in less pain as I can. I am totally new to all of this essentially and don't understand that there isn't anything that we could step up to to take care of this.

     
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    Old 08-02-2014, 08:47 AM   #2
    solofelix
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    Re: New to Board and somewhat new to PM have questions

    Hi,

    Welcome to HealthBoards, its good to have a new member and I know you will
    soon get a response to your question.
    Wishing you well,

    Solofelix.

     
    Old 08-02-2014, 10:03 AM   #3
    tortoisegirl
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    Re: New to Board and somewhat new to PM have questions

    Welcome! It sounds like your doctor isn't a good fit. Maybe you can find another one who will try other treatments for you. Typically adjunct meds and alternative therapies are used in conjunction with the opiate pain meds to maximize relief. Yes there are stronger meds available, but as a patient's tolerance will only rise over time, the goal is to keep the dose as low as possible.

    I don't think it is right however for a doctor to do nothing when a patient's pain is under control. Patients and doctors should discuss what pain management goals are reasonable. 50% pain relief is often a typical reasonable goal. You may want to seek out other doctors and go to initial consultations to see what their treatment plan would be for you.

    Just be careful not to sign any contract or accept any prescriptions, until you would formally cancel your relationship with your old doctor and start one with the new doctor. It can be quite difficult to find a good pain management doctor who uses a variety of treatments to get their patient's pain under control. I hope you can get more relief soon. Best wishes.
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    Old 08-02-2014, 02:22 PM   #4
    tuloud54
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    Re: New to Board and somewhat new to PM have questions

    Welcome, Sorry you have to search for this type of board at your age! Not sure how old you are but young is your saying. Remember the first med you were on and how soon it just didn't work as well? Most opiates will need to be increased,over time,which creates quite the dilemma for patients and drs. I started on Darvocets in 2007 and within 6 months,they did not work. Switched to vicoden 5mg and 6 months later went to 10mgs.6 months later switched to 5mgs Percocet,etc.etc.ect. I was 54yrs before severe pain got me so bad that I welcomed death.I at least had lived a good life and that is what I wish for you! Not knowing your age,if injuries will get better and other factors most drs are scared of treating young patients aggressively due to tolerance issues. You will reach a point when pain is really hard to manage.I wish I knew how to help but at least get a second opinion and do not get any meds until releasing prescribing dr.With the laws today,it was easier for me to get a pain pump and not worry if my pain was going to be covered constantly. I hope you heal some. Definitely get a second even third opinion on what is the safest,long term plan for you to manage your pain! No easy answers but people here have helped me.You are starting a tough deal with pain mgmt.,these days! Mental attitude and anti depressants can help a lot.God speed! Tom

     
    Old 08-02-2014, 03:29 PM   #5
    AWildHeir
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    Re: New to Board and somewhat new to PM have questions

    Thanks everybody. I am about to turn 39. The neck issues I have had since probably 2005-6 but didn't get a diagnosis until 2007 due to lack of insurance and promptly lost insurance just after diagnosis. The lower back is a result of being hit by a car. As long as I can find relief if I sit but then it starts hurting from sitting. Same for laying down. I never reLized that there were long acting meds out there and that one would use the stuff I take 4x a day for pain that goes right through the other stuff. I am about to move to PA so I will have to find someone up there. Probably best to stay with my current pm until I move end of this month.

     
    Old 08-02-2014, 06:44 PM   #6
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    Re: New to Board and somewhat new to PM have questions

    Hi heir, Im really sorry that you are hurting & welcome! Long acting narcotics are usually prescribed after every conservative treatment has been tried & when pain is chronic & i cant tell if you are still in the diagnostic phase of your back & knee injury with tests still to be done like MRI's. Ct scans, EMG, etc & are having acute pain, still healing ,looking to be referred to knee specialist & spine specialist to assess the disc for nerve compression & radiculopathy or if all the diagnostic testing & imaging has been done & spine specialist have been seen & no surgical option was advisable & you have been told the pain is chronic & nothing can be done except to cover the symptoms. Pm drs use alot of modalities like PT, injections, adjunct meds & anti seizure meds to help the pain but dont specialize in evaluating for nerve compression, assess if surgery needed, interpret imaging reports to make decision on if surgery is an option. Practice limited to spines only NS's or fellowship trained in spines orthopedic surgeons are the most experienced & educated specialists concerning assessing the neck & back after injuries, finding the pain generator & making recommendations for either conservative treatment like PT or with a pm dr or surgical options & if this hasnt been done yet perhaps that might be why the pm dr is hesitant in proceeding. I hope that you do get some answers soon & hope that the exact cause of pain can be fixed easily so that your pain is relieved!

    Last edited by gmak; 08-02-2014 at 06:53 PM.

     
    Old 08-03-2014, 09:35 AM   #7
    AWildHeir
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    Re: New to Board and somewhat new to PM have questions

    As far as tests and things go, I have had 2 MRIs of my neck. I am really afraid and have been told by people that deal with spine issues and patients that have had surgery that it really doesn't do much good and a lot of them end up worse than before surgery. I have had an MRI of my lower back and am trying to get referred to a specialist. If it is the same as my neck though I really don't have good feelings about surgery. From my experience and from what I have been told, this is something that I will have to deal with for the rest of my life.

     
    Old 08-03-2014, 10:10 AM   #8
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    Re: New to Board and somewhat new to PM have questions

    Hi heir, I understand & highly relate because i had 4 lumbar surgeries but if there is a disc compressing a nerve root it can damage the nerve permanently if the compression is severe enough & not decompressed. Of course, i dont think anybody wants surgery but if it is necessary to prevent nerve damage at least now there are micro invasive & minimally invasive surgeries & microdiscectomies that dont disturb so much of the back anatomy as in the olden days, i hope that your referral to specialist comes through soon & then hopefully all the options will be laid out openly so that you can make a choice on what is best for you & your health. I hope that for now the pm dr will work with you to help you find some pain relief!

    Last edited by gmak; 08-03-2014 at 10:42 AM.

     
    Old 08-03-2014, 05:27 PM   #9
    tuloud54
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    Re: New to Board and somewhat new to PM have questions

    Quote:
    Originally Posted by AWildHeir View Post
    As far as tests and things go, I have had 2 MRIs of my neck. I am really afraid and have been told by people that deal with spine issues and patients that have had surgery that it really doesn't do much good and a lot of them end up worse than before surgery. I have had an MRI of my lower back and am trying to get referred to a specialist. If it is the same as my neck though I really don't have good feelings about surgery. From my experience and from what I have been told, this is something that I will have to deal with for the rest of my life.
    A pallet fell on my neck in 1992.Felt like I slept on it wrong.Had 2 surgeries in 1993 and 1994. This was 20 yrs ago and for 20 years I never even took an aspirin.Surgery was needed and I do not regret it.As I said, even after the surgery my neck felt like I slept on it wrong but nothing requiring meds. It is amazing what we can learn to live with! Please read some of our previous post for a better history of where we all come from. If you are still healing,heal.You'll know chronic because it does not leave. You need to get as many test and drs as you can.Surgery has come a long way since I had mine done. I was 36 when I broke my neck. I know nothing woke me up to my life as that.No regrets and I would not change a thing. Prayers for you and God Speed. Tom

     
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