Discussions that mention morphine

Pain Management board

Hey Sak, There are many new minimally invasive techniques and then some very invasive surgie. Untill you know what the problem is, which your not going to get that info from a physiatrist or some Voodoo doc pushing Prolo on every patient. Everything is just a stab n the dark or backside. ;) Prolo fell by the wayside before it even became mainstream, it causes excessive scaring, arachnoiditis and the outcome can be as etreme as your moms botched surgery.

I had 3 back surgeries go bad and fortunately LA pain meds had become available during all that mess and after 7 years of jumping through every hoop offered it was opiates that got the hospital bed out of my den after the last 6 level fusion failed and hardware snapped. Surgery horror stories are easy to find but not the norm. There is no IT forum for people to come together and talk about how great their sugrgery went.

Unfortunately when you start looking into pain management, those are the docs that clean up the messes that are made, so the likely hood of seeing someone with a succsful surgery at your physical med docs or the Voodoo doc aren't very likely. So it's easy to support the opinion you shouldn't go there no mattr what it takes to manage your pain? Does that make sense. Foks that had surgery and moved on with their life don't go to the rehab doc or Voodoo doc for prolo.

You can look for docs that are trained in the less invasive surgical methods. Not every surgeon is capable of doing the newer methods. If they learned to do a full laminectomy jut to give them plenty of room to work to trim a bulging disc, that's how they tend to aproach every disc surgery. If a doc was trained to do micro discectomies or arthroscopic back surgery he will be looking for the least invasive method to repair a problem. If you ask 10 surgens how to fix a back problem and you will probably get 5 different answers or told to wait untill the pain is unbrearable.

Unfortunately while your waiting and if you use opiates you may be able to put off surgery for some time, but pain can also imprint into the nerve pathways over time if the problem isn't fixed. If this happens even a surgery that apears completely succesfull, won't do a thing for pain that's been imprinted.This is part of the gateway theory which is well proven. Conditions like RSD or Chronic regional pan syndrome flurish when the actual problem isn't corected. Basicaly the longer you wait, the less likely you are to have a positive outcome, that's the downfall of pain management. You can spend years jumping through every hoop and cranking your tolerance up to opiates and during that time the window of opportunity to corretct the problem slips away.

I you go see a chiropractor, he's going to recomend chiro to avoid surgery, If you see a PM doc that makes lots of money doing Prolo, or nerve blocks or gives everyone 3 epidurals, guess what he's going to suggest.

You really need to get a surgeical opinion and find the source of pain when conventional therapy and the not so conventional methods aren't helping. If it 's a mechanical deffect that can be corrected, then you look to different surgeons to find what's the least invasive aproach and best method to correct the problem.

I meant to say Meylogram, not bone scan with the Disco gram. The advantage of a meylo is they inject dye and tilt you in every direction on a table and shows what weight bearing does to the discs under floroscopy. These tests can be much more telling than static veiws of a problem that may only manifest when you flex, extend or just stand.

The way sepecialist veiw their own field. Even if your PM doc said you need surgery, it doesn't mean a surgeon would agree and be willing to do it. So their opinion really carries no weight in another specialty like surgery. See a surgeon and at least be informed before you let a couple docs condemn you too life in their care. Docs overstepping their bounderies is really a pet peeve of mine. Evry GP is now a practicing psychiatrist because of HMO's, Now their getting into PM. Rehab docs giving surgical opinions just seems a little back asswards.

Pain meds will always be an option but if you could fix something and toss the cane in 6 months and not look back. I would think the reward may be worth the potential risk. You are right, things can certainly get worse, But I haven't met a single long term chronic pain patient that is truly happy with their care and wouldn't choose a cure in a hot minute over another month spent on meds. It's not that docs aren't trying to manage pain or using opiates and advanced techniques like morphine pumps and spinal cord stims.

I have an implanted synchromed pump that delivers dilaudid to my spine. To someone new and struggling to find relief it sounds like the Shizba, but in reality the best it can do is relieve 50% of my pain and that still leaves me disabled. 50% pain relief to one person may mean they can return to work and be relatively comfortable. To me it means my wife doesn't have to hold me up in the shower and I can get the dishes done by taking a break every
3-4 minutes.

My perspective is a little different than someone looing for some form of relief when nothing is being offered. I just know the limits of what meds can do. I have to find a balance between acceptable relief that allows me to function but doesn't leave me feeling impaired and sleeping all day. Pain management isn't a cure, it's something to help cope with problem that can't be corrected.

Get some surgical opinions and see if your problem can't be corrected before letting docs tell you there is nothing that can be done other than their method to help manage pain. Keep in mind, a surgeon seeing you for the first time, may want to repeat what you have already done as far as more PT, epidural steroids, just the normal drill so that he's confident surgery is the only option.

Patients that finally beg for surgery when they have already gone the PM route and are presently taking large amounts of opiates have a very hard time finding surgeons willing to risk their succes rate on a patient already dependent on opiates. Those that do have surgery after years of PM also have problems with post op pain control unless they have their PM team in on the post op care. Most PM docs don't have hospital privlidges unless your seeing one through a hospital clinic. Private practice and private clinic PM docs have no influence over a surgeon or what goes on as far as post op pain control in a hospital. You are at the mercy of your surgeons comfort level.

There is just a lot to consider. I understand the imediate need for pain relief, but don't give up on finding a fix at the age of 28.
Good luck, Dave