Uncontrolled Pain

[Guest guest]

Hello to the group. I have not been reading all the posts because I

am in so much pain along with stress.

I have been in excruciating pain for about a month now and it was

off the scale when I visited my son because of all the things Maureen

and her husband were doing to me on my supervised visit. If you want

to know I will tell you about it but I may have already, I am so

confused. I know for a fact and by experience that stress causes pain

and I have had to take more of the meds than are prescribed. I don't

know what to do. Now I am going to run out before my Dr visit. I am

feeling depressed and very anxious.

I have a referral for a surgeon that was supposed to already have been

made. It was put in my PCP's chart March 28 and I called them

yesterday and they said it wasn't even in the referral file. So I've

been waiting all this time thinking they had already set one up. They

said they would put it in the referrals yesterday when I called them.

If I hadn't called them it probably wouldn't have ever gotten in.

I like my Dr, he believes me about my pain and anxiety, and I don't

want to go through the hassle of finding another one who thinks I'm a

drug seeker like most do. And like all Dr's they are very busy and

have too many patients. I told him maybe I could go to pain management

and he said all they do is give stronger meds and epidural injections

so to wait and see what the surgeon says. He said that pain clinis

want to do epidural injections because it' a lot more money and

insurances always accept them. But right now I need something stronger.

But I am in so much pain and have so much anxiety I am thinking about

going to a pain clinic Monday. The lortab 7.5 is not working hardly

at all and when it does it's only for an hour or so. It never has

worked that good but I'm afraid if I ask for something stronger he

will think I am a drug seeker. What should I do? Thanks

[Guest guest]

--- " v_fulcher " wrote:

>I told him maybe I could go to pain management

> and he said all they do is give stronger meds and epidural

injections

> so to wait and see what the surgeon says. He said that pain clinis

> want to do epidural injections because it' a lot more money and

> insurances always accept them. But right now I need something

stronger.

Hi Vance -

I agree completely with your doctor regarding steroid epidural

injections for pain. The research shows over and over that they

don't work and their risks for permanent damage are dangerous. They

are NOT an FDA-approved procedure. And the medication they use

clearly states that it is NOT to be used in the epidural space and is

neurotoxic to spinal nerves. They are nothing more than a money-

making scheme by some doctors.

However, NOT ALL pain doctors rely on epidurals! And there's nothing

wrong with " stronger meds " when it is appropriate. Pain medications

are designed to treat pain, and they are very safe when taken as

prescribed. There are also many other types of medications that can

be used as an adjunct to help control pain - such as antidepressants,

anti-seizure medications, muscle relaxers, sleep enhancers, etc etc.

A pain management doctor is trained to determine the right mix of

medications to help a particular patient's problem. A good one will

combine medications with other therapies, such as physical therapy,

massage, even accupuncture, as well as psychological therapy to help

a patient learn to deal with their pain levels more effectively.

They can even offer more invasive techniques, such as spinal cord

stimulators and implanted " pain pumps " for the worst cases.

A great deal of chronic pain can't be " fixed " - that's why it's

chronic and must be MANAGED. That's what a PAIN MANAGEMENT doctor

does. So while I would agree with your doctor that you should avoid

any pain clinic that insists on epidurals as their first and only

line of treatment, I disagree that a pain management doctor wouldn't

be helpful for you.

My recommendation is to **interview** several pain management doctors

in your area. Let them know you are interviewing them and several

others, and you're not asking for medication or any other treatment

in your first appointment. Instead, you want to talk to them about

your problem, and find out their philosophy of treatment.

Have them lay out for you how they would go about diagnosing and

treating your condition and look for someone who is willing to

explore a lot of different treatment options INCLUDING pain and other

medications.

Ask questions about how often they would see you; whether they would

see you themselves or you would see a nurse after the first visit;

ask how they make themselves available after hours; ask everything

you can think of.

And then do NOT ask for stronger medication! Tell them your pain is

uncontrolled at this time. Tell them what you have tried in the past

that has worked and not worked. Spell out exactly how the pain is

impacting your life - Are you not sleeping? Not able to dress

yourself or take care of simple hygiene? Are you unable to drive,

walk? How long can you sit or stand? How much time are you spending

lying down to relieve your pain? That kind of thing.

Then let the doctor lay out their plan for tests and therapies to

help. If pain medication is NOT on their list, then you can ask

why. If you don't like their answer, then don't " hire " them!!! Just

walk away!

If epidurals are on their list, and you tell the doctor you don't

want them, do they agree or try to blackmail you into them? (for

example - " I won't prescribe pain meds until you try the epidurals " )

If they won't treat you without epidurals, just walk away!

THAT is how you go about finding a good pain doctor and getting

appropriate pain treatment. It takes work, unfortunately. It may

take interviewing a lot of doctors (Note that if finances are an

issue, some doctors will waive or reduce their appointment fee if you

tell the scheduler that you want to interview the doctor and are not

looking for treatment in the first appointment. Ask if they will

reduce or waive the fee! It doesn't hurt to ask - all they can do is

say no.)

I went through almost three years of pain and literally dozens of

doctor's appointments before finding my pain management doctor, and

he has been a lifesaver.

In the meantime, you can certainly continue to pursue seeing a

surgeon (in fact, see several surgeons! Don't take the first

opinion - always get a second and third opinion) to see if there is

a " fix " to your problem. But remember that like all doctors,

surgeons only have one tool - and when all you have is a hammer,

everything looks like a nail - so the only treatment they're going to

offer is surgery. Surgery may or may not be the " right " treatment.

But you have to go to the appointments and get multiple opinions to

find out.

But there's no reason to continue to suffer in pain while you wait.

It takes as much as four months to get in to see a neurosurgeon here

in Phoenix, and if your area is the same, you need to be going ahead

and looking for pain management at the same time so that you don't

suffer any more than necessary while you're waiting.

Cheryl in AZ

Moderator

[Guest guest]

Vance wrote:

> But I am in so much pain and have so much anxiety I am thinking about

> going to a pain clinic Monday. The lortab 7.5 is not working hardly

> at all and when it does it's only for an hour or so. It never has

> worked that good but I'm afraid if I ask for something stronger he

> will think I am a drug seeker. What should I do? Thanks

Hi Vance

I'm speaking from personal experience, so your mileage may vary.:-)

Getting more appropriate or perhaps stronger pain medication sounds like

a sensible thing for you to do. However, instead of just going for

stronger pain medication, there are other things you can do to help

yourself cope with your pain and with the stresses in your life.

Eighteen years ago, I got my family doctor to send me for Cognitive

Behavioural Therapy. Once I got the hang of applying that, I went to

another specialist to learn Biofeedback techniques. Both techniques

continue to help me cope with everything from chronic pain to life in

general.

I know people often think that surgery, pain medications, and/or anxiety

meds etc. are going to fix things, but for those of us with chronic

pain, it takes more than that to feel healthier, both physically and

emotionally. Among other things, Cognitive Behavioural Therapy and/or

Biofeedback training can teach you new ways to cope with stressful

situations and lessen the anxiety. Consequently, your pain levels will

ease up, as your reaction to pain and to circumstances changes.

I do take pain medications, but I take them at lower doses than I would

have to, if I hadn't learned other processes for living with pain. I

also do my physical therapy exercises every day, I lift light weights,

and I do what I call " Lyndi Aerobics. " I used to dance, so since I

can't dance properly anymore, I made up routines that I can do, that are

based on my physical therapy exercises. I use light hand weights while

I'm doing most of the exercises.

I showed the routines to my physical therapist and he was delighted with

them. He also recommended that I do any kind of bopping around that

wouldn't cause me increased pain for more than a few minutes. So, for

years now, I've used a combination of choreographed and just bopping

around, with hand weights, routines. (I look silly, but it feels

good.:-)

I can't " dance " for more than ten minutes, or three songs worth, but I

keep doing it. When I first started, I could only last about 45

seconds. It took me awhile to build up the type of physical and

emotional stamina I needed to keep the pain levels in check while I was

" dancing. " The Cognitive and Biofeedback skills I've learned, came

into play when increasing what I could handle.

In the time period when I had to use a wheelchair to get from point A to

point B, I " danced " in my wheelchair. Ditto for when I use my cane.

(Crutches however, are too unstable :-) For people who use crutches,

sitting down and " dancing " is a whole lot safer. <grin>

Getting my needed physical exercise by " dancing " makes me feel much

better both physically and emotionally. Of course, I had to learn the

hard way to avoid dancing to most country music, sad songs, or songs

that reminded me of sadder times. Those types of songs play negatively

on emotions. People with chronic pain sure don't need is to listen to

music that brings us down further.

The point to all this is - keeping up our physical strength and our

general and emotional health is always very important. They're even

more important when we have other stresses on our body - like chronic

pain, illness, events we cannot control, or emotional problems.

Life can throw some wicked curve balls at us. How we learn to react to

those, makes a world of difference in how we feel, both physically and

emotionally. Thinking Therapies can be very helpful in helping us handle

all life's circumstances.

--

Lyndi

Reminding everyone -- eat well, get some exercise, and smile. Those

things won't make your pain disappear, but you'll feel better anyway.:-)

[Guest guest]

, Cheryl in AZ wrote:

> A pain management doctor is trained to determine the right mix of

> medications to help a particular patient's problem. A good one will

> combine medications with other therapies, such as physical therapy,

> massage, even accupuncture, as well as psychological therapy to help

> a patient learn to deal with their pain levels more effectively.

> They can even offer more invasive techniques, such as spinal cord

> stimulators and implanted " pain pumps " for the worst cases.

>

Cheryl,

I agree with what you say. Pain management doctors can be any doctor

that decides he wants to be a pain management doctor, like other

doctors can say they are surgeons, oB-gyn, etc. The training they get

is through several Pain management endorsements.

Anthesiollogists are in the high volume practice of pain management as

they can do many injections in a short period of time, for a high cost

for the time involved, and practice under pain management. Most of

their practice involves injections.

Some of them are on staff for a clinic or they have other specialists

on staff with them.

Unfortunately for me, I went to one that was single practice and that

was his main focus injections and he didn't even offer physical therapy

or recommend it.

Most anthesiologists accept all insurances so they are in high use as

there are a number of them to choose from since they accept insurance.

Think about it, anthesiologists just put people to sleep or help OB

patients. They are usually assigned to a hospital like pathologists.

This is why going into the pain management field is so lucrative to

them. They would other wise not have a patient practice.

I just remember always going in and their were people lined up on their

stretchers and being called back as soon as they could dismiss them.

The nurses even kidded about the stick day being high volume day. This

is not a hidden fact. I cannot say EVERY anthesiologist is not there

to help people but if they keep insisting after the first three sticks

as the protocol states to keep injecting you somewhere, RUN as I too

have the scarring to prove it does more harm than good.

This is my experience, I just ask you to consider all the options and

get a doctor that has a multi-modal effect to treating your pain.

I have no choice now thanks to a anthesiologist who wanted to stick

again. Bennie