Re: Pain meds for those truly in Chronic Pain/Mel

[Guest guest]

>Mel wrote:

>

> I'm not trying to 'shop' for a doctor who will give me pain meds. Nor have

> I gone to doctor's specifically seeking pain medication. But after all of

> these tests, invasive procedures, and other meds with their side effects; I

> have just started to question why I am unable to get something to help

> alleviate the pain.

>

> However, I am so frustrated because my life has been changed so dramatically

and yet I can't get a doctor to understand that if I

> could reduce my pain even a moderate amount, then I could function more

normally. I would be able to think more clearly and even work from home. The

doctors just don't seem to understand that chronic pain changes a person in many

ways.

Mel,

Medication therapy is a part of a pain management program and has been for

years. Actually, it is supposed to be used before invasive procedures and

accepted by the WHO World Health Organization and Pain and each state has pain

medication acts. This website lists some information and ironic it is developed

from your home state university " St Louis University.

http://www.painandthelaw.org/statutes/state_pain_acts.php

You may have to shop around to find a Doctor that adheres to that policy. I have

my pain certified as intractable pain. Yes, my Doctor in the past was an

advocate for pain patients and actually had criteria to be considered

intractable pain and each state has acts and the DEA has articles on this also.

I actually had a card that I was to give an ER Doctor if I had to go to the ER

that my complaints are justified and if they needed to call him, he had his

office number, cell phone and answering service.

I never had to produce this as I have so much metal in my back it is apparent.

I do not do invasive procedures and it is documented in my records now that I

have arachnoiditis and the medication and solutions they use in the injections

are neurotoxins that irritate the spinal fluids and cause arachnoiditis (do

internet search).

Usually a management program includes: assessment, medication, physical therapy,

topical therapies (compounded creams, lidocaine patches), tens units, heat/ice

therapy, water low intensity aerobics, stretch home program developed by

physical therapist for you condition, counseling therapy, and alternative

therapies (acupuncture, bio-feedback, imaging, positive thinking, cognitive

behavior training, etc).

The medication program includes : opoids for pain, muscle relaxant for muscle

spasm, medication for nerve pain (Lyrica, Neurotin,Topomax etc),anti-depressant,

anti-inflammatory medication and other medications targeted to you specific

pain.

Every pain management Doctor I have gone to have this program in place along

with a pain contract and medication testing with saliva or urine testing every

three months to make sure the medication is being taken and no other

recreational therapies are being taken.

These precautions protect the Doctor from audits by the DEA Drug Enforcement

Agency and is currently protocol with the Pain Societies and Best Practices

being Developed.

I do not mind doing this as the Doctors are giving a service that is needed and

their intent is to assist the patient. I am not helped by any of the invasive

procedures and you need to check, as I said, if they only do interentional

therapy which is injections only and primary care physicians manage their

patients and send them there for interventional therapies.

Most pain management doctors maintain a website that states what services they

offer and their philosophies on pain therapy. My last doctor had a team meeting

when patients came and they all met to develop the pain management plan and he

had a psychiatrist, counselor, anesthesiologists (which all the doctors were),

physical therapist, and rehab specialist.

Jewish Hospital and Washington University has excellent care in St. Louis

and they have a Pain Management Center. I went to Jewish Hospital Nursing School

and worked at Jewish Hospital for a year and found it to be patient

orientated.

I have also had to drive outside my area for competent care. Once a month for

five years I drove three hours down and three hours back to a great pain

psychiatrist and pain management doctor that was double degrees. My insurance

reimbursed me for my visits as he did not accept insurance but gave you

information for you to file and even though he was out of network, the paid as I

provided information to justify his services. *I had a very bad experience with

a doctor here.

This is why I believe in keeping a pain dairy and putting it in my medical

records as it justifies my pain levels and what is and what is not working and

what the doctor is and is not doing.

It protects me as a patient and gives me documentation when I need it to

advocate for my self. Pain Dairy or Pain Journal Examples can be found at the

American Pain Foundation under the publications section, and it's heading is

Target You Pain.

These are the steps I have taken for my pain and you can verify your chronic

pain by keeping a dairy/journal so the Doctor can see what is happening to you

and then request a treatment plan be developed for you to target the pain. By

being specific an on target, the Doctor needs to address your pain. Another

guide to read is " Survival Guide for Intractable Pain Patients " by Dr. Forest

Tenent and can be downloaded from paintopics.org or just type it in an internet

search. Dr. Tenent has been a pain management doctor for over thirty years and

assisted a foundation for pain patients along with the doctor I went to and they

are very active in the field.

I did not mean to write a book but it seems your Doctors are not meeting your

needs and it is okay to ask for opoids that treat pain. The VA did not used to

treat their patient appropriately and got in trouble for it and now they have a

Pain Management Policy that follows the guidelines as presented in WHO and this

protects the veterans with the multiple traumas.

I have seen active duty patients at my pain doctors and my neurosurgeon going in

for spinal surgery and I live thirty miles from Fort Hood that has thousands of

veterans

Mel, just check out some other pain management options and get a diagnosis for

your pain so you can be treated appropriately. It is very frustrating and I have

sat in my car at lunch when I was working, crying, I was in so much pain.

Please let us know what you find out and how you progress as the members here

are very helpful and all are at different points in their pain journey. Good

Luck.

Bennie in Texas

[Guest guest]

Mel wrote:

> The most recent doctor had the nerve to ask if I was beginning to get

> depressed over the pain, or anxious! I informed him that I'm not depressed

now, but if this continues I could become depressed. He wanted to try more

steroids, which I've developed a bad reaction to, or NSAIDS which I can't take

due to GI issues. Then he replied that that didn't leave much else!

Hi Mel

When the every day medications starting harming me more than helping me,

I went to a physician who specializes in treating chronic pain. I typed

up a list of every surgery and procedure I had ever had. Also a list of

every medication tried for pain alleviation and a list of current

medications for high blood pressure etc.

The doctor loved my thoroughness. After a 45 minute physical

examination and " visit, " he wrote me two prescriptions to try. They

were both at low doses and he told me to take them for two weeks and

then come back in and see him for reevaluation. He made sure I was

aware of the side effects and what to watch out for. He insisted I make

my second appointment on the way out of his office. :-)

The medications promptly gave me back some quality of life. At two

weeks, the doctor increased the one and added Lidoderm patches to the

things to try. The man was amazing. He not only figured out what would

work, but his efforts on my behalf allowed me to keep working and to be

involved in my community. Over the years, we tried some of the trendy

medications, but I reacted badly to everything from neurontin to Savella

to Topamax. (my hair started falling out - all over me)! Since then, we

have stuck with the old fashioned tried and true narcotic medications.

Thankfully, most of my hair grew back!

Please don't let your personal feelings about needing better care get in

your way of getting that better care. It can make an incredible

difference to how you live each day.

I still wish I could take prescription NSAIDS as they do work best for

serious arthritis. But, like you, they rip up my gut. I can handle 600

mg of Ibuprofen once a day, as long as I have food in my stomach before

I take it. The Ibuprofen is a great aid for the narcotic medication and

lowers my arthritis pain for several hours.

Lyndi

[Guest guest]

Hi Mel

That leaves opioids.

Steve M in PA

Mel wrote:

The most recent doctor had the nerve to ask if I was beginning to get

depressed over the pain, or anxious! I informed him that I'm not depressed

now, but if this continues I could become depressed. He wanted to try more

steroids, which I've developed a bad reaction to, or NSAIDS which I can't

take due to GI issues. Then he replied that that didn't leave much else!