Pain Psych experiences: Advice needed (?)

[Guest guest]

Hi group,

I recently had my second session with the pain psych. I felt

obligated to makes these appointments as my pain doc was

pressuring me to do so. Although it wasn't overtly said, it

seemed to be implied that my attendance was " highly

encouraged " . My first session basically resulted in the psych

giving me some pointers in how the mind deals with chronic

pain and she helped me to re-think my attitude about " toughing "

things out....how that can actually be more harmful by causing

the brain to re-set pain thresholds so that we feel more intense

pain or the same pain but sooner in the activity. She had me pay

more attention to timing my activity rather than relying on pain

signals...that is, to stop a repititous or physically demanding

activity based on elapsed time not on the first twinges of pain or

when the pain became to unbearable to go on. In addition she

gave me a relaxation tape to use. In the three weeks between

sessions I tried the tape a few times but ....I have to be honest

and admit that I found it to be worthless (but I wasn't that blunt

with her). I am just not comfortable with that type of thing.....I

burst out laughing when the guy says to breath in with your

toe...or imagine that there is a hole in the top of your head like a

whale's blow-hole and that the breath is going in and out. So I

am not really complying with this advice. But I am trying very hard

to be more time conscious rather than pain conscious as a way

to pace myself and I think that there is some merit to this, at least

in my lifestyle.

My second session, I updated her on my thoughts concerning

the tape (I put it very delicately) and activity pacing. She then gave

me advice about starting some yoga exercises....which I haven't

tried yet, but I think that they will be more compatible with my

personality. But....here is what made me apprehensive:

She mentioned that her goal is to get me completely off pain

meds. I was dumbfounded at first and when I found my tongue I

sputtered out that I didn't think that was a reasonable goal; That

in order to eat I need to have some kind of pain control; That I do

not want to go back into my dark hole that I lived in for so long a

year and half ago. I told her that a more reasonable goal in my

eyes is to get down to needing two pills a day (one for lunch and

one for supper / bedtime) with extra available for when I want to

eat out or eat " real " food or just celebrate a birthday or holiday (or

when I get myself into trouble). I also advised her that a flare can

occur anytime, and there is nothing I can do to prevent it and that

once this happens, any progress that I have made in reducing

pain meds is out the window. So my question is........I am

apprehensive that my relationship with my pain doctor is going to

be affected by my seemingly unwillingness to " let go " of my need

for pain meds. Am I being too paranoid? I can't help but think

that this pain psych may not be too familiar with the pain lifestyle

that is inherent with CP....but I do not want to be overly dramatic

either so that they think I am " making a case " for having a drug

dependency. But I have to be honest, the idea of not having pain

meds available scares the heck out of me.....but if I say that, is

that just another " symptom " of being messed up? As far as the

pain psych is concerned?

I feel like I was between a rock and a hard place....that is, if I

didn't go to the psych, my pain doc was going to stop seeing

me....but then I am afraid that because I did go to the psych, she

is going to tell my pain doc that she should stop writing me

'scripts.

Anyone have experience with this type of situation?

Laurie

[Guest guest]

Laurie,

That's a tough one! What you need to find out is how seriously your

pain doctor considers the advice of the pain psych. From what you've

said, it appears to me that the psych hasn't had realistic experiences

with a chronic pancreatitis patient. Which doctor are you supposed to

see next?

I haven't had an experience like this before. Anything I say would

just be things that I would try to do if I were in your shoes.

Firstly, I'd ask to see the pain doctor for a conference and ask her

whether she plans to follow all the recommendations of the psych. I

would also explain to her that although I'm willing to implement as

much of the pysch's suggestions that are possible, that I find it

unrealistic to give up all the meds that allow me to function. I

would stress that I'm are only asking for enough medicinal help to

function as best as I can, and that the purpose of pain management

treatment is to accomplish this.

As we all know, no amount of yoga or breathing imagery is enough to

suppress the pain of a full blown pancreatitis attack. We're not

going through childbirth here.....an acute CP attack is a different

animal! I've been through both, several times, and I'd take

childbirth anytime...

I'd also gently explain to the pain management doctor that I didn't

feel that the psych really understood the the way a CP attack presents

itself, and ask her how many other CP patients the pysch had treated

successfully. I think it's only fair that they should discuss these

facts with you. It's not unreasonable for you to inquire about the

pysch's previous track record, especially since the pain management

doctor was so firm about you seeing this other doctor.

Let us know who it is that you're supposed to see next, and then maybe

we can come up with some feasible suggestion for you. I understand

your fears exactly. I would be scared, too.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina Rep

South Eastern Reg. Rep., PAI

Note: Any advice or comments are based on personal experience only,

and should not be substituted for consultation with a medical

professional.