another pain management question

[Guest guest]

Hi all,

I have been feeling terrible for the past few days. I haven't had a

pain free day since sometime in June. But this last week has been

down right awful. I am finding that I have to take more pain meds

than usual. My question is, Do I ask my family doc for a referral

to a pain management clinic? or do I look one up myself? My family

doc is the one who is prescribing me my current pain meds, but

sometimes (and very often) they take away about 70-80% of the pain

but not all the pain. Just wanted to ask for people's experiences

on this. Thank you in advance.

Kris in TN

[Guest guest]

Hi Kris: Geez, sometimes I wonder if the weather is factor in CP,

not to be flip, but it sure seems like alot of us are suffering more

than usual this past week (me included.) I don't know much about

the pain management doctor end of things, but probably will soon, as

I like you, get my pain meds prescribed by me PCP. I would think it

would depend on what your health insurance carrier's policy is...do

you need referrals to specialists? Or do they (like my ins.) have

to be in the " preferred provider network " and then you can make the

appointment yourself? Check your health insurance....if you don't

have the actual brochure handy - there should be a phone number on

the card itself that you could call. So, sorry that you're having

worse than usual problems this past week. I can SO relate to

that...I've been pondering the pain management aspect as well

because of having to take it more often than the prescribed 6 hrs.

More like 4 and sometimes 3.5 hrs. So, I'm trying to be somewhat

proactive and look into it myself. Let me know how you make out with

this.

take care and I hope you feel better soon

P.S. What part of TN are you in? I have some nieces and grand-

nieces in the Chattanooga area....my sister used to live there as

well. Sure hope you have a/c, I'm in the northeast and the humidity

is just awful....I can only imagine what the south is like right

now....whew!!

[Guest guest]

Hi Kris, I'm sorry your having so much more pain this week. Some

one in another post, sorry forgot who, said must be the weather,

well I am feeling pretty lousy too. Even saw my interenits today

and got all my meds refilled. Big time. Demerol 100mg; and

Dilaudid 4mg; 120 of each of them plus 60 Ativan. I dont think I

will run out soon. I had thought about going to a pain clinic.

I guess I would have to ask myself what I would expect from a pain

clinic that I can not get from my present doc. Also your insurance

co. may require a medical referral. I have thought about it

though. It wouldn't hurt to look up and see what and who are

available in your area. I thought it would be nice if I saw a

female pain spec. All the ones I know are anestheologist and male.

Once you know what is in your area you can talk with your doc about

it.

There are a lot of people on this board who have gotten a great deal

of relief from the regiment the pain docs set up.

Good luck

Chrissy

[Guest guest]

Kris,

My suggestion is to talk with your PCP and ask him if he'll suggest a good

referral. Explain to him that your pain is getting worse and that what you're

taking right now just isn't handling it. Tell him you know that it's going to

be a

long hike with this condition and you'd like to get some help from a

professional in the mangement of pain. I think he'd trust you more and not

feel that you were going hehind his back as he would if you found one on

your own and didn't involve him in it. If you like this doctor, you want to

keep

him on your team, so to speak, because you may need his help for something

else in the future.

Then if you see someone he recommends, and don't like that doctor, you're

free to go to whomever you prefer, but at least you gave it your best shot and

you didn't allienate your family doctor. Just my opinion....sorry you're not

doing well right now with the pain.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina

SC & SE Regional Rep.

PAI

Note: All advice or comments are based on personal experience or opinion,

and should not be substituted for consultation with a medical professional.

[Guest guest]

,

Hi and thanks for your response. I am feeling alittle better

today. My pain level is down alittle and the constant nausea is

lifting up too. I forgot to mention that I am currently prescribed

demerol w/phenergan 50mg. every 4-6 hours. Only I had been taking

it twice a day and was doing pretty good until this week and now 3

times a day keeps most of the pain away but I still feel lousy and

still get some pain. It just has been wearing me down both

physically and emotionally. My family doc has been great so far, I

just didn't know if I should be seeing a pain management clinic or

not. I guess if my family doc is ok with prescribing my pain meds

then I will just stick with him. I will go see him next week and

let him know that my pain has increased. I don't want him to see me

as a drug seeking person. I always feel funny when I'm there to ask

for more pain meds. You know what I mean?

Anyway, I am located in middle TN , about 1 hour south of

Nashville. I am starting to wonder is the weather is playing it's

part too. It has been awful here (weather wise). And feeling sick

and nauseous doesn't make it any easier.

Hope you are feeling good today. Do you have an upcoming appt. with

a doctor? Any testing?? Sorry if you already posted that, I have

been in kind-of a fog lately. Take Care

Kris in TN

[Guest guest]

Re: Re:another pain management question

Kris & ,

RE: " I think there is something you need to know though. When you are

taking narcotics for pain relief you will not become a drug addict.

Dont confuse physical dependancy with

addiction.

When you take pain meds for pain you can become phycially dependent,

ie increased tolerance to a drug requireing more to achieve the same

affect. There may also be some withdrawel from some pain meds.

It is NOT the same as what would be for a drug addict with

the physical and phsycological addiction.

There is absolutly no reason for you not to take the meds when you

are in pain and there is absolutly no reason for you to worry about

becoming a drug addict. Take the meds as prescribed, get some

relief, rest and feel better "

Hi! This is exactly what my pain doc told me and I wanted to thank you

was posting this, because so many of us are afraid of addictions and

the side effects of our pain meds that we linger in our pain for too long.

I made my concerns of this known to my pain doc about this. In my earlier

post Kris you will probably remember me saying how much research he does. He

stated about the dif between addiction and dependence as mentioned and

how our body deals with pain. He told me about a study that they did at a burn

center on addiction. He said that as you can imagine they are on extremely high

doses for long periods of time. These burn victims are weaned off the pain meds

to help alleviate withdrawal symptoms, but they didn't " crave " the medicine

after this. I also mentioned my concern for being on long term pain meds and

what would happen if I had to continue to up my medicine. (I am 28 years old

and thinking of being on it for another 60 years!) He said that in his

experience after you find a med that will control your pain better, the only

reason they might need to " up " your meds was because something has changed

etiology wise, like a pseudocyst, more damage to pancreas, other changes in your

body. And that he has had people on the same dose for 6 years or more. My

other concern was being on a longer acting med how will I know if I need it or

not because I, like you, was only taking meds when I KNEW I was in pain and

feeling it. (I think I was in denial about actually having this and wanted to

make sure it was actual pain I couldn't live with! Goofy, I know, but then I

didn't understand how our bodies deal with pain, and I think with a chronic

illness your mind plays tricks on you because you have hope within you that you

don't have this.) What he said was sometimes you just take a holiday from the

meds to see. And finally did he have any idea in his experience with cp if this

pain would ever go away? He said it could if my panc burns out or my nerves. I

don't know what it means when your panc burns out at all, but maybe that

tingling we feel is our nerves burning out?? I didn't think to ask him that at

the time.

One thing I should mention with visiting a pain doc, both my husband and I

were a little disappointed at first. We were like that's it? I could have told

him that! (as far as treatment went the duragesic is good for cp...thank you to

the group for sharing always!!) I think we had high expectations of a

treatment.........like hoping he knew some way new way to cure that we weren't

aware of yet. Or maybe we were so use to the trips to other docs and the search

to find out what and why, but he dealt strictly with my pain symptoms and

nothing else. (and I'm not sure if that is with all pain docs) My mind was

finally at ease though about actually having pain. I was thinking my body was

making me have pain so I then it could have meds (totally far fetched

misunderstanding of addiction) so I would make sure I was in at least a 5 for

pain before I felt comfortable taking anything. Since I first was having

symptoms of cp, all hospitals and docs and especially the ER put the fear of

addiction in me from taking pain meds long term. Which could be the

disappointment- that this illness would not go away through addiction treatment.

Anyhow my mind was finally put at ease about this and I am taking better care of

the pain which helps with day to day living. So visiting the pain doc was so

worth it and he had a better understanding of cp then my reg doc who felt

uncomfortable changing my pain meds. I probably couldn't have recommended to

her that I needed to change my pain meds to the duragesic patch because I am on

this group stated they are having good results with it!

Sorry about the book! Hope everyone has a little sunshine in their day

today! Angie B