Re: Well Here We Go!! - pain mgmt docs

[Guest guest]

,

From my experience with the 7 ERCPs I've had, it is impossible to know how long

you will have increased pain. For me, it has been anywhere from just a few days

with the last one I had in June at the Mayo Clinic to 6 weeks or more with some

of the previous ones. For me, it's often hard to know if the ERCP is really

responsible for the increased pain or if I'm just having flares (with my panc

that doesn't seem to want to behave itself) and that's the cause for increased

pain.

I also wanted to tell you that, in my opinion, being under the care of a good

pain management specialist is absolutely essential when dealing with just about

any type of severe chronic pain, but especially with cp or even recurring acute

panc that hasn't yet advanced to an 'official' diagnosis of cp. I have been

under the care of my pain mgmt doc since Nov 2002. This was just 4 months after

the acute panc attacks returned. They first started in Jan 2000 and after a

rough year, I had about 18 months of no serious problems - still had the 'naggy'

sort of pain, but nothing bad enough to send me to the ER. Anyway, when I

realized that I was going to need long term narcotic pain med just to be able to

make it through the day, I asked my pcp to refer me to a pain mgmt doc. At that

point, my only diagnosis was recurring acute panc. Initially, I thought the

pain doc was kind of a jerk. However, by my second visit I realized he was not

a jerk at all and was actually pretty compassionate. I did have to sign an

agreement that I would not accept pain med prescriptions from any other doc

without his okay, I would use the same pharmacy for all pain med prescriptions,

and I would agree to random drug tests if he deemed it necessary. He has been

very cooperative about upping my pain meds temporarily if I'm having an

especially rough time or when I've had surgery. I do have to go in person and

meet with his nurse every single month to pick up my prescriptions and that's a

little bit of an inconvenience because he is in the next town and it is 45-60

minutes drive. I am on MS Contin 30 mg three times a day and Oxy IR 5 mg 4

times a day for break through pain. I have had 5 celiac plexus blocks and they

seemed to help with the pain after the 3rd one. I had the last one on July 1st

and can have them every three months. The last one hasn't helped as much, but

it may be helping more than I know and maybe without it I'd be having even more

pain and more hospital admissions. I intend to have another just as soon as I

can - around Oct 1st.

In a way, all the controls seemed a little demeaning, but then I realized that

all the controls and strict rules about the pain med is as much for my

protection as it is for the doctor's. When you live with severe chronic pain,

it would be very easy to be tempted to break the rules and get yourself into a

dangerous situation. I find knowing that I could be checked up on to make sure

I am 'obeying' my pain mgmt doc's rules somewhat reassuring. I'd like to think

I'd never allow myself to get into a dangerous situation and abuse the pain med,

but it's often hard to be strong when all you know is that you want the pain to

be reduced (I don't think mine is every totally eliminated - the pain meds just

get it to a tolerable level and allow me to have a much better quality of life).

So, without the controls that the pain mgmt doc puts on me, I just might do

something stupid. It is very hard to be rational and logical when you are in

severe pain for days on end!

So, my whole point to that was that going to a pain mgmt doc does not have to be

a bad thing. It can be a VERY good thing. However, there are many people who

have not had as positive an experience with pain mgmt docs as I have had. I'm

sure there are just as many 'crappy' pain mgmt docs out there as there are

'crappy' ER docs, GI docs, and every other type of doc.

Take care and try to have a nice weekend.

W

alabama