Managing Arthritis Pain
When to Start and When to Stop
It is interesting that I overheard two clinicians speaking recently and this is generally what I heard:
Clinician 1: I got a call from Doctor X's patient while I was on call and he was away. The patient was 2 months after arthritis surgery and was asking for a refill of pain medications.
Clinician 2: What did you do?
Clinician 1: I don't give pain medication to drug seekers.
OK. Now I am only paraphrasing but this happened somewhat like this. It brings up an interesting point. Doctors are often blamed for being on both sides of the problem. I hear that doctors are blamed for prescribing narcotics too freely and also blamed for holding back pain medications in many situations. What is the truth?
There is no right or wrong answer here. The problem is that pain is an individualized problem and while there are numerous guidelines, many patients break out of those guidelines. Additionally, most physicians are not formally trained enough in the science (and art) of pain management. Considering one of the most common complaints any patient has when walking through a doctors doors is, "I have pain," most medical schools have little to no curriculum on pain management.
In my experience as s surgeon for over 16 years I think that most patients are undertreated for their pain. For, example, I see many junior faculty prescribing Oxycodone 5 mg for postoperative pain which is fairly low dose. In general, the current approach to pain management is referred to as "multimodal." This means a combinations of narcotics, antiinflammatories, acetaminophen, ice, exercise, and possibly alternative methods. Most hospitals, though, do not have well-developed pain management services and even fewer have modern cold treatment or ice therapy machines and continue to have nurses put on ice packs at irregular intervals.
Knowing when to start aggressive pain management after surgery is easy. Knowing when and how to stop is more difficult. In a non-surgical setting in the case of arthritis even knowing when and how to start is a challenge.
What has been your experience in the management of your pain -- good and bad?
Dr. K.
Related Topics:
Technorati Tags: arthritis, pain management, health-and-wellness, medicine
It is interesting that I overheard two clinicians speaking recently and this is generally what I heard:
Clinician 1: I got a call from Doctor X's patient while I was on call and he was away. The patient was 2 months after arthritis surgery and was asking for a refill of pain medications.
Clinician 2: What did you do?
Clinician 1: I don't give pain medication to drug seekers.
OK. Now I am only paraphrasing but this happened somewhat like this. It brings up an interesting point. Doctors are often blamed for being on both sides of the problem. I hear that doctors are blamed for prescribing narcotics too freely and also blamed for holding back pain medications in many situations. What is the truth?
There is no right or wrong answer here. The problem is that pain is an individualized problem and while there are numerous guidelines, many patients break out of those guidelines. Additionally, most physicians are not formally trained enough in the science (and art) of pain management. Considering one of the most common complaints any patient has when walking through a doctors doors is, "I have pain," most medical schools have little to no curriculum on pain management.
In my experience as s surgeon for over 16 years I think that most patients are undertreated for their pain. For, example, I see many junior faculty prescribing Oxycodone 5 mg for postoperative pain which is fairly low dose. In general, the current approach to pain management is referred to as "multimodal." This means a combinations of narcotics, antiinflammatories, acetaminophen, ice, exercise, and possibly alternative methods. Most hospitals, though, do not have well-developed pain management services and even fewer have modern cold treatment or ice therapy machines and continue to have nurses put on ice packs at irregular intervals.
Knowing when to start aggressive pain management after surgery is easy. Knowing when and how to stop is more difficult. In a non-surgical setting in the case of arthritis even knowing when and how to start is a challenge.
What has been your experience in the management of your pain -- good and bad?
Dr. K.
Related Topics:
- WebMD Video: Arthritis Drugs Provide the Help Patients Need
- WebMD Video: New Medications Ease Crippling Arthritis Pain
Technorati Tags: arthritis, pain management, health-and-wellness, medicine
Labels: arthritis, pain, pain management
82 Comments:
Chronic pain is the worst. I've had severe acute pain - childbirth, major abdominal surgery (long midline incision xyphoid to pubis), etc) - but the pain from my fibromyalgia and rheumatoid arthritis is very difficult to manage. Some days are almost "normal," but some days there is severe (8/10) pain in both joints and muscles. Some of the time it is more joint pain, some of the time it is more muscle pain. I'd say that my pain level most days is 5/10. I don't take pain meds for the most part - I worry about dependence / addiction, but I also don't like being "zoned out." NSAIDS are out because of gastritis (brought on by NSAIDS). As you pointed out, pain is very individual, but I wish I had something that didn't "zone me out" or make my stomach hurt that would ease the pain so I could be functional.
Unfortunately, this is a subject for which I am all too familiar, having suffered a multitude of injuries over the years resulting in arthritis in my knee, ankle, shoulders and back. Finally, it was a mountain bike accident that landed me in the care of a Pain Management doctor a couple years ago. But before that happened I suffered long and hard. A knee injury at age 15 brought me grief for over 30 years before I finally had a partial replacement a few months ago. Back in the 1970’s there was no such thing as Physiatrists and/or Pain Management doctors. At least I’d never heard of them. I toughed out my life with knee pain by biking, swimming and mostly living with ice packs. Oh yeah, I drank a lot of beer and margaritas (among other things I won’t mention) which really did help a great deal. However, once out of college and into the work force that became less of an option. There were more injuries and surgeries which provided temporary relief. What I have found over the years (no offense Dr. K.) is that orthopedic surgeons are okay at pain management after surgery but they pretty much suck at it the rest of the time. I didn’t realize until I switched surgeons a couple years ago that some are much better than others post surgery. My previous surgeon just really didn’t get it at all. He prescribed just 15mg of hydrocodone no matter what kind of surgery I had. Usually sufficient enough for a scope of the knee but he’d obviously never had shoulder surgery or had an ankle rebuilt. But, I didn’t know any better so I didn’t complain and I lived through the hell of the first couple of sleepless nights post surgery. When I tore up my other shoulder I decided to try a different surgeon for a variety of reasons, none of which had anything to do with my doctor’s lack of pain management skills. What a huge difference in pain management! The new doctor sent me home with oxycodone plus meds for nausea, and sleeping pills. He also put a pain pump in my shoulder that was full of Marcaine to keep my shoulder numb, and an ice machine thingy. They shot me full of something (who cared at that point) before I left the hospital and when I got home I thought I must be dead because I was feeling no pain. After living through the first shoulder surgery I would not have thought it possible. For the first time in my life of many surgeries I actually slept on the night of surgery. When I next saw my doctor he refilled my prescription without me having to ask, a first for me. He told me he did not want me in pain. Say what? I won’t say I didn’t suffer after that surgery but the difference in pain management between those two surgeons was like night and day.
As for the chronic pain I’ve suffered since my fateful bike accident, what a nightmare. My family doctor just flat out refuses to treat pain for more than a couple of days. I still had my old ortho doc at that point and he thought that surgery on my back “might” help. But after several opinions and much research I decided against that. By chance I ended up with a Pain Management specialist. I didn’t know much about them other than a few stories about them being drug dealers of a sort. I was pleasantly surprised when I met this guy. He suffers from several herniated disks of his own so he totally gets it. He uses the “multimodal” approach. He explained everything to me and also told me flat out that I was probably always going to be in pain. There was no sugarcoating; I am a chronic pain patient. This is not something you ever expect to hear out loud even after years of living with pain. You always think that someday you’ll get better. This guy got me to a point where I didn’t spend my after work hours and weekends in bed curled up with a heating pad. The pain is always there but it’s finally manageable enough for me to live my life. God bless the doctors that “get it” and are willing to treat us.
I stumbled upon a pain management specialist 2 years after BCA with MRM. At the time he was a godsend. But over time I began to worry about addiction to morphine. My doctor always maintained addiction was very very unlikely when you are taking meds for real pain. Anyway I eventually gave morphine up with no problem.
I continued to take trilisate a NSAID that was easier on the stomach. I was pain free most the time, and I had Norco if I had breakthrough pain.
Then my prescription ran out and I was of Trisilate for about 30 days.
Then every day was a new pain.
Bone pain was so bad I began to suspect I had bone mets. A bone scan cleared that thankfully and pointed to 3 areas of "mild" joint degeneration. Lower cervical, L5 and base of my right great toe.
The chemotherapy used to save my life came with cardiac toxicity, neuropathy, bone pain and a host of other side effects.
Don't think I'll let the Trisilate run out again.
I have severe RA and fibromyalgia with chronic fatigue. I have pain every day with swelling here there and every where. I have tried all types of meds with no luck. I no longer take pain meds because all they do is zone me out. So now when I hurt I just take a Benadryl pill and off to sleep I go.I am so tried of taking pain pills that don't take the pain away so why take them.I have accepted my illness and now I just deal with it.I have tried herbs and they don't work. Humira injection and I had to stop them because I had a blood disorder. Humira did work for me while I was taking it.I am so scared to take anythong because I am scared to get another blood disorder.So now I am taking an antibotic call minocyline and hydroxychloroquine and I still have severe pain and swelling all over with no strength on both hands.I depend on my husband and kids to help me with my daily tasks.I have learn to deal with Gods Blessing. Helen
Ihave realy bad bone pain cant use right arm had neck surgery tree lower back syrgies and a leasions on my hip i can feal the pain when i walk through head to toes doc say they dont no and cant keep giving med i want to kill myself from pain what do pain pepole do a nife would not hurt as much as the pain i feal i just stay in one spot 40 years old and it gets worse every day on death row
Hello good Doctor: As a nurse, I have to trust what the patient is telling me. I am sure that some patients do abuse pain meds, but I would not want to punish one person on someone else's account. Also, too often pain management is taken as the focus of care; it is just one part of the clinical picture. For example, the patient that is overweight with bad knees. Losing weight takes a lot of stress off the affected joint, lessens the need for pain meds, helps that patient to participate in therapy ... The overall health of the patient needs to be addressed.
I am a disabled nurse and I always tried to keep my patiences as free from pain as possible. I worked labor and delivery and I had been there and I know it hurts like hell to have a baby. I had vag. and c/s. But it is hard to get anyone to do the same for me. I have lupus,arthritis,fibromyalgia,hypothroid,RA,reverse lordosis,COPD,and my pain level is 6-8 with pain med. I want to be fixed. I moved back home and I could not find a doctor that would give me my pain med. so I could get out of bed, so i had to move back to my reg.doctor. It is sick that drug abusers,addicts,and dealers have made it people that need it can't get it. Doctors treat everyone like a criminal.
I have JRA and fibromyalgia, and I've been lucky enough to have a very supportive PCP who's willing to aggressively treat my pain. I have 3 medications available for me to take when I need them: tylenol 2, ultram, and flexeril (for when my muscles spasm). Medical marijuana is also quasi-legal in my state, and that has been added to my anti-pain regimen. Out of all of the anti-pain options I have, that's my favorite. It has the least amount of side effects and, in my experience (I've been using these 4 options for about 2 years now), the least chance of developing a dependency or tolerance. (I'm still using the same amount of marijuana now as I was when I started, whereas sometimes I have to take double the amount of T2, Ultram, and Flexeril that I used to.)
Pain can be terrible at times of extreme weather. During cold speels i prefer not to take any medicines but try to take natural remedies such as white willow bark. The side effects of NSAIDS are not to my liking and has caused unwanted stress on my behalf!
Michelle
http://arthritis-treatment-painrelief.blogspot.com/
I have been in pain since I broke my Tailbone at 9yrs. old, as a teen many days I had to crawl around, still with a 'step-stool' I did the dishes, laundrey,ect. I saw my first M.D. in my early 20's, his advice?..'LEARN TO LIVE WITH IT', gave me a few 'trigger shots' a mild pain med. So I set out to learn everything I could about 'Back Pain', I picked everyones brain, in the waiting room, or out.I had an HMO as my Ins. so to them as long as I was still breathing & they were getting there money, they thought they were doing there job, this was durring the 70's. My G.P. was the one who gave me 'Vicidon' but on a limited bases, he tried to send me to the 'few' pain mang. Drs. who were finally coming on the sceen. Still even after looking at what they called an 'MRI' & X-rays, I was 'belittled', talked down too, told to get a 'Hobby',a job, even to find a boyfriend,quess they didn't look at my chart 'enough' or not at all, they would off seen I was married & had 3 small children. Many-many times all I 'wanted' to do was leave there office, I was close to crying out of 'frustaion'& I wasn't going to let them see that they had me in that state, I would get to my car & sit crying for 10-15 mins. many times I would have to pull off the road cause just think about how I was treated & 'talked to' I started crying again. I don't know if it was cause I was a woman, or they didn't know what to do for me & many Drs. didn't understand about pain patients & 'ADDICTION'..'HOW I HAT THAT WORD'!!
I stayed away from surgey, partly cause of the Drs. & my Ins, or talking to people that had surgey only to come out with more pain. I FINALLY found a 'pain Dr.' who 'belived me'..worked with me, wasn't afraid to give me pain meds.He would give me the shots & if he heard of a new treatment & went to be trained about it, I would agree to let him 'try' it on me & I would report back how it helped or didn't. Still the meds would only calm my pain down, Yes I have been to Chiropractors, in fact my G-Parents were chiropractors, I did the 'Natural' way with vitiams, Really I did it all.
Still for 35 yrs. I have pain 24/7, I sleep 2-3 hrs. at night & NO! I don't have everthing done for me, I do it all even though my Kids are 'Adults', my Husbands Cancer came back after 7yrs, so he had 2 'Free-Flap' surgeys, was layed off his job the day before his first 'Free-flap' operation, we were lucky he was 63, or maybe not, I live in So. Calif a place others save yrs to come for vacation. To see 'Disneyland' Hollywood Blvd.,places that when its mentioned to me all that comes to mind is..'SCREAMING PAIN'. Many people or friends don't understand the pain we 'live' with every day & why we can't go to 'Disneyland', or paint our house, they have an idea..well it will calm down after a few days, then you'll be alright. Isn't it so frustaing 'trying' to make them understand? & then they tell us what 'Aunt Betty' did for her her 'bad back you should try it'..WE HAVE!! & more, still were in pain.
I'll try to list a few things wrong with my back, 4 bad dics, 2 our 'buldging' one to the left one to the right, one disc is paper thin, one has 'taken off somewhere' & has allowed 2 vertabrays to grow together, 2 vertabrays overlap each other when I move certian ways. I hurt my sholder, or my neighbor HURT my sholder, long story & I just add it to my pain list. Well my G.P. takes a X-Ray of my sholder & sees that my upper back has 'compressed' more & the ddd & arthritis in that area is worse...Didn't he hear me 'complain' about pain between my sholder blades for the last 15-20 yrs.? which makes wearing a bra adds to my pain after 3-4 hrs...Don't the Drs. 'hear' us tell them how our pain has changed? I of Course have Arthris, up & down my spine I started on 'Osteoporosis' meds. in my late 30's, I'v been told I have CFS, Fibro, I know there are a few more things wrong, well the curvical, has been going on since I can remember. I even joke I know more then the Drs. ..Haven't I had pain longer then they go to school?
On any given day my pain is more then 10, it goes down to a 10 after I take my meds, so call me..'ADDICTED' if you want, all my blood test come out normal & 'you are NOT ME. I don't say to my family...'my back hurts' I'm tired of saying it & they know & now I WON'T LISTEN TO 'ANYONES' STORY ON WHAT I 'SHOULD' DO FOR MY PAIN, I'll be rude then hear that 'tape' AGAIN. One treatment that 'HELPED' was having an I.D.E.T., I was able to walk 2 days later without the knifes stincking me in each hip, I sleep 5-6 hrs. at night, was able to do more, like 'clean my house'...'Don't you love the ones who tell your husband to 'get on you, to keep it cleaner'...when you see what amess their house is, the kitchen is grimey & greasie, all along their base boards is 'stuff' an inche of cigaret butts, dog hair, pieces of paper & they 'BREED' Doxies, so the male 'markes' every where. or cause on a few of your 'really bad' days, so bad your thinking of 'where is a train I can jump in front of', so you pull out something from the freezer, you have made & froze some of...well there wife will 'teach' you how to cook'...ya she burnes everything & I'm a great cook...'Thank you very much. had to get that B out, now back to the I.D.E.T., well for 6 mons my mood was better, then as I'am putting Christmas boxes away, we have a boat in the garage which makes it handy for me to reach the rafters. As I'am getting out I slip on the fender & fall hard on my 'full lower' back ..both legs straight up, for 3 wks. I couldn't sit, lay or walk without 'screamin'pain & yes I'am sorry I didn't go for x-rays, now my Ins. won't pay for another one, saying 'even though it has been done for yrs, it hasn't been approved in the U.S.A.'
I have another 'bad dr. story' but i'll spare all of you, but one thing he did was back me against the wall & told me if I didn't say some people get addicted to 'pain meds' he wouldn't write me anything, this was after he again looked at my x-rays & said...'Yep I see why your in pain', then he writes me '800mg. Motrion'. So if I see a new Dr. I now put a tape recorder in my purse, NEVER AGAIN will I be 'BLACKMALED' to say something I don't believe...just a tip for you 'painers'. So I'am an 'Addict' if you want to think I am, one thing about 'Nancy Regan' who started this 'War on drugs' ...lets talk about the 'Drinkers' yes I got close enought to her to make sure it was coming from her. Also I NEVER say..'HAVE A PAIN FREE DAY'...i DON'T REMEMBER WHAT ONE IS & WHO EVER THOUGHT UP THAT'so cute' saying, hope she or him got shot...LOL. Thanks for reading my book, I have more this is the 'short version'...LOL. Hugs Painers, Pegi
I'm in my 50's and I've been dealing with idiot doctors and their pain "solutions" since I was a little kid. The problem is that doctor's see pain as a
1) reason to write a prescription, or
2) a reason to indicate that the patient has a mental health problem, or
3) a "life-style" problem that the patient can resolve by means of following rules presented in
physician lecture
when the real problem is that the doctor does not view the situation as a reason/opportunity to **resolve** pain(s).
The research money goes to drugs, not resolutions because resolutions do not perpetuate an industry.
And I can also say with certainty that there are many many more bad doctors in 2007 than there were in 1955. (At least in 1955 they had the excuse that there wasn;t much that they could do.) But the medical school model produces businessmen who if they have to spend more than 3 minutes on a problem will blame the victim and send them on their way, devoid of solution(s), devoid of compassionate care, devoid of hope.
Its not right. And the "Boomers" moving through the U.S. medical system will change it radically in the next 25 years...legislatively, if necessary.
And the docs will have no one to blame but themselves.
I read everyone's comments with such sadness and I relate to almost everything said in one way or another. This is all such a tragedy!
My story is that I have tried over 60 modalities, treatments and medications and paid out of pocket after good insurance $250,000 and lost a fantastic loving ballroom dancing husband in large part to not being able to "find a cure". He even learned craniosacral manual hands on therapy (similar to physical therapy) and worked on me almost every night and it did keep me more functional and helped tremendously with the chronic daily headaches and migraines but as a researcher and rocket scientist (literally!) he wanted a cure and believed in medical science way too much as he was a scientist in hard metals (aerospace). I went 4 years laying around in a lazyboy with no pain relief wanting to slash with a knife along the dermatone route of the cervical radiculopathy pain radiating from my neck and had thoughts of starting to amputate my arm outside of an emergency room as the pain was so bad and I'd just live with a prosthetic....but I knew I'd probably have phantom pain so I didn't..... I had mild to moderate episodic pain from age 10 with headaches/migraines and neck pain and a few years after that back pain and always low energy (I also have fibromyalgia/myofascial pain syndrome and probably chronic fatigue). My pain became severe/suicidal and constant in 1990 and has remained there ever since and will not change. My diagnosis from Johns Hopkins (I went to the best) is "chronic intractable failed neck pain syndrome (status post cervical surgery C5-C6 with titanimum screws and bolts) with chronic daily headaches complicated by a migraine disorder" with fibromyalgia/myofascial pain syndrome, hypothyroidism, Raynaud's syndrome and chronic fatigue. Through extensive internet research I found Dr. William Hurwitz who is the best pain doctor in the US in my opinion but the DEA has been after him and he has had his license suspended numerous times for prescribing opioids to pain patients. I have had my opioids stopped twice; once under Dr. Hurwitz' care and once under Johns Hopkins Pain Center. That is beyond traumatic....to be on a pain management program that does help and find out that the doctor can no longer prescribe and there is no one else that is available and you are left scrambling....or your incredibly horrible pain will return as well as going through withdrawal... We are physically dependent on pain medications...but that is just like a diabetic or a heart patient or high blood pressure patient is on their medications. They must take them or they will go through a withdrawal....their bodies "require" them and they will have various severe problems if they don't. Addicts are psychologically dependent on opioids. Chronic pain patients are not. We don't "live" to take opioids. We take opioids to have a life. Therein lies the difference. When you go to the doctor, keep emphasizing what you want to be able to do.....more housework, be more of a spouse, do a little work, do a hobby, whatever.....they want to hear that you are taking the medications to have a life and to improve your life. You should ask to be "titrated to effect" which means getting sufficient opioid to handle the pain as well as handle any side effects, ie. constipation, nausea, drowsiness (which will probably be psychostimulant like Dexedrine or Ritaline), rash, etc.) Just because you have side effects at X level of opioids does not mean you should lower the opioid amount. You should have as much opioid as you need for the pain. PERIOD.
Good luck to one and all....for we need it.
I'm lucky to have a PCP and rheum doc who has followed me for years and knows I've reached the point of needing stronger pain control.
Most doctors worth their salt should be able to see your pain patterns and know when it's time to up the ante.
Chronic pain is as debilitating as the diseases of the joints and muscles we all suffer from.
At 52 I've taken just about every anti-inflammatory, anti rheumetic drug known to man. It wasn't hard for my docs to see that I wasn't 'faking' pain especially since I've gone through all the usual pain meds already.
If your arthritis is moderate to severe, it doesn't take a rocket scientist to know that your pain becomes progressive in correlation to your disease process.
If your doc is intimidated by DEA then find one who isn't. My doc didn't batt an eyelash when I asked about pain patches. We had a lengthy discussion of pros and cons, of course, but the DEA wasn't even a consideration.
Any doc with a solid rep, shouldn't have to concern themselves with DEA pressures. I'd be concerned if I had a doc who couldn't take a little heat or be willing to champion my medication needs. If they didn't believe I needed it, then they shouldn't be prescribing it in the first place anyway. Are they going to call my doctor a liar when he says that I have had years of chronic pain and his best medical opinion is that I need to go on a long lasting potent pain regime? I doubt it. The DEA aren't medical professionals first of all, and secondly, they don't have the right to interfere with my doctor's treatment of my arthritis pain, unless what he was doing was illegal. Opiates are legal when prescribed by a legitimate doctor for legitimate reasons.
Don't take no for an answer if you are medically appropriate for strong opiates like Oxycontin, or Fentanyl patches. Find a doctor who has some back bone and who's first concern is his patient's well being, not his own comfortability range.
Thanks for sharing your stories, I dont' feel so alone when I read of others struggles with their pain and arthritis.
Take care
Colleen
I'm 53 and had RA for years. I live in eastern KY there is no such thing as pain meds here. If I go to a pain clinic I have to travel 50 or more miles,with RA that is no fun. The DEA needs to get out of esp. the older generations pain and leave our Drs. to do what their supposed to do help their patients. Many of our understanding Drs. have lost their narcotic lic. for (over prescribing) I am severely allergic to asprin, Ibroprophen, naprosen, any of the inflamatory drugs. so I'm up the creek.
I have RA and OA and have damage in almost all of my joints, proven thru testing, X-rays and MRI's..I have become "used to" the everyday pain but during flares or bad days I do take pain meds to take the edge off...
When I get to that point of the meds not helping I go to the doc and get either an injection (steroid) or a systemic injection if too many joints are flaring..
I have also used a medrol dose pack to help me through the rough times..
I do find that alot of docs don't like to prescribe pain meds and I have quite a few friends with RA that can't seem to get them at all and just have to suffer through the pain..
It has to be frustrating for them, I know that at times without my pain meds I wouldn't be able to sleep at all..
Even with them there are times that I can't stay in bed because of the pain..
I think pain is individual to each person and that would be hard to gauge but my docs seem to know that when I say I am in pain, I am in pain or I wouldn't bring it up at all.
Cindy
Umike07
I have to live with it every day some parts feel like someone hitting me with a hammer and thats almost every day, my Dr. and I manage it and all with pain meds and glucose sulfate which helps the large joints but nothing for all the small ones, the bad things is I can't take anti- inflamatories, so I have to watch I don't get in trouble taking to much .
I have had 3 cervical fusions in as many years. My first year was the most horrific. My wonderful neurologist didn't believe in pain medication. I was on a waiting list for 3 months. He prescribed Darvocet after my primary had given me Vicodin. I was literally at his mercy. Due to his impending retirement and fear of litigation he refused to offer anything but Darvocet. I went to the E R 34 times. Many w/ 3-4hr waits. They would give me 5-10 tablets. I was told to find a "friendly" doctor, I was told I was a drug seeker etc. Had I known this doctor's agenda re RXs I would have told him no way. I was stuck. After a 3 level anterior fusion and a 8 inch slash, he gave me more Darvocet. Although I have tried to "forgive" him I still have dreams of castrating him and giving him Darvocet. Anyways, his fusion failed. Second one 1.5 yrs later. No one told me this was an ongoing surgery. Rigid stabilization causes future disk degeneration. DO NOT HAVE A FUSION!! There is new technology on the horizon. Went to number two doctor for a 3 level posterior fusion. Thank God he had a conscience and gave pain meds which I weaned myself off. Unfortunately his 10 year time was reduced to 1.5 yrs after which I had another Posterior 6 level fusion at LARGE clinic. I have a 3 plus allergy to Nickel. Had been tested for Titanium. Unfortunately Neuro "forgot" to check allergy band for NI allergy and I now have stainless steel with 15% Nickel. What a nightmare my life has been for my family. Still have pain and have to convince doc that nickel can be dangerous to me as a foreign body I can develop all kinds of wonderful things. I can only warn people to WAIT! There is pending flexible disks soon. I wish someone had told ME. Now I am not even a candidate. Not too happy with the "practice" of Medicine at the moment. Had last fusion Nov 06. If a patient needs pain medication. It must be given. My blood pressure would go 180/120 with pain. I'm only 46. I had months of fetal position pain just wanting to die. No doctor should have the right to hold back medicine. I should have taken him to the State Board. Dependency and mental addiction are two different ballparks. Doctors are so scared. No wonder people buy off the internet. You have to go to major pain clinics to get medication. Something is definitely broken in our medical system today. The almighty dollar! Thanks for listening and please don't get the current rigid stabilization fusions. Patients are not warned this is an ongoing procedure. If I can help just a few people not have to go what I and hundreds of others are going through now. The doctors KNEW there was new technology around the corner but they needed to pay their bills now and couldn't wait for FDA approval. Wish I had gone to Germany.
I am from northern Iowa and had a pain specialist at one time and she had to up and move to Colorado. I have multiple sites of severe OA, severe Fibromyalgia and suffer from not only migraines but severe regular headaches. My GP gives me 50 Vicodin a year for my regular headaches, I take Topamax for my Migraines which has helped tremendously plus Amerge for the migraines I still have and I'm on Celebrex and Ultram for my OA. I still have a 7 for pain every day and I thought I wasn't getting any relief but when I ran out of medicines I realized the medicines do help. I've lived with this pain for several years and I'm 47 now. My last OS did not believe in pain meds and didn't give much after surgery. My new one I'm not sure yet, I've only have one surgery with him and it wasn't a big surgery and I got through it fine. I usually take myself off the pain meds if I feel I don't need them. I live with quite a bit of pain now. I can live with some pain after my surgery's without taking some medicine. I am looking a 2 tkr's very soon and an ankle replacement within a year or so, so maybe I will revise that statement. I also have severe OA down my whole spine, I also had my L-5, S-1 fused and my L-2,3,&4 are all bulging discs badly so I have quite a bit of pain in my back. It's not fun to live with. I can't stand for very long and I can't walk hardly at all only with a walker. To the person who said not to have fusions in the back, I didn't have a choice. My L-5 disc was totally gone and I couldn't sit for more than 10 minutes without a great deal of pain. I had to have surgery because I couldn't stand either. My L-2 disc was already bad and I knew that my other discs could get bad because I had a OS at that time that had already had back surgery and he explained it to me. But, I didn't really have a choice. I agree though that people who abuse narcotics do make it harder for us who have chronic pain. Doctors don't want to hand out the drugs. To the person who smokes marijuana for medical reasons and thinks you can't become addicted to it, think again. My son smoked marijuana and that was his drug of choice. He didn't smoke alot. But he was addicted to it. Not only that, it has impaired his thinking abilities and his ability to handle everyday things. We have to be careful around him, what we say to him and how we say it. He can be a ticking time bomb. And let me tell you, he didn't smoke it for alot of years and he didn't take other drugs, he only smoked marijuana. Why people think that drug is innocent and is not as bad as other drugs is beyond me. It may help your pain, but what is it doing to your brain? Think about it! I know what it did to my son's. He is now 29. Linda Kennedy
Hi,
I am a 49 year old lady living in west central Florida. Iam a registered nurse and an opiate addict in recovery for 10 years.
I was diagnosed with osteoarthritis of the cervical spine, knees, and hands when I was 27 years old. I was able to manage my OA with nutrition, exercise, rest, ice, heat, and NSAID's. I lived an active lifestyle until 10 years ago when my knees became more painful and limited my activity.
I had a C5-6 diskectomy with auto fusion in August 1994 in Gainesville, Florida and have been pain free in my neck, shoulders, back, and arm ever since despite the fact that C6-7 and L5 are herniated...they don't hurt YET! My PCP started me on Darvocet and Soma for the pain in 1992 and I was addicted to pain pills without even knowing it initially. I knew when I took the pain pills when I didn't need them, took more than called for, and begged, borrowed, or stole more that I was addicted.
I asked for help,joined Intervention Project for Nurses in Florida and got clean and sober. I have tried every treatment possible for chronic pain without narcotics for the last 10 years and now I am finally getting a partial left knee replacement Tuesday May 8th. I had a brace made for my right knee and will pick that up tomorrow. With artificial synovial fluid injections and the brace I should get 2-3 more years before I have to face a replacement on the right knee.
I have bilat carpal tunnel syndrome, bilat ulnar nerve compression at the elbows, motor neuron dysfunction, but these haven't bothered me since I modified my lifestyle and activity level.
I have been fortunate. I tell all of my doctors in Citrus, Marion, and Alachua counties that I am a pain addict in recovery. I have a pain management specialist from Hernando who is happy to help me and appreciates my honesty with my past addcition to pain pills. He is better able to help me. For this upcoming surgery he will use a multi-faceted pain management regimen. Initially including the PCA morphine pump, methadone, then patches and oral meds. This physician has ensured me that I will obtain adequate pain relief and I believe him because I have cared for his patients on a cardiac step down unit, many who are opiate tolerant. My physician knows I want as much as I can get and more because my tolerance to opiates is so high in order to have adequate pain relief and he knows that I want to be off the opiates as soon as possible. My sobriety is number one, the knee second.
I will probably have a short run off toradol which is a wonder drug as far as I am concerned. Too bad it is only feasible for short term care.
I am sorry so many people suffer needlessly. I am fortunate to be in a semi-rural area and find so many people willing to help me. No one is taken aback when I tell them I am a pain pill addict in recovery. They state they are in awe of my honesty and appreciate my willingness to speak so openly. I have to be...that is how I get the help I need.
I didn't ask to be an addict. I didn't plan on becoming addicted to pain pills. But when I was ready to get help I was honest with everyone. That is why I have been treated with respect. I have been brutally honest. Thank God for the 12 step recovery program. The most challenging patient for a physician is an opiate addict in chronic pain. Just because I am an opiate addict does not mean I am not entitled to adequate pain relief. I would encourage all of you who judge addicts to pray for their recovery so they can become useful members of society again. It is possible in some cases.
God bless everyone who still suffers needlessly. My suggestion is to search high and low until you can find someone willing to work with you, because the technology exists. It is out there so find a practioner willing to use it and compassionate enough to care.
Karen
Dr. K.,
This is a great topic. I, in 55 years was never treated so badly as i was following my Total knee replacement, from any Doctor. The pain control was so bad as to be almost missing completely. I came home from hospital on day 4 with 15 darvocets and instructions to take 1 every 3-4 hours. IMPOSSIBLE. this was no kind of pain control at all. I spent the worse couple of months trying to get over the pain from this surgery that in honesty I ended up hating this surgeon. I also think Drs. should look at past history when they are deciding if someone is look for a fun time on pain pills. I have NO history whatsoever with abusing any pain pills or anything else. I have ulcers in my esophagus so all arthritis meds are out as is even an aspirin a day.
1 darvocet every 3-4 hours! GIVE ME A BREAK!
I am new to all of this. I had 2 surgeries last year and now am being told that I have OA at the L5 level and they are treating it with celebrex. My question is I have gastritis and my understanding is this is hard on the stomach. I was just hospitalized for bleeding ulcer and many other erosions in my stomach. My PCP has me on Lortab but keeps reducing the strength so I wont get addicited. I have told her numerous times I dont use it unless I need it but that does not seem to matter. I fell on my right knee that has OA and bersitis in it and now they tell me to learn to live with it.I am not sure that it is strong enough for this at all. I live with pain everyday and am told to just learn to live with it.I am overweight and they tell me that, that is my problem and if I loose weight it wont hurt so bad. Thanks for listening and if any advice please sent it my way.
Most Dr.s are afraid of the dea. This and drug addicts hurt those of us in need of true pain relief. I had seen about 50 Dr.s befor I found one that treated my pain, I always got the DEA spill. After finding my pain Dr. I had surgery and still have pain. My PAIN Dr. understands this and prescribes me 60mg of methadone a day. I can say I am addicted but not an addict. I live my life now mostly pain free. You need to decide if you want to be addicted or not live your life!
I am 21 years old & the pain of my RA can become very unmanageable. Before I was diagnosed I had spent a couple of months bed ridden & completely unable to move. My parents had to do everything for me, shower me, turn me, sometimes help feed me, all because I could not move. Now with treatment the pain is bearable, but still the flare ups make it to where something as simple as turning a key to my apartment is an absolute chore. There are so many times when I wish I was just your normal 21 year old. I know there is no cure for this & all I can do is "live with it". I am in the same boat w/ these other bloggers as far as the medicines go. I get so sick of taking pills, & if I don't just one day of skipping treatment throws me into 3 more days of trying to get over the pain. A lot of these otc painkillers dont work for me either. It took me about a year to just be wiened off of prednisone. I noticed that in my case humidity makes me feel a lot worse & a steaming hot shower makes it feel a lot better! :) Every night before I go to bed I take a hot shower & the first thing I do when I get up is take a hot shower. It helps me to begin & end my day a little more easier. My parents & grandparents keep telling me that if there were ever a time for me to get RA, it would be now. Especially since there are so many treatments for it & each one can be modified to best fit me. I feel for those who had to live w/ RA before now & there was nothing for them. For them there was no hope of getting better or dealing w/their chronic pain. I indeed feel blessed
I have had several artho surgeries on both knees (right knee worse)over the past 2 years. however right after surgery the pain is back. My Dr tells me not to do steps are walking alot, My Dr also told me that the cartilige is gone in my right knee which means I have bone on bone. I have tried the injections and they only last about a week maybe. I am trying to lose weight but I cant walk even a little before I am in so much pain. I would appreciate any help or suggestions you might have. I am only 56 and I want to play with my grandbabies and If I get down on the floor with them I cant get back up without help.
Thanks Mary
Hello;
The above situation tends to be a common one, not that it happens all the time but most chronic pain Pt's have experienced it at some point in their Pain therapy. The problem I feel has more to do with our view as a society with regards to people who take these meds, all of them from the start are viewed as drugies or someone who is drug seeking etc. Have you noticed on average in a Pharmacy someone who drops off a script for a narcotic or pain med has to wait almost 2x-3x as long as someone lets say whos filling a antibiotic, why? Allow me to give some unique insight & behind the scenes knowledge. I have previously managed 2 of the nations largest retail pharmacy's (u know them) that's when I began to notice the trend & Pt's complaining of wait times, I even would have the Pharmacists or Techs say directly to me that all these people are just wanting to get high, never mind Mr. X who came in with a Halo bolted to his broken neck or Mrs. Y who has had multiple knee & back surgeries, nope stillthe same feeling back in the Pharmacy these people are wanting to get high.
Things progressed to where the staff would make a game of it seeing how long to make them wait until they would show the beginning stages of withdrawl, or how they would pick Pt's out as they approaced & say yeup this guy I bet has a script for happy pills. I later married a Pharmacist who's opinion was that of what I just mentioned, she would actually be angry at these Pt's not the Doc's who the Pt needed in order to get the meds, and the person who was more qualified than any of us to decide who needed these meds or not.
Oh by the way I am a Nurse Pain Specialist & while working in the pain clinics things there went from bad to worse, initially pt's were placed on a strictly monitored opiate program for various disorders, then when the negative stuff hit the media I began to see all the doctors start to become more reluctant to write for the meds, due to not so honorable doc's who got busted selling scripts illegally for big money. So the gov set it sites on all doc's who wrote alot of pain meds, therefore the doc's would now stop writing them & the Pt's would suffer greatly, then the Doc's came up with a dangerous plan, now Pt's had to agree to the Doc's course of Tx which almost always included some form of risky surgical procedure, leading Pt's to feel obligated to allow these surgeries so they could get their meds, if they refused several of the Doc's would write in Pt's file that "Pt has ignored or refused the appropriate treatment regime, begin discontiuing opiates immediately, or over the next month". You see Pts dont know they have the right to be involved & choose their course of treatment, and for a Doc to do this was one illegal & immoral.
The Kicker is one day the Pain Doc just laid into a Pt who he moved off of opiates to Gabapentin (a non opiate, at the time farely new med, really not desired for pain) without any stepping down he told the Pt withdrawls wont kill you, that they should tuff it out & give the meds (Gabapentin, which he presented to Pt's as the next thing in Pain meds, which it has many uses & pain is at the botton of desired uses) time to work, so the Pt is in terrible pain coupled with withdrawls & I know this med isn't going to touch their pain.
I stepped in informing the Doc of all that I've monitored in my short 3 mths their & how he's crossed the malpractice line, violated Pt's rights, and black mailed Pt's into procedures they didn't need to have, I then informed him that it hurt me deeply because I too am a long time chronic pain sufferer & have taken opiates for the better part of 7yrs now, so that getting high part of everyones can just go out the window. True Pain Pt's do not get a high if u will from pain meds they first of all get relief though never total relief, allowing us to function at a level that without the meds we otherwise would be on the couch all day. Dont get me wrong there are those Pt's who take the meds incorrectly as I have myself before, and trust me it's not a cake walk you get dizzy & sick to stomach & can't function, so the idea that all of us are seeking a high well that one time for me if that's the high everyone has rumored about I never want to see it again.
This is a subject that really gets me riled up! I was diagnosed with RA and Fibromyalgia 6 years ago at the age of 20. I started having JRA symptoms when I was 10, but they were dismissed as "growing pains," and I was told to deal with it. At 10 years old! Nevermind that I stopped growing then, and the pains continued until I got pregnant at 18. They were "growing pains." Right before I turned 20, I was suddenly hit with adult RA, and a few months later Fibromyalgia. Luckily, when I first got sick, I was going to college, and had access to a good medical school and got a diagnosis. I couldn't take care of myself and my child while going to school anymore, so I had to move back home to southern West Virginia, where opioid addiction is an enormous problem. Until recently, there have been no rheumatologists anywhere near me that would take my insurance. I've been limited to GP's and Internists. Every doctor that I have been to in the past 6 years has automatically looked at me as a drug addict as soon as I tell them my symptoms! I have taken every NSAID on the market, every over the counter pain killer and anti-inflammatory, and combination thereof until I have dammaged my liver. None of these work. At all. Steroids help some, but the Dr.s I've seen are reluctant to prescribe those because of the side effects (like I care at this point!). I did find a doc once that I thought was compassionate, but he was just using narcotics as a marketing tool! When I tried to tell him it wasn't enough, he threatened to take my meds away! He took me as just another addict! (And in re to pharmacy attitudes, I was once accused of changing a date on a narcotic script that this doc wrote, in the middle of wal mart pharmacy! I literally cried for days!) That's the only pain relief I've ever had, and it was just a taste of 10mg Norco. He wouldn't let me take anything else because of my liver, so I didn't even have a chance to try any other options! No one will even TALK about it! You'd think the DEA had the offices tapped! I've finally found a PCP who will at least give me steroids and ultram (but he still won't talk about it!)and a Rheumatologist out of state. I'm tired of fighting off the pain every minute of my life! I can't sleep, eat, think or do ANYTHING because of constant, mind-numbing pain! I can't handle anymore, and its criminal that Drs make people live like this! If you call this living!
I am 41 yrs old living with RA fibromyalga inflammatory collites hypothyroidism and now bilateral lower lobe ground glass infiltrates. I was diagnosed at 35. I had to stop work at 38. I have 5 doctors I see on a regular basis. I am currently on 28 meds including medrol methatrexate flexeril and remicade. My problem is getting diability to pay. I take percocet 7.5 daily without this meds I could not live! I have people in my family who say I only want drugs that I don"t need them.They blame the drugs for my health problems not the other way around! I helps me to read others stories so I don"t feel so alone.Yhanks for reading.
Qote: my fibromyalgia and rheumatoid arthritis is very difficult to manage. Some days are almost "normal," but some days there is severe.
I live with this problem also, I also read everything I could. Most doctors will say they don't beleive in pain medication,It is time to get away from that doctor because he is a qack! My doctor said he does not beleve in pain, thank god! 90% of people on pain medication use it correctly. After all alternative pain relief, my doctor sat me down and said take the Hydro/codone Mike! We have done the others and they where not working! For 1 year I had great success, then my doctor was tranfered and it has now been two years before I was assigned another full time doctor and thus far he has been great. With the words: I do not beleive in pain Mike. If you are taking to strong of meds simply take less. however if you are taking to little the pain will stop your hart or create high blood pressure and kill you! I also hate it when I talk with someone whom has been procribed psch meds! Cronic pain does not mean we are crazy. Treat the pain properly and then ask if I have lost my mind!!!!! I have lived with this pain for more then 4 years now. I get very little sleep, my stumick is torn up because of the low dose approch. Yes I took the so called great drug also Vioxx with little help for my pain. Doctors can do blood work to see if you are using your medications correctly and if you have even been using it. So for you drug abuser, your time is coming. The old doc can tell. America wake up. Once my medacation was correcty I went back to work. However when it is incorrect I draw SS. It is my body, and the doctor resonsibility to properly help me. I even ask My Doctor once: It seems like maybe I got "HIGH" from my meds! He stated; no mike, we manage to releive your pain and you got rest and your energy level shot up. He was right that is not getting high. If you are in pain I do not care how much pain meds you use it is almost inpossible to get high! They place blockers in them to stop that. Be careful with the meds, do not give them away, you may need them one day.
hello, I am a young student at a medical class around 25. I chose to go to med school because of the brutal construction work I have been doing since I was 15, one of the worst (tile) I know tile work is very bad for the knees among other important joints... my knees hurt every day, some times my muscles. when I am on my knees doing tile on the concrete my knees some times pop. it seems like they pop back in to place but when I get up it is no different, maybe my knees adjust to being on the concrete. but even when I move wrong moving buckets of cement (with my right hand) I force my hip out of place and it hurts on the left side and in my tail bone for a week or two, until it pops back in to place. when I carry the bucket of cement with my left hand I can hold it much more sturdy and have less pain. although my knees still experience a lot of pain the more I am active almost like a sharp pain and a burning combination. although I am only 25 my grand father had crippling arthritis when he was 16 so maybe I inherited some of the hereditary disorder that plagued his life.. thanks doc
I have personally experienced a big reduction in osteoarthritis pain since adopting a plant based diet. I have since recommended this to my arthritis patients. Dr. John McDougall, M.D. and Dr. Dean Ornish M.D. both have great programs.
I've had a long history with managing pain and Doctors. I suffered a compression fracture of C6-C7 in the early 80's that went undiagnosed for too long. I suffer with a herniated disk in my neck now which, if ignored or abused by too much computer work or reading, causes knots to form all across my scapula and shoulder right side. Trigger point injections were my only relief then. No meds prescribed short of tylenol and codiene on rare occasion.
1990 saw me suffering a fall on my tailbone. Again my injury was ignored. Not just by emergency room staff, but several Orthopedic doctors. I even had one of them tell me it was due to my poor financial status. He said had I been Joe Montana, I'd have been healed. Some muscle relaxers, bio-feed back and ice mixed with condescending attitudes from treating physicians was my experience with medical care.
1998 I was diagnosed with osteoporosis and told to take calcium. A year later I ruptured my first lumbar disk lifting a high chair. Prescribed Hydrocodone 5/500mg and flexerils. On the advice of a friend, I saw a leading Neurosurgeon in Wilmington, N.C. He put me through a mylogram and then a diskogram before telling me there was nothing he could do for me. He did prescribe injections in my right facets at the pain and treatment clinic though. Doled out pain meds as if I were an addict, but upped the dosage to 7.5/750mg.
On my own I have learned to tolerate high levels of pain and only take my pills when it is so bad I get suicidal. One 60 count prescription has been known to last me 6 months. I've also been known to break them in half.
2005 ushered in the second disk rupturing in my lumbar region after moving furniture back once repairs from hurricane damage were completed. This time it wasn't one week of hell but three before I began to see relief. I've been so programmed to believe my doctors will only send me home with a "sorry nothing I can do", I chose to bear it until the simple act of breathing caused me to cry and pray for death. My current physician sent her nurse in to inject me with an anti-inflammatory which began to help with my pain the following day, but also caused me to bleed internally less than 15 minutes after I left her office and upped my dosage to 1000/750mg. She's a good physician and I love her the best of any I've been to in my entire life.
Just recently my hips began to cause me problems along with my shoulders too. I waited 8 months before telling her, but when I did, she sent me for blood testing to determine if I developed rheumatoid arthritis. And yes, I can now add that to the list of issues I must deal with.
The question is you ask is how do I rate my experience with pain management? Poor! I moved 1.5 hours away from my doctor and I won't switch to another physician because I refuse to argue for what I need. I'm scared to see a Rheumatologist even though I know I should because the meds used to treat it will cause me to bleed internally, so why bother?
I find most male physicians to have a condescending attitude towards women thereby missing or misdiagnosing health problems as a neurosis. That's even prior to talking in terms of managing pain. In my opinion Freud's theories are very much alive and well still today.
I have been living with RA for about 7 years now, most of that time without any type of pain control. I also have Fibrcystic Breast Tissue, and Osteoartheritis. When I would hurt really bad, I would just double up on NSAIDs such as Ibuprofen. As the disease started spreading, I was sent to a Rheumatoligist. So far, in 2 years of treatment, I have been given Plaquinil for the RA, and told to take Advil or Tylenol for the pain. He doesn't "believe" in strong pain medication, as he believes I will need narcotics when I get older. Now the RA is in my fingers, wrists, knees, feet, shoulders, and lately I have been having problems with my eyes. Still, he insists on no pain meds. How do I cope? I self-medicate. I take 9-12 ibuprofen a day, plus 6-8 acetomenaphin on top if I'm in a flare. On the nights I get less than 2 hours sleep (which is about 2x a week), I take me a nice shot of Nyquil. I used to take a Benadryl to sleep, but the last few times I have, it felt like my flesh was crawling off my bones, heart pounded, and it kept me awake for hours feeling like I could not set still. Last year, after having a tooth pulled, my dentist gave me 10 Vicoden, of which I took 3. When I had a flare, I remembered those pills in the cabinet, and took one. The relief was great! When those ran out (2 months later!) I went back to my RA doc and explained my predicament. Am I addicted? No. I can live without them, and have now for quite awhile. What is harder on my body (and mind), living with terrible chronic pain, or taking a narcotic when I need it? Of course he refused to give me any pain meds, and prescribes steroids for my flairs. I have gotten to the point that I got rid of all the firearms in my home, as well as have my oldest son hide the knives when I am in a flare. This is NOT living, and a doctor that lets a patient suffer the way I do should have to live my life JUST ONE DAY! Cause people, this ain't living. Why would anyone want to live when almost every day is hell? Addiction and dependance are the least of my worries. Getting through another flare without eating a bullet is.
my husband had a hip replacement in 2002. it was bad from the start. his blood was so low and no transfusions, home a week without blood thinners and he had a blood clot from his knee to his ankle and spent a week in hospital. It is 4 1/2 yrs later and he is still in pain altho they cannot find any reason why. do you think he should have it done again in case something has came loose.donna m
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Want a great OTC medication for the pain of osteoarthritis? It's called SAMe. I've been using it for years and it always works, and right away -- not like some of those other homeopatheic stuff! The only bad part is that my health insurance doesn't cover it, nor can I get reimbursed on my flex benefits. But you know what? It's worth every penny. I have tried for YEARS to stop my pain from osteoarthritis and this stuff ot onlu takes away the pain, but it also strengthens the joints. Works great and it's also good for the liver.
i feel so bad for all of you, as i was 24yrs old when i could not walk. thanks to awonderful rheumatologist, he told me my pain was quite real.when i had flare ups, i can usually get in to see him the same day. i have been injected in every joint in my body. i have had several surgeries as a result of the arthritis. when one drug does not work, he tries something else.i do not have ra ,but inflammatory arthritis.i am now over 50 yrs old and i do not know what i will do when my dr. retires. i have a regiment to do lidoderm pain patches, aspirin, vicoprfen because vicodin does not help my pain.to be honest folks, use your computer to find better or top doctors in your state. i found a very caring and wonderful endocronologist at the cleveland clinic. also found excellent orthopedic surgeons by typing in top specialists in the state you live in. also look under clinical trials going on in the country and see if you can get in one of those.my pain level on a good day is a 6. it seem when we get diagnosed with arthritis we have other disorders going on. it seem like thyroid problems, migraines, diabetes and fibromyalgia are things we share in common. also the majority of patients with multiple problems are usually female. i count each day i can still walk ablessing. like someone else said we live in atime where is new research going on.back surgery i will not have. also to the person who was told her weight was causing her pain,bull crap. less weight on a joint makes less pressure, but bottom line ra was not determined or caused by being overweight.my form of arthritis can run in families so what caused this to happen to my family members who have never had aweight problem? i am glad i finally had a total knee replacement. was in hospital less than 24 hours.only wish i had done it sooner. take care all
In Alabama You are a DOPE HEAD SEEKING DRUGS!!!
They treat me like that ,with my pain from this arthritis.
I hope the Docs rot in HELL!
I have suffered for 7 years with this crap..I was a machinist for 30 years and now I can bearly walk without pain meds.
And GOD bless dont smoke any POT!!
God bless us all with this pain!
I was shell shocked at Emory University Emergency Department. I had somehow gotten a "crick" in my neck, and initially went to (forgive me) a doc-in-the-box. Never actually saw the doctor, just the practitioners. Ultram, Celebrex, and some muscle relaxant later, the pain was still unreal. I tried ice (did work best), heat, praying and since my pain was in the cervical area, spending my days with the affected arm straight up in the air, or folded across my head. I could not get away from the pain.
Went to Emory at around 10:00 PM. ER's are busy, but they gave me a script for hydrocodone with acetominaphen (sp?) I hate even taking an aspirin!
Days later , pain kept getting worse and the ever so well taught "Doc-in-the-box" actually told me to return to the ER! At which point they flat out told me they would not fill another prescription after the second "visit". They treated me like a drug seeker! The Hydrocodone never worked, so I wasn't even takeing it!
It was a unusual, I suppose, slow day in the ER (Graduation Day), and I was shunted back to a room. Could not help it, I cried, I couldn't lay down, sit or stand.
A nurse finally came in to take the particulars. She wrapped a blood pressure cuff around my sleeve. Then left. A Doctor came in and listened to my breathing, tapped on my back a bit, and then returned with TWO hydrocodone tablets, and a tiny cup of water. She then said to follow her the get my release papers, not noticing I was still cuffed to the BP machine (which never was used). I kinda thought, great, I'll follow you and also haul this big ass machine out the door as a parting gift.
Here's the kicker. I emailed the doctor and let her know I felt like I might have been keeping her from something vastly more important, like a McDonald's biscuit getting cold on her desk. I know that sounds rude but that's how I felt.
Next day I get a call from a consumer satisfaction person, and granted he was very nice, and concerned.
I blew my stack when he said that my initial heart rate was this, and my exiting heart rate was that!! No one took a heart rate! He further described my initial blood pressure, before and after medication! No one took a blood pressure, temp or heart rate! That is agaist the law to fill in those blanks!!
I've hear that ER rooms are monitored at Emory, but it seems too much trouble to go through to complain.
Didn't mean to be this long winded, but bottom line I WAS IN PAIN and they made me feel like a pill seeker. Maybe I should drop off the 18 tabs of hydrocodone I have left after their scipt of 20. It didn't work. Advil does just as well. Keeps me from gnawing my arm off, anyway! :)
Hi All,
I would like to say that I am sorry for you all and the pain that permeates every aspect of your life. I have worn similar shoes. 'Still wearing those old rotten shoes. I am weary of even mentionong my ailments, suffice to say, I am no stranger to pain. I am also no stranger to doctors who apparently could care less. I have suffered, I have watched others suffer, some until they passed on. I just do not understand it, the whole "no pain med angle". I reckon' I'll just keep sky watching, wating for it to split! MARANATHA!!!!!!
I completely understand where the Dr. and the readers who left comments are coming from. I am 30 years old. I have had severe back and neck pain for almost 10 years. 3 years ago I finally found a doctor (after about 10 specialists) who diagnosed me with Degenerative Disc Disease and a curvature of the spine. I have a bulbous disc in my neck that gives me migraines 2 to 3 times a week and at least 3 others that hurt tremendously. The curve in my spine is probably the worst though. It causes my right shoulder blade (and everything around it) to sweel a LOT! The doctor who diagnosed me made me happy that I could finally KNOW what was wrong...however he will not prescribe pain meds unless he "cuts" you. My PCP prescribed for almpst 2 years and then one day decided that was enough. These doctors don't know how to start someone or to properly stop someone. I am trying to "live with it" but I haven't been able to work for 8 months! Now that I have no insurance I cannot even find another doctor. My old PCP won't see me and the guy who diagnosed me won't refer me now becasue the PCP told him not to send me to anyone and that I should be able to "live with it". My pain is at an 8/10 every single day and if it weren't for 1 person in my life who is taking care of me right now I would be in a gutter or on the street...or even worse...becasue I cannot deal with this pain I experience. What is a person to do? Are you supposed to "shop" for a doctor who will help you?
To anonymous 1:34pm:
I'm sorry you're having such horrible pain! You have great questions -- I hope you'll visit our Back Pain Support Group. The members there are very supportive and might have some suggestions that would help you.
What is the drug in tablet form blue with the number 787 and West Word on it. A local physician prescribed this.
I have had two back surgeries for lumbar disc and now have arthritis in my hands and arms. There is a pain management group in Dallas but they charge $600 for four weeks of medicine (which is 15/80 hydrocodone/tylenol) Is this normal?
I have to have something for pain or cannot work.
I believe that Doctors have moved away from treating each individual patient to a gross generalization in pain management. It has gotten to the point that I no longer trust Doctors very much because I believe that I have not received the best available care possible in treating arthritis in my hips and chronic back pain from a herniated disk. I also believe that Doctors don't understand that most patients seek pain medication in increasing doses or variations because the medication provided simply does not work.
If there is a safe alternative, most patients would gladly leap at the opportunity to finally live "pain free" or with minimal pain. I myself, have reached the point where I no longer go to the Doctor. I will only hear the same old song. There needs to be a change in patient care. Afterall, we do pay for treatment and deserve to be treated with dignity and respect.
I have arthritis pain and a bulging disc in my neck for 2 1/2 years now. I have had MRI's and x-rys. Because i have a history of depression, which is controlled by meds. The Dr's read that on my medical history and throw me in a basket marked crazy and pain is caused by depression.I have dealt with severe pain all of this time because of this. My life has changed. I have to plan my days activities around my constant and severe pain. I have learned one lesson though and that is to leave depression off of my medical history and any meds that I am on to control the depression. I don't know what srep to take next. Can anyone give me an answer on how to control my pain and lead a normal life again?
I'm 36 years old and have suffered with lower back pain for almost 8 years, after an accident. At the time I would lose feeling in both of my legs and be forced to lay where I fell for hours, waiting for the feeling to come back in my legs. I was told it was a bruise, the doctor didn't even look at my back. After years of "chronic bruise pain" I was broadsided in an accident in March this year. This then the pain has been unbearable most days. After months of physical therapy and methocarbinal and vicodin for 'whiplash', I was finally referred to a pain clinic. The pain clinic then informed me it was "in my head" and I 'could see a shrink and stop taking the Vicodin, but here's some cyclobenzaprine instead' and 'lets get an MRI to see why you have incontinence problems now.' Today I get the call that it's degenerative, 'mildly with implications of osteoarthritis' but keep going to physical therapy and don't take your pain medications anymore. Why should anyone have to go through that?
I've spent the better part of the past two hours reading posts on the site concerning pain management. I'd like to add info I have come across and throw a general question out there for folks to consider: I am 48 and provide support for my 73 year old parent. She had an accident in 1986 requiring a prosthetic right elbow implant. The same accident caused damage to her left sacroiliac (sp?) which has now been invaded with arthritis. She is in constant and severe pain. I underwent 10 months of therapy with interferon and PEG-IFN. Had to stop because I became so anemic and my sed rate had dropped so low I had started bleeding everywhere and didn't have the strength to get out of bed. My GI that was supposed to have monitored my chemotherapy did not prescribe the IFN, the rep from the pharm company did, she came in the tx room, showed me the new pen for injections, stamped the Rx and the MD signed it. Later I learned (calling the mfg hotline) that the "normal tx" is to start you on something like Zoloft or Paxil for 10 days BEFORE the IFN. When the chemo put me in the hospital, my GI packed up his office and left the state, literally, overnight. I was then terminated from my job after 17 years for "missing too much time", I worked during the chemo even though I was told to take off instead of taking extended sick leave, but then I was told that I was still "on-call 24X7". Long-story made short, I went almost two years before I couldn't stand the pain everywhere. Every joint and major muscle group in my body hurt, and continued getting worse until all I could do is sit. The only way I can describe it, and most people don't remember what I'm talking about, is the feeling of a "stone bruise". The entire bottom of both feet and the palms of both hands feel like huge stone bruises. My knees, wrists, ankles, and elbows, neck, back, etc. ache, and even clothing touching my skin caused goosebumps. I finally submitted to finding a new MD, one fresh out of med school who had a 2 yr GP before moving to his hometown and joing two other MDs opening a Family Practice Clinic. I did not ask for meds, but provided him with a copy of my records (I suggest YOU keep copies of all records you have, tests, X-Rays, MRIs, etc-YOU PAID FOR THEM AND THEY BELONG TO YOU! If the techs give you any problem in having your XRays and MRIs, invoke HIPPA, it clearly states they belong to you! Anyhow, my new dr never gave me a chance to ask, the first thing he did was run bloodwork, next thing he sent me to a neuro, then told me something that blew me away! A largely unreported side-effect of the IFN, mostly the PEG-IFN is the destruction of the "myalin" cover over my nerve endings leaving me with, literally, every nerve in my body being "raw". He did not hesitate to write an Rx, but he said my liver panel indicated the lack of some proteins necessary to metabolize codeine based meds, so he wrote me an Rx that I actually sat in my car and cried when I left his office. He gave me 50mg Demerol tabs qid! He told me to take one in the morning and one at night, and save the other two as "rescue" doses through the day. For the first time in almost three years, I woke up without being disappointed that I did! Of course, addiction became a concern, and he did end up seeing me in the ER. Not from overdose, but after developing a tolerance, I had taken 100mg, felt better to the point that I was irritated that I cannot continue this and flushed the pills. I wound up in the ER dehydrated and going through serious withdrawls. For almost two years now, I get 480 5mg OxyIR, 20mg qid prn. I prefer this over the Oxycontin because I control how much is in my system at any given time instead of the pill being release at a consistant rate. Now here's the only problem: two months ago my MD told me that he and his two partners decided to "get out of the pain mgmt business", but he would make an exception for me. He's a great guy and a wonderful dr, but if he isn't available (Drs w/o boarders, vacations, new family addition, etc) the other two will not write the Rx. Now, I suppose to prove the point, my parent uses the same dr, he won't even give her 1 grain codeine, 7.5 hydro, etc. So-I'm forced into committing a felony. I take my meds as needed, staggered doses to reduce tolerance and dependence, but share these with my Mom. I dare anybody who may read this to try and convince me that they wouldn't do the same thing. After she's had too many surgeries to count, the last being a CABG-5 (her cardio gave her Darvocet for post-op pain), she may take 5-10mg oxy in a day. Then I find her crying in her bedroom because she's depressed (taking Lexapro) about taking my meds and afraid I'll run out early and she'll get in trouble. Considering the recent outbreaks of contaminated food, I feel the FDA needs to concentrate more on the F and less on the D, but they don't get funding for the Food part, more for the War on Drugs which all should know is no more than a political cash freefall. If the DEA and FDA put half the effort into closing down these meth and crack labs as they do harassing legally licensed doctors and patients we would have a much more productive, happier, and contributing senior and disabled population than a semi-police state. I've also introduced my Mom to THC-the pills are crap, the pharms can only synthesize 12 of 18 compounds in THC, so don't let anyone tell you that Dronabinol or any other sythetic THC is the same as smoking a joint is either trying to set you up or simply a liar. In any case, now with an adequate supply of pain meds along with 1-2 joints (shared) a day, we are returning to where we were before the chemo destroyed my life, income, reputation, and will to live. I have told my doctor, do not even suggest anything that has not been on the market for at least 10 years! These greedy pharm companies should be closed down-most useful drugs aren't made here anyhow. This blatant lie by the FDA about foreign meds is pure nonesense, the PEG-Intron I got was made in Puerto Rico, the Ribovirin was made in India, but distributed by the company in the US. If our government wants to reduce the federal debt, I suggest doing away with the DEA (they are useless), realign the FDA to do away with their drug oversight (useless also, when they get paid enough, yes I said the FDA got paid by the drug mfgs, they have the authority to "fast-track" approval for a drug in as little as six months, whereas if they don't get paid by the lobbyists, it takes up to 7 yrs!) most of these drugs you see on TV as causing all kinds of problems and lawyers (mostly useless) are watching better than the FDA, and the fast-tracked drugs are the same ones that the pharms are getting sued over. WE have become their test subjects-be careful when trying something "new". My problem with pain management is not with my doctor, but with the useless and greedy federal and state agencies that are second-guessing the doctors and threatening them with suspension, restrictions, etc. that would impede their ability to treat patients. I have experienced the lack of control with the PEG-IFN and the over-control with pain meds. Get the govt out of medicine-after all, my personal feeling is that all politicians are liars, lobbyists are crooks and thieves, and the State Medical Boards are primary composed of MDs with a chip on their shoulder! In short, I want my state and federal government to keep their collective noses out of my personal medical business and relationship with my health care providers. If I have a problem with them, I WILL LET YOU KNOW, otherwise, back off, shut up, and close down the DEA. They're the real root of the problem when it comes to pain management-I've never met a physician that wasn't willing to treat pain, but always had reservations because of possible sanctions! I'm ready to plan my own Thebane and THC, process it myself, and take my chances. What else are we supposed to do? Isn't pain treatment protected under the "pursuit of happiness". I wish someone with funding would challenge the DEA all the way to the Supreme Court on this issue!
I have been diagnosed with spinal stenosis as well as lumbar stenosis and "degenerative" arthritic disks in my back. Have been in a lot of pain for several years. Since I must drive (only way for me to get around) I cannot take most pain medicine that make you drowsy. I have put together recently a combination that helps me ALL DAY. I use OTC eight hour Arthiritis strength Tylenol 3 times a day along with one 100MG pill of Ultram ER in the AM. The Ultram is a once a day pill, so the only thing I have to remember is to take the Tylenol every 8 hours. The results are amazing. I am 85% pain free. Check with your doctor on using the Ultram ER.
I came to pain management shortly after a kidney transplant in 97. It began with severe hip pain shortly after the transplant surgery. After some exams it was found that I was going to need both hips replaced soon. The pain continued after total hip replacments. The docs at the hospital thought it was normal post op pain and that it would "go away" in 6 or 7 years!! Then someone else took over the pain clinic and I and others were told they were no longer going to