Contemporary narcotic restrictions

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Gary : get a pain management specialist ASAP. You will have to do a TON of paperwork (if they're reputable) and submit your MRI's,but the grief is worth it. Most ortho's seem to chisel you to death on meds (as you're aware) and never dose you enough where you can rest properly.
 
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My observation and research have shown that we have issues with pain management in our healthcare industry with doctors being very reluctant use what might be the appropriate level of medications and err on the side of prescribing less than the desirable amount.

It's primarily due to the "war on drugs" mentality and the occasional DEA investigations of some physicians. When everyone prescribes less, the ones who do the appropriate level stand out and are viewed with suspicion. The end result is more pain that is necessary.

To remedy the situation, what flacoman suggested is the best course of action at this point. Find a pain management specialist.
 
It seems like a good approach. Naturally it dumps more costs into my process (wife's insurance ..etc..etc.), but I might not have any recourse. The thing is, at present, my appropriate level of medication is one of intoxication ..and even at that I'm for most purposes disabled.

I'm adjusting better to the isolation when Joyce is at work or otherwise out of the house. Thank goodness for wifi
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While it may not be everyone's experience, I find opiates "opportunistic". I can usually dismiss the drowsiness easy enough to be alert, but the first mentally idle moment and it sweeps in and you're nodding out.

I could never consider this any form of recreational "feel good" thing. It would be something that would just make me sleep. I'm obviously missing something.
 
This is why you should see a pain management doc. By trying and altering dose levels and medications you can get the help you need and not be dizzy/sleepy. Some meds do nothing but make me dizzy ,some really help but hurt my stomach,and so on. Once your properly dosed ,you'll be a much happier camper (not like that!)
 
This just gets better and better here.


On my last request for medication it was during the holiday weekend. I left a message with the nurse as usual. Now they already give me only 40 pills for a 7 day stretch that needs 42 ..but so be it. During the last phone call I stated that I might as well make this an official request for my 40 pill script on Friday (3 days forward) so that we could avoid the same scenario next Monday (me out of pills and she wanting 48 hours notice).

This finally triggered a light bulb in either the surgeon's pr nurse's head and they wrote the script for 50 instead of 40. This would allow 1+ days leeway in getting another script.

I get a call from the nurse saying that the doctor requested that since I was being treated with steroid shots by another practice, that they take over my pain management.

Given my experience with the ER giving me too few meds before my first appointment with the surgeon, I asked that we first verify that I have enough medication to make it to my appointment with the group giving me my shots. She stumbled and hemmed and hawed. She asked, "haven't you gotten any relief from the shot?". This was the FIRST inquiry into my condition. Only when I was attempting to assure that I had enough pain medication. She could have not cared less before then. Truth be told the shot did improve my condition, but not to the point of not needing 24/7 pain medication. 50% of torture is still suffering.

At this point I had had it with this "anxiety of silence" and blurted out, quickly, "Don't put yourself to any trouble. I'll move on and be done with you. Have a nice day!" and hung up.

I got a letter from her office telling me that she wasn't going to treat me anymore due to my rude behavior.

Now this is really interesting. With my first visit to office that gave me the shot (post shot follow up) the doctor was very concerned and attentive, referred me to pain management specialist and offered some highly effective alternatives to narcotics.

Over the entire span of my "care" from the surgeon's office I had not been asked ONCE how I was coping with the pain. There was never any discussion of "we normally like to limit the use of narcotics and attempt to use alternatives" ..nope. No interest in my challenges and limitations ..not one inquiry or showing the least bit of interest in how I was doing. I was left to my own means to cope with those things and she couldn't be troubled.

..and I was "rude"??

She's very fortunate that I wasn't someone more prone to depression in the midst of despair. The condition that I was in, if left untended, would surely have thoughts of suicide going through your mind.

I'm preparing a well thought out response to the surgeons letter and hopefully will insult her properly for what I interpret as medical malfeasance and depraved indifference.


..but this also puts me in a catch 22. The surgeon was the affiliate of the steroid shot people. That is, if surgery is required, they have no one to refer me to.

The obstacle course just keeps building itself in a reactive manner to my situation.

Right now I'm doing much better. If not for the prohibition on blood thinning agents (aspirin, etc.) since I'm getting a second injection (Tues), I would almost be narcotic free.

Now "much better" doesn't mean "great" other than miserable is great compared to tortured. I still can't sleep in my bed nor sit on a hard chair ..nor walk too far without paying dearly for it, but I can "not suffer too much" with the current tools at my disposal.
 
I am dealing with LBP from severe DDD and degenerative Scoliosis. I have had a bad back for years having done concrete work for 30 years. I have seen 2 different surgeons in the last months and neither offered anything for the pain. The arthritis has effected the bone marrow in the vertebrae. When I went to my family doctor, an internist, to get some blood tests done he was very willing to prescribe some pain meeds. Do you have a general practician who can help you out?
 
Well, the pain management guy that I'm seeing Friday is supposed to do something for me. That's where the steroid doctor sent me too. If the witch didn't want the task of prescribing meds, she could have easily done the same.

This whole process more or less bypassed my she devil (a lovely girl) internist. She's part of a much larger practice. I was looking to avoid all the ancillary testing and whatnot that I'm way behind on with her. She's of the "process" medicine neo-doctrine persuasion. She pencil whips a bunch of expensive tests on a 6 month basis and then pencil whips a bunch of expensive meds. If something is amiss, she pencil whips a referral to a specialist who does more expensive testing and then, depending on the results ...has some technologist perform some therapy. None of it is too attuned to your sensible behaviors and likely outcomes.

I am what I am and have a high resistance to being put into the cattle chute. I like to see her "as needed". She insists on feeding the machinery whether you need it or not. We're in eternal conflict that leaves my non-compliance as my only input into my health care.
 
Originally Posted By: CivicFan
My observation and research have shown that we have issues with pain management in our healthcare industry with doctors being very reluctant use what might be the appropriate level of medications and err on the side of prescribing less than the desirable amount.

It's primarily due to the "war on drugs" mentality and the occasional DEA investigations of some physicians. When everyone prescribes less, the ones who do the appropriate level stand out and are viewed with suspicion. The end result is more pain that is necessary.

I saw something on TV about this. The DEA is so bad about this that most of the doctors on the show urged new doctors NOT to go into pain management as there is a really good chance you will land your behind in jail because a bureaucrat didn't like what you are doing.

A big problem though are guys like MJ's doctor that was giving him operation level drugs on daily basis. Gives the DEA a lot of ammo.
 
I'm another member of the DDD, back pain club. Epidural steroid treatment had no noticeable effect. Ortho doc called it a torn annulus, describing it as being similar to a punctured tire allowing disc contents to leak out and aggrivate the surrounding nerves.

What got me was the little sheet they have you fill out asking your pain level at that exact moment in time. My pain basically varied from low to severe. When it was at it's worst, there was no way I could endure the car ride to the doctor's office. When it was tolerable, and I went to the doc, he didn't want to prescribe anything beyond celebrex or tylenol. Eventually I had to exaggerate the severity to get the script so that I'd have it for the times when it was so excruciating. I don't like how the controlled substance medicines make me feel, but when you need them, you need them!

In May 2002 I had a really bad episode that had me confined to the bed for a while so I didn't eat much. As a last-ditch effort, I decided to go on a limited calorie diet and lost about 60 pounds over the next 5 months. Back pain has been drastically improved, but not eliminated.

(One back specialist told me he had as many skinny people with back pain and heavy ones, so it's not a cure for everyone)
 
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I don't like how the controlled substance medicines make me feel, but when you need them, you need them!


That's my disposition. The last thing I need is to be on the brink of narcotic stupor to control the pain. If any doctor has alternatives, I'm all for it.

If there is no medical/pharmacological alternative, there is absolutely no ethical or moral reason to deny meds to that patient. In fact there's a moral and ethical mandate to employ them.

They don't have the right to sentence you to a life sentence of pain in a prison with no doors.
 
back pain sucks. sorry. i had two bulged and one ruptured disk. Thw sciatica felt like a lightning bolt going down my leg. the crazy thing is that when it hit, i would make it worse by reflexivley bending forward to seek relief. The MRI identified the injured nerve as being compressed at the front of the spine. So bending forward made it worse. I still sit in the car with a pillow at the small of the back maintain a convex lower back which optimizes the opening for the nerve.

anyway, it took four of the epidural injections to finally get better. The first three provided temporary relief for a day or two, but the pain came back. I never felt much at all during the first three injections. The fourth injection was really painful. My surgeon decided to put the medicine directly on the nerve instead of in the area surrounding it. Did I mention that this was painful? This direct application seemed to do the trick for me. I have been mostly better for three years now.

sorry so long. I just wanted to comisserate with you. Heartily agree, thank your deity for wifi.

good luck,
Dinosaur.
 
Dang Gary - I had no idea what the title of this thread was about. Man the neck surgery was the best decision I ever made. Drugging up was the worst. I know addiction, I was sick for nearly a weak getting off the synthetic heroin. Nasty.

I just want to encourage you to hang tough big guy!!
 
Originally Posted By: Gary Allan

I could never consider this any form of recreational "feel good" thing. It would be something that would just make me sleep. I'm obviously missing something.


You're not snorting them or crushing them up, and you are in pain. For someone who is not in pain and is abusing them, they can get a high, and it is crazy easy to get hooked on them.

That said, there's no reason they shouldn't be available to you given your current condition. If you need them, you need them, period. Opiate addiction sucks, but chronic pain really sucks. People who need these medicines should have them available.

Unfortunately, it is significantly easier to get these types of drugs through illegal means. The laws have done nothing to affect availability if you don't care about breaking the law. The laws against opiates really only hurt people like you.
 
I've known enough contemporary drug abusers with my ministries with the homeless. One guy chewing on his fentanyl patches ..and long list of other like antics.

I my case the point of appreciable sensation was also the point of losing consciousness. They kinda looked at me funny when in the ER and they shot me IV with dilaudid and a couple of other narcotics

It was like they were on two separate frequencies. I was expecting some pain free euphoria. What I got was blunted pain and drifting in and out. If that's all there was to main lining drugs ..no thanks ..I'm glad I've always passed on the distraction.

In my state, it was no more impressive than a nicotine rush for an infrequent smoker.
 
I had a similar experience after my hip replacement. I was on a morphine pump, but it did very little for the pain . It was a slight dulling of the pain but it never took the edge off of it. When I went home I was taking 4 Vicidin at a time to get some relief. At that point I would just sleep. Never got a high. I am taking Tramadol now for the back pain and have to double the dose. I think some people just do not respond to the meds. That might be why some people have problems with addiction and others don`t. I was warned that Tramadol was highly addictive, but I have no problem starting and stopping.
 
About the only perceivable problem with the Oxi's that I have now is that there's an anxiety/depression component to them in withdrawal. That alone could compel you to keep popping them. The walls did start to close in on me and the anxiety level was substantial. It was fine with family around, even if they were just in the room. But alone... with nothing to do (or could do) I would want to panic and run ..but I couldn't move. Very stressful time.

It appears that I'm past that now.

It appears that there are plenty of us walking wounded out there. Gentlemen, you have my sincere sympathy for all you've endured. I feel that I've walked at least part of a mile in your shoes. Given your mobile med levels, you're in or have been in worse condition than I am.
 
I managed to avoid most gastric side effects. Not that I would have noticed when urinating was a major task. It was like trying to play Twister sorta.
 
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