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gregalanggregalan Posts: 9
edited 06/11/2012 - 8:45 AM in Chronic Pain
I will appreciate comments and guidance. I am also trying to guage the percentage of chronic back pain people that work. I have been suffering from chronic back since 2003 and had two coflex spacers inserted in 2008. I have DDD, stenosis, arthritis, herniated discs, & mild scoliosis. I tried to deal with the pain for years and worked full time from 2003 through 2005. I am a 20 year government worker that sits and drives a lot. From 2005 through the end of 2008 I received partial disability. I returned to full time in Jan. 2009, it was a struggle but I managed with the help of tramadol, trigger point injections, rest, heat, ice, tens, etc. In March 2010 I was in a bad car accident while in work status. Approved for workman's comp. due to three bulged cervical discs and post concussion syndrome. My back pain is worse now but it wasn't approved due to a pre existing condition. My doctor ramped up my work schedule and I am scheduled to return to full time in 2 weeks. While the back pain is chronic and troubling, I am so fatigued. It is a struggle to do anything for 4 to 6 hours straight. I know many of you have the same problems or even much worse. I am struggling whether to apply for retirement disability if I do not get much better. How do you put in a full day's work and attend to personal responsibilities? It doesn't seem fair. The doctor did give me oxycodone for pain, and taking 3 5mg pills per day can make me productive. However, should I have to take those just to work? There is not much of an exit strategy for us.



  • All I can really say is if 3 5mg pills of oxy make you productive, then you need to get a firm handle on whether this is "all there is".

    Are you being seen only by workmans comp? Is there a Pain management doctor in the picture? Taking 3 5mg oxy pills a day would seem like a walk in the park to many people here. Not downplaying your pain at all, pain is subjective and don't let anyone tell you how much you should or should not hurt from any of your problems.

    If, you have no other avenues to pursue and must work and need those 3 pills a day to do it, then that in the end will be your choice to make. I've done it, many still do it. You will need to be sure that you have access to a doctor to manage your pain treatment. Don't just take the 3 pills a day till they are gone then try to figure out where to go from that point. Be proactive and make sure your care in the future has some continuity.

    As far as an exit strategy, there may not be one.
    Whoever said that life had to be fair? My answer to that has always been that no one ever promised us that life would be fair. If someone made that promise, well, they were not exactly being truthful!

    There is a lot of good information here and a lot of good people willing to share their experiences. read, ask, learn.

    Welcome to Spine-Health
  • I still work full time every day. I have a sedentary job, I sit on my ass every day and program. Personally, I like the money to much and I really love what I do for a living. Having 2 kids approaching college in a couple of years also adds to the equation. I understand the fatigue and deal with it on a daily basis. The only one that can truly gauge whether you should continue working is you. 15mg of oxycodone is really not a lot to take every day and if it helps make you comfortable, I'm not sure you should use that as part of your decision making process. You do get used to taking it after a while and some of the fatigue does go away. I do understand your position and am currently struggling as I acclimate to a new muscle relaxer, I say that as my eyes struggle to snap the toothpicks holding my eyes open.

  • If you can get by with 3 pills a day - that's pretty amazing right there! I get 4 10mg percosett and have one helluva time working 9 or 10 hours a day, taking care of the house, the yard, the animals (which I LOVE to do) afterwards. Frankly I just can't do it all anymore, even tho I want too. Work kicks my butt bigtime. I personally feel that I waste my life at work and by the time I get home, I'm so trashed I can't enjoy anything - then spend the weekend trying to catch up. To me, it is a vicious cycle that doesn't seem to have an end. IF I did not take narcotics at work - I would not be able to be here at all - simple as that. I think many are in that same boat. You cannot function if you hurt so bad with every breath that you cannot stand it. IF there was any way possible for me to take a medical retirement, I surely would - no question about it! I am wasting my life working and not enjoying anything else because I have to work. If you can get by with a medical retirement, I wouldn't think twice about it. I too am a government worker for 31 years now, (IRS) and a medical is not too good. I would lose over half my pay and I cannot do it. I would lose everything. IF you can afford it, I certainly would. Best wishes to you, I sincerely hope you can and will do what is best for you.
  • That made me laugh. It is nearly "finally" time for me to break free of this dunghole and I feel the same way. By the end of the day, my eyes will hardly stay open LOL!
    One thing I will say, I was on the 10mg lortab, and my doc switched me to the percs. Same amount and mg. She said it was possible I was getting too used to the lortab so they weren't as effective. I can tell a huge difference. The percs really work well in controlling the pain, my trouble is that they only last 4 hours..
  • I worked for quite a few years after my second injury. It took me 4 10 mg Norcos to get through an 8 hour shift, but that's just what I had to do. I got to a point that I could no longer sit, therefore I could no longer drive. That is the only reason I chose to quit working. I guess there are a lot of us who are of the same mind- you just do what you gotta do for as long as you gotta do it. Messing with the whole workers comp/disability system is a job in and of itself! I loved my job, loved the people I worked with and the hospital I worked for.

    Unfortunately this is something that has been thrust upon. And that which does not kill us will make us stronger....:) Or so "they" say.

    I'm going through the w/c system right now and thankfully I've had no problems thus far. I wish you the best of luck in whatever decision you choose. I understand how hard those choices are, because like mentioned above, they don't just involve us. They impact our family, our children. I know personally that I fight harder and faster when it comes to my children and their well being. And my well being directly involves their well being....you see where this is going...:)...

    Again, best of luck to you!
  • If you can be productive on 3 oxy a day, you wouldn't qualify for SSDI, if that is what you're talking about. At least I don't think you would.

    I do not work. I take 3 MS-contin a day and Norco for breakthrough, but the other meds I'm on make me far from productive, and I am still in pain much of the time. I've never, ever thought the words "this isn't fair." Of course it isn't fair. But I got over thinking life is fair long, long ago.

    I would love to be able to go back to work. If I could trade spines with you, I'd gladly do so.
  • I am also a federal employee. I have chronic lower back/hip pain and neuropathy in my feet/legs and hands. I continue to work full time although i pay for it dearly every night. I also have considered disability retirement until i look at the pay offer. 60% of your high 3 for the first yeat then 40% from second year on sounds decent. But after looking long and hard, it really isnt that great. So i struggle through the week the best i can until i can not do it anymore. Right now my PM does not have me on any narco pain medicine. But that may have to change after my appt come Monday. The decision to retire is a deifficult on that only you and your family can decide on.
  • rplatt56 said:
    60% of your high 3 for the first yeat then 40% from second year on sounds decent. But after looking long and hard, it really isnt that great.
    You need to remember that the 60/40 doesn't consider your TSP portion. I retired under FERS DR, and when *I* crunched the numbers it actually is a push to a plus!?! Let me explain. When all my stuff started, I knew I wasn't going to mandatory age anymore (law enf. 57 max) so I got my finances in order, and planned as if the TSP wasn't there! Now if I went out right at 20 law enf. at 1.7% per year, that would have been a retirement of 34% not counting the TSP! Take a non law enforcement FERS with 25 years, and then you're looking at 1.1% = 27.5%! Again, not counting the TSP portion of the annuity. Maybe I missed something here? Just thoughts..... :) I went out at 19 years, 9 months and 29 days - per OPM Retirement gurus! Due to getting my finances in order, plus being now in a lower tax bracket, my take home on the annuity is literally only $50 less a month!

    One other thought... Lower tax deducted, no TSP, SS, or Medicare removed, retirement etc., not coming out of your pay, so that for the take home money may not be as bad of a bite either.

    Like Mouse said too, *if* you can afford DR, than it works out. Each of us has different finances and obligations (bills, kids, toys etc.), so it all comes down to the individual. Good luck!

    Ps.. If you do opt for the disability retirement route, it isn't easy to get approved. OPM has the guidelines on their site and too what is considered to be disabled - it is a benefit you paid into much like social security. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Whoops forgot one other thing about DR under FERS. Unlike SS, your not restricted much if you wish to work while retired under FERS DR. You can earn as much as 80% of the current years salary for your grade and step that you retired at. So if you want or need to work after DR, as long as you don't exceed 80% your annuity won't be affected. Please let us know how it goes. *hug*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Gregalan,
    It is always hard for anyone to surmise what level of pain is sustainable for another, the key is to focus on what you can do and that is not always conducive to any working environment. Even with effective pacing you will not be able to continue to do it all and some of those want objectives have to be sacrificed on the basis of the things we need to do. Over time that need to do list also comes under pressure, it is the accumulative effect of continued effort, having committed ourselves to a unsustainable pace we are then mandated to evaluate what and how capable we now are.

    Many are working through financial necessity and many chronic pain patients pay a high physical and emotional price for the desire to continue working. Knowing how our condition may deteriorate or be impacted in working is always difficult and we are trying to guess, with the option of making a decision before we are forced into one through increased pain.

    For me having not worked for a considerable period I always wanted to return to work, which I have now done, I did voluntary work to pace back into working and understand the skills and effort needed to continue, it is not easy, pain all the time while trying to present functional capability. I have a finite physical capability which does vary every day, so once that time has been used my day is done. Nobody should be expect to work with this level of pain and I have seen both sides, using what I like to call my downtime I used that specific opportunity to change jobs to one less physical. I want to work and have used all my skill and endeavour to assist this, some days it seems impossible.

    Some here desire work and that is not always achievable, given the right environment conditions and appropriate support it may be possible, and we all have that decision to make for ourselves, the working environment is not chronic pain friendly and our accumulative skill and knowledge is not fully utilised as it should be, once the word disability appears we are attributed with all those misconceptions of our perceived capability. I am adapting to my own new normal and pacing effectively, my current employer is aware of my condition and makes reasonable adjustments to facilitate my specific needs.

    Pacing into work will take time as you may have not experienced that, can you sustain every day 4-6 hours, making adjustments is part of the managing process and we need to have some feeling of control.

    Take care and good luck.


  • As you consider all that has been written remember the emotional side of work. Most of us have an emotional need to work, to feel productive, to interract with others, to be part of a workforce. It may be painful to work but it can also be painful to not work.
  • I hate the fact that you have to give up all of the "bearable" hours you have in a day to work, and the rest of the time you're home, you're useless to yourself and your family! I love what I do, but when I come home and can only load up on breakthrough meds and sit on a heating pad--it sucks. I'm going on a cruise in 2 weeks...I'm not thinking about how great all the sights will be...I'm stressing about a new bed, being on my feet, having enough pain meds. Your mind works very differently as a chronic pain pt. I SO wish part time disability was available! I feel like I could work 1/2 days, but I can't afford that. I can't afford full-time disability either. I think mentally and physically I NEED to work some, but this is killing me!
    I know it seems like 15mg is a lot in a day, but I've had to function on 40mg of Opana and vicodin for breakthrough! Everyone's tolerance and acceptance of sacrifice is personal. Do what you feel you need to do within the financial ability you have. If I could afford it....I'd so be home for my family, and enjoy being able to pace myself better throughout the day!
  • Thank you. Even though I explained a lot, I didn't explain everything. I do not like oxycodone and I am afraid of becoming addicted. Therefore, I take 3 to get by plus OTC medicine, a lot of rest, heat, ice, exercise, PT, tens etc. In fact, I just quit taking oxy and I am surviving on OTC. It is tough, so fatiqued. I do not like the rollercoaster ride with oxy and I really would need double what I take to lesson the pain a considerable degree and do most everything that I want to do. At this point, I figure that if I can not manage work with OTC medicine, then I should not work and apply for OPM disability. If I could work at home for two to three hour shifts then I could do it, but unfortunately my job doesn't allow that. Thanks for your sincere input.
  • Have you mentioned these concerns to your doctor? They are valid, and there are tons of other drugs (non addictive) that I am sure are out there. As for OPM and such, just have that plan "B" ready just in case. It also lets you get a real financial eyeball as to whether you can make it on it or not.

    Also too, just like SS, your doctors have to be fully supportive as if they aren't, DR won't happen as OPM weighs heavily on what your doctors diagnose and feels is your prognosis. Keep plugging away Greg, it will work out. Please keep us posted. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • That is exactly how I am too! Instead of being fired up for a trip somewhere, like I used to be, I'm stressed out about the same exact issues! Will I be able to sit in the truck for the drive there, will I be able to sleep and enjoy any of it and will I run out of pain meds because I decided screw it, and took a few extra so I could enjoy it as much as possible??!! You do think differently. My husband constantly says - jeez, your whole life revolves around your drugs - no kidding??? Really??? God I hadn't realized that... It makes so much more sense now. It's actually my pain and keeping it in check that it revolves around, but hey, we may as well be rude and imply I'm a drug addict right??!!
  • I'm sure everyone here would be glad to talk to you. Why not start by going to the New Member Section and introduce yourself. Just a small note, you need to lose the caps, people will think you're yelling at them.

  • I can certainly relate to everything you said. I also get the 4 a day and it just isn't enough. After a massive shoulder surgery, she upped it to 6 a day and it was perfect. Even after major surgery I felt better than I have in years as far as pain is concerned. I don't know what the big deal is. Especially if you "MUST" work, they need to understand that. Not everyone has the option to take a disability because of financial reasons, and not everyone can afford to work part-time either. As far as the stigma of narcotics, you are dead on with that. I know one day at work I accidently said something at break about it and the gals there just stared and said, you have got to get off of those! You'll get addicted! Really? No, you gotta be kidding me??!! Then they ask stupid questions like, have you tried advil, or tylenol, or heat or ice? Uhm, no, I've had this crap for about 13 years now and gosh, I've never even thought of trying an alternative to cure non-stop nerve pain - how stupid of me! Oh well, what do ya do... Glad you enjoy the people you work with, I hate my bunch. A nosey bunch of gossipers that I steer clear of! It used to be about 7 older federal agents, then when they started retiring, the new guy started hiring a bunch of young gals. Holy cow - I've never seen anything quite like it! They are just brutal...
  • I took my pills,could just about get through the day at work, with lying down every 2 hrs and for a whole hr at lunchtime while the shop was closed.
    I cried every night when I got home and begged for sleep, awake the next day, dreading the long hrs till home time.
    It got to point where my boss was noticing I was making stupid mistakes, not something I could get away with as I was dispensing peoples prescriptions.
    I felt there was only one thing to do, take less meds and hope and pray I could deal with it.
    You make think my boss would be more understanding but he thinks anyone having controlled drugs is a drug seeker ( he did change his mind when his wife needed them )
    The outcome was if I took my meds I could just about cope with the pain but my concentration levels were not good.The final straw was when I dispensed the wrong meds due to pain and not taking enough meds to please the boss. I would have killed that person.
    Since I decided to go on sick and claim disability my pain levels are SO much better but still not controlled.
    The down side is now I have time to enjoy life at my pace I do not have the money to do it lol
    I hope you make the right decision for YOU, money does not make a person happier but its good to be able to spend it
  • That's quite a story! I guess in that case, it was safest for everyone for you to take a medical. I'm glad you were able too and glad you are enjoying it for the most part. I work so that I get in my 80 hours and have every other friday off. On the long weekend I can sure tell a big difference in the amount I need to take and how much better I feel by saturday! On the short ones, I just start feeling better and then have to go back the next day. LOL! I am extremely fortunate however that the pain meds don't affect me in any way except to get rid of the pain. I am very lucky, I know a lot of people get groggy and tired, but they don't do that to me - thank the Lord!
  • I am very frustrated with the stigma associated with narcotics. If I told people that Massage, PT, or Acupuncture kept my pain in check, they would say "Cool". If I said I'm managing my pain using a neuropathic med such as Lyrica or Neurontin, they would say "Okay". If I say that I'm using Hydrocodone or Oxycodone, the unsaid assessment is "drug addict". Is that paranoia on my part? I don't think so. Even my own NS has told me that despite my INCREASED pain since my fusion in January, he wants me to decrease from 6 hydrocodone pills per day to 4. I challenged him on that because it seemed totally arbitrary -- my pain is worse, so why would my treatment decrease? I submitted to trying Lyrica after giving up on Neurontin. I seem to be back in the "Okay" category for now. The truth is that the only thing that is taking my pain away is the narcotics. The rest of this is just window-dressing as far as I'm concerned.

    Meanwhile, I just went back out on partial disability (12 hours per day will now be 6 hours per day) to protect myself in the likely case of my job performance being impacted by all of this medicine as well as a reduced work schedule. Reduced narcotics = reduced working hours for me. My NS is forcing my hand. I guess on a positive note, he is supporting my reduction in working hours in order to alleviate pain from sitting. Thus, reducing the need for narcotics?

    I will miss working fulltime. Work has been my primary social outlet.
  • :OO

    I went down that road till I ended up abusing my body to work. Has anyone addressed the legal aspects of liability when driving on meds. Before I had to file for disability I had to take my two norcos and soma and hope it was enough for the next 5 hours. Just a warning trying to compete with our old life and expectations just will not work.
  • Yes I relate to what you said.
    I finally had call it quits this year. Surprisingly I got the SSI in about 4 months! and that was with mostly spine issues and I nowhere near as bad off as others here. I got a letter from SS that my appeal was noted and that it could take anywhere from 14 months to 48 months! 45 days later a letter from SS that I was approved for total disability. Received a check for about 9 months but I had to return that to my disability company as agreed. So I'll get half from SS and half from the disability insurance company.
    I was more or less forced to "retire", at 56 that could be a cool deal except after an hour of driving I'm in quite a bit of pain. Mostly hang around the house these days. After this med check (ten days) I'm going to see about moving up to something stronger than this NARCO so maybe I can do some traveling or a little more yard work. As far as being addicted I'm not and you probably aren't either. As others here will agree with addiction is a state of mind a craving for the drug. Not for getting rid of the pain. While you might be physically dependent on the narc's you just taper down and maybe take some clonidine to help and your off. But if your still having pain that OTC or Neurotin (hated that med) can't help with, then the best thing is the opiate based med. Gosh they've been around for years and other than those idiots who steal "your" meds to get high, most of us have no problems. I believe that because we are in and have pain issues the drugs acts differently on us than on someone who isn't in pain. (?) That's my take on it anyway. Good luck to you.
    C3-4-5 fusion 2005
    C-5-T-1 disk bulged
    L-4-5 bulge to the right, with Microdiscectomy, failed
    L5- Bi-Lateral bulge
    Pain in right foot -loss of feeling
    Left butt, hip and front thigh pain with bad shooting pain into inside ankle sometimes
  • On the way up the medication scale we always perceive that it will bring that expected relief and it is just a phase to imagine that medication alone can be our sole improver. The notion that imposed pacing will reduce the necessity for taking less medication does have some merit and when the pain increases the first thing we do is rest and over time that in itself does reduce the symptoms hopefully.

    It is never easy when the financial constraints of having to work require us to continue while in unmanaged pain, it becomes our normal and acceptable. As alcb said, work where possible, fills that void where how we feel about ourselves develops and I did some voluntary work that made me feel better about who I was, knowing that staying at home just created unique problems in itself. The dilemma is that even when we know working and having to go is mandatory, we have to be realistic, where that point is when we have to stop is imposed by our physical condition or we pre-empt that change and stop sooner, even without financial security. Jobs do give us self-worth, confidence and that inherent value of surviving.

    We are not drug addicts because we use medication, any association between our prescribed use and others usage for alternative reasons has to be separated, the reason we use them differs, it is naive to amalgamate all usage as the same and shows a lack of understanding behind our underlying condition, had our lives continued in the healthy persona we once may have been, we would not be using medication in any form.

    I try to associate with others who can help me, encourage and be supportive of my goals and aspiration, working has not become achievable because the pain has reduced, only that the need to be included and those detrimental nuances that were on the horizon could be managed more effectively once I was feeling better about who I was. I would say that my physical capability has reduced over the years and I need to be more productive for reduced results, the pain has never diminished, and I too am questioning my capacity to continue for something I worked so hard to acquire.

    Take care

  • I was unemployed all of last year, so I had no health insurance. I'm single and could not find and Orthopedist who would even see me w/o insurance. I went back to work as a high school teacher,for just the insurance. I knew I would not be able to hold up and function satisfactorally.

    I started seeing an Orthopedist and the referred me to an Ortho Pain Mgmt specialist. I have Spinal Stenosis in C7(not bad) last epidural last barely a year. I knew from the pain since '03 in my lower back something else was going on. MRI showed medium to severe issues from L1 to S1. First set of epidurals in lower back did nothing but I was in the ER 36 hrs. after with Diverticulitis.I knew I had Diverticulosis but this was my first attack of Diverticulitis. Due to the possible problem of corticosteroids side effect my Dr. decided not to continue. Dr. tried a medial lumbar branch nerve block. Did give me relief, so I guess before
    my insurance runs out in August, she will do a Neurotomy in this area. I've been living on Norco 10/325 since last Oct. barley makes it tolerable and have other health issues, TIA in Jan. '09

    If I get relief great. It will be only temporary, 12-18 months at most. Texas had massive RIF's in public education and I was one of them. At the age of 58,things are going to get tough. The Dr. said I am not disabled. I was thinking of applying for my teacher disabilty but she's being a real bitch about it. I told her it wasn't SSI. I'm having other prevenative medical procedures done since my insurance will lapse at the end of Aug. and I can't affor $500+ a month. Am I pretty much screwed? I
    can take early retiremnet but it would reduce my pension almost in half. With my other health issues of cardiovascular disease, hypertension. I take about 7 medications a day since my mini-stroke between them and pain meds, I'm so lethargic, I could do my job as a classroom teacher proficiently if I wanted to. I missed over 50 days out of my
    187 day contract this year. Any suggestions

  • SavageSavage United StatesPosts: 5,476
    re' the disability...I'm not sure if I am understanding..is it your pain management doc who said you are not disabled?

    I think most of us here share in having more than one system of our body acting up on us. Each so individual and complicated. As you, I have circulatory and GI issues.

    Without my pain doc..I'd be in the ER twice a month or more. SO out of control. I now take meds that ususally take the edge off the pain...but nothing takes it away.

    I went to a Disabily attorney the first week I decided I no longer can even fake it at work any more. The pain..and all..I couldn't do it anymore.
    I was granted disability 6 months later.
    We don't pay the attorney's fees so that is such a win-win.

    However, you do need your docs to recognize the shape you're in. Really clear communication about what you can't do and about your body's response to activity.

    At times it may seem difficult to explain..thinking you are complaining..but for the docs it needs to be loud and clear. If they just "look" at you and you "look" like you're handling things...then to them you are.

    For me, I focused on the pain and everything my body was and was not doing..with my docs.
    I spoke with others re' how to get by and live with what I had and what resources are available to me.

    It can be a lonely and desperate state of affairs. Take a deep breath and keep on taking care of yourself.
    Best of luck to you!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • Savage thanks for your comments. Just recently my General Practioner after I had a blood chemistry done, called and told me I had diabetes. I knew I was marginal and it so easy to fall of a diet regimine. Most of problem in this area is from me drinking too much beer.
    After my first series of lower epidurals, I had an attack of Diverticulitis. Knew I had Diverticulosis but never had a flair up like that. Before deciding to go to the E.R. I had a fairly good idea that was what it was, after check symptoms and location of pain, I was correct, still went to E.R. though becuase I just have never had such pain in my lower left abdomen. 10 days of Antibiotic, I was fine. There is documentation that corticosteroid can cause really serious G.I. problems but they are rare.
    So I have a Coloscopy scheduled, it's over do anyway.
    The I start on Lower lumbar/sacral neurotomies one session right next left side. With all my cumulative health issues and 10 meds daily, I plan on applying for disabilty retirement through my teacher's disabilty retirement system. All they can do is turn me down but it shouldn't be as strict as SSI.

    I want to do something productive, even if the disabilty is granted. First priority if neurotomies work as they should, is start getting exercise, start walking a quarter mile and see how it goes, my weight is probably adding to my back problems. Let you guys know at the end of August, how everything turns out.
  • Other than the soreness to injection areas. I can already can tell pain is gone, in two weeks we do the left side. I plan on recuperating at least a month or so before I start looking for work again but being a teacher, I'll have to take what's available just to stay in my Teacher's retirement system. Just glad pain is gone but I have to get active to really gauge the success of procedures.
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