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poor Pain Management, worsening:horrified

Lorraine0079LLorraine0079 Posts: 4
edited 06/11/2012 - 9:02 AM in Chronic Pain
I have been following the sight for about 1 year and after reading thur Robin's messages I had to reply..

I worked in the long term care field in social work during 1980's when Joint Commission came on the scene and mandated proper pain management for every human being as a right.

I worked with alzheimer's residents who never had there pain managed s/t their inability to verbalize their pain needs, this increased their agitation, created addition confusion, issues with bowel and bladder and quite often their pain was evident on their face (non verbal) we were taught that ever human had a right to live pain free (as much as a possible goal) (and they were placed on behavior modifying medications when pain was the source of the issue)

and it is a quality of life issue, the circles of pain faces were implemented 1-10 verbal and not ..for a facility, MD's office , pain management, hospital to become Joint Commission certified they had to adequately provide pain management..

what a full circle we have come: when humans are treated worse than a dog (who would never be left to suffer, as they should not) I am hugely concerned with the doctor;s just stepping back on this quality of life issue because it is not easy,,what about do no harm..

the risk for addition with chronic pain patients is a minimal risk but we are told time and again risk for addition is the reason we are made to suffer in pain..okay really..when people have real pain they do not misuse their meds..
I have stood on my head (which isn't easy with my conditions) to be complient with medication management and my pcp manages pain at request of PM once they closed..I am 46 years old and what will happen if my pcp leaves retires ect..
will I be up against what Robin is::I already have been met with descrimination from pharmacy..and other MD who do not have a clue of the road I have traveled ..including all of the other interventions I have attempted,,I see a huge lack of education over the last 5-6 years and there are addicts there will always be addicts and so that means I am at fault.

I think it is time for the chronic pain patients to say enough,, and demand the care that we are so deserve..I am looking into the American Pain Association and to see what can be done..i say enough.

this is my opinion and no doctor bashing is intended..



  • lyrica 75 mgs 2 QD
    Cymbalta 60 mgs QD
    Ambien 10 mg at betime

    tons of supplements for nerve regeneration
  • 2006 shingles inner left ear, recurrent left sided
    face, shoulder chest wall, dx with post herpetic neurlgia 2007, chronic. Mrsa in sores to face contracted at NH I worked during one of my 4 attempts to return for my FMLA

    Bi lateral Carpal Tunnel EMG, Bi lateral ulnar nerve compression, decompression left carpal tunnel nerve, ulnar nerve

    dx with peripheral neuopathy EMG, gait disturbance, foot drop left side, left decompression nerve at calf
    2011, cva..atropy left sided extemities

    left shoulder rotator cuff fraying, type 2 acromion impringment..

    osteo arthritis all major joints and hand joints


    multi level spinal spondyloisthesis

    lumbar tear, stenosis, nerve encroachment, moderate
    thur out
    cervical broad based protrusion , moderate c2-c7, causing moderate impression on anterior thecal sac..

    thoracic spine has growth in focal growth t4 hemangioma, moderate disc bulge t5-t6

    interventions: ear coning, 2 years accupunture, 12 epidural steriod injection, trigger shot to the face s/t shingles nerve damage, prayer, pt 6 months
    3 nerve decompression surgeries,
    medication could not tolerate patch,

    prescribed perocet 6/325 QD, methodone 5 mg tid
    d/c methodone 2009 at close of pm clinic, d/c from 6 10/325 perocet to 5 QD
    changed from perocet to oxycodone 2011 d/t risk of liver damage
    current 10 mg oxycodone, 4-5 QD,

    current medications allow me to get up of fetal position and parent my children, I was just approved for disabilty after 4 tries to return to long term care..start up of ebay business failed d/t loss of function...

    medications allow me to fuction, at a level 4-5 never expect complete relief as that is unattainable for me, just want some quality of life..
    never 1 in 6 years have I increased, I have decreased..

    no s/s of addition, and really what is my option do not meed my pain needs d/t small risk of addition

    crazed by what I have read some people have to endure
  • Lorraine,

    First let me say welcome to spine-health. Have a look around and you will find, many whom come from both sides of the isle, who have great pain management and then others whom don't. At one point and time I was kind of in your position and I thought what are others doing different than I am not. My quest began to find a good doctor to treat the pain issues. I can tell you it takes some time to build a relationship with pm doctors. From what I have seen most new doctors are don't like to take a patient and prescribe strong meds from the starting gate. Also further they like to go back through the repeat testing and injections and what not. My opinion is to do it, if that is what it takes for them to help you. But in addition there are just sometimes that a relationship between doctor and patient can't be worked out and you need to seek someone else out. Now thankfully I Live in a large city and we have plenty of doctor's to choose from. I feel for those living in small towns.

    You also have to realize that not every doctor takes on chronic pain patients and is planning to prescribe for a life time. With the ever increasing news of narcotic medications causing deaths and overdosing many doctors are getting nervous and are tightening their ropes so to speak. I know I see in my pm doctors office that they are doing more drug screens, which is fine with me, I have no worries. I think it is more important to get the message out as to what to expect when changing doctors and to have a back up plan if your doctor, retires or leaves the practice. Honestly there is a little to much noise coming from the media on what prescriptions drugs can do, when we all know there is a greater problem with the street drugs, but in that situation the media has no one to blame, so there is no story.

    Just thought I would stop by and welcome you to spine-health.
  • Lorraine, you hit the nail on the head with your post. I to have felt the same way and Tam is correct, you have to find the right Dr. it took me over a year and I finally found him. Best of luck. Chad
  • It is hard knowing that the things we thought and the system itself are not able to manage our pain as we might like.

    Melzack and Wall wrote the Textbook of Pain.

    The APA are good and your best and only option may be PM.

  • i have said this a million times, get as many tests as you can, mri, cat, nerve conduction tests, disography, x-rays, report from your regular doctor. You should have seen your regular doctor first and then an orthopedic or neurosurgeon first before any pain doctors. So make an appointment with your regular doctor have some tests, then go to a back doctor, mri, cat scan, nerve tests then pain doctor who will probably do injections or even a discography. this is a test where they inject dye into your disc and if the dye diffuses then your disc is probably herniated. it is very painful. you need to have all of this done first. then the pain dr will try injections first and go from there. this is the stage where they might and i mean might give you meds, maybe naisds. if those don't work then they will to to narcotics. don't be surprised if you have to sign a contract re the narcotics if he decides to give you some. it is a long hard process, not simple and most doctors will wait until they give you narcotics.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Have a look at this link, hope it helps.


    Jon's advice is good and a better way to progress.

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