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The patient is going to be compliant

dilaurodilauro ConnecticutPosts: 9,856
edited 09/27/2013 - 5:14 PM in Chronic Pain
those were some of the words I just read in one of Sandi's posts. But they are so very true.

Many people feel, for whatever person reason, that doctors owe them everything, because they are paying for that service.
Unfortunately, it does not work that way.

You bring in your fairly new automobile to an excellent service center because of a series of problems you have been having and you need them fixed. The mechanic checks you car over, making notes along the way. Then at the, they bring you into the office to review the findings.

Yes, you have a weakening "A", I think "B" should be replaced in the next year or so. You don't need to rush into anything, as long as you follow a few rules:

1 - Dont drive over 60mph
2 - Avoid Abrupt breaking
3 - Take corners slower

You listen to the mechanic, they give their rationale, it make sense to you, so you part with the understanding that in about 6 months you will need to have this revisited. You go home and in the first week, you follow all the rules, but then slowly as week goes by, you start driving over 70mph, you are constantly jamming on your brakes, and you love to hear the tires screeching as you swerve around turns. Then one day, your car really is having problems. And this is only 3 weeks after I saw the mechanic. You arrange to have your car towed to the mechanic, where are you are preparing to give him hell. After all he told me that I could wait 6 months before I came back..

What do you think the mechanic told this person, after the mechanic ask about his driving habits and if he stuck with those three rules.?

Its not really all that different with doctors and other service related folks. They have a job to do and they take it very serious. When they tell you do a number of things that should help, their expectations are that you will do them.
But when the patient comes back with nothing but excuses as to why they didnt do what they were suppose to, what do you think the doctor is going to say?

And what do you think the doctor is going to say when that same patient says Hey doc, listen, yeh, I didnt do all those things, but next time I will, meanwhile, I need 120 40mg Oxycontin to help with my miserable pain.

On the flip side, over the years, I have follow all my doctors instructions. They might have asked me to try this or try that, etc, I gave them all a try and then provided feedback. This way, both my doctor and I were able to work on a updated plan that many times required narcotic medications. I havent had a problem with that yet and I doubt if I will.

Broken down, its really very simple.
Ron DiLauro Spine-Health System Administrator
I am not a medical professional. I comment on personal experiences
You can email me at: rdilauro@veritashealth.com


  • RangerRRanger on da rangePosts: 805
    So true Ron, I've worked in the service industry, automotive to be exact, most of my entire adult life. I like helping people and it gives me incentive if they want to work with me and not mess up my work. I think it goes the same with the medical community.
    Hence I try and give as much useful information to my caregivers as possible to help with diagnostics.
    Sometimes it can be very trying dealing with so many different personalities day in and day out. I take those thoughts with me whenever and wherever I go in the public service community and treat everyone with the respect that I expect to receive.
    Good post Ron.
  • is to know that when you are changing doctors, especially when it comes to pain management doctors, that you may very well be expected to start from step one all over again- http://www.spine-health.com/forum/pain/chronic-pain/chronic-pain-treatment-step-step
    Simply because a patient has undergone an injection at their previous doctor does not preclude another doctor from wanting to do them again, simply because they may believe that the type of injection or the location of the injection was not in the right area or the right type. They may want to send you back to physical therapy or water therapy, or repeat emg studies to make sure that there is no worsening or improvement in neuropathy or radiculopathy that showed up on a test some two years prior....
  • Always remember, if you ask for narcotic pain killers, you can not have them..
  • I am so willing to try anything that will help reduce the pain, or make my day easier. (as long as it is legal). Some of my reactions to things have been so negative, put still I press on. Sometimes I feel my not so stellar reaction to the lastest technique cause a negative response from my caregiver (Dr, PT, PM). No I am not looking for more meds, I hate having to take the ones I need to get through the day. One thing I have tried recently at the suggestion of my massage therapist is Lemongrass essential oil. I mix it with lotion and rub it on my neck and back and it really has helped the tension/ cramps. All the pain doesn't magically disappear, but I find it helpful.
  • terror8396tterror8396 Posts: 1,832
    edited 09/29/2013 - 2:05 PM
    why do a lot of people state that i hate taking pain meds or i don't like them or i don't want to get addicted? it is something i read all of the time. people don't have to write this because there are little judgemental people here. i personally don't care if one takes them as long as one does not scam a doctor, doctor shop, or take more than they are supposed to or break their pain contract. as long as one follows the rules then no problem with me. take them if need be and don't feel guilty or you don't have to convince me that you are taking them for the right reasons. it does not bother me a fig when people take them. don't feel guilty.
    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.
  • From this post, I believe we do have responsibilities to our Doctor's and our PM's and Physical Therapist. We are not going to get better if we do Not do OUR part in the healing process. I have recently had a second cervical surgery. My New Surgeon is willing to talk to me like a Human, my first Surgeon was totally different. I had to walk away from Surgeon #1 and am I glad I did I made the Right Choice for me, Susie. All my Family and Friends are like how did You find Surgeon #2 it's from the Experience of my FIRST surgery. I did so much research and I knew this was going to be a Big Surgery so I set my Mind to Be as Positive as possible, and Listen very very carefully to Surgeon #2 and Guess what I am doing very well Fusing at a Great Rate, do to this Doctor using the Gold Standard. Surgeon #1 was using Un-Proven Methods, that I was NOT aware of, MY OWN FAULT for NOT ASKING QUESTIONS. I learned from that.

    Great Post Ron, I agree with Ranger as we have PM'ed a bit on this Subject.

    ACDF C4-C7 5/13/2010. Synthetic Bone Graft Failed Fusion.
    PCF C4-C7 8/13/13. Rods and Screws Fused in 3 Months with Autograft.
    C6-C7 Spineous process Surgically Shaved Off 3/11/14.
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 09/30/2013 - 11:55 AM
    They make me tired, lethargic, sometimes dizzy. I like to stay active, being tired all the time is an obstacle. I also have a young child, you need extra energy for that, not something that makes you want to "plug" your child into some electronic so you can recharge. That is the one thing I feel guilty about. I haven't come across very many judgemental people on here, but It has nothing to do with what people think of me - could care less!
  • RangerRRanger on da rangePosts: 805
    edited 10/01/2013 - 2:49 PM
    I'm pretty much convinced that a lot of time taking strong medication usually has an effect on other internal organs that aren't always good. One has to weigh the pros vs the cons which can be a tough decision.
  • "Why do alot of people state that they hate taking pain meds?" Well, one reason I can think of is that a person misses the life they had before spinal issues and chronic pain came into play!! Having to visit drs constantly (PCP, ortho, neuro, PM, etc..), some patients end up having to have surgery, in which some improve and some dont--some will even get worse. Then there are endless amounts of injections of different kinds. Weeks of physical therapy, where a person has to pay anywhere from 30-80$ (depending on their health ins.) out of pocket, I might add. Then having to see a PM specialist every 1-3 months and all the jumping through hoops that requires (and, yes I already know you do not have to do the hoop jumping like the rest of us--so you don't have to repeat THAT part to us again) And then there is the part of what having all the painful spine issues does to a body mentally. Then there's loosing out on family stuff or doing activities one use to enjoy, e.g. walking, runnirng, sporting activities or just simply being able to concentrate long enough to read a chapter in a book. Just the thought of what it was like before all this when you could just wake up in the morning and not have to reach for that pill before even putting your feet on the floor........when you could get through the day without having to think about the constant dull, deep, sharp, burning, stabbing, tingling, numbing or deep ache you feel somewhere throughout your spine, hips, legs, feet or toes...or when you could just get ready and go out the door to that job you loved with that carefree smile on your face, or when you could just play with your kids or pick them up without nearly dropping them because of the sharp pain you felt. Back in the day when you could plan a nice meal for your family instead of just planning quickie meals because you cant stand up in your kitchen long enough to prepare the nicer meal or if you do the nicer meal you have to sit on your barstool to prepare it. Remember when preparing Thanksgiving and Christmas dinner was something you look forward to doing for your family instead of thinking of it as a dreadful chore? Now secretly you wish someone else would offer to make it, suggest to have it prepared and delivered or suggest we just dont do it at all!! Remember when you could have a "healthy romp" on the living room floor with your partner and the only pain you had to worry about was the pain from the carpet burns? I could go on and on on this subject, but for the sake of not getting myself banned, I better not. Doesn't any of this make you wanna say you dont like taking pain meds??? It does me and I'm sure I'm not alone. I hope this helps answer you question, Jon..........
  • i really don't deal with any of the above issues. I am not stating i am the best or better than others. it does not enter my mind and never has. yes i go to pain dr every 2 months, no issue. i still work and do things with my family. it does not affect me mentally because i am used to the meds so taking them is like taking aspirin. i don't really think about the pain and i have put it in the back of my mind. i take them with my other meds, blood pressure and cholesterol meds. so once again, i don't think about them, they do no affect my life per se, working and family time. i work 5 days a week and have extra time after school for meetings. i walk to classes and i meet with parents and kids. i just drove to reno to see a show and stay the weekend and i also drove to san diego and went to sea world. i rented a wheel chair but no big deal. so if you let it, then i guess it could be a problem. i don't let it enter my life, i don't feel sorry for myself and i don't complain to others. maybe people should take a more positive bent on life instead of letting chronic pain rule their lives. my advice, go out and live and don't think about things and how chronic pain is bad and how it affects my l life.. i have never had these issues and never had negative thoughts about chronic pain. how do i do it, i don't know but my mind set is not to let it get the best of me
    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.
  • It is like reading a novel and coming to the twist in the end,
  • ChrissysmomCChrissysmom Posts: 46
    edited 10/03/2013 - 10:57 PM
    I have 2things, the first being that yes, you need to respect and listen to your doc within reason. My docs call me jokingly their noncompliant patient because I do not always to what they recommend. They make a suggestion and I go home research it, think about it and make the decision for myself. Today we all need to be up on our medical history. Many times the patient ends up knowing more about their particular situation than a doc. I think as long as you use common sense and can tell the difference between something serious that you absolutely need to follow and something that may be more procedural and not a have to.

    As far as what Jon posted, that is great that you can do all that. Many of us cannot and as Taren said, when you can no longer do the job you loved and instead of looking forward to all the Holiday comings, parties and cooking and socializing. I wish it would just go away. It's too much for me and I end up overdoing it to try and make it what it used to be. Yes I get that we all need to accept where we are and that things are different, but that doesn't mean we don't mourn them and want to be back when we could do those things. Most of us do the best we can. Be grateful you can work, play, vacation, enjoy life, not all of us can do that.
  • RangerRRanger on da rangePosts: 805
    You are not alone Chrissysmom, I try and stay "within the limits" my doctors recommend but I am guilty as many are that I always push the envelope. If I do fail I have no one to blame but myself. I have this mentality that I can always improve myself both physically & mentally. I set goals that are attainable so I don't get discouraged.

    I feel very fortunate for what I still do have and what I can still do. I constantly remind myself how lucky I am and look around and see that it could be a whole lot worse. This part of my life with my medical issues has taught me to be a better person and to be considerate of others who may not be as fortunate as I am.

    Every day is a good day, some are just better than others.
    Be safe my friends!
  • like i have stated before, i have students who are in wheelchairs, who have chronic pain, who have cancer and going though chemo and they still manage to come to school, study, and most of them graduate. this stuff about i can not do anything at all do to my pain is something that i have issues with. yes all of us have different levels of tolerance with respect to pain but i also believe that if there is a will, there is a way. i have to have my wife help me dress, i can't walk too far because of pain, the pain in my leg keeps me awake at night, but i still get up, shower, and manage to go to work. if a student who is in pain who is in a wheel chair, who has cancer and undergoing chemo can get up and go to school, then i believe most of us can do something. i had a girl whom i home tutored who was diabetic and eventually went blind. she managed to get her credits graduate, and a big deal for her, walked across the stage for her diploma. she was so sick she eventually died due to kidney failure. another student who has scoliolis and was in pain managed to come to school. she graduated and also trained herself to walk across the stage albeit with help to get her diploma. so unless one is absolutely bed ridden and cannot do anything, i think most of us can find it in ourselves to do something. there are veterans that have major issues, blind, head injuries, multiple amputations who manage to have lives, work, and so things with their families and even participate in things like running, playing basketball etc. i think most doctors, pain and orhto, want us to get out and keep busy and not lie around all day. if you can't move due to some illness that the doctor says you need to stay in bed, then get out and do something. maybe one can work part time if you feel you cannot work.
    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.
  • terror,

    Everyone is different, as usual. You say you don't think about the pain but then you say you can't walk too far because of the pain. I can walk as long as I want, no problem. But if I ride in a car for 30 minutes my day is ruined. That is why I can't work. I can't sit and I can't even stand in one place too long.

    You say you don't think about the pain-killers and you have no problems with them but you still take them. If you tell your doctor everything is great he probably would start taking you off them. I would probably feel better if I had the amount that you are taking which is at least triple what i receive.

  • terror8396tterror8396 Posts: 1,832
    edited 10/04/2013 - 2:46 PM
    by the way the name is jon and you are not getting my point. you are taking my words out of context to show that i am being contradictory in my statements. if a student who is in pain and going through chemo then most of you can do something instead of saying my pain is so bad i have to stay in bed or whatever. by the way i have told my dr i have no problems with meds because as everyone knows all pain patients develop a tolerance to them. i can't sit either but work bought me an orthopedic chair and i have to get out of my car also when the pain is bad but so what. i still drive to work and work. you are trying to justify not working because you have pain and i am saying i have students who have things bad or worse but they go to school and graduate. you are ignoring my point. by the way has your doctor said you can't work due to pain? most drs will want people to work and not to sit around.doing nothing makes pain worse not better. if it is that bad you should be in a hospice or a hospital. i think if pain is that bad a doctor would do something instead of saying just stay home. i know workman'c comp want their patients to eventually work and so do most pain drs.
    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.
  • Hospice is for people dealing with end of life issues, not pain alone. Hospital are for people with acute conditions or acute changes in chronic conditions. I worked in a pediatric intensive care and saw all kinds of kids that had resilence to over come grave conditions, I also saw many in pain at the end of their fight. I am not sure you know about them and how sad it is to see a child in pain. You can't seem to concede that some people have a different degree of pain than you, need different meds than you, have different resources than you. But one thing they need is encouragement, and this is where you don't get the point.
  • dilaurodilauro ConnecticutPosts: 9,856
    My intent with this thread was to identify how important it is to be compliant with your doctors orders, before, during and after surgery.
    The question about taking pain medications or the level of pain we have does not really fit into this. Its sort of like trying to put a round peg into a square hole.
    The points made are valid, but just not on topic.

    Please remember what the original thread was all about!
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • ron
    i find it amazing the point about my students going to school in wheel chairs, taking chemo and serious back issues has fallen on deaf ears. not one person has made a comment about my point that if these kids can go on with their lives then the adults here who have chronic pain issues who don't work or what ever choose not to. it is a lesson to be learned, if these kids can overcome their pain issues and graduate from high school then maybe we can see why. these are not one time issues also, there are all sorts of kids at my high school who are disabled physically that over come things to work and graduate and most of all not complain about their physical issues. this not only goes for high school but elementary also. my student who managed to walk across the stage to get her diploma who is confined to a wheel chair is an inspiration to myself and others. i just wonder why people refuse to see what the point i am making is.
    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.
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