This is another ongoing story we read about so very often here.
The scenario is about the same, but the details may differ
Patient : Doctor, I have not been able to sleep in days. I can not stand on my feet for more than 30 minutes at a time. I dont go out, I am in constant 10/10 pain
Doctor: I understand. However, all the diagnostic tests have come back and while they do indicate you have a bulging disc, there is nothing that should be causing the amount of pain you say you are in
Patient : But, I am in terrible pain, I need you to prescribe something for me to take away this pain!
Doctor: I am sorry, but I am not going to prescribe pain medications just so you will not be in pain. There are many other options at your disposal
Patient I've tried them all and nothing works. The only thing that helps is the pain medication. And by the way, even the XXXX narcotic you prescribe for me no longer works, I still have pain
This can go on and on.
Lets put this in black and white.
1) No question that you as the patient are in pain
2) The medications you have been taking so far just dont seem to be doing what they did in the beginning
3) Nothing works any more. I will probably have to go to the ER if you dont prescribe medications for me.
A ) There is nothing to justify the amount of pain you say you are in, Therefore, I can not and will not prescribe any more narcotics.
B ) The ER will not provide you with any more medications without figuring out what the problem is.
Sounds frustrating? Isnt it. Is there a right or wrong here? My gut and instinct says the patient is wrong. But, I've been there, I understand what is happening. You go from being normal to now, when pain is ripping through your body and you want that to stop.
There really isnt one solid answer to all of this. Instead there needs to be ongoing dialogue between you and your doctor. Yes, you are in pain, and at times desperate. That can come across as being a drug seeker, only wanting to eliminate all the pain. But in reality, you just want help. You really dont care if its narcotics or some other pill, you just want to be more comfortable
You talk about your diagnostic tests and plead with the doctor You can see, I have a problem, my disc xxx is bad, I need pain relief
Your doctor comes back to you with You films do show a problem, but nothing that is severe
I can go on and on with dialogues ore conversations that really do happen
The best I can leave you with is to Always remain true and honest with your doctor. No doctor is going to be receptive when a patient tells them I am in pain 10 out of 10 every minute of the day Doctors understand as well as the rest of the medical field that having pain levels of 10 out of 10 all the time is not true. It is unfortunate that the pain scale was put in place to allow patients to describe their pain levels. You need to understand that when pain levels start to reach 8 or 9, the patient is slowing becoming unable to take care of themselves. A level 10 and they should have been at the ER before that happens!
But, because of this scale, many patients feel that if they point out that their pain levels are way off the charts, then the doctors will do something to help them.
Try to remember that your doctor is there to help you and not to make things worse. Because they may not prescribe another pain medication, a refill, a stronger one does not mean that they do not care about your well being.
This is all so very valid. But what makes this even more complicated is when you are talking about the patient being young! There is so much stigma assigned to young people that they are drug seekers and are only looking for a quick fix. I really do not have any answers for this
Back to my statement before, being up front and honest with your doctor. Talk to them about your problems, ask them for their help and what they can recommend.
This can all be so very frustrating I only hope that there are you out there who have figured a way to work with all of this.
Ron DiLauro Spine-Health System Administrator I am not a medical professional. I comment on personal experiences