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WC just switched everything around

The GmanTThe Gman Posts: 5
edited 08/20/2015 - 2:15 PM in Chronic Pain
WC just switched everything around and I now have a new pain Dr.
The odd thing is is that he doesn't give B/T meds if you are on a 24 hour med. Anyone have this situation?

Welcome to Spine-Health

One of the most important things that members can do is to provide the rest of the community with as much information about themselves as possible. It is so very difficult for anyone to respond when we do not have enough information to go on. This is not meant to indicate that you are doing anything wrong or violated any rule, we are just trying to be pro-active and get the information upfront so that people can start responding and your thread is more effective.

So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong, The fact that your test results are negative does not mean that you are fine and without any concerns. Many times it takes several diagnostic tests and procedures to isolate a specific condition.

Here are some questions that you should answer:

  • - When did this first start?

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  • . Which doctor did you start with? Ie Primary Care Physician
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  • . Physical Therapy
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  • . Summarize the results, please do not post all details, we cannot analyze them
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  • . Name of Medication
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Providing answers to questions like this will give the member community here a better understanding
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Please remember that no one at Spine-Health is a formally trained medical professional.
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As such, no member is permitted to provide

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What could be good for someone could spell disaster for another.
You should also consult your doctor to better understand your condition and the do’s and don’t’s.

It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have are

I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

Diagnosing spinal problems can be very difficult. In many ways it’s like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then it’s up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.

Specific comments :

Personal Opinion, not medical advice :

--- Ron DiLauro, Spine-Health System Moderator : 08/20/15 20:15 est



  • sandi123ssandi123 Posts: 456
    edited 08/20/2015 - 5:26 PM
    There are pm doctors who won't use breakthrough meds, believing that adequate dosing of your extended release offers around the clock pain management/relief and the use of breakthrough meds only adds to the increase of opiate tolerance because of too frequent use of breakthrough meds by some patients.

  • The GmanTThe Gman Posts: 5
    edited 08/21/2015 - 12:49 PM
    Well I believe he has made a poor decision, due to the fact that I'm in fairly severe pain, with all these breakthroughs going on. It took me and my prior Pain Doctor several years to hit on a even, stable dosage of medications that I had no need to increase and left me with a reasonable quality of life. Now along comes the new Doctor who wants to mix everything up (without really knowing me or my condition except for a VERY cursory evaluation of me physically). He seems dead set on getting me off of opiods altogether without knowing the benefits that they've provided me, just that I was on (in his words) "a high dose". My pharmacist thinks I should have been left alone, he's seen me for 6-7 years on the same dosage without any increase or asking for anything early and a fair quality of life.

    100 Microgram fentanyl patch q48 hrs.
    3-4 30 mg. oxycodone PRN for breakthrough pain daily
    10 Mg. Diazepam 3 times daily for muscle spasms
  • dilaurodilauro ConnecticutPosts: 9,832
    I could see why a someone would say that you are on a high dosage of pain medications. Besides the fentanyl patch, was is on the high side, that should reduce the amount of breakthrough that you need. 30mg of oxycodone is very high in terms of breakthrough. 30mg 3-4 PRN is adequate for most moderate to severe pain relief, even with out the patch.

    But one thing is missing here. From the list of questions I attached to your thread, can you give us some more details about your medical condition. Some details may explain the need for the dosage of pain medication that you are on.
    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
  • I started in 1998 with a bulging c5,6 disk onto the nerve that goes into my left arm and then had a fusion to relieve the pressure This was all from a repetitive motion injury. I proceeded to snap the Titanium screws from the surgical plate off at c-5, dropping it down onto c-6 about 3 mm. I then had a re-union in 2000 that didn't alleviate the pain into my left arm and left a lot of scar tissue in and around my cervical nerves that descend into my arms. I subsequently developed bi-lateral Thoracic outlet syndrome (Brachial Plexus Lesions). After a second opinion it was discovered that c-3,4 had failed also and I then in 2003 had a fusion on those, so now I'm fused c-3-6 and also had a posterior foramonotomy at c-6. Still no luck with the pain, just more of it. I slowly worked my way up to the doses of opiates that I was on, and was on a stable dose, as noted above, with a reasonable quality of life. My pharmacist and prior Pain Dr. felt that the dosage was not excessive and was reasonable for the amount of pain I was in. What I have to come to realize is that I have suffered through 4 failed cervical surgeries, something that the new pain Dr. even acknowledges.
  • dilaurodilauro ConnecticutPosts: 9,832
    is that narcotics/opiates/pain medications is not the end all for pain control. It is just one piece of a total picture. No one is going to be pain free using narcotics unless they want to be zombies.

    Everyone should look at the total approach. Take a look at The Blend This is something that so many people follow and has proven to be a valuable tool in the fight against chronic pain.
    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
  • The GmanTThe Gman Posts: 5
    edited 08/22/2015 - 4:33 PM
    I've never been a "Zombie" on my pain meds, rather always wide awake and cognizant of my surroundings. AND I've tried almost all of "The Blend" modalities over the years. PT many. many times. Acupuncture and a variety of the others, also.
    Please don't lecture me on my pain management attempts.
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    edited 08/22/2015 - 9:43 PM
    I'm on a relatively low amount of opiates, 15mg of MS-contin 2 times a day, Percocet 5/325 up to 4 times a day as needed for break through pain, Lyrica 100 mg twice a day. Four other prescription medications for another disease but which may or may not help with pain. Most recently my pain has been getting worse and I had been taking my break thru med up to 3 times a day so I switched back and am trying to use less Percocet and more relaxation, aromatherapy, distraction.

    Difference being that I worked in pharmacy and studied advanced pharmacology. While we may become tolerant of the pain relief of opiates we never become immune to the serious side effects of opiate medications. We all have a level of opiate which can depress our respiration to a point that we just fail to be able to inhale the necessary amount of oxygen to keep us alive and to keep our brain functioning. About 3 years ago I had a serious infection which caused all the soft tissue in my mouth and upper respiratory tract to swell. I didn't know I was not breathing efficiently. I was making crazy decisions and having difficulty finding my way home. I was totally dependent on my service dog.
    In the same way, when we experience respiratory depression we fail to know that we are not getting enough oxygen. This is how all those celebrities are dying of heroin overdoses!

    There is no reason for anyone on this site to want to stop someone else from experiencing pain relief. We don't get the opiates that you don't get! If anything, we want people to feel comfortable coming here so we can all support each other! I remember first coming her last December terrified I'd be judged for being on morphine! On the contrary I got loads of support and private messages that made me feel welcome and cared about! I can help people figure out medications but I have no experience with different procedures and ways of being productive despite the pain.

    There's nothing like being in pain and coming here and seeing bunches of people just like me! Realizing that I can decrease the meds, the break thru meds by smelling good oils, getting involved in things I enjoy, finding more information I'm relieved. Admittedly I was wary of the moderators because I'm a moderator on another site and I can be a hard [edit] I have to be. Here people have the opportunity of learning from people who have been there, done that. As a moderator on another site I wish I could trade aggravation for a salary! Volunteerism is not appreciated- free advice is valuable despite the price!

    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
  • This all started when WC switched me to a new pain management Dr. (I use that term Loosely). He doesn't believe in breakthrough meds for anyone that is on 24 hour meds. Instead he Rx'd a 4mg. Medrol Dose-pack for me, which made me into an angry, SOB, that cursed and screamed at everything around me in fact even to the point of me telling the Moderator "not to lecture me..." which I have since apologized to him in a PM. In any case, the Medrol hasn't done anything for the breakthrough. Thank god I have some Valium around to take the edge off (all Rx'd of course). I am now trying to get a hold of a pain Dr. that I have dealt with in the past to see if he will take over my care. This new guy is from out of town and I believe trying to make inroads into my city.
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    edited 08/24/2015 - 1:55 PM
    I'm guessing someone (hopefully) has told you that "Medrol" is a steroid pack. It's broken down so you get a blast of steroid and then wean down. It sounds like you (and I know me) get mood change with it. I seriously thought I was losing my mind the very first time I took a Medrol pack! One of my doctors finally told me it could have an effect on moods and I was very afraid I was bipolar. But its purpose is to stop inflammation. Although I'm not in pharmacy anymore I wonder when we are going to realize that over-prescribing steroids is leading us in the same direction as when we are/were over-prescribing antibiotics.

    I am very allergic to aspirin and NSAIDS so I don't have an option to take them so I have been given a lot of prednisone of late. But the pred takes the place of the aspirin and NSAIDS ability to alleviate inflammation and not relieve pain. (Sometimes the relief of inflammation in and of itself relieves pain.)

    What I had wanted to say and I think I got tired was the other distractions I can use when I am in pain. They definitely do NOT address pain like my breakthrough pain med does and I'm not going to pretend that they do! On the other hand, help is help. One thing is honest, being emotional, angry, anxious, happy, sad, all mood states have an effect on pain. To attempt to change mood by any way possible can cause pain to feel less intense. For me it's staring at a fish tank (yes I watch the snails move!), I draw, listen to music, and now have added the aromatherapy. I won't say, "Relax" because, for me, that's a reason to get angry but looking for things which can make me relax does help.

    If there's anything else I can do to help, please feel free to PM me too. Anger scares me into making me want to make everything okay but I know people can be angry without throwing a dining room table!

    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
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