Hi Robin ,

There is no reason that one has to suffer with pain . I went through the "Interventional Pain Gauntlet" so know all about all of those nice needles. Thing is that my PCP at least prescribe me Vicodin for my pain. I have cervical spine issues so my chronic pain is in my neck. Fighting it for about 6 years now. After my last surgery in 2009, we moved and I had to leave the best neurosurgeon and best PCP I have ever had. I had a 2 level ACDF at C5/6 & C6/7. My pain was reduced by about 60%. Unfortunately, before I moved, I was forced to file for Social Security Disability 2008, which I was awarded in 2010. Pain began increasing to the point that now I am back in Pain Management. These guys ALSO do the facet blocks, epidural blocks, etc., but I am on a regiment of pain meds as well. Perhaps your Primary Care Physician could render some assistance? Please do not suffer. There ARE other alternatives. Keep me posted. Can send PM (Private Message) if you would like to. Hoping for relief for you soon.

Do you have a family doctor that you can see and explain all of this to, and get a referral to a different pain management doctor?

It sounds like this doc is not the right one for you. I would find another pain management doctor. It took me a few tries before I found the right doc for me. It is so sad as pain patients we have to jump thru all the hoops to get the care we need. Dont give up, and dont settle for the options you have been given if they do not work for you
Susan

I cannot believe your pain management doctor is treating you like this. I know that medicine provision in the USA is totally different to ours (here in the UK), but surely, a doctor would not almost blackmail you with "inpatient rehab" (whatever that is). The fact you say it's 'extremely unpleasant' seems to be making you reduce you own pain meds for fear of going anywhere near it. And as you've found out to your cost since, your pain levels have increased. I'm not a doctor, but even I can tell this isn't the way to go to improve your current sitatuion, it's only making it worse!

NB: I just had a giggle to myself, sorry. I first typed "iMpatient rehab" by mistake, but think it's probably more apt in your case, lol.

Also, when you say "I go to work Monday thru Friday and the weekends are for lying in bed resting my back so that I can do it all over again" - that's exactly how I have been throughout my 7 years of chronic back pain and needing to continue to work (which I'm not at present, but that's a totally different story!!!). I know exactly what you mean - resting your back for fear of not being able to return to work on a Monday and NOT doing anything too physical AT ANY TIME that could jeopardise your ability to continue working.

You have done nothing wrong, have followed all the correct guidelines and need effective professional support - which you are clearly not getting from your current pain management doctor.

So I agree with the others - try and find a new pratice to attend that is more supportive and will maintain your current efforts to reduce and manage your pain levels, so you can continue to work, which sounds like your main priority at the moment. If the injections do not work, then you should be allowed to keep your medication regime so you can continue to work.

I can't believe some of the awful experiences I've read on this forum - and it seems to me that most of them are coming from the USA where "contracts" for medicines seem to be the norm. I don't understand them, to be honest, but hope we don't ever adopt this system in the UK.

There is further help for you out there, I'm sure, and perhaps when you've found it you could let us know how you get on?

to another. I believe that one needs to get to the bottom of why one particular doctor is not providing the level of care that you (the patient) is expecting.
Many times there is sound reasoning.

But after reading your post, I was shaking my head.
First, 6 injections at one time! I know no doctor in this area would every give more than one at a time and the major insurance companies only will approve 3 a year. Thats for ESI , done with or without a fluoroscope and has the two needles, the first insertion and then the medicine delivery (steroid).

I've had 4 or 5 trigger points a one time. I have heard of multiple facet injections.

But what bothered me the most was the statement from the Pain management doctor

That should Never be the way it is going to be. I havent heard of many pain management doctors that do not prescribe pain medications. I would seriously look for another doctor at this point. Someone who is willing to work with you. And I am sure you know that doesnt mean more medications, it just means helping you so that you can continue to work and function.

When a doctor refused to help a patient in this area, someone who is willing and wants to work, they are basically sentencing them to go on disability. Now in the long run, we all have to pay for anyone going on disability.

I was approved for it many years ago, but I refused. As long as I am able to work and be someone productive, I am going to do it. When and If there comes a time, well I will cross that road later.

Robin, I commend you for wanting to do just what is right. I hope you can find another doctor that will be willing to work with you. I don't know where you live, but see if you can find any physiatrist.

Best of luck

It is time for a new PCP, and a new pain mgmt doctor. You must be extremely nice (probably why your a nurse) to tolerate that first conversation with this guy. I'm afraid I would have told him where to put his needles and I would have left. Never subject yourself to anything you aren't certain off. It is YOUR body and I agree with Ron, I have never, ever heard of that many at once. That is scary in itself!

Docs don't tell pts who need multi level fusions that pain meds stop working, especially oxy meds. They migrate into our tissues and aren't in the blood stream to bind with our opioid receptors in our brain, spinal cord and gut.

Oxy is the worst for this but the most highly used.

I am in the health care profession with an adv degree. Pls make sure everyone knows. My plan 18 mos post multi level fusion with spinal cord damage is to get my muscles as strong a possible, use rare opioids, use other meds to calm my legs and eat well.

Hope all is well for All of You but, pls don't let doctors escalate your dosage or put a pump in you. It is all so they will make money and not benefit you but, can harm or kill you.

I have to agree with that - I have been on a variety of pain meds for many, many years as many here have been. If you do become immune, or used to one, you switch to another and can go back to that one after 6 months or a year. I have swapped between lortab and percocett numerous times. What he/she said makes no sense at all to me either. I think it is great when people can get better, get strong and everything works for them. Not everyone, or hardly anyone is that fortunate however.
I also think that doctors that have no knowledge of how "we" feel, can decide for us when it's time to be off pain meds. That is a ridiculous statement in itself. We know our bodies, how much pain we can tolerate, and I am pretty sure we'd all rather be skipping happily to work each day than being married to a doctor who doles out what he thinks is correct and crawling down the road we're on currently. I know I would!

Robin, so sorry to hear that your doctor is treating you like that. Unless you live in a really small town, I doubt you would get the label of "problem child" Switch doctors, especially now with the insurance change, it's a perfect time.

As someone has already said, it is YOUR body. It is your future, your well-being, your decision. Any doctor that tries to make you feel bad, problematic, guilty, or anything other than comfortable with them is the wrong doctor.

good luck!

Although I posted after joining 30 minutes after the fact, my points should not be lost.Perhaps there are other forums where people aren't so nervous about not having access to pain meds and want to discuss other ways to address pain than opioids.

I am happy that I have made the decision to take the least possible amt of opioids after reading the comments. I intend on living my best life possible, without a clouded head and if one is comfortable in their own way of doing things, my decisions should not lead to defensiveness.

Even a small group of people who are so pro-opioid cause problems for people, in terms of perception in society.

As you stated, you have been here only a short period of time. There is no way you could possibly understand the various discussions and dialogue that goes on here. People here are informed and get more information as they stay here.
Your plight or ways is fine for you. I am happy that you have found a path. But do not think that your way is a path that all others should follow. People here are not nervous about not having access to medications or discussing other alternatives. People here are smart and educated about their conditions. Unfortunately, you would not know that since your time here was not spent on reading and understanding. If you feel there are other forums and web sites that will address your needs, then please I encourage to find someplace that will make you happy, since we have obviously not met your expectations.

Ron DiLauro, Spine-Health System Administrator 02/07/12

I agree with Ron - it's time to fire your doctors!! I only got pain meds from my surgeon for the first three months after my surgery. After that, responsibility for those meds was transferred to my Internist, and four years later, I still occasionally refill the prescription. I am thankful that I have recovered to the point where I don't need them that often, but when I am in pain, there's no amount of tylenol that's going to do it. I can't take NSAIDs because I'm a weightloss surgery patient, so it's basically oxycodone or nothing. Those of you who are not that far out on your surgery have my sincere sympathy. I don't think you should put up with this kind of treatment (or lack thereof).

Please do not walk, but RUN from that doctor. I am sorry, but any doctor who threatens inpatient rehab for a patient with very legitimate pain issues is simply not worth your time OR your money. I urge you to search for a new PM doc AND surgeon for a second opinion. Remember, YOU are the one in charge of your care and YOU are the one that gets to decide what is acceptable and what is not, and it sounds like you already know the answer to this one.

"People here are not nervous about not having access to medications or discussing other alternatives. Unfortunately, you would not know that since your time here was not spent on reading and understanding. If you feel there are other forums and web sites that will address your needs, then please I encourage to find someplace that will make you happy, since we have obviously not met your expectations."

clouded head? opoids are bad?
what is this guy saying? he obviously does not know or care to know about chronic pain patients. well my friend, my mind is so clouded, i teach special educaton kids in high school. my mind is so clouded i hold meetings with parents, students and administrators. my mind is so clouded that i test students and write up IEP's. my mind is so clouded i drive 30 miles to work everyday, go home, raise a family etc etc. this guy really fries my bacon. like ron said, run don't walk to another web site that best suits your ideas. i have been on pain meds for 10 years and can function normally.
jon

Hi Robin,
It sounds to me that this pain doc as gotten to comfy with you and thinks he can say and get away with saying such things.
Like you stated it's like a bad marriage, and I so get that we get that it's so hard to switch and then you get from the new doc....all the ????'s why are you switching.
I have been thru a few pain docs and I let them know why I was leaving and never referring others to them (unless I knew of druggies). My issues is they get pissed when the injections don't work. And I was told by all of my docs. Only 3 esi per yr. and I had the 4 facet ones. but I say 6 wow and more.
Easiest for you to simple say my insurance has changed and leave it at that.
I so want to work myself doing anything. I give you a lot of credit for wanting to do the right thing. It is so frustrating to get these docs to listen, I think they take it so personal when they can't fix us up with these shots. Me I won't get them, last pm I fired injected so much into me I swelled up.
Funny how those files go poof.
Please get into another doc as soon as possible, we are chronic pain people and we have to demand respect.
tc and let us know how you do, I'm also interviewing (as I call it) finding a new pain doc.

I also have an "advanced degree"...but still need pain meds for my multiple thoracic/lumbar issues, and could not get through the day without them...and guess what, I take oxy drugs too. The meds do change your opoid receptors in your brain in many ways and that is unfortunate and because of this, most people will need increases in their meds, plus some unkind side effects.

I am not, nor will I ever accept that I am addicted to these drugs, and would never agree to inpatient rehab...for what???? Never had pain meds before my fusion at age 50. I only take the meds for pain and like you, but still have pain levels from 5 to 8 everyday. Have had 11 procedures other than the fusion, none worked for me, and actually caused me to have cushingoid symptoms from all the steroids.

You are the second person that has mentioned that their PM doctor wanted them to enter inpatient rehab for drug use. I am livid that patients are being treated like drug addicts, instead of treating the pain. Yes, if you take pain meds you are physically dependent. We all know this, but people with spine issues generally did not create their spine issues but are having to react to the pain. If you read material from the medical community, it is your right to have your pain managed appropriately.

If there was a magic invasive procedure, there would be no one on this site, correct??? Obviously, pm doctors can not offer us a permanent solution, so to suggest that you get off your meds completely is crazy.

Utimately we have the right to decline a procedure and should not be brow beaten or given an ultimatium for doing so. Only we as patients can determine what is best for us. Risk vs. benefits.

I think as long as you follow the rules completely, show effort with other modalities to decrease pain; ice, heat, tens, PT, then you should be treated correctly for the chronic pain, and with dignity and respect.

I don't see these doctors talking about the risks of the invasive procedures; such as infection, scar tissue, arachnoiditis, endocrine issues, degradation of the disc, osteoporosis from excessive steroids. It is really a toss up, and everyone has to make up their own minds about how they want their journey to be.

Lisa

yes i also have an advanced degree- a masters in special education. it was a struggle due to my clouded brain and lack of thinking skills according to our resident expert on pain meds. my thesis was on a specific workability program helping or not helping special education high school students. let me think, my brain is getting cloudy again, oh yea, the program helped the students.
those meds make me soo stoooopid
jon

"Just a little while ago, before I took my pain meds, my level had gotten up to a 9 and I was almost in tears it was so bad. The nerve pain going down my left hip, wrapping around to the front of my thigh, and on down to my foot was excruciating. (as I'm sure you all know too well) "

Yes, many of us know it well and that is no way to leave, nor is there any reason anyone should have too! Please find a new doc soon! That makes me whince just thinking about it..

I will find a new doctor. I am actively looking. Like I said though, the first few I called in my network were not accepting new patients. And I need to be sure to transfer to a good one. One who will actually listen to me and respect me as a human being in need of pain management.

As to Certifried, sleeprgirl, terror8396, and of course ME...how dare we all shatter Mr Advanced Degree's notion that ALL pain patients are locked in a drug induced haze and therefore cannot possibly get ahead and be successful in life. As for my credentials, unfortunately, I am one semester (17 hours) short of my master's degree in nursing. I had to drop out for awhile to take care of my mother who was dying of cancer. That was a few years ago and way before I had the final injury on my back that forced me into a desk job. I haven't gone back to school yet because you know...student loans came due....momentum got lost...life got in the way...etc...etc. But I'm sure I'll go back. I've even been looking into some online masters courses recently to try and go ahead and finish up my degree. But I DO make pretty damn good money now, and I'm not sure how much difference it will make if I get my MSN, other than it will be satisfying for me to reach this personal goal.

But the back injury thing has been so completely frustrating for me. Here I am up in the middle of the night because my pain woke me up. Because I'm only taking my pain meds 3x daily now, the pain gets too far gone and I'm not ever getting it under good control anymore. Now it's beginning to affect my sleep. I haven't wanted to think about this, but I'm actually a little worried about another infection. I got those 6 injections in my spine 3 weeks ago and it seems that the left side (which normally is the worst) has gotten even more painful lately. I can't tell if it's just because of the decrease in pain meds, or if there's something new going on. I'm so freakin paranoid about the infections since I've been through it twice now, that I get real nervous when I see an increase in my pain particularly when it seems to localized to a specific area.

So YES, I do plan to find another doctor as soon as possible. However, in the meantime, I'm going to continue weaning down off the pain meds, for two reasons.

Number one- I haven't been completely off of my pain meds since this whole thing started three years ago, so I am curious just how bad it still is without any pain control at all. I suspect it's still very bad since I'm currently living at level 6-8 while taking the meds 3x daily.

Number two- There's no telling how long it will take me to get set up with a new doctor and once I do, there's no guarantee that he won't be an asshole like the current one and refuse to manage my pain. In the meantime, I'm stuck with the guy I'm with and will have to depend on him to refill my pain meds, which he is already decreasing and expecting me to be off of them soon. So because I don't want to get stuck in a situation where he suddenly cuts me off and I have to go through a forced physical withdrawal, I need to do without my pain meds as much as possible so that I'll have some left in case he decides to do that to me. I do not trust him NOT to do that to me. He did it last year shortly after my surgery with the Soma I was on. He just decided one day not to refill it when I asked him. I was scared to death that I was going to begin having seizures because that's what can happen when you suddenly stop taking Soma. Luckily, I wasn't taking enough of it to suffer withdrawals, but it scared the crap out of me and he was not concerned....he just decided it was time for me to be off of it, so he refused to refill it when I was almost out.

I've read a lot about pain medicines and dependence and one thing I've learned is that there is physical dependence and emotional dependence. Obviously, I've no doubt that my body is physically dependent on the pain meds because I've been on them for three years. But I do have my doubts as to whether or not I'm emotionally dependent on them. I really don't have an addictive personality. I've never enjoyed the feeling of being "high" or impaired in any way. Because of that, I've never been a drinker or ever really experimented with drugs. I do not like to feel out of control or foggy in the brain....never have. I've tried various other meds at the doctor's suggestion. I took Neurontin ONE time and felt like I was drunk, so I refused to ever take it again. I've tried Lyrica and actually gave it a chance for about 2 mths....hated the way it made my brain feel sluggish and foggy, so I stopped taking it. I've still got a whole bottle of MScontin that the doc gave me after surgery last year and my daughter told me that it made me forgetful, so I stopped taking that one right away. I can't take Percocet because it makes me vomit. So the Norco has been the best compromise for me. They do not impair me. They do not make me nauseated or foggy. They control my pain fairly well.....at least well enough that I can function. The pain is never GONE, but at least it's tolerable and I felt like that was a good compromise. So that's all I take now, but now that's being taken away. As I've said, I've followed ALL of their rules, taken ALL of their suggestions, done everything they've asked of me, and have really tried to be a model patient.

And look what good it has done me.

I'll find a new doc soon and I guess I'll have to start all over trying to build that trust that I'm not going to abuse the meds. I've been with my current PCP for close to 15 years now, so you woulda thought that he trusted me by now, but apparently not. Back when I used to have just periodic back pain flare-ups, he'd send me for ESIs and give me a prescription for about 20 lortab to get me through the acute phase. Back then, a bottle of 20 would last me a year or more. But he still does not trust me not to abuse them...even now when I have NEVER abused them in all the time I've been on them and all the time he's been my doctor.

Sorry this is so long. It's the middle of the night and as I said....I just took another dose of pain meds because the pain woke me up. Now I'm just waiting for it to start working so that I can try again to go to sleep.

Nite everyone

...and now losing your physician's support for your medical issues and pain.

What you are going through has touch my heart deeply.
I so appreciate you sharing your situation. It's so unbelievable..as is so much of what many of us experience. If I wasn't living my life..not sure I'd believe it.

My situation is different as I do have memory problems now..from strokes..not meds..but I'm not working. When I was working..I would be more "altered" when I tried to work without the pain meds.

I was so trying to keep pain under control...I could barely stand it when someone wanting to talk to me...esp useless and redundant conversation or info. I started to feel I wanted to bitch slap everyone.

In any profession, that's not good so I had to throw in the towel and now I'm on Disability.

Your thread here is such a great example of the difficulties we face...similiar and yet each so unique. Learning to support each other, help with advice..without judging.. has been one of the best things about this site.

Also, sharing the injustices that happen to us and how to problem solve for our sakes and that of our families has been so life changing for me. Again, thanks for this thread.

It's 2012! No need to suffer!

I'm glad you are going to get a new doc and certainly hope for the best for you!

Thanks for sharing some of your situation as well. It's truly amazing to me how many of "us" are out there and yet the medical community still "labels" us for the most the part and refuses to help us in any significant way.

I remember when I was in nursing school and we had a pain doctor come and do a lecture on pain and pain management. It's been several years ago and I wish I had still had my notes because I really did enjoy his lecture. (this was back before I was a chronic pain patient) I do remember some things he said though and I wish I could remember his name because I'd definitely contact HIM and see if he would be my new pain doctor. He seemed to have a good handle on the physiology of pain and how to best manage it. One thing I do remember him saying was that "if a person has REAL pain, they are not going to get addicted to pain medicine." And he went on to explain the differences between people who take pain meds to "function" versus those who take simply for the "buzz." REAL pain patients do not need an ever increasing dose of pain med, they do not take more than what's prescribed, they do not ask for early refills, and the most obvious sign that a person is a REAL pain patient is that after taking the pain meds, they get up out of bed and begin to function whereas an addict will just stay in the bed and ride out the "high."

When I began working on a medicine/oncology floor, I found that to be very true. The cancer patients who had terrible pain, would suddenly get up out of bed and begin cleaning themselves up, go for a walk, and just basically function, after they'd had their pain meds. Some of the medicine patients we had were drug seekers and would lay in the bed and constantly be pushing the call light asking for their pain meds early and getting angry if it wasn't time for any and would often become abusive to the nurses and staff if they didn't get their pain meds every 3-3 1/2 hours when they were ordered for every 4 hours.

I remember getting into an argument with another nurse once because I had given HER patient his pain meds which were already over an hour late and I heard him crying out from the hall. She told me, "You shouldn't have given him anything yet. He's taking too much as it is and is going to become addicted. He just wants the pain meds, he doesn't need them." I was SO angry with her and said, "That man in there is DYING and most likely will not survive another month. Who the hell cares if he becomes addicted? It is our duty and responsibility to make that man as comfortable as possible." I was furious with her attitude particularly after watching my own mother die of cancer.

But it's an ATTITUDE...a MENTALITY....that so many healthcare providers share and that's why we as pain sufferers get the shaft, the runaround, the third degree, the reluctance to help, the stigma, and the all around poor treatment. Pain management has come SO far in recent years that there is NO reason that someone should have to LIVE in constant agony.

Robin you explained it very well. Jon and others who have been doing this for a long time understand the dynamics.

I think you can break down the reasons patients take pain medications into two categories

Those that Need to
These are the folks that take their medications to get through the day. They need them to be able to function at the best level they can. The pain isn't eliminated, but taking them along with other medications helps manage their total pain. I've seen many of these types and while they are still in pain, they function and are productive. Teachers, Nurses, Programmers, etc. You would never hear one of these talking about needing to get 'high' from their pain medication.

Those that Want to
These are folks that want to take their medications every chance they can. They want more and more. Higher dosages. Complain to their doctor's that their current dosage isn't doing anything. These same folks could look like you or me, but in many ways their mindset is the same as a street junkie.
These folks will lie and resort to stealing other patients medications just to get their high.

No one wants to be in pain and I dont think there is anyone here that doesnt try working with their doctors to help minimize that pain.

I have an outstanding physiatrist. She has told me from the day I met her over 8 years ago that she knows when a patient needs pain medications and when they only want it.

She also totally believes that while a patient is suffering, they should be given the appropriate dosage of pain medications to mange the pain. Now that can vary from person to person, but after a doctor gets to know their patient for a while, they now what is right.

Some doctors, Robin, like the one you have been seeing determines in their minds if you still need to be taking pain medications and at what levels. But I get the impression, that is done more on a time-line basis then reality. Many doctors feel that after xx months, a patient should no longer be needing pain medications.

I have been on Oxycontin, Oxycodone IR, Opana ER and Opana on a regular constant basis for 8 straight years without any breaks. Prior to that, over the 30+ years, I was on some narcotic pain medication at 3,6,9 and at times 12 month periods, all depending on what problem I was going through.

So, I dont think time has anything to do with IF a patient needs pain medications. I just wish that all doctors would see things as they are and not make judgements based on what feat there is out there. But as in life, you get the good and you get the bad.

workingtogain - like terror said (more or less) no brain fog here. I have been on oxy and Fentanyl patch for aprox 4 yrs now and am studying to get my IT degree WITHOUT the pain meds I would be sitting in a corner crying and would have NO quality of life.

Ron - Sadly what RobinR has experienced is what ALL the pain clinics in my area are like. Every single one! My PCP who works with some Drs at our local PC wrote them a letter about me saying what a perfect pain patient I am. When they called me they said bring all your pain meds with you or we won't see you. I asked "why do I need to bring pain meds". Their response was "WE not your Dr will be the ones to decide IF you leave here with or without your pain meds". I did not go to appt and my PCP (I live in a hick town so my PCP covers my pain meds to save me for 2 hr each way trip) was very upset with them. He thought the letter he sent them would have them treat me differently. He said they all treat patients like that.

Before this I DID go to a different PC and the Dr walked in and said "we are in the wrong patients room". Long story short when she looked at my MRI (before she came into the exam room) she expected to see someone in a wheel chair.

BUT within seconds of knowing she had the correct patient she went on to tell me I was a drug addict and she would never give me pain meds etc etc. She was going to write a letter to my insurance co and tell them to stop paying for them!!! Thankfully my PCP got involved and got it all straightened out for me.
My point is from my and many others who I know experiences with PC make us fearful of them for our quality of life.

RobinR - sorry for the thread highjack Some of what I posted was for you though too as I want you to know your not alone in the PC nightmare

What have you decided to do?

PS: My apologies I skipped over your post about trying to find a new Dr. Please keep us updated how you are doing

When I read your post, all I could say is "wow." It shouldn't surprise me though. A thought that occurred to me today as I was lying here on my bed in pain because I still had two more hours to go before pain meds, was that the doctors are all STUPID! I mean, my docs see me walk into their office and I'm not crying out in pain, I'm walking upright, and I tell them that my pain is at a level 3 or 4 at the moment. So they look at me and think "Hmmm...she doesn't need to be on pain medicine, she's fine. Hell she's walking and going to work and pain is only a level 3 or 4."

Well guess what dumbass....the REASON I'm walking and working and functioning and my pain is only at a level 3 or 4 is BECAUSE I'M TAKING THE DAMN PAIN MEDS ON A SCHEDULE!!!!!

This is precisely the reason that I'm going to go through with the withdrawal of all meds. Not only because I want to see exactly how bad my pain is without any pain control. But I also want my doctor to see how bad my pain is without any pain control. Yes it will be sheer torture for me and going to work every day may get real tough. But I need to do this. After two weeks on a reduction of just one dose per day (taking 3x daily currently instead of 4x) my pain level has increased up to an average of 6-8 daily. On Monday, I'm cutting out another dose and will only be taking my pain meds 2x daily. I've decided that I will take two doses during the day at about 8:00am and 4:00pm and then nothing at night. On that schedule, it means that I will not take my first dose until after I've been up for about two hours. It'll be hard because by the time I get up in the morning, I've usually been without pain meds for about 12 hours, so the pain is high first thing in the morning. But I need to spread out the doses to try and get the best coverage which is why I decided on 8 and 4. I will stay on this schedule for two weeks and then cut out another dose and be on just 1x daily. At that point, I think I'll try to take my only dose at about 12 noon. I'll do that schedule for about two weeks and then go to every other day for a week, and then nothing.

So in 5 weeks, I will be completely OFF pain meds. At that point, I'm going to schedule an appt with my doctor and let him see me without ANY pain control at all and see if he still thinks I'm "fine."

All I can say Robin is "I will keep you in my prayers"

I would be a screaming maniac with low doses of meds.

When my Dr suggested the Fentanyl patch to me I could not complete a sentence with out stopping to wince in pain and do my blowing breaths to try to keep my body from tensing up (like women in labor do - which by the way does work lol).

I do understand your reasons and will pray for the best out come possible for you

Please keep us updated..

Did you read John's link to the Chronic Pain Handbook? It is a very important read. It discusses intractable pain. It discusses how intractable pain effects the nervous system and that it is vital to manage your pain otherwise you can develop coronary disease, hypertension to name a few.

Lisa

I know what you are doing and I know you know what you are doing.
It just so scary when I hear of pain levels hitting 7 or higher.
Thats getting real dangerous.

i have been on this site for a long time and what really gets my attention is the same posts from different people, my pain dr won't give me meds or adequate amounts of meds. he thinks i am a drug addict. they treat me like i am dr shopping etc etc etc. the question is and i have tried to put in my two cents in the past is why do a lot of people on this site have the same issues with clinics and doctors.
first of all, if one is on disability, one has 2 strikes against you to begin with. automatically one gets a reputation especially with backs of drug seeker and not wanting to work, don't shoot the messenger, this is what i have heard from people on disability. a friend of mine was actually photographed and filmed after he had neck surgery. he was lifting heavy amounts of wood when this happened.
second of all, one's attitude when one goes in for an appt. bring and i mean bring all tests results, films, mri's etc etc with you. be as honest as you can when reporting your symptoms. drs use tests like bending legs to assess your pain level. some of these tests are not supposed to cause pain so when you are screaming in agony at something that is not supposed to be painful, watch out
pain drs get hit up all the time by people who want opiates. some have a negative attitude towards new patients from the get go. you could not pay me enough money to be a pain dr. too much asking for meds.
remember you are assessing him as well as he you. if you get bad vibes then think about seeing another dr. don't get hostile and walk out if you don't like his attitude. listen, walk out smiling and then find another dr. if a lot of your drs are giving you a bad attitude, maybe it is you and not the doctors. never exaggerate your pain level and always and i mean always be honest and out in front with him. always show up for appts and do all the tests they want you to do.
don't say the only meds i can take are opiates. naisd's don't work at all or i am allergic to them. if he does not give opiates at first , go back and see what happens. if he is dead set against opiates then if you need them find another dr
establish a good relationship with your dr. most important thing to do. if he is in a bad mood, ignore him. if he wants to cut back meds, don't whine
just a few suggesions
ihave been with pain drs for 10-11 years now. one retired and i have been with the other for 6 years. the first retired because he was tired of the hassles with the patients demanding meds. one more important thing, the office staff gives input to the drs, so don't talk to strangers about what and how much you are taking. it is no one's business except you and your dr. if you can work, work. drs admire this in pain patients. some have a bias against patients who won't work when the dr thinks you can. i use a cane, have accommodations from my dr, wake up every night due to leg pain, but i still manage to go to work. don't whine at work or with your spouse or relatives. they don't want to hear whining. don't talk about meds and pain with relatives and friends unless they ask.
jon
jon

..seems a little conflicting in part and a little critical.

Funny to think about doc admiring patient for working. I think docs look at the individual and appreciate patients doing the best they can.

The being honest with doc may be in conflict with don't whine..as you say.

Depression...anxiety..whatever else..could also be syptoms that need to be addressed along with pain management.

The only way to get anywhere with anyone in relationship..the doc patient relationship.. is good communication... about pain, meds effects, your activity level and tolerance to name a few.

Congratulations for you being able to work..but some can not. And some would need another job if on your pain meds as they would not be allowed in all professions.

There is no recipe for how to be. We are individuals and the things you list as wrong could be..as I mentioned...symptoms of other things going on with patient or a person's personality tendency in which life gives feedback and consequences to actions.For ex: some stranger you may have been encouraged in sharing some of your story and that they are not alone...such as here on this site.

I am very sure it is a hassle at times for docs...as every profession has its hassles and one needs to decide if pros out weigh the cons and may need to change jobs... but also it is hassle to be in pain.

My response here is only to share that whoever we are, we can be helped and supported and still a valued part of this world.

Thank you

if you read this carefully
these are suggestions of what to do based on my experiences. yes doctors like it when people work. people who say i can't work sometimes sends up a red flag especially when on disability. back problems are the number one problem with respect to disability. drs always hear my back went out and i am in pain. problem especially if there is no proof ie mri's nerve conduction tests, disectomies etc. i am just letting people know of what i have heard from doctors and other pain patients. just because a dr does not like it when one states that one cannot work does ot mean that all drs feel that way but some do. my dr is appreciative that i work. i am not bragging, just stating the facts. what may be extreem pain to one may be not so much with another person. i work because i need the money, it makes me feel worthwhile and i don't want to sit home feeling sorry for myself and neither does my wife. i know people in wheelchairs who work. there are also people with missing limbs who work and also there are people with cancer and major pain who try to work. how does a person know he can't work if he does not try to.
just food for thought and not personal attacks like some take it
jon

i too am about 13 months from my last surgery, but the fusion i had in 08, touches home with your problem. when the surgeon pushed me to pm after 3 months, my pm doc at first went back to the meds i was on before surgery, i think it was fentanyl 75 and oxycodone for bt pain, anyway, after no improvement in like 2 visits, he said "well narcotics arent working for you" and out of the blue took em all away and gave me steroids and muscle relaxers. i dont even need to tell you the kind of withdrawels i went through, but the pain was unbearable! just days later i called the office to explain and his coworkers couldnt beleive he did that with me being on narcotics for over 2 years previously! they had me come in and get a perscriptin for something, cant remember what, but i just made an appt. with another pm doc. and completely opposite of this guy he talked to me for about 15 minutes, and i left there with fentanyl 100, stronger bt meds, sleep aids ond depression meds! we have had the best relationship ever dreamed of since. it sucks changing drs., i know that. but you have to do what works for you. even though i told the other guy, im gonna lose my job if you dont help me get this under control, he just insisted on no narcotics and injection after injection even just being 4 mos. post op from fusion. its a shame to say or even have to go through, but some drs. just have no idea what its like to hurt so bad, but on the other hand, there are drs out there that do, its just up to you to find them. i hope you do, you deserve it!

another fact that nobody talks about is that every injection ive ever had only fixes the "lightning strike" nerve pain, not the constant pressure pain in my lower back/butt. well so does methadone! i dont know why they dont prescribe that more often, after all it blocks the high from narcotics and is a miracle for nerve pain! not to mention that its the cheapest medication out there, even if you dont have ins. its like $5.00 reg price for a decent amount! so if thats the worst kinda pain you are dealing with, id ask to try that.

Robin,
From my understanding the theoretical concept for not taking medication was something that some PM clinics adopted based on academic research and some residential PM schemes stipulate this as a prerequisite of acceptance, perhaps going in clean, so that the true nature of your pain can be assimilated, chronic pain has many facets, layer upon layer in its development, if those layers can be stripped away the suggestion is that PM itself is more effective.

Robin, you said a very valid observation, “my life already revolves around the pain” and that includes medication, it is a cyclical process to take medication and as the pain increases more meds as a consequence are needed, the theory is to break that cycle of dependency, the most effective overall strategy is a “simultaneous collective of ongoing treatments” of which medication is only one aspect, in Melzack and Wall 1988

Your doctor suggested 6 months timescale for a reason and you need to utilise that overall time, to have a plan and reduce medication over that time allowed, doing it over a shorter time is dangerous and not a good idea. You could ask which academic paper supports the idea of less medication the date and name of the paper also.

I have been on a inpatient residential pain management, I take less medication as a direct impact of learning to cope more effectively. I do not think the idea and concept of why you were being asked to do this was explain sufficiently and an opportunity lost as a consequence.

Any change of this magnitude would fill anyone with initial panic, those who can adapt to change like this are more likely to succeed in PM, other strategies will be introduced to compensate and over time learned behaviour with be addressed through cognitive behaviour therapy, it is hard at first and the doctor is trying to help you, success is in your hands. As Robin poignantly said, just surviving the week, fluctuates between doing the minimum and total rest as a consequence, trying to pace under the pain, never easy.

Ron, is correct to say that in the Chronic Pain Handbook the good Dr does say, that pain should be managed with medication, I know from experience that this is a different strategy and some of my fellow colleagues found that transition to reduce medication so difficult to accept, they were not offered a place, my wish it that they were supported and encouraged so that the next time they too had a chance at this lifetime opportunity. If you expect and want the best possible treatment you have to seek out the best, you may not like or even agree with what they are suggesting and from my heart it will pay dividends in the long term.

The decision is yours and yours alone.
Peace and be kind to yourself.

Take care, John..