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MME - Morphine Milligram Equivalents, forced to cut dose



  • memerainboltmemerainbolt IndianaPosts: 6,221


    You cannot control how another member respond to you. MaryBogie never called you "stupid" and no matter how she started her opening statement, it would not be good enough. She also did not call you a "nightmare patient". 
    The purpose of this forum is a place for spine patients to support each other and give personal experiences. Everyone's opinion is not going to be the same as yours. But that's what it is, an opinion, not a reason for arguing.
    Please be respectful as everyone else has been. 

    Spine-Health Moderator
    Please read my  Medical History
  • Point taken, SanJenAz. Thank you for reciognizing how nurses are being overworked with very high expectations. I feel my pain history helps in my job because I BELIEVE these patients while many others don't. By saying multiple surgeries, I meant repeats of the same one, i.e. revision after revision. The best treatment that worked for me was PT. I had awonderful guy who was very knowledgeable, when I finishedmy treatment, I was 80% better. I do my PT exercises religiously at home. And in recent months been able to get back intoyoga, yay! There are many approaches to treating pain, opiods is just one of them.

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  • nutcase007nnutcase007 United StatesPosts: 877

    From what I can piece together, several of us in this discussion/thread are on permanent disability.  Some of us have found methods like PT, MM, opioids, meditation, yoga, surgery, natural supplements or blends to work for them and give them back some quality of life.  A few of us struggle to make it from day to day, no matter what we do.  I'm one of those people.

    I am one who lives with the fear that my opioids therapy could be pulled from me.  My neurosurgeon has sent me to the best pain management doctors in my region of the country (the few that are still in practice) and they told to continue my low dose opioids.  I continue to try to do some walking in attempt to maintain some physical condition.  I've been discharged from PT, because I didn't show enough improvement, even though I worked very hard at the PT site and on my own.  I was thrown out of my first neurosurgeon's office after my first ACDF with the accusation that I was making up the remaining pain.  He flat out missed my primary issue in my neck and has left me with permanent spinal cord damage.

    So am I disappointed with the medical profession?  Yes, most of them.  I've been taunted by many who should have known better.  I am grateful that I finally found a neurosurgeon who is highly qualified, performed my second and third ACDFs and who fought the insurance company on my case, but it took many years and now I'm left with severe pain.  If my multiple cervical conditions would have be diagnosed in a timely matter and the insurance company would have allowed my neurosurgeon to do his work, I'd likely still be working and have some quality of life. 

    Okay, way too much about me.  I'm frustrated and I'm sure many who posted in this thread are frustrated.  Has some of the harsh comments made in this thread been about our on frustration (in other words, the pain talking).  I thought the purpose of this site is/was to share our experiences and attempt to mutually support each other.  I know I can fall into a defensive mode when I'm writing in severe pain. 

    I hope this posting makes some sense.  If not, go ahead and ignore or delete.   



    Do your due diligence, trust you know your body and question everything if it does not fit.  Advocate for yourself and you will be surprised what will be revealed trusting your body and instinct.

  • As I've read through this thread, it's apparent to me that we all have one thing in common; we all have very deep seeded feelings about the pain we have versus the perceived pain we shouldn't have in the eyes of the CDC and others.  What is even more troubling is the "guidelines" are assuming we all metabolize medications exactly the same and that an oral form of medication is equal to an IV dose (not even close).

    We have a heroin problem in America.  It's a problem because one side wants to coddle addicts, give free needles, give them a place to shoot up so someone can give Narcan to bring them back, yada yada yada.  The other side are the legit pain patients.  Opioids do work long term.  I've been on them for 11 years.  My PM is extremely strict about who he will see and the medications he will prescribe.  If he didn't think they would work, he wouldn't prescribe them.  Unfortunately, there are a lot of doctors out there that will write an opioid willy nilly just to keep a patient happy.  I've heard doctors (and the CDC) talk about "Hyperalgesia".  This is merely a theory and has not been medically proven to be a real thing.  But, it's strong enough of a theory to cause medication reduction by some doctors.  The one, most important fact that is being missed is the physician/patient relationship.  It has been nullified by the MME argument that 90 MME is a limit.  For people who are poor metabolizers of pain medications, 90 MME isn't crap.  I'm at 160 MME and it works okay so long as I don't have a flare up.  But, my PM is okay with how much I take because of the test result that shows I'm a poor metabolizer.  Perhaps that should be the litmus test for the CDC...perhaps patients should have the genomic testing done before any pain medication is prescribed to see what will work best and what a therapeutic dose should be. 

    This is a very personal issue for anyone who has chronic pain.  It also tends to make us defensive when we hear people that have never had to take pain meds (media, etc)try to preach to those of us that do.  The real problem is heroin (and meth, and coke, and spice...on and on)  legit pain patients are not the problem.  The need to get high by addicts is also the problem.  Targeting established patients who have legit issues was an unfortunate avenue the CDC decided to drive upon.

    We all need to be sensitive to the fact that people tolerate and handle pain differently than others.  What might be a 10/10 to someone might be a 6/10 to someone else.  Regardless, a person who is in pain deserves the right to feel better.  We trust the wisdom of our physicians because they went to school a heck of a lot longer than we have.  In my humble opinion, the CDC and others need to, at some level understand that the physician/patient relationship should be respected.  If a physician gets busted doing stupid stuff, then go after them.  But blindly targeting is wrong.  

    I hope everyone has a relatively pain free, safe day!



    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Many good points made by everyone.  My biggest gripe is also a patient having a dr who is certified and licensed giving us a treatment course then having the government step in and say no, you can not do this.  This tramples on the very freedoms this country was founded on. 

    Throwing the chronic pain patient in with the heroin addict is like saying all politicians are corrupt.  MME's should be on a case by case basis.  I resent being told what I can and cant do by big government.  Setting up safety regulations for the good of the population is great.  Seat belts are proven to save lives.  Taking away the quality of life of the chronic pain patient is morally wrong. 

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