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Going to request a PM referral, the pain has won for now

Frustrated101FFrustrated101 Posts: 279
edited 06/11/2012 - 7:24 AM in Pain Management

I got done with the Rheumatologist, gout is chronic and has possibly spread to my left knee as well.I cannot walk without tweaking my back and ruining my posture further, hence the cane next week.I was rx' 1500 mgs of Naproxen since the other NSAIDS have been allergic reactions, my first dose of 500 mg brought on the itches big time, I must now consider they are not for me.The rheumatologist also does not recommend steroid shots/meds for me due to my reactions(high blood sugars, weird mental status to the point of suicidal thoughts) unless absolutely necessary.

So, I have only one choice to find a PM doctor willing to try meds, PT, acupuncture, massage, and CBT.Most PM's are "shot" factories here, so next week my PCP and I are going to have to find one that will work for me.

My question is are PM clinics going o even want to deal with me?

Has anyone had similar limitations to procedures and gotten taking seriously, I am not some addict just looking for medications.I just want some relief and coping skills.


  • You have conditions that require treatment and they have to work with and around the other problems. I had a 2 level fusion to fix retrolisthesis and recurrent herniation at L4-5, severe DDD and disc bulge at L5-S1 compressing the nerve, along with other problems.
    You should be referred to a back specialist, or a pain doctor can refer you to one as well. Is the Rheumatologist the only doctor you are seeing?
    There is help available out there for you.
  • My pain Dr. does injections my family Dr. still gives pain meds. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • I have a PCP, longtime relationship, the rheumatologist was added last year due to gout and now arthritic symptoms.I went to the spine center at my local hospital, who did my PT, MRI, and final DX.Since I am low income/SSDI its been hard to get a referral of a pain doctor, I had to stop some meds to make ends meet.I realized in the last 24 hrs, more than ever, PM is what I need.My area is somewhat limited in resources which adds to the frustrations.

    The high dose of Aleve has me so sick to my stomach this morning and I am supposed to add colchicine to the mix(which made me really sick 15 years ago) due to steroids being the nastier of two side effects hopefully.

    All I want is this year long nightmare to be closer to being in control.Just sick of hurting.
  • I forgot to ask about all that Aleve you take. I think that's way to much and can seriously hurt your stomach. I take only 1000 mg a day (rx strengh). Norco is less toxic than all that NSAID, and it has only 325mg of tylenol in it.
    I know about having it tough affording meds, esp. nowadays with the economy in crisis. And also, a lot of providers don't take Medicaid or Medicare because of low reimbursement rates. I'm sorry you have to deal with all this. There are programs like SHIP, where the state pays the deductible, premium, and coinsurance of your meds. You pay little out of pocket. Call Medicare 1-800-Medicare and ask about all programs. Help is out there, they make you dig for it. There is also a program that will pay your Medicare premium and you'll get to keep close to $100.00 in your pocket. I don't know what they are raising the 2009 premium to, but we are getting a raise starting Jan. 1st, the biggest since 1982 (per CNN).

    If you can't find a PM to take you, ask your primary care doctor if he would, and that you are willing to sign a contract to only get narcotics from him, and use one pharmacy.
    The cheapest long acting meds I know are Methadone and morphine sulphate. Hydrocodone not too bad, depending on quantity. You can also sign up at Walmart and pay $4 for prescriptions, but I doubt they do it for narcotics.
    I hope you get the help you need.
  • Have you ever tried opiates? Much easier on the stomach and organs and since they are so long lasting you usually only need to take them 1-2 a day. Oh yeah and they are cheap. I pay $1.98 a month for my methadone with insurance. Without insurance it would still be cheap. Might be worth trying. Good luck.
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  • As you are finding the notion of just taking more medication is not the real answer to your problems in the long term and your condition and the impact it is having, has assisted your decision and you need to keep that in mind when accepting, where and what you are going to do.

    You make the assumption that just shots are given but I would suggest that they will use a collective strategy in helping you cope on a daily basis, part of this is knowledge and understanding and I always like to have that before I go.

    In the aspect of CBT they will help you put your condition is some perspective, that is a difficult mental adjustment, a pain that is with you all the time and we are intended to think it less vociferously, it will help, life can become just about the pain and all that this makes you do and the language you use in addressing it and the presentation of yourself to others, remember the origin of the pain is in your leg or spine in enters your psyche and becomes something else, it is that element of thought and interpretation and the pain response and behaviour they will help you with changing. This is hard when you are in pain and some acclimatisation is to be expected and this will take time and effort on your behalf, even when you are not at your best.

    They are trying to minimise the development of those supportive element that define our chronic pain and help us cope and manage it more effectively, you have made the right decision and good luck to you. Have faith in yourself and you will get through all this and come through the other side more able to cope on a daily basis.


  • Thank you, John for the perspective, I am just lost in this situation.My Psych doctors over medicated me to the point of being an emotionally dead person that missed his grandfather last days, so I learned from that experience.Medications are but a tool in any condition.

    The reason I focus on the "shots" so much is the "gatekeeper/RN" at the spine center says thats the main course of action for my DX.My Rheumatologist will not even do these injections do to my mental issues and previous reaction last year.I already did PT to limited benefit, I still do the exercises at home, core strengthening does help, but does leave me bedridden at times.Its amazing what we take for granted sometimes, the 15-20 minutes I do would have been a joke even a year ago.

    My biggest worry is that I really need to get a better doctor(not happening in my area) to look at the whole picture.I went from walking miles on end to weak,tired, and extremely sore in multiple regions within a years time.My symptoms are so consistent at times, but then I get odd symptoms that "fit" my dx other times???

    First, a gout attack last year(right foot), that took 3 months to heal, followed 1 month later with all these back issues, another gout attack(left foot) this past month, and now my left knee with the same kind of pain only no inflammation.

    BTW Reading this as I typed gave me just what I needed for my doctor visit monday.
  • I calmly brought up my concerns, pain levels and my bottle of meds to show compliance to the pill.All that happened was my pain meds were almost taken away, doctor feels that I have been on them to long(6 months), during which gout was added to the mix for 2 of them w/o even asking for more meds or stronger despite wanting to.I have never had a substance abuse problem much less even a ticket!!!He knows that and tells me that he trusts me then pulls this.

    I told him straight out then get me someone who can explain why all these symptoms are happening within the last year and a proper DX to get a better prognosis.I was angered at his insistence to stop pain relief and not give a solution, I have done X-Rays, MRI, and PT, the meds allow me a quality of life at least.I have a Rheumatologist, working as well, but he is focused on the gout before looking into my knee.The cold is killing me daily and the large doses of aleve and extra tylenol I know is doing more harm than good.In the end I got my meds for now, but no solution, PM is a no go due to my steroid issues- because the PM he recommends does that before all else.

    I am so frustrated right now, my body is screaming somethings up and I get practically ignored.I really like my PCP as a person too, which makes it hard to just dump him at the moment.I am too broke to do anything radical at the moment, so such is life.

    I cannot get over how potential RX abuse is more important than obvious symptoms of pain and frustration are nowadays.
  • I truly wished it would have went differently. I don't know why is it that we have to get into so much debt to get the help we need, or to find someone who will listen. Many people have to go from doctor to doctor and it can take years, to get a diagnosis. Hopefully the right one. Doctors have guidelines we have to follow, and all conservative measures are tried first. But I really think you should cut down the Aleve yourself if possible. Try heat and ice, and warm baths. Ask a pharmacist for a good muscle rub that's not costly.
    Let us know how things go for you. Take care >:D<

  • Thank you meydey for the kind words and support, I am so broken mentally today that my depression is creeping in on me.I read what others have been going through here and it just hurts more.I realize that doctors have to follow guidelines, respect it too, but for my depression/anxiety and mood swings they toss meds around like there candy.Before my PDoc even saw me, my rx's were ready to be picked up before really getting down to how I "feel".Now, being in pain its even more off kilter.You have to fight to prove you hurt, then expect to be doubted and treated like a addict for wanting a med to help while on the road to recovery/DX.If the treatments are are contradictory due to other health issues your left out in the cold.Mind you, I get great care for my diabetes overall, my mental issues are getting better, so I am not bagging on the system as much as it reads.

    RE: Aleve, I had to stop my stomach just cannot take it anymore.The itching is worrisome as well.
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