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Concerned about transition to spine center and pain clinic - need advice!
I'm new here but have had chronic low back and leg pain for over 15 years. This is from a bad fall off a horse that crushed the lower vertebrae in my spine. For the last 15 years I've also only treated with one clinic for primary care. I've had a series of MRIs and other tests that have both suggested I would benefit from surgery and have led me to continue conservative therapy and pain management. I don't want surgery. I work in the legal arena of medical negligence and have done so on both the plaintiff and defense side for over 25 years. My reluctance to have surgery is largely due to my professional experience and opinions I've formed, and frankly fear and financial reasons. I mean no disrespect to anyone who has had surgery. I've had no lapse in work due to my chronic pain, am married 25 years and have three active children. Through trial and error, I have learned to both live with pain and have had excruciating pain no matter what I do. Like many chronic pain people, I have good days and bad days.
What I'm coming here today for is something I'm terribly embarrassed about. For the last 10 years I've done the gamut of spinal tests, injections, ice, heat, strengthening programs, EMGs, MRI's to name a few. There is absolute degenerative disc issues, disk herniation, nerve impingement, and now recently pain but no nerve impingement. Recently I learned my vertebrae are fusing together on their own.
My GP retired about 3 years ago. My care is now in the hands of a great Internal Medicine doc at the same clinic. Here's my predicament. I have ulcerative colitis (with 3 hospitalizations). Taking NSAIDs isn't an option. My GP put me on MS Contin ER 30 mg bid approximately 4 years ago. Percocet for breakthrough pain. I have a pain contract and have not once had an issue or compliance problem of any nature for all this time. Yesterday, I went in for a routine "medication" visit as I also have mild depression, anxiety and take 25 mg of Atenonol for hypertension. I'm 47.
At the end of our appointment, my doc said she would like to do some blood work as it's been over 3 years since a workup was done. She told me she also needed to validate through the tests I was taking the narcotic medication she's been prescribing which seems fine. The lab took my blood and a urine sample. I also got a referral to a spine specialist and a pain clinic mainly because the recent workup done in 2014 did result in my not needing imminent surgery. She also knows I am not favor of having back surgery even if it was recommended - unless imminent.
About a week ago I was on vacation w/old friends. 8 of us. It was a weekend of camping and light hiking. Unfortunately, I made a really stupid choice and smoked some pot. It's not something I do regularly. I am freaked and embarrassed and am not sure what to do now. I have two packets of information to fill out for both new clinics (spine and pain) for upcoming appointments. After my appointment, I realized it's pretty likely the lab result will be positive for cannabis if she tested for opiates. I fear my doctor will be completely disappointed in me and may even decide not to treat me anymore.
I would love some input - or even better, some encouragement. I am completely unsure what to expect from my regular doc and also to start treatment at a pain clinic in terms of continuing my medication. Please be kind, I know I did something stupid. Thank you for any thoughts you can offer.