Hi.. I'm new to these forums.
I have studied medicine for over a decade,.. a little at university and the rest on my own.. it was originally a passion of mine and ironically has become combined with my own medical/pain issues causing me to be hyper focused on studying the pharmacology, neurology, anatomy, etc of what may be my own condition/cause/root of chronic pain.
I am currently 35. I had two head on collisions in my 20's (about a year apart) one at 50mph and one at 40mph.. both totaled the cars and knocked me out (with airbag deployment).
Aside from severe cases of long lasting whiplash and back soreness I recovered at the time.. and was "fine".
Fast forward a few years. I started to get some pain in my neck and lower back.. Fast forward to about 2006-2007 -- The pain had progressed to a chronic nature at this point.. and I was not realizing it as much at the time.. but looking back I had already started cutting back sharply on social activities (going out with friends, etc) -- Cutting back on work.. and well.. LIFE! All because of the pain I knew I had.. but I had no proof and didn't link any "cause" to it.
Now fast forward to present. It took till December of 2013 to get my first MRI ordered. And that was only of my cervical region. (You know how that goes..)
C3-4 - No significant stenosis is seen.
C4-5 - There is uncovertebral and facet hypertrophy causing moderate right neural foraminal stenosis.
C5-6 There is uncovertebral and facet hypertrophy causing moderate Bilateral neural foraminal stenosis.
C6-7 - No significant stenosis is seen.
Impression: Moderate degenerative changes within the cervical spine.
Now I'm not asking anyone to interpret this for me. (mods please don't remove / close this
It's straight forward on paper.. I have narrowing (due to growth in uncovertebral and facet areas/joints) which in C4-5 is on the right side of the nerve exit,.. and in C5-6 is on both sides.
My pain is hard to just one sentence out to a doctor or anyone. Best way I can say it is my whole spine hurts.. all the time, 24/7/365. But that's very unspecific.
I have particular areas that are more prominent -- and a few that are sharp, and agonizing that can cause me to double over in pain everyday with certain movements.
Briefly -- my neck is stiff ALL the time.. never stops, is VERY stiff in the morning.. and pops crackles and snaps with any movement (luckily most of that crepitus is not that painful) -- the neck is quite painful though.. but has taken a back seat to my back now.
Another bad spot is between my right shoulder blade/scapula and the spine.. when I breath in it hurts sharply. When I don't breath it hurts all the time. It flares up I'd say 5 days out of 7.. where I'm in my inversion table.. using a massager.. doing light resistance rhomboid, teres, lower trapezius exercises.. using two tennis balls in a sock on the wall.. ( you know the things we do..) -- and while driving I can hardly focus in these times.
The other MAJOR spot is around my SI Joint. This is one that causes the "sharpest" pain - and the one that can cause me to nearly fall to the floor many days. Hate getting out of bed in the morning and that first step is agony! I'm sure you guys can relate.
I'm constantly modifying the way I walk, figuring out ways to bend to pick something up, and so on to just try and make that area not feel like a sword being jabbed into the Sacro illiac area.
The pain examples can go on.. but no one wants to read that.. just giving an idea of it.
This chronic pain has caused me.. (to my shame) .. be back in with my parents.. work from home (I'm in IT professionally) and make a very meager living.. limited to the pain -- and more to the point of this post -- limited to how many days I have some medication that literally allows me to function.
We all know this kind of pain never goes away (I can't remember what it felt like not to be in pain anymore) -- but I can accept having the level lowered and power through it .. it's the cards I've been dealt.
Well.. I'm on Hydrocodone and a few Tramadol.. have been for years..
Problem is the tramadol helps, but it's weak for this kind of pain (in my case) -- and the Hydrocodone actually works enough that I can operate/function on it. But, I get enough for about 9-10 days a month of functioning.. the other 2/3rds of the month I'm lucky to get a few hours of work in.
So I've had it.. Knowing I'm doing everything I can on my own to help the pain (I do a lot of exercises for it on my own.. inversion, diet to help inflammation, etc ) -- I must get on with my life. 10 days a month doesn't cut it.. I need to have pain levels lowered for the whole month.
So I finally get brave enough to tell my doctor (he is a smart doctor, and the 3rd one in the last 10 years.. first one I've actually been impressed with his knowledge.)
But I finally decided enough is enough.. and go in and have printed out diagrams the body/spine.. and the musculature of the back. I marked properly where my pain is exactly. I wrote out two pages of how the pain is effecting my function.. from the sleepless nights, to work, to school (I'm back finishing a degree).. to social life, and so on. All 100% the truth, and my entire family wanted to GO with me to this appointment because they can't stand to see me live like this anymore.
I tell them thanks, but I'm a 35 year old man.. and I think this is best if I just do it alone.
Well today at the doctor -- I didn't tell him .. hey doc,.. I need XYZ medication.
I handed him my MRI hard copy (that he never had.. he just heard the phone call from the imaging center last year) -- and mentioned the papers and he just grabbed them (I meant to explain them to him) -- but oh well, he started skimming it all.
I then said, The hydrocodone works well,.. but it only provides X amount of relief per month. So, do you have any ideas for replacing the tramadol with something that will give me more time of the day and month to be functional?
"Yes, I can think of a thousand. but we aren't going there."
I said something.. being courteous .. but trying to get my point across .
He says: "Your MRI shows nothing. I could go have one and it would show something."
I say a few more things..
He says "Do I believe you have SEVERE pain?.... Yes!" .. "Do I believe your pain is chronic and persistent? Yes, absolutely." "Do I believe you have done everything you can to help that pain? meeehhhh" (Sort of a no sound..)
He then says "You need more MRI's to go that route." (I'm sure he means getting a medication that is an extended release medication so I can have pain relief for more than just X days a month or X hour a day)
I respond "Dr. xxxxx, I have asked you 5 times this year for MRI's of the Thoracic and one of the Lower back,.. but you have told me each time that I don't need them. That I wasn't going to have surgery,.. so they are not needed."
He says "Well, you need More scans,.. and unless a scan shows something we aren't going there with the medication."
I respond" Fair enough."
He just walks out..
I was mad and amazed at the same time. This is a NICE guy.. nicest doctor I've ever been to. But he acted super short, and just didn't give me a chance I feel this time. He also said right to my face he knows and believes I'm in Severe chronic persistent pain but yet he can't / won't help me with the relief to control it for a reasonable amount of time.
So.. what do you guys think?
I know my MRI , I guess,.. is completely normal.. But it is just of the neck,.. and how can any one be 100% sure that the stenosis shown isn't causing any of my upper back/neck pain? Or arm weakness?
Am I wrong here? Is it that black and white?
I hope at the same time my Mid and lower back MRI's (when I have them this month) show some problems.. but also I don't WANT major problems. I just want enough pain relief to live my life. This is no kid trying to get high,.. I'm doing everything by the book.. I see him every month.. always have,.. never miss appointments, never call in about medicine, I get drug tested randomly,.. and on and on.
So.. I need to figure out a way to get the pain relief I need. But I just don't know what to do. I'd be lieing if I said the near decade of living like this hasn't had the thought of ending it all at times.. but I don't want that -- I just want to not be disabled to the degree I am.. especially when there is help out there to be had.
Can anyone relate?
Can anyone, perhaps, offer some ideas on how to go about finding a physician who will help?
What would you do?
Thanks for taking the time to read this,..