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Have my first appt with a PM doctor

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Chronic Pain
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Posted 2/26/2011 5:16 AM (GMT 0)
After months of treatment, my doctor finally thinks I need to go to a PM specialist. I have been in chronic pain for now approaching 16 months with causes unknown. I am only 18 years old and so far my doctors think its a pain syndrome because we can't trace it. I have freak muscle spasms, tremors, insomnia, shaking, migranes, chronic soreness, chronic fatigue, constant dehydrations, brain fog, all that fun stuff. I have recently been locked to my couch for the past few weeks and I am currently sitting writting on a healingwell forum on a friday night. Depressing stuff...

Anyways I have been tapering off my SSRI medication which I has always seemed strange why I was put on it. It causes some bad withdraw symptoms and made my already bad sleep problems worse. This got to the point where I went days without sleep because of the pain regardless of which sleep aids I took. (ambien, lunesta, seroquel, valerian root, melatonin, and natural sleep techniques). One night I went on facebook realizing I wouldn't fall asleep and started a chat with my friend at around 4 am. He lives close to me and said that whenever he can't sleep he .........


Anyways my doctor is sending me to a PM and I read how they often drug test to see if they are abusing the meds. I've never had a problem with abuse and this was the first time I have even restored to illegal drug use because I have never been so desperate in my life. I know the THC will be out of my system in a few weeks and don't have to worry about it anymore but I don't want to go to the PM doctor, show up postive for THC then not be able to receive treatment. My question is should I tell my PM doctor about what I did to explain the results or just hope I don't get tested on my first appointment? I know they often make contracts allowing for random drug tests which after the next few weeks I am not worried about, I just dont want to be denied from the start because of a stupid drastic decision I made when I saw no other option (my doctor didnt pick up his phone for 2 weeks. This is the same doctor who had me on 120mg Cymbalta daily and then forgot to refill my prescription for 9 days aka hell).

I just don't know if I should be honest and he may see me as just drug seeking as I am a young male going to college, or pray for the best and see if I dont get tested.

(I had to edit your post since discussion of illegal substances is not allowed on this forum. Chutz)

Post Edited By Moderator (Chutz) : 2/26/2011 12:48:33 AM (GMT-7)

Posted 2/26/2011 7:56 AM (GMT 0)
Hi again~

I'm sorry you're having such a rough go of it right now. I'm sure every one of us can understand your desperation when the pain is so horrible and now you are paying for a decision you made to try and find some relief. IMHO that tells me that the medical community is falling down on their responsibilities when it comes to pain control. We shouldn't be put ina position to make a decision like you had to make.

That said, here's my opinion of you r position right now. It might not be the same as anyone else but here goes. Fill out the paperwork and be honest. But in your situation I wouldn't offer up anything you don't have to. Are you currently using any illegal drugs or have you ever been a constant user? Then when/if they ask about illegal drug use you can answer no since it was a one time thing. Nothing more, nothing less. If you are pushed to the wall or found to have a positive test then the truth is your only way respond. They may refuse to treat you but anything but the truth will only make it worse in the long run.

I hope this helps...
Chutz
Posted 2/27/2011 11:46 AM (GMT 0)
Something to think about. I agree with Chutz if not asked directly offer up nothing but if asked, I would be honest and briefly explain the situation; if you say no and a test comes back positive you will have a record of not telling the truth and who knows where that may lead; I once heard of a contract that stated if you do not inform staff of misuse and test comes back positive you will immediately be terminated from PM clinic (harsh).
Posted 2/28/2011 12:22 AM (GMT 0)
Actually Lucy, that is true. On my contract it says that if I test positive for substance abuse and lie about using I can and will be terminated from my Pain doc. It's standard I think for all pain contracts.
Posted 2/28/2011 11:27 PM (GMT 0)
Coming back with a report and I had the strangest luck. I went to PM doctor this morning for appt and when she came in, I realized I knew her haha. She knew me on a personal level and knew of what I have gone through. She was the one who ordered pin point injections in my back and gave some advice on other physical therapy activities all the way back in September of 2010. She never drug tested me and we decided to try out Lyrica. I am only on 100mg a day right now and I will say this is the most relief I have had in awhile. It brought my pain level from a 8-9 own to about 5-6. It wares off pretty fast and I am going to discuss with her about uping the dose on the next visit but for now I will stick with her treatment.

I still have an appt with my rheumatologist so we can figure out my joint issues. Every single joint in my body cracks like I am 80 years old. Its not a relief crack but painful, but more painful if I don't crack it. The weirdest joints that crack are my hips, knees, both ankles, my left wrist, and when my back cracks it sounds like an AK-47.

Lyrica is the first fibromylagia related medication that seemed promising. It doesn't take off all the pain and I dunno if upping the dose will fix this. We discussed tramadol also but I don't want to overmedicate myself. I have been through many psychiatric medications that only made things worse so I am trying to limit myself. Im scarried of this being a chronic disease and having to deal with this for who knows how long. I hope its not fibromylagia but there is something else that can be corrected and causing this pain.

Meanwhile I know if it is chronic I need to start manageable pain therapy. Anyone have any experience in long term lyrica use? Does tramadol along with lyrica provide significant relief? I dont know if I am just overwhelmed with joy for having my pain being lower than its been in months but I know it will slowly creep back up. Narcotics are the only thing that provide close to complete pain relief but I want to exhaust all options before going back to that. I know I will be able to be able to use narcotic therapy for long term without abuse potential however I also know how it effects people with repetitive use. Ive pondered maybe altering between narcotic use and lyrica use so I don't become dependent on either but for now we will just wait and see. Thank you all for your support!
Posted 3/1/2011 12:57 AM (GMT 0)
It's good to hear that your pm appointment went good. I wish you good luck with this being what you've been searching for. Take care.

hugs
Loretta
Posted 3/1/2011 4:52 PM (GMT 0)
Dear Zabu,

Good morning *hugg* I hope you are doing a bit better today. I was relieved to read your post. To finally be able to breath and concentrate is blessing for you, I am sure. But!! You can get your pain even lower. Lyrica is very promising. Many people see positive results with it. You will have to be one it for an extended period of time before you feel its full effect on you. It is one of those medication that need to build up in your system. You may yet get even more results from it. Here is some information about it...

~~~> Lyrica

Tramadol is a great med too. You will have to be careful with it though. It has a chemical make-up that can cause an interaction by itself or with other medications. However, you can start out at a low dose. Be on the look out for any adverse reactions. It has many benefits, one of witch is that it doesn't impair your ability to function once you become accustomed to it. It would be really nice if you could get your pain down even lower.

~~~> Tramadol
~~~> Serotonin Syndrome

I became worried when you mentioned you didn't want to become dependent on any medications. I wanted to tell you that at this point, if you do not get help, your life will continue to be effected negatively. I know it is a hard decision to begin to take medications that you will never be able to discontinue without a doctors assistance... but you deserve a chance to get your life back. You have severe pain. It isn't going to go away. You have suffered enough. It is time to start living again. Also, I do not mean to scare you in anyway.. but if you continue to go with severe pain you will permanently damage you body. You see, all this time you have been in severe pain you adrenaline is going non stop. The "fight or flight" response has been going this entire time you have been in severe pain. Eventually you run out of adrenaline and dopamine... then insomnia, spasms, forgetfulness, difficulty with attention, and difficulty completing tasks, impairment in attention, memory, mental flexibility, verbal ability, speed of response in a cognitive task, and speed in executing structured tasks. In short, you body cannot continue to be in pain much longer. Eventually you will effect your body's ability to heal from injuries, Immune system....

~~~> “Please, do not make us suffer any more...”

In the end you will do what you feel is right. I really hope the lyrica continues to help as it builds up in your system of the next 2 weeks. KNow you are in our hearts here.

*hugg*
dani
Posted 3/2/2011 6:25 AM (GMT 0)
Zabu, a couple things...

First off, raising your meds so soon after just starting them may not be the wisest idea; you already have such a great improvement on what you're on. Also you have to be aware of limits of stuff in your system; your Doctor will know what's best, but be sure to do your part and follow her directions. Alot of times it's hard to adjust to a set schedule for when to take your pain pills, but believe me, to do otherwise is to wreck havok on your treatment. I didn't get to try Lyrica personally, though I did try Cymbalta. I've also been on Vicoden, Loritab, and now I'm on Percoset. From experience my doctor has tried to provide me with the highest, and safest doseage possible for me so I can still function (I'm a single Mom) while balancing how many pills per/day. It's a constant negotiation process, and once your PM helps you discover what exactly is the problem you'll be better able to tailor a drug treatment from there.

Now the biggie. The fact that you found here is a big goal, one that took me years to do. I looked for local groups and never found any, but it took me over three years before I started looking online for a chronic pain support group. You have found probably the best bunch of people a hurting person could ask for. They're sympathetic, carring, kind, considerate, and always there for you. So don't feel alone.

I know you're scared about your issue being a chronic disease. You know when I first started having chronic pain I never thought for a second that I could have something along those lines. I just knew I'd seen every specialist out there and no one could tell me what was wrong, much less fix me and make the pain stop. For almost 3 years I just wanted someone to be able to figure out what was wrong, and to fix me. Well I finally got my wish, my Pain Management doctor figured out what was wrong with me.... and it's not something he can fix, and it's not something that will ever go away, and ... it'll only get worse with time as it's already proven to me it will. It took me awhile to accept it, to accept how radically my future and my life had changed; the life I had versus the life I have are so opposite. I was angery, I was sad ... I still have days like that. Don't bottle it up. Talk to people, even if it's only to post here ... people are here for you.

Keep us up to date on how things go, and always stay in touch with this family. Whether it's to ask questions or just to talk, to ask about if someone has the same issue, a new treatment, meds, whatever. I'm sorry you're hurting.... but I'm glad you found here.

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