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Chronic Pain
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Posted 3/30/2011 8:20 AM (GMT 0)

This is all new to me. I can not sleep, due to having my first PM appt tomorrow! I am not sure what to say so I will just jump in. This is my quick hx..had a benign mass and parotid gland removed 2 years ago with many lymphnodes. Was very hard to recover from, but I did and went back to work Nursing. 8 months after my surgery the pain had return. I have been seing my PCP monthly or more and they referred me to OU, since I have no insurance! They believe the mass is back, and I also have alot of scar tissue in my Eustacian Tube and nerve damage behind my R earlobe from the mass removal surgery that will take 2 to 3 surgeries to correct. I also had torn my back muscle the same year while lifting a pt that I had my mass removed! I am allergic to so many meds...some that I was allergic to, when I had my first baby 16 years ago, I seem to be able to take fine now. Although I am very fearful of any allergic reaction to meds! I have been housebound for almost a year, can't drive due to severe pain and nausea and vomitting and constant falls due to my ear! Miss out on so much of my childrens activities and it kills me, cause I was always the mom that went! It hurts my heart....

My PCP can not get my pain undercontrol so I decided to go to PM on own. I have no insurance so I am private pay. I know it is expensive but if they can help and they believe so, it is so worth it to me. My surgeries will not start till May!

Questions: what kind of meds do they usually start with? If u have already been on so many and one type for years, also I am afraid I will not be able to afford the meds after the visits I know that most of the Good meds r really expensive. I have all my records, do I just let them look through them, do I just talk, which I rattle ( as u can see by here) sorry nervous! Not worried about drug tests, or contracts, just worried that I will not ever not have a 0 on my pain scale! I was on Lortab 10mg 2 tabs prn, but usually only took at night and in the middle of the night when the pain was the worse, afraid I would run out and the pain would be unbearable. They changed to Norco which helped some better, but like over the last 3 days...it doesn't matter what I take the pain is unbearable and I end up in the ER for a shot! Sorry this is so long! I promise I will keep the rest shorter. I hope I got it out there..anyone that can give me some hope, or alittle courage. It would be much appreciated. Any info on meds would be great to ask my dr about! I didn't know if it was appropriate to list meds we r taking..if that will help anyone help me, I am fine with it! 

Thank You my new Friends.....

Posted 3/30/2011 8:55 AM (GMT 0)
I am gonna try to catch a few hours sleep. I will check for any infor before I leave in morning. If not I will be sure to check in when I get done and hope to discuss what Dr. said and our tx plan is! Ty all..Nite
Posted 3/30/2011 9:59 AM (GMT 0)
Welcome to HW. Okay. I will try to answer your questions as best as I can. I still (after years) of going to my doctor, get nervous! It's great that you found a PM doctor. Tell the doctor what you have tried, and what has helped. Tell him about the limitations that your injury causes you in your day to day life. Tell him about all of the things that you are not able to do because of your pain. Oh, also, tell him about all of the things that you would like to be able to do--like your goals.

In regard to medications--again, when he asks, tell him what you have tried and what has worked for you. No, I wouldn't ask for a specific medication, but I would tell him what has worked in the past. Remember that some PMs don't prescribe pain medication on the first appointment, but some do. All are different.

Maybe if you have time, you can write a little list about the things that you want to discuss.

Is someone coming to the appointment with you? Sometimes it helps to have two sets of ears there.

But, try not to be nervous, because even though it's stressful, you are being really proactive in your health care and that's great.

You'll be just fine. Please, keep us updated and let us know about how your appointment went. All PMs are different, but I know that there are still tons of doctors out there who do really care about their patients.

Hugs,

Flower
Posted 3/30/2011 12:34 PM (GMT 0)
 

          Good morning Nurse!

               We understand your fear and it is common to feel that way. Every PM clinic is different, and the med's they treat with, will depend what is wrong with you. Fibro may be treated differently than lets say, low back pain.

      By all means share everything you have with them, and I imagine they will ask for it on the first visit. Be truthful with them, and all should be fine. Please do come back and report how it went!

          By the way!....Welcome to the forum! I'm sure you will enjoy the members here, and we are so glad you took the time to find us. wink

       Good luck to you today, and remain calm. We will visit with you when you get back.

     SE wink

Posted 3/30/2011 1:17 PM (GMT 0)
Hi Nurse and welcome to Healing Well. Wow, you have sure been through alot. I am sorry you have so much pain. I just had two lymph nodes removed from my neck on Monday, and between the swelling and the pain I don't feel great.

I hope that you can get some answers and some relief from the PM doctor, please keep us posted. Once again welcome to the family! Take care.
Posted 3/30/2011 10:18 PM (GMT 0)
How did your appointment go? Hope it went well!
Posted 3/30/2011 10:51 PM (GMT 0)
Hi Nurse and welcome aboard. I am so glad that you are going to be seeing a PM dr and hopefully he can come up with a plan to get you feeling better. By all means arrive at your appt early enough to fill out paperwork and be sure they make a copy of your medical records and return your copies back to you. Do not just hand over those records, tell them they can make a copy and return yours back to you.

When talking to your dr about your pain, be specific, don't say my back hurts, that tells him nothing, describe the pain you have, it may be a stabbing type of pain, burning pain, or a a dull aching type. I think you get the picture on how to describe it. Do make a list of all medications you have taken and include what you are currently taking. Make a note of what worked and what did not work. Tell the dr what you do at home to try and get your pain down too.

The dr will ask questions and he should do an exam and such. I do hope he will supply you with something for pain relief. Let him know you only have so many pills left, in fact take the bottle with you and show it to him. You will most likely be given a Contract to read and sign if you are going to be his patient. This Contract states what you agree to do as a patient and what he agrees to do as your dr. Mine have always stated I have the right to fire him and he has the right to fire me as a patient for not doing what I agreed to do by signing the Contract. The Contract is something to cover him as far as you agreeing to use one pharmacy, not get pain meds from another dr while under his care, and agree to random UA's.

Please let us know how your appt goes and what you think of the dr. Sometimes we have to try them out sometimes we have to see another if we don't care for this one. Take care and again, welcome aboard.
Posted 3/31/2011 3:17 AM (GMT 0)
Welcome to the chronic pain forum Nurse. I'm glad that you found us, although I'm sorry for the reason you are here. I hope your appointment with the PM doctor went well. Please let us know how it went. As you can tell, we're all a big family here. I'm so sorry that you've been in so much pain. I hope the dr. gave you something to get your pain in better control. Take care. I hope you're having a low pain night.

hugs
Loretta
Posted 3/31/2011 5:41 AM (GMT 0)
I noticed that you mentioned OU....are you from Oklahoma? If so, nice to see another Okie on here! Best of luck to you, I am in my 8th week of post cervical fusion house fever! If you are in OK, depending on where you are, I can vouch for a couple of really good docs...primary, osteo, neurosurgery, and pain management....let me know
Posted 3/31/2011 10:37 PM (GMT 0)
Thank you everyone for all your comments...I really appreciate all the things that was said and the info that was given.
My appt went HORRIBLE.....he was rude did not even examine me. Asked what I took, how many a day, I was trying to explain it that they had just changed my meds, he told me to stop talking. He couldn't think. He asked me my goals...I said to not have pain, to eventually stop taking all narcotics after the rest of my surgeries area finished and go back to work. He said FINE i can get u off narcotics,,,here is a script for Neurontin...I told him I had taking neurontin before and it did not help this kind of pain but it did help when I had migrains, that I no longer have. He YELLED at me, with his nurse in there, she gave me this i'm sorry face! He said u talk in circles, I do not take care of ear and that kind of neck pain, I do only backs....if u want off narcotics u will take this med and it will only work if u want it to work, but if it doesn't work it is cause u r addicted. I never got ugly, i was getting ready to cry, I told him that I had been saving the meds I had for at night cause that seems to be when my pain is the worse and also around 3 or 4 in morning, so I do not take them all day and i can go without them for 2 or 3 days, I have the severe pain, but not the withdrawl feeling? He said good them. Take this and come back and see me in a month! I started crying, thank God I took my mom in law with me. I payed $220.00 cash up front, I had already spoke to the office manager before I made my appt to tell her about my condition, cause I did not want to make a trip if he could not help me and she assured me he could. I got out to the car, didn't want to go back in so I called inside and told them I felt like I was taken advantage of...I paid all that money for less than 5 mins of someone to not even want to understand what hurt or even why it hurt, he did not even touch me or look in my ear. I said I want not all my money back but atleast half.....since u girls did do all the work...! The office manager didn't know what to do..I told her i was not going to leave until they did something. So she got on the phone with me and said the Dr said to have my pcp call him and he would see what he could do. I was like " ahhh" Thankgoodness! The day got worse, I called my pcp, she is a PA, they told me to just find a PM dr, they did not refer me to him so the DR's over the clinic told her she could not call and talk to him, they wouldn't want him to have a bad opinion of their clinic." I have been going to that Clinic for over 2 years and worked with the PA while she was in school while she was a RN and personally was one of the Dr's Nurses for 3 years" My world collapsed. I felt like I had just been let down by everyone that I trusted! My Clinic said if he would call them then she could talk to him. I told them u know he would not do that, but it was lunch so I left a message for the PM Dr. on their machine asking to call my pcp, I said I was prayin that he may do this for me...Hoping that today someone would even care that I was actually Human and not just a pt #! Sooooo that is how it ended, me home in hysterics, I had a fiend come over and bring her table and gave me a full body massage to help with the stres and pain, so I could take only half of a dose of my meds! She was my Guardian Angel last night! I have one day left of my meds, no idea what to do now! finallyreallycrazy I am in S.E OK, but willing to go to Dallas, Tulsa or back toward OKC if I have to if u know of anyone. I have a appt with a Dr that OU set me up with April 21st....another $270.00..I have no insurance and waiting anyday to hear about my disability! Thank goodness for moms she said she would cover it, or if I can find someone else local! What do I do till the 21st! My pain level is a 8 everyday and 2 days out of the week it is a 10....I am so afraid of the pain. Thanks for listening!
Posted 4/1/2011 12:16 AM (GMT 0)
Wow. I'm so sorry that you had to see such a mean doctor. I don't know what you should do next. I wonder if you should go to the ER...? Others hopefully will chime in with some advice.

No one should have to go through what you went through. It took me years of being with a doctor that I didn't like to finally finding one that I love. You will find one. It's ashame, but it usually does take time, and it's ridiculous that you have to suffer while waiting.

I'll be thinking of you.

Hugs,

Flower
Posted 4/1/2011 1:00 AM (GMT 0)
Flower...Thank you for your kind words. I did speak to my speacialist Nurse and she said if it got to bad to go to the ER.. I have or was a Nurse in this area for going on 13 years, and have taken care of everyone of these Dr's children in the ER to there family on Hospice as they passed away! Not that they owe me anything for that!

 I believe Nursing is a gift, and I am so glad it was given to me! Buttt....like my husband said, make an appt with a local dr and not ur pcp ( cause I am not going back there anymore, after the way they treated me) I will go with a loving heart and be truthful as I always am, and pray that one will help me through till I can see the next PM Dr. on the 21st! I think me asking them in person, they may be more open to helping me. 

What I really hate is that I C people that fake it all the time and get meds month after month. Why am I having such a hard time? Should I fake it, or make it look like I am worse off than I am? That is not me though, and I would be ashamed of myself!  Who knows though, if I can't get anyhelp soon, I may just fall off our horse! lol shocked

Posted 4/2/2011 4:12 AM (GMT 0)
Nurse,
You have to remember that a PM doctor is not going to treat your ear pain, he is there to treat your pain from your condition. When a patient is new, he wants to hear about your pain levels, how it impacts your activities of daily living, when it is worst, when it is better, what you do to treat it, what has worked previously and what has not. What medications you currently take, what dosages and how often you take them, how they effect your pain levels.
If you have your records with you, he can read those. He may ask what diagnostic testing you have had done and for any reports that you may have.
As far as what medications they start you with, that depends on the condition and what you have tried before. I would suggest unless you have a true allergy, ie- hives, throat closing, severe itching, etc. that you don't call it an allergy. Telling a PM doctor that you can't take this medication or that one without having an actual allergic reaction to it is going to get you looked at twice and will raise a red flag. I am not saying that you are doing this, but many patients go into these offices claiming they can't take this pain medication because of an allergy when they are seeking specific medications.
Can I ask why you aren't going to see an ear, nose and throat doctor or the surgeon who is planning your next two surgeries? They might be better able to treat your condition and might be willing to prescribe pain medication if they feel it is necessary. It seems to me that if your pain is stemming from your ear area as a result from the surgery,maybe give the surgeon who is planning these next two surgeries a visit and he might be willing to give you pain medications in the meantime if he thinks they are warranted. You may get far better results from visiting the surgeon or an ear , nose and throat doctor if they feel that your condition needs treatment with pain medications since they must be far more familiar with the effects of the type of surgery you had than your GP or a PM doctor might be.
Good luck,
Sandi
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