PM appointment on Wednesday

Hey Mamaof3,

I'm glad you have a PM appt on Wednesday.

Essentially, I would start by telling your PM everything that you've said here. You actually said it perfectly. That your pain is affecting your quality of life (QOL). It is impacting your job and caring for your three young children. That you need to figure out a course of treatment that is going to help you be able to cope w/ your pain issues and increase your QOL.

Let the PM know what you've tried.... what has/hasn't worked....

One way that you can bring up the topic of an ER med - without actually asking for it straight-forwardly (which I actually don't see a problem with... maybe not asking for the med by name - but asking for a long-acting pain med).... is just telling the doc you have lots of ups/downs pain-wise on the Vicodin and you need something that is going to offer you more wide-spread coverage. That's essentially the "point" of a long-acting medication. In addition, a PM doc might also give you something for BT (breakthrough) pain - the times when you get spikes of pain. But it's really best to have the right ER med on board....

I'd also ask the doc about a nerve medication.... and let them know if the flexeril is/is not working.

My encouragement that I like to give here on the board.... is to go in with confidence.... You know you aren't a drug seeker.... you are simply going to have your chronic pain issues dealt with.... just as you would go to a doctor for diabetes or heart issues. You are your own best advocate - let the doctor honestly know how much of an impact that this has had on your life....

I wish you the best of luck. I know how difficult that health/pain issues can make life when you are juggling a full life and children. Please update us, if you can, after your Wed appointment.

--Tina

 

        ...I fall right in line with the other two mods here...lay it out to him...but be respectful. And by all means,... if you have a family member that you can take with you, then do so.

   Good luck!

 SE

   

Good luck and good results with your upcoming CP appointment

david

Hi there....Welcome to the boards..

Sorry to hear that your experience with this PM has not been very good.

Usually a Dr. has an issue when their patient only asks for an increase in the opiate and not just asking to find a better way to manage their pain.

So, it seems from what you wrote that if 75% of your pain is
nerve pain then it's certainly ok to ask to be put on a nerve pain medication. I would think they would be happy to do this.

As others mentioned, it is best to approach him in a way that just tells them what type of pain you are having and what you do that helps the pain, and when your pain is at higher levels. Then if you just ask them what ideas they have to help you get to a more manageable level they are more receptive to this.

Certainly if you don't feel that this Dr. is a good fit for you then seeking out another one is best. Just know that you have to terminate one relationship before you actually accept any opiate prescriptions from another. But it's perfectly fine to go and have an initial appt. to see if another Dr. is better.

The key with chronic pain management is to use as many possible "tools" to help our pain. Especially those of us with spine issues....many are on a nerve pain med, an opiate, and then a muscle relaxer. Maybe an addition of a nerve pain med and a switch to another muscle relaxer could really help you get to a level 5 or so on the pain scale which is what most Drs. shoot for with chronic pain.

Happy birthday to your daughter!! I truly hope it's a good day for you overall and the appt. goes well...Keep us posted..

Can't say my appt went great, but not terrible. The PA switched me from my vicodin 10/325 to Nucynta 100 mg 4 x a day. Go back in 4 weeks to re-evaluate. Next step would be Butrans patch. But no mention of BT meds with the patch. If that doesn't work, the going back to Vicodin with hopes that my "holiday" will help them work better.

Was told my herniated disc doesn't push on my nerve root so she doesn't know why I'm having nerve pain. I tried to explain that my nerve pain isn't constant. It does it when I move, bend, or lift a certain way. Also depends on how I'm sitting or sleeping too. I'm not crazy! I know it's pinching my sciatic nerve when I get shooting pain all the way to me knee on the right side and to the top of my thigh on my left side.

Asked about ER meds. She said the only extended med they could put me on would be the Butrans patch. I'm guessing the other ER meds are too strong? She didn't really explain why not.

And didn't add an anti-inflammatory, so I guess I just keep taking my ibuprofen. I'm willing to give the Nucynta and Butrans a shot. But going to start looking for other PM's in the area just in case because doesn't seem like they willing to do an ER med with nerve med and anti-inflammatory. It's so frustrating!! I just want to cry.

And I'm worried about withdrawals from the Vicodin since Ive been on it for 7 years but I'm stopping it cold turkey. Took 1 nucynta so far. Helps some, but not great. I've read though it can take 5 days for it to really start working. Just sucks becs my daughters birthday party is Saturday and I've got lots to do when I'm already in pain.

Amber

Amber,

Thanks for updating us about your appointment. I feel for you.... it's so frustrating when things aren't working.... and, to top it off, you have a doctor that isn't willing to explore every possibility to find something that DOES work. I don't understand her hesitation or limiting you to certain medications.

I think you are doing the right thing. Give these new meds a try. Who knows? They may end up working - and that would be fantastic. But, in the meantime, I'd be looking into other PM doctors - just as a back-up.

Like I said.... while you don't want a doctor throwing any old medication at you.... I don't agree w/ saying that you are limited to just one or two medications - when there are SO many drugs on the market these days. Including nerve meds, etc.

Wanting pain control so that you can simply live your life is completely appropriate, remember that.

How many Vicodins were you taking per day? I think you said 4 a day... I would have "thought" she would have tapered you down on the Vicodin w/ you being on it so long.... but hopefully the Nucynta will cover up any withdrawal from it.

Hang in there... how was your daughter's party? Take care --Tina