Having a bad day... advice? or a sympathetic ear?

Hey all, I feel like My attempt at starting out positive is failing...

I am hurting so bad today.  I have Psoriatic Arthritis in the S/I Joints, Fibromyalgia, and a recently confirmed  bulging disc touching the s1 nerve.... likely causing the shooting pain down my backside to my achilles, but I am in tears. (Not exaggerating) I had the S/I Joints injected last monday, and by thursday was feeling pretty bad. Started a medrol dose pack after speaking to rheum and PM on Friday (Yesterday) but today I am struggling to even get to the bathroom.  Before my PCM referred me to the PM (who I have seen twice and talked to once on the phone)I would have probably gone to Urgent care to break the pain cycle (Which is what the nurseline for my insurance always says to do when it gets this bad) but I dont know what to do now, since I signed that PM Contract and dont want to have problems when I am just starting out, establishing a relationship and all. I dont like taking the pills, because i have had withdrawals in the past and am petrified to go through that again, but meds really have helped me be able to get up and move around, which then also helps the pain (the moving, I mean). But the New PM hasnt even discussed Physical Therapy, TENS, Meds, or ANY other options, just straight to injections (He is an anesthesiologist, perhaps that where the $ is made). I think when I go tuesday for the next injection, I will ask him for his long sighted treatment plan, and if it only includes injections, would I be breaking my contract getting a second opion? I have seen other members explain that it is a COMBINATION of treatments that is most beneficial, which is what I am looking for. A multi-disciplinary approach! 

  I sent my girls to the backyard to play so that I could cry in private. They are so resilliant.... they even made me cereal and a sandwich for lunch cause I cant move without shooting searing pain down my leg! Just feeling hopless and discouraged and ALOT of pain today. Now that it has come to a full head, I think of the good questions for the doc. (and of course its the weekend, so no calls allowed) Trying to make it through hour by hour. Sorry for the LONG negative rant, but I had to get it out. So thanks for letting me vent.

Thank you for the advice, i did leave a message and am waiting for a call back with instructions. This is not the way I wanted to start out, being the "pain in the butt patient who calls on weekends"

I take enbrel ( for the psoriatic arthritis), Prozac (for depression), just started a medrol dose yesterday for the flare, mobic for inflammation, and Tylenol.
I've had lyrica before but when I switched rheums they changed to enbrel.
When I first saw PM he said we start with injections and if they are unsuccessful then "we have other things we can try before surgery" .... no one ever mentioned surgery before him. I've just been hurting so much lately that I haven't been able to think of the right questions to ask, like "what do I do while I'm waiting to see if the. Injections work since what I've been doing is insufficient" I don't think of that until moments like now when it's totally unbearable and the wrong time.... I appreciate your suggestions and will definitely be calling the office on Monday. But would I get in trouble for seeking a second opinion?

Oh, it should not be a violation of your PM contract to get a second opinion, the only violation would be if you accepted medications from a new PM without ending your contract with the other.

Matt thank you for your input. I did look over the contract and I think you are right, seeking a second opinion is not a violation, but accepting tx without formally ending the first would be.... funny though, it also states "should your consultation result in controlled substance therapies".... by that definition since he isn't prescribing then i wouldnt be breaking the contract, as unless he scripts a controlled substance there is no contract (I'm still gonna ask though, I don't want trouble)
In any case he did call back, I told him I was sorry for calling but I didn't know what else to do. I told him my symptoms, and he said...." if it's that bad you should go to the er, maybe they can give you some steroids". I reminded him that we spoke on thursday and he already had me on a medrol dose pack, then he remembered the conversation....duh! So i said thank you for calling me back and i will bring the discharge papers to my injection appt on tuesday. I'm going to keep the appointment since I'm hoping it will help, but I'm considering a second opinion in the meantime.... come to think of it his consultation wasn't as in-depth as I thought it would be. More about diagnoses' than history, pain triggers, duration, what I have tried already that works and doesn't, etc...
Straydog- I totally know what you mean.... ever since I had children (no-one warns you that your brains come out with your baby...lol) I have to live by a notepad.
in any case, after I talked to doc, hubby took me to the er, they gave me dilauded and phenergan (for that awful nausea) I'm snuggled back into my heating pad ready to sleep and try again tomorrow.
Thank you all for your responses, concerns, and insights.
Have a blessed night

Many times the injections are tried first, and then based on how those go, the other options are explored. Ie PT, tens, meds, etc.

For some people the injections work great and so less is needed to supplement them. In some cases they don't work very well or at all and then other options are explored.

If the injections aren't working for you, say so at your next visit and ask the doc "where do we go from here?" If he says he only does injections, then you'll know you need to go elsewhere.

Many times docs dont want to refer patients to PT until the pain is under control to some extent because PT in itself is painful. Most of the PT's I've ever been to tell me they feel more comfortable if their patients have a good treatment plan in place for the pain first.

Since you got some help at the ER, hopefully you can hang in to the next appointment. My guess is when you mention the injections arent working, that's when he'll bring up the meds etc. If not, definitely get that second opinion!

Post Edited (LexiRae) : 3/10/2013 10:48:48 AM (GMT-6)

I just need to add in reference to getting a second opinion with another PM dr. I have been trying to get a second opinion for close to 2 years now. I have not found any office that will help me without a complete discharge from my current PM dr. Then I run the risk of ending up in worse shape than I started out in. My PCP understands and has tried to be the middle man in getting me an appointment but they still wont even consider taking me on as a patient and making an appointment unless I am completely discharged. What if I get the discharge and they decide not to take me, or I dont click with the dr, then I am up the creek without a paddle, who knows if the first dr would take me back at that point. I said I dont care if they put huge orange stickers all over my chart NO MEDS till official discharged from current dr. They all want medical records and there is no way to hide the fact that I have been in PM for over a decade. In the past my PCP said she would write scripts during the transition but thats not the case any longer due to all the governemt oversite. I cant imagine trying to continueing working if I abruptly lost my PM plan, I am sort of stuck.

I am hoping you are feeling better today, and good luck with your injections next week.

Hugs,
Shell

Wow seems like it was a rough weekend for others instead of just me. I ended up in er on Friday due to unbearable pain that had me screaming and sobbing hysterically. I definitely know how horrible the pain is from the sciatic nerve being compromised. I never thought I could feel worse pain than I did when I had my back surgery but I was wrong. If your pain was anything like mine then the er was definitely the place to go.

It took 6 hours for them to get my pain under control. In the end they gave me a shot of toradol, a nortriptalyne (sp), and my regular meds of hydromorph contin and dilaudid. I'm glad you were able to get some relief and hopefully they can get your pain under control on a daily basis. Here's hoping that you never have a pain day like that again.

I know just how you feel!

I get chronic UTI's. I'm in the middle of battling one now, that actually caused a secondary infection. So I had to switch meds, take care of the secondary infection first, and then go back to knocking out the UTI.

When something like that happens on top of the already horrible every day pain, you feel like throwing up your hands and saying "forget it!"

I hope you can get on antibiotics asap and get to feeling better!

I'll know in a few days, fingers crossed.

My biggest challenge today will be fighting the rain! Ha THAT's not going to happen but I'll settle for not rolling around in bed in pain all day because no matter how I lay it hurts.

Isn't it?

Good luck!

Let me know how it goes :)

Actually turned out as a kidney infection diagnoses. Cipro, rest.... and a close eye on digestive symptoms. Fingers crossed this passes quick

***??? The dr office just called and said the labs came back NORMAL... the in office test came back with blood, and WBC. and I swear I didnt make up the urgency, and flank pain. I do feel a bit better, still taking the antibiotic... Something seems funny here. -Scratching my head

At least I feel a bit better. AND I think the ESI is working, theres definatly been a reduction in leg/back pain the past few days :) happy news :)

Im sorry I didnt know that What I wrote would prompt a censor... please forgive my moment of frustration.
Thanks Lexi for checking in, It kinda makes my day to see responses and know someone out there cares that doesnt have to... So THANK YOU!
I asked the nurse when she called what this means, she said she wasnt sure, but also thought it was weird because she was the one who did the dip and saw it light up.
Like you also said, she told me to continue antibiotics and come in if symptoms change or persist.

I am enforcing a 48hour rule on myself from here forward, so as not to burn myself or my doc out. leave it alone for 2 days, if its still a bother, then call.... probably a good topic for a new thread.... burning myself out with worry to the point of wanting to throw my hands up and do nothing.

ok, enough "wah-wah" time. Im going to have popcorn and movie time with the kids....and if energy levels permit, perhaps a game of "Five second rule" (They really like that one)

I hope everyone gets to enjoy their weekend, and has a low pain day. TAKE CARE