New member with question about medication for severe chronic back pain

I was severely injured 3 years ago at work. I've been to pain management doctors, orthopedic surgeons, neurologists and physical therapy. I have had 7 epidural injections, trigger point injections and SI joint injections, a spinal cord stimulator trial and a discogram. I have a severely bulging disc in L5, an SI joint disfunction and severe nerve damage in both legs all the way down to my feet. I also have pain in my pelvic area as well as both of my hips. I have a lot of weakness and numbness as well as severe pain in both my legs which cause me to fall down often. As a result of losing my balance I have injured my knee and shoulder also. When I fell I also hit my head very hard on a concrete floor.

I suffer from migraines that are so bad they cause me to vomit, I now have blurred and double vision and i constantly see black spots moving toward my eyes. From receiving so many steroid injections
I have also developed cushions syndrome from too many steroids in the body at one time. My quality of life has severely diminished which has left me very depressed and dealing with a
Great deal of anxiety.

Because it is a workers compensation case I am constantly being ping ponged around between different doctors and all of the testing/procedures take FOREVER to get approved. I am currently awaiting an authorization to have an MRI done of my thoracic spine to see if there are problems there also.

Lately my pain level has really started to spiral out of control. I am feeling an increased level of pain every day and it is becoming unbearable. I cannot sleep at night because of the pain and it is becoming harder for me to function. I am currently taking Percocet 10/325 three
Times daily for pain. I was taking it 4 times daily but the doctor tried to cut it down last month to 3 times a day which is definitely not working for me.
I was barely getting relief at 4
Times a day.

I should also mention that I am not taking anything for break through pain. I really don't like to take a lot of medication but I can't take it anymore. The pain is so severe it is even causing my blood pressure to spike and my anxiety level.

I have been trying to take the medication 3 times daily but am finding it difficult and often have to take it 4 times which causes me to run out of Meds about a week before my refill is due. I want to call my doctor and ask if I can come into see him before my next appointment, which is next Friday to discuss this with him.

I would also like to express to him that i am feeling depressed and see if he could give me an rx for depression meds to help me through this difficult time. I also don't know why my pain is getting significantly worse. idk if it is just that my body is building a tolerance to the medication that has been giving me relief or if I've developed CRPS or RSD or fibromyalgia, which are a few
Things i have come across while doing research.However I am so nervous because I don't want him to look at my like an abuser or something, because I am not, I'm just desperate
For some relief.

I'm also nervous that if I tell him that I occasionally need to take the medication more then 3 times daily that it will mess up my workers comp case. I am always tip toeing around the situation walking on egg shells because I am terrified that being honest will mess up my workers comp case and my pay check. Which in return gives me
Severe anxiety worrying about it. I have a family and children to support and I would
Rather suffer in pain then take a chance
At sacrificing my workers comp. Is that ridiculous? Will me being honest with my pain management doctor and discussing a possible increase in my Meds daily or a MG increase or medication change affect my workers compensation?

These are all things i am willing to try. i have been seeing the same pain management doctor for about 8 months now and I really like him. It is just incredibly frustrating that all of these little procedures they have given me over the last 3 years have not helped and now the Meds aren't really helping either. Idk what to do :(. Any advice would really help and put me at ease. I am also worried that if I don't do anything about it that I will have to go a couple days with no Meds and I hAve never gone through withdrawals and don't know if I even will, but I am worried about that as well as being stuck in excruciating pain until next week. I have enough Meds to get me through the week, but not enough to last till my refill next Thursday. I'm sorry for the long post, I've
Never used one of these forums before.
Thank you in advance for any information you can provide. :)

I have made paragraphs which will make your post much easier to read.....Susie

Post Edited By Moderator (straydog) : 5/13/2013 5:38:22 PM (GMT-6)

Hi Liza & welcome to the chronic pain forum. Sounds like you have been put through the wringer for treatment. I am assuming the drs all say no surgery is needed.

Why did the dr reduce your meds last month? It sounds like you have some nerve involvment but you did not mention being on any of the nerve medications like Lyrica, Gabapentin or Cymbalta to name a couple. There is a good chance that you have become tolerate to your current pain medication or your condition would also be getting worse. You may do better if your dr put you on a long acting pain medication with something for BT pain. That generally works the best, that you are not constantly chasing the pain. You need to let the dr know that you have not been taking the meds as directed & I hope he is understanding. That tends to send a red flag up with a dr when a patient starts running out of meds early. Depending on his reason for cutting back your meds I would think he would understand this time but I would not do it again. I think if you told him just what you have told us it should be ok. I don't see how this would have any affect on your comp claim unless you have a history of this previously. By the way, chronic pain & depression go hand in hand for some reason.

Yes, w/c insurance takes their time approving tests & treatment. They just don't get in a hurry for anything. I feel for anyone having to deal with that mess.

We have a Fibro forum & migraine forum that you may want to check out. Also,we tell all of our new members that we do have forum rules that the owner/administrator asks that we all honor. So, when you get a minute check them out.

Take care of yourself & welcome aboard.

If you ask everyone here they will all tell you they do not like taking medication but sometimes we have no other choice. I do know the drs try to keep the meds on the low side with young people but if you are not getting any relief then something needs to change.

Again, just be honest with your dr & tell him what you told us & take it from there.

If you live in chronic pain, you must face the fact that medication may be one of your only reliable sources of relief. No one likes to be dependent on medicine but that is what they were invented for ; relief/ treatment.
See a PM Doc - usually you would be treated w/ a Long acting med and Breakthrough meds on a daily basis. This is standard for lOng term pain care.

Good luck
Never give up
Be your own advocate

Josh

Hello Liza!…and Welcome to the forum!

Your in a tough spot, and I'm guessing you are seeing a Dr that the company wants you to see? Workers Comp?

I agree with others here and you may want to consider asking your Dr about Nerve damage meds…like Lyrica, Cymbalta, Gabapentin…and Nucynta.

It really looks like you are under medicated, according to all of the descriptions of your pain. Is there any way you can look for another PM?

Again, Welcome and Enjoy the forum!

SE

As has been said already, truth is the best policy with PM docs, and I would get a script for the Gabapentin and pay cash, it really isn't expensive and if it works W.C. will have to reimburse you. Your are right about your PM taking your meds down because of tolerance and 3 years on the same med is ridiculous. Just like most of us you need at least 3 different pain/nerve/psych meds. Can you take IBU or Tramadol? If you can do the Tram, they make an oxy with no tylenol, it only comes in 5mg but your only on 10 so its an extra pill. That's what I'm on and I take Pristiq which is serotonin/norepinephrine combo, of the Gaba and Lyrica don't work for you. You would have to wait like 30 days for the psych med combos to get up to full strength but they also take a Lot longer to work up a tolerance for.These are just suggestions but the 3 dif. meds are pretty standard if you cruise through people's med lists and your PM should not have a problem with this as its his job to help you function as much as possible with as few body destroying drugs as possible. Keep in Touch, Angie