Pain Management Solutions

Hello Everyone,
Recently motivated by my Pharmacist to try and work with my doctor to try alternative pain management. 2 surgeries; 1st was fusion of L-1 & L-2, then later, due to the change in my stresses because of the fusion and previous damage to the disks between L-2, L-3, and L-4, required second surgery for a total of 4 fused vertebra in my back, L-1 through L-4. Last surgery really went badly; same surgeon and everything, but there was apparently extensive nerve damage. Not clear whether it was caused during or before, but I feel much more pain seemingly now than prior. Not looking to place blame, just move on.

Started w/Cymbalta, Percocet and Valium; the Valium was trial and error as the best fit for me as a muscle relaxer. Get knots in my back by the end of the day, and the only way to ease them was the addition of Valium.

Percocet started out as 2 every 8 hours (5-325's) or as needed, but after about a year, it just wasn't cutting it and I couldn't work. Went to 2 every 6 hours, but waking up was terrible because I had let all the pain medication wear off, and it takes a while for it to "kick" back in. During the second year, doctor phased in Gabapentin (Nuerotin) and suggested the larger the dose, the better. Was also experiencing uncontrolled twitching of muscles in my lower back and R/Leg.

Backing up a bit, there was a post-operative issue the second go round, and I got a blood clot in my right thigh. That really did a number. I lost about 30% of my muscle mass before I forced myself upright and started a walking regimine, pain be darned.

Now at 2 Percocet every 6 hours, w/2 300mg Gabapentin, and 1 5mg Valium. Was also taking 90 mg of Cymbalta over the day, but I weaned off of it because I have no insurance and it's absurdly expensive.

There was also a period where he gave me a slow release Morphine (don't recall the dosage, etc) that I used before bed so I wouldn't wake up hammered tight.

I am not looking for sympathy, or blaming, just a solution. Tried a time release pain patch too, but that didn't really work well at all.

Every post I have read seems to end with the same thing; go see a Pain Management Specialist. What I am looking for is something more from you all out there, which is genuine direction towards solutions. No lectures on "Why it's a good idea" to see a Pain Management Specialist; I am not stupid, and understand completely. It's just that I have no insurance, am not interested on getting permanent disability, and want to continue to have a productive healthy life without the "Fuzzy" mental status, and burning out my liver and kidneys. I'm only 52, and would like to live more that another 10 years if you can feel me.

That said, on a "No Insurance" budget (still a W-2 Contractor, and companies NEVER seem to hire anyone full time anymore). Like where I work, and would love for them to pull me in Full Time, but it's their call.

Hence my pointed question; what are the alternative pain regimines out there for someone in my exact or very similar condition? Can anyone give me explicit examples or "someone who knows someone who did this"?

Desperately seeking relief, QuadFusion.

Hi Quad,

I have a number of prospective thoughts to consider after reading your post.

• Do you have, or can you get access to a teaching hospital? This can be extremely helpful because, as a pleasant surprise, those fresh eyes can often pick up on things that the salty practitioners dismiss. When I went to one, there was little to no cost, they would bill if necessary, but either way, the care was remarkably less expensive! Remember, the students are not green, and all are monitored by MD's.

• When I did not have insurance, and needed a medication that worked extremely well for me, but obviously there was no way in Hades I could afford it,....many pharmaceutical companies, (more than many people realize) have programs where they will provide you with your medication at no charge. With your doctor's assistance with a small amount of paperwork, they (the pharmaceutical company) will mail your medications to you in 3 month supplies at a time. All they asked of me at the time I did this was to fill out questionnaires about the benefits I felt taking their drug. I also had a small amount of simple paperwork to prove that I did not have the funds or insurance to afford the medication through the "regular channels."

• The decades I was in pain prior to eventually having to have my surgeries (which included full laminectomies, decompression, and fusions of L1-L5, bone and marrow graft taken from my pelvis), I utilized as many natural approaches as possible. Many natural health practitioners will offer their services on a sliding fee scale, and you can end up paying no where even close to their "full price."

• Check with local Massage Schools. When I went to school, (it's a 2 year program), we had to complete a certain number of massages on different people,....family members, neighbours, strangers,...we just could not do them on other students (we did that during part of our daily class time). There are " Event openings" where people could come in and all massages were free. But periodically checking into the actual massage schools in person and speaking to someone in charge, expressing your concern, and your health problems,....you're a golden nugget for the students to work on! Again, students are always monitored, and ask a lot of questions to make sure you feel comfortable, then you fill out a survey after the massage explaining how you felt about the therapist, the massage, if you were comfortable, and while they ask for what you enjoyed the most, they will always ask you where you saw room for improvement! The "quota" for each student to reach within each discipline of massage is pretty high, so there was never a shortage of access to a therapist-in-training!

[list]* Have you consulted with a naturopath or dietary physician? I mention because often, these type of practitioners evaluate and give you guidelines for what you can do for yourself,--as opposed to weekly or monthly visits and Rx refills.[/list]

[list]* Similar to a previous comment I made,-- but I really understand how financial strains affect our ability and access to health care. I've been to chiropractors, acupuncturists, and of course massage therapists, who have, as I mentioned, sliding-fee scales. And even if they do not advertise that they do, it does absolutely no harm in asking because,--especially in this economy,--they may surprise you, and be willing to help you out.[/list]

[list]* Another thought, -- and while it sounds antiquated, once again, you may be surprised and have nothing to lose. But some practitioners (of anything, actually,....from working on cars to working on bodies), will accept the barter system. I have done this in the past and I enjoy it. It's not only allowed me to work, but in exchange, receive items I never would be able to otherwise. What different people can truly give, and what others really enjoy receiving, are all so varied! This is where "value" isn't deduced by the dollar figure, but by each person individually.[/list]


I hope that I've given you a few nuggets to think about, and I'm also hoping you find it useful. Please let us know if any of these ideas sound good to you, and how it works out!



M.


REASON FOR EDIT: My leaky memory forgot a lot of additional perks that I wanted to mention. Not to mention, what the gosh-darn happened to those last 3 "lists", huh?

With respect to your original post about alternative ideas for when one does not have much of a margin of expendable cash,....

Joan brought up a good idea of the TENS unit. I have one, and I've used it/them on and off for decades, for various forms of pain management.

If you look on Amazon, (maybe even e-Bay, but I don't know),...various models can be purchased for about $45.00. Most come with a selection of electrode pads (mine also, to my great surprise, came with a 9v battery,--but anticipate having to buy a few, because if this works for you, as it did for me, you'll be burning through those 9v batteries right and left,--depending on your usage).

If you use the "search feature" here and check out TENS or STIM and various other threads relating to electrode pads, you'll find quite a bit of information. The pads are re-usable, although they suggest not using each pad more than a few times before replacing them. But they do last, they do stick, and they are not expensive....and the unit should last you for years!

Most also come with a variety of settings, so your body won't "adapt" to a single source strength, rate, or intensity. This also helps with the pain by mixing things up, and helps financially because being able to change the settings, compliance is greater and you'll get a maximum benefit from that investment.

If I can think of anything else, and I'm sure I will, I'll post. As I did mention, I spent decades pre-surgery utilizing anything at my disposal and really checking things out. When I was in a position in my life where my source of food was the local Food Pantry,....I really do "get it"....where you're coming from, that is.

Regards,



M.


PS: Just for reference, (not really sure it matters, buuuut), I'm 50 years old, almost 51.

WOW, lots of GREAT STUFF from you all. Very, very much appreciated. Not sure what a Tens Unit is, but I'm guessing from the replies that it's some sort of electro-shock therapy. I had a unit of some sort that they gave me after my first surgery that had pads with wires that was, as I was told, for my bone grafting to heal better. I still have the wires and the pads, don't know if I can locate the device. It had some sort of code where they "expire" after a certain amount of time, apparently there is an inner clock chip that kept track of the days.

A very special "Thank You" to "Merrida" who offered a plethora of suggestions that I think at least some are pretty probable for me. Living near the great NYC area, I bet there are plenty of "Teaching Hospitals" in the area. I'm going to hop on that.

Oddly, I haven't tried it recently, but massage therapy seems to have absolutely no positive benefit, unless it's the end of the day, and the muscles are knotted. The actual pain is DEEP inside, it's difficult to try and accurately describe it. Not like a Sciatica type pain, but similar in that it's internal, and I don't believe it's muscle related as much as maybe "Neuro-Skeletal" if that's even a actual phrase. It's definitely nerve related, and as Mercy&Grace and I think another of you suggested, maybe acupuncture could help. I will definitely investigate that avenue.

All in All, anyone else out there, PLEASE KEEP THE SUGGESTIONS/EXPERIENCES coming. I remain CONVINCED THERE IS A BETTER WAY, and I am determined to find it!

Thank you all again very much!!!

I have been using the heating pad every evening

Quad if you have a microwave you can make your own hot packs with it. I take kitchen towels & wet them & then wring them out well. Put them in the microwave for just a few seconds because they can get way too hot if you are not careful. That is a great way to make moist heat which seems to work the best for me.

For ice packs here is a good trick rather than using ice, buy a couple of those cold packs that you put in a small cooler to keep things cold. My husband takes insulin & it arrives in the mail in a small disposable cooler with frozen gels packs. I saved 5 of those gel packs & keep them that way. When I need a cold pack I am ready. You can also use a bag of frozen peas or corn, but I prefer these gels packs.

Take care.....

A cloth sack full of dry hominy, pasole, or corn makes a great reusable/microwavable moist hot pack.

I've tolerated 2400mg/day of neurontin and even 3600 for over a decade. My memory is notoriously bad, possibly because of it, but it is the only drug that I have found that can touch my nerve pain.

acupuncture is ridiculously expensive where I live. I find that if I eat a very spicy meal (and I mean habenero, ghost, scorpion, scotch bonnet type chilis) it releases 10x the endorphins of accupuncture. . .and you get a meal. You also get a rather unpleasant but acute side effect beginning 4 to 6 hours later.

Definately a mistake Quad not to utilize water!! It allows movement and utilization of the parts of your body that dont get used due to pain. In warm water those movements are effortless.

If Neurontin was working please check into their website for a patient assistance program to see if you qualify for it.

Glad you checked back,sorry about the FiL and we sure get that life gets in the way of things sometimes.

Keep us updated and let us know what works.

Wow MaxV, I am once again reminded that no matter how bad you think you are, there's always someone out there that's got it worse... (no ill will intended here).

What is ACA? I am not familiar with it, but I live in NY (I never ever thought I would say that, but then I met my wife who is from here....).

Anyway Max, please elaborate; I am rather ignorant, and I am SURE there are probably a plethora of programs I am not familiar with, and don't even know where to begin. I guess you could say this FORUM is my beginning of trying to reach out to others like yourself that are in such prediciments and see what I am missing and what I can do better.

THANK YOU for bringing this up. BTW, I am not actually classified as disabled. I actually filed when I was collecting unemployment (on the advice of some legal friends) and was told to let them turn me down, as most are initially. At the time, I didn't have the resources to obtain and get the pertinent medical statements and records to them, so they denied the claim. That really wasn't the object of the exercise however; it was that if and when I DO file again and get approved, everything back to my initial application/claim becomes retroactive and I get a huge some backdated to the date of my original application. This is, as I was advised and understand, true and happens frequently, (as I said, they always deny the first claim).

Please get back; I am very curious and a bit excitedly optimistic.......

ACA is the new health care law.

Regarding filing for disability, you have something wrong. If you file again, do not count on the back pay from before, it does not work that way. When you file for disability, even though you put down a date of onset, SSA is the one that decides if that is the date they agree with, if it isn't they can and often do change it. When you stop working, your work credits begin to expire. SSA gets your medical records with no cost to you, so they had your medical records. Since your medical records didn't contain enough info and/or by SSA criteria you aren't disabled, you having filed that application has no bearing on any future applications. SSA's disability process is very complicated and often long. You need to speak to an attorney who specializes in Social Security Law. For the anything federal and most state things, you must be found disabled by SSA to be considered disabled. It isn't having an impairment that determines disability, it is he level of severity as documented in your medical records and how that prevents you from working. The criteria your dr uses to say you're disabled is not the same criteria SSA uses.

You need to start now making sure that your drs write detailed notes in your medical records. You need diagnostic test results, treatments tried and their outcome, meds, details of exactly how your impairments prevent you from working etc. Every few months get copies so you can see exactly what they have written. Drs don't always write down the things we think they do. You also need to find your denial letter and see the reason(s) were SSA denied you the first time. You also need to find out when your Date Of Last Ensured is, because that is when your work credits expire. Your age, education and previous work history are also factored in. You also must remember that if you're under 50, SSA may find that you can do any job in the national economy. It doesn't have to be in the same field as your education or previous work or even making the same amount of money.

Disability Evaluation Under Social Security-
www.ssa.gov/disability/professionals/bluebook/general-info.htm

Post Edited (Mercy&Grace) : 3/15/2014 8:52:22 PM (GMT-6)