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How do you convey pain to your doctor?

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Chronic Pain
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Posted 12/3/2014 11:13 PM (GMT 0)
Hello. I am new here. Joined because I have mid back pain that is KILLING me. Have had it for over 2 years. I have been to 2 orthopedic surgeons and 2 pain managment doctors. So, I am on my 4th doctor now that is a pain management doctor. He says I have intercostal nearol something or other and last month did injections into 4 of my nerves. It helped for 2 days but that was it. He wants to try electricl waves into the nerves next. Waiting for insurance to approve it.

Anyways, I was taking Oxycodone 10 mg for about 3 months. At this last appt he switched me to Hydrocodone 10 mg. This new one takes my pain about 10% away. The old one took about 60% away. Im wondering why he switched me to something weaker? Im thinking he doesn't believe me that I am in terrible pain. I hate the position he has put me in feeling like a druggy or something asking him for the Oxycodone back.

What do you guys suggest for me? Get a new doc? I made an appt to see this doc next week so I could try to explain to him the pain I am in. I am literally getting depression dealing with this. I just need help knowing how to convey myself I guess so he will beleive me. UGGGGGGG.
Posted 12/3/2014 11:54 PM (GMT 0)
Hey HC.Welcome to Healing Well.

Just be honest.Tell your Doctor that the new medication is not as effective as what they had prescribed before.

A lot of Doctors want to be the one making the decisions on what Meds they write you.What I mean is they don't like when we,as patients,ask for particular Meds.

Be honest.If you're in more pain than you were before the Med change then tell your Doctor that.

It makes sense.Oxycodone is quite a bit stronger than Hydrocodone.

Just be calm and discuss it with your Doctor like you're talking here.If they are a Pain Management Doctor they should want to get you out of pain.

That's just they way I feel.I think my Doctor and me are in this together to manage my pain.She writes the Meds.I tell her if they're working.

I hope you get the treatment you deserve.

Rick
Posted 12/4/2014 10:10 AM (GMT 0)
Hi HC & welcome to the forum. Sorry to read what you have going on with the upper back pain. I read that the injections the dr did gave you relief for a couple of days & now he wants to do ablation of the nerves which is done by radio frequency. This is a very common procedure they do these days & many get relief with this procedure. I do know that prior to doing the actual procedure the dr will do some diagnostic blocks to see if a person is a candidate for the RF ablation. Since you did get relief I bet that is what the injections were that he did on you. Had you not got any relief he would not be trying to get it approved.

I am wondering if he lowered your medication to see just how much relief the ablation gives, this is my thoughts on why he switched the meds. Did you ask him why he changed the medication? Any time a dr changes the medication usually they will tell the patient he is making the changes. If he doesn't then you need to ask.

With the atmosphere being as strict as it is towards pain mgt these days I would be very careful about trying to switch pain mgt drs. The last thing you need is to get labeled as dr shopping, then no pain mgt dr will take you on as a patient. I am not sure if you know about the rules & guidelines these drs are working under or not. Things have really changed in the past 2 yrs & its not good for the patients or the drs.

Anyway, welcome to the forum & take care.
Posted 12/4/2014 10:41 AM (GMT 0)
Hi.

I agree with Susie.

Changing docs is probably not a good idea at this time--with all that's going on in the wonderful world of pain management. Very much a good idea to talk to your doc, find out why the switch in meds, ask lots of questions about what the plan is for treatment, etc. You have a right to ask your doc what he/she wants to do and why. Ask them where to get more information, the exact name of the procedure(s) they want to do, get informed on your condition, the treatments, meds, and also read up on how pain management is changing--things are getting really strict about obtaining meds (who, what, when, where, how).

It can be rather intimidating, but the more you know, the better. It's important to be informed also so that you can effectively be your own advocate. It will help you to understand how things work, and when/how/why you may want to question a decision made regarding your care. We really have to be our own advocates when it comes to any doctor or healthcare personnel, more now than ever.

The RF is something I have had a couple times now. Lower back, both sides, has worked pretty well for me. Definitely worth it for me. Had it done end of summer/beginning of fall 2013, repeated about a year later. While I still take my same pain meds now, the improvement has been significant. I do not think about pain 24/7. Sure, certain tasks, etc, still cause quite a bit of pain, but like I said, it's not on my mind every minute of every day. Wow, what a wonderful thing that is!

Good luck with your doc and always feel free to post questions here. People here are really smart, not to mention very kind, caring, compassionate, and supportive. You have found a great resource with the people of healing well.
Posted 12/4/2014 11:41 AM (GMT 0)
I would have to agree with the others as far as seeing a new DR and return to the old one and just tell him that this medicine isnt working like the other one and leave that ball in his court You could go into how much more you could do on the other med and how much less you can do with the hydro. These meds although similar in dose work differently in each of us,some will get better relief with 10mgs of oxy while others get better relief with 10 of hydro so I am sure he has heard this story before. As far as giving you a weaker med he didnt do that and actually gave you a med equal to the oxy but still different and it just isnt working as well for you. They are the same class,equal too each other and the same stigma is attached to both pretty equally. Drs just have favorites and this may be his.

That would be my first choice of what to do and seeing more then one prescribing DR is a NoNo and can and will leave you without any care at all. Do you have a contract with a previous Dr? Sign anything about not getting meds from anywhere else? You also have to understand that far more Drs do NOT prescribe opiates these days as a first defense and the new one may not prescribe them at all and if the old one finds out he will not see you again and then no Dr at all. You have to be very careful and as for being treating as a junkie? We each deal with that from some one or another everyday in our lives.
Posted 12/4/2014 8:15 PM (GMT 0)
You will have to be honest with your Dr. about one med working better than another, after all for 28-30 days a month you're the one managing your pain not him.

That one brief day you're at the Dr. most of the time if you're in really bad pain at the office they won't work on you. If I'm dying in pain I get my scripts and I'm out. The days I feel good enough for him to work on me then that's what we do.

My next appointment (12/10) I get 3 trigger injections in my neck. I'm also going to talk with him about switching my meds around, not that they don't work but because in Florida we have issues getting if filled.
Posted 12/5/2014 9:26 AM (GMT 0)
Hey HC, just wanted to say hi and that you've got some really good advice here. I'll reinforce one item and add a new one too. I would definitely not tell the doctor what you want from him/her or anything like that. This person is like a little squirrel you are trying to get to come over and hand you his nut. He is very leery of you and you want something that he does not want to give if there is any alternative. So the part I will add is (as already said), be sure to tell him your experiences what you could do before and not now, the thoughts of depression. . .very important. But also, you need to be really flexible and willing to push yourself to endure and to try things you (maybe both of you) think have a low probability of working. You just need to be able to deal with things like what you are doing right now so that you can work out the best path to relief. This willing behaviour is good evidence that you are not just shopping for the most abused drug on the planet and that you are a reasonable person. In my experience, if you do those things and the others already mentioned you will be kept in a tolerable amount of pain. . .in part by expanding your definition of tolerable. That's the best you can hope for PM and I hope you are in a place where you can get that standard of care.

Hey, welcome aboard! This is a truly great forum and there is just plain nothing like knowing the rest of us are out here dealing with similar stuff and getting what you are saying. . .and all the mods are angels. Literal angels that also fit the preceding sentence.
Posted 12/5/2014 1:07 PM (GMT 0)
Welcome :)

My doctor is happy to prescribe what works. If one thing doesn't, we try something else. I agree with everyone else that it's usually NOT a good idea to ask for something specific, but I think that it is well within your rights to ask why he switched you from something that was working to something that isn't.

That said, it will take time to build trust with your PM doc. It will take a couple (at least) of visits where you have good pill counts, running your reports to make sure you're not being prescribed narcotics anywhere else, exploring options beyond meds (which you're certainly doing!) and probably a few UAs to get him to trust you. At that point, perhaps he will be a lot more open to options.

My doctor is surely aware that I'm not a drug seeker because of the fact that I've gone through two nerve blocks without sedation. Anyone out there that just wants to get high or sell the pills on the street, I don't think they'd put themselves through that.

Have you read the sticky "Chronic Pain 101" at the top of the forum page? It's very helpful when you're just getting started in this world of dealing with CP.

Glad you found this forum, you'll get a lot of support.
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