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My appointment at Pain Management is tomorrow..

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Chronic Pain
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Posted 10/16/2013 2:48 PM (GMT 0)
I seriously have had the roughest 6 weeks I can remember.My lower back,lumbar,is shot.

I've got to somehow get across to them that I need help.

I have trouble telling Doctors,Physicians Assistant,etc.. exactly how bad off I am.

I'm at a breaking point and I need their help.

I'm taking Nucynta ER 150 x2 with no BT meds and it isn't working.

I'm not going to suggest anything unless asked and am not sure what that would be.

She might see a grown man cry tomorrow.

Hope y'all's day is going well,
RICK
Posted 10/16/2013 5:08 PM (GMT 0)
Rick,

I recently had a disastrous appt with the new PA at my PM. She clearly didn't like me and seemed very hostile. She changed my meds, which put me into withdrawal until I saw the good PA a few days later.

For the second appt, I brought with me a "Pain Portfolio" which includes x-ray and MRI images, photos of all the adaptive devices and furniture I have around (custom chair, etc.) and even a printout from Amazon for all the TENS pads I bought over the last year.

Maybe, gather up similar stuff in your life, put it in a folder, and when you see the doctor, express how much trouble to you have explaining what's going on and ask that they first look at the portfolio.

It may also be worth explaining what you can't do -- that you're forced to spend X hrs in bed, can't do Y and Z, etc., that the pain is just not being managed well enough that you can have a life... that you needs something to help bring down the pain so you can be with family, work, etc..

I well understand the sense of a "breaking point" as I was in a real crisis through the summer. My new med change is making things modestly better, fortunately, but it seems pretty clear that you need some BT meds and maybe a different time-release med.
Posted 10/16/2013 10:54 PM (GMT 0)
Can you ask that all your appointments are with the Doctor and not the PA.? Or maybe look into getting a new Doctor if possible. Sometimes this isn't worth the frustrations your going thru, so maybe see if there is another Doctor or another pain management clinic in your area. It's hard to lose a good doctor because of his PA, Maybe write this doctor and explain what this PA is doing and how it's hurting you...I sure hope something better can be done for you. Prayers and well wishes...
Posted 10/17/2013 1:24 AM (GMT 0)
Hey Rick. Generally all Drs have to ask either by an intake form when you sign in or when you get back there. The rules for charting on patients on a class II med is clear on what has to be documented.

That's your cue!! If your med and or amount isn't working that is the opening you use to jump through and honestly say NO its not working and its leaving me curled up in a ball in bed 5 days out of 7? That's how you make your move to change it, up it, add a b/t if you have a Dr that utilizes them, and if you dont feel the nucynta is a good choice of med for you no matter what the dose tell them you dont really want to go higher with it due to all the things you've seen regarding side effects and dangers and is there possibly another medication altogether you could try?

Honest, to the point, clear and concise you are the only person who can get your Dr to treat you adequately if he's going to. If not then I certainly would be "shopping " for a new PM.

Good luck!
Posted 10/17/2013 3:29 AM (GMT 0)
Good luck tomorrow Rick. I agree w/ just being open and honest - on how much your quality of life is affected. I would use the words you've used here - that you are at your breaking point. That your pain is seriously compromising your QOL. I would suggest writing down anything else that is relevant - for instance, time taken off of work; time spent in bed; inability to do basic life tasks; whatever your situation is - get it down on paper to either tell the doctor.... or type it up and give to the doctor.

Anything else that you think might help your situation - tell the doctor! If you are in tears daily.... if you are withering in pain...... whatever the case - you have to let them know.

Are your meds the equivalent of taking water? Let them know that. If you get slight relief, let them know that.... whatever the case.

Let the doctor know you can't continue living this way - and that you HAVE to try something else in terms of medications, injections, etc. That you are open to anything.

Good luck. Remember to advocate for yourself by sharing any and all relevant information. And please update us and let us know how it goes.

--Tina
Posted 10/17/2013 3:16 PM (GMT 0)
Thanks for all your responses.I'm less than 3 hrs til my appt.So I'm just relaxing,or trying to.

I don't see the Doctor there.I've only seen him once in 6 months.

But that's fine.I like both P.A.s.I've never asked for anything before.So,I think they'll work with me.

I've let them give me 3 injections in my Rt. knee and 3 lower back injections(procedures).

I think the main thing is being able to communicate how bad it's gotten.

The RN will ask the same questioner about pain levels.

I've just got to open up and tell the P.A. that I'm hurting a lot worse than I was 6 months ago and I'm going to ask her for help.

Hope y'all's day goes well,
Rick
Posted 10/17/2013 3:28 PM (GMT 0)
hi there rick, sorry to hear about your pain in the lower back area.
been there myself. i can understand about talking to the doctors also
as in there were times i would just clam up and not mention some
pains i was having.i'd get to a point where i would write things down so
i could talk to the doctor and then theres the meds discussion.
even though i was in a lot of pain, i wouldn't ask for an adjustment
because i was afraid he would think i was just looing for drugs.
which wasn't the case. i've really been lucky that i've had good doctors
well good luck at your appt. today and i hope things work for ya....
Posted 10/17/2013 10:08 PM (GMT 0)
Well I just got home and I am very happy.I love the P.A. there.She is so sweet.I thought she was going to hug my neck.

Vickie,you were spot on about the questions they ask every time.The P.A. said that she'd noticed that my Medication's effectiveness had decreased every visit.I really hadn't thought much about the pain levels and percentages that I'd told them til today when I said my Meds were 30% effective.

She said she thought I needed to change from Nucynta.

They wrote me a prescription for 60 30 mg Oxycontons.I have tried it before but have never taken it daily.

I can't get it filled til Sunday but I'm expecting great pain relief.

Hope y'all's day is going well also,
Rick

eta:Thank y'all so much for your advice and suggestions.All are exactly right.

I really don't know if I would have been able to communicate the things I did to the Doctor that I did to the P.A. that came in.

Right now she's my favorite person in the World.

Post Edited (tidalmouse) : 10/18/2013 4:24:29 AM (GMT-6)

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