Be prepared when you go in for PMD appts

Great subject, Merrida.

Yes, go in prepared. Write down what you're there for. Just don't make the list too long. Where the pain is currently and if the med or injection last time worked. And no more than one extra, new complaint. Even one new thing every appointment can make the doc want to dump you, maybe not listen.

I think I've had too many things hurting and the pain doc can't handle any more for a while. I'm not supposed to come back until it's time for a new med visit in December.

No, everything is not alright. Thank you guys for asking.

It was a disaster yesterday morning.

I went in to see my PMD for migraines. Separate issue. Next Thursday is my routine 28 day f/u for my back/hip/leg stuff. While nothing's changed, my migraines have recently gotten worse.

I've had them since I started my period, great, hormone related....I'm now not only post menopausal but I take Femara which is an estrogen depleting drug.

She repeatedly referred to it as "hormone replacement" and that my migraines had a hormonal component.

Asking how I was doing over all I said how I've never felt more balanced, I'm more functional, doing more, even have lost weight (which doesn't happen on these hormone depletion meds, usually a gain of 10-15lbs is normal), I'm happier, healthier, more active.

I even told her that we had company this weekend we haven't seen since Christmas and they were amazed at well I look and am doing (I was previously a lump on a mattress, not social and always wincing in pain).



Her reply was, "That's good and all but our goal here is to get you off opiates. We discussed this before,...this is only short term."

And I'm baffled thinking,....we did? Since when? What happened? I've been on opiate pain meds for over 20 years. I'm on what is probably the lowest dose of both ER/IR that I've ever been on, EVER,....my neuro surgeon, my PS, my oncos, my PCP, my PT,....and Hubby of course,....have all expressed how remarkable I'm doing.

Top that off with how I just now came out as confronting childhood sexual abuse and I'm in therapy twice a week for that....

I got new dentures several weeks ago....

These, to me, are things that can trigger migraines.

I've been on Femara since 4/4/14. She wants me to call my med onco and see if this is related. Fine, I will. But I'm talking recent exacerbation.

Then she tells me I'm probably getting rebound headaches.....(did she forget I take ER and IR both?) It would appear so.

She wants me to, for now, rub 2% lidocaine on the base of my skull and left temple 3 x day.

Other option: RFA

I do NOT get migraines every day. Didn't have one yesterday.

I had worked out and was feeling hyper/happy....and I can get quirky and excitable when I've had good workouts. Working out is my holy grail and my happy place and my safe place and the one place I have total and absolute solace. As long as I can work out I'm happy. Even if we do have extra dog hair in the house and dishes in the sink and a load of laundry waiting.

I'll get to it.

I'm not happy guys.

She said we'll talk more about it next week, but I am in a full freak out mode because I'm on low dose meds, I've made exceptional progress. I'm only doing PT once a week instead of 3 x week because insurance runs out and I have to pay cash, so I cannot afford 2-3 x week.....so it's not like I'm getting "that" better.

I'm confused, I'm scared, I feel like I did something wrong, there was miscommunication, even misunderstanding on what "pain management" is supposed to be.

So much stuff is coming up, out and going on,....I feel like I may be losing my foundation....

(Sorry for the super long post)










M.

Sorry you had a bad appointment. I hope things start to look up.

I'm sorry if this is off-topic, but I absolutely HATE the fact that we feel like we can't be honest with our docs because they might think we're drug seeking! I have at least 2 new concerns that have come up since my last visit. Am I supposed to keep those to myself because of what my PMD might think? I just can't do that. If he and I are truly partners in my health care (he says I'm the captain, he's just one of the navigators), then I should be able to tell him what's wrong. I understand the need to tread lightly, especially when you're with someone new, but right now I'm in a TON more pain than I feel I can handle, and my appointment isn't for another 10 days. So what am I going to do until then? Suck it up, grit my teeth, and aggravate my injury even more because I simply can't sit on the sidelines of life with three kids. Argh! Sorry for the rant but I do think this is relevant to your post, Merrida. Again, sorry for the bad appt. Gentle hugs.

Jp your absolutely right,the entire PM,quality of life issue is centered around the question " does my current plan of treatment" provide me with a better quality of life? Now mind you that aspect(Dr prescribed) is not solely responsible since I have a obligation to contribute and participate on a continuing bases. We can not,must not expect that the prescribing Dr alone is the control factor and any failures of our PM is not his alone to carry.

My Dr is ecstatic when I can continuously validate alls well and I am surviving this,even managing to enjoy a few things long forgotten how to. It means what we're doings working,I'm stable at this time and if I stay that way we look at whether it's possible to back down on something. It's a known fact that the very treatments we use are working against us and causing untold issues with our health much like radiation and chemo,the benefits have to outweigh the risks. Look at the things we have to do to counteract the opiates and Neuro meds. Many times taking other meds to achieve the balance.

Chronic constipation is not normal nor healthy. Nausea is not either,some people who are extremely susceptible to opiates require a med to counteract the lethargy,sleep aids to reverse the insomnia associated with opiates many experience. Weight gain is a potential issue with most opiates as is fluid retention,and cardiac issues. All are detrimental to our health and longevity of life. Medicine in general has to weigh benefits over risks and thats with all treatments,surgery and procedures. First do no harm!!

In saying that any progress in the ability to function with the lowest risk possible is going to be any Dr worth his salts goal and should be each of ours as well.

And we love you too! ! Now get back to the plan.