OT - my back - and emotional distress

poet_kelly
on 4/17/12 10:55 am - OH
I'm gonna get a second opinion and was thinking of the Cleveland Clinic.  I'm not that concerned about addiction, really.  I mean, I certainly don't want to get addicted to anything,  but I'm more concerned about being on heavy duty pain meds that would make me unable to drive or things like that.  It's my understanding that using pain  meds as prescribed when you have a lot of pain does not usually lead to addiction, although I'm sure it could in some cases.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

Lady Lithia
on 4/17/12 11:26 am
My PCP, while not a pain specialist by any means, is acting as my pain management doctor -- This is an important service he provides for me -- Particularly as long drives to get prescriptions from the nearest actual pain specialist would entail a drive of 100 miles round-trip.

One thing that my PCP said regarding the narcotics was that there are two issues involved with them. Dependence and Tolerance. He said that addiction -- as in abuse of the meds -- isn't likely because I am taking them for a known reason. He said if I stop taking them, I'll hurt, because I'm taking them for pain, and without them I'll feel the pain. More insidious is the "Tolerance" issue.... in that as the body becomes more and more used to the narcotics, they have less and less effect. I can tell you now that the meds I take today -- four years ago and I'd be a mind-muddled mess and unable to function .... but I've had issues with tolerance, so the pain meds the way they are now don't really affect me cogntively like they would have when I first started. I need to have a conversaton wth my doc about the background meds, upping them, or increasing the frequency so that they are more useful.

In any cases, I just wanted to point out that my PCP was far less worried about addiction than he was about tolerance and the side effect of pain if I come down off the narcotics.

One of the things that used to bug me.... mum was dying of cancer, and the docs kept saying, "we don't want to give her too much pain medicine, that will get her addicted." I was like Really? really? she's going to die in the next couple of days, and you're worried about addiction? Made me want to smack a few docs upside the head. Idiots!

~Lady Lithia~ 200 lbs lost! 
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!
giraffesmiley.gif picture by hardyharhar_bucket

JUSTJUNQUIES
on 4/18/12 12:59 am - Citrus Heights, CA
RNY on 04/04/12
I wonder if the gel injections would help with your back ???SUPARTZ, . Pain patch? Pain pump?
Not all "pain specialists" are the same , I took my daughter to one ( because she couldn't drive) , we went in and she was USING A WALKER , pale , unable to stand straight , looked like death warmed over and the "doc" jumpt on the ground and told her she needed to do yoga and he showed her all these things she should be doing...I said what the F???? she can barely breath without passing out and YOU want her on the floor??? fat chance, she went to him a few times and then we fond someone else.
Just because you have a DR. in front of your name does not mean your aren't  an idiot.
My PCP passed me off to the phisiatrist - sports/pain management , he thought I would be mad at him and I told him I would go to ANYONE who would help me, and I love my 12 year old doc, I am not out of pain , but I am so much better than I was !!!

Donna Q. --5'8" -60 years old
Band 2005
hw320 sw276 lw with band 195 gw 160-180? 
Bypass 4/4/2012
pre sw 258 lw RNY 162 cw 203

poet_kelly
on 4/18/12 3:39 am - OH
My mother also suggested I try some yoga.  I've taken yoga classes in the past.  I cannot possibly imagine doing it now.  I mean, I can't bend over.  If I got on the floor, someone would have to help me get up.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

JUSTJUNQUIES
on 4/18/12 4:13 am - Citrus Heights, CA
RNY on 04/04/12
I actually damaged myself more going to a yaga class.!!!! I do think strengthening your core muscles is very important ,  even if it is a struggle

Donna Q. --5'8" -60 years old
Band 2005
hw320 sw276 lw with band 195 gw 160-180? 
Bypass 4/4/2012
pre sw 258 lw RNY 162 cw 203

Leisa L.
on 4/17/12 10:50 am - long beach, CA
RNY on 03/19/12 with
I see  a pain management doctor for back and hip pain.  She helped me ween off all my nsaid's when I told her I was having bypass surgery.  
I asked her what should I do if the intense pain returns she told me there are other meds that I can take that aren't nsaids that could help control the pain.  
I right now am not in intense pain although I am in pain daily.  I use Lidoderm patches when it gets above tollerable and those help, but as far as intense pain, I know that fentanyl patches have worked for me before and I am sure I could go back on those again if an oral med just doesnt work.  
If your ins. covers seeing a pain management doctor, I would recomend it. (might have to get a referal from the doctor you just saw depending on what ins requires).
They dont all shove oral pain meds at you and if they understand your cir****tances, most are willing to work within those restrictions to find something that would help.
I plan on using the fentanyl patches again if pain gets out of control.
I hope this helps in some way. I really like my pain management doctor.
She helped me go from 85% bed ridden to now where its barable (I have a high tolorance also).

Leisa

    
bridie_53
on 4/17/12 11:04 am - IL
RNY on 05/16/12
 PAIN MANAGEMENT SPECIALIST PRESCRIBE IN A WAY FOR YOU TO CONTINUE TO LIVE your life daily. That is the ultimate goal. Go for it!
                
Lady Lithia
on 4/17/12 11:18 am
He doesn't sound like he's very empathetic. One of the things that really helped me was to see an orthopedic pain specialist. Believe it or not, even though he did prescribe me pain meds, To his perspective, he was there to try to alter whatever was causing the pain, to help the body to heal, and to move the patient towards independence from both medicines and from seeing him. He was very much an action man, and immediately he focused on the cortisone injections as a method of reducing the tailbone swelling and ultimately reversing the trauma that caused the overall pain.

In my case that didn't work out as you know, and I ended up having it removed. But I was truly impressed with the Pain specialist in that he didn't get me on a pain contract, and he didn't even begin to go to a pain-medicine mentality in the entire time I saw him. Like I said, he gave me pain meds, but it was never as part of pain control and meant to be a permanent thing. In fact, once he realized that nothing that he could do would eliminate my pain, rather than just saying "Okay, let's get you on a pain contract and dope you up for life," instead he said, "Let's get that sucker out," and he actually had to do the shopping around to find a surgeon who would remove my tailbone.

So my point is, an orthopedic pain specialist might be able to look more clearly at your issues and discuss methods of helping you to conquer the pain. Yes he or she might give you pain meds to help in the interim, but there is Radio frequency Ablation, the nerve block you mentioned, and they even have some fancy things they're developing using Botox of all things.

~Lady Lithia~ 200 lbs lost! 
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!
giraffesmiley.gif picture by hardyharhar_bucket

Jennifer M.
on 4/17/12 11:46 am - MN
RNY on 02/17/12
Addiction is the least of your problems if you are having severe pain.  I'm glad that you are getting a second opinion.  It sounds like this doctor had a very small bag of tricks.

I'm always amazed that doctors attempt to predict pain by looking at MRI's.  While you can see orthopedic damage with and MRI, you cannot actually see pain.  It's such an obvious concept that I'm always a little surprised when doctors try to tell me that I shouldn't be having so much pain from my knee damage.  It's always such a clinical opinion, too.  I'm like... so I can't climb stairs, but I should be able to?  How does that help me?  A few years ago, I had a bumper fracture of my left fibula (left knee, rear quadrant) when an SUV ran into me as I was crossing the street.  I went to an orthopedist who said that although they could see my fracture on the MRI, they thought that my pain was referred pain from some degenerative knee damage I had.  When I pointed out that the pain was in one knee only at the site of the fracture, I got a blank look.

Oh well... one of the reasons I had my RNY was to delay the need for knee replacements.  Even the weight I've already lost has helped immensely, BUT the knee fracture still hurts all the time (especially when it gets rainy).  

I'll be thinking of you and hoping you find some relief soon.  
    
Jenya37
on 4/17/12 11:57 am - Cloquet, MN
Just wanted to chime in- I work in the addictions field, and ANYONE can become addicted.  Most of the women that I work with became addicted to opiates for legitimate pain. The two hallmark features of opiate addiction are tolerance and/or withdrawal.  (This would qualify someone for a DSM modifier  "with physiological dependence."  Once someone becomes dependent on a chemical, that's where the addiction behaviors start.  Dependence and addiction are not that far from each other.  Many of the chemically dependent women that I work with have a history of drug seeking, which may be what your doctor was concerned was happening.  And believe me, you would rather find out the root cause of the pain than become addicted to opiates.  It is a hellish addiction.  Think the movie "Riding in Cars With Boys" with Drew Barrymore and her husband becomes an opiate addict.  You won't die from opiate withdrawal, only wish you would (it's that bad). By the way, hydrocodone (originally marketed as non addictive) is simply synthetic opiates, many people say are more addictive than heroin. Lots of clints most recently addicted to Opanas (another synthetic opiate).  Not to scare you, but just be careful.  It CAN happen to anyone. 
Jennifer
    
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