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Title: Would someone explain pain mgt to me... Post by BarbaraD on Mar 5th, 2006, 8:08am My daughter-in-law (an RN) works for a pain managemnt doc and it's NOT what I thought it was. I thought Pain Management was where you learned to deal with the pain - NOT where you went to get drugs! From what I'm getting from her, they dispense drugs more than anything else - and some GOOD ones at that. They run tests to make sure everyone is taking them the way they're prescribed, but this isn't what I thought pain management was all about. The reason I bring this up - she was threatened by a "junkie" cause he didn't get his "fix" (he'd taken all is meds too soon and she was his target when she told him he couldn't have any more). I just think something doesn't sound right about this doc. He's seeing up to 75 patients a day and dispensing this much drugs. Anyone been to a pain management clinic? I know we've had discussions on them in the past, but can't find the threads. I was under the impression that these clinics were to help you get "off" drugs and learn to "deal" with pain thru other methods if possible. Anyone -- if you can give me some insight on this I'd appreciate it. I just can't believe this is what these places should be doing - even in LA. Hugs BD |
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Title: Re: Would someone explain pain mgt to me... Post by Grandma_Sweet_Boy on Mar 5th, 2006, 8:22am I don't know about a private clinic setting, but in a hospital - the Pain Management Team is generally there to try and find the meds that do work to control the severe pain. When our grandson was in hospital - he had a Pain Management Team and they were wonderful in helping to figure out which meds would take the pain levels down to something a 2-1/2 year old could handle without turning him into a little zombie. When it's a private clinic dispensing meds - I too would wonder what it's all about. In my field of work I find those types of clinics are generally designed to help people find coping mechanisms and treatments designed to help with pain, rather than feeding them more meds. They're also damnably expensive but they are not prescription centres. Interesting thoughts Barb - wonder what's really going on there? Hugs Carol |
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Title: Re: Would someone explain pain mgt to me... Post by purpleydog on Mar 5th, 2006, 8:43am Pain management clinics evaluate your pain, your physical health, your psychological health, then decide on a plan of action to deal with your severe chronic pain. Docs do dispense pain medicine to manage chronic pain, and if taken as directed, does not cause a problem. That is why they test people's level of meds in their system, to make sure they aren't over doing it. They also have patients sign contracts to agree not to take more than the alloted supply, and if you run out early, then you are stuck. Pain clinics also employ ansthesiologists, who deal with severe pain by implanting a pain drug release system in your body, usually a morphine drip of some kind. That way it takes much less of the drug to be effective, than taking it in another form. The anesthesiologist then has to replace the drug in the pump, and only an anesthesiologist is licensed to do this. Please be aware, most people who are going to a pain clinic only want their pain load to stop, or lessen. They know they won't be totally out of pain, but get just enough relief so that it is not at the front of their mind, so they can concentrate on other things besides their pain. They also use other ways to help people deal with the pain, especially break through pain, but in most people's cases, drugs are the only way to get any relief. The doc may use a combination of pain meds to reach this goal. Pain medicine is the most common way to help people to acheive this goal. People just want to be out of pain, not to have the doc be their drug supplier. There are lot's of conditions that will put you in chronic pain, and severe chronic pain at that. I don't begrudge anyone pain relief. Not evey patient is a "junkie". That's pretty rare, actually. Patients are screened with a psych evaluation, and have to go through testing, before the doc determines if the patient will be helped by pain management. Some people are turned away. Most people are helped. Yes, there is a physical dependency that happens while on some drugs, and when you stop taking them, your body goes into withdrawl. But with most pain management patients, the psychological dependency isn't there, so addiction isn't a problem. |
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Title: Re: Would someone explain pain mgt to me... Post by BarbaraD on Mar 5th, 2006, 8:55am What really bothers me is that they're dispensing Meth a whole lot. Isn't that what atticks take? Sorry, I'm not up on drugs. Aspirin is about all I have in the cabinet for pain. (Actually Aleve and Advil - depending on which kind of pain - reg or arthritis). But 75 patients a day -- that guy doesn't even have time to READ the charts much less figure out what the patients NEED! This has really got me worried. Hugs BD |
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Title: Re: Would someone explain pain mgt to me... Post by purpleydog on Mar 5th, 2006, 9:18am Methadone is a legitimate pain control medication. As with most meds, it can be used for more than one thing (think verap, BP med, and CH med, etc... ). Yes, methadone is used to wean herion addicts off of herion, and maintain them. It is also a damn good pain med in itself. The great thing about methadone, is that once you find the dose that works for you, you don't need to adjust it upwards, because the same dose will continue to control your pain. With other pain meds, you develop a tolerance to them, and your dose has to increase in order to control the pain. Methadone doesn't work this way. You can be on the same dose for a long long time, and it will continue to work. Methadone has a bad reputation, just because it is used to help herion addicts stay off the heroin. But it works great for pain control. edited to add: Most docs are familiar with their patients, it's not like these people are walking in for the first time, so he may not need to read the entire chart every time a patient comes in. |
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Title: Re: Would someone explain pain mgt to me... Post by FramCire on Mar 5th, 2006, 9:29am I went to the local Pain management doctor when I had the disk problem in my neck and shooting pain in my arm. I got shots in my spine (I would have got pain meds but I already had them). These shots were part of an attempt to fix the problem (with PT) without surgery (which I later had). I think the previous poster was mostly correct but I believe that people with chornic pain that are untreatable fall into 2 categories. 1. Legit pain that needs to be managed. 2. Drug seekers (most likely addicted from a previous injury/painful condition). Since it can be tough for your family doctors to distinguish between the 2 in cases where there is no good test to show the injury/condition, the pain management doctor is a great resource to send these patients to because they have more experience in figuring out the difference between the two. Anyway, most people with chronic pain probably need drugs in some form to help. Shoot, I had wondered if I should contact the doc about my CH and see if it was something he knew anything about but found a headache clinic 25 miles away instaed. Our local pain management doctor is a very good guy. However, I get a feeling drug seekers wont be happy when they get reffered to him. Also, I am shocked any doctor sees 75 patients a day without PAs or NPs working with them. |
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Title: Re: Would someone explain pain mgt to me... Post by FramCire on Mar 5th, 2006, 9:34am BTW, no doctor has the time to read the entire chart on a patient. The nurses job is to gather all the info and takes notes that will allow the doctor to "know" the patient without reading the entire chart. Obviously, it is the patient's job to tell the doctor important things that are relevant (to the best of his/her knowledge). If a doctor has good nurses, they can see a lot more patients per day, although 75 is a ton more than I can imagine. |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 9:40am Mthadone is also one of the most difficult meds to detox from. |
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Title: Re: Would someone explain pain mgt to me... Post by purpleydog on Mar 5th, 2006, 9:44am When I went to see my doc, he and I went through my chart page by page. We discussed all the docs I had seen, and all the meds I have tried, and everything else that was in it. This is an intake appointment, and this takes a long time. Not your usual, 10 minutes in and out, then lets start treatment. And don't forget the testing. So, yes the docs in a pain management clinic do read your entire chart. It's just that they don't need to re- read it on every visit, because they are familiar with you and your case, and only need to see the updated notes the nurse has taken when you are there for a return visit. The doc may have NP's and PA's, this wasn't mentioned. It would be hard, otherwise, to see that many patients, I agree. He or she would definitely rely on the excellent note taking capabilites of the staff, and the instinct of the staff. My doc works closely with the nurses, who also know the patient too. |
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Title: Re: Would someone explain pain mgt to me... Post by Melissa on Mar 5th, 2006, 9:47am This is a bit off topic, sorry. :-[ There has been only 1 RX drug I've ever been addicted to in my life, and that is Tylox. Has anyone else ever taken it or know what it is derived from? TIA |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 9:58am Tylox Brand Name: Percocet |
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Title: Re: Would someone explain pain mgt to me... Post by purpleydog on Mar 5th, 2006, 10:00am Tylox is a mixture of oxycodone, and tylenol. Also known as perocet. A lot of pain meds are mixed with tylenol, or ibuprofen, or caffeine to help them work better, and to kill the pain faster/ better. Oxycodone is a narcotic that relieves moderate to severe pain, and comes in many forms. You can become physically dependent on it. Your doc will wean you off of any meds that can cause physical dependency, so your body doesn't go into withdrawl, if you have to take them for the short term, meaning a few weeks or so, as opposed to months or years.Of course, you will be weaned off of any drug you stop taking, but when you say addicted, Mel, this was a physical thing, right? When you stopped taking it, you noticed the effects, correct? There is a difference between physical depency and psychological dependency. |
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Title: Re: Would someone explain pain mgt to me... Post by Melissa on Mar 5th, 2006, 10:05am on 03/05/06 at 09:58:13, chewy wrote:
Holy crap! I had no idea. That stuff made me feel so good! Not only with pain, but it made me so relaxed and happy.... NOT a good thing for someone like myself! Wow. Ever since that stuff, I would only ask for Tylenol 3 after having surgeries. It amazing the amount of rx meds rx'd to patients that are addictive compared to the illegal ones. Just WHO is right here anyway? :-/ (don't answer that, it should be for a different thread [smiley=laugh.gif]) |
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Title: Re: Would someone explain pain mgt to me... Post by Melissa on Mar 5th, 2006, 10:08am on 03/05/06 at 10:00:07, purpleydog wrote:
I guess you would have to say psychological? As it enhanced my mood, even when the pain was gone. I didn't want to stop taking it due to my outlook on everything had changed. When I did stop taking it though, it seemed like I dropped. I was very sad for about a month or so, and then things evened out for me again. |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 10:13am Then you were on the path of addiction. Glad you stopped when you did. |
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Title: Re: Would someone explain pain mgt to me... Post by john_d on Mar 5th, 2006, 10:14am on 03/05/06 at 09:18:36, purpleydog wrote:
I just saw an HBO special on that stuff, apparantly the heroin heads can take it with one of the Valium or Xanax family of drugs and it chemically changes it into a heroin high. If they can't get heroin, they can usually get Xanax and methadone- thanks to the taxpayers. What a sham. |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 10:21am A high enough dose produces the heroin high without additional drugs. You do however develop a tolerance to it in the sense that in time the heroin effect wears off at a consistent dosage. |
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Title: Re: Would someone explain pain mgt to me... Post by john_d on Mar 5th, 2006, 10:23am on 03/05/06 at 10:08:41, Melissa wrote:
I got some Vicoden, hydrocodone- an opiate as well, for a tooth ache and after I finished the bottle I craved more. Those opiates are scary. |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 10:28am The phenomenon of craving is one of the first indicators of addiction. Doesn't take much or take long for it to manifest. Especially in individuals who are predisposed to addictive behaviors. |
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Title: Re: Would someone explain pain mgt to me... Post by deltadarlin on Mar 5th, 2006, 10:49am on 03/05/06 at 10:05:18, Melissa wrote:
Hates to tell you this Mel, but Tylenol 3 also contains codeine. Lorcet/Lortab also contain a form of codeine, hydrocodone. As does Hycodan, Vicodin and a few others. ALL of them can be addictive. |
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Title: Re: Would someone explain pain mgt to me... Post by Drk^Angel on Mar 5th, 2006, 10:52am My GP once prescribed Percs for my CH (this was before I was correctly diagnosed)... When I had the follow-up, I told him it didn't help the attacks, but a double dose was almost enough to make me not care once the attack was over... He almost prescribed it again... "At least it does something." LOL Prolly a good thing he gave up and sent me to a neuro a couple of weeks later. PFDAN...................................... Drk^Angel |
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Title: Re: Would someone explain pain mgt to me... Post by purpleydog on Mar 5th, 2006, 10:53am on 03/05/06 at 10:14:39, john_d wrote:
Yes, it's too bad there will always be people who try to take advantage of the availablity of pain meds to feed their own cravings. And yes, the tax payers pay for it. But the tax payers also pay for the legitimate pain relief for a lot of people, i.e. those on disability. In my opinion, there are far more people being helped than users taking advantage. Because of the few who are abusing the system, it's not to say that everyone who is being helped, whether on disability or if they have private insurance, or not, should not be taking medicine for the relief of chronic pain. Just be glad you aren't one of those who has a psychological dependency, and are addicted, and has to search for your drug of choice, just so you can get high, so you can waste your life. And that is a monkey on your back, some people realize this and get help for it. |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 11:01am Quote:
Doctors are finally getting wise to that though. Most Docs will have you sign a contract now if they are going to Rx pain meds. They will also do baselines to determine if are taking the prescribed dosage or not. |
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Title: Re: Would someone explain pain mgt to me... Post by tanner on Mar 5th, 2006, 11:09am Barb, There are pain management centers like the one that I travel to the dc area to go to that would rather cut off your arm to give you something else to focus on then prescribe drugs. The team of doctors i see try all kinds of alternatives like acupuncture, bio-feedback, physical therapy, herbal remedies etc. Now I should point out that chronic back pain is what I am being treated for there not ha's. When we lived in California there was a clinic (so called pain mngt) that people could go to, say that they had migraines and trouble sleeping and walk out with a script for 200 ten mg Valiums and 100 quaaludes. often they did not even see the doctor himself and they filled their scripts right there at the attached pharmacy. We know this to be true because one Linda's sisters was a regular customer. Clearly a drug pushing scam. I think that the different law enforcement agencies have since cracked down hard on those kinds of places but it does not mean they don't exist. http://opioids.com/oxycodone/medicolegal.html I would think that your daughter-in-law as an RN would be able to tell the difference but I would be concerned also. ..........................tim |
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Title: Re: Would someone explain pain mgt to me... Post by lilboo on Mar 5th, 2006, 11:22am My husband was seeing a pain managment doc. and they put him on methadone, yeah they have you sign a contract but that dosent keep you from over doing it. I can tell when he's on it, I still think he takes more than is prescribed but he won't admit to it, his whole personality changes he becomes overly nice and spend happy, then when it runs out he becomes very moody and wants to sleep all the time. We changed Insurance companies back in Nov. and they are keeping him on the meth but they have yet to send him to a pain managment doc. By the way he does have a very addictive personality and was a drug user, he quit for about 4 months and was going to NA meetings, then he had his heart attack and they put him on pain meds. and that's when the vicous cycle started over. |
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Title: Re: Would someone explain pain mgt to me... Post by john_d on Mar 5th, 2006, 11:32am on 03/05/06 at 10:28:02, chewy wrote:
I would definitely say I have an addictive personality, no destructive addictions in my life yet though, by the grace of God I suppose, plus a little common sense and healthy fear. |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 5th, 2006, 11:48am Quote:
It also keeps you from under doing it. If the narcotic level in your system is below expectations then what are you doing with them? |
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Title: Re: Would someone explain pain mgt to me... Post by Cerberus on Mar 5th, 2006, 11:52am It should also be noted... Pain Mgmt. clinics are typically reserved for those with incurable chronic pain afflictions (i.e. terminal cancer patients, fibromyalgia (severe), advanced Rheumatiod arthritis, and so on.) Most of THOSE people are sent there when their regular doctors and specialists are at a loss to treat them or have expended the limit of normal treatment with no results. Not just anyone can usually be referred to a pain mgmt. clinic. and "generally" is closed to addicts for which there are other treatment options. 'Bus |
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Title: Re: Would someone explain pain mgt to me... Post by Melissa on Mar 5th, 2006, 12:04pm on 03/05/06 at 10:49:15, deltadarlin wrote:
I know, but I have never had a problem with codeine. I can go off T3 without a problem, and I never want to take more when my pain is gone. |
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Title: Re: Would someone explain pain mgt to me... Post by cootie on Mar 5th, 2006, 1:36pm my doc is quitting the end of the month cuz of the cost of malpractice insurence and he said he has to pay a huge fee if scripting certain pain meds too ta cover his ass. Plus he said the feds are watching docs and who they script to and why and how much BIG TIME now. They have to have lots of evidence the patient has TRUE chronic incurable pain isses to be allowed to be given narcotics. And they have to go in once every three months to be seen and checked. My doc is a good doc.....he was doing everything rite and following strick laws......but now I have to start all over again. Were hopein my new doc that was his old partner will follow with my old docs treatment plan but they all have different views on pain meds. Clinics can run some bucks with needing more MRI's and tests and things (I understand alot of that needs done of course) but they know insurence will pay for it and it becomes a big money pit. Our ins pays 80 % of what the bill SHOULD be and I have a high deductable. So been kinda happy to not have to take the expensive route yet.....my doc does blood tests off and on and knows me and trusts me. But alot of docs don't want that mess that goes with it anymore and won't script certain things. Too many drug seekers out there.......since I been goin to this guy so long I hope his partner trusts me and continues with what works. I just want to feel normal and not hurt head to toe. Not after a buzz what so ever. Feeling smashed and crumpled Pam |
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Title: Re: Would someone explain pain mgt to me... Post by BarbaraD on Mar 5th, 2006, 3:15pm Thanks for the info guys. Guess I really didn't understand exactly what these places did. I still think there's something "not right" about this particular doc Tam works for cause this is not the first time she's come home upset about a patient getting upset at her about not getting what they wanted or her not "fixing" their reports or one thing or another. As far as chronic cases (cancer, etc), I'm for giving them what they need to keep them out of pain as much as possible. My brother died with cancer and I would have bought morphine on the street for him if it had been needed (luckily he got all he needed). I don't want to see anyone in that kind of pain. Guess I've just watched too many trolls come on this board looking for drugs or something. Thanks again for the insight..... Hugs BD |
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Title: Re: Would someone explain pain mgt to me... Post by kcopelin on Mar 5th, 2006, 5:43pm The pain management program I went through used bio-feedback, progressive relaxation, guided imagery and hypnosis. I can bring my blood pressure down, slow my heart rate, even warm up my fingers (no kidding-that was over 10 years ago and I can still do those things) BUT it didn't help the clusters. In fact, the relaxation made them worse, which I understand now, but didn't then. Did help tension, anxiety and my ulcer. So, thre's different clinics, focused on different treatment modalities, and the best I suppose would be the ones that offer the widest range of options and truly personalize the treatment. PFDAN y'all kathy |
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Title: Re: Would someone explain pain mgt to me... Post by Karla on Mar 5th, 2006, 11:53pm I went to a pain management/ha clinic. They verified that I had ch and migraines and that I had tried all the meds under the sun. They had me try a couple of things like topamax at 900mg vs 200mg and another drug related to treating ha. Neither worked. So they tried me on methadone 10mg a very low dose. It worked but I was so tired all the time. So after a year of that I went off of it with no problem. Then I was put on the fentanyl patch also called the duragesic patch 50mcg. Where I have been pain free for the last several years. However, I have had breakthrough pain recently and my dr added to my diet an ace inhibbitor called lisinopril. I have not had a ha in the last 2 days!!!! So something is working I think. But pain management is where they try to give you the best quality of life posible and sometimes that involves narcotics. Now the pain management dr doesn't perscribe all the narcotics and drugs. They make the recomendation and it is up to your gp to see you monthly and give you youre script. |
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Title: Re: Would someone explain pain mgt to me... Post by nancyc on Mar 6th, 2006, 11:50am Sis, I go to a neuro/pain management doctor...I have seen several patients in his waiting room and heard some of the things they have said ...I was sure they were addicts and only there to get high...But guess what, I did not see them there again....He weeds out the folks that are there only to get high...My regular GP and I are very close...been going to her for 15 years..you should hear some of the horror stories she has told me about her experiences with addicts....You will find drug seekers in EVERY doctor's office....I am sure pain management doctors see their share but I am also sure they try to weed them out even faster because their practice is regulated so closely by the Federal government. Sorry Tam has to go thru that.....smiles, nancyc |
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Title: Re: Would someone explain pain mgt to me... Post by wildhaus on Mar 6th, 2006, 1:13pm Hi I am going to „pain therapy-management“ and the only „drug they will give me is the one that was tested on me and was doing good for me.............. O2 other than that some Zomig nasal……… And at the Hospital (where the clinic is located) they do the “Gloa” a Buprenorfin treatment using Temgesic injection for the “Stellatum” done by an anesthesiologist. And a TON of needles they call acupuncture I call chinese torture……… but seemingly doing good (for me) Michael |
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Title: Re: Would someone explain pain mgt to me... Post by Opus on Mar 6th, 2006, 1:31pm on 03/05/06 at 17:43:31, kcopelin wrote:
It seems that most people and doctors cannot understand that relaxation makes CH worse. I have seen many articles that say trip-tans relax the blood vessels, I guess because it is unbelievable to them that the opposite is true. Thanks all ( especially PD) for a thread with so much information. I have already sent someone to this thread. Opus/Paul |
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Title: Re: Would someone explain pain mgt to me... Post by cootie on Mar 6th, 2006, 4:51pm I don't mean to draq the subject out but I did ferget to add a few details in LIGITAMATE chronic pain suffers defense and good responsible docs. Anyhow.....me and my doc discussed meds and treatments in detail and he explain'd sum stuff goin on in the world today and answer'd sum questions for me. He is a good doc......hate to see him move.....and dread STARTING OVER. Anyhow...........he told me that any doc giveing out scripts for pain meds is watched EXREMLEY CLOSE by the DEA........they watch who is givein pain meds out and how much and how often....what for....and even to WHO. With the new time released longer acting pain meds that can mean a sumwhat normal day for a ligitamate suffer from spine or joint injuries or athritis stuff (esp things that never get better only worse) abuse has gotten worse cuz the stuff is in big demand for abusers. ONE pill can pack quite a wallop and last all day and even get a crowd high I suppose. Sum of the stuff has gotten a BAD rap cuz of it.....it doesn't give anyone a buzz and a good med for people needing sumthin and can carry on there jobs and do whatever in moderation and not feel dopey loopey or strange or even nausious. So I would imagine the doc that is givein out so much of it at the clinic possibly only see's chronic pain patients in and out his door so it would appear he gives alot of scripts out a day. But if he is givein everyone lots then tryin to jus CUT them off he needs a better plan cause that would be createing a problem. But for people in pain it's part of life. I'd imagine he is bein watched and if not got into trouble he has been following the strict guidlines. I suppose a pain clinic would be a big place that hands out lots of pain med scripts......and certain types of pain needs to be treated differently and not given meds if it is temporary stuff and theropy or whatever else mite work. I don't think people that hurt themselves need to be givein TONS of pills then CUT OFF......there docs should of taken a different route cuz addiction can happen otherwise. And then people will get used to taken the stuff and want more and crave it......and they shouldn't take it DAILY without bein sure they wake up and NEED it either. But for ch I don't see how any pain med would help....or bio feedback either. Maybe for stress or anxiety when not in cycle. OK that's my two cents on it.......the bad people make it hard on the good ones Pam Hope I didn't piss anyone one off in defense of a good doc with a good program with pain meds. I rotate meds and I do NOT get up in the morning and take a dam thing. If I need it......that's one thing......if I don't.....that's an even better thing. I appreciate the good meds can do and won't let myself be a victom !!! Wish me luck with the new doc.......hope he doesn't prescribe advil or tylonal for Brad's ch or my back crap and benydryl for insomnia. It could happen........not sure how he feels on O2 either so we are goin to go meet him and go over records this week. I am the QUEEN OF white coat syndrone.................................. :P back to my corner.............. |
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Title: Re: Would someone explain pain mgt to me... Post by marlinsfan on Mar 6th, 2006, 5:24pm I've been a patient of the Pain Mgnt Clinic at North Shore Medical Ctr in Miami, under Dr. Schou. He has treated the 2 herniated disks in my lower back and 1 in my neck. Dr. Schou's treatment is pretty basic: epidural sterioid injections under a flouroscope. He has fixed about 80% of the pain in my lower back/leg, and 100%of the pain in my neck/arm. He has only prescribed narcotics once after he did a disk nucleoplasty procedure in my lower back. He gave me vicadin for 10 days, I only used 3 days worth. |
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Title: Re: Would someone explain pain mgt to me... Post by purpleydog on Mar 6th, 2006, 5:40pm You and the doc will go over your records line by line I bet. I sincerely hope you don't have to start over from square one. Chronic pain sucks, and I wouldn't wish it on anyone. It really fucks up your life, there is no quality of life, there is no relief, and it's depressing as hell. People need pain relief to help them function so they can work, and actually be a productive part of society. You are right Pam, the people who take these meds aren't looking to get high, they are looking to feel normal. It sucks when you wake up in the morning, and can hardly get out of bed, cant move without your body screaming at you, and that's all you can think about, whether you want to or not. And you are correct about the docs being closely regulated, and to whom they are giving the meds to, and how often. There will always be a few who abuse the system, and drug seekers who will go from doc to doc to try to get scripts, but the pain management docs weed them out right away. You can tell when someone is in real pain, and when they are just saying they are. You can see it in their eyes. Plus the nurses who work with the docs are no dummies, they are the first to see the patient, and their opinions count, even though the doc has the final say. Makes me wonder about the security measures at hospital pharmacies, because they get the kind of quantities that a person could illegally acquire to sell on the street. |
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Title: Re: Would someone explain pain mgt to me... Post by Trapp on Mar 6th, 2006, 8:13pm Wow, there's a lot of great stuff in this thread, thank you. I almost went to a pain management clinc about a year ago in order to get off the narcs all the other docs had put me on...too bad I didn't know all this information then. I didn't go because I was afraid all they would do was to put me on more narcs. I know ya'll aren't docs, but I was wondering if anyone knows of a pain management drug (mainly an anti-inflamitory) that is not additictive? I've been on all kinds of narcs since I was about 10, and OTC doesn't work on me. I also get that craving very quickly, so I need to be very careful about what I take. Also, if I were to tell my doc this, would it look bad or would it look as though I am trying to do the right thing (which is definatly what I am trying to do)? Thanks, Sheena |
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Title: Re: Would someone explain pain mgt to me... Post by Jonny on Mar 6th, 2006, 8:29pm on 03/06/06 at 20:13:42, Trapp wrote:
It sounds like good start to me. Any time I go to a doc for any kind of pain the first thing I say is "I am not here for drugs, I am here to find the reason of the pain and correct it" I have to say this because of the way I look.....hair to my waist and full tattooed sleeves. Plus I quit getting high drugs 15 years ago ;;D Best bet is to be honest with your doc. Good luck!! |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 6th, 2006, 8:45pm Must suck explaining away the tatts and long hair at the bean supper down at the Grange Hall. |
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Title: Re: Would someone explain pain mgt to me... Post by Jonny on Mar 6th, 2006, 8:52pm on 03/06/06 at 20:45:25, chewy wrote:
I dont eat beans you punk ass sucker, dont make me come over there! WAIT!, you have the attack dog Tucker....nevermind :o |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 6th, 2006, 8:56pm "Fuck with me and you'll need pain management" http://img.photobucket.com/albums/v388/bgull2/pathetic.jpg |
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Title: Re: Would someone explain pain mgt to me... Post by Jonny on Mar 6th, 2006, 9:02pm I would never even enter the same room as that killer, just look at the "Wanting to kill" look in his eyes.......LOL ;;D Edit to add.....He is demon like.....LMAO!!!! |
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Title: Re: Would someone explain pain mgt to me... Post by Lizzie2 on Mar 6th, 2006, 9:05pm I only started pain management a few weeks ago, and I'm not going to our pain management clinic because I didn't like the way they do things. You have to have a referral from one of our docs, and they'll do the initial work, but they send you right back to your doc as soon as they put you on a med, etc. It sounded like they were treating everyone as if they were drug seekers right from the get-go, and I knew it would cause me more anxiety to be put in a situation like that. It's been hard enough for me to agree to pain management as it is, due to a number of reasons. But...I'm so glad I did. I'm still tired a lot, and I'm still trying to get used to the side effects, but my constant migraine has dropped to about a 5 average pain - something that hasn't happened for me in over 5 years - staying at a 5, that is. Right now, my back pain is worse than my head pain, which has never happened for me. I actually feel like I can think clearly. I'm needing triptans less, and my quality of life is improving a lot....albeit slowly! haha It wasn't a decision I took lightly. In fact, going on long-acting meds for pain was first brought up to me in the summer of 2003, and I turned it down. But a lot has happened since then, and some stuff has gotten to the point where I will lose it all if I can't get some of the pain under control. Didn't take my pain 100% away, and that isn't the point of pain management. But it did get it to a level where I could function. I'm still working on getting myself together, but I'm making progress, and I'm also trying to take things day by day. I am also on a lower dose than we predicted I would need, and I'm glad for that. :) The CH are still there, but I'm actually even tolerating them a little better because the REST of my pain is a little less. Sometimes too much pain just gets downright overwhelming. It's not for everyone. Very few people who take pain meds FOR pain become addicted, however - the number is only something like .0001% (that's not exact - but it's something very small to that effect). Lots of people are denied or refuse to take pain meds because they are afraid of addiction and instead that belief forces people to suffer in unbelievable pain when they could get some relief and try to get their lives back. I wasn't, and am not, afraid of addiction, but I was just worried about a lot of things. In the end, it was a choice I had to make in order to get a life that halfway resembles that of someone living without constant, severe pain. I'm glad I did it. :) Part of my story, anyways... :) Carrie :) |
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Title: Re: Would someone explain pain mgt to me... Post by chewy on Mar 6th, 2006, 9:06pm "Or maybe not" http://img.photobucket.com/albums/v388/bgull2/000_0020_0003.jpg |
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Title: Re: Would someone explain pain mgt to me... Post by Jonny on Mar 6th, 2006, 9:08pm He only looks like that cause you gave him a happy ending......LMAO ;;D |
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Title: Re: Would someone explain pain mgt to me... Post by cootie on Mar 6th, 2006, 10:49pm Sheena......have you ever tried Ultram (tramadol).......it's a synthetic and they have taken the addictive nature out of it and it fools the brain so it doesn't crave it as it does other meds. There is anouther version with tylonal included or sumthin in it also but forgot the name. Ultracet I think it is......tylonal (anti inflamatory) and thepain med supposidly work well together and fast. Doc told me there is a Utram CR now (long acting)......it's one of the things we talked about at my last visit last week before switchin docs since mine is leaveing. Anyhow......Ultram seems to work 'ok'......but for me it makes me feel a bit wierd and eyes a bit fuzzy which the other stuff doesn't do to me. (I'm into meds that leave me feelin normal......I hate stuff that messes up my day makein me feel it) It's not a bad med tho and what I WAS doing was routateing it and other meds so I didn't take one too long and it not work. You can get refills on this med too. It helped me with migraines when I get stressed or tense or agravate my neck injury when doin too much or out tryin to talk to people and sit in wierd chairs. (throws yer posture off) If I felt my neck tensein up so TIGHT I have actually blown muscle fiber (I do that alot actually....it's a mess) I'd take one or two and it seem'd to help it not develope into such a bad ha I would get blood red eyes and not able to move my head and cry like an idiot sitting there ! (no one understands that anyhow) DOESN'T mess ya up tho type stuff but it doesn't last real long if ya have alot of chronic pain.....not tried the cr version. It helped but ya gotta catch it early of course as with anything. Maybe that med would help you and you be able to get it and not worry. It's safer as far as being addictive so I've read and been told. Wierd thing is it is expensive.......other stuff I pay 10 to 15 bucks and that stuff I pay 50 bucks WITH insurence !! Quality pain Pam Man Lizzie yer so rite.........when pain overwhelms you cuz it is constant round the clock like someone jus dropped ya out of a moveing vehicle ya gotta figure out a routine to get back into life. Cuz it will eat you up.....I even get stomach pains when it all starts up in the mornings......seems to be a chain reaction of double side effects. PS: try goin to a new doc with all my tatts and hair with my issues to discuss. Only thing missing is a motorcycle club patch and ride into the waitin room on a harlely askin the nurses to hold my beer and cigar. (I could arrange that........ ;) ) Love the doc pics by the way.....what a cutie pie......... |
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Title: Re: Would someone explain pain mgt to me... Post by Roxy on Mar 6th, 2006, 11:33pm on 03/06/06 at 22:49:18, cootie wrote:
Cootie, I'm taking Ultracet right now for my knee, but I haven't had any trouble with it except for wanting to sleep the first couple of days. The sleepiness has worn off, and it seems to be having an extraordinary effect on my ch's. Glad to hear that about the non-addictive qualities. The pharmacy told me that, but it's nice to hear it again. Roxy |
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Title: Re: Would someone explain pain mgt to me... Post by cardogman on Mar 7th, 2006, 7:34am I spend most of my working day covering Joint Repacement Surgery in the O.R. in a lot of the NY metro hospitals. I am a non practicing R.N. All of the posts regarding pain management is pretty right on. It basically consists of: 1. Evaluation of pain 2. Localized injections of Depomedrol and Zylocaine for extruding discs in the spine. From Cervical to Sacrum. Up and own the spine. 3. Dispensing of Pain Meds 4. Blocks for Chronic Nerve pain using the same meds as above. 5. Pain Pumps with a catheter inserted locally. Biofeedback 7. Surgery to either burn the nerve or cut the nerve. Sort of similar the the trigeminal nerve surgery. Pain Management Doctors are usually Anesthesiologists. That's pretty much what I know. Burt |
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Title: Re: Would someone explain pain mgt to me... Post by cootie on Mar 7th, 2006, 1:34pm I just hope my new doc will follow my old docs plan......have been haveing a rough week so far......since I have NO IDEA what the new doc will say I am slowin down with meds in case he says NO WAY......my other doc said even if I tried a pain clinic he'd still help me with what I needed cuz he KNOWS I am ligit 100 % ! But now I gotta see how it goes tomarrow.......I been havein nitemares I am in pain and wakeing up crying and tramatized.....that is jus WAY too wierd but I wake up in pain and that's causein the dreams I guess. Dreamin I slid off a roof cuz of a flood and layin on my back only hangin onto the eves of the roof on my back with my elbows with rest of my back bending backwards swingin in the breeze and not able to move cuz of the slick metal roof my elbows dug into explains alot.......best discription yet and I made it up in my own head ! I know this new doc is a beliver in topomox for ch and there is NO WAY Brad could even think of handlein that stuff.......no no no no noooooo. If ya don't go with some docs plans (even tho ya KNOW it won't work and could make you loose work or loose a job or get hurt) they get pissed off and refuse to treat you. So wish us both luck. Gut wrenchin pains Pam I have the fentynl patches but not tried them yet.......not sure this doc will ever 'go there'.....cuz of malpractice ins some of the pain meds are now HIGH RISK so some docs get a break refuseing to script them out or at least if they do that have to be 100 % POSITIVE it is a ligit person. Doc told me if someone steals a script and abuses it and gets caught with it or sick or a kid was to get ahold of it and get sick or die and HIS name was on the bottle HE IS LIABLE. So alot of docs jus will NOT take that route unless they know you very very well and sum now just refuse to give it out period and not have the worry. Seems us good people have to fight for everything......always sumone messin it up for us all. I will have the faint or peuk syndrone tomarrow cuz just meeting a new doc gives me the willies. It's jus personal for me and odd to sit in front of a stranger with life records in hand esp if ya find ya don't like the guy rite off. PS: I think this new doc is pretty nice were goin to go meet and use if we like each other.......I just want a carein doc and one I can talk to......not one that has no time for you and acts like your bothering him and always in a hurry to go play golf. |
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Title: Re: Would someone explain pain mgt to me... Post by Lizzie2 on Mar 8th, 2006, 12:05am Coots, Seriously some of that stuff is a little over the top... If some kid steals my pain meds and something happens to him, my neurologist is in NO way liable for what happened to the kid. Yes, we would probably both have to explain what happened as far as he prescribed the meds for "such and such" condition and someone stole them from me, but he's not liable if someone else steals them and then has some catastrophe!! I seriously think some docs say this stuff just to provide more ammo for why they won't prescribe pain meds. YES the DEA is tough, but people are still prescribing them and taking them. I don't think my doc is getting charged more because he prescribed the pain meds for me - but then, I've never come right out and asked him... If so, how could some docs even afford to practice? Post op patients almost always need pain meds. There are zillions of conditions that need pain meds at some time for one reason or another. If your new doc isn't willing to work with you, you've gotta find someone who will. I know it's not easy and it gets frustrating, but you NEED to take care of yourself. Don't give up just because some doc is paranoid about the DEA. It's not right to make patients suffer in extreme pain just because you're afraid of what happens if you prescribe a low dose, long acting narcotic to a responsible person.... Take care of YOU!!! Hugz, Carrie :) |
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