Face to face with pain doctor

[Red53]

@geegee - truly I am sorry this happened to you and your loved ones. Are you in the USA, Canada or the UK? In the US some states (including Virginia) have codified law guaranteeing analgesia for severe pain relief for non cancerous and cancer patients. There are individual states which decided damages for surviving spouses and dependent family members impacted by a loved one’s death (even if their loved one died by their own choice - suicide). Denying sufficient analgesia to a scientifically accurate diagnosis of prolapsed disk violates state laws and prior judicial decisions

My L5-S1 was injured in a fall three years ago and ultimately prolapsed. Nerve Conduction Studies confirmed increased pain from earlier MRI scans of my nerve root impingement versus healthy nerve root function.

Your injury requires neurological examination and orthopedic care, not just to determine if surgery is necessary or even possible. Fusion surgery is the point of “no return”. Osteopathic spinal manipulation is not an option by a Doctor of Osteopathy whose patient presents with prior spinal surgery.

The workup includes
1. Physician exam of a patient
2. Radiology studies including X-rays and MRI
3. Blood lab work to determine health; SED is an important indicator of inflammation
4. Neurological exam including Nerve Conduction Studies which confirm patient pain
5. Orthopedic exam and diagnosis.
6. Plan of care

I’m in Ireland, so they are not as strict with controlled medication as they are in some parts of the world but they won’t leave you on them forever either.
I had all the above done in hospital and then had the nerve blocker done as an outpatient nearly two weeks ago. I’m waiting to be called for physical therapy but as this has happened to me before in 2023 I have all the exercises and I’m doing them 3 times a day on my yoga mat.
The pain nurse that came to me that day is just a horrible person, and I’m not the first person to say it. There is another pain nurse and she was so nice to me. But what I don’t understand is if she was so concerned about the medication why didn’t the pain management doctor say it to me when he called to me an hour later!!
Anyways i’m about to call my gps practice to see if i’m ok just to stop the controlled medication as im nearly 90% sure that the spinal injection worked. I haven’t taken the medication today and I have no pain only a discomfort in my lower back which is a spasm. I got spasms after the last time my discs came out.
Thank you so so much for all that information and being so kind to answer me.

If the situation allows, bring a trusted friend for support and perhaps some form of advocacy.

Boy do I definitely agree with this! Something about having a third person in the room seems to make a doctor "try" to be more fair and reasonable, imho. It's like anything else, just having third eyes affects people's behavior - again, imho.

Yes I have to agree...more people in the room helps a lot.

My dear hubby has been given pregablin for his nerve pain after shingles and is hoping that eventually he will get some relief.

However, he bumped into a friend who told him that his mum (who was sadly at the end of her days and in a lot of pain) met up with 2 GP's who both told her that if she found no relief with morphine to stop taking it and use a B vitamin only. Thank God this really helped her cope with the pain...the thing is this friend cant remember which one of the B vitamins gave his mum relief.

I've been doing lots of research and I've found that B1 B6 and B12 is recommended for nerve pain but as yet cant find any one who has used these B vits for pain.

If any of you guys can give me any info on what his friend was talking about......please please let me know. I would be eternally grateful ....

sending love and peace to everyone on the board (you guys have helped me so much over the years) xx and keep praying to your personal "God of understanding" for peace and sanity in our mixed up world...love Red xx

 

[KC67]

There is a podcast on Spotify all about this issue. It's called the Doctor Patient Forum. You should give it a listen, it's two ladies fighting for pain patients rights to be treated fairly and not like criminals or drug seekers. It's based in the US.
But they do interviews with different people and doctors in the industry and also give a little advice when it comes to pain management in today's world. I think they do a pretty good job and it's rather informative!

Wow, thank you for mentioning this! My anxiety went up simply at the thread name. I've had very bad experiences with being labeled as a drug seeker while simply looking for relief from my many legit pain issues.

 

[zakalipo]

There is a podcast on Spotify all about this issue. It's called the Doctor Patient Forum. You should give it a listen, it's two ladies fighting for pain patients rights to be treated fairly and not like criminals or drug seekers. It's based in the US.
But they do interviews with different people and doctors in the industry and also give a little advice when it comes to pain management in today's world. I think they do a pretty good job and it's rather informative!

Wow, thank you for mentioning this! My anxiety went up simply at the thread name. I've had very bad experiences with being labeled as a drug seeker while simply looking for relief from my many legit pain issues.

Same here. Before I had a family doctor, walk-in clinic would always look at me as a drug abuser because I simply wanted Codeine to get through my migraines to be able to keep working instead of laying in bed all day with pain.

I can understand if I walked in and asked for oxy, it's too bad this is the stigma around pain meds nowadays.

 

[jaders]

There is a podcast on Spotify all about this issue. It's called the Doctor Patient Forum. You should give it a listen, it's two ladies fighting for pain patients rights to be treated fairly and not like criminals or drug seekers. It's based in the US.
But they do interviews with different people and doctors in the industry and also give a little advice when it comes to pain management in today's world. I think they do a pretty good job and it's rather informative!

Wow, thank you for mentioning this! My anxiety went up simply at the thread name. I've had very bad experiences with being labeled as a drug seeker while simply looking for relief from my many legit pain issues.

Same here. Before I had a family doctor, walk-in clinic would always look at me as a drug abuser because I simply wanted Codeine to get through my migraines to be able to keep working instead of laying in bed all day with pain.

I can understand if I walked in and asked for oxy, it's too bad this is the stigma around pain meds nowadays.

It’s insane. If you ask for a medicine you know will provide relief the assumption is that you’re a “drug seeker.” Yeah - a drug seeker for pain relief. It’s truly a no win situation…

It does help if the MD can get to know you. It’s made all the difference with my doc anyway…

 

[infamousryan]

same thing is going on with me right now,
saw pain management,
nodded my head like a bobblehead to be kind,
and somehow walked out with a reduced doseage of lyrica "so i can take it everyday"
ive been taking it everyday lol
she also gave me ketamine cream, but it has 10 other medications in it.... it was $50 too.
i got occipital nerve block injections and they did absolutely nothing


so idk what i am doing anymore, kinda just want to die at this point...

 

[jaders]

same thing is going on with me right now,
saw pain management,
nodded my head like a bobblehead to be kind,
and somehow walked out with a reduced doseage of lyrica "so i can take it everyday"
ive been taking it everyday lol
she also gave me ketamine cream, but it has 10 other medications in it.... it was $50 too.
i got occipital nerve block injections and they did absolutely nothing


so idk what i am doing anymore, kinda just want to die at this point...

You just have to take your medicine needs into your own hands these days. Doctors just aren’t listening to their patients anymore. Just too concerned about “addiction.”

It’s sad but I think most folks feel better when they take control of this issue. It’s why we’re all here!

 

[Ellyn]

@jaders I agree that with respect to managing chronic (or often even acute) pain we have to take our care into our own hands, but it's not that doctors don't listen to their patients. Sometimes, they listen and agree, but they have the DEA breathing down their neck with respect to prescribing, even if they are carefully monitoring their patient. An urgent care (that I will never use again) sent my spouse home with multiple sutures from a very hard-to-close wound and instructions to take Tylenol. Unlike me he's no wimp, but he was hitting the ceiling when I had to change that bandage (first twice a day and then once a day) for a week, the pain was that bad. And that was with some of my carefully preserved stash of leftover Norco from a prior surgery (no, we did not stick with plain Tylenol). His dentist will not prescribe anything other than plain Tylenol for root canals and extractions because the DEA is so obnoxious about it, not even a measly 3 day supply of a pain medication. Back to my stash. When my daughter had four wisdom teeth pulled in one appointment she received 10 Norco, and had to go in to get more. Unfortunately, her extraction was on Thursday and she ran out of medicine on Saturday morning right about the time she developed a dry socket. Not fun (and back to my stash - this time it was my tramadol because I'm out of Norco). But it's the DEA that's behind this mess for the most part, not the individual physicians. People who are not abusing anything but who have legitimate pain management needs pay the price. It's awful.

 

[jaders]

@jaders I agree that with respect to managing chronic (or often even acute) pain we have to take our care into our own hands, but it's not that doctors don't listen to their patients. Sometimes, they listen and agree, but they have the DEA breathing down their neck with respect to prescribing, even if they are carefully monitoring their patient. An urgent care (that I will never use again) sent my spouse home with multiple sutures from a very hard-to-close wound and instructions to take Tylenol. Unlike me he's no wimp, but he was hitting the ceiling when I had to change that bandage (first twice a day and then once a day) for a week, the pain was that bad. And that was with some of my carefully preserved stash of leftover Norco from a prior surgery (no, we did not stick with plain Tylenol). His dentist will not prescribe anything other than plain Tylenol for root canals and extractions because the DEA is so obnoxious about it, not even a measly 3 day supply of a pain medication. Back to my stash. When my daughter had four wisdom teeth pulled in one appointment she received 10 Norco, and had to go in to get more. Unfortunately, her extraction was on Thursday and she ran out of medicine on Saturday morning right about the time she developed a dry socket. Not fun (and back to my stash - this time it was my tramadol because I'm out of Norco). But it's the DEA that's behind this mess for the most part, not the individual physicians. People who are not abusing anything but who have legitimate pain management needs pay the price. It's awful.

Such sad awful stories! But honestly, I do think doctors could come together and exercise some pushback against this horrific overreach by the DEA. Even the CDC rewrote their opioid guidelines to relax these restrictions, but it's being ignored by almost everyone.

I do know of a handful of folks who are getting adequate pain medicine, and I had three healthcare events this last winter and feel I was prescribed adequate pain meds all three times. Definitely not as generous as the "old days," but not horribly unreasonable either. So I just don't believe that it's ALL the DEA. Some doctors are just less willing to go to the mat for their patients, and it's very sad. They seem to've lost sight of their oath to help and not hinder.

 

[Dusty22]

I don't believe it's all the DEA either. Even when doctors were allowed to leave chronic pain patients on opiods (although a reduced amount), doctors were putting every patient on a schedule to come off of their medication. My pain doctor would tell me he had to do it. However, I had read a lot about the new opiod requirements. I knew he was lying. He could gave allowed some of his patients pain relief in a reduced amount.

 

[jaders]

I don't believe it's all the DEA either. Even when doctors were allowed to leave chronic pain patients on opiods (although a reduced amount), doctors were putting every patient on a schedule to come off of their medication. My pain doctor would tell me he had to do it. However, I had read a lot about the new opiod requirements. I knew he was lying. He could gave allowed some of his patients pain relief in a reduced amount.

And honestly I feel like the fact that in America we have a bad habit of always trying to hold someone else responsible for our own choices when they turn out badly. The lawsuit culture here pretty much insures that no one wants to stick their necks out too far because it only takes one greedy individual to figure out a way to hold a person responsible in financial terms for something they really shouldn’t be held responsible for, imho.

I’ve told this story before, but in my state there was a woman who was in some sort of treatment for opioid addiction. She went in for a hand surgery and was prescribed fifty oxycodone after the procedure. She neglected to tell the surgeon that she was in treatment (I think methadone) and she od’d and died on the oxys. The dad said they handed her a “loaded gun,” as tho it was the doctor’s fault in any way.

These are the stories that are why doctors are often so reluctant imho. It feels like they see everyone as a potential addict who’s family is going to find a way to sue them if something happens.

It frustrates me.

 

[Peanutheadm]

There is a podcast on Spotify all about this issue. It's called the Doctor Patient Forum. You should give it a listen, it's two ladies fighting for pain patients rights to be treated fairly and not like criminals or drug seekers. It's based in the US.
But they do interviews with different people and doctors in the industry and also give a little advice when it comes to pain management in today's world. I think they do a pretty good job and it's rather informative!

Wow, thank you for mentioning this! My anxiety went up simply at the thread name. I've had very bad experiences with being labeled as a drug seeker while simply looking for relief from my many legit pain issues.

Same here. Before I had a family doctor, walk-in clinic would always look at me as a drug abuser because I simply wanted Codeine to get through my migraines to be able to keep working instead of laying in bed all day with pain.

I can understand if I walked in and asked for oxy, it's too bad this is the stigma around pain meds nowadays.

It’s insane. If you ask for a medicine you know will provide relief the assumption is that you’re a “drug seeker.” Yeah - a drug seeker for pain relief. It’s truly a no win situation…

It does help if the MD can get to know you. It’s made all the difference with my doc anyway…

This is the same for needing antibiotics. Even if you know the exact antibiotic that has worked on this same condition - you can never mention it by name.

You must gently nudge him to it.

“Oh, I don’t think augmentin worked last time. I believe you had success with something that started with an M?!?”

You have to act like an idiot to get what you need. Smh

 

[Peanutheadm]

I don't believe it's all the DEA either. Even when doctors were allowed to leave chronic pain patients on opiods (although a reduced amount), doctors were putting every patient on a schedule to come off of their medication. My pain doctor would tell me he had to do it. However, I had read a lot about the new opiod requirements. I knew he was lying. He could gave allowed some of his patients pain relief in a reduced amount.

And honestly I feel like the fact that in America we have a bad habit of always trying to hold someone else responsible for our own choices when they turn out badly. The lawsuit culture here pretty much insures that no one wants to stick their necks out too far because it only takes one greedy individual to figure out a way to hold a person responsible in financial terms for something they really shouldn’t be held responsible for, imho.

I’ve told this story before, but in my state there was a woman who was in some sort of treatment for opioid addiction. She went in for a hand surgery and was prescribed fifty oxycodone after the procedure. She neglected to tell the surgeon that she was in treatment (I think methadone) and she od’d and died on the oxys. The dad said they handed her a “loaded gun,” as tho it was the doctor’s fault in any way.

These are the stories that are why doctors are often so reluctant imho. It feels like they see everyone as a potential addict who’s family is going to find a way to sue them if something happens.

It frustrates me.

And don’t forget: they now have the computerized system that lists all of your meds, and issues you an overdose probability number.

A doc just showed me mine a few weeks ago.

My number was 430 (above average). Due to my ongoing Tramadol prescription I’ve had for 10+ years. Lol

 

[randalg]

@Peanutheadm those scoring models should be outlawed. They have disclaimers that those alone shouldn't be used to deny meds. Yeah and the college testing companies say not to use those scores to deny college admission too.

 

[Peanutheadm]

@randalg I was in shock when I walked in to her office and saw what she had pulled up!!

She was about to give me some norco for back pain. But saw my history and changed her mind.

This is the world we live in now. Everyone policing each other. I’m always wondering where it ends. Like, how far up the flagpole do we have to go to find the people that aren’t being watched?

Hell, there is technology in cars that can tell if you were distracted during an accident. How many times you yawned. Were you closing your eyes more than usual?

Where does it end?

 

[jaders]

There is a podcast on Spotify all about this issue. It's called the Doctor Patient Forum. You should give it a listen, it's two ladies fighting for pain patients rights to be treated fairly and not like criminals or drug seekers. It's based in the US.
But they do interviews with different people and doctors in the industry and also give a little advice when it comes to pain management in today's world. I think they do a pretty good job and it's rather informative!

Wow, thank you for mentioning this! My anxiety went up simply at the thread name. I've had very bad experiences with being labeled as a drug seeker while simply looking for relief from my many legit pain issues.

Same here. Before I had a family doctor, walk-in clinic would always look at me as a drug abuser because I simply wanted Codeine to get through my migraines to be able to keep working instead of laying in bed all day with pain.

I can understand if I walked in and asked for oxy, it's too bad this is the stigma around pain meds nowadays.

It’s insane. If you ask for a medicine you know will provide relief the assumption is that you’re a “drug seeker.” Yeah - a drug seeker for pain relief. It’s truly a no win situation…

It does help if the MD can get to know you. It’s made all the difference with my doc anyway…

This is the same for needing antibiotics. Even if you know the exact antibiotic that has worked on this same condition - you can never mention it by name.

You must gently nudge him to it.

“Oh, I don’t think augmentin worked last time. I believe you had success with something that started with an M?!?”

You have to act like an idiot to get what you need. Smh

That is SO true!! It’s like an insult to their ego if you actually know what med works for you. I remember telling an urgent care doc the best antibiotic for my sinus infection and he balked. He left the room for a while and I guess he let down his guard enough to actually listen, and did give me the one I asked for, even tho he’d disagreed earlier. I also asked him for one lousy refill since I usually have to take two courses and I was traveling soon. You’d think I’d asked him for heroin. I got the refill from my own pcp at least…

 

[jaders]

@randalg I was in shock when I walked in to her office and saw what she had pulled up!!

She was about to give me some norco for back pain. But saw my history and changed her mind.

This is the world we live in now. Everyone policing each other. I’m always wondering where it ends. Like, how far up the flagpole do we have to go to find the people that aren’t being watched?

Hell, there is technology in cars that can tell if you were distracted during an accident. How many times you yawned. Were you closing your eyes more than usual?

Where does it end?

Man that sucks so friggin much!! A number based on some ridiculous algorithm related to what you’ve been prescribed?!?! The fact that you HAVE taken a narcotic for YEARS without a problem should mean that you are NOT at risk for od’ing, or much much less.

I just want to pull my hair out when I read these stories!