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Urine drug screening is now becoming widely used in pain practices. Unfortunately, this has caused you a significant amount of distress and has impacted your medical treatment. I think it would be worth it to talk to your doctors about the possibility of a having a false positive result and having them re-evaluate your plan.View Thread

The term "peripheral nerve" does not denote a specific nerve in your body but is a general term to describe any nerve of the body that isn't a part of your "central nervous system", namely the brain and spinal cord. Your doctor may have a specific nerve in mind but it sounds as though she didn't give you the name of it. Your pudendal nerve would be an example of a peripheral nerve.
It concerns me that you don't feel well-informed by your treatment team and at the same time interventional procedures are being performed. I think it is important for you to know exactly what is being recommended and why prior to any treatments being performed. I think it is reasonable to ask for some information about what evidence-based studies have been done or published to support the recommendations they are making. It is your body, and they owe you that.View Thread


Subutex could be an alternative medication for you to consider. We have been using medications like Subutex for several years and have found it to be a good alternative to high dose opioid therapy for most who have tried making the change. There are a number of reasons for this. Many patients report feeling more clear-headed and like their old selves after making this type of change. When the body develops a tolerance and continues to feel like it needs higher dosages, the buprenorphine seems to help diminish that craving.
You may have heard or read about something called opioid-induced hyperalgesia which is a theory that prolonged opioid use can make the body more sensitive to pain. In cases like that, buprenorphine may also be a good alternative.
Despite some of the potential benefits that it may have, it is important to also remember that pain management can be a very comprehensive specialty that encompasses much more than just medication therapy. It would be reasonable to talk to your doctors about other approaches to help you with your pain. It is also understandable to be anxious about making any medication change and you should be able to receive the appropriate education and counseling to help you work through that in a supported manner.View Thread

Treatment includes:
- Use anti-inflammatory medications or a cortisone injection right into the joint for more painful cases;
- Ice, elevation, Physical Therapy, and maybe compression can also reduce inflammation;
- If the Synovitis is caused by a specific underlying disease, like rheumatoid arthritis for example, then treating the disease will eventually help reduce symptoms;
- Nontraditional approaches would include herbs to reduce inflammation and acupuncture (not much scientific research to support this though).

Another factor to consider is that medications can also effect the way we feel emotions, and being off of the hydrocodone may mean that a depression is coming out that possibly was hidden for a while by the medication.
If you are feeling depressed I think it is important to get help. I suggest that you talk to your doctors right away and consider consulting with a behavioral health specialist like a psychologist or psychiatrist.View Thread

I have worked with many patients over the years who have struggled to overcome their dependencies and addictions to things like hydrocodone. Fortunately, I have also seen many of their triumphs and successes from folks like you that are brave and willing to overcome some of their fears, and they have gone on to lead very fulfilling lives. Getting the right help and having the support that you need is really important.
The next step is to find out what resources are available in your community to help you treat your addiction and pick the program that seems to be the best option for you. Once you are able to get off of the hydrocodone, then the third step will be to embark on a process of exploring other ways that you can learn to better manage your pain so that you can develop a program for yourself that leaves you feeling in control of you.
Remember, your journey begins with a single step.View Thread

Worrying about the future can sometimes create unneeded anxieties. It may help to realize that nobody, including doctors, can really predict the future, so I often suggest to my patients to try to live in the moment, do their best to manage the pain that they have today, and try to make today the best day possible.View Thread

Antidepressants have been used in treating pain for quite some time. Historically, certain antidepressants have been used to help in the treatment of nerve pain problems. More recently, antidepressants have started to get used in treating musculoskeletal pain problems like fibromyalgia. Because mood changes like depression often accompany chronic pain, antidepressants frequently get used to treat concurrent depression, as well.
Unfortunately, antidepressants can have significant side effects for the user, and in some cases can leave a person just not feeling like themselves. When the problems and side effects seem to outweigh the benefits, then it is reasonable to talk to your doctor about the best way to wean off of the medication.View Thread

Small studies have also been done on hepatitis C patients taking the combination of buprenorphine and naloxone as is the case with folks prescribed Suboxone, and again it appeared safe.View Thread
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