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Pain Management Community

Reply: Opiate Tolerance

Hey Beth, I'm not sure if you are in the middle of your "holiday" or not but my prayers are...

Posted by mel0222

44 Replies | Reply | Watch This DiscussionReport This| Share this:Opiate Tolerance Hey Beth, I'm not sure if you are in the middle of your "holiday" or not but my prayers are...

Reply: chronic pain and addiction?

Again, CTBeth, you have a wealth of information that is already so very helpful,...

Posted by mel0222

Again, CTBeth, you have a wealth of information that is already so very helpful, encouraging, and comforting to me; thank you. First, my name is MEL 0222. Sinemet IS a medication for Parkinson's, however, when RLS was first recognized and named, Sinemet was the only medication that helped relieve the infuriating feeling in the legs, and for me, the arms as well. Dr.s did/don't know why since they really don't know what causes the restlessness in the first place. Since then, Mirapex and Requip have been formulated. I now take Mirapex and it is working for me at this point. It seems as though the levodopa is the component that calms the crazy, annoying sensations.

It is very encouraging to me that you have had the very fusion that my doc is recommending and that it has helped you and not caused further complications that are debilitating. I used to work in physical therapy about 20 years ago. Granted, back surgeons have learned much since then, but I have heard so many horror stories from patients who have been on their 3rd, 4th surgery with no success, if not a worsened situation. Since I have had so little success with my knee replacements, I am a little wary of starting that process with my back. Three surgeries on my left knee with more needed, and two on my right in the same situation. If I could just get my pain to a place where I can sleep through the night and be able to find a job where I can alternately sit and stand, I could live with it, I think.

An additional challenge that affects my healing process concerning surgery is that I am on Medi-Cal. Though my neurosurgeon is gracious in my office visits, I believe that the fact that all parties involved in a 6 or more hour surgery not getting reimbursed financially as they are accustomed to affects his enthusiasm,. He has mentioned the costliness of it. He is the only neurosurgeon in my area that takes Medi-Cal patients. However, if I truly believe that surgery is necessary, he would have no choice but to perform it (if Medi-Cal and the hopsital would approve it). My surgeon did recommend the implanted TENS, and spinal cord stimulator which was denied by Medi-Cal; it's cheaper for them to put me on drugs :-{. He did not suggest the spinal pump because he does not do any narcotic pain management, he leaves that to the primary care givers. Between my fibroid tumors, endometreoisis, total hysterectomy, knee replacements and reconstructions, I have had about 10 surgeries in the last 20 years. Then my CHF and heart attack put me in the hospital for 10 days as well. Honestly, I am just really tired of hospitals and surgeries. True, I do not like my life in constant pain and non-productiveness either. This conundrum I have been in much prayer about. I am forced to choose the lesser of two evils.

Yes, my primary will refer me to pain management. She did do this prior to my CHF but Medi-Cal sent me to a chiropractor! Can you believe it? He took one look at my MRI and list of meds and said he couldn't help my pain because of the extent and nature of my back issues but I should get off most of my meds. Really? If my primary and I can not come up with a non-narcotic solution that I can live with, I will try again. The contracted insurance carrier with Medi-Cal has changed since the first of the year so we will be working with a different insurance group.

I have had three epidurals. The first two were a godsend!! I got relief for three weeks; sooo amazing. I had forgotten what it was like to get out of bed without being brought to tears. The third did not touch it. Could it be because of the gabapentin? I don't think Medi-Cal will pay for any more. Steroid shots have been ineffective. They didn't work for my knees either. I have not heard of RF ablations; I'm going to have to research that.

Well, I could probably go on for hours but am limited to 4000 characters. Thanks again CTBeth; I look forward to more of your wisdom.View Thread

Posted bymel0222

21 Replies | Reply | Watch This DiscussionReport This| Share this:chronic pain and addiction? Again, CTBeth, you have a wealth of information that is already so very helpful,...

Reply: chronic pain and addiction?

Wow, thank you so much for your response and questions CTBeth. Thank you as well for...

Posted by mel0222

Wow, thank you so much for your response and questions CTBeth. Thank you as well for clarifying all the origins of the pain medications, it was very informative. Let's see if I can clear up some confusion.

Before my CHF and heart attack, my nurse practitioner prescribed several combinations of meds: methadone, Fentanyl patch, anti-depressant, anti-anxiety, RLS meds (Sinemet), sleep meds, and others to manage my pain, depression, anxiety attacks, insomnia, etc. I was on the highest dosage allowed on most of them. After doing some research, I believe that my meds were mismanaged. I occasionally took extra to try and kick the intense pain but never got my prescription refills early. As a result, my nurse practitioner is apprehensive and will not prescribe anything that may be addictive or narcotic; not even a muscle relaxer. I am not currently on any narcotics. As I look at my previous experiences with pain management, narcotics seem to affect me mentally in such a way that I feel in bondage to a substance. The only option I would consider would be the Fentanyl patch. This method of pain control would not be so easy to abuse. I'm just afraid that the morphine would put me in that mental state of wanting more. I'm trying to be perfectly transparent here so I can get the best advise from others who may have been or are in the same situation.

I just got the results of my echo and my heart has completely recovered. However, I am afraid to tax it unnecessarily.

My neurosurgeon explains that my L2 to my L5 needs to be fused together, a multi-level fusion. He explained that the vertebrae above and below would eventually wear down from the rigidity of the fusion and would have to be reconstructed or fused at a later time as well. My spinal cord is being compressed in my lower lumbar from arthritis as well as the exiting nerves and bulging discs. In addition, my left knee replacement has a mechanical problem and causes so much pain that I cannot walk most times. I need surgery on it as well but the Medi-cal system takes a year or more to go through the steps.

Yes, Medi-Cal does have a list of meds that they cover. Again, they make a patient go through ridiculous and unnecessary steps to finally get to the solution or desired affect. My NP will make me go through a referral to pain management in order to get any relief. That's another reason why I was seeking a non-narcotic solution.

Yes I have tried marijuana for sleep. I cannot smoke it because I was a cigarette smoker before my CHF and the edibles and oils I have taken make me feel awful. The few times I did manage to get the dose at a level that didn't make me sick, I slept but woke up in more pain than if I hadn't slept well. My system just doesn't like it. Besides, it's very expensive and I am on a very limited budget.

This is all very frustrating for me because I have always been a very productive person. I have a driven personality and all my other surgeries and osteoarthritic knee problems didn't stop me for long. This back issue has kicked my butt and put me down. I hate being dependent on the government and without an income of my own. I really want to get to a solution so I can get back to work. Thanks so much for your interest in my particular situation. I look forward to your response.View Thread

Posted bymel0222

21 Replies | Reply | Watch This DiscussionReport This| Share this:chronic pain and addiction? Wow, thank you so much for your response and questions CTBeth. Thank you as well for...

chronic pain and addiction?

I'm so glad I stumbled upon this site as I was researching non-narcotic solutions to my...

Posted by mel0222

21 Replies | Reply | Watch This DiscussionReport This| Share this:chronic pain and addiction? I'm so glad I stumbled upon this site as I was researching non-narcotic solutions to my...

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