Help Please!!

[Fender Strat]

I have recently been dismissed by both a back surgeon and a pain management specialist, for reasons I'll mention, after a bit of background. I'm a 56-year old male. I have undergone a total of nine orthroscopic knee surgeries since 1998, two to my right knee, seven to my left knee; two orthroscopic surgeries to my left shoulder; one partial knee replacement (left knee) and, approximately 5 years after the partial knee replacement, I had to have the entire left knee replaced. In April of 2008, a previously ruptured disc "fragmented", resulting in nerve impingment. In June of that same year, a neurosurgeon removed "90%" of the fragmented disc. Unfortunately, since the fragmentation, I have nearly constant numbness and tingling in the right foot, accompanied by constant sciatic nerve pain in the right leg. According to the neurosurgeon, the numbness and tingling in the right foot will be with me for the remainder of my life. He also advised that due to narrowing of the disc spacing in my spine, I have the spine of a "75 year old man." I have arthritis in my left big toe, left hip and left shoulder. Aproximately three years ago, I began seeing a pain management specialist who eventually prescribed one 10mg OxyContin every twelve hours. My shoulder surgeon also prescribes one Vicodin ES (750mg/7.5mg) "2 or 3" times a day, as needed. Despite what may seem like a great deal of pain medication, I have begun receiving less and less relief from the medication. A second neuro surgeon was scheduled to implant a spinal cord stimulator several weeks ago; however, I backed out of the procedure. I'm just not comfortable with the device, fearing that the "masking" of pain may make it difficult to detect new or worsening conditions to either my spone or sciatic nerve. My reasoning for rejecting the procedure was unaceptable to the neurosurgeon, and he instructed me to find another physician. When I went to see my pain management physician, he asked why I hadn't gone through with the spinal cord stimulator implantation. Several visits previously, I asked the pain management specialist to increase the dosage or frequency of the OxyContin; he did not do so, but never offered a reason. No traces of OxyContin were found in my last two urine samples, although traces of Vicodin XS were detected. I informed the pain management specialist that, due to decreased effiecency of the prescribed dose, I felt the need to take more than the twice-daily dosage of OxyContin. There were occasions when I took as many as 4 or 5 in one day. As a result, he too dismissed me as a patient. To add insult to injury, the specialist claimed he would have increased the daily dosage of OxyContin, had I not "failed" the urine test.

I feel as though I have nowhere to turn. My family doctor will not prescribe opiate-based pain medication because he once developed an addicition to them, or so he has said. My medical records maintained by my former pain management specialist will surely contain reference to the two failed urine samples. Under those cirumstances, I doubt if another pain management specialist will take me on. I'm tired of living in pain, and simply receiving lip service from medical professionals who claim to be empathetic, but treat me as if I'm an addict. Any constructive suggestions would be greatly appreciated. Thank you!

[Robert_325]

I have recently been dismissed by both a back surgeon and a pain management specialist, for reasons I'll mention, after a bit of background. I'm a 56-year old male. I have undergone a total of nine orthroscopic knee surgeries since 1998, two to my right knee, seven to my left knee; two orthroscopic surgeries to my left shoulder; one partial knee replacement (left knee) and, approximately 5 years after the partial knee replacement, I had to have the entire left knee replaced. In April of 2008, a previously ruptured disc "fragmented", resulting in nerve impingment. In June of that same year, a neurosurgeon removed "90%" of the fragmented disc. Unfortunately, since the fragmentation, I have nearly constant numbness and tingling in the right foot, accompanied by constant sciatic nerve pain in the right leg. According to the neurosurgeon, the numbness and tingling in the right foot will be with me for the remainder of my life. He also advised that due to narrowing of the disc spacing in my spine, I have the spine of a "75 year old man." I have arthritis in my left big toe, left hip and left shoulder. Aproximately three years ago, I began seeing a pain management specialist who eventually prescribed one 10mg OxyContin every twelve hours. My shoulder surgeon also prescribes one Vicodin ES (750mg/7.5mg) "2 or 3" times a day, as needed. Despite what may seem like a great deal of pain medication, I have begun receiving less and less relief from the medication. A second neuro surgeon was scheduled to implant a spinal cord stimulator several weeks ago; however, I backed out of the procedure. I'm just not comfortable with the device, fearing that the "masking" of pain may make it difficult to detect new or worsening conditions to either my spone or sciatic nerve. My reasoning for rejecting the procedure was unaceptable to the neurosurgeon, and he instructed me to find another physician. When I went to see my pain management physician, he asked why I hadn't gone through with the spinal cord stimulator implantation. Several visits previously, I asked the pain management specialist to increase the dosage or frequency of the OxyContin; he did not do so, but never offered a reason. No traces of OxyContin were found in my last two urine samples, although traces of Vicodin XS were detected. I informed the pain management specialist that, due to decreased effiecency of the prescribed dose, I felt the need to take more than the twice-daily dosage of OxyContin. There were occasions when I took as many as 4 or 5 in one day. As a result, he too dismissed me as a patient. To add insult to injury, the specialist claimed he would have increased the daily dosage of OxyContin, had I not "failed" the urine test.

I feel as though I have nowhere to turn. My family doctor will not prescribe opiate-based pain medication because he once developed an addicition to them, or so he has said. My medical records maintained by my former pain management specialist will surely contain reference to the two failed urine samples. Under those cirumstances, I doubt if another pain management specialist will take me on. I'm tired of living in pain, and simply receiving lip service from medical professionals who claim to be empathetic, but treat me as if I'm an addict. Any constructive suggestions would be greatly appreciated. Thank you!

I am a 58 year old male and I've also had a ton of knee surgeries, as well as others, have RA, Fibro, Raynaud's, degenerative disc disease, the list goes on. I am also a chronic pain patient and symptathize with your pain. But I don't take it upon myself to increase my prescriptions. In fact I take no narcotics whatsoever for pain and haven't in nine years other than Ibuprofen and soma for my back. That is irrelevant here.

The point I'm making is that your drs are prescribing schedule II narcotics to you with oxycontin. Those records are scrutinized regularly by the DEA. If your drs allow you to take whatever you feel you need without their permission they are subject to losing their ability to earn a living for their family by losing their licenses. You were advised to have the implant, which is a common procedure for pain patients. You chose of your own accord to not follow his suggestions but chose instead that you wanted more drugs. I can't really find fault with the drs when you refused treatment that could help you lower your required narcotic consumption. I am not judging you as I know how it feels to be in pain but your actions are why the drs are treating you like they think you're an addict.

I am not trying to be judgemental of you. I am attempting to explain the drs' side of all this. They are responsible for helping you, not for being a drug supplier. What if the implant worked? Would you not want something that commonly DOES help with situations such as yours? Why would you just want to keep increasing the level of narcotics you are taking if there was another way to alleviate the pain? I will give you odds that the drs would have medicated you adequately had you gone along with their advice and then it didn't work.

I would contact the drs again and see if the surgeon is still willing to do the implant. That is my best and most sincere advice. Hope that makes sense and you take what I said in the manner in which I intended it, just to be helpful to you. Let us know how it goes. God bless.

[shellybeau]

Dear Fender Strat,
I feel terrible for you. Dr. Oz had a show last week about how chronic pain is a disease in and of itself. I wish you the best of luck. I suffer from chronic back pain. Because I am an addict, I can't take opiates. I take Suboxone, NSAIDs and Soma (which is in the danger zone for me). I just brought my friend to her pain specialist to get a temporary spinal cord stimulator implanted in her back/neck. It's a test run for maximum of 5-7 days. She has become addicted to Norco and needed to take this next step to show her doctor she was serious about wanting an end to pain, not simply more meds. She had to have a psych evaluation prior to the procedure. She was pleasantly surprised at how much the stimulation helped her neck & back which has a metal plate and rods in it. Big Brother, AKA the DEA, is now watching how much and what controlled substances you take with the computer tracking system at all pharmacies. Your doctors know this and are in fear of being "caught" by the DEA. The U.S. is HORRIBLE at chronic pain management. Doctors are taught very little on pain management, pharmaceutically or otherwise. Call your previous doctors, tell them you have reconsidered the spinal cord stimulator because you simply cannot tolerate the pain. Once implanted, no more MRIs but you can get other tests to determine your condition. I wouldn't let that stop you from getting one. WTH - it could really help. I know the pain of sciatica without any drugs (immediately post Katrina in New Orleans - no doctors in town). You may be amazed at how the pain meds can alter your perception of pain. I had to get off all opiates to even realize how much pain I was/wasn't in. Best of luck to you. If your drs. won't see you, go to another pain specialist and explain your situation. God bless.