[beam]

Since a few broken vertebrae,
I had been treated by a neurologist who prescribed
low-level pain meds, just to get the pain level known.
Since he left, an MD who is NOT a neurologist has kept my pain under control. I can still feel a little pain, but as med student, I want to know if something else has gone wrong.
THE RUB: My sked is 30mg. of Avinza in AM, and Actiq 600mcg. for breakthrough pain.
I am dumbfounded that one pain clinic and one neuro, whose a pain specialist, do not realize that the Avinza should be titrated up, and the Actiq possibly lowered-
since it's FENTANYL.
Ihave been stuck on 30mg. Avinza since May. Needless to say, I am overly tolerant to the dose.
Is there a real neuro out there who might comprehend
that spinal stenosis, degenerative disc disease,left-side nerve compression, and MS in a patient would need to handle this?
They seem bewildered and just
either turn away, or say that "they don't 'do' Avinza & Actiq".
What's wrong with this picture? Any feedback is welcomed.


~beam~

[kellrx]

Even if you titrated up in the Avinza dose, you would also become tolerant to that eventually. Any narcotic you use to treat the pain would result in the same fashion. Either you will be on pain medications for the rest of your life, which is dangerous and looks suspicious especially if you are a med student/doctor, or you seek a treatment or surgery to correct the problem.

[beam]

quote:Originally posted by kellrx

Even if you titrated up in the Avinza dose, you would also become tolerant to that eventually. Any narcotic you use to treat the pain would result in the same fashion. Either you will be on pain medications for the rest of your life, which is dangerous and looks suspicious especially if you are a med student/doctor, or you seek a treatment or surgery to correct the problem.

Hey,kellrx...
Much appreciation for your response, especially after I was blowing off steam,
as well as a bruised ego.
Update: Neurologist found who did a total work up for all...even MS.
It looks like I will be on 60mg. Avinza for a while. It seems to cover the symptoms w/o breakthrough px meds.
After a comprehensive exchange w/ the School of Medicine, they understand, and
we are all aware that I might have to cut school in specialist studies eventually/.
(No candidate for surgery.)
In the meantime, PAs & NP have my workload, and the school is keeping a close eye on my situation.
Regardless of my condition, I no longer have leanings toward despair, and the truth did win over all the angst.
Whatever the future holds, I refuse to give up learning....and objective feedback from any sensible source.
Thanks Again...


~beam~