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Painful contractures

Painful contractures

My wife suffers from what seem to be very painful contractures of the achilles tendon as well as chronic pain in both knees and her left hand (which she thinks is from the contractures in 2 of the fingers there).  The foot drop happened during several comas (from a then undiagnosed metabolic disorder) and she also suffers from peripheral neuropothy resulting from bariatric beriberi (which advanced to the point of delusions and complete lack of control of extremeties before being diagnosed).  She is on medication that she reports to be helping with the neuropathic pain, but is on a LOT of narcotics for the other pain.  Understandably, her doctors are worried about the number and the doses of these, but she insists she is still in pain (and given the cries of pain when pain meds are basically witheld, that seems reasonable to me).

Is there a way to impartially measure the pain experienced so as to dictate what type and quantity of medication can best treat it?  Currently, her physician (and she's hospitalized for a different condition at the moment, so it's a hospitalist rather than anyone who's seen her for more than 5 minutes of her life), thinks that the dose he's selected of the medication he's selected must certainly be plenty, though the teary calls I'm getting seem to indicate otherwise.  I've never had a contracture for months at a time, so I can't say exactly how much it could hurt.  Is there a scale or something I can present to her or her physician to attempt to break the nightly impass of "you have plenty of meds" vs "I'm still in pain, please do something"?  Fighting with the administration (and that's exactly what it feels like to be honest) is taking far more out of me than actually attempting to care for my wife, and I'd very much like to step back from the role of angry healthcare project manager into the role of caring husband.
Tags: narcotic
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