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4 months post op SPINAL FUSION advice please

Hi, i am 4 months post op from a fusion surgery i had on my l5 s1. At the 3 month mark my surgeon filled a prescription for me of norco 5-325 mg. When i called for a refill a week later (he prescribed them weekly) i was told that it was too far out, and since he had released me to work i have to talk to my primary physician or get an appointment with a pain management doc there. Unfortunately, they didn't have anything with in even a month because of the holidays i guess? So anyway, i went to my doctor. He acted like i shouldn't be on pain meds and criticized me for taking 300 a month. I was taking them as prescribed and honestly they hardly help with pain, but they are a lot more effective than just advil and tylenol. I am not sure if my back has fused yet. I see my surgeon every three months. Wondering if anyone can share some of there thoughts on this? Should i not be in pain still? Has anyone else experienced this? I'm wondering if i should be taking something stronger than what i am on, or if their is something wrong and i just don't know it. The thing that is most confusing is, when i first saw him (my primary physician) he prescribed me 320 of these same tablets right off the back. He made it sound like i was doing something wrong by getting 4 scripts a month...yet he was prescribing the same amount monthly. He gave me 120 tablets but i was having a really hard time with pain before when i was taking two tablets every 4 hours. someone please help! advice please. Thanks in advance.
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Avatar universal
Hey thanks for the advice. Its nice to talk to people who don't have ulterior motives and get some truth. I did ask the surgeon earlier on about the nerve meds and he didn't want to give them to me.i would love to take a non-narcotic. I will take anything that works. I reallywant my life back and am scared something is wrong. I have a lot of pain especially when sleeping. I am released to work, yet the one day that i worked killed me. I was on the couch for a good 4 days after words. My lawyer got me an appointment with a board appointed doc so hopefully he can take a look and give me some honest answers about my pain and what he sees. I have been using a tens unit a lot lately and it does provide some temporary relief. Im guessing by your answer that pain can still be present even when its fusing like its supposed too? Anyway thank you guys for taking the time. This has been a very lonely and scary journey for me. I am pretty afraid i lost my athletic ability for life...
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Avatar universal
Hi there...Sorry to hear of your pain...

I've had 3 cervical fusions (two levels each time)  over the last 11 years. A surgeon is only going to treat you for a short period of time after surgery. If there is still pain at the 4 month mark...it has moved into the "chronic" phase and not in the acute post-op phase anymore.

I would suggest trying to find another Board Certified Neurosurgeon to make sure everything is ok as most people are weened down from their medication by now and shouldn't have great pain. So I would find out if anything is wrong and needs treating.

If they don't find anything, then they can easily refer you to a Board Certified PM Dr. Either one of these would be able to get you to the needed physical therapy and usage of all the other modalities for pain relief. It just may be that you need an injection of steroids (or a round of oral ones) to help reduce the inflammation.

Or, many times there can be some lingering nerve pain but this is best helped by actual nerve pain medication. An opiate (like the Norco) is not really meant for that type of pain. Nerve pain meds are Neurontin, Lyrica, or Cymbalta.

There are also muscle relaxers to take as needed that can be helpful. These are Flexeril or Amrix, Robaxin, Skelaxin, Baclofen, or Zanaflex...

The key is making sure you are open to any/all pain relief methods and not just stating that you need an opiate.

Good luck..
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Avatar universal
Hey thank you for your response. Im not real sure about going through my surgeon for a referral. He is a great doctor himself but i was seeing a spine doc for pain management before seeing him. This is probably the guy he will refer me to because i was revered to my surgeon by that doctor. This spine doctor im speaking about was appointed to me by work comp. He treated me pretty badly. He said my back was fine after looking at an Mri when in reality i had a torn and bulged disc. It was so visible that i i knew it was either bulged or heated when i looked at the images...before the report came out. The mri report reflected the tear and bulged disc. So with that in mind its probably not in my best interest to see my surgeons referral. I also must add that my case is still on going, and so far the work comp nurse has managed to screw me in everything she involves herself in. I can imagine that if i go to someone at that same doctors office, especially referred by my surgeon(or his secretary), that i will have problems getting the treatment i need and pain medication because that will be more money the insurance compant has to pay in the end. I also got screwed out of some pt and work conditioning because of them. I feel like im still in need. Its depressing that pt was helping me more then pain meds but the insurance company refuses to let it happen. Pretty much everyone does what the work comp nurse says. It also ***** that i can't call and speak to my doctor without the my docs assistant and the work comp nurse intervening. So i don't like calling to ask the doc questions through his assistant. I guess i will try a pain clinic. What really stinks is i don't have insurance right now, i have had several job interviews but i know the work is going to hurt me especially when i run out of meds.
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351246 tn?1379682132
MEDICAL PROFESSIONAL

Hi!
I am sorry to hear that you are in so much pain. You need to talk to your surgeon regarding this persisting pain. Maybe even after the fusion the pressure has not lifted off your nerves. Other than pills you can opt for pain relief patches and nerve blocks. You need to talk to your surgeon for this assessment and he can then refer this to a pain medication doctor. Also ask your surgeon whether you will respond to physiotherapy etc. Take care!
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