Chronic Pain - Need Assistance with Communicating Needs with Dr

[mlrhodes80]

I've had chronic pain for years in my knees.  I had arthroscopic knee surgery on 8/5/13 on my right knee where it was discovered I have many areas of exposed bone.  My surgeon cleaned up the cartilage as best he could but told me right after the surgery that this likely would not do a whole lot to relieve my pain and I'd need more procedures.  He said it is a bad knee; the knee of someone in their 60's.  I am 33 years old and, until around 2009, was an active runner and served 8 years in the US Army (got out in 2006).  I am miserable 24/7...worse since the surgery but he said it would be at least 12 weeks for recovery.  Before the surgery I was on tramadol (50mg, 4 times a day).  Since the surgery (on week 7), I've been on norco (5mg hydrocodone/325mg acetaminophen).  I've done well with one Aleve in the morning and 4 norcos throughout the day.  Until last week.  I was in the ER on Friday night with unrelenting pain.  They gave me a shot of something and a handful of Percocet...which also works very well but makes me too sleepy so I would not be interested in taking that.  I have severe osteoarthritis which my surgeon said caused all the problems I have.  He told me at my follow-up today that I would probably need several more procedures on this knee with the next procedure sometime after 12 weeks post-op from the arthroscopy (my 12 week post-op is scheduled for 10/29/13).  He said if I was in pain with this procedure, just wait until the next.  Super.  

I am depressed.  I am in pain and cannot seem to see a light at the end of the tunnel...especially since he tells me I have so many more procedures to go.  Because I am so young, he told me he will not do a replacement.  If I was 50, that's what they would have done.  I have an active life, although I do not run any longer and he told me I cannot run on this knee again.  Lately, I have been less active.  The pain medication works but I'm so very afraid of my doctor thinking I am drug-seeking so I do not ask for refills...I only have taken it when they provide me with a new prescription...twice since surgery for about 50 at a time.  I've decided today that I am going to take time away from the meds (I did not ask for a refill today and he did not give one) and see if I can find alternative methods to treat my pain.  I have not been able to find anything thus far but I will keep trying...I am thinking of acupuncture.  

I want to be honest with my doctor...that the norco works 80% of the time to take the edge off (it never goes away totally) and that I would like to keep taking as we go through the treatment process but I'm afraid of his reaction.  So, I didn't tell him today I would need a refill with the next couple days.  I know I am in for a real treat next week when the pain will be worse without anything but the aleve.  He saw what my knee is about with his own two eyes...he knows why and how I am legitimatelly in a lot of pain.  I know if I ask, I probably would not be turned down but I need him to be my surgeon through these next procedures because he has been a Godsend after some really horrible doctors who have treated me badly...so I do not want to do anything to sever that relationship.  

I need help with how I can approach this topic with him.  HOW do I talk to him?  Do I just ask or do I just deal with the pain and hope he offers something in the future?  

Like I said...this is terribly depressing.  Most days I do not want to continue living...to be completely honest.  I feel like I will never again have a "normal" life where I can do the things I enjoy doing...being ACTIVE...so what's the point?  I am in pain when I wake up, throughout the day, when I go to bed...it is unrelenting...it never goes away.  It is often all I can concentrate on.  The norco medication he's been prescribing works to take the edge off 80% of the time but I just feel very strange just coming out and ASKING.  I've never done that before...

Thank you for any assistance you can provide...this is a very hopeless place to be...I hate it.  :(

~Michelle

[spark929]

I've been in pain for years resently no pain med but thats my fault  i'm not good with taking my meds properly beacuse a will do anything to get out of pain for a little while but  let me tell you do not stay in pain it will eat your world up in many diffrent way you have a possible cure so be pro active in your care and don't be scard to tell your doc what you need it sounds like you might even need an anti-depresant just till you can get out of your funck but what i realy wanted to tell you is about nucynta its a pain med that doesn't give you as much of a narco felling or the sleepiness TALK to your DOC about what you need the worst he can say is NO but most of the time good doc's will listen who knows your body better then you

[shinty]

I think the doctor wouldn't have any problem writing you pain medication prescriptions while your under his/her care, and especially if surgeries and other procedures are needed. there are some very good non-narcotic medications that are available by prescription only (not OTC), that may help your pain also. Whatever you happen to end up taking for medication, my belief is the lowest dose possible that helps is the best dose to be on-that way if pain does end up becoming a problem a dosage increase will most likely help the situation. Second opinions are a great idea, and almost always covered under any health insurance plan. Good luck.
       shinty

[marycarmel]

I agree about another opinion.  And whatever doctor you see, you need to have a relationship where you are comfortable being honest about your pain and what helps.  Pills should not be the only thing they use.  Gels, therapy, procedures all fall under pain management.

[trixy71]

Personally I would get a second opinion, right away. If your doctor is telling you that you need more procedures and they are all going to hurt, there is no way I wouldn't get at least two more opinions. Honestly, I would probably run as far as possible from this doctor. Why numerous procedures instead of a knee replacement? I don't buy that your too young for a replacement, Yea so they don't last forever, but would you rather have 6 or more arthroscopies and then a replacement eventually or a replacement now and maybe another one in 20 years. Seriously, do the math, he won't make as much money that way.  I understand your in pain, but at least get another opinion, just because this doctor has given you pain pills is no reason to stay with him, yes, many doctors can be jerks or have a bad bedside manner, but I just don't trust it. BUT this is just my opinion. I wouldn't let him touch me again without at least one other doctor confirming. You can always talk to your family doctor about getting refills for the Norco. Good luck to you.