New, Need ideas for Chronic Back Pain, Old things don't work.

[fluffypurrcat]

( I am new here) Hi, I am a 55 year old female with chronic back pain and other health problems. I have Hypothryoidism, Migraines, High cholesteral, high blood pressure, and had symptoms of MI in April. Went to Heart forum and had hard time getting diagnosed, but appear have Variant Angina, or Coronary Spasms. Anyway, hurt my back in 1999 on the job, and have not worked since 2000 when I was laid off because of my back.

        I take 60 mg of Methadone a day, down from 90 mg and ES Lortab, 7.5/750 for breakthrough pain. I have been on Methadone since 2004. I tryed muscle relaxers, Vicodin, Lortab, Lidocaine patches, Physical therapy, Epidural injections, SI injections, Facet Joint INjections, TENS Unit, Pool therapy, I had foot surgery recenty and the Methadone didn't even touch the post surgical pain, was prescribe Percocet, nothing, had a script for Diluadid, and it finally worked. Seems I have a high tolerance for pain meds. I have been taking Vicodin of one sort or another since my first foot surgery in 1998 and think they are terrible.  I have never gotten a " high" off of them and can not understand their attraction. I was taking 10 Norcos a day with no pain releif, that is why my dr. gave me Methadone and it is the only thing I have ever had that works. When I have a flare up I end up in the ER and get a shot of Tordol.
           Allso tryed Viox, Bextra, and Celebrex. I went to a Pain management clinic in SF. and saw a dr. twice. They wanted to do a procedure called IDET, but they wont' do that anymore. I also had a dr. in 2001 willing to do surgery, ( did not ask what type ) but I wanted to continue with more Conservative route.
                 Now I dont know what to do. I have been on the Methadone long enough, I don['t mind taking it except for the brain fog, and tiredness, falling asleep in the movie theater for example. My husband can not stand the fact I take this, he thinks it is ruining my ( our ) life. He thinks I would be better, more Energetic etc without it. Problem is he doesnt want me on ANY Narcotic. I have another Pain management appt in July, but I am sure all they will talk about our Epidurals which last for one month at most. I would like to discuss surgery again, but being on Workmans Comp it is almost impossible to get anythng done even if the dr. is willing. I also have Medicare and they will pay for things like that.My dr. allso suggested Accupressure and Pool therapy, but WC won't pay.
I also have arthritic hips and now my knees are suffering and a very bad foot needing a fusion. Does anyone have any suggestions or ideas? I need some ideas before I see the dr. again.                    Fluffypurrcat

[fluffypurrcat]

HI, I thought I would add the reasoning why Workmans Comp wont' authorize Accupuncture. I got a letter from their Advisory board, acutally three of them about a week ago, here is what they said, see if it makes sense to you.
""I AM UNABLE TO SEE WHAT THE REHABILATIVE BENIFITS OF ACUPUNCTURE ARE GIVEN THE HISTORY OF THIS PATIENT WHO IS A SURGICAL CANDIDATE IN WHICH CASE ACUPUNCTURE WOULD NOT OFFER ANY CORRECTIVE BENEFIT FOR WHCH SURGERY IS NECESSARY.IT IS DOUBTFUL THAT ACUPUNCTURE WOULD OFFER ANY CORRECTIVE OR REHABILATIVE , LONG LASTING RELIEF,OR CURE FROM EFFECTS OF INJURY AT THIS POINT IN TIME, 8.5 YEARS POST INJURY.  Blah, blah, blah. Sounds like I have a case for surgery though, it is stated right in this document that I am a surgical Canidate.          Fluffypurrcat

[fluffypurrcat]

Hi, thanks, I meant to say ACCUPUNCTURE, with the needles . WC does not want to pay aything and it is so stupid. They at one point did not want to pay for a $5.00 Stool softner, ( common with opiate use ) but would pay for a trip down to San Francisco to a QME , as well as two trips to SF for pain managnment consultation, expensees for bus fare, lodging in motel for two nights, as well as food and of course the dr.s fee which is not inexpensive by any means. Go figure their reasoning. Methadone is very cheap, lot cheaper than VIox for example. I fogot to meniton I have allso taken NEURONITN, ELAVIL ALSO. I had to quit the Neurontin ( referred pain ) as it did not mix well with Methadone, I was having hallucinations, not fun at all.

       WC also won't pay for Yoga, Physical therapy, pool therapy, had to fight to get my TENS Unit, and when I was hit by a car on my way to Rehab, they authorized a set of three epidural injections for my back. I had one then when hit by the car, waited to see how much pain was due to back pain and how much from being in a cast and on crutches because of broken foot. When I told my dr. I wanted another epidural, It took the Insurance company 8 MONTHS TO AUTHORIZE MY SECOND INJECTION EVEN THOUGH IT HAD ALLREADY BEEN APPROVED.  All because I did not have a lawyer handling my case. I had to go to court to get anything done. Judges orders.

It is one of the worst insurance companies not my words, but drs. I go to kno;w this company well. NOw that I dont have a lawyer, my case was settled in 2004, I can no longer get any help. Even though I settled with future medical benifits, I still have to fight for my rights all the time, It is getting rediculous.

As for my husband, he is a tough cookie. He also had chronic pain, shoulder problem and back pain, but nothing like myne. His dr. put him on Morphine, and lots of vicodin. Crummy dr. , should have never prescribed Morphine, but drs. sometimes are more apt to prescribe over for a male, esp when they are older. My husband suddenly decided he did not want to be on ANY PAIN MEDS,  he is addictive personality. He went cold turkey sick for about ten days. Then about a year ago he went off Vicodin complety . He took them not so much for pain, but becaused he liked the High. I never understood that, because it does not make me feel high, not even kills the pain,
     So now that he is off of all pain meds, he thinks I should be too. He would not listen to any dr. he is very stubborn, I have asked him what should I be taking and he says anything but a narcotic. He does not care and no doctor is going to change his mind.
If he was in the pain I am in, mayby he would understand. This is one reason I am thinking about the Surgery again, but I don't know if WC would pay for it. My understanding of WC is that you can not go to any other dr. other than WC doctors for the ailment they are covering. If I do, I am not sure what I would lose. WC doctor wanted a updated MRI, but WC would not ok it. Just a X-Ray. I have degenerative disk disease.
  Recent X-ray showed;  MILD TO MODERATE DEGENERATIVE CHANGES PRIMARILY OF LOWER LUMBAR SPINE  WITH ENDPLATE OSTEOPHYTES. THERE IS HEIGHT LOSS AT L3-4, L4-5 AND L5-S1. NO LISTHESIS OR SPONYLOLISTHESIS.
MILD DEGENERATIVE CHANGES AT THE SACROILLIAC JOINTS.
        IMPRESSION. MILD TO MODERATE MULT LEVEL DEGENERATIVE
CHANGE OF THE MID LUMBAR SPINE.

My last MRI showe a broad based bulge at L4-5, and dessication and height loss. I have had these back problems since an injury in 1999 and been on WC ever since. Because I can no longer work with the chronic pain and its disabling components, I am on SSI and Social Security.I would much rather work, I worked with children (teaching) and did inhome health care but with a bad back can no longer lift more than 10 pds.It is hard to imagine if a dr. can not get accupuncture authorized, I have no chance of getting surgery authorized. I am comfortable with the Methadone, but even my dr. tells me I can not be on it forever. BUT HE ASKED IF I THOUGHT OF SURGERY OR A MORPHINE PAIN PUMP IMPLANT? GO FIGURE THAT ONE. Pain ***** big time and trying to get rid of it or get WC to do anything esp, without a lawyer is almost impossible. Thanks for the suggestions though. Mayby someone else can help too.    Fluffypurrcat

[Toomanyadvil]

Hi Fluffypurrcat

   It seems you have been through alot and have tried many options for your pain.
I know you mentioned accupressure but have your tried accupuncture?
WC also may not cover that.
It boggels my mind when things like alternative medicine arent covered. You would think it would be harder to get narcotics covered than something thats considered to be more "healthy" for your body by so many.
Also Hydrotherapy(pool therapy) is considered a part of physical therapy. And keeping you from getting it just seems silly to me. How can anyone hold back physical therapy. Especially WC. Is there any way to fight that with them if your DR says you need it?

I'm not sure if I understand correctly but does your insurance cover it? I know your under WC but what would happen if your insurance covered it instead of WC, would they drop your case?
I was under WC a few years back for a knee injury and I do remember that they had to cover what my DR recommended for me because they took the case. But not ever case may be like that.

I can understand your hesitence in the medication because your husband doesnt want you on narcotics. Have you tried to explain to him that you need them to function with the CP and without them you may not be able to have as fufilling life as possible?
You have ibviously tried many many other options and have found that methadone with Percocet for breakthrough pain works the best for you.
Is there any way to take him with you to the DR  with you if he is having a hard time understanding why you need the medication right now. The DR may be abe to explain to him that right now the medication is helping you more than if you werent taking it.
Research shows only 1-3% of chronic pain patients will become addicted to narcotics. Thats a very low number.
Because we experience such severe pain our bodies dont chemically react to narcotics the way someone taking them to get a "high" would.
Our brains have shown not to react to the pleasure feeling in the same way if we do feel a little dizziness or grogginess that can happen when we are adjusting to the medication. We are running to life when we are taking narcotics for our pain versus running from life when someone is intending to get "high" Thats a big difference in how our bodies react to the side effects narcotics can cause.
But as I said some people are suseptable to addiction from pain medications or other narcotics. It's just shown not to be the norm when it comes to treating CP.

I hope your husband can become more comfortable with your medicines. You deserve to have a little pain as possible and have as fufilling a life as you can.
Maybe you can talk yo your DR about having the surgery an how to gett WC to cover it(not sure how it works when it comes to surgical procedures) or whether your insurance can cover it without being dropped from the WC case. If understand correctly you saod your insurance will cover it?

I hope you can get the treatments you need whatever they may be. Keep trying. If your DR says you NEED this surgery because of the back injury from work and there is no other treatment that could work as well maybe you can get them to cover it.

TMA