Pain Management Dr. Problems

Hello Everyone!
I'm new to this site and have been looking around at questions and comments and find all of you to be helpful when someone is in a position where they need help.
I am currently having some issues where it would be nice to have some opinions.
I have Degenerative Disc Disease, Spinal Stenosis, 2 Herniated discs (1 of which is torn), and sciatica. I'm 24 years old and have had these problems for the better part of 6 years. Recently, the pain in my left leg has become unbearable. I find that I can still walk, although I am very slow and limping and in a lot of tremendous pain. The pain does not go away with heating pads or ice and the Vicodin prescribed does not work either. My leg is sensitive to touch and even having a blanket rub on it is excruciating.  I have told my Dr. all of this information yesterday at our appointment and he does not see any need to increase or change medications. He has been my Dr. for pain management for a year now and all I get from him is that at my age, I am too young to need surgery for this. I have been through everything he has requested of me (Physical Therapy, all kinds of medications, MRI's, X-rays etc.) and still the pain is getting worse, but he says "You're only 24, too young for this surgery" Well, yesterday when I showed him how much worse my pain is, I asked him how to go about getting a wheelchair through Medicaid. Again "You're only 24. No body would give you a wheelchair" I'm tired of hearing that I'm too young. I'm in a lot of pain, crying most of the day, everyday. I want someone who is proactive. How do I go about "firing" this Dr. and finding another without looking like I'm "Dr. Shopping" for prescriptions?

[femmy29]

Hi Emerald and welcome to the pain management community.  I am so sorry you are dealing with so much pain and have to be here especially at your age.  Because you are young, doesn't mean that you should forced to deal with the pain and be refused treatment.  You definitely need a new pain management doctor.  It is OKAY for you to make appointments with other pain management physicians to discuss how THEY would go about treating your pain.  BUT, once you accept a prescription from them (for any medication, controlled or not), you should only fill the prescriptions from the replacement doctor, if you have old scripts from your current doctor...those need to be purged.  Additionally, you need to send a letter off to your pain mangement doctor that is basicially a "notice to quit" stating that you are beginning pain management care under x doctor on x date.  Make sure you do not fill your new scripts before the date that you note on the letter.  Have a notary notarize the letter and send it through certified mail so that you have a receipt that the doctor received your letter from the postal service.  Keep a copy of the letter and notice of delivery receipt from the postal service for your records should your records ever be monitored through the prescription drug monitoring program.

I deal with very similar ailments as you as I am on very strong medications that are helping increase my quality of life significantly.  

You need to be EXTREMELY CAREFUL about surgery.  Fusion surgeries are only 50% successful and typically only are a good idea if you have lost bowel or bladder control or the nerve damage is posing a risk for paralysis.  Many come out of surgery with MORE pain 10X worse than they had before.  The type of pain they come out of surgery with is mostly nerve pain which most opioids don't treat effectively.  

The pain you are describing sounds like a lot of it is indeed nerve pain.  I also deal with a lot of nerve pain.  Anti-convulsants (such as Neurontin-Gabapentin or Lyrica)and a couple of anti-depressants (one being Cymbalta) have been more effective at treating nerve pain.  You may still need opioids as not all of my pain is nerve pain.  I take Gabapentin and a long and short-acting opioid combination along with Valium as a muscle relaxer.  This combo keeps me pretty comfortable.  Realize that you may need a different combo to most effectively manage your pain as everyone responds to medications differently.  Have you tried Neurontin or Lyrica before?

I am planning on having endoscopic spine surgery done next year.  It is a minimally evasive surgery that only requires local anesthesia and it has a success rate of greater than 90%.  They effectively treat spinal damage that you and I have with minimal recovery and risk.  I recommend you research it as it could eliminate your pain such that you can start living a long normal life and not have to take medications to have a life with less pain.  After endoscopic surgery, I plan to reassess my pain to see if I still need pain meds or if I can live comfortably without medications.

Hope this helps.  Good luck and again, welcome!  :)

femmy

[Ginger077]

I agree with what Femmy is saying. I've had several lumbar surgeries starting at a young age and the last one being a fusion. I'm in the same amount of pain before the last surgery 4 yrs ago but now nothing can be done for me except pain management. Lyrica is amazing!  Narcotics don't take that nerve pain away. I would see about getting on it and I think you will notice a huge improvement if it works for you. Please exhaust all options before going thru surgery. My first one was successful but my last two were not and my dr told me that the ONLY way to get out of pain was a fusion... What a liar!!
Best of luck to you!!
Ginger

[omhome]

ginger or somebody?  how much lyrica do you take a day and do you notice any side effects? i have nerve pain and it seems to help a little but i take only 50mg  4 times a day......and does anybody want to start a chronic pain patients right to proper medication group with the goal of maybe finding legal remedies to our individual chronic pain journeys?  OM

[Emerald_Frog]

I have recently spoken to my Dr. about the serious pain in my leg. He said that, as a pain management Dr. he can think of no other options for pain management except for surgery and recommended me to a surgeon. I go to see him on Sep. 10th. Thank you for suggesting Lyrica, but I've tried Lyrica and some other medication like it and they just made me sleepy. I've tried all kinds of nerve pain relief medication, prescription narcotics, Physical therapy, ice packs, heat packs...etc. etc. The most this Dr. was willing to give me in narcotics is a 10/325 Vicoden. It does seem to help but I still have pain. (I'm def. not expecting to ever be 100% better) but,  I am going to see this surgeon and see what he says. I'll keep you all posted.

[babygirl6152]

Have you tried either Neurontin.?..
Nerve pain, somehow seems to loosen up the nerves my disc is sitting on, I have sciatica.

I also tried cymbalta (there is another similar one, Effexor maybe it is called?,...... it blocks all pain receptors and is an anti depressant
It is an SNRI, similar to anti depressants that are only SSRI's, well the ones I have taken are SSRI

Read up on these, GOod Luck, neverending pain is enough to make a girl insane