Pain management and family.....suggestions?

[lee73010]

So I'm on here again and I have a question about dealing with family.  It's a two part question and one that I will post in the addiction forum as well.  My mother is convinced that I am not in enough pain to warrant taking opiates and is convinced I'm an addict.  I might be an addict but I am also in pain.  When I don't have meds, I don't do anything but sit around so my pain is a lot less.  I take the pain killers so activity is tolerable.  I'm going to see my PCP this week and mom is going to be pissed when I get my Rx.  

Any suggestions on dealing with family?

[mkh9]

Hi nurseaudrea,
Glad to hear you are doing so well in your career. It is great to hear sucess stories despite the pain. You asked if I had done resistance training, conditioning  and light exercises. Well, it sort of is a long story. When I first got reinjured 2 years ago my pain wasn't that bad and I was able to do all my normal activities except bend and twist. I went to a PT #1 and she got me out of pain in 6 weeks but forgot to tell me not to bend and not to do a particular exercise so I got reinjured. I was upset due to that and because we had lost two family members and so I went to another PT. I was doing pool therapy but that guy said I had SI joint and was making adjustments to my left SI but one day did the opposite leg and I went into major pain. I got onto pain meds and sat for a month (my doctor said don't move around too much) and I got weak and my left leg got weaker too than the right. I finally went to a third PT and he pushed me too fast and I pulled a muscle and then he bruised my ribs and pulled another muscle. I finally hurt myself at home and now I still can't bend, twist or cross my left leg over my right to put my pants on myself or socks etc. I couldn't even lift my left leg to get outside for two months. It has been a tough time and I wish I had gone to any PT's. Now I am walking 1 hour and have done 3 moderate hills a day. The integrative pain med doc seems to think it is myofascial as I responded very well at first (had no pain or little pain ) after taking the muscle relaxer also after taking Ibupropin for two weeks. It seems musclar but little things give me pain. So during the 3rd PT I was doing his stretches and strengthening but now I have stopped other than the walking. Do you have some specific exercises I can do to get a little stronger without pulling my back out?  I can probably do the bridge, clam (knees bent laying on side and lift the bent knee a little, knee to chest and ball squats where you lean against a ball and ball is agaisnt the wall and squat. I haven't done these in a while nor have I done stretches because it seemed to aggravate things. I don't know really how to go faster. It hurts to stand more than 5 minutes but lying down is good and walking and sitting with a heat pack is ok too. MRI is normal, bone scan normal and Hip Xrays normal even though I can't cross that left leg. Any ideas?
thanks for asking and sorry this is long.
mkh9

[lee73010]

I feel for you about the career thing.  My first love is being a paramedic and with my back.....I can no longer do that.  It kills me but.............I can't put the people I'm trying to help in jeopardy and first and foremost, I need to protect my body.

[mkh9]

I'm so sorry you are in pain even with Oxy. I hope you can continue with your career at some point. I am a microbiologist and had to quit because I got carpal tunnel in the left wrist and tendonitis in the right from too much pipetting and typing. But then now I have a back injury too that is muscular but I got atrophied or deconditioned from sitting too much due to pain and I have had this for two years. My pain varies from a 4 one day to about a 6 the next unless I turn the wrong way etc. I am stuck at home most of the time and have lost my career. Well, at least I can help people on medhelp sometimes. The doctor says I should recover but it is so hard. I was on pain killers, vicadin and tramadol but got off and now I'm mostly on Flexeril and NSAID's and some supplements and doing accupunture, biofeedback and walking. Sometimes strife and similar experiences bring people together. I also take Klonopin at night for a migraine variant that I've had for 20 years. I still get looks from new doctors when I tell them which meds i'm on. Oh well it works for the stomach pain/vomiting I used to get at night but not for the headaches. I don't care what they think anymore either.
hugs to you all,
mkh9

[lee73010]

Well, I am still working on becoming a nurse.  I went into the doc today and he changed my meds up a little to see is a long lasting with IR will help do the trick except I've take 30 mg Oxy 1 hr ago and my pain is still at an 7.  Boy do I hurt.  Mom will never understand so I've kind of  come to the understanding that we will always disagree, but hopefully we can come to a point where we can agree to disagree.

[Totie]

With me it is a "Need to know basis", & frankly, they don't need to know what medication I am on if any.....

My health is my personnel business & I have 16 sibilings (yes all from same parents) & I can say NOT one knows what medication I am on....

[nurseaudrea]

Why does she think you have MS? Have you had all the tests done also? I don't understant why she would think you have it when the medical professionals say you don't, and they have done the tests? Am I missing something?

And to answer you question about becoming a nurse, when I was in college I found out I had a congenital problem with my spine that required years of corrective surgeries. I decided to go ahead and continue my education. When I had my first surgery a nurse came into my room and told me I would never make it as a nurse with the back that I had. You can imagine how that made me feel. It just made me want to prove everyone wrong. I finished nursing school and had my last fusion and went into Neonatal ICU nursing. I have only taken care of adults on the post-partum floor when there was a shortage of nurses because we have to be cross trained. I love being a nurse and plan on going back to get my Masters next year to work as a Nurse Practitioner in Pain management.

And as far as you being leary of Chiropractors, many people are. And at the same time, many feel the same as your mother, they helped her so why wouldn't they be able to help you, she thinks. You have to feel comfortable with the choice you make and make sure you make them for you and not for anyone else.

Oh, and just for the record, I was also told I had myofascial pain syndrome before they know what was wrong with me. It is usually a fall- to diagnoses given when they don't know what else it is but know you have pain. As far as your atrophy, have you tried to do any conditioning type exercises. Any type of resistence training, or light exercise to start off with would really help so you don't strain any muscles.

[mkh9]

Hi, and sorry for all that you have been through. Did you ever become a nurse after all the back surgeries or did it keep you from your career?  I have a mother in law like that. She believes the TV shows too and keeps telling me I have MS even though my MRI is negative and the neurologsist says I am normal and so forth. She says things like once you have back pain you will never get better. I have myofascial pain syndrome. I have been to many doctors and am starting to get somewhat better though I get set backs and it is hard to get out of atrophy. I get the pain med thing too as that happened to me in my twenies as well. It is very frustrating as I try to explain to her but she says go see a chiropracter . I tell her I don't believe in them she say why why? They helped me get rid of a sty and my mother got better from one too. I just don't like chiropracters. sorry I am frustrated today as I keep trying to get out of atrophy or being deconditioned and I got a strain last night. I guess I needed to add to this string and also I feel for you and the others here on this string.

take care all,
mkh9

[nurseaudrea]

Some people just have a closed mind and you can't change it no matter how hard you try. My mother is one of those. I have had four spinal surgeries and two of them were for spinal fusions in my lumbar spine. I was 22 the first and was an athlete in college. The last fusion was one month after I graduated nursing school. I finally made it through college, don't know how on the pain meds that last semester, but I had to take them to get me through. My mom never understood then and still does not. I tried to get her to go to so many appointments and she refused every time. But she had no problem calling my doctor's office to tell them I did not need to be on pain meds because I was too young. At that time I was about 24 I think and was taking Vicodin. I wasn't even on the really strong stuff yet. That didn't come until my last semester of nursing school right before I had that surgery. I was put on Oxycontin. My mom about flipped out when she found out. All she knew is she heard about all the overdoses of the famous actors or actresses or nightly news reports with a big story about how bad and deadly that med was. She just knew it was going to kill me. I tried to reason with her and told her the only reason they died was because they misused it and if you take it properly it is completely safe. She did not care. Her mind was made up. She believes what she sees on the tv more than what I tell her and I have a feeling many of you go through the same thing. You can't change their mind. You can educate, but unless they open up and are willing nothing will change sadly.

I wish all of you luck.

[mellie4]

I've struggled with my family for a couple of years.  I've always been open and honest but they just don't believe my meds are necessary and they don't understand the kind of pain I have.  I have offered for them to come to appointments and they've declined.  They've seen me post surgery but they can't grasp what chronic pain is.  I don't think most people can.  I agonized over our differences and posted about it here a lot and thankfully I got tons of support here.  I have FINALLY realized that I don't have to have my sister's approval.  If she chooses to remain uneducated about my health issues, then she has no right to opine about my treatment.  You do what's best for you and that's between you and your doctor.  We all want our family to be understanding and for those that have that, it's wonderful.  But for those of us that don't, we have to learn how to set boundaries.

[bigj693]

Hey first yes all too familiar. An addict relates to pain as a normal functioning part of the body with opiates as the cure for all. But Im not judge n you. My  younger brother is an addict. Ive disown him and my father. My brother for choosing to continue buying my dads Ativans. My Dad for choosing to sell to him. My brother is also takin Methadone at a clinic cause he went to rehab twice as a failed attempt. The choice was theirs and I lost connection with them. 8 yrs ago my Mom OD at that. Next time you see your Mom ask for help to eliminate the pain. To get your body as well as mentally fixed so taking meds are not even an option. Its possible to get pain free if you want it. Be greatfull for your family or even the lack of. Dont let drugs get the best of you. Give your Mom a hug and tell her thank you

[mkh9]

Hi Lee73010,
It is hard dealing with family when they are not supportive. I've sure they are just worried. You have to have faith in yourself and try to not worry what others think. I didn't have problems with my family rather with the doctors. If I went to the ER due to vomiting and stomach pain, and asked for pain meds about half the time the doctors would make a comment or withhold painkillers from me until they decided I was not a drug addict. To this day (20 years later) I still get angry when I bring it up. It is so hurtful. I now have a diagnosis back then they didn't have a clue. One additional thing I wanted to add is I don't know if you are on morphine. But, morphine can cause pain after a while. So you then you take more and it causes more pain. My sister in law was caught in this loop. She went to a bunch of doctors had a bunch of procedures done and finally got a morphine pump. It leaked after a year and the ER doc had it removed and didn't give her anything for the withdrawal and she went into severe depression and withdrawal. So, she checked herself into a rehab center and when the doctor saw here enough times he was able to get her off the opiate and then give her a combo of drugs for her pain that gave her life back. She then went back to work and got married. She still has a neuropathy but she is on an antidepressant that works on the pain and depression plus a drug like Lyrica and another one and now she has stabilized. Her dad thought it was all in her head so to speak and wasn't helpful other than to keep her from getting a research procedure done. So, I would start to think about maybe doing something similar is to get onto program where they get you off the opiate onto something maybe more helpful. It depends on the kind of pain nerve versus spinal or other pain.
Hope this helps,
mkh9

[Jaybay]

Family can be one of the most difficult issues we face as chronic pain patients.  They don't understand it to begin with and as far as opiate therapy is concerned, they're operating on the assumption that being physically dependent equals addiction.  

First, anyone on regular opiate medications will become physically dependent on them, meaning we experience withdrawal symptoms if it's suddenly stopped.  It's the same withdrawal a strung-out addict experiences.

Addiction is a mental condition and drug abuse is merely a symptom of a larger problem.  While it's true that some patients on opiate therapy abuse the medication, the percentage is pretty low.  If you find yourself taking more than prescribed, craving the euphoric feelings, obtaining more from different doctors, you have a problem.

To make matters more confusing, there is a little-discussed phenomenon called pseudo-addiction.  A person displays similar behaviors as an addict like doctor shopping or taking more than prescribed, but the motivation is pain relief rather than pursuit of euphoria.  It's a tough call for the doctor or even the patient to make sometimes.

Over the years I've learned that a whole lot of people, family and friends included, just refuse to be educated about pain management in general and opiate therapy in particular.  If you've given it your best shot and still can't get anywhere, stop fighting.  People will have their opinions and ultimately, it isn't anyone else's business but yours and your doctor's.

Tolerance is always an issue with opiate therapy, so have a chat with your doctor about how he handles it.  You want to avoid constantly increasing your dose, so changing medications or even taking an opiate vacation every few months can help with that.  While we all want that magic pill to cure our pain, it just doesn't exist.  Opiates can improve it, but most of the time we have to live with a certain amount of pain.  Never forget that the practice is called pain management and not pain cure.  Talk your doctor about your goals for pain management so that you're both on the same page.  Mostly you're looking at improving your life rather than restoring you to perfect functioning again.

Also ask your doctor about therapy with a pain psychologist.  I'll admit I thought it was a big waste of time and money when my pain doc asked me to try it.  That was almost 6 years ago and I still see her when things get crazy.  She was the best at helping me resolve the very family issues you're having now along with other mental tips and tricks to better deal with the pain.  I'm sure your mom would approve of that non-narcotic option!  :-)