Is it really Anxiety?

[Iggygray]

Hello,
I have never done anything like this before and I don't know what to do for my husband. I think he has several issues going on and having problems trying to address the symptoms for the right problem. I will do my best to explain his history.
He is a 39 year old male. has had 2 knee surgeries in which he will eventually need a need replacement but can't at this time. Since the surgeries he had been on hydrocodone and in the end Percocet. He has also hurt underneath his shoulder blade and haven't been able to find a doctor to help.  he is constantly in pain and didn't like the way the pain pills were making him feel and after so long of taking them he couldn't tell if they were helping or making the pain worse.  He would take more than the recommend dose and then running out before he could refill his prescription, so he would towards the end take less leading him with chills, hot flashes, shaking. He would do this for several months and eventually decided he wanted off the pain pills. he thought he was in withdrawal from the way he would take more in the beginning then take less. so, he went to a rehab center thinking he was in withdrawal and wanted help. after being there a couple of days, they didn't know he should be there so he checked himself out and after being home for a week those symptoms started to come back. he went to our family doctor and we don't think he has the compassion to help. the family doctor has prescribed an anxiety medicine thinking that he may be experiencing that.  they prescribed citalopram 40mg, he was also taking zolpidem to help him sleep and no success cause his symptoms would come back.  one minute he is hot then cold and has shaking. when he was at the family doctor they did blood work and everything was normal but they did find high level of inflammation in his blood.  they recommended a rheumatogist. so he has recently been to ER and they also recommended. they gave him something that  did temporary help but we can't keep going to ER until we can be seen by the rheumatogoist which is not until April 11th.  

I can't think more I want to thank you for reading this and any help will greatly be appreciated.

Frustrated Wife that want to help husband!

[Paxiled]

I think he's got doctoritis -- too much doctoring.  Obviously to me he keeps putting himself into withdrawal and he's abusing his prescription for opiates.  I'm sure this is due to frustration.  The symptoms you're describing are pretty classic withdrawal symptoms.  Chronic pain can cause all kinds of emotional distress.  You can't do what you want, it interferes with sleep, and the nerves get very touchy so the pain feels worse.  Taking opiates regularly will make the dosage not work so well, so you take more not so much for the pain but to avoid the withdrawal.  But what you haven't said is if he feels anxious or not -- if he doesn't, he doesn't have anxiety.  Putting him on an antidepressant just adds to the drugs, and they are very hard to stop taking as well.  All these need to be tapered off of slowly to avoid bad withdrawals.  If you miss doses or fiddle with your doses as your husband is doing, you also throw yourself into withdrawal.  The brain needs time to learn how to operate without the drugs.  As for the inflammation in his blood, of course he has -- he wouldn't have the knee problems or now the shoulder problems if there wasn't inflammation.  But it's hard to see how the rheumatologist will help him permanently -- mostly they do cortisone, and if he does have anxiety, that will make it worse, and you can only do so much of it so at best it's a temporary fix and at worse it destroys tissue.  I'd have him see the rheumatologist, but also I'd see a physiatrist, a doctor who specializes in pain control.  They sometimes know some things, such as platelet replacement and other techniques, in addition to cortisone.  They also know about drugs such as neurontin and it's newer versions that block nerve pain.  But mostly, he needs to get to the cause of the problem.  Surgery often leaves permanent problems behind, and orthopedists are one of the main sources for the current opioid epidemic because their surgeries are often unnecessary or poorly done.  I have no idea whether any of this is what's going on or not but these are issues to face when dealing with doctoritis -- you need to be as hard on them as you would your plumber if your toilet kept overflowing.  Find one that will fix the problem even if that means going somewhere such as Mayo Clinic or Johns Hopkins or wherever that specializes in fixing things instead of mediating them.  Then you'll at least know if it can be fixed.  For your husband, I'd suggest looking into non-medication forms of pain control, such as hypnosis or acupuncture or meditation or a combination given he's on the strongest painkillers and they're not doing the trick, he's probably addicted, and he's very frustrated.  Keep fighting.