Ortho Appt

[geminigirl1963]

I just got home from my ortho appointment a short time ago and wanted to post an update about my hip.

The ortho doc (actually PA, but that's quite all right) was very, very nice and very, very concerned when she walked into the room.  The first words out of her mouth were "you look absolutely MISERABLE!" and of course, I told her I was miserable.

She took a look at the xrays that I had taken the other day that I had brougth with me and fortunately, there does not appear to be any fracture - although she did say that one area looked a little "suspicious" for one, but thought it might just be the angle they had taken the film at.  I do have degenerative disc disease and a bulging disc that she said she's 99% sure has at least one nerve pinched/trapped.  She said that would explain all my pain, why it's worse when sitting, why it goes down my leg and also the tingling/burning in my foot.  Her exam, of course, was excruciating and she was very apoogetic for hurting me, but of course, it couldn't be helped.

She's given me a medro dose-pack (prednisone) to try and alleviate some of the inflammation and thereby hopefully relieving some of the pain.  She also gave me a script for Nucynta, however, I was not able to get that filled because my insurance does not cover it, it was goign to cost $110 for a 10 day supply and even though she had given me a discount card for it, because my prescription coverage is through Medicare, I'm not eligible to use that card - nobody with any type of government prescription coverage is.  Which totally and completely SU***!!!

So I put a call into her office to let her know about the Nucynta - they're closed for lunch right now, so I'll call back shortly if I don't hear from them soon.  I don't know if there's something else she may want to try or if she'll just want me to stick with the dilaudid (the dilaudid does help).  I have no problem staying with the dilaudid since it is helping, but I'm also all for trying something else if she thinks it might help better.

I'm to call her on Monday and let her know how I'm doing.  She said if I'm not at least 50% better after taking the dose pack by then, then she'll order an MRI to get a better look at what's going on there and then we'll have an appointment to go over those results.  If I AM at least 50% better, then she'll order some physical therapy for about six weeks - she said that sometimes once the initial inflammation and pain is settled down, the PT does help and may help this from happening again.  Even if we do start the PT, if I don't notice an improvement after a couple of visits, or find that it's making things worse - she'll do the MRI at that point.

I asked her about SIJD and she didn't feel that that was my problem - she said with that, the majority of the pain is right in that SI joint area at the back of the hip and since mine compasses the entire hip, it didn't quite sound like that was the situation in my case.  However, she did say that that would be one thing they would look at if/when we do the MRI.

I'm about to go lay down for a while - I'm totally miserable right now - doesn't help matters that I didn't feel I should take the dilaudid this morning with having to drive (it does make me sleepy and I had at least a 1/2 hour drive each way), so instead I took one of my regular pain meds - lorcet plus.  I did tell her this and she said that was absolutely fine.  But, of course, the lorcet does not do barely anyhthing for the pain and by now it has completely worn off.  So the first thing I did when I got home was take a dilaudid and I'm hoping it will "kick in" soon and hopefully I haven't waited too long to take it and let the pain get too far ahead of me where it might take a couple of doses to get ahold of the pain.  I also need to take the first dose of prednisone, but wanted to get something to eat first - I've learned from past experience NOT to take that on an empty stomach.

Sooooo - that's where we're at for right now - here's hoping she's on the right track.

[geminigirl1963]

Sherry -

It could just be the particular Medicare prescription plan that I have (RX America, but I don't remember WHICH Rx America plan - there are two of them).  I do not qualify for Medicaid secondary either, mine is strictly what I believe they call Medicare Part D.  I don't have a secondary through any other insurance company either.

I'm sure I could switch the prescription plan to another one, but I've been with this one since Part D became available and have always been pretty happy with them, so I'm a little hesitant to change.  I may check into a couple of other ones, though, just to see if there is better coverage out there for me.

The Ambien 10 does ok for me - some nights better than others - but the CR definitely did a better job at allowing me to STAY asleep than the Ambien 10 does.

Thank you for the kinds words :)

[namnam46]

Robyn,

You're not going to believe BUT I get the Ambien CR and it IS covered by MY Medicare. I just picked it up this week. I wonder if there is a difference from week to week OR possibly it has to do with your diagnosis?  Are you on Medicare with a Supplemental Coverage such as AARP United Healthcare OR with Medicaid secondary? I have the Supplemental Coverage as I don't qualify for the Medicaid secondary.

I'm just VERY glad that you ARE getting help now....Sherry

[geminigirl1963]

Sherry - I'm sure you're right about the Medicare prescription coverage.  The ortho did say that this was a relatively new medication.  I've had almost this same type of thing happen to me a couple of times - once with Zofran.  Once it was with Prevacid when it was still only available by prescription (but apparently the OTC version was close to being approved so they stopped covering it) and the third time was with Ambien CR - they used to cover that, but have stopped covering the CR and will only cover the "regular" ambien since there is a generic form of that available.

I'm VERY grateful for the prescription coverage that I do have - I know for a fact that I would not be able to afford my medications without it - but it still can be frustrating when there's a medication that you doctor thinks will help you and they won't cover it.

RunningMom - I think you're also right about the medrol dosepack - I do believe it's a little less strong as "regular" predisone, so maybe it will be easier on my stomach, but I'll still take it with food, as that's what it says to do on the instruction paperwork that came with it.  It's been a while since I've had a dosepack, I typically just get prescribed prednisone when I need it with a tapering schedule, so I couldn't remember exactly.  I also don't know the dosing difference between "prednisone" and "methylprednisolene" that's in the dose pack.

Jaded - I'm sorry about your MIL and your own DDD and herniations.  I hope you're both getting some kind of relief from treatment - you're right in that it's VERY painful.  I do think this ortho is very open to trying different things and doing further testing if need be, so that does definitely alleviate some of my anxiety and worries.

I couldn't figure out how to link this post to my previous post about the hip pain and the problems I've been having with it, but if anyone wants/needs to refer to it, I believe I had it titled something like "desperately seeking ideas/suggestions - in agony" - or something similar to that.

[jamlws]

Im sorry about all your pain. I am glad you found a dr that was super nice which helps so much when you are under their care.
I hope the meds help take the pain away so you don't feel so bad. I know when I am hurting and drs touch my face it makes it worse so resting is great for you right now.
Take it easy
Jamie

[RunningMom]

I'm so sorry you are having such a hard time right now.  I'm happy to hear that this doctor is helping you and I hope the medrol pack will be of some help.  I believe the medrol is not quite as strong as the prednisone taper, so it should be eaiser on your stomach.  I hope you are able to go ahead with the MRI.  It's always nice to know how severe the discs are.  Take care and I hope you are feeling better soon.

[JadedSweetheart]

My MIL has a very similar condition and it causes her a lot of pain daily.  It sounds like this doctor is treating you correctly, though.  As the pain came on quickly, she is treating it with a short term solution and being open to more later, if need be.  I have DDD and 2 disc herniations in my neck so I know it's a painful situation.
I hope the prednisone and other meds treat the flare up and that it gets better for you.  

[namnam46]

I'm SO very glad that your appointment went so well for you!! CONGRATULATIONS!

I REALLY helps when you like your Dr. and a BONUS when you like the PA also!! So  glad that you got some meds to try and I HOPE that you will get a different med from her this afternoon that when she calls back that Medicare will cover. I FORTUNATELY haven't run into that problem with my Medicare and I HOPE that I don't. Sometimes it's because there isn't a GENERIC out yet and that's why Medicare won't cover it.  I'm sure later down the line that Medicare WILL cover it just not while it's so VERY new and there are so many others out there that do the same thing.

I'm glad that they have a plan for you and you don't have to worry about WHAT is coming NEXT!  They went over it with you and you ALREADY know.

I' VERY happy for you my Dear.....Sherry