getting correct help for long term back pain

[Dmacman]

Hello everyone,

I just found this site, and I am very happy to find a group of people who can relate to me and help me. Thanks in advance.

My issue is I had a lower laminectomy (L5S1) in 1995. After months of Physical Therapy and tests, my neuro-surgeon removed this disc. He said it was like a tire on the highway that blew up.

Since then I have had almost none of the lower leg pain and numbness. But I have had intermittent pain and spasms in the lower back that my PCP has treated me with Hydrocodone and muscle relaxants. This works and within a week or so, the symptoms were relieved. I have not had this issue again since I started going to the gym 2 years ago.

I have had Gastric bypass since then to help me lower my weight (I was 375 pounds, and now 255). I go to the gym 4-5 times a week doing 30-45 minutes on the elipse and the weight exercises my physical therapist suggested

For the past 2 years I have had off and on severe upper back pain that is like someone is grabbing my spine, muscle and nerves and twisting them in a knot. I went thru physical therapy for months (core training and light weights).

In October I had gall surgery and was told I could not exercise or lift weights for 8 weeks.

At Christmas I was told I could go back to the gym but now I have had constant upper back pain. My PCP started treating me again with Hydrocone (7.5 750, the same dosage I have taken off and on again since 1995)
After 8 weeks, and no improvement, I asked to be referred to a pain specialist and get PT again. He agreed.

Since then I had 4 weeks of PT and they said it was not helping and I needed to get an mri and see a pm doctor. The pm doctor wont see me until I get a MRI. My PCP had me get a lower back MRI even though it is my upper back that hurts, to check the lower surgery area.

I still have not seen a PM doctor and now my PCP is making it difficult to get my prescription refilled (I call several days before I run out, since he is not in the office several times a week, and the doctors on call do not want to prescribe my pain meds since they dont know my history).

His nurse says she will talk to him, doesn't call me back until the end of the day, and then lets me know if he will refill it.

He makes me wait until I am almost out of medicine and even then it takes several call by me to even find out whats happening.

I am doing everything he, the insurance company and PT want me to. And even the PT said that me going to the gym and doing all the physical training I am doing is great and the PM doctor will be glad to see me making such an effort.

How can I talk to my doctor to speed the process up to see the PM and to get him to get my pain medicine refills without a constant battle?

I appreciate any help and advice.

thanks,
Don

[mellie4]

I think, Tuck, that is an excellent idea.  I think when you can look your doctor in the face and talk knowledgeably and explain your frustrations without seeming to attack either the doctor or their staff it can go a long way.  I think when you're dealing with chronic pain and you see and/or talk or interact with these doctors more than usual, it's imperative to have a really good one-on-one relationship with them.  It can make all the difference in the world.  (Same goes with the staff.  Befriending them and appreciating them can go a long way and can make the difference of getting an earlier appointment or them going an extra step for you.)

[Tuckamore]

Hi Don,

Welcome to the Pain Mangement Forum. I am so glad that you found us  and took the time to post. I found this site almost two years and have never left. It's a great place to share, learn and vent.

Sounds like your PCP is a bit skittish about prescribing narcotics. You might want to make an appointment with him and have a honest and open discussion. Sometimes I think the patient needs to put the physician at ease. A chat may do just that.

Explain how frustrating it is for you to make call after call and never know if he will or when he will prescribe the only relief you obtain from the horrid chronic pain. Telling him how the pain effects your daily life may help. He may need to hear from you again that this is not a simple, over done it backache. Most physicians aren't cruel or unreasonable. Appeal to the humanity in him.

Please let us know how you are doing. We'll look forward to hearing from you. And please feel free to respond to posts and ask additional questions.

Best of Luck,
~Tuck

[mellie4]

The Thermacare heating pads are fantastic!!  They last so long.  When I have fibromyalgia flare-ups (none in a while thank God), they are a life-saver.  I've tried the cheaper brands but I find they don't work nearly as well.  Costco sells a larger size pack and it's much more economical.

[betty1973510]

well i use those heating pads from wlmart that has the magnets called thermacare they work for me and i also use Arnica cream it wrks great you get at your local herb shop

[mellie4]

It's so frustrating when the doctor's office drags things out.  I've had that happen to me as well.  And I get anxious about calling more than once or twice because I feel it will be looked at as drug seeking.  I never know when it's best to call.  

I'm sure once you get to see the pain management doctor they'll work with you to get a plan in place.  I think most of them are difficult to get appointments with.  (I'm fortunate with mine because if I have a flare-up or if things get bad she'll squeeze me in within a day or two.  And we also communicate by email on a fairly regular basis.)

I'm sure there will be more people coming on.  Don't get frustrated; sometimes it takes a little while to get a response.  But you'll love this site.  So many great people here with a lot of knowledge and great suggestions as well as a lot of empathy.  No one can understand chronic pain like someone who also experiences it.

Good luck with everything.