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Pain Management Community
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767538 tn?1276578920

Going back to work.

I guess I'm clutching at straws here folks. I'm attempting another return to work this Monday April 6th. In the last 5 years I've had 3 spine surgeries and two shoulder surgeries and have had severe chronic pain since my 2 level L4-5 S1 fusion in 2003. I have severe lumbar stenosis and also have lumbar radiculopathy and peripheral neuropothy. I've been on around 7 leave of absences in the last few years due to the pain. I attended a PMP in February and it helped me a lot and it was great because they use a complete mind body approach to treat CP. They teach you proper pacing techniques etc, etc. I'm very anxious and stressing out about trying another work return but also stress about not being able to work again and the prospect of LTD or SSDI. I'm SO afraid of undoing all the good I learned through the PMP and over exerting myself which is what always ends up happening. I'm at Manager at Costco and work 10-12 hours days on concrete floors which I know is not good for me but I just can;t seem to get myself to face the reality that I cannot continue to abuse my body and accept the inevitablity that I either need to change my job or feel good about having to apply for SSDI.
Can anyone offer any words of advice or encouragement to me for my situation. I have received some GREAT feedback from Tuckamore and Mollyrae which I have appreciated greatly.
Has anyone else been in a situation like this that would be willing to share their story with me?
I just want the best quality of life possible as I know we all do and know that my quality of life is SO much better when I'm not working and I can really use the techniques I learned in the Pain Management Program from relaxation, breathing exercises, meditation and proper pacing of my tasks that I need to carry out each day.
My work has been my life, my identity, my everything really which I know is not good also.
I stress about the income loss, losing my medical benefits as I'm the main provider for my family of 5 and so on and so forth but I know I have to care of my body as well. I was able to titrate down from 60mg of Methadone in the PMP and haven't taken any for 49 days which I feel really good about but stress about how I will be at work without having the methadone. I've gotten by with Endocet 10/325 and I can usually get by with 1-2 in the evening if needed. My Dr wants to put me back on methadone which I have said no to. I considered asking him about the fentanyl patch but don't if that's a good idea? My pain has been increased over the last 3 days and I'm sure it's due to being anxious and stressing out because of returning to work. I'm returning at 4 hours initially which will help but can't imagine getting back up to my normal 10-12 hour days.
Well I've written enough already!!!! Thank you all in advance for your prayers and advice.
Thanks.
Brian.
15 Responses
Avatar universal
49 days sounds like long enough to have it well and truly out of your system. You're doing very well. If working is important to you then i would suggest doing it even if after a while you need your dr's help again. now that you know what can happen regarding pain meds i'm hopeful that you wouldn't have those problems again. I am one of the ones who takes fentanyl. honestly it's way better than anything else i've taken(esp side effect wise). It never makes me high or anything like tat so i think it's abuse potential is faily low(certainly not zero though). there's no need for you to beat yourself up. maybe if neccessary you caould even just try the weakest patch. it's about the equiv of 25mg morphine a day. that's not much to a person inchronic pain but it may help. going back to work is beyond me at the moment but one thing that might be worth doing is working on your general fitness levels before you work again. being in constant pain and on drugs makes it difficult to maintain good health. I've said lots of good things about the patches, but i should also say that it makes me grumpy(anyone noticed?). but this only happens on high doses or when i reduce my dose(as i sometimes do to minimise side effects). anyway, i'm not sure i came up with any great advice. best of luck anyway,

Nick.
767538 tn?1276578920
Nick, I tried to leave you a note but it wouldn't let me? Not sure why?
Thank you for you response! I really appreciate the info on the patches. I see my Dr tomorrow and I may bring up the question then. My Ortho surgeon has suggested a spinal pain pump but I don't want to go that route unless it's last resort. As for the Methadone.........Believe it or not I still have some mild W/Ds, mainly yawning and tearing up. My sleep is almost back to normal but I take Amitriptylene 75mg for sleep. I have noticed a lot of your posts and wanted to tell you in made realize something. I posted many things in the substance abuse forum cos I thought I was addicted to Methadone but have come to understand that is was a physical dependency to help control chronic pain and NOT an abuse. I feel myself gravitating much more to the PM forum and that is thanks to you!!! Would you mind sharing your story with me? I noticed you live in Oz.........I am from the UK but live in Seattle now. I feel I'm too young (43) to have such horrible pain but I see you are 11 years younger than me and I always try and remember there are people worse off than me. In terms of you saying it makes you grumpy. I relate to that, when I was on Methadone and Endocet for breakthrough pain at the same time, I was snapping at my kids, the wife everything, not sure why? But anyway, now I'm off Methadone my mind is like a whole new one, I was in such a fog and didn't even realize it.
Cheers.
Brian.
356518 tn?1322267242
My son works as a manager at a huge department store also and he works on his feet for hours on end. He will stay even after his shift to make sure everything is done. He has a knee injury from basketball that kept him from trying out professionally and it really bothers him some days. I know where your coming from, as a mom who wishes her son would take better care of himself I can relate.
Have you discussed the possibility of trying a new positions that would not be so demanding? How long have you been a manager? Do you maybe have the option to move up to a less demanding job? I know the company my son works for absolutely will do what they can for him because he is such a great manager. Talk to them and see what they can offer. Finding good help these days is very hard, most are just willing to do the bare minimum to get by and have no motivation to exceed, so when a company has a good employee they will do what they can to keep them with their company I understand that is a very discriminating comment but that's my opinion from my experience.
Good luck, let us know how it goes.
Avatar universal
sandee:
that's not a discriminating comment at all sandee. i think most people would agree on that one.

brian:
thanks for what you said. i needed something like that right now. yeah it's a difficult issue to understand especially when you are going through it. I know what it's like because evry now and then i take myself off my meds to see if the pain is as bad as i thought it was. very silly but i do it occasionally. it always ends up the same. horrendous pain lets me know that i haven't gone crazy yet. hope that makes sense.
I'm not sure why it wouldn't let you leave a note. it's not through my doing. I will write a summary of my story and send it to you as soon as i can(when i feel up to it). thanks for making me feel a bit better.

good luck to all

nick
767538 tn?1276578920
Hello Sandee.
I totally relate to you son......He sounds just like me.....I'm never there for less than 10 hours and tell myself I'm going to leave right at 10 hours and then end up being there 12 hours!! My wife gets so mad at me but she doesn't relate to what is required of me as a manager. I have been a manager for many years and have worked at Costco for 17 years in total. They will work with my restrictions for 6 weeks at which point they expect me to be back at 100%. If I'm not, they will see if they work around the permanent restrictions and if not they send me back oiut ona leave of absence.
Costco is a good company and they do all they can to take care of their employees that have restrictions or limitations. There are other positions that they have that I could consider but it's a substantsial income loss for me and it would require me to commute 65 miles one way. I currently only commute 17 miles and I hate that.
547368 tn?1440545385
Hey Again,

Do you think you could take the commute? I am concerned that just the travel would increase your pain.

Sandee is correct that companies try their best to maintain good employees. I am hopeful that you and your employer can come to a reasonable solution, whatever that may be for you. Some times there comes a point that we know it is just over in spite of our desire to maintain employment. I hope you and your physician have discussed this in detail. I'm wishing you the very best.

We'll be watching for your updates, Tuck

Avatar universal
6 weeks seems like a reasonable time frame to get back into things. good employers. many wouldn't be that generous. best of luck. perhaps working will even help distract you from the pain.

nick
535089 tn?1400677119
Hey Nomometh:

If you ever want to know the benefits of the Patch, I would be more than happy to give you information. I have  used the patch for a year now and have had great success with it. I don't have to worry about taking daily medication and it does not make you feel euphoric and things of that nature. It really helps the pain. If you find that working is taking a toll on you then please consider the patch. It may just be the ticket.......

Good luck my friend,
Molly
767538 tn?1276578920
Hi Molly,Tuck & Nick,

I'd love to hear your input on the patch. I didn't have enough courage to bring it up with my Dr today. I had a very uncomfortable appt with him last month and I just didn't want to rock the boat with him today.
He was very nice today, supportive, understanding and just generally caring which I appreciated considering my last appt. If you are interested you can read about it on one my recent journals.
I told my Dr I am anxious and stressed about returning to work and he told me that's only natural. I also told him I was anxious about not having the Methadone to help me work and he asked if I wanted a precription to which my reply was "I want to try and do it without Methadone." I have Endocet 10/325 which I can take if needed but it only seems to last for about an hour which is not effective when I'm working as many hours as is required of me.
This is why I've been considering asking him about the Fentanyl patch if I can't handle work.
Molly, what kind of side effects does it have? How well does it control your pain? What strengths should an individual start at? What is the maximum dosage that can be taken?
I'm so afraid of going anywhere near Methadone again even though I have to say I termed it as a " miracle drug" when I first started it. It was just SO very difficult to come off of. I'm at 50 days and still dealing with some W/Ds which blows my mind. For some reason my Dr really believes in scripting Methadone for chronic pain patients.
I guess I'm trying to find out what is the best med to take with taking in to account that I may have to take it for the rest of my life. I did tell my Doc today that I only need Endocet on hand for the times at home when I have pain flare ups and that I can get by with the "Big dog" meds as long as I'm at home and not working and my quality of life is greatly improved when I'm not working.
He told me he's in my corner and he won't throw me to the wolves!!  I also told him that if I come in and see him and ask for a full release (I normally do this) that I need him to be my best advocate and tell me what's best for me even if I don't want to hear it to which he agreed. Basically telling me if I have to go on disability he will support me through it and won;t give me a full release if he feels it would be a detriment to me and my my body.
I just want to thank ALL 3 OF YOU for your support and understanding in helping me through this. I feel the same kind of bond with you all as I did with the other chronic pain patients I met through my pain management program.
We are starting up a chronic pain support group on April 14th through the hospital that did the PMP so I'm really looking forward to that. It will be good for all of us.
I honestly think we have these bonds because we all know and understand how difficult it is to live with chronic pain and can relate to one-another so readily. Not a pity party either. Just supporting each other, listening, encouraging and the like.
Talk to you all soon.
Brian.

535089 tn?1400677119
Hey Brian:

I will send you a pm and give you the info on the Patch.

Chow.........
Avatar universal
i will also PM you later tonight with as much info on the patch and it's effects as i can along with some other stuff that i promised.

nick
Avatar universal
I can totally understand not wanting to go back on Methadone. I had to take it when I could not afford Kadian when the insurance company decided it was not reasonable or necessary for me because I was too young to be on narcotics because I would become dependent after being on them for 5 years already. They cut me off for 2 years and I had to pay out of my pocket. It took two years for me to fight for my benefits. It was ridiculous. I was in my late 20's by then. I swear I will never go on Methadone again unless it is the last resort. It was the worst thing I have ever come off. When I think about it I cringe. I also have been on the patch and from what I remember it was great, except the adhesive kept making me break out and itched like crazy. I could not handle it. I kept scratching at it and it kept coming off so that only lasted a few months. I did like how it handled my pain though. Also like Nick I take myself off meds every once in a while to make sure I need them. I totally understand that. Thank goodness my PMP goes along with me everytime. I guess he understands that. I am to the point now that I am realizing I may need to be on them forever. Although that idea does not agree with me. Some people in my family still frown at the idea that I take pain meds on a daily basis. They just don't get it.  
I just wanted to throw my support your way and hope your return to work is in your favor. Make sure you don't over do it and pace yourself.
Good luck,           Audrea
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