How to approach my Primary Care Dr

[doubleavn42]

I have double avascular necrosis of the hips and degenerative disc disease in my back. I am currently going to the VA where my Doctor only prescribes 60 Loritab 7.5's every 4 months. This does not last me 4 months with the pain and surgery is out of the question. The Ortho said that I must try to make it another 20-30 years and manage the pain before they will perform surgery for the condition or I will be having surgery every 2 years. This Dr was outsorced by the VA and I had the same opinion from a teaching specialist that refused surgery. I do not know how to approach my primary care provider at the VA she said if i go over 60 pills in 4 months she would have to put me into Pain managment and I don't even understand what that is. I know people that go to Civilian dr's and get Loritab 10's prescribed to them 180 per month. I do not understand hy I would have to go into pain managment just to get 30 a month instead of 60 every 4 months. The pain most of the time is terrible and this allows me to function. Should I enter pain managment or ask about a higher dose so i don't take as many each day. Should I ask for a change in prescriptions that may last longer throughout the day? I am afraid to ask anything of fear they may see me as a pill junkie and cut my prescriptions totally out. I have never recieved any type of pills for pain from the VA until this year and been going for 10 years to the VA. Any advice would be appreciated and remember I am dealing with the Veterans Healthcare System, so any advice or past experience would also be appreciated.

[doubleavn42]

I am currently unemployed due to my rating and about to become 100% va unemployed with social security disability due to my disorders. I have no medical care beside VA so anything beyond VA would be out of my on pocket.

[shinty]

The VA has been on a "crackdown" lately regarding pain medications-meaning they are "stingy' with them. I think it's a shame, for I believe that veterans should have top-notch medical care. That includes top-notch pain control also. Can you go to a non VA doctor at all? good Luck,
              shinty

[mopar1]

I do go to the V.A. I had a bad experience with the V.A. but your primary can only give you so much then you have to go to Pain Management they will perscribe what you need I personaly went to my own PM Dr and I get my script filled at the VA they have a cronic pain program and I get my scripts evey 28 days on schedule feel free to message me if you would like

[only1barbi]

I think what Dr. Mathur is saying is good strong advice.  While I am on pain medication and do go to pain management, it is best to try and find other ways to deal with the pain because the problem with pain medications is if you are say, 45 and start taking them, then by the time you are 50, it takes more and more dosages to treat the pain as our bodies become used to the medication and they are ineffective.  I wanted to tell you a little about pain management - they will work with you to find out what works best for your type of pain and have other alternative treatments in addition to medicines.  The good thing about pain management doctors is that they have seen many cases of the same thing, specialize in treating pain and they can regulate and keep an eye on things so that you don't get too much or too little of something and they know when it is time to switch you so you do not become addicted or even overdose etc.  They will also do random urinalysis.  Unfortunately, they have to do this because so many people are getting pain pills just to sell on the street to make money.  We have a widespread problem in America right now with this.  Pain management doctors are under scutiny from the DEA espcially right now but understandably so.  Pain management doctors may also order additional tests and refer you to specialists and other doctors who can help you but you will only go to them for your pain medicine.  It keeps people from getting pain medicines from 3 or 5 different places.  It is really for you own good to have only 1 doctor prescribing pain medications.    Hope that helps.  

[Dr. Kokil Mathur]

Hi!
If the pain management center at VA gives a more holistic approach to treatment then that should be tried. I do not have any experience regarding VA, but what I can suggest is that you need both pain medications (as in Loritab) and physiotherapy to manage both avascular necrosis and disc degeneration. Only pain relief medications will not work. Electrical stimulation can also be tried. So, if your primary doctor is able to arrange this then go ahead with the doctor. Otherwise, you may need to see a pain management clinic. You could probably ask your doctor if physiotherapy will help and ask for referral to a physiotherapist. Also, you could ask for an extended release medication to help over a longer period of time. Hope this helps. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.