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Avatar universal

NEED ADVICE TO TALK WITH MY PM DR.

I need some help to bring up my medication topic to my pain management doctor.  I have been seeing him for the last few years.  I just recently had an MRI done where they found quite a few issues on my neck, arm and back.  I went to see my psychiatrist yesterday and we were talking about the pain in my neck, arm and back and I told him that I felt that the vicodin helps but it's only for a few hours.  The psychiatrist then said you need to be on a long lasting medication, and then basically said why are you not on something longer than vicodin.  I said the doctor has never put me on anything else.  I have NO idea how to bring up this with my pain doctor.  He defiinitely knows I have issues as he's trying to get the stimulator put in me, so I don't think it's a question of what my issues are, I just don't know how to ask him if he could put me on something else, or what I should be put on.  Does anyone have any idea what I should do?
7 Responses
547368 tn?1440541785
You have offered some good information in the past to others that have posted with a very similar questions. It's strange that it is always different when we are actually in the situation. So follow your good instincts. It wouldn't hurt to inform your PMP of the discussion you had with your therapist.

I never advise anyone to ask for a certain type or specific opiate. In my opinion the best approach is to tell your physician exactly how you are feeling including where your pain levels are from hour to hour. Give very detailed information. Your PMP needs to know how your pain effects your daily life and your ability to function...or not function.

Once you have successfully relayed the impact your chronic pain has on your life, ask for his help. Ask for suggestions and additional approaches to treating your pain.

Most competent physicians want to treat you with the least amount of narcotics as possible for long term chronic pain. The younger you are the more years you have ahead of you to mange pain. In my opinion you don't want to get into the big dog meds at high doses any sooner than you must. On the same hand life is too short to live with unrelenting pain. You deserve to be comfortable and have your pain adequately controlled. It's a fine line and one that a good physician take seriously.

So just be open and honest with your physican. Give him the opportunity to suggest pain management options whatever they may be. I know you'll keep us updated. It's always good to hear how you are doing. Please remember to be good to yourself.  

I'll be thinking of you.

My Best,
~Tuck  
1275919 tn?1279836004
I'm so sorry! You've been going through so much lately! I recently brought this up with the new doc. I simply asked if there was anything that lasted longer that he felt comfortable with me trying. I told him that after 4 yrs of PM that I'm getting tired of the ups and down. And I am. I'm sick of popping a pill every 4-6 hrs. Sick of always having to have them with me because if I don't take the meds as soon as I start to feel pain by the time they kick in I'm playing catch up. I also wanted something that would even the pain out. Something that didn't make me feel as though I'm on a rollercoaster always up and down with the pain. When I had the nerve block done last month the doc gave me the 10mg oxycontin. Not sure if you remember but he only gave me 20. When I saw them on friday it was a different doc in the same practice and when I asked again. He said.. well I see here that the doc put you on 10mg oxycontin. and I said yeah, but he only gave me 20 of them and I wasn't quite sure what to do with them so I was taking them at night so I could maybe sleep better but I didn't see any great improvement. So he bumped it up to 20 mg. and gave me the full 60 and told me to take one with breakfast and the next 12 hrs after that. It seems to help some. I know how frustrating it is being on short acting meds. If you don't take them at the first sign on pain it can be difficult to get it under control. Talk to your doctor. If you've been with him for a few years then you should hopefully have a good relationship. Let him know that you are wondering about it and then let him know why. Tell him how you feel about your meds, if they help, how much, what you would like to see improvement on, what you are satifsfied with... Are you one of the ones that's up at night a lot? (Sorry, I know we all have our nights but I know several of you have more than others). If you are, I know I had many sleepsless nights before the long acting meds. Less once the sleeping pill was added, but still. That's another thing. Say you're allowed to take your meds 4x/day. One of my big frustrations was that if I used one of those up at night I was taking away from my daytime meds when I needed to be at work or involved with the kids. I hated taking the meds to help me fall asleep (get comfortable enough to sleep) but needed to. I felt like I was wasting them. Then if you don't wake up in the middle of the night you wake up (or I did) in excrutiating pain because the med has left your system entirely through the night so you start the morning having to play catchup with pain control. I was really tired of the short lasting meds. And frustrated. The 20 mgs. seems to help more than the 10mgs did. I'm still taking the breakthrough meds 4x/day though. I want to get that down. I would like to find something that requires way less bt medication. But really. Tell him the pros/cons of what you're on and where you would like to see yourself. Let him go from there making recomendations and then try whatever he suggests. I do hope you find relief soon. You poor thing. You deserve a break!
Avatar universal
I agree completely with Dont.  Just tell the doctor how you're feeling about taking the ST meds and ask about something more LT.  That way the doctor can take it from there and give a good suggestion about what to do.  You've been going to him for a while, so I think he should definetly work with you.
I hope you feel better soon!  I know you've been going through a lot and it's time for things to go well for you!
Avatar universal
Thanks Tuck,  

I'm still thinking of just saying nothing and hoping that I will feel much better soon.  I feel bad because my PM doctor and I had a BIG discussion a few months ago about pain medication and I told him that I wasn't comfortable being on anything else than the vicodin and he was GREAT with that.  Now, my psychiatrist feels that I need to be on something else, and I would never ask the PM doctor to put  me on a certain medication because I feel that is his specialty of what he does.  I do know that I've been with my PM for over two years and I've never had a medication change.  I've done physical therapy, accupuncture, I've done the tens unit, and a unit to help stretch my neck, I've had xrays, and many, many epidural injections and just recently he has given me lidoderm patches to help with the shoulder pain that I'm having and I've also had an MRI.  I've also agreed to do the neuro stimulator, even though I have no idea when that will be, if it will get approved, my psychiatrist just gave my pain management doctor a note stating that I'm a good mental candidate for it so I'm in limbo about everything.  I don't know what to do, but I do have an appointment, so I will let everyone know what will happen.  EVERYONE, thank you.
Avatar universal
Karen - I'll leave it to you to tell evderyone what happened, BUT I wanted to let you know that I'm THRILLED about your outcome today!!!!

Glad we had the chance to talk before AND after and that your Nice Doctor listened.

(((((HUGS!!)))))..........Mama Sherry

Avatar universal
Everyone, thank you for all your great advice, Bree, Dont understand (sorry don't know what your first name is) and of course Mama Sherry and Tuck.  I've started a new post and updated what happened!  I'm so thankful I listened to all of you.
1275919 tn?1279836004
I'm glad it went well! And my name is Amanda :)
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