uncontrolled pain

[scoobydooisawesome]

was just wondering if anyone else finds it odd ---- started pain mgmt in nov of 2010 he barely asks me any questions gets up and asks me to stand up comes up behind me and pokes me on both sides in my shoulder area and says does this hurt?  i said it is tender.. i didn't even get to tell him about all my other agonizing pain..... so he gives me an rx for 2 5mg oxycodone a day, i come back in a month and he asks me how it is working and i tell him i still have alot of pain so he says he will increase it, so now i am at  5mg oxycodone 3 x day.  next visit, tell him it is better than before but still in pain... writes same rx again goes on until 4months in a row i tell him my pain is out of control and it is like he just ignores me and continues to write the same rx and tells me he is concerned about the long term effects of my other meds i have multiple sclerosis, and high blood pressure too.  so he says something about doing a shot.  i said well i have already had shots (cortisone), he said no this is state of the art equipment... and then mumbled something which i thought was that if i still wanted to after that he would raise my meds.  so never explains procedure to me and i am thinking it is a high tech shot.. well, i learned a few days before the "SHOT" that the medial nerve branch block required anestesia and that made me nervous.  in fact i didnt even know that it was called MNBB until i had to call and cancel because i could not make appt because of flooding in our area and had to reschedule --- so now we are at 6 months later, the 3 days prior to the SHOT i was a nervous wreck.  go in and it was like an assembly line of ppl getting the same thing done.  My husband even tells the doctor that the medication is not enough and he says i know that is why we do this.. which i kinda feel like i was pushed into doing this. if it had been explained to me i don't think i would have done it.  Still have out of control pain that seems to be continually getting worse.  Wondering if this DR is ever going to try to control my pain or just use me as an experiment volunteer (that is what i fealt like).  I feel like my issues are being ignored and it is making life extremely difficult for me along with all of my other difficulties and obstacles i face on a daily basis.  Anyone else have a problem like this or any advice as to what to do?  

[scoobydooisawesome]

MNBB (median nerve branch block) ... I have been having some severe lower right above the hip back pain along with a lump about the size of a banana that has moved closer to my spine now.  It is causing horrific pain, I just pray that this doctor will hear me... it is like when I talk he looks at me and it just passes right through as if he has already determined what he is going to do as far as the meds and that is nothing... but really 5mg is not alot.  I think if he were to increase it to 7.5 or maybe 10 i would be fine.  But it is as if he just ignores me and in the meantime my pain levels have been ever increasing along with my frustration.  I wanted to say thank you to everyone for your responses.  I appreciate the responses as it makes me feel not so alone in this.  Being in pain all the time takes away your joy and zeal for life and I just want to have my life back.  I pray that God will see me through as to the right decisions to make in this and give me the words to say because I am just at a loss.  Thank you all so much.  I pray that all of us find our way to happiness and pain free... God bless you all.

[gari56]

I'm experiencing chronic pain in ankle after replacement. Getting unbearable. What meds might be best suited?

[Tuckamore]

Hi Scobbydoo....

Welcome to the Pain Management Forum. Please excuse my tardy response. I've had some laptop issues! I am glad that you found us and took the time to write a detailed post. Thank you. It makes our responses and suggestions easier.

A MNBB (median nerve branch block) is not a brand new procedure. The goal of this injection is to interrupt the pain signal carried by the medial branch nerves to the effected (or painful) facet joint. The success rate varies as do most procedures. It's not a long term solution but if effective it will give your PMP an idea of how effective other treatments, such as RFA may be in reducing your facet joint pain.  

In my opinion your PMP did a dismal job of preparing you for the treatment and explaining the rational. I am very sorry that he is lacking in that area. I can understand why you feel like an "experiment volunteer."  I may feel the same in your situation. My heart goes out to you.

I know it may be easier said then done.... but if you are not satisfied with your PMP I urge you to seek another. Yes, you may want to try to open the lines of communication with him. If he will listen and begin to build a good doctor patient relationship with you I would certainly retain his services.Your PMP may just be over-booked and carry a too heavy a patient load. Consider making a list of the ways your pain interferes with your life, including your nights. Make every moment of your appt time count.... and go from there.

Remember that Physicians are not Gods, they are service providers. We or our insurance company pay them dearly. They do not care for us out of the goodness of their hearts. If they do not provide service to your satisfaction it's time to move on.  There are some great physicians out there.

I don't know what "other medications" your PMP may be referring to when he says he is concerned about the interactions. Your pharmacist should be willing to discuss all your medications and the possible interactions with you in detail. They are the experts and often will take the time for a consult... or set up a time to speak with you. I encourage you to educate yourself in this arena so you may have a detailed discussion with your PCP regarding his concerns.

One thing I do know is that life is precious and in my opinion no one should have to suffer needlessly with unmanaged or poorly controlled pain. I believe that should be every PMP outlook. Unfortunately some believe that more strongly then others.  

I am very fortunate that my physicians are kind and caring. They take the time to listen to me and explain facts. That wasn't always the case so I can relate. However once I came to understand what I have said here, I sought out physicians that did care about my well being and if my pain was controlled. I urge you to do the same.

Please keep in touch and let us know how you are doing. We're all in this together. I'll look forward to hearing from you.

My Best and Take Care,
~Tuck

[namnam46]

Hi scoobydooisawesome,


First, I want to welcome you to the PM (Pain Management) Forum and let you know that we are glad you found this Forum. We are all CP (Chronic Pain) Patients that help each other with our own expertise and experiences that we have developed through our own CP Issues.

I'm so sorry that you are faced with this problem on top of all the pain issues that you are experiencing!!!  You would think that when you go to a PM Doctor that all of your pain issues would be over but unfortunately, that's now always the case!! I'm wondering if his hands are tied in some way because of your medications that you are on for you MS? There may be too many pain meds that will interact negatively with those meds.  

That being said, whenever you aren't happy with a Doctor you definitely need to check around and see who else might be a better fit for you.  I would suggest that you sit down and have a "good old heart to heart" with this Doctor and ask him specific questions about just exactly what Meds you have a choice of taking.  You must make it clear to him that the ones you are taking now don't work and you must get relief from your pain as it is entirely unbearable for you and you can't live like this!!  

Which of your Doctor's sent you to your PM Doctor?  Whomever it was, you need to contact him/her and let them know that he isn't helping you at all and your pain is unbearable and not getting any better.  Let him/her know that you must have some help and could he/she please refer you to another PM Doctor ASAP!!!  I'm sure that he/she will be willing to help you as he/she knows the unbearable pain that you are suffering with!!

Do you mind telling me what the initials MNBB stands for?  Those initials I've never heard of before.  :(  

The PM Doctor's do expect you to try as many of the other remedies, i.e. injections, PT, whatever they might have to offer, to see if it will help you.  If you aren't willing to at least try them then they have every right not to treat you.  That being said, after you have tried them and they didn't help you, you don't have to continue doing those procedures anymore.  I wasn't very excited about trying the RFA (Radio Frequency Ablation) on my Lumbar back but I did it and it gave me almost 100% relief for more than a year.  I still needed Pain Medication as I have mutltiple painful issues with my back but that procedure took care of one of them and it was the most painful of them all.  That procedure allowed my Pain Medications to work!! So I learned a lesson and was very fortunate.  I have also had epidurals on both my Cervical and Thoracic areas that didn't work and my Doctor totally understands that we won't be doing those again as they didn't do me any good.  Only lasted a matter of a few weeks and then the pain returned full force.

I wish you the best and hope that you will be able to find the relief that you need and deserve!!  Please keep us updated on how you are doing and what your Doctor has to say as I really am concerned for you and everything that you are going through!!!

I'll be looking for your updates and hope to see you on MH often........Sherry  :)

[BlueKnight007]

   Yes , I agree with the above post, time to see another Pain Management team. I also understand your feelings and the pain you must be feeling and the lack of understanding from your Pain Management Team. A-lot of us who suffer chronic pain are steered down not so helpful paths leaving us to fight for our release from suffering.
I caution you on changing Doctors to many times. Try and work with them, but IF THEY don't work FOR YOU then by all means seek other advice. ASK ask ask questions is important. That was hard for me cause I didn't know where they were going half the time.
You may want to ask what kind of medications are available for your pain issues and start looking them up for there known side affects. That will add to your question list.
I wish you good luck.
BK

[1spartan]

I have seen two pain mngmt. drs. and am going to see a third in a few days.  The 1st dr. was all about shots, blocks, and then finally a spinal cord stimulator.  He had upped my meds from 1 avinza a day, to two 10 mg oxycodone a day and when I agreed to the stimulator I went to 3 10 mg oxycodone with one hydrocodone for breakthrough.  I canceled the stimulator and found another dr.  The second one did very thorough checkups but no med increases.  That is why I am trying a third. ViolaBow is right.  Have your GP refer you to someone else.  The dr. you are seeing now is making alot of money from the injections.  Pain drs. like that are give and give. You give them your health, they give your insurance company large bills and then give you a script that will work, which will make it seem like the injections work.  I hope everything works out for you.

[ViolaBow]

Take a list of questions and ask, ask, ask. If he is still being this uncommunicative ask your GP for a referral to someone else. Sometimes you have to really hassle to get what you need and require out of the medical profession. Some are great but many are hopeless. I think they think because they "know" what they are doing we can automatically read their minds. I would probably be seeking another pain specialist you can relate to. Easier said than done. All the best with it.