A rant on pain management, in this country.

[mskafka]

I would just like to rant about the current status of pain management in the USA!

Some of you know....care....don't care... (and who cares?) that I was diagnosed with multiple sclerosis on Dec. 29, 2011. I'm not looking for pity; and this is totally not the point of this thread.

What I am PISSED about, is the the quality of pain management that we as patients receive.

For those of you who are unfamiliar with many autoimmune disorders....in autoimmune disorders, we have what are called "flares". Basically these are flare-ups of the wonderful, MULTITUDE of symptoms that go along with these diseases.

I recently had a flare that lasted for 7 days. My left hip began to spasm on New Year's night. I mean VIOLENTLY spasm-with fasciculations so bad, that it looked like an alien was going to pop out of my leg. I couldn't walk when they would start. I found myself on the bathroom floor three nights in a row, unable to walk back to bed. The pain was excruciating, that I thought I'd fractured my hip, spontaneously. Worse than any kidney stone, or ovarian cyst that I've had....and I've had a few. (TMI? Okay....I'll get to the point.)

3 days into this, I finally contacted my neurologist. Pain medication? No. Even though I was biting my lip not to scream on the phone. I got to talk to her "nurse" (medical assistant.....hey....no offense guys, but there is a huge difference between the two) and was basically told to hang in there. And a day passes, I'm still basically flat on my back, unable to stand for more than 15 seconds without having to sit down, due to the monstrous fasiculations. I get a call that home health will be to my house the next day for 5 days of solu-medrol IV infusions; and to make sure that I take TUMS between infusions for the gastrointestinal discomfort. Nothing for pain...for the muscle soreness that accompanied my involuntary muscle contractions in the above-mentioned. Gee thanks, doc.

I received the infusions, which stopped the contractures. And now, it feels like I've spent a week hiking and rock climbing. And I've done this many times my friends, so I know that there is going to be some amino acid buildup afterward for several days. I was in fantastic shape before all this began. Also, rheumatoid arthritis hasn't been ruled out, yet. We're just trying to halt the (MS) disease process, right now. One lesion on my cervical spinal cord is enough.

And finally down to the point of this entire thread:
The significant dosage of neurontin was not helping (what I thought was probably muscle soreness secondary to the contractions). I explained to this...medical assistant, that I was ingesting approximately 3200mg ibuprofen daily-to the point that I was beginning to get gastrointestinal symptoms as well. This didn't even strike a c-major in this woman. "Well......Dr. (no giving name) wants to try botox injections."

I asked these people if I could have 10 pain pills....would have settled for tylenol 3, tramadol...whatever. Nope. SOL and JWF!

I had to go to my PCP who seemed to understand that I was in a lot of discomfort, and gave me what I asked for. Nothing more. Nothing less. I wasn't asking for 90 oxycontin, or 50 fentanyl patches. This is the FIRST time I have asked for something narcotic-wise since this disease process began. And now, I feel like a criminal. I have been referred to a "pain clinic". I find that very insulting. All I want to do, is to be able to return to work, and walk with full range-of-motion of my extremities. I'm getting physical therapy, trying to exercise...doing all the right things.

I want to thank all of the dope dealers out there who go to these establishments, and get these pills to sell. Has it ever crossed your minds to get off your duff and get a job.....do something with yourself? You make me sick to my stomach.

What do I do? Write my representative. My fiance being a pharmacist, told me that doing so might be cathartic, it's probably a waste of time.

So what if you have bulging disks in your lower back. I have 2, and have managed to work...FOR YEARS....without pain medication or disability. Now, I have a true disability, with occasional disabling pain, and I can't get the help I need. Life is not fair...but this is BEYOND UNFAIR. Just 10 pills please, doc. That's all I'm asking.

Thanks for listening; and I'm open for any suggestions, rebuttals, etc... Bring them on.

 

[Katzndogz]

What about an electronic nerve blocker implant?

 

[lizzie]

I'd say that the docs in your area must be much different from the ones around here. When I'm on the job, I spend my days popping morphine and dilaudid to patients like candy.

 

[mskafka]

I'd say that the docs in your area must be much different from the ones around here. When I'm on the job, I spend my days popping morphine and dilaudid to patients like candy.

Yes, I also work in healthcare. We can administer (to an adult) up to 400 mcg fentanyl IV, without additional orders. I guess these people look at pain management differently.

My understanding is that it is a federal mandate. And I could understand if I'd wanted something off the charts....like 200 ms contin. But TEN PILLS?

 

[lizzie]

Hmmm- I'll have to check on the federal mandate issue- haven't heard of a change, but that doesn't mean it didn't happen, lol.

 

[Mr. H.]

I was given an rx for fentanyl patches when I cracked my ribs a couple years ago.
After reading the fine print on the insert, I was afraid to use them LOL.

 

[lizzie]

I don't blame you Mr H. Fentanyl is one of the drugs that I will refuse to give IV on the floor where I work. I've seen too many patients start declining toward respiratory distress on that crap.

Now, on the issue of the federal mandate, the latest one I see was in 2007. What were you asking for (specifically) that your doctors wouldn't give you?

 

[mskafka]

I don't blame you Mr H. Fentanyl is one of the drugs that I will refuse to give IV on the floor where I work. I've seen too many patients start declining toward respiratory distress on that crap.

Now, on the issue of the federal mandate, the latest one I see was in 2007. What were you asking for (specifically) that your doctors wouldn't give you?

I asked for 10 pain pills. I told them I didn't care...tylenol 3, ultram, lortab (the weakest strength)....or something other than the 3200+ mg ibuprofen that I was taking daily. I told them that I didn't feel like adding dialysis to my problems.

 

[lizzie]

I don't blame you Mr H. Fentanyl is one of the drugs that I will refuse to give IV on the floor where I work. I've seen too many patients start declining toward respiratory distress on that crap.

Now, on the issue of the federal mandate, the latest one I see was in 2007. What were you asking for (specifically) that your doctors wouldn't give you?

I asked for 10 pain pills. I told them I didn't care...tylenol 3, ultram, lortab (the weakest strength)....or something other than the 3200+ mg ibuprofen that I was taking daily. I told them that I didn't feel like adding dialysis to my problems.

Then it doesn't sound like it was an issue concerning the federal mandate. The mandate, from what I glean reading various articles, is on the triplicate-prescription drugs and long-acting narcotics.

 

[whitehall]

Legend has it that Elvis used to have a Physicians PDR book next to his bed and a Dr. Feelgood on call. The King would simply mimic symptoms to correspond with the drug he craved at the moment and the druggist would have it ready. Pain is a bitch and chronic pain can be dulled with regular dosages of drugs. Frankly I'm surprised that a person suffering from a disease that causes sudden "flairs" of pain doesn't have the prescription or the medication handy to deal with the problem.

 

[Kooshdakhaa]

I think you should go to the pain clinic. What's your problem with the pain clinic?

That's the purpose of a pain clinic...managing pain. You should at least give it a try.

What happens with other people suffering from MS? Do they also have pain? How is it treated? Sounds like a forum for people with MS might provide you with some help and answers. Maybe?

 

[Kooshdakhaa]

Legend has it that Elvis used to have a Physicians PDR book next to his bed and a Dr. Feelgood on call. The King would simply mimic symptoms to correspond with the drug he craved at the moment and the druggist would have it ready. Pain is a bitch and chronic pain can be dulled with regular dosages of drugs. Frankly I'm surprised that a person suffering from a disease that causes sudden "flairs" of pain doesn't have the prescription or the medication handy to deal with the problem.

Yeah, well that sounds basically what Michael Jackson's doctor was doing, and look where it got him.

 

[lizzie]

Legend has it that Elvis used to have a Physicians PDR book next to his bed and a Dr. Feelgood on call. The King would simply mimic symptoms to correspond with the drug he craved at the moment and the druggist would have it ready. Pain is a bitch and chronic pain can be dulled with regular dosages of drugs. Frankly I'm surprised that a person suffering from a disease that causes sudden "flairs" of pain doesn't have the prescription or the medication handy to deal with the problem.

Yeah, well that sounds basically what Michael Jackson's doctor was doing, and look where it got him.

You'd probably be surprised at just how many people travel down that road.

 

[Quantum Windbag]

I would just like to rant about the current status of pain management in the USA!

Some of you know....care....don't care... (and who cares?) that I was diagnosed with multiple sclerosis on Dec. 29, 2011. I'm not looking for pity; and this is totally not the point of this thread.

What I am PISSED about, is the the quality of pain management that we as patients receive.

For those of you who are unfamiliar with many autoimmune disorders....in autoimmune disorders, we have what are called "flares". Basically these are flare-ups of the wonderful, MULTITUDE of symptoms that go along with these diseases.

I recently had a flare that lasted for 7 days. My left hip began to spasm on New Year's night. I mean VIOLENTLY spasm-with fasciculations so bad, that it looked like an alien was going to pop out of my leg. I couldn't walk when they would start. I found myself on the bathroom floor three nights in a row, unable to walk back to bed. The pain was excruciating, that I thought I'd fractured my hip, spontaneously. Worse than any kidney stone, or ovarian cyst that I've had....and I've had a few. (TMI? Okay....I'll get to the point.)

3 days into this, I finally contacted my neurologist. Pain medication? No. Even though I was biting my lip not to scream on the phone. I got to talk to her "nurse" (medical assistant.....hey....no offense guys, but there is a huge difference between the two) and was basically told to hang in there. And a day passes, I'm still basically flat on my back, unable to stand for more than 15 seconds without having to sit down, due to the monstrous fasiculations. I get a call that home health will be to my house the next day for 5 days of solu-medrol IV infusions; and to make sure that I take TUMS between infusions for the gastrointestinal discomfort. Nothing for pain...for the muscle soreness that accompanied my involuntary muscle contractions in the above-mentioned. Gee thanks, doc.

I received the infusions, which stopped the contractures. And now, it feels like I've spent a week hiking and rock climbing. And I've done this many times my friends, so I know that there is going to be some amino acid buildup afterward for several days. I was in fantastic shape before all this began. Also, rheumatoid arthritis hasn't been ruled out, yet. We're just trying to halt the (MS) disease process, right now. One lesion on my cervical spinal cord is enough.

And finally down to the point of this entire thread:
The significant dosage of neurontin was not helping (what I thought was probably muscle soreness secondary to the contractions). I explained to this...medical assistant, that I was ingesting approximately 3200mg ibuprofen daily-to the point that I was beginning to get gastrointestinal symptoms as well. This didn't even strike a c-major in this woman. "Well......Dr. (no giving name) wants to try botox injections."

I asked these people if I could have 10 pain pills....would have settled for tylenol 3, tramadol...whatever. Nope. SOL and JWF!

I had to go to my PCP who seemed to understand that I was in a lot of discomfort, and gave me what I asked for. Nothing more. Nothing less. I wasn't asking for 90 oxycontin, or 50 fentanyl patches. This is the FIRST time I have asked for something narcotic-wise since this disease process began. And now, I feel like a criminal. I have been referred to a "pain clinic". I find that very insulting. All I want to do, is to be able to return to work, and walk with full range-of-motion of my extremities. I'm getting physical therapy, trying to exercise...doing all the right things.

I want to thank all of the dope dealers out there who go to these establishments, and get these pills to sell. Has it ever crossed your minds to get off your duff and get a job.....do something with yourself? You make me sick to my stomach.

What do I do? Write my representative. My fiance being a pharmacist, told me that doing so might be cathartic, it's probably a waste of time.

So what if you have bulging disks in your lower back. I have 2, and have managed to work...FOR YEARS....without pain medication or disability. Now, I have a true disability, with occasional disabling pain, and I can't get the help I need. Life is not fair...but this is BEYOND UNFAIR. Just 10 pills please, doc. That's all I'm asking.

Thanks for listening; and I'm open for any suggestions, rebuttals, etc... Bring them on.

You can thank the federal government and the war on drugs for your pain.

Drug Control vs. Pain Control - Reason Magazine

 

[mskafka]

I would just like to rant about the current status of pain management in the USA!

Some of you know....care....don't care... (and who cares?) that I was diagnosed with multiple sclerosis on Dec. 29, 2011. I'm not looking for pity; and this is totally not the point of this thread.

What I am PISSED about, is the the quality of pain management that we as patients receive.

For those of you who are unfamiliar with many autoimmune disorders....in autoimmune disorders, we have what are called "flares". Basically these are flare-ups of the wonderful, MULTITUDE of symptoms that go along with these diseases.

I recently had a flare that lasted for 7 days. My left hip began to spasm on New Year's night. I mean VIOLENTLY spasm-with fasciculations so bad, that it looked like an alien was going to pop out of my leg. I couldn't walk when they would start. I found myself on the bathroom floor three nights in a row, unable to walk back to bed. The pain was excruciating, that I thought I'd fractured my hip, spontaneously. Worse than any kidney stone, or ovarian cyst that I've had....and I've had a few. (TMI? Okay....I'll get to the point.)

3 days into this, I finally contacted my neurologist. Pain medication? No. Even though I was biting my lip not to scream on the phone. I got to talk to her "nurse" (medical assistant.....hey....no offense guys, but there is a huge difference between the two) and was basically told to hang in there. And a day passes, I'm still basically flat on my back, unable to stand for more than 15 seconds without having to sit down, due to the monstrous fasiculations. I get a call that home health will be to my house the next day for 5 days of solu-medrol IV infusions; and to make sure that I take TUMS between infusions for the gastrointestinal discomfort. Nothing for pain...for the muscle soreness that accompanied my involuntary muscle contractions in the above-mentioned. Gee thanks, doc.

I received the infusions, which stopped the contractures. And now, it feels like I've spent a week hiking and rock climbing. And I've done this many times my friends, so I know that there is going to be some amino acid buildup afterward for several days. I was in fantastic shape before all this began. Also, rheumatoid arthritis hasn't been ruled out, yet. We're just trying to halt the (MS) disease process, right now. One lesion on my cervical spinal cord is enough.

And finally down to the point of this entire thread:
The significant dosage of neurontin was not helping (what I thought was probably muscle soreness secondary to the contractions). I explained to this...medical assistant, that I was ingesting approximately 3200mg ibuprofen daily-to the point that I was beginning to get gastrointestinal symptoms as well. This didn't even strike a c-major in this woman. "Well......Dr. (no giving name) wants to try botox injections."

I asked these people if I could have 10 pain pills....would have settled for tylenol 3, tramadol...whatever. Nope. SOL and JWF!

I had to go to my PCP who seemed to understand that I was in a lot of discomfort, and gave me what I asked for. Nothing more. Nothing less. I wasn't asking for 90 oxycontin, or 50 fentanyl patches. This is the FIRST time I have asked for something narcotic-wise since this disease process began. And now, I feel like a criminal. I have been referred to a "pain clinic". I find that very insulting. All I want to do, is to be able to return to work, and walk with full range-of-motion of my extremities. I'm getting physical therapy, trying to exercise...doing all the right things.

I want to thank all of the dope dealers out there who go to these establishments, and get these pills to sell. Has it ever crossed your minds to get off your duff and get a job.....do something with yourself? You make me sick to my stomach.

What do I do? Write my representative. My fiance being a pharmacist, told me that doing so might be cathartic, it's probably a waste of time.

So what if you have bulging disks in your lower back. I have 2, and have managed to work...FOR YEARS....without pain medication or disability. Now, I have a true disability, with occasional disabling pain, and I can't get the help I need. Life is not fair...but this is BEYOND UNFAIR. Just 10 pills please, doc. That's all I'm asking.

Thanks for listening; and I'm open for any suggestions, rebuttals, etc... Bring them on.

You can thank the federal government and the war on drugs for your pain.

Drug Control vs. Pain Control - Reason Magazine

Oh, I totally agree! Several of us in healthcare have made the joke (well, maybe a little serious) that one of the solutions to the skyrocketing cost of healthcare, would be to put...a cigarette-dispenser-type machine in the waiting room of most emergency room waiting rooms, and fill it with all the narcotics that one could possibly want. I'll bet you, that EMS call volume would decrease dramatically. There would be no drug seekers in the ER.

Or better yet...make it OTC. Then there is the issue with DUI's and so on. But it's a thought. I believe that the cost of healthcare would decrease exponentially.

 

[mskafka]

I think you should go to the pain clinic. What's your problem with the pain clinic?

That's the purpose of a pain clinic...managing pain. You should at least give it a try.

What happens with other people suffering from MS? Do they also have pain? How is it treated? Sounds like a forum for people with MS might provide you with some help and answers. Maybe?

There is a stigma attached to pain clinics. I'm just recalling how many people I've intubated and treated from OD's from pain clinics. In THIS state, they are considered legal drug pushers; and this area....not very highly respected.

I have and do belong to an MS forum/chat. The reason that I am posting in here, is I'm wondering if anyone is aware of anything political...recently...that has addressed this ridiculous issue. I'm here, because this to me, is a political issue. And because I belonged to this forum LONG before I was diagnosed with MS.

And yes, I'm totally with Ron Paul on the "War on Drugs". I believe it has been a disaster. Now...do we need someone to make sure that people don't place harmful chemicals into the drugs that we swallow? Yes. (Even though it somehow continues in cigarette smoke with no problems).

And no, it's not constant pain. But when you have 7-10 days of involuntary contractions in a part of your body...it's going to get sore. This makes perfect sense to me.

Now there is constant numbness in certain areas, but pain? Only after a flare. And it sux.

 

[lizzie]

To me, it sounds like an issue between you and your doctors, and not a political issue.

 

[mskafka]

Legend has it that Elvis used to have a Physicians PDR book next to his bed and a Dr. Feelgood on call. The King would simply mimic symptoms to correspond with the drug he craved at the moment and the druggist would have it ready. Pain is a bitch and chronic pain can be dulled with regular dosages of drugs. Frankly I'm surprised that a person suffering from a disease that causes sudden "flairs" of pain doesn't have the prescription or the medication handy to deal with the problem.

Uhm....I KNOW, that you're not suggesting that I don't have MS! Please tell me that I'm misinterpreting what you're saying!

 

[mskafka]

To me, it sounds like an issue between you and your doctors, and not a political issue.

UGH! Yes, I have seen debates about it on C-Span. Jaysus, never mind!

 

[mskafka]

I don't blame you Mr H. Fentanyl is one of the drugs that I will refuse to give IV on the floor where I work. I've seen too many patients start declining toward respiratory distress on that crap.

Now, on the issue of the federal mandate, the latest one I see was in 2007. What were you asking for (specifically) that your doctors wouldn't give you?

I haven't personally had that experience when administering it.