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Well, it is very simple. Those who don't want pain medication or prefer to take Tylenol for pain conditions that warrant opioids, don't take them. But, don't prevent others from taking them who do need them. ANd, i find it a little disturbing that an ER provider on this board takes the "patient as addict" attitude right off the bat.
Unfortunately the law only allows physicians to prescribe substances - like opiates - that have an extreme potential for addiction even in patients who have previously never had problems with addiction to anything. The law will not all physicians, in most states, to prescribe pot. While marijuana certainly isn't going to work for all pain, it works a lot better the ibuprofen and tylenol
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.
SACRAMENTO, Calif. (AP) -- The first U.S. clinical trials in more than two decades on the medical benefits of marijuana confirm pot is effective in reducing muscle spasms associated with multiple sclerosis and pain caused by certain neurological injuries or illnesses, according to a report issued Wednesday.
Well, it is very simple. Those who don't want pain medication or prefer to take Tylenol for pain conditions that warrant opioids, don't take them. But, don't prevent others from taking them who do need them. ANd, i find it a little disturbing that an ER provider on this board takes the "patient as addict" attitude right off the bat.
Unfortunately the law only allows physicians to prescribe substances - like opiates - that have an extreme potential for addiction even in patients who have previously never had problems with addiction to anything. The law will not all physicians, in most states, to prescribe pot. While marijuana certainly isn't going to work for all pain, it works a lot better the ibuprofen and tylenol
Really? Pharmacologically, MJ has absolutely no analgesic properties. Ibuproffin (and other propionic acids like aleve) are analgesics and anti-inflammatory. Tylenol is an analgesic but not an anti-inflammatory, but has anti-pyretic properties. The mechanisms of action of these drugs can clearly be mapped out.
I understand that altering your perception w/ MJ might work for some people's pain, but it's not really a pain medication.
A laboratory study supported by the center examined if pot could be helpful in treating migraine headaches and facial pain. In that study, rats given a cannabis-like drug exhibited reduced activity of nerve cells that transmit pain.
Cannabinoid ReceptorsCB2 receptors appear to be responsible for the anti-inflammatory and possibly other therapeutic effects of cannabis.
http://www.nature.com/nri/journal/v5/n5/execsumm/nri1602.htmlMoreover, as I discuss here, a wealth of information also indicates that these drugs have immunosuppressive and anti-inflammatory properties; therefore, on the basis of this mode of action, the therapeutic usefulness of these drugs in chronic inflammatory diseases is now being reassessed.
'These effects were found to be due to the suppression of spinal and thalamic nociceptive neurons, and independent of any actions on either the motor system or sensory neurons that transmit messages related to non-nociceptive stimulation. Spinal, supraspinal, and peripheral sites of cannabinoid analgesia have been identified. The discovery of endocannabinoids raised the question of their natural role in pain. Multiple lines of evidence indicate that endocannabinoids serve naturally to suppress pain.
http://www.nature.com/neuro/journal/v10/n7/full/nn1916.htmlCannabinoids mediate analgesia largely via peripheral type 1 cannabinoid receptors in nociceptors
http://www.ncbi.nlm.nih.gov/pubmed/16449552Cannabinoid analgesia as a potential new therapeutic option in the treatment of chronic pain.
http://www.bmj.com/content/329/7460/257.fullHigh hopes for cannabinoid analgesia
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.
Mskfka, I'm sorry for your pain, and I don't know what to tell you, except You might do a search on pain management caregivers who approach pain differently from your current cabal. I too have an autoimmune pain complex, which took me over 10 years to truly learn ways to manage my pain better, and a change of physicians (when we moved to a warmer climate) who found another issue that truly helped when it was fixed.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.
Well, it is very simple. Those who don't want pain medication or prefer to take Tylenol for pain conditions that warrant opioids, don't take them. But, don't prevent others from taking them who do need them. ANd, i find it a little disturbing that an ER provider on this board takes the "patient as addict" attitude right off the bat.
I find it a little disturbing that you and your cohorts keep attributing sentiments to me that I never said and don't believe.
Then again, you guys continue to miss the ball on this matter. If you really knew what you were talking about, you'd understand why the ED is not the appropriate place for people to try and manage their chronic pain.
Unfortunately the law only allows physicians to prescribe substances - like opiates - that have an extreme potential for addiction even in patients who have previously never had problems with addiction to anything. The law will not all physicians, in most states, to prescribe pot. While marijuana certainly isn't going to work for all pain, it works a lot better the ibuprofen and tylenol
Really? Pharmacologically, MJ has absolutely no analgesic properties. Ibuproffin (and other propionic acids like aleve) are analgesics and anti-inflammatory. Tylenol is an analgesic but not an anti-inflammatory, but has anti-pyretic properties. The mechanisms of action of these drugs can clearly be mapped out.
I understand that altering your perception w/ MJ might work for some people's pain, but it's not really a pain medication.
Really? Sure, if by "absolutely no" you mean "many studies suggest yes"
From article linked in above post:
From another source:
Cannabinoid Receptors
http://www.nature.com/nri/journal/v5/n5/execsumm/nri1602.html
'
Cannabinoid analgesia. [Pharmacol Ther. 2002] - PubMed - NCBI
http://www.nature.com/neuro/journal/v10/n7/full/nn1916.html
Cannabinoid analgesia as a potential new th... [Ann Pharmacother. 2006] - PubMed - NCBICannabinoid analgesia as a potential new therapeutic option in the treatment of chronic pain.High hopes for cannabinoid analgesia | BMJHigh hopes for cannabinoid analgesia
cannabinoid analgesia - Google Scholar
Sorry - but your suggestion that marijuana has "absolutely no" analgesic or anti-inflammatory properties is simply not supported by the available evidence. Why did you even make that claim?
I do know what i am talking about and i didn't say the ER was the ideal place and venue to manage pain. But, the reality is that there are people with chronic pain who are going to have breakthrough pain and at times present to the ER. If you wan't to deal with that kind of stuff then maybe ER medicine isn't for you.
People go to the ER for any and all things whether they should or shouldn't is beside the point , they do and they have to be treated adequately based on their condition.
I don't see the need for you to be condescending. I do know the differerence between ER physicians and PMDs and their roles and so forth. But, whatever. Apparently, i am not allowed to disagree .
I don't see the need for you to be condescending. I do know the differerence between ER physicians and PMDs and their roles and so forth. But, whatever. Apparently, i am not allowed to disagree .
Wait, you just told me that, after four years of slaving through Medical School, you tell me that I am going into the wrong field because my idea of the appropriate use of narcotics doesn't conform to your perceived notion of what they should be, and you say I am being condescending?
My viewpoints are tame compared to most of the ED attending physicians I have worked under.
That reflects a problem with the level of suspicion and fear of censure imparted to medical professionals by the DEA. My GP told me that my age, MRI confirmation of my condition and the relatively small dosage I require enable her to comfortably prescribe for me.He is not the only 'medically trained' person on this thread. And I don't think that is what he is saying. I have seen my share of drug seekers as well. Probably more in my 23 years as a nurse than he has. They exist. They are out there. They have a pattern of behavior, usually.
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.
I think you will find this relevant:
SACRAMENTO, Calif. (AP) -- The first U.S. clinical trials in more than two decades on the medical benefits of marijuana confirm pot is effective in reducing muscle spasms associated with multiple sclerosis and pain caused by certain neurological injuries or illnesses, according to a report issued Wednesday.
Marijuana Provides Pain Relief, New Study Says
While I dont have an exact statistic on this, I can say that most of us are sensitive to the heat. In fact, for many years, the "hot bath test was used to diagnose MS. A person suspected of having MS was immersed in a hot tub of water, and watched to see if neurologic symptoms appeared or got worse, which would earn them a diagnosis of MS. (This practice was stopped when MRIs came on the scene, but is still practiced in some countries where MRIs are not readily accessible.)
Heat Intolerance and Multiple Sclerosis - Heat and MS - Pseudoexacerbations in MS
you are such a fucking dumb bitch at times
And hysterectomies were used to treat ill behaved (read: "women who don't want to have sex with their husbands) at one time.
The link between latitude and MS incidence (sun/heat exposure) has been disproven.
I really think a hot bath is a wives tale. It's a hell of a lot cheaper than an MRI w/ T2 Flair, and if it were at all accurate, would be a better test.
Exactly. You know they USED to diagnose mumps by having the kid eat a pickle. If the parotid gland hurt then he/she had the mumps. Well this Remodulin I'm on causes that to happen every time I take a bite of anything. According to the wives tale, I will have mumps until the day I die. Think I can get disability? LOL
Well, what did you spend thousands of dollars on? You sound very condescending toward the patients you supposedly treat? You don't seem to like your job much or the people you deal with. And, i would assume substance abuse often goes hand in hand with pyschiatiric problems as well and part of your job would involve that also.
As for your rude comments toward me, i have never taken an illegal drug in my life. But, apparently you want to resort to character assassination so i will do likewise.
