View Full Version : Chronic Pain (Please help!)


Laserbeak
12-31-14, 12:47 AM
I am on the verge of tears about this, I am so afraid.

I am currently on 5mg oxycodone 3x a day, but think it should be raised to 4x a day since IR opiates last only around 4 hours.

Anyway, these doctors don't like prescribing it because they think it'll bring attention to them and have been trying to shove me off to some pain doctor for this.

I went to this pain doctor twice, the first time he prescribed meloxicam and Lyrica. The meloxicam is no more effective as an Advil, and the Lyrica is not covered by my insurance and is extremely expensive (like $500/month).

Now he is sending me for an MRI (which is fine, I had one before a long time ago on my elbow for the same problem), but then he wants to put me on nerve blockers that need to be injected into my elbow and will basically deaden the nerves between my arm and brain for a month, then I get a new shot.

I do not want this.

Right now, the oxycodone I'm taking is an extremely small dose and almost entirely takes care of it. If I got a prescription for 4 a day, it would be perfect. Oxycodone comes in tablets up 30mg, so my entire day's prescription would be less than that, so this pain doctor saying "oh, you'll die if you take oxycodone" is either completely ignorant or intentionally misinformative.

What should I do? I have one PCP covered by my insurance and another that I used to go on my prior insurance who doesn't take what I have now.

Should I just go in and break down and tell them I'm scared to death of these nerve injections because I'm a computer programmer and need to use my fingers well in order to make a living, I can bring my mother along too, she's very skeptical about drugs, but even she thinks Oxycodone is the best one for me by observing me. When I had a nerve block during the surgery it lasted much longer than the doctors thought it was supposed to, they called in neurologists to look at it and kept me in hospital for like 2 more days than expected.

Should I get the MRI and then take the results to one or both of the other doctors?

michaelaisabell
12-31-14, 01:02 AM
Hi, I say tell them the truth about why you don't wish to do nerve injections.

Also you might want to try a new pain management dr.
I go to pain management. The first one I went to would only give me a muscle relaxer, and an anti inflammatory and she kept wanting to give me cortisone ****s even though they didn't help.
So I went back to my Pcp and got refered to a new pain doctor.
The new dr started me off on 5mg oxycodone 3x a day then after a fee months switched me to 7.5mg 4x a day.

If say just be honest and try a new doctor.
Also, I was sent for X-rays, and two MRI scans , as well as a nerve conductivity test and they still never figured out what causes my back pain.
I also did phsyical therapy.

Greyhound1
12-31-14, 01:35 AM
Beak,
Sorry, to hear about all the pain. I would go to the most reputable Pain Specialist around. If opiates are the answer a specialist will understand that. Most importantly, won't be scared of the DEA questioning them.

Also, make sure to keep an open mind with treatments. Ending your pain is the bottom line and medications never really do that. You need someone that can help resolve your pain.

Best of luck, I have been battling terrible back pain again myself.

Laserbeak
12-31-14, 01:44 AM
Also, make sure to keep an open mind with treatments. Ending your pain is the bottom line and medications never really do that. You need someone that can help resolve your pain.


I agree with the idea of keeping my mind open, but please understand that a large section of bone was surgically removed from my arm since it was shattered.

There is no possibility, other than some miracle by God, that it will come back. The nerves around that area are some how twisted or pinched or something in a way that that keeps me experiencing constant pain, even after having two surgeries by a hand surgeon who is/was supposedly one of the best in the U.S. It does wax and wane, but it is always there.

I have been on a million different drugs, and the only thing that comes near to stopping it is oxycodone.

MrsNewton
12-31-14, 02:16 AM
The way the Drs look at it is if you are in as much pain as you say you are in, you will try anything and everything to make it stop. If you refuse other meds and procedures, it throws up red flags and they won't treat you for long.

4 percocet a day is indeed a lot, and even at 325mg of tylenol per pill, (the lowest dose they come in) that is A LOT of Tylenol to be taking every day. You can take them every 4 hours, but that is the absolute minimum amount of time allowed between doses. ( If they are giving you straight oxycodone, I would be surprised. )

You indicate that you don't want the pathways from your nerves to your brain to be messed with, but oxycodone alters your brain chemistry far more than a nerve block ever would, just FYI.

I would strongly encourage you not to go up on your daily dose. I would spread them out to every 6 hours while awake and take the meloxicam in addition. Meloxicam is a powerful anti-inflammatory and can work wonders if given the chance.

It's not that they think it will bring attention to them, it really will. They have to provide documentation for what is going on with you as well as what other methods have been attempted when the DEA comes knocking, which they regularly do.

Laserbeak
12-31-14, 02:47 AM
The way the Drs look at it is if you are in as much pain as you say you are in, you will try anything and everything to make it stop. If you refuse other meds and procedures, it throws up red flags and they won't treat you for long. ...


Well my father was a doctor so I know what is up. And I haven't refused the nerve block yet. I may try it once. I just don't personally believe will be right for me but it's only one month so we shall see.

Laserbeak
12-31-14, 02:49 AM
And if they screw up I'll be able to sue for millions of dollars.

Maurice
12-31-14, 06:24 PM
Laserbeak, I understand chronic pain. No 4 effing Percocets a day is NOT a high dose or even close to it.

Doctors are scared to death of the DEA. That's your problem. I have told you before that it is possible to get the pain relief you need and deserve.

I was taking 6 X 30 mg. Oxycodone a day, for breakthrough pain.

I was taking 5 X 200mg. MS Contin (morphine) a day for chronic pain.

You've just got to keep trying until you find a doctor that has a pair.

PM me if you need anymore help.

Best of luck to you!

Maurice
12-31-14, 06:26 PM
The way the Drs look at it is if you are in as much pain as you say you are in, you will try anything and everything to make it stop. If you refuse other meds and procedures, it throws up red flags and they won't treat you for long.

4 percocet a day is indeed a lot, and even at 325mg of tylenol per pill, (the lowest dose they come in) that is A LOT of Tylenol to be taking every day. You can take them every 4 hours, but that is the absolute minimum amount of time allowed between doses. ( If they are giving you straight oxycodone, I would be surprised. )

You indicate that you don't want the pathways from your nerves to your brain to be messed with, but oxycodone alters your brain chemistry far more than a nerve block ever would, just FYI.

I would strongly encourage you not to go up on your daily dose. I would spread them out to every 6 hours while awake and take the meloxicam in addition. Meloxicam is a powerful anti-inflammatory and can work wonders if given the chance.

It's not that they think it will bring attention to them, it really will. They have to provide documentation for what is going on with you as well as what other methods have been attempted when the DEA comes knocking, which they regularly do.

You obviously have no conception of chronic pain.

Maurice
12-31-14, 06:30 PM
Well my father was a doctor so I know what is up. And I haven't refused the nerve block yet. I may try it once. I just don't personally believe will be right for me but it's only one month so we shall see.

The last thing you want is a nerve block. The first thing I thought of when I was offered a nerve block is absentmindedly resting the palm of my hand on an electric stove element and wondering where the burnt smell of meat was coming from lol.

Lunacie
12-31-14, 07:30 PM
I do know about chronic pain. I found acupuncture to be helpful, but only
when done at a Chinese clinic by specially trained doctors.

I recently bought a TENS unit that uses electrical pulses to moderate pain.
I've been using it on my lower back and my bum knee and feel it is helping,
although it's not curing anything yet and probably won't.

The TENS unit was much cheaper than visits to the clinic. Got it at Walmart.

Little Missy
12-31-14, 08:34 PM
I believe Laserbeak is talking about the little 5 mg oxycodone. Not Percocet.

Laserbeak
01-01-15, 07:50 AM
:goodpost: (didn't notice it until I wrote what is below).

Just to be clear, I am NOT taking Percocet, I'm taking 5 mg pure oxycodone tablets, no other active ingredient is in them.

I can not take Percocet (which has 7.5 mg/pill of oxy + Tylenol) because Tylenol makes my liver enzymes go through the roof even in small doses.

Little Missy
01-01-15, 08:12 AM
Those little 5mg oxycodone were what I took for many, many years. And yes, they are much easier to go off of than hydrocodone mixes.

Laserbeak
01-01-15, 08:20 AM
You've just got to keep trying until you find a doctor that has a pair.

Amen! Amazingly my female doctors seem to be stronger in that area than the male ones! :giggle:


PM me if you need anymore help.

Best of luck to you!

Thank you! I probably will PM you someday with a private question about all this.

Laserbeak
01-03-15, 03:15 AM
I think I'm going to get the MRI as soon as possible and get copies sent to both my primary doctors and one to myself as well as this guy. I also have already gotten another referral to a hand surgeon -- different than the one that did the original surgery. Maybe I can get an appointment with him soon, but those types of doctors in NYC usually take forever to get first appointment with. Anyway, I have decided I DO NOT WANT A HUGE NEEDLE STUCK INTO MY ELBOW!!!!!!! I don't think it will help and I think it is dangerous. Why fix something that isn't broken? Just a relatively small dose of oxycodone works fine!

Laserbeak
01-03-15, 03:33 AM
Those little 5mg oxycodone were what I took for many, many years. And yes, they are much easier to go off of than hydrocodone mixes.

I had to go for like 5 days without them after taking them for a year, and besides feeling generally ****ty and sick to my stomach, I did not experience withdrawal symptoms like I have with Vicodin which is supposed to be weaker.

Lunacie
01-03-15, 11:28 AM
I had something like Tennis Elbow many years ago (but I didn't play tennis).
The doctor injected a corticosteroid in my elbow and the pain was gone.
Never came back. :yes:


I would almost have killed for one of those when I developed TMJ nerve pain
following a tooth extraction. But didn't have health insurance to pay for doctor
or treatment.


Finally I did some online research and found that application of capsacin
ointment might help. I was amazed at how much it helped.

Do some reading and maybe give that a try?
Google "nerve pain + capsacin".

MrsNewton
01-03-15, 07:19 PM
:goodpost: (didn't notice it until I wrote what is below).

Just to be clear, I am NOT taking Percocet, I'm taking 5 mg pure oxycodone tablets, no other active ingredient is in them.

I can not take Percocet (which has 7.5 mg/pill of oxy + Tylenol) because Tylenol makes my liver enzymes go through the roof even in small doses.

Percocet has 5mg of oxycodone and 325mg of tylenol at the lowest dose available and it goes up from there, but that's good you're not taking them because that would be a lot of Tylenol. Most docs won't write for pure oxycodone if they're not in pain management, so I assumed you were speaking about percocet.

Good luck, hope you get it worked out.

MrsNewton
01-03-15, 07:40 PM
You obviously have no conception of chronic pain.

Not only do I know about it, I live with it. I also know that long term use of pain meds should be a last resort, after all other attempts at pain relief have failed.

Pain meds are great for acute pain and for those who can't get relief any other way. The comments I made were based on the information given by the OP, and are only my opinion.

MrsNewton
01-03-15, 07:51 PM
Have you tried anything designed to treat nerve pain? Physical therapy? Have your nerves been severed?

I had a lotion specifically compounded for me via my doc that I can apply directly to the area. It has a component that drives the ingredients under the skin so that they go directly where they are needed, and there aren't any systemic effects.

It has gabapentin, ibuprofen, ketamine and a bunch of other stuff in it. You may want to ask about it, it's fantastic. they can have it made with anything they want.

Laserbeak
01-07-15, 03:42 PM
Have you tried anything designed to treat nerve pain? Physical therapy? Have your nerves been severed?


I went through some physical therapy after my surgeries, but it was totally useless. Both the doctor and the therapist were surprised at my range of movement, which was practically 100% normal. The problem was chronic pain, which therapy is much less effective with dealing with. I had an MRI before the second surgery, which I imagine would show that, and the doctor didn't say that, he thought it was being pinched by the implant so he removed the implant but the pain remains.


I had a lotion specifically compounded for me via my doc that I can apply directly to the area. It has a component that drives the ingredients under the skin so that they go directly where they are needed, and there aren't any systemic effects.

It has gabapentin, ibuprofen, ketamine and a bunch of other stuff in it. You may want to ask about it, it's fantastic. they can have it made with anything they want.

Gabapentin did nothing, ibuprofen sometimes helps, but usually only alongside narcotics, and ketamine made my head feel like a balloon that left my body and floated around the club (many, many moons ago).

MrsNewton
01-15-15, 12:50 AM
Gabapentin did nothing, ibuprofen sometimes helps, but usually only alongside narcotics, and ketamine made my head feel like a balloon that left my body and floated around the club (many, many moons ago).

Right, but like I said it's topical, so it doesn't affect you systemically.

Laserbeak
04-20-16, 05:29 PM
Update

For pain I am now on Oxycodone 5mg 4x day, Meloxicam 15mg 1x/day, Gabapentin 900mg/day (300mg x 3 at once). I really don't think the Gabapentin does anything, but it keeps the doctors happy. Meloxicam is pretty much just like a few Advil or Aleve, but it keeps down the inflammation and helps with the pain, and of course the Oxycodone obliterates the pain most of the time unless it's really acting up (then I can take one or two extra). So now I'm doing fine. I have a doctor who got me into a pain management clinic and they were totally OK with me getting the Oxy 4x a day and understood my desire to not get any injected nerve blocker. So they just wrote up a report to give to my GP and she electronically sends the prescription to the pharmacy every month. No problem now that she has the letter from the pain management specialist. I've been on this regimen for about a year now, let's just hope it lasts!

Jiberish
04-25-16, 06:42 PM
is their a long term solution to the problem with pain besides the meds and or nerve block? I take up to 30 MG percocet a day, however their are also days I do not take it. They are scary pills, i cant wait to get my surgery on my back done to get off them, but pain isn't well understood in our country. Unfortunately the drs are scared of the long term dependencies etc. They are under a lot of pressure from the GOV as well. I hope you find a remedy, I can attest pain is horrible. I have a spinal fusion coming up :(

Laserbeak
04-25-16, 11:21 PM
is their a long term solution to the problem with pain besides the meds and or nerve block?

If there is, I haven't found it yet. My hand surgeon who was supposed to the best around thought he could get rid of it through surgery, but that was a failure.

Really the Oxycodone is fine for me, it has almost no side effects compared to Hydrocodone and the myriad of other opioids I've been prescribed.

If I were you, I'd try to switch from Percocet to pure Oxycodone. The Tylenol in Percocet is more dangerous than the Oxycodone really.

I was on Vicodin at the time and they did a blood test on me, and my liver enzymes were literally off the scales because Vicodin, like Percocet, contains Tylenol.

I was quickly moved to pure Oxycodone and my liver enzymes returned to normal and have been so ever since (like 15 years).


edit:

Actually the FDA is supposed to be phasing out drugs like Percocet and Vicodin over the next few years, anything that contains Tylenol mixed in with prescription drugs.

Socaljaxs
04-26-16, 12:17 AM
is their a long term solution to the problem with pain besides the meds and or nerve block? I take up to 30 MG percocet a day, however their are also days I do not take it. They are scary pills, i cant wait to get my surgery on my back done to get off them, but pain isn't well understood in our country. Unfortunately the drs are scared of the long term dependencies etc. They are under a lot of pressure from the GOV as well. I hope you find a remedy, I can attest pain is horrible. I have a spinal fusion coming up :(
What is your fusion for? I had a 3 level spinal fusion of L4-s2 and currently have a cage and 8 titanium screws. Huge surgery long recovery, but best decision, I ever made. I had a grade 4 spondylolisthesis.

edit:

Actually the FDA is supposed to be phasing out drugs like Percocet and Vicodin over the next few years, anything that contains Tylenol mixed in with prescription drugs. source for this please? Currently take percocets as needed, so if this is true please let me know how I could find that relevant information?

Laserbeak
04-26-16, 02:08 AM
source for this please? Currently take percocets as needed, so if this is true please let me know how I could find that relevant information?

One of many, do a Google search for more:

http://www.nbcnews.com/id/31664450/ns/health-health_care/t/fda-panel-votes-eliminate-vicodin-percocet/#.Vx8FsDrov_8

Laserbeak
04-26-16, 02:29 AM
I know this is old, but the FDA does tend to move at a snail's pace. There is an older drug called Vicoprofin that is a mixture of hydrocodone and ibuprofen (Advil). Recently, they've also introduced a time-release pure hydrocodone pill. Oxycodone has been available in pure form for pretty much ever in instant release and lately in time-release as OxyContin.

Socaljaxs
04-26-16, 11:24 AM
Unfortunately, ever since the CDC's published their most recent "Prescribing opioid guidelines"(restriction-crackdown), Doctors' now seem to be even more terrified and even more hesitant or just flat out refusing to prescribe any type of narcotic/opioid type-pain medication. Even pain management doctors and pain management specialist are refusing to Prescribe any form or type of narcotic type opioid pain medication.

It's really sad and scary to see what may happen is already happening, because of this. Chronic pain sufferers especially, I think/feel are going to suffer even more so. Another crazy part of this restriction currently in place, is that the guidlines publicly published aren't even as restricted(unless docor's have get a different set guideline than what is visable published to the public) as the doctors' are now leading patients to believe...

For me right now I can't even switch to my pain management doctor to take over my medication because they won't do it. My GP and I spoke in detail about this, she can see every prescription I pick up which is part of the new guidlines. So until this restriction gets removed or change pain medications are going to be even more difficult to get if needed.

Jiberish
04-26-16, 12:21 PM
What is your fusion for? I had a 3 level spinal fusion of L4-s2 and currently have a cage and 8 titanium screws. Huge surgery long recovery, but best decision, I ever made. I had a grade 4 spondylolisthesis.

source for this please? Currently take percocets as needed, so if this is true please let me know how I could find that relevant information?

I have a herniated disc at L5. This normally wouldn require a fusion, but I was born with a pars defect. So L5 is unstable......causing pain. Fusion is to stabalize it. I am not stoked as im only 30. If their wasnt a pars defect, this would be not remotely as big a deal :(

Laserbeak
04-26-16, 03:00 PM
For me right now I can't even switch to my pain management doctor to take over my medication because they won't do it. My GP and I spoke in detail about this, she can see every prescription I pick up which is part of the new guidlines. So until this restriction gets removed or change pain medications are going to be even more difficult to get if needed.

It's the same way here. Most pain management doctors don't prescribe anything. Luckily, my doctor found one that at least would recommend narcotics in writing (even though they don't write prescriptions themselves) so that she could CYA herself writing the scripts.

I may have already mentioned this, but we also have this new system in New York State that tracks all controlled substance prescriptions and doctors are now required to get a report on you before they "write" a controlled substance prescription for you to insure you're not doctor shopping and getting multiple prescriptions for the same thing. Pharmacists have access to this system too. I quoted "write" because everything here is switching over to mandatory electronic prescriptions, so there are no more paper prescriptions except in the case of power outages, etc.

It's very big-brotherish, but in a way it's good since the doctor doesn't have to guess if you're a doctor shopper or not, so it's easier for him/her to write you a prescription if the report comes back that you haven't been prescribed that in an overlapping time period.

Socaljaxs
04-26-16, 03:39 PM
Weird we have to have controlled medications printed out nothing,can be faxed at c2 and above. But my doctor mentioned the trackimg system which she finds a positive while on prescription contract and she sees everything I pick up. I had another doctor perscribe medications but I never picked them up which is all she cares about. I was going to have a pain management doctor take over but the medications were something I'm not comfortable,taking.

It's the same way here. Most pain management doctors don't prescribe anything. Luckily, my doctor found one that at least would recommend narcotics in writing (even though they don't write prescriptions themselves) so that she could CYA herself writing the scripts.

I may have already mentioned this, but we also have this new system in New York State that tracks all controlled substance prescriptions and doctors are now required to get a report on you before they "write" a controlled substance prescription for you to insure you're not doctor shopping and getting multiple prescriptions for the same thing. Pharmacists have access to this system too. I quoted "write" because everything here is switching over to mandatory electronic prescriptions, so there are no more paper prescriptions except in the case of power outages, etc.

It's very big-brotherish, but in a way it's good since the doctor doesn't have to guess if you're a doctor shopper or not, so it's easier for him/her to write you a prescription if the report comes back that you haven't been prescribed that in an overlapping time period.

Laserbeak
06-22-16, 06:49 AM
The Dreaded Pain Management Doctor

This is a new guy since my doctor switched from the Mount Sinai system to the NYU system.. I have no idea what to expect. I hope to God he doesn't try to pull my Oxycodoone prescription out from under me. It's truly the only thing that's worked on my broken arm and has minimal side effects.

Laserbeak
06-23-16, 10:21 PM
Weird we have to have controlled medications printed out nothing,can be faxed at c2 and above. But my doctor mentioned the trackimg system which she finds a positive while on prescription contract and she sees everything I pick up. I had another doctor perscribe medications but I never picked them up which is all she cares about. I was going to have a pain management doctor take over but the medications were something I'm not comfortable,taking.

Well it's not just called or faxed in. It goes through a centralized computer system ran by the State of New York. So New York State processes and can deny every single prescription before it is sent to the pharmacy. Although, the pharmacy can still deny it if it is being filled too soon or something. From what I gather, some pharmacies (especially chains) have rules that can be more strict than the State law.

Laserbeak
06-24-16, 01:18 PM
I've ran the doctor circuit again, basically because my GP moved to a different hospital system and wanted new reports from doctors in that system. The Pain Management doctor said I'm fine, actually I had a low dose of Oxycodone for my injury. I also went to a Orthopedist and he said there was nothing he could do other than injections so recommended continued medication therapy. So that's it. Looks like I might be getting a bit more Oxy since my insurance covers 180/month and I'm only getting 120/month and the Pain Management doctor said I had a low dose...