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Question for Doctors
bj1208 posted:
Hi there - I have a question for you all -

My story, in brief, L5-S1 disc blew out in 5/06 - went for all treatments: steroid injections, pain injections, facet joint injections, piriformis injections, physical therapy, chiropractic care, TENS Unit, Spinal Cord Stimulator Trial Implant - All treatments have failed and finally had Anterior Lumbar Fusion L5-S1 (done 2/08) -and have been in worse pain than before the surgery. Since my surgery, I have found out from OSS that I have 3 more slightly bulging discs at L4, L3 and L2 -I have seen 3 OSS in the last year and they have all agreed that surgery would not be an option as it would only add to my pains and not make them better.

2 years ago I started seeing a Physiatrist Pain Management Clinic - they have me on 60mg Morphine Sulfate 4X Daily, 15mg Oxycodone 6X Daily, 3600mg gabapentin daily and have been on this same dosage since. As it goes, I am becoming immune to the meds and in more pain.
The PA and Physician I see have stated that I am at the limit of the amount of pain meds taken each day. They did try methadone and I found out I was allergic (hives) - Opana (have insurance where we pay out of pocket and mail-in for reimbursement) but a 30 day supply was over $1,000.00 - so I was put back on the Morphine/Oxycodone.

My only option now is to get the pain pump implant.

I would like your opinion as to the thought of am I really taking the highest dosage amount of morphine/oxycodone and since I am in such bad chronic pain would the pain pump be a good solution?

Let me know if u have questions - thanks much! ^Joy^
Rafael Levin, MD, MSc responded:
Dear Joy,

You are currently taking "industrial" amounts of narcotic and other medications for pain control as prescribed by your Physiatrist. I can certainly understand your desire to reduce your long-term dependency on these drugs, and I support it. As an orthopaedic spine surgeon, pain pumps are outside of my personal expertise, but it sounds like you might be a reasonable candidate having exhausted most alternatives. I am also in agreement witht the other surgeons who told you that additional spine surgery is not a good option for you.

Don't loose hope and please keep us updated.
bj1208 replied to Rafael Levin, MD, MSc's response:
Dr. Levin - thanks so much for responding - no one really said I was taking so much pain meds - most of my friends and family are amazed that I'm not a zombie but as I said I've gotten so immune to them they hardly phase me. I do want to get back to a more normal life style and reduce any chances of damages to my liver from long term use.

I forgot to mention with the nerve damage in both legs - my left leg is worse where I do wear a leg brace - drop foot - with the brace my leg is getting a little stronger - I am going for an EMG Nerve Conduction Test the 6th (oh how I love those! LOL) but at least it will let the Physiatrist know if the other discs are impinging nerve roots and may need to have a current MRI done -

I will keep u updated with the results - thanks again! Joy