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    Robino819 posted:
    Hey All, I had back surgery 2 years ago on my Lumbar 1, 2, and 3. I have now been diagnosed with a herniated disc on L4 and L5. Same Doc wants to do more surgery. I am getting a second opinion at Mayo in June. Does anyone have problems getting the pain meds one needs. My Pain Management Doc originally gave me 2 pills a day--Vicodin. After my recent MRI my surgeon did up that to 3 pills a day. I am so frustrated---my pain returns every 4 to 5 hours-even waking me up at night. Unfortunately, I wind up getting so frustrated because I know I will run out of my meds before the end of the month. I was under the impression that Pain Management Doctors are supposed to help with managing your pain. MINE DOES NOT. I understand the issue of dependency---but I want some quality of life and when I can only take 3 pills a day, it's not happening. Is there a law that says a Dr. can only prescribe 3 per day. I am beginning to think maybe I need a different Doctor. Any thoughts out there or advise. Thank you so much for anyone's advise.
    bj1208 responded:
    hi and welcome to the support group -

    regular pain management clinics normally will not prescribe controlled narcotics - a PHYSIATRIST pain management clinic is set up to do this - here's a link about Physiatrist care

    look up to see if any pain management clinics have this in their name or call and see if they do - I have been going to one for about 3 years now and they do prescribe controlled narcotics and have helped me tremendously.

    hope this helps - keep us posted - take care - Joy
    Robino819 replied to bj1208's response:
    Thanks, I will do that. And, no I did not know any of that.......thanks again. I will keep you posted.
    Rafael Levin, MD, MSc responded:
    As a surgeon, I can confess that the art of finding the optimal dose and regimen of pain medications for my patients, particularly narcotics, is far from perfect. As clinicians we struggle with our desire to provide the patient with adequate pain relief while minimizing the long term risks of narcotics including dependency as you mentioned. It is possible that you are currently under medicated and if your current pain management doc does not feel it is appropriate for you increase your dose, you should consider seeking a second opinion. At the end of the day this is a risk/benefit ratio decision like many others you and your spine surgeon and pain doc have to do as part of your treatment including your decision to possibly have another fusion.

    Good luck and feel well

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