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    Pain Management
    nadine2011 posted:
    I was diagnosed with systemic Lupus, Reumatoid arthritis, Sjogrens syndrome, and several other ailments as far back as 1999. Lately, things have gotten so bad I've been hospitalized about every other month. My pain is so bad and I do take meds, but since I also have HepC I can only take dilaudid or anything not containing acetaminephin, or ibuprophen or Nsaids. I have been to several pain magmnt docs, but they say my condition is too complicated to treat, and I was politely dismissed. My regular doc doesn't seem to want to give me anything else for pain, since the dilaudid is barely taking the edge off the pain. I live in an very remote area in Texas and the nearest Reumy is about 3 hours away! I am at the end of my rope... Please help if you have an answer. Thanks.
    allie_bf responded:
    The best answers will be found at the rheumatologist's office. Even though it's a long drive, it's important to make that trip. With multiple rheumatic conditions, the rheumatologist is the person who should be managing your care, not the pain specialists. They are correct in saying that your condition is really best treated elsewhere because to try to treat pain without adequately addressing inflammation is putting the cart before the horse. If, as a lupus/RA/SS patient, you have pain that is not manageable with dilaudid, something is very wrong, and you almost surely have inflammation that is way out of control. That overactive autoimmune response is the problem that needs to be addressed first, and relief of the pain and fatigue will follow. You didn't mention the non-analgesic medications that you are taking now, but it sounds like they need a complete review, and probably some major changes that are beyond the scope of a regular internist or family practitioner. You may have to make a few trips across state to see the rheumatologist, but please try, and soon. Lupus that is that severe can lead to kidney failure, heart disease, and central nervous system damage if left undertreated for long.

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