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HELP!!!! need some advise
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Wehalk posted:
I am a 55 year old male have been livimg with cronic pain all of my adult life. Started with a car accident at 16 at 20 Chiropeactic helped me to walk again and left me in pain but able to walk at least. at 25 the pain had increased to the point I needed Percoset, ot Tylenol W/Codine to handle the pain at 30 they switched me to Morphine as the Tylenol was screwing with my liver. at 40 I finally agreed to surgery to replacve a disc L-5 S-1 with an artifical disc. Four recision surgeries later and the installation of a electronic"Stim" and I suffer from "failed back syndrome" and take more than 240mg of Long acting Oxycontin and 90 mg of Oxycodone for breakthrough pain. This is enough to "take the edge" off but I still can't take care of my self because of the pain. The day to day chores, cooking, cleaning etc.
I had an epidural done three years ago and promptly went blind. (my blood sugar was over 600 five days after the injection.
Nix those,
Finally in desperation I convinced my Dr. to do a
Facet block. He agreed and did six injections and the next day between that and my meds I felt Great!! for the first time in I can't remember how long I WANTED to get out of bed not dread it with every fiber of my being. I had things to do and places to go and I felt like a new man!
For exactly 3 weeks and 1 day.
Then the pain came back.
I begged for a RF procedure hoping that if we burned the nerves the pain wouold go away purmantly.
Two painful procedures later and I feel worse instead of better.
On the 11th of this month my Dr's. office called to confirm my 2:00 follow up the next day. to discuss what went wrong and what to do next.
And then called me up the day of at 1:30 pm and told me I missed my 1:00 apt. and would I like to re-schedule for "sometime after Christmas?"
Well I lost it. five years of going to the same dr. with no relief and then this? it was the last straw, I told them never mind. They weren't helping me anyway and I would be out of meds by then anyway.
I've really hit the wall again. I'm seeing another surgeon to see if he could do anything. (at this point I would give up walking if I could stop this UN-relenting pain . but I need someone to prescribe my medication long enough to find out if he can help or not.
Pain meds alone haven't been able to help me but without them I fear for my own safety. I've stood this pain for as long as I can and unless I get some help soon, I'm liable to do something stupid. I'm getting to the point that I can't think straight from the pain. I need to see if the surgeon can help, but he's not into pain management and will not write prescriptions except for recovery.
Is there anyone in Denver that can help? I've been in to see a couple of "pain Doctors" that don't believe in narcotic pain relief,(won't tell you that up front and waste your time and money.)
There is so much I still want to do with my life, but can't go on this way.
HELP.............
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annette030 responded:
You might try your primary care doctor. He could help you.

If you feel like "doing something stupid" please call your local ER or hot line for mental health emergencies.

Take care, Annette
 
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cweinbl responded:

Here is a link to the most comprehensive spinal intervention research that I've seen in the past 40 years: http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf . It provides an in-depth examination of all major interventions, along with morbidity data, short and long-term efficacy.

Almost all contemporary double blind, algorithmic, control group research pegs the success rate for spine surgery at around 60% (lower for fusion and for patients with prior spine surgery), because of the proliferation of fibrosis and osteophytes. No, surgeons don't tell you this.

I'm assuming that you have tried all major pain management techniques, including biofeedback, TENS, brace, corset, traction, acupuncture, systematic relaxation, meditation, PT, kinesiotherapy, etc. The only two other choices are the spinal cord stimulator and the intrathecal infusion pump. They also have low success rates (40% - 60%), particularly if you've had prior surgery. None of these are likely to remove most of your pain. But I would examine mind-body techniques. I can reduce my pain by about 20% with biofeedback. They are all worth a try.

One other aspect of your story merits discussion. It's rarely useful to fire one doctor who has been prescribing opioids before you have replacement. While opioids rarely take away our chronic pain, in most cases they do help at least a little. Since one never knows how long it might take to find a new physician, there is a real risk of running out of medication and experiencing not just higher pain levels, but also withdrawal symptoms, which can be exceedingly uncomfortable and can last for a few days. Even when we are tolerant to a medication, it is likely to be still helping.

Disc replacement for the cervical spine has been in use globally for about two decades. The success rate is pretty good. The reduction in pain is good and you have better range of motion than if you had the spine fused. However, disc replacement is still considered rather experimental for lumbar surgery. Think about how much more weight the artificial disc must bear at the base of your spine, compared to the top (in your neck). I was a Guiney Pig for a microdiscectomy in 1984 and again in 1985. My surgeon recorded the operation as a teaching tool. Needless to say, both surgeries were failed and I ended up with even more pain because of the fibrosis (scar tissue). We all grow it at our own rate. In my case, I grow it like it's going out of style. My last myelogram resembled a road map of New Jersey, with scar tissue everywhere. Fibrosis can impinge a spinal nerve root just as extruded disc material, a tumor or an osteophyte. Therefore, spine surgery is a poor risk and it should be avoided unless absolutely necessary.

We call the treatments for our pain, "pain management" for a reason. Those of us with damaged spines, degenerative disc disease and failed back surgery syndrome will never become pain free. At best, we'll eventually discover which treatments and which combinations of medication are useful for our unique history and body chemistry. But we'll deal with our pain for the rest of our lives. Therefore, attitude can make a great deal of difference. For example, I worked for seven years as a vocational rehabilitation counselor. On a daily basis, I worked with paraplegics, quadriplegics and people with terminal illnesses. On our worst day, we can still sit, stand, walk and care for our bodily needs. Yet, there are millions of people who will never be able to do those simple things. Compared to them, we are the fortunate people.
cweinbl
csw2@bex.net


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