guidance/suggestions please??

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Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/8/2011 3:35 PM (GMT -6)   
Hello, I am new here.  Condition below.  My PCP has been taking care of me for quite some time, even when I had no ins, and I love her.  She will continue to treat me for all my general needs  Unfortunately my pain has progresively gotten worse.  Due to my pain worsening, and the new legislation in FL, my PCP and I decided that I should go to PM.  I decided to go to XXXXXXXX (not throwing anyone under the bus).  Well, they reduced my meds, specifically the SOMA which really helps the most when my condition is aggrevated.  So, my pain has gotten worse, and meds have gone down.  It is partly my fault b/c I didn't say anything when I was there last.  I have always been apprehensive about speaking my mind regarding my meds (feel like everyone will think I am a drug seeker).  So, my pain has been completely unmanaged.  I called the office to ask for a change in script, and to have a Dr. call me back to discuss.   I received no call back.  2 days later, I call and the receptionist/nurse tech tell me the Dr. said "absolutely not, 1 a day at bedtime".  In a tone I would use to scold my 3yo son.  This is why I am reluctant to discuss with dr. in the first place.  I asked to have the dr call me to discuss, and said "if he has something he would prefer I take as opposed to Soma, I am open to try it, but this is not working".  Here it is Sat, 3 days from my original inquiry, never received a call from Dr, and I have no real releif, the vicodin just does not do it.  So, here is the question:
 
Does anyone have somewhere they would recomment in Tampa, Fl, for spine dr, or PM.  Or what do you think would be my best course of action.  They want me to do the RF leisioning of the medial branch nerves in my C-spine.  But, my whole back hurts.  Now I am reluctant do the treatment, after what I feel is poor treatment, and the fact that my back is hurting BAD, from my pelvis to my skull, with a TON of muscular pain around the Cervical.  At this point I am lost.  I went back to my pcp to have them call in the muscle relaxer for me and was completely honest with them about what happened with the dr. not calling me back about the change in quantity (I have been dealing with this for years, and have never contacted 2 dr.'s for meds)  PCP called them in, but pharmacy would not fill, because it was before 30 day and not the PM dr making the change.  I am so frustrated that my pain is not being managed because of the legislation caused by all the oxycontin addicts in my state.   I have been experiencing more migraine headaches than ever, it always starts as unmanaged cervical pain, and once the headache starts, no amount of meds or ice will stop it.  I know I need to find a new Spine doc, ortho doc, or PM doc.  Or a combination.  But this is new to me, and I already feel like I've been screwed.  Please if someone can point me in the right direction, I would greatly appreciate it.  Sorry for the long post.  Thank you for reading.
 
Frustrated in Tampa
 

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/8/2011 3:38 PM (GMT -6)   
Sorry, don't see my sig. Here it is:

29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/8/2011 4:46 PM (GMT -6)   
Oh, I do realize that most will not be in my area. If you are not but may suggustions of how to find a dr that is right for me. I am all ears! Thanks ahead of time.
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 10/8/2011 5:02 PM (GMT -6)   
Sorry about your pain and the weird issues with your PM doctor.

I'm not quite sure what SOMA is exactly, in terms of classification--but have you tried any medication other than narcotics to see if they helped at all? So far my experience with actual narcotics has been that they didn't touch my pain at all.

Also, with your condition I would think that you should definitely be able to get good pain management help. That is to say, your condition sounds like it would be severely debilitating, so I would think people would be more willing to prescribe dosages of medication if you ask. Obviously your current PM is the exception, I do agree you should see a new one. I live in Pennsylvania, so unfortunately I don't really know of any specific doctors that would be of benefit to you.

When you do find one though, it sounds like it is time to be proactive and explain in detail how your medications are helping or not helping and how much. It doesn't sound like you have any bad habits with medications, like over taking or what not, so I see no reason why a doctor would have a problem if you just explained your situation. I think you know that now, though, since you asked if you could try something other than the Vicodin. Hopefully they do get back to you on that, but I would still see a new PM.
--Patrick, aka Misterkatamari

I'm active on several boards. Main issues are: Chronic Pain due to Scoliosis & 2 Herniated Discs, possible DDD and/or arthritic facet joints. Also active in the Depression/Anxiety boards. Meds include: Prozac 40mg, Xanax .5 mg, Tramadol 50mg

“We must let go of the life we have planned, so as to accept the one that is waiting for us.” - Joseph Campbell

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3694
   Posted 10/8/2011 8:13 PM (GMT -6)   
Sick_N_Tired
 
Am I to understand that your PCP originally prescribed the Soma to you? and your PCP wanted you to go to a  PM doctor? and referred you to the PM Doc? If that is the case and your PCP knows all about your condition, why can't your PCP call your PM Doctor and explain everything to him/her, usually these Doctors communicate with each other and they can get you back on the right treatment. I have heard more bad things about Florida, I had considered moving there, as I am looking to relocate to a warmer climate, but everything I have heard about their pain management there, I think I have pretty well crossed that state off my list. I dod wish you well, I might add I think I would consider the RF if they don't offer you any other type of treatment. Have you seen any surgeon or anything about your neck?
 
Oh I should have said this at the beginning, I want to Welcome you to Healing Well Chronic Pain Forum, I do hope that you will stick around and become a member of our family. I wish you well and do hope that you can get your pain under control. Good Luck to you!
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/8/2011 8:27 PM (GMT -6)   
Thank you for the reply. Soma is a muscle relaxant (I've tried flexeril and skelaxin, neither worked) I've only tried prescription strength Ibuprofen, Tramadol, and diconoflec, none of which worked for me. Though the narcotics are not working now either.

"Also, with your condition I would think that you should definitely be able to get good pain management help. That is to say, your condition sounds like it would be severely debilitating, so I would think people would be more willing to prescribe dosages of medication if you ask."

This is what I thought. I'm not going in there blowing smoke, I have MRI and X-ray confirming. I actually give my wife my pills to disperse as prescribed, not because of abuse, but fear of abuse (seen others ruin their lives with pain killers). I actually asked them if they wanted me to try something other than the Soma. They have no problem prescribing 120 10mg vicodin a month (go figure). I have definately decided to find a new doc. Will not be going back there, do not like how I was treated in every aspect.

How do you guys find docs you like, without taking off a ton of days at work for multiple consultations. This is something I am struggling with, I just assume all Dr.'s are good, how else would they have become dr's. I've sure learned this lesson the hard way. Sorry for the long rambling posts. Anyone who's read completely, I really do appreciate it.
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/8/2011 8:38 PM (GMT -6)   
White Beard. The answer to your first 3 questions is YES. I did not think to have my PCP call and explain, good idea. But at this point, I just don't like how I've been treated in all aspects.

Just recently Florida has become difficult. They are more worried about drug addicts, that will move on to heroin, cocaine, ect... than they are those of us who are legitimately in pain. In fact I beleive this started 10/1/11, though I am not 100%

I am definately considering the RF, but my doctor did not even do the facet block, and every time i've gone in I've seen someone different. So, I think first on my list is to find a Dr. I like, then look into the RF asap.

Thank you both for the replies.
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/9/2011 12:15 PM (GMT -6)   
Hi, I'm pretty much in the same boat as you. My doctor referred me to a pain clinic due to the new legislation. I don't like the PM but I don't know how to find another.

One thing I would suggest is if you are comfortable with your pharmacist, is to ask him or her if they know of any good pain management doctors and or spine/ortho doctors. Just tell them what's going on as they're pretty up on all the latest problems in Florida. At least they won't suggest the pain clinics that aren't legit. :)


Aside from that I don't know how else to do it but to wade through the doctors. And I'm not even sure what is allowed legally if I'm already seeing a pain clinic. Argh this is confusing. I wish I could be more help.

Is it possible to tell your primary that your PM clinic is not helping and you would like to switch to another? Is it possible to tell the PM doctor's office that you would like a referral to another clinic? I did that in my previous state when I didn't like the clinic I was at.

I tried asking my PM doctor here in Florida but he said he didn't know of any others closer to me. I should have told him I didn't care where it was. I know he doesn't want to see my since most of my pain is idiopathic, meaning it doesn't show up on an MRI like yours does.

Imme

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/9/2011 1:06 PM (GMT -6)   
I'm sorry your dealing with the same issue. My PCP would give me new referral no problem. I did not think to speak the pharmacist, but may do so. It is hard to continually take days off of work, to find doctor that I am comfortable with. Should I be seeing an ortho, a PM, or both? I just don't know.

I am having a hard time with the fact that legislator's (NOT DOCTORS), are telling DOCTORS how to treat their patients, and my tax dollars are paying for it. There are MANY other things that they should be focusing on.
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 926
   Posted 10/9/2011 1:29 PM (GMT -6)   
Hi SickNTired,

I'm in bad shape today, so excuse the typos...

I've gone through pretty much all the muscle relaxants and most have nasty side effects for me. But I recently tried Baclofen. It definitely helps with muscle tension for me and doesn't make me feel crappy, like flexeril, etc.. Baclofen is not on the drug schedule, not even schedule four or five, so if they won't increase your soma (which has an abuse record), ask to try baclofen -- the doc (I believe) does not even need his DEA number to write the script.


Do you have an underlying diagnosis for your spinal issues? If it is scoliosis, you can look for a scoliosis specialist via their website. If something else, then there may be a web site devoted to the condition and may feature a search for specialists as well.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/9/2011 2:38 PM (GMT -6)   
Thank you Cogito, I will discuss the Baclofen when I see new doc. Condition is below in sig. It took me a few years before I ever saw a dr for the pain back in 2007. But I'm pretty sure it was from a bad car accident when I was 18, plus I was just rough on myself overall when I was young, dumb, and invensible. LOL.

I do understand that soma may be abused, but I have taken it the same way for 4-5 years without ever asking for an increase in dosage or quantity. Even now, I just want what I have been taking and what I know works. Like I said befor, when I asked the dr. to call me to discuss, I said I would be open to trying other things. But to not call me back for 3 days + the weekend and leave me in agony is just not what I need from someone that is to be looking out for my well being.
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/9/2011 2:48 PM (GMT -6)   
Re-hi,
I think if it were me and was trying to decide between an ortho or a PM doctor or both, I would try the Ortho route first because that one doctor might be able to handle both issues at the same time.

When making an appointment with an orthopedic specialist I would ask the receptionist right up front if the doctor also handles pain management or if you would need to see another doctor for that too.

I have a girl-friend (lives about an hour north of Tampa) who has a friend with back issues. I will call her and see if she can ask him to recommend a doctor. But I would need your email address in order to pass that information along.

Also I don't have much success when I'm reviewing doctors via the Internet but once I have a name of a recommended doctor I google him or her and see if anyone has reviews of their visit with that doctor. There are quite a few sites that offer patient reviews now for free. Even when just using Google it will show if there are reviews at other sites for the doctor your googling. Plus you can find out their credentials. Hope that makes sense.

Unfortunately it's been my experience that it takes a lot of energy and time spent in doctor offices waiting rooms to find a really good doctor and one who isn't gun-shy when it comes to pain management. We have to be our own advocates. I'm still not very good at it because I know a lot about what's going on with the system and I don't want to come across as a drug seeker, and also in my family we were brought up not to complain about our problems. I've become a very good actor when it comes to hiding my pain. Kind of a catch 22.

I've spent probably over a year just sitting in doctor offices and at least another year seeing a doctor on monthly basis. What a way to spend one's life huh?

I'm at the point where I know medical science does not have the answers to my problems right now. So I've put it on hold until something comes along that looks like it might be able to help my condition. Now I just want pain management so I can have a "semi-normal" life. Nothing like the old life, but it's better than the quality of life I had before pain management by a very long shot. You on the other hand sound like you have a ways to go before you can decide on what route is best for you to take.

I too have a very hard time with the fact that the government sees fit to decide what doctors can and can not do. The war on drugs is so costly, billions of dollars every year, and we don't get any benefit from it that I can see.

And doctors, phew. I would not want to be in their shoes. I read a very interesting article by the Cato Institute. What I took away from it is that that the government is now trying to blame the failed war on drugs on doctors.

In other words doctors have become the scapegoat for the failed war on drugs. :(

Imme

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/9/2011 4:25 PM (GMT -6)   
I do understand the doctors perspective. Their license/career is on the line, and I've even heard of instances where criminal charges were put forth. It just blows my mind. I'm sorry if anyone has family dealing with substance abuse, but it is your own personal decision to use heavy duty narcotics, with no need for these narcotics. So when it bites you in the ass it is your problem. Unfortunately, it has turned into my problem. War on Drugs is a crock of #$*@. I'm tired of being in pain, and tired of my tax dollars being wasted, or even being used against me.

"I don't want to come across as a drug seeker, and also in my family we were brought up not to complain about our problems. I've become a very good actor when it comes to hiding my pain. Kind of a catch 22. "

I do the same, it's hard not too. Even with MRI to back it up, it is hard to express the level of pain for fear of being seen as a desperate junkie. Not to mention the drug testing every visit. It's just demeaning.
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3694
   Posted 10/9/2011 6:38 PM (GMT -6)   
Sick_N_Tired
 
If your having problems with muscle spasms Baclofen is an excellent medication, I have been on it for years. They usually start you on a very low dose and gradually increase it till it becomes effective. I take 30 mg every eight hours which is about the max dose recommended per day.The only thing about the medication is you can not just quit taking it, you have to be weaned off of it. I have found one of the side benefits of this medication was that I could get by with less pain medication. It not only  relieved the spasms but also helped control my pain. This medication is often used by MS patients and patients with spinal cord injuries, to control muscle spasms.  I know I had tried flexiril and a host of other antispasmodics and this Baclofen has helped the most.
 
You know I see all these horror stories about the PMs in Florida, and I feel so blessed and lucky with the Spinal PM Doctor I have here in Illinois! He does everything!  He has referred me to surgeons for diskectomy and fusions, he does the epidural injections, and nerve blocks and every other thing, heck he even gave me a referral to a counselor that would accept medicare and tricare when I was having martial difficulities.  Has ordered me more MRI's and all the other types of tests needed to find out what was going on and causing my pain!  And of course  if you need pain meds he also prescribes them! The only thing that he requires is that you have to submit to a urine test every time you come in for a refill. And when you do come in for a refill he comes in and talks to you and ask you if your having any problems and if you are then he does what is needed to find out what they are and fix them. He treats the total person!
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 10/10/2011 12:51 AM (GMT -6)   
Speaking about pain is difficult with the scrutiny currently seen. This scrutiny started to drop until more recently when the florida issue became national.

I've learned honesty will save you A LOT of issues, even if it seems like you are sacrificing your dignity and feel like you are being judged.

The way I look at it is this. If doctors in the past called me a liar, shame on them. I have my MRIs that prove something is wrong (they can't prove level of pain, just that some form of pain likely exists). I'm on prescriptions and using them responsibily. I'm telling my doctors when I need both less and more, showing what medications levels I have left. Therefore if I get acused of drug seeking, I have an ARSENAL of proof that its just the opposite.

Also, I use SOMA as well. I've been on it for months, and I use it less than the 3 times a day its prescribed for. Unfortunately its a good medication with low risk that's gotten a bad rap. If used as prescribed, the risk is minimal. Its when people take 8 at a time and end up in the ER that gets doctors wary of it, and unfortunately its a very dangerous medication to abuse the way these kids do. For us that use it as needed, its very safe and provides good relief WITHOUT all the drowsiness and lethargy that many other muscle relaxants cause.
 
I think whitebeard's recommendation is well worth a try. While it didn't work well for me, I've read up on it and saw that most people felt it worked well for them. It's a Gaba-B receptor agonist (instead of Gaba-A) so your body builds tolerance to it more slowly and therefore is believed to have a lower abuse potential. I know, the whole "abuse potential" thing is ridiculous, but its an unfortunate reality.

MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.

Post Edited (grainofsalt) : 10/10/2011 12:55:40 AM (GMT-6)


sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/10/2011 7:45 AM (GMT -6)   
When I first met with a doctor on a consultation basis only I told him I tried Soma, and he asked me if I liked it. I said I thought it helped but that I did not get restful sleep from it.

I asked him why he asked me about Soma and he said that Heroin addicts like to use it as a substitute. There's a small chemical component (for lack of better terminology:) in Soma that turns into an opioid when metabolized. At least that's what he told me and I respect him highly as I've known him for around 10 years now and he has never steered me wrong. FWIW
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