The time has come when I really need to get the dosage of my pain meds increased, but I could use some advice on how to approach the subject with my doctor. This is my situation...I have chronic pain issues, primarily bad back and knees, as well as chronic migraine headaches. I go to a major university Pain Management Center for treatment for my back and knees, and to another one which specializes in the treatment of migraines. However, both PM centers require that my regular Primary Care Physician take care of writing the scripts for my pain medication.
I am on an incredibly low dosage of Lortab, 1- 5/500 tablet 3 times a day, which doesn't come close to making my daily pain manageable. I only get 30 tablets at a time, so I have to manually pursue my PCP for a refill EVERY TEN DAYS. Sometimes I can get him to write it seven days apart, but even that isn't adequate. I also get #50-50mg. Tramadol every 30 days., which also isn't written with any refills. I've been on this dosage for several years now, and it's not remotely satisfactory in making my pain levels manageable on a regular basis.
At this point, in order for me to function, I need to take a minimum of four Lortab when I first receive my prescription. Within a couple of hours, I am finally comfortable enough to perform the basics, start handling my daily chores, and dealing with the various aspects of normal living. I have to take at least one or two more Lortab every four hours or so, in order to keep operating at this level, which is just tolerable. I definitely don't feel completely normal, but at least at this rate, I can get by somewhat comfortably for a few days. Needless to say, my Lortab script runs out far ahead of schedule, at which point I start augmenting it with 3 or 4 Tramadol at a time. My level of functionality drops off significantly, but at least the Tramadol does temporarily postpone the withdrawal symptoms from lack of Lortab.
When I get a migraine, which happens at least two or three times a week, it throws off the whole system. In the past year, on average, I have had to get a Narcotic pain shot(15mg. Nubain) from my PCP or local walk-in clinic about once a week. The addition of a narcotic shot does not do anything to improve my daily functionality, as the migraine headaches correspondingly decrease my activity level. I just underwent BOTOX injection therapy to help deal with the migraines, which consisted of getting 31 shots of BOTOX in various points around my face, head, and neck. Never let it be said that I'm not willing to try anything to mitigate my pain issues!
I guess the bottom line is that level of pain medication I am receiving does not adequately manage the amount of pain that I deal with on a daily basis, and being unable to maintain a steady quality of life has gone well past the point of acceptibility, especially when you consider how long I've been at the same low levels of medication. It's not like I've got a major OXYCONTIN or Methadone habit, no Fentenyl patches, heck...I'm not even up to freaking Percocet.
I don't think it's too much to ask to be given enough medication to be somewhat comfortable, so that I can have a fairly decent standard of living. I guess I would just like to know what/how would be the best way to approach the subject with my PCP, so that I can reasonably represent my situation without coming off sounding like a dreaded "drug seeker". Any suggestions or advice would be greatly appreciated.
Thanks for listening,
•On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ, stomach problems
•Divorced, 46, spawn-free
"THE WEATHER IS HERE, I WISH YOU WERE BEAUTIFUL." -Jimmy Buffett