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Pain Meds - Again

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Chronic Pain
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Tammi
New Member
Joined : Jan 2019
Posts : 2
Posted 1/16/2019 8:49 PM (GMT -7)
I am actually posting for my husband. He is in chronic pain from rheumatoid arthritis, fibromyalgia and disc/stenosis issues in his back. He has tried steroid shots for his back, however they have limited success. Currently the only thing that really works is opiates and his doctors are currently working on reducing them to zero. He has been forced to see a doctor at a pain management clinic because our family doctor refused to continue writing his prescriptions about a year ago. This pain management doctor does not want to see him, and continually tells my husband that he is only doing it as a favor to our family doctor and that he needs to work on reducing his doses. His dosage was already reduced last year and if they keep reducing his dosage he will become bed-ridden. Pain meds are currently the only thing that work. He is 100% compliant. Has never asked for an increase in his meds and has always passed his urine tests. We live in the Seattle area. Can someone please suggest a doctor or a clinic that might be able to help him. I am not sure if people are comfortable posting this but I am new to this and not sure where to start.
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Chutz
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Joined : Jan 2005
Posts : 9477
Posted 1/16/2019 10:42 PM (GMT -7)
Hi Tammi,

I live west of Tacoma so we're like neighbors in this worldwide forum. Glad you're posting for hubby. I hope one day he feels comfortable posting also. But at least you've got the ball rolling.

One thing that's hard for us to remember is that WE are hiring the doctor. WE are paying him to provide a service for us. Most people don't really think about that and are intimidated by doctors and hope they will take us. NO, it's "will WE hire them"?

With that said, I believe all doctors, at least in WA state are being required to do this. They have a formula they go by to assess our level of pain med intake. <I only know about half of the rules off the top of my head but will look it up and post it here soon> The more medications you take the more the doctor has to provide either services and/or referrals to get you to lower you dose or live with pain. There are ways to have pain medication when it's appropriate and your husband sounds like one of these. I'm still on pain meds but I reduced a couple of years ago at MY request. I just was tired of the side effects and the nasty looks and comments from nurses and pharmacy techs. I'm not as comfortable but I'm making due. Your husband may have a harder time with this.

I do have a wonderful Doctor who will prescribe my meds. I'm like your husband and I don't abuse my meds. We have built a trust over the years. I don't think he's taking new patients but if you email me I can give you his name and number. It would be a long drive for you. We and the doctor are about a half hour west of Gig Harbor.

One thing I have tried is CBD oil. If you're like me you may not know what that is as first. It's one of the elements of cannabis. There are two sources of this oil..one from marijuana and with it legal in this state it's easy to get. CBD oil is NOT what gives you the high. That is THC. So what you have to do is buy something with maybe 2% or less of THC mixed in with the oil. Shop around and only from places that look reputable and decent. I've seen some pretty cruddy places from the Harbor to Shelton selling. My clue is if their large sign outside their business is a full sheet of plywood with their name painted using a can of spray paint, keep driving.

The other source of CBD oil is the hemp plant. The best of the hemp oil is derived from using the entire plant to produce the product. It's referred to as industrial hemp. My understanding is this is legal in all 50 states because of it's source. One of the common ways of using hemp CBD is in a lotion form that you massage into the painful area. When my doc told me about these products and said I should try rubbing them on the areas that hurt I started to laugh. I told him I'd need to bathe in the stuff to get everywhere I needed it...lol Some people get relief from one source and not the other, some get no relief, some get lots of relief. All you can do it try it.

I bought a tincture/oil and tried two of the most painful areas with rubbing it on the skin. I just took a small amount ,like a tablespoon or two, of very plain lotion I had in hand and mixed in a dose of the oil. Stir like crazy to try to incorporate it. The brand I had was near fluorescent yellow! I noticed a reduction in pain. But I needed all over relief so that's when I tried ingesting it. That gave me some relief all over. Not sure yet if it's enough to justify the cost. If you buy the oil you can make your own lotion, a little at a time. Then if you want to try ingesting it you already have it in it's purest form. That's the route I took. The brand I bought tasted like a mixture of kerosene, diesel mixed with skunk. Really! They suggest you hold it in your mouth for a couple of minutes to get the fastest results. They HAVE to be kidding. Since we had some flavorful commercial eggnog around the holidays I mixed it in there and after a lot of stirring I was able to get it down with minimal aftertaste. Other brands may taste different...maybe they will leave out the skunk. <yucky> It should only take 15-30 minutes to know if you are getting any relief.

You can buy the hemp base online but shop around. There's a new place in the north end of Tacoma, I think on 6th, that I'm going to check out soon. I've tried the cannabis form and I did get some all over relief but for me it lasted about 4 hours at taking what was considered a 1/2 dose. I now want to try the hemp base CBD and see if it's any better.

But, a couple things to remember - Using the cannabis source can be horrifically expensive. Our wonderful state government, greedy as they are, <ok, sorry for getting on my soapbox> put a tax on any form of marijuana at 37%! You read that right. Thirty seven percent tax! That is just heartless IMHO. BUT, your doctor can't prescribe it but he can fill out a state form that says you may benefit from it's use. Basically using it as medical marijuana then you don't have to pay the tax.

I do wish I knew someone closer to you for any of these suggestions. But I would look for a new doctor. YOU interview them first before taking them on as your primary provider. OK, I've babbled on way too much. I am glad you and your husband are here. We'll find him some relief some way. I have faith in it.

Anyone wanting to try this I would recommend talking to your doctor about it. Also, please do some reading and research of your own. We are all so unique that we need to be careful. I want you around for a long time.

Warmly,
Chutz

ps...It's late and I'm sleepy so I hope there are too many typos. ;-)
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Darla
Veteran Member
Joined : Jun 2018
Posts : 508
Posted Yesterday 4:49 AM (GMT -7)
Hi Tammi! I am sorry you and your husband are going through this. I am in a similar situation with Psoriatic Arthritis and Sjogren's Syndrome and Connective Tissue Disease. I am on the other coast but a similar situation, where the Dr's sent me to pain mgt where I have been treated nicely sometimes and treated like garbage sometimes. After going to the same place for years they closed and I went to a competitor of theirs. The climate in these places is very offensive to me. Some people are there for drug-seeking reasons I think and the behavior can be intimidating. I am sure the Dr and staff are wary of patients due to these people. I have my husband watch me walk out when I leave with prescriptions! The Dr has indicated that he thinks I am on a good dosage of meds for me but coming soon (he thinks this month) things will be worse and he will have to cut back to whatever number he is told. He advised me to try and stockpile some pills! This is ridiculous in my opinion. Would the govt crack down on blind people and say we are phasing out braille? Who is going to stand up for those of us who are ...sorry, but kind of broken. We have all we can do to keep living a meaningful and productive life while handling a lot. Pain has become a kind of buzzword for nothing serious. Nothing really wrong, it is just pain. We are all aware that the meds are often abused. Let's try and fix that but this is like Prohibition but harming medically needy patients.

OK, but you are here for help, not to hear me rant. I have tried the CBD oil that Chutz has mentioned. The Hemp Oil CBD. I take a small amount under my tongue. Not sure how it tastes as my taste is impaired with the issues I have but it is oil which is kind of gross to me. The product I have tried was recommended to me by my son (Millennials know this stuff, lol) and cleared with a 'try it' from pain mgt. I really recommend it. Not a high, but some calming pain relief right away. I don't see it as replacing pain meds...Maybe in a higher strength or dosage? Mine is a weak one because I don't want too much.

It is nice to meet you! Please let us know how your husband is doing and if he has any success with Chutz's rec!
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sbennett51
New Member
Joined : Dec 2018
Posts : 12
Posted Yesterday 6:09 AM (GMT -7)
Hi Tammi
I believe what Chutz said is accurate about the formula. It also seems like they are more willing to perscribe when you are under more intense care of specialists for your pain conditions. That’s my experience

At times when I have not been going to regular apts with my specialists they have talked about decreasing. Now I see a whole slew of specialists and they increased my prescription last few months. I don’t even want more and only did a partial fill at the pharmacy and told them this month I want less.
So it does seem like their may be a relationship to your outside medical services. I wonder if with the Opioid epidemic they have been forced to follow certain criteria and regs. While I know it’s more costly to visit other specialists who can substantiate your husbands chronic pain maybe that may help the pain center be more willing to continue treatment.
The stigma associated with needing pain medication sucks. If I didn’t get the minimal amount I receive I would be bed ridden.

Other great advice about CDB oil above as well.
Best of luck to you and your husband.
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pitmom
Veteran Member
Joined : Jan 2015
Posts : 2757
Posted Yesterday 7:13 AM (GMT -7)
Just read an article about copper deficiency and connective tissue problems. Might want to have the level checked, just in case it's contributing. I have nothing else to add to what the others have said. I hope things level off for both of you. Glad you're here.
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puppylover
Veteran Member
Joined : Feb 2009
Posts : 882
Posted Yesterday 9:08 AM (GMT -7)
Like Chutz I use CBD oil ingested. It does taste yucky but it really helps me. I only use a few drops under my tongue. I live in Ca. So it is easy to get. My sister lives in a state where pot is not legal but her doctor recommended that she try the hemp CBD oil, even gave her the website where she could buy it. It helps her also. It is worth a try.

I do feel like those of us with chronic pain are being punished because of the misuse of pain meds by others. I wish some compromise could be made.
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18244
Posted Yesterday 9:52 AM (GMT -7)
Tammi, sorry to read what you & your husband are dealing with. Your story is like so many other chronic pain patients across the country. The pcp had no choice but to stop prescribing your husband's pain medications. He got leaned on heavy for prescribing to a chronic pain patient. As it stands right now pcp's can prescribe for acute pain for 3-7 days only depending on the diagnosis. The CDC & DEA are watching closely & monitoring any dr that prescribes pain medications.

I also suggest that you google search pain mgt drs in your area, then look at Vitals.com & Healthgrades.com to see what you can find. There are other sites out there that can help locate drs by their specialty. It is much easier today to check drs out than what it use to be & to see if they accept your insurance. If you find one get your pcp make a referral to get your husband seen. Then decide if the dr will be a fit or not.

Take care.
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Tammi
New Member
Joined : Jan 2019
Posts : 2
Posted Yesterday 12:01 PM (GMT -7)
I wanted to thank everybody for responding to my post. I know that we are not alone in this struggle. You see posts all over the internet from people with chronic pain who have been cut off of their pain meds. My husband's pain specialist informed him yesterday that the current standard of practice is to not give pain meds. He was told that he would just have to live with the pain. I am not entirely sure how that is considered good medicine to send a patient home saying that he would have to live with pain, knowing that people who are in constant pain actually live shorter lives, with the quality of their life much, much lower. I did ask if he had any other options for us, and he initially said no. He then indicated that we could try some expensive procedures, that may work, and also may make the conditions worse. Basically he wasn't making enough money off of our monthly appointments and wants to bill our insurance for some expensive procedures. I really don't know how it is good medicine to take away a known treatment that works for another treatment that might possibly work. I can understand trying those procedures with the hope that the pain meds can be reduced in the future, but that was not the scenario we were given. The pain meds, regardless of what procedures were done or not done, would be taken away. He called my husband bullish, which he then changed to stubborn. I am not certain how not wanting to be in pain is being stubborn. He then said that our appointment next month would be with his colleague who is equally as bullish or stubborn - maybe he could explain to my husband the reality of the situation. That sounds like a totally unproductive appointment and a complete waste of time for both us and the other doctor. This is supposedly a pain management clinic and they are unwilling to prescribe pain medications so who will? I am currently doing lots of research and putting out feelers as I really do not want my husband to go back to this clinic again.

As for the THC or CBD oil, we are uncertain as to how that works with the pain management contract that you have to sign with pain specialists. It is currently legal in our state, however the federal government still considers it an illegal drug and most doctors do the same. I have seen pain contracts stating that despite the fact that it is a legal drug in our state you still cannot try it if you want to continue receiving your pain meds.

Anyway, thanks for your responses and if anybody else has any suggestions we are completely open.

Tammi
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18244
Posted Yesterday 12:19 PM (GMT -7)
Tammi, I urge you to check out the two sites I listed to check for other PM drs in your area. If you find any that catch your eye, call their office. You have the right to ask if the dr only does procedures only & no medication. The reason I am suggesting this is because there are PM drs that do injections & procedures only. It is a very lucrative business for them. In other words there are two types of PM drs out there, one that does procedures only & no meds, or the ones that do some procedures & will prescript medication if the dr deems it necessary.

This drs comments are inappropriate to a patient. I do not blame you one bit about your feelings. It is going to take some work on your part, however, you may hit pay dirt.Your husband may or may not get medication on the next visit, it's a gamble.

Good luck in your search. Don't limit yourself to just your local area, look a little farther if you have to.
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Darla
Veteran Member
Joined : Jun 2018
Posts : 508
Posted Yesterday 1:21 PM (GMT -7)
Tammi, that Dr was out of line. You probably can only do better, as that was insulting and still going to result in the meds being terminated. When I made an appt to go to a new PM place, after my Dr sold his business, I was required to bring a note saying the previous place was no longer treating me. Nobody ended up asking for that letter but they may require one. It is hard to be a new pt and get pain medication but I think it sounds like a good time to consider it. If you start somewhere new and are already on the meds they are more likely to continue them. I believe. If your husband is off the meds I do not think a new place will be as likely to start narcotics.

I think it is helpful that your husband has a 'qualifying' condition/s. That should be a point towards medication.

Some of the Drs take advantage of patients but not all. Hopefully the next time will be better. Doesn't sound like it could be worse. I had asked my PM about the CBD oil before trying it, to be careful with the contract. He did not see it as any big deal which surprised me. I said what if it shows up in the next drug test? He said just let us know you tried CBD oil. That sound odd but such are my experiences with the PM drs. I think it might be something to ask when you are settled in the new Dr relationship I know is out there for you. Best wishes in the search. Not easy.
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Darla
Veteran Member
Joined : Jun 2018
Posts : 508
Posted Yesterday 2:23 PM (GMT -7)
Tammi...I just thought something else to consider are the other medications that can support better living in the face of these issues: Gabapentin has brought many of us some relief and Drs do not seem reluctant to use when indicated and muscle relaxers (Robaxin seems to be what is often prescribed currently, imo). Some people are given Tramadol which seems to be an opiate that is not quite as restricted. My husband has been given a small dose of Tramadol for years for chronic ankle pain. It would not be sufficient for my needs but he finds it helpful and has absolutely no problem getting the RX from our pmp! I do know it is supposed to be restricted but thus far it seems to not be problematic.
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Mercy&Grace
Veteran Member
Joined : Jun 2013
Posts : 1870
Posted Today 11:55 AM (GMT -7)
Call your husbands insurance company. Ask for a list of pain management doctors in your area that accept his insurance.

What primary and pain management doctors will and won't prescribe. Seems to depend on the individual doctor and patient. Some primary doctors still prescribe opiates for chronic pain. But they are selective which patients they do it for. The dosage the patient is on has,a,lot to do with primary and pain management doctors prescribing opiates. The higher the dosage. the less likely any doctor is to prescribe opiates.

It takes time and it is not pleasant. But after a while less opiates can work well. Although the patient probably will not be able to do certain things they could do in the high doses. Chronic pain patients have to adjust their lifestyle. This is true with any severe chronic illness. Unfortunately, most chronic pain patients got use to taking high doses of opiates and not adjusting their lifestyles. This was not good for the patient health wise.
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livingwellsoon
New Member
Joined : Jan 2019
Posts : 2
Posted Today 6:30 PM (GMT -7)
I am so sorry he is going though this. I live in California and I ve been " lucky" in that I have had doctors open to trying medications that I bring up that may help with pain and I have been prescribed pain meds. I am being forced out of my state due to high rent. One of my major concerns is my pain management for the same reasons you are being faced with.
It maybe worth trying other meds ( if you haven't tried them already) having a list of medications you have tried and didn't work will work in your favor for getting opioid..... and maybe one of those new meds might help. I tried LDN along with my pain meds which didn't help me but has helped others. You might be able to find a doctor who deals with more complex health problems like lyme that is use to not coloring in the lines.
There is a pain med that I really want to try that is used in Europe Katolodon its used for pain and has helped people with fibro. Its not a opioid somethings like this can be bought online.
when I have a bad flare I get a shot of Toradol its an anti inflammatory and its really helped. I am just thinking about what you could ask for if you some relief and you can't get your medication while you are searching.
also might think about nasal ketamine. I know another big impossible med but it does help with pain and depression, easier to get it for depression but you have to do what you can to survive pain. Dr Sajben in san diego pain management specialist has lots of great information on nasal ketamine as well as pain management in general.
breaks my heart and makes me really mad how we are treated with pain

if you do decide to try CBD do consider how that could affect your care. here in CA every doctor I have gone to asks if ive tried it ……...gets them out of having a patient on pain meds and they want t. I did try it and it was terrible for me. made my pain worse and even CBD got me high which I didn't want or like. have to me mindful that there is no knowing how someone is making it. There are people who it has helped a lot so don't want to discourage you either. wishing you much luck, hopefully someone here can suggest someone. I would recommend on your first visit with a new doctor add that you are open to also trying other meds that you haven't tried emphasizing what didn't work and how stable you were on whatever you were taking and the dose. They need another way in and so do you . I agree they "work" for us but we are not on equal footing and doctors have a terrible amount of pressure being put on them wishing you the best possible outcome and healing.
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BlueberryPie
New Member
Joined : Jan 2019
Posts : 3
Posted 1/19/2019 6:41 PM (GMT -7)
Hi there- I am in the Seattle area and may have some suggestions for you. I'm not comfortable posting names of doctors on this site. Unfortunately there is no private message service on this site. It seems the only option is to allow your email address to be shown on your profile.

If you don't want to do that, let me know and I will create a disposable email address you can contact me at.

Sorry to sound all secretive... lol ... like I said, I just don't think its good to post doctor's names on open forums. I normally just read this forum as a guest but created an account tonight because I saw your post. best wishes.

Post Edited (BlueberryPie) : 1/19/2019 7:03:21 PM (GMT-7)

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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18244
Posted 1/19/2019 7:15 PM (GMT -7)
Welcome to Healing Well Blueberry Pie. Thank you for not posting information about drs in your area as the administrator does not allow us to do this. It sounds like you have a good dr taking care of you which is important.

Take care.
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BlueberryPie
New Member
Joined : Jan 2019
Posts : 3
Posted 1/25/2019 2:58 PM (GMT -7)

straydog said...
Welcome to Healing Well Blueberry Pie. Thank you for not posting information about drs in your area as the administrator does not allow us to do this. It sounds like you have a good dr taking care of you which is important.

Take care.

Thanks Straydog. Yes I am fortunate to have a doctor who prescribes pain medication. I know how stressful it is now for those of us who need these medications. I hope the OP will come back so I can pass some names on to them.
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cogito
Veteran Member
Joined : Oct 2010
Posts : 955
Posted 2/8/2019 6:10 AM (GMT -7)
I know a pain management researcher (M.D., Ph.D.) in Seattle who just opened up a clinic. I suppose we're not allowed to list doctors, but what about pain research centers?
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18244
Posted 2/8/2019 7:28 AM (GMT -7)
The admin does not allow us to list this type of information. You can put your email address in your profile & suggest the member contact you via email. Since we have not heard back from the member, she may or may not see your thread. Another member offered to exchange dr info via email too.
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cogito
Veteran Member
Joined : Oct 2010
Posts : 955
Posted 2/8/2019 5:09 PM (GMT -7)
I created an email address just for this...

I've met the doctor several times at conferences and know he offers both routine prescribing as well as alternative pain management, including cannabis. If I recall correctly, his PhD is from Berkeley and his MD is from Univ of Washington. His practice is near UW.


Cogito, sorry I had to remove your email from your post, this is why I suggested putting your email in your profile. Only members can access your profile.

Post Edited By Moderator (straydog) : 2/8/2019 5:28:35 PM (GMT-7)

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cogito
Veteran Member
Joined : Oct 2010
Posts : 955
Posted 2/8/2019 6:22 PM (GMT -7)
Oops, will put in profile
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