Finally back to pain management....

[broadindaylight]

Hi all,

So I finally saw a nurse practitioner who deals with PM last week. She was extremely thorough
and was really detailed in asking about my levels of pain during different times of day or during
the month. She did a physical, and suggested both a biofeedback doc and social worker for a CP support group,
both of which are part of their comprehensive program.

However...the biofeedback doc doesn't take my insurance and charges $175 a visit (prohibitive for me).
The support group meets at 2 pm in the afternoon--I assume those who go aren't working full time? I'm hoping
I can maybe at least get to see her one-on-one if she has availability.

Finally, I can't begin to be treated medically until my bloodwork and urine samples come back (an estimated 2 weeks, which sounds way too long but who knows the volume of patients they have). The NP did mention
taking me off vicoprofen (my wonder drug) and placing me on something longer acting (something like Opana or
Kadian, which admittedly I know nothing about). I have mixed feelings about that, as there are days I am not
in severe pain; I like the idea of taking something 'as needed', but I'm going to be flexible and see what happens.

If anyone has any advice, or has been on any of these meds, or even tried biofeedback, please let me know (or PM me). This is so new to me, any info from members would be really appreciated. :)
BID

[29sillygirl]

All I can add is that I was fortunate enough years ago to have insurance coverage for biofeedback.

I was being treated in a psychiatrist's office for panic disorder, which at the time manifested physically as icy cold fingers, as well as the attacks on road.  

The main benefit is that you learn that you can control your subconscious..through repetition of phrases appropriate to situation.  I haven't tried technique for pain, but it might work as pain signals originate in brain.

I do know well how hard it is getting this kind of help...Medicare pays for nothing like this, so when I went through anal cancer treatment, and it was offered at oncologist's office, I simply pulled on past experience.  And took oxycondin for 6 weeks so that I could continue radiation without the pain it causes.

Good luck....

[Tuckamore]

Thanks for the update. I have been wondering how you were doing.

Opana is Oxymorphone. Obviously it is a narcotic pain relievers. It is similar to morphine. It is a semi-synthetic opioid derived from morphine. They both have short half lives but have a Opana is more potent than morphine. Some ppl find that a semi-synthetic has less side effects.

Kadian is Morphine (morphine sulfate to be exact) in Extended-Release Capsules. This is a natural product that is the prototype for the class of natural and synthetic opioid analgesics. It is not a a semi synthetic or a synthetic.

Our systems are different and therefore react differently to medications. I could not tolerate morphine slow release. It gave me respiratory issues. I have not had Opana. When the morphine was ordered by my PCP I felt like you. I didn't have severe pain every day but I did and do have nasty pain daily. My PCP felt that I would be better controlled and have less flares on a long acting narcotic. That is the goal of pain management. I would have continued to take it as it did provide more consistent pain control had I not had the respiratory issues. My system is extremely sensitive to any forms of medications. I encourage you to be open minded and give it a try.

I have not tried bio-feedback in a medical setting. I have read books on it but that is the extent of my knowledge. I do practice some of the principles that I learned in the book(s). If it is cost prohibitive I suggest either purchasing a book on the subject or visiting your local library.

And to RockMD. Yes they have the "right" to drug test you if you are requesting pain management. Indeed it is normal practice upon admission and often through treatment in a PM Clinic/setting. Of course you can refuse it but than they have the "right" to refuse to treat you. It works both ways. The DEA keeps close tabs on PMP. Sometimes I think the war against drugs is really a war against narcotic prescribing physicians. Sad but often true. Physicians place their licenses on the line unless the follow the strict guidelines of the DEA. Every now and than you hear about PMP/Clinics being raided by swat teams and shut down for anything suspicious, rather true or suspected.

Again thank you broadindaylight for keeping us updated on your plight for pain management. I am hopeful that your new physician will be effective and beneficial in the treatment of your chronic pain.

[RockyMD]

I have a question. Why the blood and urine?  I see a lot of people mention this on PM boards and such. Is like to test for abuse, like how much you're taking?  Like if you have a prescription for Lortab, does a DR. have a legal right or if he wants to, ask for Urine/Blood to see that your not abusing your script?

[nurseaudrea]

If you require meds on a daily basis it really is better to be on something that is extended release. It will help stop the roller coster of the pain cycle. You can always use break through meds for spikes in pain levels. I have been on Kadian for well over 5 years. It has saved me. I was also one who did not have severe pain everyday, but it would vary depending upon what I was doing. I never knew when the severe pain would strike, unless I was doing something I knew would get it there, like being on my feet too long, or sitting in the same position too long(driving), so for me the extended release has really helped. It has also cut down on the amount of acetaminophen I put in my body everyday. I think that alone should be a good reason to go on extended release. Too many people really don't know the dangers of vicoden or vicoprophen. Too much ibuprofen can hurt you as well.

You said you were going to be open to new possibilities in pain management. That is a really good attitude and you never know, you might just discover your pain is being controlled so much better than you ever thought possible.

Good luck and God bless.