back pain and pain management

[bluebigman2006]

Ok so I have been dealing with severe back pain over a year. This past april I was in ER and could barely walk. Turns out I had a disc pushing up against my spinal cord. Well anyways had emergency surgery to correct the issue. Well after surgery I was/am still having back pain. Just recently gotton some more images dones on my back. Turns out the disc was completely removed with no spacers or fusions done. So at my L1 L2 lvl its bone on bone my new pain management doc says this is the main cause in my pain. Along with scoliosis and degenerative disk all through my spine oh and arthritis. Any ways I'm currently taking 20mg of oxycodone 4 times daily for pain. The constipation is killing me. I been reading up on a drug called Targinact and was wondering peoples thoughts on here about it. Aswell as other possible options. I meet with my pain management doc later this afternoon. Thanks for reading and any advice you may have for me.

[philnoir]

Good advice given on constipation. Of course, a high-fiber diet always helps.

As for your pain at L1-L2 -- has anyone ever mentioned spondylosis or facet joint syndrome?

The facet joints lie on either side of the spine at each level. When there is disc disease, these joints are stressed and develop hypertrophy, which often pushes them over into osteo-arthritis.

A lot of back pain comes from these joints, although the only physicians in my experience who treat them are board certified interventional pain specialists.

Treatment involves lysing or destroying the sensory nerve to these joints via a pulsed electric current, specifically, the medial branch nerve.

It's a non-surgical procedure, done in a surgical center, but you're on your way home 1 hour after the procedure. Recovery lasts 2 weeks, and if successful, you'll feel a good percentage reduction in pain.

Often the procedure is called RF ablation and many here talk about "burning the nerve" which is not quite accurate.

Here's more information on the specialty --

http://www.painphysicianjournal.com/linkout_vw.php?issn=1533-3159&vol=6&page=485

[bluebigman2006]

Thank you I will take alook at that link in just a few. I'm really liking this forum now. Alot of people here who know what im going through to an extent.

[ChristNonsense]

p.s. Oops I should have mentioned:
http://www.medicalnewstoday.com/info/oic/treatment-for-opioid-induced-constipation.php

The Naloxone in your Targinact theoretically has no ORAL bioavailability. In other words, when you eat the pill, the naloxone won't do anything. Naloxone is ONLY included in pills to deter people from Injecting their Pills, because Naloxone that is injected will antagonize opiates (kick the opiates off of their receptors) and cause horrible withdrawal symptoms.

However, naloxone taken orally is said to have NO effect. (Some debate this, though -- they say it 'gives them headaches.')

However, naloxone's cousin (or is it brother) NalTREXone, actually DOES have oral bioavailability. In other words, take some naltrexone, and that will kick those opiates off of their receptors and cause withdrawal!

That's why someone who has just gotten OFF of opiates is sometimes given daily naltrexone to take -- so that they won't be "tempted" to go back on opiates, because if you are taking naltrexone, and then you take an opiate, those opiates will be beaten away commensurate with whatever dosage of naltrexone is prescribed.

Moving right along.... Naltrexone has a nephew, called METHYLnaltrexone -- medical professionals have been experimenting with methylnaltrexone, and they are finding that certain dosages of methylnaltrexone are "just strong enough" to help prevent opiate-induced-constipation. Somehow, methylnaltrexone specifically targets the opiate receptors in the "gut," and therefore "BLOCKS" opiate activity vis a vis the bowels.... and it does all of this without interfering too much with the Pain-Relieving action of whatever opiates you are taking.

So, that link I provided here in the post discusses all of that. You may wish to ask your doctor for methylnaltrexone (AFTER you have tried the Mirilax... of course :-)

[bluebigman2006]

I will speak with my PM later today about it.

As for the malpractice issue im trying to get a doc to agree to surgery or some other long term fix without pain meds before i atempt it. Been fighting with hospital for months now trying to get the surgery notes from my precedure.

[ChristNonsense]

Miralax is different -- and for me, it took 3 days to work, as it has to ... erm... work its way through your system. I HATE laxatives, it took a LOT of persuading to get me to even THINK of trying it.... but if you only tried it once, then you may wish to try it again, for 3 days (under docs approval, of course).

I agree with you -- finding another doctor vs another PM. Yes, that is what I would do.

I feel for you, and I will keep my fingers crossed for you.

[bluebigman2006]

Thank you i have tried all the over the counter stuff none of it really works anymore.

Im tring to find another doctor to look at my surgery wise not just PM. I live in montana back surgerons here are hard to find. My last back surgery was in louisiana.

[ChristNonsense]

Oh my....

I'm not a doctor or medical professional, or even want to be one (well.... maybe for the money LOL).... so this is not "advice," rather, it is what I've heard:

Miralax.

People on Opiates-That-Constipate speak wonders of Miralax. I have used it myself. Google this:
opiates miralax
morphine miralax
And you will see people sing its praises.

Try that FIRST before you throw all kinds of serious metabolism/body-affecting nerve drugs into your system -- and, of course, ONLY try it after you have gotten approval and permission from your doctor.

Oh my goodness....the way you post your message, it almost looks like your first doctor screwed up big-time. I once suggested that you immediately look into hiring a malpractice attorney to look into and verify whether  malpractice has taken place -- but a very long-time and knowledgeable poster here made a good point: Other doctors will "run the other way" when they see you coming, if they know you are in the middle of a lawsuit.

So.... hmmm.....

Perhaps, well, I guess what I would do is see as MANY doctors as I possibly could (from OTHER practices than your first doctor, of course), and let them all see what has been done.

I, in my own personal beliefs, feel you will, as an end-result, be OKAY! Whether you have further surgery, or implants put in, or whatever, remember the Body has a mysterious way of FIXING itself -- it's called "establishing homeostasis." But, by "fixing itself," I don't mean laying around doing nothing -- again, see as many doctors as you can, make sure they come highly-recommended, perhaps start Googling Best-and-Highest Rated back surgeons in your area.

It seems every area/region, if you ask around, almost everybody will have ONE name of the "Best Doctor" to see. Well, THATS who you want to see.

When you find that "Best Doctor," then you can go anywhere -- like an Urgent Care center and make an appointment JUST to get a referral to see that Top Doctor.

Then, go see him/her.