Chronic back pain

[pgoeltz]

I have 2 fusions which did nothing, and 2 other surgery's, the pain medicine is not enough, and it just gets worse.
Do i detox and get off the opiates,   then what do i do for pain?
Pain management say breath, walk, etc.  But there is no energy left, i think I'll be stopping work soon due to pain.
I take 30mg methadone 2x day, i was taking Oxycontin but they said i don't need that anymore and life has gone downhill from there.  do i find another doc?  they say no to everything, pump, pain meds, I'm fine on pain meds at least i can function, without or not enough i suffer at home.  why can't i be given the right pain meds, i read people are taking these except me.

[pgoeltz]

the last DO, the other 2 were the same from kaiser

I am sorry that you are in so much pain, but I am uncomfortable prescribing your medication and will be unable to refill them. You can change back to Dr. Worku in order to obtain refills, or perhaps Dr. Cherry can prescribe the medication for you. I believe you were also scheduled today to follow up with Dr. Matan. I hope you were able to go to that appointment in order to discuss the treatment plan.

same story, even the hmo help people did nothing, i can no longer work do to [pain and lack of sleep

I have been referred to kaiser Sf level 3 pain control which is maybe more doctors saying you need meds, but they will not give them, just advise on coffee, walking, tens etc.

still looking for help, maybe when on disability i can get offfff of kaiser

[pgoeltz]

I have been going at this for 2 yrs, Just had another MRI yesterday, filed a complaint dept hmo help, and to my Board of directors, as the money they pay is public money, for my insurance, and the public is getting ripped off,
I am still looking for new ways, thanks for the DO tip will follow up
what ***** is 2 yrs ago after last fusion, they said stop the pain meds your fine, and did they forget i was on methadone for 2 yrs, so big sickness and back to the Eroom of course i was sick and got a bacteria infection,
so to change drugs they said i have to suffer and detox, even thou they did it by mistake,

My 1st surgery was at Stanford, the chief nero guy dc kim was fired for doing unnecessary surgery's, then to UCSF, with the 49ers team doc, again fusion another level, but still pain, so i have gone to schools, etc,
keep the advice coming it all helps, ask me anything, I will tell the truth
Hoping as they said i will be on meds to get a pump and the right meds
thx,
pg

[mkh9]

Hi and very very sorry for all you have gone through. The opiates do cause pain after a while and maybe it would be good to switch drugs. My sister in law had some very bad doctors as well. One tried to drill a hole in her head for her nerve pain in her stomach. Another had her license removed.My sister in law had a morphine pump for a couple of years then it leaked and they took it out at the ER without giving her any other drug to get off of it. She went into severe depression and they put her into a rehab facility for a month and could watch to see what triggered her pain and try different meds. She came out very well but has had to try various combos over the years and is doing better now and is finally back to work and got married. She wasn't doing anything for years due to the pain. Have you thought of a place like a large university hospital where they have a place where they can work with you. Of course you wouldn't be able to work and so i don't know if you can do that but it sounds like you are getting close to not working anyway. Well, I hope this helps.

mkh9

[Tuckamore]

Hi,

I hear your pain and frustration.... again my heart goes out to you!! Ghilly offered some good suggestions and has great insight but it sounds like you have been to all the physician's in your area.... am I correct?

First let me say don't go the illegal route!! I know how desperate you can get when you have uncontrolled horrific chronic pain!! I truly do!! I've been there... and it's not a good place to be.

I can't recommend a physician, even if I knew one in your area it's not what we do here for obvious reasons.

What I am going to suggest may sound foolish to you. It would of sounded foolish to me twelve years ago. However it was a D.O. (Doctor of Osteopathy) that diagnosed me and treats me. She specializes in Internal Medicine. When I was at my wits end, this new grad examined me and provided me with answers. I saw her in error and was not there for pain. I had given up BUT she recognized my pain and asked about it. She insisted on the examination, where she touched and examined my joints and alignment. After the exam I asked her how she knew I had pain and where it was located, as no one else even seemed to believe me. She said, "I can feel it."  Later accepted medical tests proved her diagnosis to be correct.

D.O.s that practice OMT (Osteopathic Manipulation Therapy) are trained to "feel" what's right and what's wrong with your body. If you can find a DO that practices OMT I suggest that you consult one. It's OMT along with medications that allow me to function. In my state it is the PCP that prescribes for and treats their Chronic Pain patients. I assume it is PMP that do that in your state. However is it not true that your PCP needs to diagnosis you and suggest pain management? In my opinion If that's so you need a good PCP to believe in you and back your pain management efforts. That's what seems to be lacking in your picture.

Those are my suggestions for what it's worth. There has to be a physician out there that will listen and treat you. Please don't give up. Keep searching, like me you may find help in the most unexpected place. Do you not have a say so in your current medical system? will no one listen?

Please keep in touch. I am so glad that you posted today. I can't make the pain go away but if support helps at all you've got it.

Take Care,
~Tuck

[pgoeltz]

Thanks, , just plain worn out disc, i will be in pain or the rest of my life.
Part just wearing out, and part WC, yeah i got 50k, but nothing for back, yes i can go to who i want and did, many still go, now thou, there is no money, or a little bit, i just need to know the doctor to see, someone in the bay has to know, san jose is were i live.  I have seen 20 doc, 50 shrinks, another 50 pain, back, acupuncture, etc  and still pain, now Kaiser wants me to breath the pain away, i have seen 49ers docs, etc.   I have friends looking etc.  I don't want to buy meds illegal, but feel I'm being pushed into a corner, just told HR to complain, filed complaint dept of HMO help.
but just need the name of a doctor who is not afraid to follow the path.

[Ghilly]

This advice may or may not be helpful, but from what I have read it is the only thing I can offer.

Tuck asked if this was a workman's comp injury because it sounds like you are being bounced around within the confines of one specific medical group, and I have to agree, it sounded that way to me as well, however you did ask if people here thought that you should find another doc.  My answer to that is a resounding YES!   Get on the internet or get out the phone book and find yourself another doctor as quickly as you can!

Even if these doctors you have been seeing are associated with your job somehow or are the only ones that you have been told you can see, I would not let anything stand in my way of finding a new doctor to treat me.  You live once.  That life should not be one of torture, pain and agony.  The doctors who are treating you now are slowly but surely taking away everything that made you feel better.  It's as though they WANT you to leave your job.  That may or may not be at the request of your employer, if you got hurt at work.  At this point, if I were you, I would make it easy on them and just go.  If you lose your job because you went to find a different doctor than the one(s) you're seeing now, how would that be any different than losing it because you're in too much pain to do it?  At least if you go find another PMP, they can put you on meds that work and at that point you can go find yourself another job.  Yes, I know, the economy is bad and jobs can be difficult to come by depending upon where you live and what you do, but compared to the ONE LIFE we get, jobs are a dime a dozen and if you look hard enough you can always find SOMETHING to do for a living.  No matter how hard you look you cannot find a second lifetime to replace the one that is being destroyed by living it in chronic, untreated pain.

Methadone is OK for pain control, but from what my own PMP has told me, unless it's mild to moderate chronic pain that is being dealt with, no medicine will control it on its own.  I take 10 mg of methadone three times a day, but my doctor has me taking 60mg of immediate release oxycodone every four hours for breakthrough pain if necessary.  The upper side of moderate and on to severe pain almost ALWAYS needs something for breakthrough pain.  Sure, pain management clinics will suggest things like breathing exercises and biofeedback, but these are only to help take the mind off the pain and they teach us how to redirect our thoughts so we don't dwell on the pain.  If the pain is right there, uncontrolled (or poorly controlled), no amount of breathing or biofeedback or anything is going to help.  In order for ANYTHING to work, there has got to be good pain control as a baseline, and 60mg of methadone a day, if your pain is severe, is not going to remove enough of your pain for breathing exercises to make any appreciable difference.

Start your search today.  Most hospitals have pain management clinics within their walls, usually run by their staff anesthesiologist(s).  Do a Google search for Pain Management doctors in your area.   When you are food shopping, or at the local mall, or even walking down the sidewalk in your town, if you see someone walking with a cane or on a scooter or in a wheelchair, excuse yourself, tell them you are not meaning to be nosy, but ask them if they are in pain management.   It sounds desperate, I know, but desperate times call for desperate measures.  Just make it your mission to find yourself a new doctor, one who cares about you and realizes that your life needs to be made as comfortable as possible.  

What general area do you live in?  For obvious reasons we cannot recommend specific doctors here on the forums, but I can sure as heck help you to search for places that you can then contact.  Please post back.  And don't give up!

Ghilly

[Tuckamore]

My heart goes out to you!!! It sounds like you are getting the run around at the very least! It makes me both angry and sad so I can imagine what it must do to you.

Is this a workers comp injury? They seem to be treating it like that.

If I understand this correctly you are remaining in the same system which means all these physicians are affiliated! This means they are going to "stick" together. One isn't going to oppose the other.  Excuse the expression but it's like a good Ole Boys Club!

I assume any out of network appointments must be paid out of your own pocket. I hate to say this but that may be your only choice.... that and try to obtain a different insurance carrier even though this is apparently the insurance offer by your company. If you can't maintain employment you'll lose much so the goal should be to remain employed and have some quality of life. It's obviously not going to come from your current providers.  

It's possible that once you obtain an outside opinion your current set of physicians may continue the plan of care established by the outside consult. The key (in my opinion) is to select a facility that has more clout and recognition then your current physicians. An example would be a nationally known clinic or a large university medical center. This could get expensive... unless you can obtain an approval for an out of network consult.

It's obvious to me that they are trying to and hoping that you will wear down, go away and give up. Keep that in mind and don't even contemplate throwing in the towel. This must be horribly frustrating. I wish I had better suggestions.

Keep on keeping on... jeez this response is filled with cliches'. I apologize. If it's any consolation I was in a similar situation. I had enough ump to make it through the day, barely. My career robbed me of a personal life, at the end of the day I was completely done in. I chose that for almost five years until I simply couldn't maintain the demands of my position. I had to quit. I don't want this to happen to you. In hindsight I should have pushed for stronger, long acting meds... but I knew they would reduce my ability to problem solve and concentrate which I required to be effective in my career. It was a catch 22. (sorry another cliche)  It sounds like you are in a similar situation.

I hope something I have said is helpful. Please keep in touch. I'll be very interested to hear how this is progressing and the final outcome. I'll be thinking of you.

~Tuck

[pgoeltz]

I have gone both routes, Stanford the head Nero surgeon who talked me into the first fusion, was let go , for what i heard from one of his students now a doc at Kaiser, he did unnecessary surgerys.  I have gone the blue shield route, now at Kaiser, gone through 10 docs, I keep complaining, keep posting, but I'm getting worn down, I almost have nothing left.
Again this morning another complaint to KP.org, and i sent complaints to Dept of manged health care.  I have again complained to HR to get with the kaiser rep. The next board meeting i plan to address the board, as my insurance is public money, that they are be robbed by kaiser, or the public is not getting there fair share.  The pcp seem dumb, the pain clinic each one with different ways, they told me walk, have sex , breath go out, I do, i' ve done that, this last 2 years I have gone from a very good person, to almost a vegetable.  THEY ALL HAVE SAID i WILL BE ON MEDS THE REST OF MY LIFE, BUT NO ONE WILL INCREASE put a pump in or nothing, talk talk talk.
I'm tired, if i knew the doctor outside of Kaiser that i have not seen, I will pay out of pocket, just tell me the doctor to go see,

[Tuckamore]

Hi pgoeltz,

Welcome to MedHelp's Pain Management Forum. I am so sorry to hear about your poorly controlled chronic pain. It doesn't sound to me like your PMP is listening or is not taking your complaints of pain seriously.

As you have discovered not every medication is effective for everyone. Although the Methadone being prescribing for you may be very effective for some that doesn't appear to be true for you. Our systems respond differently and finding the right combination of medications is often a long trial and error process. Why your PMP has changed your meds I can only speculate.

Methadone is considered a non-abusive opiate and your PMP may have been concerned about dependency. Again I can only guess. It's a good question to re-ask including asking why he doesn't appear concerned with your increasing pain levels. If his approach isn't working and you've given it a good shot then other alternative should be offered.... at least in my opinion.

What I do believe is if your physician is not listening and you are experiencing uncontrolled pain it can be beneficial to obtain a second opinion. In my opinion consulting another PMP IF your current one refused to work with you and your pain is a good option. You are your own best health care advocate. Be assertive.

Life is short and precious and quality counts. You deserve to have better pain control. Maybe a heart to heart discussion with your current PMP would help. If he/she is animate about remaining on the Methadone I'd strongly consider searching for another PMP.  

Please keep in touch and let us know how you are doing. I'll look forward to hearing from you again soon.

Take Care and Good Luck,
~Tuck