How doctors respond to chronic pain

[UglyGreed]

Please don’t come back!

My forehead thumped down on my desk after a ten minute appointment that had stretched out to over half an hour, I felt completely exhausted and still I had another 17 patients to see and I was now running 25 minutes late. It wasn’t just that I felt exhausted, I felt useless and demoralized and more than that, I felt angry, really pissed off.

I had spent the last 30 minutes listening to Sharon describe her pains, which shifted from the somatic – how they feel, to despair – how she feels, and anger – how she feels about me. Why didn’t I know what was wrong with her? Why didn’t I refer her for more investigations? Why didn’t I send her to a [another] specialist? Why didn’t I listen? At some point I tried to introduce the idea that perhaps a pain-psychologist might help but this merely ignited the oil I’d been trying to pour on troubled waters. “You don’t even know what’s wrong with me and now you’re trying to tell me it’s all in my head, you’re not listening to me!” she all but screamed at me, tears welling up in her eyes. “No, no, no, not at all!” I actually held my hands up in front of me in self-defence, “but pain, whatever the cause, is always emotional and physical.” I believed what I was saying as I dug myself deeper into a hole I wasn’t going to dig myself out of. She was in fighting form and I was floundering. She took advantage, “You’ve done nothing for me, nothing! I want to see someone else.” I’ve been her doctor for almost 10 years and have seen her health deteriorate dramatically, her marriage take the strain and recover, her children in and out of illness and her husband through his redundancy and depression and more. I’d visited her at home and referred her to rheumatologists, physiotherapists and a pain clinic. I felt like I had nothing else left to offer. Her killer blow left me speechless. “I don’t know what to say,” I admitted, defeated, barely able to maintain eye-contact. She stood up and left.


The sufferer is in a state of high alertness and of anger looking for a cause. What strikes me is that (in my case anyway) anger comes before the pain: a wash of strong, predictive, irritation emotion that I don’t feel at any other time. Hilary Mantel

I’ve had this consultation in various forms too many times to count and I’ve discussed the problems with colleagues enough to know I’m not alone. Why then is it so hard for doctors and patients to cope with chronic pain?

Much more at the link

http://abetternhs.wordpress.com/2013/09/07/pain/

[KamaAina]

1. A number of my friends experience chronic pain

oddly, they are among the calmest, sweetest people I know. Maybe it's the pain meds.

[Wait Wut]

2. It depends on the person.

You would have no idea that I'm in constant pain. It's "normal" to me. Others I know, won't shut up and constantly want sympathy or someone to do everything for them. Oddly enough, because they have no idea how much pain I'm in, they ask me for help...and I often do help them.

It can be really frustrating to hear people around you complain when all you can think of is how much you'd like to sleep through the nite because that's the only time it doesn't bother you.

FWIW, I have gotten better over the past few months after 20 years of freakin' agony.

[UglyGreed]

3. LOL

I just decreased my low dose to four times a day from five since I was not taking the fifth pill and had such a surplus that I would not have to go for a refill for a month and a half, And guess what I did sell them either.

[KamaAina]

4. People like me?!

The pain meds thing was a joke. And show me where I even hinted at the possibility that people were selling their meds.

[UglyGreed]

6. It's all

a part of being in agony, I don't know when people are kidding or being cruel.

[KamaAina]

9. That's what the smiley face was for

to clue people in.

[UglyGreed]

14. smileys could

also be seen as sarcasm, sorry.

[KamaAina]

19. That's why we have this

[UglyGreed]

20. Sorry I jumped the gun

I will edit my post but since that info is out there now I'm going to leave it. It is very hard for me to speak/write about my problems but I'm at a point I don't care anymore.

[Recursion]

5. I will catch hell for this, but...

The sufferer is in a state of high alertness and of anger looking for a cause. What strikes me is that (in my case anyway) anger comes before the pain

Hmm... sounds more like addiction than anything else.

[UglyGreed]

7. It also

a sign of being in pain. Ever see a dog in pain growl at those who are trying to help?

[Recursion]

8. Sure. That's how it works.

I don't know about chronic pain, but I do know about alcoholism, and what you're describing sounds exactly like it.

But, hey, like I said, I haven't been there. I was just putting that forward.

[UglyGreed]

13. That's ok

My father was a drunk and I know full well about addiction first hand.

[CreekDog]

21. so you're saying those in chronic pain are acting like alcoholics?

fail.

[Recursion]

27. I'm saying that description sounds like addiction

If the sense of self is dependent on the substance like that description said, I don't know what else to call it.

[u4ic]

29. Dependence and addiction are not the same

For example, a diabetic is dependent on insulin, but they are not addicted to it. You'll find progressive pain specialists who feel the same, that those with chronic pain are best served with pain meds. While there may be a physical dependency for relief, most do not get addicted. Not every pain sufferer is a Rush Limbaugh type. He, and others like him, have other psychological/mental health issues.

I couldn't tolerate pain meds and luckily acupuncture has helped my Fibro tremendously. Still in some pain most of the time, but nowhere near non functional like I once was.

[moriah]

59. Is a patient with insulin addicted? No. It's not their sense of self that's dependent on the shots.

It's their pancreas.

Now, a person who goes from ER to ER looking for pain shots, and starts showing a bad attitude and won't even accept Toradol (aside from those allergic) when no narcotics are offered... that's more where I see signs of addiction. Or one who MUST get their pain medicine filled and demands other people pay for it when they could just go to the post office and pick up their check, and whines that they can't walk when they can so they can't do that, may also be addicted AND a taker.

Basically, don't abuse your doctor, or you're likely to be labeled an addict. Don't abuse your friends, or you'll be labeled a taker.

[MoonRiver]

31. All I've ever taken for my pain is Aleve. My problem is caused by an inflammation,

which Aleve addresses.

[u4ic]

35. That's great that yours is fairly simple to treat

and you found something that works.

That's another issue with pain management - there are so many causes. When you've got something like Fibro or Complex Regional Pain Syndrome, for example, it can make it extremely challenging, and it's best left up to pain management drs, rheumatologists and other specialists, rather than GPs. For example, those with Fibro often have drug and chemical sensitivies, dysfunctional immune systems and digestive issues for starters. In addition, they don't even quite understand the etiology of the pain to begin with. The research is wholly underfunded.

[MoonRiver]

42. Those conditions have got to be horrible.

Thing is, Aleve just barely manages it. I am hoping the nerve stimulation helps a lot. Hanging on to that hope.

[moriah]

60. Thing is, a lot of those don't even respond to narcotics well.

My doc once offered me Darvocet for my ulnar nerve entrapment. I said "Wouldn't Neurontin work better, since it's nerve pain?" He wrote the Neurontin instead, and it helped. I'd already taken some hydrocodone I'd saved from an injury and it didn't, so I knew Darvocet would just kill my liver from all the Tylenol.

It's the right drug for the condition that's what's important. Not all pain responds well to narcotics, some respond better to things like Neurotntin and Lyrica.

[moriah]

61. Wish I could take it. Now I can't even take Celebrex, which was an NSAID I wasn't allergic to....

.... but I'm on lithium, and Celebrex raises lithium levels. So does Mobic, the other one they tried but I never filled because I didn't want hives and it was more closely related to traditional NSAIDs.

I may have to ask for narcotics at some point, but I'd rather figure out what's wrong with my hip that makes it hurt so bad, instead of just treating the pain. My Dad had to have a hip replacement before he turned 50 and my family has osteoporosis and arthritis bad. If it's just something scraping in the ball-and-socket joint, that could explain it and is treatable with surgery if it's not gotten too bad without having to do a hip replacement.

[dionysus]

54. "I don't know about chronic pain" that's quite obvious. get back to us if you ever rupture a disc

in your back or something like that.

[FloriTexan]

11. This is true. n/t

[csziggy]

34. The adrenaline from anger can reduce the pain

So maybe being angry is an addiction that helps the sufferer?

In my case before my knee replacements my doctor had no problem giving me all the Vicodin I wanted - because he knew I hated taking it. I called them my stupid pills because they made me so groggy. The doctor had also prescribed an anti-inflammatory that reduced the inflammation that caused a lot of the pain. Using those alone, the pain was bearable and I wasn't stoned all the time. I didn't like taking those all the time though since I felt they made me a little too relaxed to be safe to drive. The doctor had learned that I was not a drug seeker, so he felt comfortable offering me as much as I wanted.

What I did find over the years I was in constant pain from my bone-on-one knees was if I got really pissed off, I didn't notice the pain. Anger was a much more effective pain killer. I managed to get physical tasks done, such as cleaning the house, by getting really mad about the state of things (blaming on my husband was handy, but I'd do it while he was at work or gone). The only problem was I would hurt a lot worse later because I'd done things I really shouldn't have. At the time I got on a good mad I didn't feel the pain - that's the only way I could do very much.

[UglyGreed]

10. Let me add

my reply from another thread here.


are saying but after awhile of being ignored or told you could go to a church or a synagogue nothing will help you it gets to you.

Never mind going to an appointment and the doctor accepts a call and tells the caller that that women is just a complainer and other things. He sent me for a MRI, I go back to him only a day later he tells us that he forgot to take notes of the last visit.

Asks to repeat my symptoms , cuts me off and once again accepts a call from his wife to discuss their dinner plans, watching soccer with his children and how much should they donate to a local aquarium. Then after all that he says I'm depressed and see you in six months.

I left the office in a hurry since my headache was getting really, really bad and I vomited in the car on the way home and several times once I got home and passed out.

This surgeon is the same one who made my family and I wait nine hours in pre-op and did not even have the courtesy to visit me after the operation which I truly believe he had the Resident perform.

I am now waiting seven days to see if some other doctor will take over my case. Even before I get to see this doctor I needed to release all my information and they will see if they want to take me as a patient. Never a dull moment, sorry if this written poorly but it is very hard for me to gather my thoughts at this time and need to take long breaks even if I am just ranting on DU.

[UglyGreed]

12. Just got the call

from the Doctor I was trying to get an appointment with, he won't see me. So now my Hydrocephalus will go untreated for another few months.

[Tikki]

15. Thank you for this post...I read every word.

I will be seeing the specialist again in a couple weeks. I have learned not to tell them how
this pain has ruined my life story.





Tikki

[IBEWVET]

16. Sometimes you have to shop around.

Not knowing details, you may not be able to. I have found some doctors that I am so grateful to be in their care. They take time to talk to you and ask about your life and what you are up to. I may just be Lucky but there are caring doctors out there.

[Archae]

17. Chronic pain sufferer here.

2-3 headaches a week.
And not the average "Take a couple aspirin" headaches either.

Been labeled an outright fake by one "doctor," I called him a horse's ass and complained to the clinic he worked at.
That clinic banned me for life from there.
That particular "doctor" died a senile old man.

Others have called me an addict.
I tell them yeah, I am an addict to not having a headache.

[MoonRiver]

18. I go to a pain specialist for my chronic pain from sciatica.

I recently had a cortisone injection which helps short term. I will soon have a spinal stimulation done. People just need to find the right doctor to deal with chronic pain. It is truly hell.

[Tikki]

22. Yes it is...it is truly hell.

I hope the spinal stimulation does the trick for you and you are pain free for a very long time.


Tikki

[MoonRiver]

25. Thank you Tikki!

Right now I'm pretty good because of the cortisone, but that won't last. Hoping for something at least semi-permanent.

[UglyGreed]

23. I started with sciatica

way back in 91, had a laminectomy and that was the beginning of my never ending pain which was called failed back surgery syndrome which is just a BS diagnosis.

I believe my problems started when I was in a car wreck where a limo t-boned my 75 Camaro, I was about 22 years old. I suffered two broken vertebrates, three ribs and all my internal organs were shifted to the right.

I did not take any medication and rehabbed myself by bowling of all things since I lost a lot of strength in my left arm and I am a lefty. I thought I recovered well until 1991 when I was injured while working as a carpenter.

Now many years later I have eleven herniated discs, three were removed after having my neck fused which was a year before having shunt surgery for Hydrocephalus. Now my shunt is showing signs of either malfunction or obstruction which is common for shunts yet my doctor is not very helpful to say the least.

[MoonRiver]

24. Wow, you have been through the mill, to say the least.

Wishing you the best dealing with the pain.

[WinkyDink]

41. Oh, my! {{{UglyGreed}}} I've read that the back is basically a mystery to doctors.

[NutmegYankee]

32. Bad disk?

[MoonRiver]

33. Yes, slipped discs pushing on the sciatic nerve.

It's been going on for years. Lately it has gotten pretty bad.

[NutmegYankee]

36. I have two in my neck.

They hemorrhaged in both directions, but caused the worst pain on my left arm and shoulder. The Neurologist who did my MRI commented that he was surprised I could still move my left arm. Anyhow, the pain (and tingles/numbness) substantially subsided with only occasional spurts such that I can make it most days without anything for pain. Others require Tylenol (I'm allergic to naproxen). And then there are the "bad" days, where the unrelenting pain is so severe that I actually broke into tears once. On those days, Opioids are a Godsend.

[MoonRiver]

38. Thank goodness you have good days.

I have days that are tolerable, but the pain never really stops, except at night, which I guess is a blessing. What helped with that was propping my legs up with a pillow. I do usually get a full night's sleep.

[NutmegYankee]

44. I was informed that some disks can heal.

That it is really a race between how long it takes the body to break down the "gel" from the disk, and how long someone can stand it. If you can withstand it, the average two year prognosis for doing nothing and having fusion is basically the same. Of course, some people have such a bad injury that the nerve is getting damaged or they can't move the extremity and require immediate surgery. And if the nerve gets damaged, you get lingering pain even if the disk is later replaced.

I got lucky so far. I was only 33 when I was diagnosed.

[MoonRiver]

47. I get around, but often use a cane.

I didn't know that the discs can actually heal themselves. That's encouraging.

[dionysus]

56. they can't. once the "gel" inside the disc is gone, it's gone. eventually, the motion of the

vertebrae grind the remnants of the disc away. I was in horrible pain until my body had absorbed the gel from the disc that was surrounding the nerves. at this point, the vertebrae may self fuse. The orthopedic surgeon who consulted me said this was unpredictable; it could take 5 years, 25 years, or never happen. the last MRI I had, all the healthy discs were thick and white looking. the blown out one was thin, lopsided, and grey looking.

I say that with a caveat; tiger woods was rich enough that a surgeon sewed the disc back shut before it was empty. however, since he started playing too soon and already blew it out again, I'm skeptical.

once the vertebrae become bone on bone however, even if they don't fuse... there are no longer any disc pieces pushing out onto nerves, so it doesn't hurt anymore. however, bone on bone reaction can eventually cause bone spurs to grow, which could eventually hit the nerves.

but, if you blow out a disc in your back that isn't where major nerves branch out of your spine, you'd never even know it.

[dionysus]

57. it's not that they heal, it's that the body breaks the gel down and the remants of the disc as well.

once they are gone, nothing is touching the nerves to cause pain. vertebrae can self fuse, but it is not a sure bet. I was advised against fusion by the ortho I saw because he said it may cause a chain reaction; fuse those two vertebrae, the next disc up gets more stress. then that one could blow. get another fusion, the next one could go. ect ect.

[NutmegYankee]

66. There is also now the option of artificial disk replacement.

I'm a candidate, but the surgeon wanted to wait and watch because I bounced back so well. The Neurologist was so spooked that I was sent straight to the surgeon, who was the first to do artificial disks in the state. He evaluated me and had me instead do some physical therapy and get a steroid epidural. He believes I have a good chance of not needing surgery in the immediate future.

[dionysus]

67. glad you recovered.

[dionysus]

55. I was crippled for 4 months when the lowest disc in my back blew out, completely enveloping the

sciatic nerve on my right side. hooooboy. that took 2 years to completely recover from. that shit is NO fun!

[aquart]

26. Doctors told my sister she would always be in pain.

A good day is one that doesn't need morphine.

It's true that oxy won't work after a while. She has to cold turkey for three days, then go back. Always a rough three days.

Just as rough is the minefield of idiot regulations that keep her from being adequately medicated.

I don't give a shit about addicts and I've known more than a few. They aren't a good reason to force people to remain in agony.

And, to make it clear, my sister never gets high on her pain meds. Never.

[dionysus]

58. i think thats what some don't realize. when you're in agony, you don't get high from meds.

[aquart]

63. Nobody is ever told that. Which is why I hated House. It lied, lied, lied and never told the truth.

[dionysus]

64. exactly. if you gave me a vicodin right now, i'd get silly. when i was crippled, not so much.

[haele]

28. Pain is a symptom of so many different body and mind issues; it's not easy to treat.

Pain can be from a physical breakdown in the body, a sudden incidence or chronic condition.

It can be from a mental breakdown in the mind - the pain of stress or depression.

And it can develop from the anticipation of either; much of the pain people feel in a situational activity (like going to the dentist or getting a shot) that animals (and babies) don't is from the anticipation that it's going to hurt.

And it can be a combination of any or most of above. Pain is the body or mind's way of telling a person "something is wrong" - whether or not something is actually wrong.

And chronic pain usually has more than one root cause; removing or treating one does not usually get rid of all of it.

In a few cases - maybe 1% at most - pain can also be an emotional reaction - an addictive or co-dependent response - something in the person needs the "rush" and pain is one of the things that allows them to feel "alive", or special - or because it's one of the few things they can control or can use to get people to pay attention to them. (Munchausen's syndrome or hypochodria) This last reaction is usually from very immature people who typically grow out of it when they find they're spending too much time and money "being sick" and not getting the reaction they want from it.
Unfortunatly, these few cases are what the general public envisions when they think about people with chronic pain - just as they envision those other few assholes and cheats whose actions ruin critical services for everyone else in lots of other situations where people genuinely need help - like union membership, welfare services or disability.


Haele

[MoonRiver]

30. You seem to think pain is all in our minds.

Well mine is in my legs. It's chronic and it hurts. Hope you never have to deal with anything like it. But if you do you will realize pretty fast that it is not imaginary.

[haele]

45. No, I didn't say pain was in the mind. I said pain was a symptom with many root causes.

Pain is the symptom of a breakdown of some sort (physical or mental) and is translated through the mind. This is known because over 30 years of studies on pain have shown that animals, babies, and people with altered neural receptors feel pain differently than the average human adults does. Again, there are many different types and sources of of chronic pain -
I have chronic physical pain myself; nerve damage in my back, and 1/2 use of my right leg from a horrible fall. Some days, I feel so little pain that I could, if pressed say that I'm not in pain, it's just "stiffness" or a slight nagging ache. Other days I can't get out of bed without crying; feels like my leg is falling off in the knee. Why such a range in physical feeling?A lot of root causes. And being a reflective person, I have come to the realization that some of my pain has to do as much with my mental condition as it is my physical condition and environmental situation.
So yeah, I know pain not imaginary - but the level of pain I feel is a reaction to the combination the physical damage I've suffered over the years, the environment I'm operating in (high humidity, bright light, cold, heat, etc), and my mental ability to compartmentalize or otherwise deal with the signals my body is sending me. I'll never be out of pain, but if I start out having a good day, I can only attempt to gain some control over it before it gets to the level I can't.

Realize that everyone's pain is different, with different triggers and from different sources, even though it can be of equal intensity across the ranges of feeling. There are some people who do feel pain that is "in their heads" - especially those who are depressed or neurotic. There is nothing wrong with them physically. But they apparently feel pain...enough that they're constantly in and out of doctors offices and clinics.
Is their pain any less real? It is a mental condition that causes it, even though it is horribly aggravating and difficult for people with physical pain that is based on an obvious injury or condition to cope with a person who just "can't seem be treated".

And yes, there are the hypochondriacs who cry and become incapacitated at the slightest pinch or twinge - especially when things aren't going their way and they start hyperventilating in rage at the slightest excuse. They always seem to be in pain whenever there's something to do that they don't want to do.
To be blunt, I'm carrying one on my insurance until she is 26 - she averages around 20 medical events a year, and she's "fired" at least two dozen doctors and therapists who can't find anything physically wrong with her over the past 10 years that she's been "in pain and unable to function". Her actions over the years have indicated an unwillingness to give up her pain or go through the multitude of therapies that have been offered that might be able to assess what is going on and help her deal with her pain.

Is the above usual? No, most people don't act like that, whether they are living with chronic pain or not. But hypochondria is the sort of outlier pain situation that authoritarians and bean counters seize on to further the idea that "pain is all in your head" - because most "normal" people want to think that if they can handle a headache or a twinge in the back, someone else should be able to handle a migraine or nerve cluster damage. And the hypochondriac becomes an easy poster child for chronic malingering.

Y'know, some days I am in almost debilitating "can't get out of bed" pain, but ultimately, I still need to function even if I have to take breaks and limit some of my activities; I can sympathies with but can't see protecting the hypochondriac that clings to and uses pain to get through, because in a way, that's similar to protecting an alcoholic.
Sorry for seeming to end on a down comment, but that is where I was going - in a way, to identify why the "rugged American Culture" thinks that pain is a weakness. All it takes is knowing holding up one hypochondriac that is professionally in pain, and there ya go - anyone who can't "just do it" because of the pain is a hypochondriac indulging in a moral weakness.


Haele

[MoonRiver]

49. Ok, I understand where you're coming from now. Sorry for your pain

and the difficulty with your young person.

I suppose what you are describing is the rationale behind the spinal stimulator implant I hope to try. It changes the pain signals to the brain into a tingling sensation. At least that's what it sounds like.

[haele]

50. I hope the stimulator works. I suspect that since my damage is in nerves and soft tissue

something like this might also work with my pain.

I'm just waiting to see if perhaps I might be able to get something like this through my worker's comp settlement terms; it was settled as a "perminant partial disability" where they have to cover follow-on treatments as needed as things have slowly deteriorated - and I've been able to get some assessment appointments and therapy over the past 12 years since the settlement.

It's a "jurisdictional" issue. My employer-provided insurance won't even cover a doctor's visit if there's a complaint about my leg or back involved and it could possibly be related to that worker's comp. injury.

Single payer could take care of that - so that won't matter if it's a work-related injury, or an age-related injury, or whatever...

Haele

[MoonRiver]

70. Good luck Haele!

I have my husband's insurance and so far, through the pain treatments and a bout with cancer 3 years ago, everything except some co-pays, has been covered. It apparently is a little trickier to get insurance to pay for spinal stimulation. I meet with the pain doctors in two weeks and they will get the ball rolling for insurance approval. Hoping we can meet up here in a couple of months pain free!

[LeftyMom]

37. A woman I know was terminally ill and could not get adequate pain treatment.

She was on insufficiently powerful pain medication, and underdosed for her size to boot. Why? The explanation was that she might become addicted. She was DYING, and not slowly.

Eventually she decided she couldn't live this way anymore. She tried to overdose herself on her pain medication. She survived. They cut her pain medication further because she was a suicide risk.

She couldn't get a referral to a pain specialist because she was on public insurance and it was the policy of the clinic that they would not refer patients to pain specialists, nor would they prescribe medication necessary to keep her reasonably comfortable. Again, she was not faking, not looking to get high, she was dying and in terrible pain.

The same doctors would not fill out the paperwork to get her a walker or a wheelchair because they wanted her to go to physical therapy and build up the strength in her legs. I repeat for emphasis, she was terminally ill.

So she spent the last months of her life at home, immobile, in terrible pain.

It's inhumane. Literally. Nobody would treat their dog that way.

edit: And do you know what I learned from her experience? That as soon as somebody in a white coat says the C word to me (and family history suggests that's a when, not an if) I'm driving to Mexico and buying half the stock of the nearest Pharmacia. Because I'm not scared of dying but I'm scared shitless of dying like she did.

[MoonRiver]

39. No words.

May that poor woman rest in peace.

[WinkyDink]

43. There's $$ in rehab, not so much in a walker.

[PatrickforO]

52. Yeah we're more humane to our pets than we are to other people.

[freshwest]

40. Patient in the OP has the belief I once had, but I no longer have the luxury of belief.

In the end, it's all on us.

[daredtowork]

46. The conundrum here is

the most effective pain relievers have dangerous side effects, can cause addiction, can even cause death. Even if the patient wants death, we have a social imperative to block all routes to death no matter what tortures of life circumstances might be inflicted on a person. Homelessness, starvation, regular drenchings with acid - we will look the other way and/or demand you pull yourself up by your bootstraps! But taking your own life to escape is not allowed.

Also pain is subjective. Most of the time doctors have no way to prove how much pain you're in unless bone is sticking out through flesh. If certain tests back up you have pain-causing condition, that helps make your case. But the social and administrative forces are against "over-testing", so the doctor will prefer to lay "vague symptoms" at the door of "somatic pain" if he can. Often psychiatric medication can be prescribed after a mere personal interview, and it seems easier to prescribe/bill for psychiatric meds. But this is worse for the patient because of the A) the social stigma, B) inability to access resources based on physical disability. Not to mention whatever physical condition the patient may actually have is just getting worse because the doctor just blew it off.

Anyway, I really grok this situation because I have a genetic condition that prevents me from taking NSAIDs. Tylenol is ineffective for the type of pain I have and likely to cause liver damage if I rely on it anyway. I don't want to take narcotics or opiates during the day because I don't want to be sleepy during the day. For a long time this left me with NO options but a lot of suffering. Medi-Cal denied my doctor's attempt to refer me to a pain management clinic out of hand, too.

Recently, almost by accident, it was discovered that anti-epileptic drugs work really well for me, and my problems have been reduced a great deal. So sometimes it's just a matter of being persistent, continually reminding your doctor that the problem hasn't been solved yet. (I eventually brought in a powerpoint). Just keep telling yourself doctors are only human and they are predisposed to believe that the problem must be "in your head" if none of the easy stuff they've tried yet has helped. The doctor won't push forward if the solution wasn't easy. You have to push back.

Don't ask for opiates or narcotics, though. Seek other ways. Those drugs are what have placed doctors in such an odd position of being policemen rather than healers.

[hunter]

48. It's an excellent essay. Thanks.

I'm not quite a chronic pain patient but I love several people who are.

People who haven't been there have a difficult time understanding.

I have periods of utterly blinding curled-up-on-the-bathroom-floor-in-the-dark puking migraines.

It's not a "headache."

How do you explain that to someone who hasn't been there? I have medicines that are better than the wishing-to-die state, but I'm still left nonfunctional for up to a day. How do you explain the migraine "auras," the seeing-but-not-seeing, how the lights and sound hurt and make you puke? And no, I can't do ANYTHING when that sneaks up on me. I'm not going anywhere, I'm not going to get anything done.

I'm also suffering the familial arthritis. In my family there are those of us whose joints are only warranted thirty years. I'm more than two decades past the warranty on my drive train. Every skeletal joint in my body hurts. I go to bed when it hurts too much to move any more and then I wake up before the sun rises when it hurts too much to stay still. I've fried my stomach taking NSAIDS.

My brother is an a similar situation, migraines and arthritis, but he's also been diagnosed with fibromyalgia. This is on top of the severe damage he did to himself in a few horrific motorcycle accidents.

When we are young and strong we think anything that doesn't kill us makes us stronger.

Yeah, right...

[PatrickforO]

51. Well, because chronic pain is, well...

chronic. My wife had an unsuccessful knee replacement. It remained swollen, fluid filled an warm. We have a well known HMO, so basically we have rationed healthcare where they do the absolute minimum for you in order to cut costs. They basically told us they couldn't do anything until finally in desperation we asked to go out of network for a second opinion. Then they told us sure, we'll do the surgery, but your copay is $3,000. So we couldn't afford the surgery she needs even WITH insurance.

BUT they gave her pain pills! By golly, yes!

So she was on these oxycodones. In the meantime, because of her gait her lower back also became inflamed. She was a semi-invalid for THREE YEARS!!!!

Then, fortunately, she fell down the stairs for a SECOND time and apparently it shifted her knee so it didn't hurt any more.

So we went through withdrawal from the oxycodone. Vomiting. Diarrhea. Cold sweats. Hot flashes.

It took a MONTH for her to beat the addiction. But she did and is OK now.

This HMO deserves NOTHING BUT CONTEMPT in this matter and both of us SUFFERED. Constant pain, constant depression, working full time as an EXEMPT employee WHILE being a caregiver.

So, yeah, I'm mad. I have no confidence in this HMO at all. It seems clear to me that the capitalistic profit motive when applied to healthcare SUCKS. I advocate Medicare for all Americans, and then we could buy a supplemental policy and be fine. Because we wouldn't have rationed healthcare. When we were sick or had problems we could actually go in an get treatment. Novel concept.

I'm not mad at you, though. Just the capitalist system where our health insurance is rationed by insurance companies instead of based on what we need. I hear you about being frustrated, and I honestly wish that you and your family will never, ever have to cope with chronic pain. Because basically the medical community laughs at you when this is the case.

[UglyGreed]

68. I'm on your side

of this argument, look at my posts in this thread. I decided to posting this because it shows how doctors dread seeing someone with our problems.

BTW Thank you al who have added to this thread, IMO it needs to brought to the attention of those who do not have to deal with this problem.

[roody]

53. marijuana, marijuana, marijuana please

[dionysus]

65. i know it works for some people in amazing ways... for me it wouldn't help with anything more than a

headache (edit: great for nausea though). when I ruptured a disc in my back, I smoked... and was high as a kite yet still in agony

[MattBaggins]

62. How many are treating for anxiety with the pain

Pain and anxiety like to stroll through peoples lives hand in hand.

Throw depression in for the trifecta

[UglyGreed]

69. Kick

For the weekend folks.