Opioids Go to pain management?

[MaltnHops]

I’m a little over 4 years past my lumbar surgery (bilateral laminectomy, bilateral foraminotomy, and a microdiscectomy on two levels). I’ve been on a prescription of 10mg Percocet (10 pills per month) for breakthrough pain since being discharged from the hospital, post surgery.

I’ve grown a tolerance and tried potentiating, but it doesn’t help much. My Dr says that if I need more than 10 pills per month then he’s sending me to pain management. I’ve tried smoking weed here and there to help with the pain, but would rather not.

I don’t know what to expect from pain management. Will they treat me like a junky, will they take my meds away altogether? Any advice would be appreciated.

 

[Nurse Ratched]

Pain mgmt. will look at your health records and try and find out if you are having CHRONIC pain ( every day ). Most post surgical patients ( especially after 4 years ) should only have periodic pain hence why you only get 10 a month ( as needed for flareups ). Your reg. DR. thinks that for the most part you should be getting by with otc meds and only need a narcotic for a particularly bad day.

Pain mgmt can review your health records and MAY determine that you need more meds. They might increase the 10 to 30 pills per month. Or give you something different. Or give you nothing. But they won't take away the 10 you are getting now. But...if you leave your current Dr. and go with pain mgmt. get a consult first and ask what they can do before leaving your other Dr. If pain mgmt can't help you at least you still have the 10 and a current Dr.

But it is pretty likely that you will get more than 10 pills per month when you transition into pain mgmt. Seems like the surgeries you have had warrant it. Good luck.

 

[MaltnHops]

Pain mgmt. will look at your health records and try and find out if you are having CHRONIC pain ( every day ). Most post surgical patients ( especially after 4 years ) should only have periodic pain hence why you only get 10 a month ( as needed for flareups ). Your reg. DR. thinks that for the most part you should be getting by with otc meds and only need a narcotic for a particularly bad day.

Pain mgmt can review your health records and MAY determine that you need more meds. They might increase the 10 to 30 pills per month. Or give you something different. Or give you nothing. But they won't take away the 10 you are getting now. But...if you leave your current Dr. and go with pain mgmt. get a consult first and ask what they can do before leaving your other Dr. If pain mgmt can't help you at least you still have the 10 and a current Dr.

But it is pretty likely that you will get more than 10 pills per month when you transition into pain mgmt. Seems like the surgeries you have had warrant it. Good luck.

I appreciate the reply! I am still in pain every day, but definitely better than I was before my surgery! Most days it’s limited to my lower back and is a 3-4 on the pain scale. When I’m particularly active (or sometimes for no reason at all) it can get to a 7 or 8 and I’ll have sciatica as well. The sciatica feels like “cold fire.” I don’t know how else to explain it.

Anyways, I appreciate your assistance and I’ll do a consult first, as you recommended.

 

[Nurse Ratched]

Sciatica is awful. I have had that nerve act up 3 or 4 times in my life and it is really miserable to even walk when it flares up. If you are in pain daily then pain mgmt will be able to help you. You will certainly get more than 10 pills per month. Usually people that have had back surgeries like the ones you have had need narcotics for life. They don't have to be strong meds ( even codeine would work ) but yu need to have an ample quantity to sustain you through the month.

2 per day equals 60 pills and that should be enough to take your pain down quite a few notches. Good luck, man.

 

[Fiori di Bella]

I was referred to a pain management practice back in 2013. I have chronic kidney stones and chronic daily headaches and migraines. I was referred to a Neurologist in 1999 and 14 years later it was determined that I’d be better served by a Pain Management Doctor. I didn’t ask for the referral but I’m so glad to have gotten it! I watched my brother, unmedicated and doubled over in pain with a 1mm kidney stone, while I was able to pass a 5mm stone with relative ease, thanks to pain management.
Right now I’m struggling with a different sort of issue. While I was hospitalized in Nov. 2021, they determined that I had hypothyroidism. I began taking 50mg of Synthroid and at the end of December I noticed all sorts of side effects. I lost weight, a total of 17 lbs. to date, but I’m also plagued with an unfamiliar type of 24/7 headache that Oxy barely touches. I’m also exceedingly nauseous and often vomit in the evening (never any other time). I’ve now decided to skip the Synthroid altogether. My size 6 jeans are loose and I look gaunt.
I digress.
When you see a Pain Mgmt Doc you will have regular urine tests and you’ll sign a contract saying that you will not get any pain drugs from other doctors/clinics. A Pain Mgmt. Doc will fire you as a patient if you’re caught using pain drugs he/she didn’t prescribe you or if your urinalysis shows that you are taking drugs you’ve not told them about.

 

[fastandbulbous]

With pain management, you'll at least get a doc with a good knowledge of pharmacology (most seem to have been anaesthesiologists, in the past). IMO, other than them, most docs understanding of pharmacology ranges from poor to utterly shite. I've had GPs get really pissed off, being told their job, by some scruffy long haired git, but they were shite. They are good at determining what is going wrong, but abysmal at determining best pharmacological treatment (I think the regular GPs, at my practice, are aware of my background in pharmacology research, so treat me a lot different to locum doctors, who think they know everything and are buggered if some hippie is going to tell them they are not too wonderful at a certain aspect of their job...)