Pain Management Advice

[DetroitLions93]

Hello,

 

I have had a series of injuries (many dislocations and tears) with both my shoulders and wrist. I have torn labrum cartilage and torn rotator cuffs in both shoulders as well as a torn wrist. I have MRI's documenting the torn shoulder joints in both shoulders, but the MRI with my wrist did not show what the issue was. I have dislocated both shoulders multiple times, and had an unsuccessful surgery on my left shoulder. The surgery left my shoulder in much more pain than pre surgery, even 2 years after the surgery I still am in much more pain than pre surgery. I have been doing physical therapy for the last 7 years and continue to do so. I am in my 20's and have been explained to by the doctors that I will have pain and problems with my shoulders for life as they are not healing properly. 

 

I recently went to a pain management doctor as I am on a daily basis at a 5/6 out of 10 on the pain scale. Following a car accident I was in that caused me to have a hyperextended knee, a redislocated shoulder, and the wrist pain; my orthopedic surgeon joint doctor said that I have milder ehlers danlos syndrome and put me on low doses of Vicodin and Percocet. I was on these for about 2 months, and then we ended the opiate medication because she said she isn't allowed to treat me for pain for a very long time but referred me to a pain clinic if I felt I needed to go. These two medicines brought my pain down to about a 1 or 2 on the pain scale and greatly improved the quality of doing day to day activities so I decided I would pursue the Pain Management at some point. 

 

 

Three months later, I decided to see a pain management doctor as I have been dealing with nonstop chronic pain in these joints since my first dislocation at 15.  At my first appointment, the PM doctor tried to downplay my pain saying that it really couldn't be that bad. I was a little offended as this guy sees me for 5 minutes and assumes my pain was no big deal. If it wasn't a big deal I obviously wouldn"t have gone to a PM doctor in the first place. But I figured this guy probably deals with people with shattered spines and vertebraes all the time so I didn't speak up really. I said it was a 5 out of 10 on the pain scale which was honest. 

 

Anyways, they started me on 200mg of tramadol a day. This medicine works well as an antidepressant and maybe aleviates 5-10% of the pain, but it has a serious interaction with the adderall i am perscribed. If the adderall overlaps the tramadol at all i get very sick (throbbing headache, nausea, throwups, sweating)... 

 

I scheduled a new appointment asap with the PM doctor after dealing with a month of feeling awful with this adderall/tramadol mix and only saw the PA. I told the PA that the pharmacist suggested I go with tylenol 3's as they are very comparable to the tramadol in terms of addiction potential and dosage equivalancy and that they don't have a serious interaction with the adderall. 

 

She seemed against this and decided she wanted to try buprenorphine instead. So now I wear this buprenorphine patch. The patch makes me mentally foggy slightly sea sick and is working minimally for the pain, perhaps equal to the tramadol for pain relief. I did some research on the patch and it appears this is the ingredient for people with addiction problems which seemed odd that she gave me this. 

 

 

 

 

 

I do not understand why I am not allowed to go back to what was working perfectly fine which was the lower doses of vicodin/percocets. It seems the PM doctor that i am seeing wants to try alternative medicines that leave me with lowsy side effects and little to no pain relief instead of what worked fine before. 

 

I have no desire to get buzzed or anything. I do not drink or smoke at this point in my life. So I don't understand why the doctor is having a tough time writing the perscriptions for what worked before. They said they don't generally give younger patients traditional narcotics. I am 23 so I fall under the younger patient category. It's funny that pain doesn't discriminate based on age, but apparently this doctor does. 

 

 

 

I signed a contract saying i consent to pee tests and pill counts, so why is this doctor placing a lack of trust in me and keeping me with medicines not working?

 

 

How am i able to get the correct pain medications from this doctor/PA? Should I go see a new doctor or stick it out with the current one I have and see if we make some progression in the correction direction? I don't want to appear drug seeking or like an addict, because I am neither of those things, but I feel like I'm being framed in such a way by my two appointments with this pain management clinic so far. 

 

I understand their is a political culture against opiate medications at the moment but I don't understand why I am being unfairly punished due to it when I have MRI's and X-Ray's showing my torn up joints, especially since I don't believe i need anything crazy like fentanyl but I know I'd be in a much higher quality of life on just 20-30mg of oxycodone a day. Do I just need to pay my dues and give it 6-8 months or so of feeling sick with these alternative medicines before they eventually try what has worked before???? I understand they have a license to protect, but I don't think prescribing someone with chronic pain 20mg of oxycodone a day would cause you to lose your license. Idk, any advice would help me out. What should I do or tell this doctor to help guide them in the direction my orthopedic surgeon had me on? Should i stick it out with the current PM doctor, or go find a new PM doctor in my network that is more sympathetic? 

[ventana]

Sorry, specific medical advice is best attained through a direct face to face interaction with a PA, not on a national message board

 

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