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Old 04-14-2018, 08:48 AM
 
2,485 posts, read 1,302,996 times
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Does anyone else feel like their doctor doesnít take their pain seriously? I have a surgery scheduled in May but am in so much pain now and he just keeps throwing steroids and NSAIDs at the injury despite it being bone on bone pain and recommend icing it. I have tried tons of things including pt, Tylenol, Advil, aleve, steroid shots, steroid dose packs, ice, heat, staying off my knee, lidocaine patches, aspercreme, acupuncture, synovisc injections and Tylenol 3. Oh and a combination of herbal remedies and an anti inflammatory diet as well as crutches and a brace. The only relief I get is from Tylenol 3 (minimal) and wine, which I canít do with all the other meds. I feel like a criminal literally begging to get relief so I can work and clean my house and sleep at night. His office staff and PA seem totally unsympathetic yet he is the best knee surgeon in the area and has done my two previous surgeries. I get that the DEA is all over doctors but at the same time why are we left to suffer without proper pain management? I canít move the surgery up due to work commitments and am slated to work 21 days in a row and need help to achieve this. I carry insurance for my family as well as being the breadwinner. My boss had made it clear that I cannot have surgery until mid May despite being in tears from pain.

Any advice on how to get through to them that this is ridiculous and that I need their help managing this until my surgery date (5 1/2 weeks away)? If it was two weeks Iíd suck it up and deal and miss out on life but with it being that far off itís hard to do that. We arenít in a state where marijuana is legal or Iíd try that at this point.
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Old 04-14-2018, 09:31 AM
 
Location: San Antonio, TX
10,866 posts, read 18,937,245 times
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Maybe ask about diclofenac? It's an NSAID so some doctors are still comfortable prescribing it, and it works better than ibuprofen.

It's really unfortunate that doctors are so afraid to prescribe pain meds for those who truly need them.
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Old 04-14-2018, 09:46 AM
 
Location: Wine Country
4,858 posts, read 5,921,655 times
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Does your boss know how much pain your are in? If so it seems rather cruel that he would make you wait on surgery. I would have have a heart to heart with him/her. I mean what if your pain became so bad that you simply could not work at all?
It really is a shame that your doctor does not take your pain serious enough to prescribe something stronger for you.
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Old 04-14-2018, 09:51 AM
 
4,752 posts, read 2,185,706 times
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Quote:
Originally Posted by annabanana123 View Post
Does anyone else feel like their doctor doesnít take their pain seriously? I have a surgery scheduled in May but am in so much pain now and he just keeps throwing steroids and NSAIDs at the injury despite it being bone on bone pain and recommend icing it. I have tried tons of things including pt, Tylenol, Advil, aleve, steroid shots, steroid dose packs, ice, heat, staying off my knee, lidocaine patches, aspercreme, acupuncture, synovisc injections and Tylenol 3. Oh and a combination of herbal remedies and an anti inflammatory diet as well as crutches and a brace. The only relief I get is from Tylenol 3 (minimal) and wine, which I canít do with all the other meds. I feel like a criminal literally begging to get relief so I can work and clean my house and sleep at night. His office staff and PA seem totally unsympathetic yet he is the best knee surgeon in the area and has done my two previous surgeries. I get that the DEA is all over doctors but at the same time why are we left to suffer without proper pain management? I canít move the surgery up due to work commitments and am slated to work 21 days in a row and need help to achieve this. I carry insurance for my family as well as being the breadwinner. My boss had made it clear that I cannot have surgery until mid May despite being in tears from pain.

Any advice on how to get through to them that this is ridiculous and that I need their help managing this until my surgery date (5 1/2 weeks away)? If it was two weeks Iíd suck it up and deal and miss out on life but with it being that far off itís hard to do that. We arenít in a state where marijuana is legal or Iíd try that at this point.
How long has the pain been like this?
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Old 04-14-2018, 10:15 AM
 
Location: Swiftwater, PA
13,206 posts, read 10,607,078 times
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My wife has been on Aleve, Lyrica and Vicodin for months; she has cancer and had a pin installed in her femur to strengthen the bone. Some of the best pain relief she gets is from hot water bottles. When I was passing kidney stones the only relief I had from pain was to take hot showers and let the hot water hit my back around my kidneys. Of course you already mentioned 'heat'. Do you get any relief in the hot shower?

I picked my wife up one of the Aleve TENS units; but we have never tried it: https://www.aleve.com/aleve-direct-t.../how-it-works/. I even forgot that we bought it until your post. That unit is for back pain but there is another company that sells the Infrex Plus Pain machine for knee pain. Here is a YouTube video:


https://www.youtube.com/watch?v=q43wnlrUitE

Anyway; good luck! I wished that they had a better system and we cannot attest to those TENS units really working - maybe somebody else can?
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Old 04-14-2018, 10:15 AM
 
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Have you tried tramodol?

It is related to opioids, and often more effective than Tylenol #3. It is still a controlled substance, but not as restricted as other opioids. Doctors are usually more relaxed about trying this.

I think you need to go in and see him directly. Trying to get the medication you need over the phone, just talking to a nurse is not realistic. You need to talk with the doctor. You also should be asking for this from your rheumatologist, who should have been managing your knee for years before surgery. Surgeons should never be the ones managing pain, as their role is transient and they are being criticized the most for prescribing opioids when not following the patient long term.

Document well what you are currently trying. Make sure you follow the instructions from your doctor regarding non-pharmacologic treatments (ex. physical therapy/exercise/icing/elevation/massage etc...). Be calm, rational when talking with the doctor.

I do agree that for people who have severe pain that responds to opioids, the current obsession with controlling their use has really backfired for the people who really need them. But so many patients do not follow their doctor's instructions appropriately or don't do their non-pharmacologic treatments or ask for pain medications from the wrong doctors.
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Old 04-14-2018, 10:19 AM
 
2,583 posts, read 3,148,687 times
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Quote:
Originally Posted by fisheye View Post
When I was passing kidney stones the only relief I had from pain was to take hot showers and let the hot water hit my back around my kidneys. Of course you already mentioned 'heat'. Do you get any relief in the hot shower?

I picked my wife up one of the Aleve TENS units; but we have never tried it:


This is good advice. Never under-estimate the power of a hot or cold pack. My father has severe pain from a spinal cord injury (paralyzed after breaking his back) and he loves his cold packs that he uses multiple times a day. At times, they work better than opioids.

The OP should have a cold pack on his knee whenever he is sitting down.

The nerves that transmit pain to the brain are the same nerves that transmit temperature. As a result, applying a hot or cold pack to the area that is painful can actually "confuse" the nerves that become pre-occupied with transmitting the temperature change and they don't transmit the pain sensation as effectively.

Last edited by sfcambridge; 04-14-2018 at 11:05 AM..
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Old 04-14-2018, 10:32 AM
 
4,628 posts, read 10,515,895 times
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It seems your anger/frustration is misplaced with your surgeon when it should be with your employer...

I don't know of any Orthopedic office that would pre operatively provide narcotic pain medications prior to an elective surgery, particularly to "allow someone to work" for 3 weeks prior to surgery

If you are in that much pain that you can't work or clean your house then you shouldn't be doing those things, NOT trying to mask the pain so you can do those things....thats not what narcotic pain medications are for

How would you get to work if you had the pain medication? You shouldn't be driving while taking opioids

The Orthopaedist role in pain management is surgical treatment of the underlying cause and SHORT TERM provision of pain medications post operatively and for fracture pain.....that's it.

Narcotics should not be prescribed for OA pain with rare exceptions and in those cases managed by a Pain Management specialist
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Old 04-14-2018, 10:44 AM
 
Location: Swiftwater, PA
13,206 posts, read 10,607,078 times
Reputation: 9385
Quote:
Originally Posted by sfcambridge View Post
This is good advice. Never under-estimate the power of a hot or cold pack. My father has severe pain from a spinal cord injury (paralyzed after braking his back) and he loves his cold packs that he uses multiple times a day. At times, they work better than opioids.

The OP should have a cold pack on his knee whenever he is sitting down.

The nerves that transmit pain to the brain are the same nerves that transmit temperature. As a result, applying a hot or cold pack to the area that is painful can actually "confuse" the nerves that become pre-occupied with transmitting the temperature change and they don't transmit the pain sensation as effectively.
Thank you! With the kidney stones I was taking Percocet and had no relief. The hot showers were the only relief I had for days after I had one kidney stone physically removed in the wire basket. The opioids were a joke. The only problem with the hot showers is that you eventually have to get out or stay a prune for the rest of your life!

My wife originally used cold packs. One of the best ones we found was getting bags of black eye peas and freezing them in zip lock plastic bags. They work great and do not clump together like other frozen vegetables - plus they last a very long time (although we would not longer use them for food). She eventually reached a point where she felt the cold did not help and she turned to heat (hot water bottles and occasionally a hot compress).

Cold reduces swelling; but some of us just do better with heat.
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Old 04-14-2018, 11:13 AM
 
2,583 posts, read 3,148,687 times
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My Dad has two soft packs. One that he keeps in the freezer that he pulls out for cold. The other he puts in the microwave to heat up for warm. The one he uses for his knee is like this, with convenient velcro straps for wrapping it around your knee so you can walk around with it.

https://www.amazon.com/Cool-Relief-T...ck+knee+velcro

I agree with the other poster that the OP should not be ?cleaning the house and doing unnecessary activities while struggling with this pain.
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