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Pain Management & Medication

Started by bmw1586 on 04/28/2010 12:50pm

So question for the community... I am currently scheduled to have a spinal cord stimulator implant done on May 13th. In the interim, I have been seeing a very good pain Mgmt Doc. I have a personal aversion to using Morphine or Oxycodone just due to the stigma attached. However, I also understand the significant impact of high dose of Opiad medications that include acetamenaphen due to liver damage from the Tylenol. My Dr. & I have decided to approach my pain Mgmt by utilizing pure (specialty compounded) Hydrocone. Currently I am taking 20 mgs every 4 hours, but this is barely masking my pain. Curious if anyone might have been perscribed an RX at 30mg of Hydrocodone. I have heard there is a Vicoden 30 that was recently produced, but question is that is 30mg too high of a dose for Hydrocodone & if I should discuss switching to a different (less expensive since compounding might not be required) type of pain med like hyrdromorphone. Ulitimately, I am hoping that after the stimulator implant is put in, that I will be able to reduce my overall dependency on Narcatic Pain Meds, but for now, would like to hear what others have been taking/perscribed by their pain docs for the purpose of chronic pain mgmt. Without my meds, my pain stay at a constant 9-10. With it at 30mg, my pain is about a 3 - 4. Thanks for any advice. Regards

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bmw;

Where to start?

Suffer from adverse affects from radiation due to a spinal cord tumor i had removed in 1988. I have chronic low back pain and pain in my feet and legs.

i went to a pain mgmt. doc in February who was intent on using a spinal cord stimulator. He taught at the place that manufactures them so right there I kinda smelled a conflict of interest! I decided to get a second opinion from a neurosurgeon and he said he's done at least 2000 spinal cord stims and that with my complex problems it probably wouldn't help. He thought an intrethacal pain pump (w/morphine) would help. i was scheduled for a trial but in the meantime he wanted me to check with a pain mgmt. doc at the same hospital. So I went and guess what? He examined me and was in shock to find out I wasn't on any pain meds. He indicated that he didn't want to contradict the other doctor but that he would treat it with pain meds first to see if that didn't any good before implanting something. So I am now on: Hydrocodone every 6 hours 7.5 mg/325 mg; Methacarbamol, (muscle relaxer) 750 mg every 8 hours; and Lyrica (for nerve pain) 50 mg. tablets (2) at bedtime. The Lyrica takes 3 weeks to kick in so I have two weeks to go to see if it helps at all. So far, I don't see much of a difference except the muscle relaxer gives me headaches and the Hydrocodone makes me tired!

Anyway, I out off the trial for the pump, but if the Lyrica doesn't kick in, I'll probably go for at least the trial.

I wish you luck on the 13th. Post after you get it to let us know how you're doing.

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You say that you are scheduled to have a nerve stimulator "implanted" and do not indicate for which level, disc, or condition.Whatever it is, did you already have a trial for the implant?; did you have a psychological evaluation before you go for the trial or actual implant?; are you aware of the risks of even the trial for a nerve stimulator?. I have an excellent experienced pain manager doctor who is very thorough and very responsible, and although I am a profgessional with lots of experience in receiving and researching pain management techniques, and he has been treating me for more than 3 years, he always goes about all related issues. Nerve stimulators don't always work, can worsen your existing condition or create others. I've being treated for post-laminectomy syndrome and other complications arising from a medical malpractice to Lumbar 4-5 interspace and L5-S1.
You should go to Medtronics and/or Bionics to check on the nerve stimulators. Research is still been done on them and its efficiency, and there is always a certain percentage of failure when inserted. Remember that this is inserted directly into the spinal canal or, very rarely, onto the affected nerve itself. There is only a 50/50 chance of effectiveness.

Two years ago I had a nerve stimulator trial for L4-L5 on a Wednesday, on Friday I had to go back for adjustment, and the following Monday it had to be removed because it was causing more pain that I originally had, and at different locations. The Medtronics tech said that they (the Company) had not developed a system that would allow for the stimulator to be directed to a specific site; that it is only to 'an approximate area'.

About medications: I have a very high tolerance for pain; I have tried everything in the PDR (and everything that you mention) and still nothing reduces my pain to less than 9. I was on 30mg MS Contin CR 4x/day + Norco 10/325 mg q 6 hrs for breakthrough, in addition to nerve blocks, facet jonts, etc every 2-3 wks and still no relief. I am currently taking 60 mg AVINZA ( an extended release morphine) q 12 hrs + 15 mg IMM REL Morphine tabs 4x/day and the pain is still between 8-10. And I am again schedule to go for a stim trial on the same day that you are going (May 13), but now directed at the nerve itself. I'm seriously re-thinking about it. I trust my doctor and his recommendations, but...I have to think about the procedure itself.

Good luck to you and feel free to contact me if I can assist you in any way. I would like to know the outcome of your procedure. Have faith in God and pray; He keeps me going and staying alive.

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I forgot to mention that 30 mg of Vicodin is not a high dosage; I used to take 750 mg every 4-6 hrs as needed. Norco 10/325 is 10 mg of hydrocodone with 325 mg of acetaminophen. It is good medication, just that it depends on how severe is your pain. Hydromorphone is the same thing as Dilaudid, which may work for you, as well as Methadone; you can ask your doctor about differences and indications. With regard to morphine or any other opioid, your system may also develop tolerance, that's one of the reasons for which I have rejected the idea of implanting a morphine pump (intrathecal delivery system); the other reason is that I had a morphine pump trial and it didn't work, so why go for implanting it? According to my doctor and other consultants, that is my last and only resource, but I am not ready for that. Maybe something else comes up or a miracle occurs and I don't need it. I rather wait to see if somebody else can suggest a different alternative.

Again, good luck to you.

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There is no 750mg of hydrocodone.. that is the amount of acetimenophin or tylenol.... on your Rx bottle it should read something like 10mg/350 which is more commonly known as Norco, 7.5mg/650, 5mg/750mg

The highest dose available that I've been aware of in the U.S. is 10mg... Gee, if we could get 750mg of it, we'd be dead!

The first number is the narcotic or hydrocodone, and the second is the acetimenophin or tylenol reading like 10mg/500mg, 7.5mg/650mg

I hope I was of some help

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Rhonda:

Sorry, CORRECTION: It was Vicodin 7.5 mg of Abbot . I can not check that Rx because that was in 2004 and I disposed of it because it was not effective for me at the time. Later on that same year I had a procedure called IDET which worked so well that I even forgot that I had lumbar pain.

The relieve didn't last too long; 5 months later my only child went into a comma and as I lifted her up my back pain came back again.

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I'm happy that you have a good pain mgmt doc. In my area we can't keep the good ones...they keep moving away! The ones that stay are the ones who like to do as they please and not listen to you as to where they need to inject and how deep they need to go when it comes to epidurals. I know because I've been through it for years and every three months get another injection that doesn't work because they won't listen. I have only had ONE good epidural and it lasted for three months, but of course that doctor left right after the procedure! Guess my back side scared him off...HA! I have had three or four more injections since and I still remember what that one perfect injection felt like when he was doing it, and nobody else can duplicate it. My pain mgmt likes to prescribe meds and lots of them....lets not fix the problem, but just mask the pain! I'm waiting for a clinical trial to come to Iowa so I can go get my anatomical facet replacement surgery. It sucks that the closest place is like three to four hundred miles away and they don't take patients if they don't live within 100 miles. We need good ortho surgeons in Iowa that aren't affraid to touch you because you are soo messed up. "sorry, I can't help you"....I'm soo sick and tired of hearing that....what about MY pain? I also stay at a constant 8-9 on all the meds I'm on and I'm scared to stop the morphine because of what the pain would be like without it. Sorry gang....I kept going...thanks for listening!

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ICDAVILLA - Sorry for leaving out the details. I have already had the trial stim. Medtronic is the manufacture of the device I am having implanted. My injury is at L4 - S1 (both herniated with annular fissures). My primary source of pain is my leg, but also my lumbar region as well. My trial was a success for my leg. 100% pain relief. For the back though, I could not tell as the surgical pain from the implant was so severe that I could not discern whether or not I was getting good coverage. I am well aware of the procedure for the permanent implant. This is my only alternative to a ALIF. I am only 33 yrs old, and the Idea of having a fusion with little guarantee of successful pain relief is not something I am willing to consider at the moment. I know I eventually will have to go down that road, but trying everythiing under the sun to avoid. My question was whether or not anyone has ever been on a dose of hydrocodone 30mg (pure, no tylenol). Not sure if this is too high, and should swithch to something else rather than increase my dose, because the current 20 mg I take right now evey 4 hours barely makes a dent. Thanks all!!

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BMW, how are you even awake being on the 30mg? I know I can't personally take more than the 5/500 without being put on my rear end. And all it did for me was mess with my head, not take the pain away, and stop me up for days. Wow. What side effects is the 30 causing you to have? I know that if you have any nerve pain, which is what we all seem to have, that Lyrica isn't a bad choice, of course in conjunction with a narcotic pain medication. Lyrica might even make it bearable enough so you don't have to have the implant....worth a try, who knows?

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Hi Wendiann - Actually, I have a really high tolerance to opiate meds for some reason. Right now I take the 20 mg compounded, so no tylenol every 4hours. I sometimes add a 5/500 generic codiene when really in pain. I have tried taking 30 mg of the Hydrocodone just to see if I would have negative side effects, but have not really noticed. I just think that is a really high dose & am worried I might be damaging my stomach or liver. Thus the question if I should swith to something stronger at a lower dose, or just increase my current hydrocodone. I do not get any eurphoric effect, but at 30 mg I do feel more pain relief than at 20. I do not see my pain Mgmt Doc for another week, so guess I will just wait & see what he thinks. My only side effect is nausea in the morning if I take the meds on an empty stomach. I now take them with crackers, and that has seemed to reduce the nausea.

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Wendiann:

Sorry that you can not find a good pain manager doctor. You are not too far away from where I am in Illinois. My doctor's name is Dr. Sandeep Amin ( 312-563-3971). He is the director of Rush-Oak Park Pain Management Center; but he is an excellent human been that believes in God, not that thinks he is God. He listens to his patients, and always looks straight at your eyes when talking to you, and always looks for the best alternative for the patient. Although he is extremely busy, I am sure that if you call his office on a Monday morning between 8:30 AM - 10 AM CST seeking advise and explaining your situation, he will listen to you and probably give you a satisfactory advise. Feel free to tell him ( Amina, or Dorothy) that you are from Iowa and that I referred you to him; they know me very well. As a matter of fact, next Monday I will be at his office at 9:00 AM, if that can help you in any way.

I know what is to live with excruciating pain for which only a miracle can bring relieve. I'm 24/7 on morphine and still my pain stays at 8-10.

bmw1586:

I wish you the best with your procedure and hope that you never need to go for a laminectomy with or without fusion. I wouldn't go for an ALIF. I walked into the OR for an XLIF which is supposed to be the best and most innovative procedure, and came out with my lower extremities paralyzed and in the worst possible pain that may exist. My orthopedic surgeon of international fame, with the orthopedic team that takes care of the Chicago White Sox, and at one of the best area university medical centers (hospital)...but a mistake happened, and I am the victim of the surgical failure; and as he said, his first neural loss. But they continue going like if nothing happened, while my life and my livelyhood were destroyed. I don't say that he is a bad orthopaedic surgeon but ever since, I feel that this type of surgeries should be handled by neuro-surgeons, not by orthopedic surgeons.

Partners in pain, BE AWARE. Good luck to all, and lets pray together for some type of pain relief for all those afflicted by pain.

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Thank you ICDAVILLA, it would be nice to be able to talk to a human being that believes in God and doesn't think he is God. One of my biggest problems is the insurance and money to be able to get to another doctor. I have applied for disability but don't qualify because I haven't worked in the past 10 years. One reason I haven't worked is because stress causes seizures in me...OH JOY!, and the other is to be at home for my kids....I should qualify for SSI, but who knows? SSA wants to send me for a new MRI and I'm all for it, I know I need a new one and they have to pay for it....even better yet! I know I'm not alone on the financial difficulties around here...back problems= no money. I owe sooooo many dr bills and have no extra money to even make payment arrangements. I know the stress of that doesn't help the pain either. If I could, I'd be in Ill. in no time.... Thanks for the info...better go before I lose track and can't stop typing!

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In response to your post, I am not aware of any 30 mg of Hydrocodone dosage made. I am a LPN and what I think you are taking is Oxycontin, it is prescribed in 20,30,40, 80,160mg pills with no Tylenol in them for chronic pain. More commonly prescribed is Percoset, 10/325 or 5/500. which is Oxycodone with acetaminophen, so you have to be on Oxycodone or Oxycontin. Very addictive, I assume the stigma you are referring to is the fact that Oxycontin is often called hill billy heroin, and almost impossible to have prescribed in only a few states. Your post does not say were you are from, but if I was guessing it would be FL. were people will travel out of state to get. This pills are sold on the street at upwards to $1 per mg. So you can imagine a Drs. reluctance to prescribe such a potent drug, that the DEA highly scrutinizes.
BTW I hope you are not taking offense, because people do get these drugs, but in my experience they are usually Cancer patients. Several years ago I was prescribed time released morphine, due to similar symptoms as yours, did not work very well for me, made my stomach hurt, then once you are addicted and it only takes a couple weeks or less, if you miss a dose you go into withdrawal which is not pretty. I was also on Fentanal patches. I had fusion surgery in June of 09 of L4-L5 S1, cage screws and rods, I was on a on a pain pump for 2 days, then Percoset 10/325 for the next 3 weeks. After going to Norco, 10mg Oxycodone 325 acetaminophen, plus Soma and a valium when needed. I am still on these 3 meds today, and can't work without taking them, very frustrating and depressing. I hope the stimulator works for you, I have a TENS unit, that helps after a long shift. At your age [33] good luck, I am 54 and due to osteomalicia, softening of the bones, I do not have a very good future.
Good Luck!!

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HI BanjoNutz - No offense whatsoever. It is actually Hydrocodone. My pain Doc. writes the rx to have it compounded (made at a specialty pharmacy) without the tylenol. I am actually in TX, and we can get the Oxy here. Again, just a preference on the Hydro to the Oxy. I am thinking of swicthing to Hydromorphone. My understanding is basically the same thing (dilaudid), but smaller doses yet higher potency. Thanks for the reply.

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wendiann:

Are you sure that it is stree that causes your seizures and not the medications you are taking?
Do you have Medicaid in Iowa? When you do not qualify for SSA or SSi, or are in the process, you can apply for Medicaid which will cover your medical needs, and more than likely (95% sure) you will be approved. Even when you get your Medicare, Medicaid will remain as secondary insurance and will also cover your co-pays and deductibles. Try it, nothing to lose and a lot to gain. With that type of insurance you may be able to get your most needed medical care in any state. It seems that you really need prompt, efficient care, and you should be able to get it before the dreaded Obama Health Reform kicks in. That reform will only hurt , instead of helping the chronically ill patient.

Good luck, and keep praying.

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ICDAVILLA. It is stress that causes the seizures, I have been seizure free (grand mal) since a month after my dad died, that was almost 13 years ago. I'm still on the Phenobarbital and will be forever because everyone is scared about me coming off of it. I'm allergic to 99% of anti-convulsants because they'd overdose me on them at first, so it was back to the good old reliable Phenobarbital. BTW, used to call myself "Barbi" when it first would kick in at night because i was the ditziest blonde out there...WHEW! Plus, I'm on Lyrica now too, so that also counts as another anti-convulsant....Neurontin made me sicker than a dog and didn't even show up in my blood.

As far as Iowa Medicade, medicare....I don't qualify because "you're just a step-parent". Nice, huh? I qualify for a spend-down program, but who has an extra 750 bucks a month for it and who wants to keep re-applying for it every 3 months? They do now know that I'm pretty much considered "an In-compacitated step-parent", but we have to wait for SSI. My worker is trying, but her hands are tied, especially after my youngest step-child (I don't use the step...they are MINE) turned 12. They kick the step out of the system because the 12 yr old is able to take care of himself. Don't you love Iowa? ARGGG!
Thanks for thinking for me!

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AH Texas, I understand now. Also since that post I have went to a new Pain Management Dr, and am now taking Opana Er 15 mg 1 every 12 hours, which from my research is Oxymorophone, supose to be 2 times stronger than regular Oxycontin, so the 15mg Opana equals a 30mg OC. Of course these are all calculations made by the producer which is Pharma, only on my third dose so not alot to report. When reading others comments let's say there are no glowing reports. Seems like all want to go back to the OCs, but they all complain that the only available generics now are not like the name brand OC or one other that I do not recall., any way I am going into this with a hopeful mind set, and hope it works for me and you!
God bless!!

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Good for you Banjo....keep up the positive attitude! I hope the new meds for you!

Wendi

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Good luck Banjo. It is always good, that whenever all of us are able to, to keep a positive attitude and keep praying. God is with all of us brothers and sisters in pain. I keep all of you in my prayers.

I was switched from MS Contin CR 15 mg tabs 4x/day (morphine) with Norco 10/325 mg for breakthrough pain to AVINZA by King 60 mg caps (an ER morphine) twice daily or q 12 hrs with the same Norco for breakthrough and it works a lot better. 50% of the time I need Norco less frequently and the pain level is better controlled going from a constant 9-10 level to an 8, which is a lot to say. So, I would say that in my case Avinza provides better pain control than all others by providing me a lesser degree of pain 50% of the time. Established that AVINZA provides better pain control, I will now start using Morphine Sulfate IMM REL 15 mg tab 4x/day for breakthough pain to see which one provides better breakthrough pain relief.

bmw1586: Don't forget to keep us updated. Good luck and God bless.

wendiann: I spoke to a US Dept of Health case manager about your specific situation and she told me that, considering the minimal info provided, if you bring your letter of denial from Soc Sec to your closest State's MEDICAID administrator's office ("commonly refered as Wellfare office") you should be qualified and able to get whatever healthcare benefits you may need. She also recommended that you visit the Soc Sec website for a lot better info on benefits because they now MUST provide (and have) the shortest case processing time. She said that you may be provided with an Emergency medical card while your case is being processed. She also asked if your husband had paid into the FICA fund and that it was something that you should look into. Anyway, good luck again and God be with you.

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Thank you ICDAVILLA, I'm planning on calling my SSA rep on monday to see where things are with a new MRI that she would like to have. I still can't believe she didn't talk to her supervisor before calling me...doesn't make sense to me. I'm also gonna call the social worker at DHS (department of human services) and see if she got my letters from the doctors saying that I'm "incapacitate" as she puts it.
Yes, hubby puts into FICA. And he just retired from the National Guard with 23 years in service time, so I know they were doing it.
The one thing that kills me is where did all my money go that I put into it years ago. I think it's BS that you can't qualify for regular SSA disability if you haven't worked in the past 10 years. I worked for 20 years and paid into it....it should be kept for me to use when I need it and not just when I reach a certain age or have soo many quarters. We all pay into it in the US, is it gonna be around when I reach their retirement age? NO. Talk about needing an overhaul on social security! Government sure gets at us if we don't keep our crap in order...but don't dare say anything negative about their system other wise you're a terrorist. I'm not threatening them...just using my rights to voice my opinion. OK..rant is over...ahhhhh.

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hey,bmw. please let me know what becomes of the spinal stimulator,they have been wanting to give me one for over 7 years,and was pretty weary about it,but since you do get a trail run am considering it. i sure hope it helps. i have been taking vicodin now for over 7 years.7.5 four times a day,too no avail.but my pain stops when i stand or lay down. still cant pinpoint promblem. but since i work sitting it really is miserable.am thankful i get some relief though. hopefully this will help and you wont have to take anything. am rooting for you. good luck

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wendiann:
Good luck with your case manager on Monday. About where are our contributions to FICA going: Remember that we are paying for the benefits already granted, and to be granted, to all illegal aliens, and also for the pay increase that was just granted to our elected congressmen. When the so called "Obama's Healthcare Reform" goes completely into effect it will be even worst. There was no cost of living pay increase for seniors and the disabled, but we taxpayers are supporting the President and all congressmen, bailing out financial institutions, car manufacturers, etc. While the national debt increases, our entitled benefits decrease, and other countries needs are met with our income tax money; healthcare cost continues increasing while the American citizens' health continues declining because of the inhability to obtain necessary, adequate, healthcare services and medications. It has also been seriously considered by Congress to completely eliminate Social Security benefits, whether you have contributed to it or not.

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To Vafrye - I am sorry to hear that you have had to deal with this crap for 7 years. I could not even fathom having to doit that long. For me, it has been just over a year. I am glad you get some relief from the vicoden. a 7.5 would not even make a dent for me. I seem to have a high tolerancce for opiate meds, but am not willing to move to the more powerful kind like the ocy or the methadones. Am afraid of what the side effects are just trying to get off the high dose of Hydro I am on now... Gonna sick. However, if the SCS gives me enough relief that I can start to wein down, I am toatally for a few days of flu like symptoms. Regards the SCS, if you have the coverage or ability to do the trial, I say GO FOR IT!!! It is not a slam dunk, and surely not a fix. I had an appointment with a neuro last Friday & FINALLY got an answer as to why no other treatments have work. Reason is that my damaged discs, especially at L4/L5 have started to grow their own "pain fibers" due to the tears in the disc. I do not have nerve root compression, so never knew WHY I had pain in my leg like someone with true compressed nerve root sciatica. Back to SCS, the worst that could happen is that it does not work, and you loose a couple days of work. Well worth it to see. Mine covered my leg so well, I did not have to use my cane, I slept through the entire night (which I NEVER do), and all in all I think was a 100% success. Again, it is a 50 50 shot though. For others, no relief at all. Be positive though. Do the trial. What is the worst that could happen. I am starting to get excited, but anxious as well. Not looking forward to another surgery ( this Thursday), but I have to think about the brite side. After the surgical pain receeds, hopefully I will get some sense of normality back in my life. I will kepp you all posted. Pray for me Thursday!!!

Wediann - You are so on target with this Obama coverage. This is the absolute WORSE thig that ever culd have passed. I am not hear to say Go Republicans or Go Democrats, not the point. This coverage is taking away from the people that need it. It is like the reverse Robin Hood plan. I work in Compensation & Benefits for a very large well know food & beverage company, and I can tell you that due to this, companies like mine, ATT&T, and my former (1 of top 3 soda manaufacturers) have considered significantly reducing our plan coverage to employees because of it, or just cut the coverage completely & pay the fine. It would actually be less expensive to some of them to pay the penalty to not provide any coverage at all, rather than implement this RIDICUlOUS Obama Healthcare plan. Sorry, I will get off my soap box not. For those of you that have not read what this plan actually entails, I suggest you educate yourself. You do not have to work in the speciality like I do, but you can find the "layman" version explaining some of the idiotic requirements on the internet. Regardless of political affiliation, please reach out to you congressman & voice an opinion to have this law repealed. I have said my piece. Good Luck to all. Stay pain free however you can, and keep on fighting. We do not have to live like this. Regards,

Brandon

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BMW,

I'm soo glad to hear you finally got the answers as to why all the pain. Sure helps to know, doesn't it? I will be praying for your success on Thursday! It would be nice to finally hear of a success story in here.
I do hear what you are saying about companies cutting out health insurance all together because it will save money by just paying the fine.

ICDAVILLA,

I did call SSA and she said that decided to go against the MRIs and x-rays, but they want me to be examined. DUH...come on people, you can't tell by looking at a person that they have broken facet joints or that they have theacle impingements...or that everytime they take a step they have an electrical charge going through them, you need an MRI to find the real truth! I couldn't believe my ears...but they need to save their money to send out denial letters. I am almost ready to move to a different country so that the US can take care of me there...it really sucks how that works. Maybe I should move out of country, become a citizen and then move back illegally so that I can be covered and also get other benefits! Hmmmm...would it work? Sorry to say but I doubt it, my english is too good and no offense to anyone, but my skin isn't tan enough.
I'm off my soap box now...who's next?

Wendi

P.S. BMW, please keep us updated!

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BMW:

I have seen several of your posts.

I just wanted to wish you luck on the 13th. I think we need a success story here!

Again, please let us know how you're doing.

Pam

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To all of you that have followed my post, and wishing me well, I just wanted to say a BIG THANK YOU!! I hope the procedure goes well, and that I can finally provide a positive story. Not sure if I will have the unit programmed the day of the surgery (Thursday), or the following week. Just depends on how much post operative pain I am in. Thank you again for all the support. I will surely let you all know how it went as soon as I start feeling better. Thankfully, this is not a fusion, so hope to be up in about in a couple of days, but have planned for atleast 2 weeks off just in case. I am not going to rush or push myself. It is a full blown laminectomy to get the implant inserted. Keep hope alive to all, and I hope we all find relief somewhere/somehow. Regards,

Brandon

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I have had severe back problems for the last 10yrs. I have had 8 back surgeries and due one of my surgeons "accidently" cutting my dura during one of my surgeries I now suffer from Arachnoiditis of the spinal Cord. It has been a total nightmare for me. The majority of my pain is my lower back and lower extremities with severe electrical shocking sensations going down my legs. I have numbness/tingling and multiple other symptoms. My pain level stays at approx. 7-8 on my good days! I have been on every pain med. available it seems and none have worked very well. Now to add to my problems I had gastric bypass 2 yrs ago and now I'm limited to which pain meds I can take . I can only take Immediate/Instant release meds.now . I currently am on Fentanyl Patch 100mcg/hr. change this every 48hrs. and for breakthru pain I have taken diladid, Lortab, Norco, Oxycontin, Opana and Oxycodone. I take a muscle relaxant, anti convulant, something for insomnia and something for nerve pain. I know that seems to be alot but unfortunately it's still not working. I feel as though my pain dr. isnt really listening to my complants and concerns. He doesnt even address the main problem thats causing me all my pain (arachnoiditis) , sometimes I wonder if he knows what it is. Does anyone know of a way I could fine someone who is more specialized to my diagnosis in my area? I just turned 40 a few months ago and feel as if I am in a 80yr. old body. I 've lost over 150 Lbs the last 2 yrs but cant enjoy my new found life due my other health problems. If anyone has any advice for me please let me know.
By the way I do suggest for anyone that does have a problem with chronic pain that has tried all the other pain pills, give the Fentanyl patch a try. They start you off at a much smaller dose and increase it as needed. It did work for me great the first 8 yrs. but now not so much!
Hope this might help someone out there.
Thanks all & God bless,

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jorenee11: Get on board partner in pain. You want to find a good specialist in your area but do not indicate your area. Are you seeing a neurosurgeon or a pain management specialist? Arachnoiditis is a very debilitating/progressive condition which as you say has a multitude of symptoms, including neurologic problems. FENTANYL is a good pain reliever, but in some individuals it may cause respiratory depression or even respiratory arrest; it happened to me and I was changing it every 72 hrs. There are also LIDODERM 5% and FLECTOR 1.3% patches which you have 12 hrs on and 12 hrs off that are very good. Flector should not be used by persons allergic to NSAIDs for the same reason of Fentanyl. I don't know if you have been recommended by your doctor a trial of a Spinal Cord Stimulator (SCS) which is said to provide 80% relief to patients suffering from the inflamation the arachnoid lining (1 of the 3 linings that surround the spinal cord and the brain). Most insurance companies now require a psyc evaluation before the trial and/or implant of the SCS. Another suggested treatment is an intrathecal delivery system of the pain reliever (morphine pump) if you have already tried MS Contin. It comes ER and IMM REL . I'm currently on 60mg AVINZA q 12 hrs and Morphine sulfate 15mg 4x/day, plus Lidoderm patches. I'm still at an 7-10 pain level. Good luck.

bmw: I hope your procedure goes well and is successful. I'll keep you in my prayers. Good luck.

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Just ran into this site...and your stories all touched me. I wish I would have known of this site some time ago.

I have had back trouble for some time (46 now). For two years I did injections, chiropractic, massage, meditation techniques, back exercises and finally nothing helped at all. Ended up agreeing to a laminectomy, nad since April 09 I have had three surgeries and have a failed Spinal Chrd Stimulator. It was presented as the end all and though the trial worked some, the permanent suregery was never able to get coverage to the area. Severe pain down left leg and extreme low back pain still.

Can't do MRI due to SCS now, CT Scan and Mileogram done 1/4/10 (with a severe spinal chord leak that after 10 days of severe drop you migranes, led to a blood patch which finally ended the headaches) and xrays 2 wks ago reveiled L4/5, L5/S1 are severely degenerated with some protrusion and now...they are recommending a double fusion. I am not physically, mentally or spiritually ready for another masively invasive surgery like that.

I take 40 mg oxy 3x's day with up to 6-5 mg breakthrough oxy, 200 mg of lyrica 3xday, baclafin and cymbalta. I truely hope BMW finds relief in the SCS. It would be great to hear some faith building stories from anyone of us dealing with these issues. I just started researching Disc Replacement, which my ortho surgeon is extremely against, for the same two concerns out there, i.e. the longevity of the product and seriousness of a 2nd replacement surgery in 10 to 15 years....or less. But double fusion in this location....wow that's a hard one.

I know I am already completely adicted to the oxy, as the pain not only never went away after the first laminectomy surgery but got worse. I have been on disability, blessed that my company offered the insurance and I bought it but they are now beginning to mention filing for SS disability. I can't work and am extremely limited in my activities...even with all the meds. Can't imagine giving up my "life" so young. I was an active hiker, love the outdoors, dancing, etc. and will not give up faith that those activities are over in my life.

I don't know what I will do. Am open for any ideal, care, support that is out there and to share the same with all my heart.

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I recently was in a head on collision that herniated my C4 & C6 disks. I have seen a neurologist and a had a steriod injection a week ago. I still have NO relief from the pain or numbness that I am feeling. After the shot I felt worse than the day of the accident. I am currently taking Perc 5mg but is dosen't even touch the pain. After some discussion with the Neuro surgeon he told me that was all he could give me and that I shoule schedule another injection. I am going to see a Pain Managment Specialist tomorrow, in hope that with some therapy and medication I can find relief. Why is it that the doctors are so hesitant to try different pain mecications and act like I am making up the pain that I feel???? Will the Pain Specialist be any better?

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DEAR BMW,

THIS IS AN EXCELLENT, INFORMATIVE WEBSITE ON ANYTHING AND EVERYTHING TO DO WITH BACK PAIN ETC.....NOT JUST ON WHAT I COPIED AND PASTED! (NOTE THE TERM chemical radiculopathy BELOW)

-------Another consequence of an annular tear occurs as the body attempts to fix these tears. Although the scar tissue that closes the tear is needed, the new pain-carrying nerve fiber grow is not. You see, recent medical research has demonstrated that new nerve fiber grows from the periphery of the disc into and down the annular tear--all the way into the nucleus in some cases! This is bad news, for it means that the healed disc is now filled with more pain-carrying nerve fiber than a normal disc, which makes it more susceptible to new tearing within the healed annular tear and pain--now the whole disc can feel, not just the outer 1/3. The pain that arises from an annular tear is called discogenic pain in doctorspeak and is easily the most difficult of all the disc syndromes to treat. In fact, unlike disc-herniation-induced sciatica, we have yet to develop an adequate treatment for this condition! Besides being able to create their own horrible pain syndrome, which may be felt in the body above the involved disc(s)--i.e., in the back or neck and even down the associated extremity(s), annular tears can also give rise to the dreaded disc herniation, which in turn may compress and/or chemically irritate the adjacent sciatic nerve rootlets causing the even more dreaded sciatica or radiculopathy in doctorspeak. The ‘evil’ grade 5 tear describes either a grade 3 or grade 4 radial tear that has completely ruptured that outer layers of the disc and is leaking contract material out of the disc. This type of tear can cause a chemical radiculopathy in one or both of the extremities and result in the dreaded sciatica. Therefore the degenerated disc of a ‘disc tear survivor’ may always be somewhat painful because of this nerve fiber in growth. Another important clinical potential of peripheral annular tears are their ability to induce premature degeneration in the disc . This means that it is highly unlikely that complete, full thickness radial tears, will ever completely heal after their conception and will always be subject to re-injury. This incomplete healing may explain the recurrent nature of back pain.----------------

http://www.chirogeek.com/000_Anular_Tear_1.htm

THIS IS AN EXCELLENT, INFORMATIVE WEBSITE ON ANYTHING AND EVERYTHING TO DO WITH BACK PAIN ETC.....NOT JUST ON WHAT I COPIED AND PASTED!

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