Intro and help needed re: pain (non) management
Hi all and sorry in advance for the long post. I am adding a summary/TL:DR version at the end and so appreciate any advice.
I have had terrible migraines for as long as I can remember. They usually start at the top of my c-spine/by the occipitals. I've been on all sorts of medications for that- Topamax, depakote, imitrex, maxalt and others, with lots of side effects and little help.
About 8 years ago I started getting terrible mid back pain that felt like stabbing by my left shoulder blade. I also had severe muscle tension at the bottom of my neck and into my shoulders- basically a big vice grip spasm. Over the past few years that pain has become more persistent. I now have radiculopathy down my arms, mostly on the left side. My ulnar nerve on the left is pinched and I have numbness and shooting pains.
For about three years I saw a pain management physician, Dr. E. Eventually thr regimen we settled on was tramodol, Lyrica, amrix, etodolac, lidocaine patches, fioricet as needed for migraines and small amounts of Percocet for breakthrough pain. I did PT as much as my insurance would allow, with limited success. We tried epidural injections, but they did not help. I ended up getting facet joint (non steroid) injections followed by radio frequency ablations in 3 areas, all on the left side: C2-6, C7-T2, and T3-T8. C2-6 brought me a 50% reduction in headaches and lasted a bit over a year. C7-T2 did not bring relief. T3-T8 was most successful, bringing 90% relief for almost 18 months.
But then my doctor wanted to continue on that cycle. T3-8 was equally successful the second time, C2-6 was less successful and had a shorter period of relief, and c7-t2 actually made things worse. Dr E expanded his practice to 5 offices and became hard to reach. When I did see him, he seemed to be on autopilot and was always very late. I chose to stop seeing him and switched to another pain management physician, Dr B, at my GP's practice. He seemed compassionate and came highly recommended, so in July I cut ties with Dr. E in favor of Dr. B. The first official consultation with Dr. B was good. I'd had severe side effects with Lyrica, so we changed to neurontin. I continued on tramodol and amrix.
Though I told him I'd been prescribed 10mg Percocet for breakthrough pain, I also said I did not need a new script at that time as I had 10 pills left from Dr. E. He said no problem, just come in when I needed more. He also said I'd need to sign an opioid contract, which I verbally agreed to but never received.
When I next saw Dr B I explained that my pain had been rough all month and requested to continue on Percocet. He looked unhappy about my mentioning Percocet, almost as if I'd never reported taking it before. He made me take a urine test, which I did. It had been at least a week since I'd had Percocet, so I assume I passed. I asked what I should take for headaches and for the neck pain, and he only offered Valium. I expressed concern that it would not help with the pain, but he said to just take something OTC. I told him that tic tacs would be more effective and give me less GI side effects than OTC NSAIDs, but he just said to "call if it got really bad." I left and cried for some time after, feeling demoralized and helpless.
Dr B scheduled an EMG test, which I had today. The nerve conduction portion was excruciating and hours later my arm feels like a lightening bolt. I am pretty stoic but mentioned several times to the technician that it hurt badly. The muscle portion was less painful, and Dr B said it was "normal." He said it'd be 2 weeks for results on the other part. I said it am in constant pain averaging at a level 7 (and up) and can't function like this. He asked if my job was stressful and if I'm doing PT. I answered "not particularly" and "yes, I am 3x a week but I'm not feeling improvement." I basically had to beg for an appointment with him, which I will have tomorrow.
I am so worried that he is not taking me seriously and that I won't get any treatment. I am in so much pain that I've been too nauseous to eat during the day, I feel very depressed, and have little drive to do anything. I am happily married and have a good job, but am in so much pain that I can hardly manage getting through the day. Seeing friends and family is a rarity, and I can't take care of household chores without severe pain.
I am terrified that I made the wrong decision in dropping Dr E. I only named Percocet because it was part of my regimen for 3 years. I was always extremely conservative with dosage, but I did find the need for it a few times a week. Now all I have is one 50mg tramodol a day and some OTC NSAIDs that are killing my stomach.
How do I talk to Dr B and get him to understand that I need something, anything, that will help? I am at my wits end. Thanks so much for reading this long message, and thanks in advance for any advice!!
TL/DR version: I stopped seeing my pain mgmt Dr of 3 years when he became inattentive. My new Dr came highly recommended but is not providing me with medication for breakthrough pain or migraines. I am miserable and need advice on how to ask for treatment without being seen as a drug seeker or overreacting.