My story-hope not to bore

Trauma Columnist · Sep 13, 2004

Hi there and welcome to All Nurses. I don't have any words of wisdom for you - sorry for all you have gone through.

stevierae · Sep 13, 2004

I am a 35 year old RN who is continuing to earn my BSN with the goal of MSN/FNP. I have worked in home health for 4 years so I have seen a little of everything. Pain is now considered the 5th vital sign and we are taught to believe what the patient tells us his pain is. I have often admitted patients after orthopedic surgeries who do fine with a tylenol. Others are in excruciating pain. Each individual is different and each procedure done is different. I have always been a big advocate for the patient being treated with meds that can control their pain. Now it becomes my turn. I had two c-section (92 and 95) I remember the MD saying how many adhesions I had already after only one surgery. Seven years go by. I still have a numb spot over the incisions but life is normal. Then 2 years ago a I developed a hemorrhagic ovarion cyct that had twisted requiring surgery along the previous 2 sites. My appendix was removed then also. 6 months ago I started with a pain in the RLQ and saw my doctor. Ultrasound ruled out a cyst. We both thought it could be adhesions. Worse when I was driving, but a constant dull nagging at all times. Went through colonoscopy to rule out gi. Went through pelvic CT with contrast to rule out tumors, hernias, etc. Went through enteroclysis (AWFUL) to rule out Crohn's. Probably adhesions I thought. My docotr recommended having exploratory surgery done- not something I want to do. More surgeries=more adhesions. If I didn't take pain meds my life would be miserable. At this point I take half of a 5/500 hydrocodone every 2-3 hours. If I don't take them, the pain is awful and it takes more (a whole pill) to get back to normal. I just started a new hh job and had to get a physical. I discussed my problem with this doctor who told me that going in surgically to lys adhesions doesn't mean the ones causing pain will be found. He also said that the pain could be from nerve damage from so much trauma and the surgery would further irritate this. His advice to me was to keep on doing what I'm doing for pain control. I am functioning well, enjoying my family, and am able to work. I don't cry myself to sleep like I used to because the pain is under control. I go back to my family doctor Thursday and I know she will want to set me up with a surgeon but I don't want that yet. There has been so much drug abuse that it makes the ones in pain have a hard time. I also don't like taking so much Tylenol which is in with the hydrocodone. It doesn't dope me up and I am able to work and see my patients. We are getting an anodyne machine at work. It is used for wound healing and diabetic neuropathy as well as chronic pain. I am tempted to give it a whirl on me and see how it does. Luckily I have a great relationship with my family doctor, but I don't want her to think I'm a drug seeker because I'm not. I want to be pain free and don't know that surgery will provide that. I figure that if I can function well on what I have been taking then it may be a chronic problem she's treating. Does anyone have any advice?
Ann

Has Meckel's diverticulitis been ruled out? Or chronic PID? Either one almost sounds like what you are describing...

Only other advice I have is to get yourself referred to a specialist who understands and specializes in CHRONIC PAIN MANAGEMENT. This is ALL they do, and they are good at it. The management of chronic pain is a whole differnet ballgame than that of acute pain, and you need someone who sees it all the time and knows how to titrate narcotics--and make you an active participant in your own treatment plan--so that you can be, if not totally pain free, at least able to work, do normal ADL, and enjoy life.

Some of these docs are anesthesiologists that do pain blocks. There is usually a team approach--your treatment plan may include biofeedback. massage, PT. Also psych if needed.

DON'T settle for your family doctor managing your chronic pain. You will do both yourself and her a favor if you ask for referral to a chronic pain specialist. If you leave it to your fp, you may just end up addicted to narcotics, miserable and STILL in pain--and NOTHING will have been accomplished.

mattsmom81 · Sep 16, 2004

Good advice Stevierae and I will be following it soon with my DH, who has had a bad flareup this week of his spinal stenosis. He has been managing for years with a sedentary job (by necessity)_with NSAIDS, the occasional Ultram, OMT... but pain is now 9-10/10 on his pain scale. I caught him banging his head against the wall, literally, and vomiting...it was so bad. I called his PCP for an emergency appt and the receptionist rudely told me 'unless its an acident I can't squeeze you in til Thursday', this on Monday. Luckily I dug into the back of the cabinet and found an old rx for Vicodin...that and the Flexeril are taking the edge off til Thursday. I dosed him regularly for 24 hrs, then when he got some rest and stamina he's cut down to 1/2 a Vicodin and he was able to go to work with the pain today. I plan on going with him tomorrow to the PCP so they can't blow him off again. I was about to the point of being a demanding nurse and taking him to the ER for an injection..

Nobody should have to hurt that bad and people in chronic pain deserve skilled, understanding professionals. This is a pet peeve of mine. MY DH is not a drug seeker, he is just living with intractable pain and needs some relief, like many many undertreated folks out there.

stevierae · Sep 16, 2004

Good advice Stevierae and I will be following it soon with my DH, who has had a bad flareup this week of his spinal stenosis. He has been managing for years with a sedentary job (by necessity)_with NSAIDS, the occasional Ultram, OMT... but pain is now 9-10/10 on his pain scale. I caught him banging his head against the wall, literally, and vomiting...it was so bad. I called his PCP for an emergency appt and the receptionist rudely told me 'unless its an acident I can't squeeze you in til Thursday', this on Monday. Luckily I dug into the back of the cabinet and found an old rx for Vicodin...that and the Flexeril are taking the edge off til Thursday. I dosed him regularly for 24 hrs, then when he got some rest and stamina he's cut down to 1/2 a Vicodin and he was able to go to work with the pain today. I plan on going with him tomorrow to the PCP so they can't blow him off again. I was about to the point of being a demanding nurse and taking him to the ER for an injection..
Nobody should have to hurt that bad and people in chronic pain deserve skilled, understanding professionals. This is a pet peeve of mine. MY DH is not a drug seeker, he is just living with intractable pain and needs some relief, like many many undertreated folks out there.

Now, see--your husband would be a good candidate for Percocet, prescribed and monitored by a chronic pain specialist. Another option would be a Duragesic (Fentanyl) patch, which delivers continuous time release narcotic pain relief. Intractable pain is one of its main indications.

Traveler · Sep 18, 2004

I don't have any of the s/s of Meckel's diverticulitis or PID. I think it is adhesions or nerve damage. I saw my family doctor on Thursday. She wrote me a prescription of an Anodyne machine. I am going to rent one for a month or so and see if it helps. She really wants me to have the exp. lap but I am going to not do that if I can avoid it. She also gave me a prescription for a new med called Cymbalta. It is an antidepressant but an off label use is for diabetic neuropathy. Since I began taking it the pain has decreased tremendously. Unfortunately a s/e seems to be fatigue but I am hoping that this decreases as my body gets used to it. I am still needing hydrocodone but only about 10mg/day as opposed to 30mg/day. Some of the s/e I am attributing to the Cymbalta may be from decreasing the hydrocodone dose perhaps.

mattsmom-

I am so sorry that your husband is going through so much pain. It is the people that abuse the system that make it so hard for those truly in pain. I think it is wise that you accompany your husband to the doctor. I hope they address his pain. One thing that irks me is that it is so hard to get through to the doctors. The receptionists seem to think they are qualified to make medical decisions.

live4today, RN · Sep 18, 2004

Ann (((((HUGS))))) Sorry to hear you are having so much pain. I do pray a reason for your pain is diagnosed so you can receive proper treatment for it. Pain meds only mask symptoms, but do not cure what is causing the pain. God speed! :balloons:

mattsmom81 · Sep 18, 2004

I hope your treatment plan has you feeling better soon Ann...thanks for sharing and let us know how you're doing. I agree it really struck me the receptionist interrupted me to demand whether my hubs pain was due to an accident, as that was the only way he could be seen. What has happened to active listening? Of course I didn't start the conversation by saying "I'm a medical professional, so listen closely..." LOL.

So...let us know about this machine and this new medication and how it does for you...I know nothing of either but am interested. :)

stevierae · Sep 20, 2004

She wrote me a prescription of an Anodyne machine.

Is this similar to a TENS unit?

Traveler · Sep 21, 2004

Anodyne uses light. There must have been pretty good results since Medicare will pay as a DME for wounds and diabetic neuropathy.

ER-RN2 · Sep 23, 2004

I used an aniodyne machine for the month of august...did nothing for me....

Traveler · Oct 24, 2004

I have been using my Anodyne machine three times a day for about a week. Although my pain is not completely gone, I have been able to cut the amount of pain medicine I take in half. I also (stupidly) tried to intervene in a altercation that two of my dogs were having about three weeks ago. I ended up with a nasty dog bite. The area of greatest compression was about a three inch circle area in which I had no feeling. I have also been using Anodyne on that area and now have feeling in the area. My husband has painful arthritis in his feet especially by his big toes. I have been making him do it also. He was very very skeptical at first but did it just to please me. He told me today that he thinks it is helping.