What to expect at my visit to pain management .

Due to an injury three and a half years ago, and from being misdiagnosed many times, I am now a pt at a pain management clinic. I fell down my own icy driveway (very steep) and hit my head several times. I developed much pain in the front left side of my neck, the left front of my neck, left shoulder pain, and left sided facial pain. The muscle spasms are unreal! Many times I can feel my left clavicle being pulled up, it hurts to eat, smile, talk. I have all day headaches. I have had a negative MRI. I have had a negative EMG, negative for thoracic outlet syndrome, been fitted for two bite guards (one did not help $600, one made my bite totally off ($700) and now my mouth stays permently open. Negative TMJ condyle damage x-ray. I have had two years of PT, shoulder surgery (which I have been since told I did not need)--a subacromial decompression. I have also done massage therepy, read too many books, take magnesium, pray all the time, and take 5 Aleve and 4 Tylenol a day (for the whole three years).

My life has become "smaller and smaller" to me due to this pain. I find that I say "no" to activities that I had always enjoyed before with my family. I do not hike anymore, no more yoga, gentle stretching just makes things worst, going on any car ride even for just a few miles is torture, my husband is doing more around the house and the worst part is, my kids are volunteering to do housework (even my teen!). "It's o.k. mom, we'll do the housework....." They have seen that mom can not do what she once could and don't even ask anymore do to things like go to the pool, ect. I am a stay-at-home mom now but will need to go back to work within three years (I have only ever worked in hospitals). I need to get well!

After seeing many neurologists, dentists, and doctors, I was sent to PM. I am going back next week to request some more PT ( I must be a glutton for punishment--but they do get my neck to move. PM is treating me for TMJ ( but I wonder if I have an untreated whiplash injury--but what can be done for that anyway) by prescribing Valium 5mg q6hrs prn. It does help when I take it (I rarely ever take more than two a day), but I am so sleepy that I can't do anything but sleep. I have been seeing them for a year but I am too shy about telling them that I am not doing well and I cannot complete the activities I once could. I want to be more bold this time but what should I say. I don't expect a completely pain-free life (that might be unrealistic for me) but I would like two to three days a month of a pain medication so I can say "Yes!" to a hike or a car trip to see our folks (about 150 miles). I would like to enjoy a day of sightseeing with my family or a day at the beach. Would a request for three days a month of Ultram or something be seen as "too much" medicine?

For anyone still with me...how can I address this with my PM doc (this will be a new one that I don't know, my other one has left the practice)? I know that I need to speak up for myself, but I am grateful for what they have done for me with the muscle relaxants--I don't want to be a complainer. I also have a concern about all of the Aleve I take (I am 41 and my dad had his first heart attack at 45).

Thank for any advice you all can give me.