What to expect at my visit to pain management .

[dcampbell]

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.

[NickB]

I just read your post and noticed that no one responded and it seems that you wrote it in August. I hope everything has worked out for you and that your pain is getting better. I think if you would have taken what you typed on this website and handed that to the doctor, that would have been all he needed to hear. Best of luck to you.

[dcampbell]

Thanks for your concern.

I did just what you suggested. I wrote out my thoughts about how things were going for me and gave it to my PM doc. Things went very well. He wants me to be able to say "yes" to more things, and prescribed tramadol for several times a month. It has been very helpful and I feel happy to be able to participate in more activities.

I am still amazed at how shy I felt talking to my doc. I felt like I was being "wimpy". I would recommend to anyone to write things down like I did. The process of writing things down, helped me to gather my thoughts. Plus, I think the doctor probably liked having the details written down for him. He read it before he came into the exam room and it saved him some time, plus he had, in my own words, how I had been feeling.

The office has me complete various forms on my pain related to different activities, but by having a letter from me, I think it gives them even more information on how they can help me.

I appreciate those of you who work in PM, it can't be an easy area to work in.

[canoehead, BSN, RN]

My mother had a similar reaction after getting a tooth pulled, her neck and jaw went into spasm, and it seemed to start a chain reaction til her whole body had visible muscle spasms. She went 6 years unable to do much more than sit and wait for the next pain med, it was really amazing (in a bad way) that a person could be in so much distress and nothing was done, and they told us nothing.

[dcampbell]

Thank you canoehead for your comment.

You said that she had these spasms for six years, does that mean that she got better?

What seemed to help her get better, or did it resolve on its own?