Help/advice re husbands chronic back pain

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I'm upset again and at wits end after talking to my husband about his pain for the "1000th" time. I'll try not to be long and sorry if this is disjointed-I'm just really upset. His brief history: slipped two lower lumbar discs about five years ago-never got better. He had a laminectomy two years ago that was unsuccessful. Now the two discs are torn and leaking spinal fluid. He also has arthritis in his spine. He's been on Vicodin and Percocet and has progressed up to Oxycontin-120mg a day now for around 6 months. He does plan on having a laminectomy or I'm not sure what its called-something less invasive than a laminectomy. Understandably he's scared the surgery will fail again and has procrastinated getting it. Lately his pain has been so bad that after much nagging he has contacted his surgeon and is going to try to have the surgery soon. The past month or so the 120mg Oxycontin has not been enough-he has breakthru pain and then pain after his last TID dose after about 4 hrs. He also is on Flexeril TID. He has never abused his pain meds but occassionally has taken an extra dose when the pain is intolerable. He's also tried Tylenol,ASA, Motrin and Aleve-absolutely no help. Okay, so heres my questions: Am I right that you can be physically addicted but not mentally? He says he's addicted but like I said he rarely goes over his scheduled dose.

His Dr. is aware of building up a tolerance to pain meds (I had to nag my husband to ask him that!) but my husband thinks the Dr. won't increase his meds again or give him something for breakthru pain. So, if he won't-what would you all do?

Is there a ceiling on the dose of Oxycontin?. The Dr told him that 60-80mg of Oxycontin is reserved for terminal cancer pts.

Anyone have experience with pain centers/Drs? My husband says he's heard horror stories.

His surgeon wants to leave the pain control to his primary Dr (his first surgeon and now his second surgeon also). I find this unaccebtable. What do you think?

Finally, would you all call the Dr. yourself when your husband has told you not to!? I've always been very pro-pain control in my nursing career and feel I could plead his case better. Thanks for your replies.

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I'm upset again and at wits end after talking to my husband about his pain for the "1000th" time. I'll try not to be long and sorry if this is disjointed-I'm just really upset. His brief history: slipped two lower lumbar discs about five years ago-never got better. He had a laminectomy two years ago that was unsuccessful. Now the two discs are torn and leaking spinal fluid. He also has arthritis in his spine. He's been on Vicodin and Percocet and has progressed up to Oxycontin-120mg a day now for around 6 months. He does plan on having a laminectomy or I'm not sure what its called-something less invasive than a laminectomy. Understandably he's scared the surgery will fail again and has procrastinated getting it. Lately his pain has been so bad that after much nagging he has contacted his surgeon and is going to try to have the surgery soon. The past month or so the 120mg Oxycontin has not been enough-he has breakthru pain and then pain after his last TID dose after about 4 hrs. He also is on Flexeril TID. He has never abused his pain meds but occassionally has taken an extra dose when the pain is intolerable. He's also tried Tylenol,ASA, Motrin and Aleve-absolutely no help. Okay, so heres my questions: Am I right that you can be physically addicted but not mentally? He says he's addicted but like I said he rarely goes over his scheduled dose.

His Dr. is aware of building up a tolerance to pain meds (I had to nag my husband to ask him that!) but my husband thinks the Dr. won't increase his meds again or give him something for breakthru pain. So, if he won't-what would you all do?

Is there a ceiling on the dose of Oxycontin?. The Dr told him that 60-80mg of Oxycontin is reserved for terminal cancer pts.

Anyone have experience with pain centers/Drs? My husband says he's heard horror stories.

His surgeon wants to leave the pain control to his primary Dr (his first surgeon and now his second surgeon also). I find this unaccebtable. What do you think?

Finally, would you all call the Dr. yourself when your husband has told you not to!? I've always been very pro-pain control in my nursing career and feel I could plead his case better. Thanks for your replies.

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I wish there was something I could say to help you but alas I am a mere nursing student but I can say this. Wow. That is a lot of medication. I know there are all types of addictions but it sounds to me that your husband has built up a tolerance to his meds which is typical in patients who take them long term. One of the things you will need to do I'm sure is seriouly talk to the doctor with your husband or without him if need be. I'm sure that with his history and impending surgery it shouldn't be a problem but you never know. Doctors are very leery when narcs are involved. They think that severe pain is only warrented with cancer like he said. :uhoh3:

If your doctor won't give him something else or adjust his meds I would look for different doctor. I have a dad who went through something silmilar and he ended up going on major meds right before his sugery and I'm pretty sure it was patch of some sort. (Fentanyl) Hope all works out. Let us know...I'm curious to know what happens :)

Good luck.

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I wish there was something I could say to help you but alas I am a mere nursing student but I can say this. Wow. That is a lot of medication. I know there are all types of addictions but it sounds to me that your husband has built up a tolerance to his meds which is typical in patients who take them long term. One of the things you will need to do I'm sure is seriouly talk to the doctor with your husband or without him if need be. I'm sure that with his history and impending surgery it shouldn't be a problem but you never know. Doctors are very leery when narcs are involved. They think that severe pain is only warrented with cancer like he said. :uhoh3:

If your doctor won't give him something else or adjust his meds I would look for different doctor. I have a dad who went through something silmilar and he ended up going on major meds right before his sugery and I'm pretty sure it was patch of some sort. (Fentanyl) Hope all works out. Let us know...I'm curious to know what happens :)

Good luck.

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posted by jackson Anyone have experience with pain centers/Drs?

Wow, I feel your pain! My husband too has chronic back pain from an injury 10-12 (??) yrs ago, but it's not as bad as yours. My hubby only has 2 ruptured disks (L4-5 I think). We have had no surgery but have tried a pain Dr. We went to a specialized "pain clinic/dr.". He did a nerve block, and even though the pain didn't go away, it is now managable without pain meds. He has his good days and bad days. Like I said, my hubby's pain isn't as bad as yours sounds, but we LOVED our pain Dr. & the nerve block!!!!

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posted by jackson Anyone have experience with pain centers/Drs?

Wow, I feel your pain! My husband too has chronic back pain from an injury 10-12 (??) yrs ago, but it's not as bad as yours. My hubby only has 2 ruptured disks (L4-5 I think). We have had no surgery but have tried a pain Dr. We went to a specialized "pain clinic/dr.". He did a nerve block, and even though the pain didn't go away, it is now managable without pain meds. He has his good days and bad days. Like I said, my hubby's pain isn't as bad as yours sounds, but we LOVED our pain Dr. & the nerve block!!!!

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is there a specific reason that the previous surgery was unsuccessful? talk w.surgeon and find out what the chances are for success this time...try anything that might work...he might need meds more after surgery and if his tolerance level is too high they might not give it to him....also he might need to go slow getting off dosage...don't need withdrawal with all other problems..you have a bad situation there and limited solutions

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is there a specific reason that the previous surgery was unsuccessful? talk w.surgeon and find out what the chances are for success this time...try anything that might work...he might need meds more after surgery and if his tolerance level is too high they might not give it to him....also he might need to go slow getting off dosage...don't need withdrawal with all other problems..you have a bad situation there and limited solutions

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