Nurse on Pt end of Pain Mgmt - UPDATE

[CrunchBerries]

I am soooooo happy!

Okay, before I write.... if you are a pain mgmt person and happy with your narcotics I have bloody no reason to doubt your treatment and I promise you from the bottom of my heart I will not down you for your choice in treatment. However, I certainly expect the same respect.

So for those of you that were following my previous thread that had to be closed by the admins because of TWO people, I want to update you.

I go to the pain mgmt guy and for an epidural and EMG he will pretty well give me anything I want. Well, I refused narcotics and that caused a ****-storm. Repeat repeat blah blah blah...

Yesterday I went to my primary. Now, my primary is this old Mexican guy and I love him to pieces! He is skilled, down to earth, quiet, reasonable, yet respectful of my knowledge, I love him! He's not there, I am told he might or might not be back in August but I am in luck, his mentor is covering for him. Really? His mentor? MY guy is like... 70!

Well, this very spry, extra old guy, with a ton of energy walks in the room and asks what he can do for me. I admit it, I'm wondering what he can do for me. My attitude was quickly shot down with reality. He is nice. Really nice. I pour my heart out to him, far more than planned. Yes, I have MS but I am not end stage and yes, I have pain but not Oxy level pain and I am very educated and I believe there are non narcotic measures to be had before resorting to turning me into an addict like those (every single one of them) other pain mgmt patients. I told him, I'm not going back to that pain mgmt guy, I'm not doing it and nobody can make me! I will quickly become an addict if I do!

He put his hand on mine and said, "Honey, you don't have to do anything you don't want to!" Guys, he's like........90. He can call me anything he wants. He's earned the right. He made me feel better.

Then he informed me that he has had a license in CA to practice medicine since before I was born and nobody has asked him to return his license yet. AND...he's had a DEA license for a long time and nobody has asked for that back, either. At this stage of the game he feels he can treat my pain since we are on the same wavelength.

He doubled my Nortriptyline and said to come back in 2 weeks and think about how that is working. I am 53, he referred to me as a whippersnapper and told me I am pretty smart for someone so young and inexperienced!

I love this man!

I can work with this guy, this... I can do.

My personal opinions... I own these, they are mine. I have done a great deal of research and *I* believe, right or wrong *I* believe most pain mgmt clinics are legal dealers. Not all!!! Most! I further believe we were better off when our primary docs who KNOW us, managed our pain.

I do not down my experiences of the last month, instead it opened my eyes in an overwhelming way! I think every nurse on this planet should experience a pain mgmt clinic just to see where many of their patients are coming from. A nurse turned patient in a pain mgmt clinic is not just eye opening, it is overwhelming. When you get sassy and think (know) that you know it all, this experience is enlightening. Humbling.

I got this one, for the first time in months I believe I am on the right path.

[calivianya, BSN, RN]

I understand why pain clinics get a bad rap. We get pts that are on 100mg on oxycontin TID. DO have any idea how difficult it is to manage pain on a person like that??

Had one of those recently! Post op belly surgery, they put him on a morphine PCA 1mg bolus q6m 4 hour lockout of 24mg, a fentanyl epidural (high epidural! Scared the bejeezus out of me, had to have been T1-T3 at the lowest, it was right under his neck!) basal rate 28mcg/hr with a 10mcg bolus q30m 1 hour lockout of 20mcg, and q2h 4mg morphine IVP for breakthrough pain. That's the combination that managed his pain.

I think he's just lucky someone listened to him and he got his pain controlled. I can't imagine many people that need that much drugs would be able to get them. And that's why I hope I never need chronic narcs. Getting chronic pain patients on that much narcs to feel okay in the hospital is just about impossible.

[Horseshoe, BSN, RN]

When I was taking vicodin after neck surgery, I had the most awful trouble with constipation, even with aggressive efforts to prevent it. I cannot imagine taking narcs on a regular basis for that reason alone!

At my 3 week check up, I told my doc that the only real reason I was taking any pain pills was because of that freaking hard neck brace making my life hell. He said "then get rid of it. Really, you're doing okay if you don't want to wear it 24/7." I wanted to kiss him. Ditched the brace and the pills right then and there. :)