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Pain Management

Posted by Tracey A. on 4/03/02 at 20:51 (078411)

Dear Doctors or anyone with info.

I have one question, could you tell me how pain management
works? I have to start it and don't know what to expect. As I have said before I've had 3 surgeries in the last 2 years. They have all failed and after another nerve test it showed the last surgery(Nov.1,2001)did not work
because I still have severe nerve damage. I had a Tarsal Tunnel release and the first 2 were for Planter-fascia. I'm still in alot of pain and still taking pain meds. Any info would be helpful.

Thank-you, Tracey

Re: Pain Management

Dr. Zuckerman on 4/03/02 at 21:29 (078420)

Hi

They will give you different type of pain medications such as fentyl You may have an epidural nerve block. They may consider a nerve stimulator in your lower back. This the basic treatment plan . Such medication are morphine, demeral, dilaudid are also included in this group of pain meds

Re: Pain Management

BrianG on 4/04/02 at 17:09 (078507)

They will probably teach you some meditation and imagery techniques. There are many types of pain clinics, no two are really the same. Some of the pain meds are now long acting, which contain less additives (like Tylanol and asprin). Too much of that can hurt your stomach, intestines, etc. They can also custom tailor a plan (and meds) for you, as everyone percieves their pain differently. Some will offer nerve blocks. It's a good deal, your lucky to get in.

BrianG (not a Doc)

Re: Pain Management

Lynda S. on 4/04/02 at 18:41 (078522)

Tracey:

After two failed surgeries, I went through a Pain Management class about three years ago recommended by my PCP. It was a ten-week course where we had a workbook to read and answer questions, had to record our pain sensations three times a day every day for ten weeks, did meditation, had a pain clinic physician for an hour and a half class, met then individually with another physician. Meds were individually tailored for the problem we had as people were there for different reasons. I am on Nortriptyline, Neurontin, and Ultram. It's not 100 per cent, but it has certainly helped. Take advantage of the opportunity and hope it can help you.

Re: Pain Management

Tracey A. on 4/04/02 at 18:49 (078523)

Dear Dr. Zuckerman and Brian,

Thanks for the quick response, things are much clearer now. Do they take the pain away permanently? or just to help with the pain? My appt. is April 25th. I have been taking Percoset and it helps me sleep because at the end of the day I'm in real pain. Advil and Tylenol don't help at all for the pain.
Thanks again, Tracey A.

Re: Pain Management

BrianG on 4/05/02 at 17:54 (078606)

Hi Tracey,

In most cases, the patient will still have pain. You would have to take an enormous amount of pain meds to be pain free. This would be bad, for a couple of reasons. If all the pain were gone, but you still had PF, you would probably do things that would make the injury much worse.

Second, Our bodies will become tolerent of the meds in a certain amout of time. It's different for everyone. It may be 6 months, it could be a year or two. When this happens, the doctor has to incease your dosage. For most people this is not a hugh problem, as the upper limits are really quite high. If you were in your 20's, now that would be a dfferent story. You would most likely get the meds, but the doctors would really watch you closely. It's to our advantage to delay an increase for as long as possible. If you have more questions, I may be able to help you. I also have some prety good web site links. I'm at (email removed) if you want to write.

BrianG

PS Percoset is a good med for acute pain, but not that good for chronic pain. It's really a short acting drug.

Re: Pain Management

BrianG on 4/05/02 at 17:58 (078607)

Hi Lynda,

It sounds like we may have been through the same type of class. Do you remember if your book was written by Dr. Margaret Caudell?

BrianG

Re: Pain Management

Lynda S. on 4/06/02 at 09:46 (078657)

Hi Bryan,

Absolutely. 'Managing your pain before it manages you'. When did you go through the course? I did it about three years ago.

Re: Pain Management

BrianG on 4/06/02 at 19:50 (078720)

Same here, about 3 years ago, in Ma. I have a friend who actually went to her for the class, and his pain meds. I believe she has an office in New Hampshire.

Small world :*)
BrianG

Re: Pain Management

Dr. Zuckerman on 4/03/02 at 21:29 (078420)

Hi

They will give you different type of pain medications such as fentyl You may have an epidural nerve block. They may consider a nerve stimulator in your lower back. This the basic treatment plan . Such medication are morphine, demeral, dilaudid are also included in this group of pain meds

Re: Pain Management

BrianG on 4/04/02 at 17:09 (078507)

They will probably teach you some meditation and imagery techniques. There are many types of pain clinics, no two are really the same. Some of the pain meds are now long acting, which contain less additives (like Tylanol and asprin). Too much of that can hurt your stomach, intestines, etc. They can also custom tailor a plan (and meds) for you, as everyone percieves their pain differently. Some will offer nerve blocks. It's a good deal, your lucky to get in.

BrianG (not a Doc)

Re: Pain Management

Lynda S. on 4/04/02 at 18:41 (078522)

Tracey:

After two failed surgeries, I went through a Pain Management class about three years ago recommended by my PCP. It was a ten-week course where we had a workbook to read and answer questions, had to record our pain sensations three times a day every day for ten weeks, did meditation, had a pain clinic physician for an hour and a half class, met then individually with another physician. Meds were individually tailored for the problem we had as people were there for different reasons. I am on Nortriptyline, Neurontin, and Ultram. It's not 100 per cent, but it has certainly helped. Take advantage of the opportunity and hope it can help you.

Re: Pain Management

Tracey A. on 4/04/02 at 18:49 (078523)

Dear Dr. Zuckerman and Brian,

Thanks for the quick response, things are much clearer now. Do they take the pain away permanently? or just to help with the pain? My appt. is April 25th. I have been taking Percoset and it helps me sleep because at the end of the day I'm in real pain. Advil and Tylenol don't help at all for the pain.
Thanks again, Tracey A.

Re: Pain Management

BrianG on 4/05/02 at 17:54 (078606)

Hi Tracey,

In most cases, the patient will still have pain. You would have to take an enormous amount of pain meds to be pain free. This would be bad, for a couple of reasons. If all the pain were gone, but you still had PF, you would probably do things that would make the injury much worse.

Second, Our bodies will become tolerent of the meds in a certain amout of time. It's different for everyone. It may be 6 months, it could be a year or two. When this happens, the doctor has to incease your dosage. For most people this is not a hugh problem, as the upper limits are really quite high. If you were in your 20's, now that would be a dfferent story. You would most likely get the meds, but the doctors would really watch you closely. It's to our advantage to delay an increase for as long as possible. If you have more questions, I may be able to help you. I also have some prety good web site links. I'm at (email removed) if you want to write.

BrianG

PS Percoset is a good med for acute pain, but not that good for chronic pain. It's really a short acting drug.

Re: Pain Management

BrianG on 4/05/02 at 17:58 (078607)

Hi Lynda,

It sounds like we may have been through the same type of class. Do you remember if your book was written by Dr. Margaret Caudell?

BrianG

Re: Pain Management

Lynda S. on 4/06/02 at 09:46 (078657)

Hi Bryan,

Absolutely. 'Managing your pain before it manages you'. When did you go through the course? I did it about three years ago.

Re: Pain Management

BrianG on 4/06/02 at 19:50 (078720)

Same here, about 3 years ago, in Ma. I have a friend who actually went to her for the class, and his pain meds. I believe she has an office in New Hampshire.

Small world :*)
BrianG