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Disturbing trend - the need to vent

Posted by Sher A on 10/13/03 at 20:19 (133909)

Well after a day or two of a reprieve a couple weeks ago, the PF is back in all its painful glory. So I continue unchanged and regardless of where I go or what I do, it's just another dead end and a waste of leave and money. That's why I was wondering if this actually ever goes away. I've seen 3 pods for this. Each disagrees with what the one before said, so how am I to know who's right? The first 2 I didn't have a good feeling about, the most recent does make me feel that he is very knowledgeable in this area, it's just that he doesn't believe in treating the gawd awful pain because 'you can get addicted'. I don't even know why I bothered going in for today's visit. I told him I'm about ready for surgery and he said no on that, not until the other options have been tried and exhausted. This is wearing me down. I told him I need something to take the edge off the pain, especially when it's worse at some times than others. And he said no way is he going to perscribe pain medication. He wrote me a perscription for Celebrex and said that this will help and will also work on the pain. This is what I paid my money for? I thought he was supposed to be helping me? And part of helping me includes giving me a break on the unrelenting pain of it all. I work full time and need to think about my work during the day too. So that's experience #1.

Experience #2 was last week when I went for cortisone shots in my fingers, which also bother me at this time of the year. I explained that the PF has now turned chronic and could he give me some vicodin to get me through the month? I don't want anything much more than that because I have to stay awake. He asked me if I've considered surgery. I said yes, but fear of complications, anxiety, scar tissue, accidental nick into the tendon, and related things are keeping me from doing it. More people advise against the surgical options than advise for it. I'm not sure I'm ready to take the chance yet. So he made me feel that if I didn't think it was painful or important enough to get the surgery done, then it obviously isn't painful enough for vicodin.

Are these doctors playing a bad joke on me or something? Don't they understand how this hurts? Don't they understand that people need help in holding down the pain to a bearable level? There are medications that will help, so why won't the doctors help? What good are these medications if you have to go through hell and high water to get them? They might as well not exist. I really don't get this. I'm not going to peddle these on the street, I'm willing to take the risk of dependency until this situation is under control. Some of us have a very low tolerance to pain, like me. I'm getting real sick of going to these doctors who blow this off to your imagination or that they don't perscribe pain medication period. I'm at a loss here, and I hurt. How do I explain this to them?

Re: Brian G., can you help?

Suzanne D. on 10/13/03 at 20:51 (133911)

Sher, I'm really sorry. It is SO frustrating to not be taken seriously as far as the pain goes. And to have gone to three doctors...

I hope Brian will see this and respond to you. He's not a dr., but from his experiences he knows so much about pain medicine and will probably advise you to visit a pain management doctor. Maybe he can give you some advice as to what your next step should be.

Hang in there; people here understand your pain and frustration!
Suzanne :)

Re: Disturbing trend - the need to vent

wendyn on 10/13/03 at 23:26 (133920)

Sher - I don't have a lot of experience with pain meds - but I think that most doctors prescribe anti-inflammatories for PF. Usually Celebrex, Vioxx, Arthrotec etc. Can't take any of them myself - but I think that's the standard protocol.

Re: Disturbing trend - the need to vent

Kathy G on 10/14/03 at 08:49 (133940)

Sher,

Have you a Primary Care Physician whom you like and trust? He may be the person to help you with pain medication. I would make an appointment with him and tell him of your situation. My Pod is excellent but he seems to leave pain management to my PCP and it has worked out for me. The Celebrex may help your pain as it should cut down on the inflammation. It can take a few days to work, however.

I am so sorry that you are having such a hard time. Chronic pain is so difficult, as we all know. I hope you can find some relief.

Re: Disturbing trend - the need to vent

john h on 10/14/03 at 08:58 (133943)

Sher: I totally disagree with the Doctor who told you if it is not painful enough for surgery then it is not painful enough for Vocodin. I think that is an idiotic statement and I would forget this Doctor . It is very likely you will eventually get through this very painful period but once you have surgery that is it. Many Doctors understand the need for 'pain control' immediately. When you find something that will control your pain you then know there is always something that will help even if you come off it. That knowledge in itself is a relief.

Re: It's difficult, but it can be done !!

BrianG on 10/14/03 at 15:49 (133986)

Hi Sher A,

Kathy G. has hit the nail on the head! The majority of Podiatrists have not been trained to treat chronic pain, nor do they want to !!! There are some that might treat you with acute pain meds for a month or two, but thats it. You need a doctor who will treat you with daily long acting opiates, which is what is called for in treating chronic pain.

Your best, and easiest, bet is to talk to your primary family doc. What a lot of people don't realize, is that you have to document your pain for the doctor. If you just go in and say my heel has been killing me for a couple months, I doubt that you'll get what you need. These doctors have to follow the guidelines of the state they practice in, when dispensing narcotics.

I would suggest starting a 'pain diary'. Update it a half dozen times a day, if thats what it takes. Write it all down for your doc, how the pain has affected your life. List what you can no longer do, document your sleep patterns. Are you depressed? If so, write that down. Your doctor will need this information in your records, in order for him to feel like he is protected from the prying eyes of the Feds! You can thank your local dope heads for this red tape. I'd also go to some of the 'chronic pain' web sites, that you can find through any search engine. You'll find information from dotors explaining why it is good to treat chronic pain with the appropiate opiates. Print these articles out for your doctor. Educate him if you have to.

If this doesn't work, and you run into a doctor lacking compassion, it's time to look for a new one. You can also find 'pain management clinics' (and doctors) using internet search engines. Every state in the union has it's own policies and procedures when it comes to treating chronic pain, this includeds opiates. Once again, you can find this information from a search engine. Print it out for your doc. So, as you can see, you will have to do your part also, which is not always easy when your hurting. Do you have anyone (sibling, best friend, mate, etc.) who can help you out with this preperation work?

I'm no expert, and not a doc, but I do hate to see people suffer needlessly. If you need any addiional help, just ask.

Good luck
BrianG

Re: Disturbing trend - the need to vent

Sharon W on 10/14/03 at 16:31 (133990)

Sher,

Please pardon me if you have posted about this somewhere and I've missed it -- but have you ever had nerve conduction tests done? Quite a few times, someone diagnosed with PF that's been as painful as yours, has turned out to have nerve problems with their foot/ankle that had gone unrecognized -- often tarsal tunnel syndrome (TTS). TTS has some symptoms quite similar to PF and sometimes they can be mistaken for each other, especially if you do have PF, too.

It might at least be worth asking about, if you haven't already been checked out for it.

Whether your pain is 100% caused by acute PF or whether your problem is complicated by something else, it definitely sounds like you are being UNDERtreated for pain... and you are right to complain!

If you want to show your Dr. that you know your rights with respect to pain, here is where you can find a copy of the JHACO 'pain management monographs'. While these are long, very techinical, and EXTREMELY tedious to try to read, they are the REAL McCOY, the actual guidelines that doctors and other health care professionals are supposed to be following (in case anybody is interested).

http://www.jcaho.org/news+room/health+care+issues/pm+monographs.htm

Sharon
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Re: It's difficult, but it can be done !!

John H on 10/14/03 at 18:08 (133994)

You also might consider going stright to a pain management doctor of your insurance allows it. if your pain is really severe they will not fool around with aspirin or anti inflamatories.

Re: Disturbing trend - the need to vent

Sharon W on 10/15/03 at 09:46 (134022)

Sher,

I thought perhaps this article might be helpful for you in convincing your doctor(s) that pain is important to TREAT, not simply ignore:

This article is found in
Pain. 2003 Sep;105(1-2):363-70.

ROLE LOSS AND EMOTIONAL ADJUSTMENT IN CHRONIC PAIN.

Authors: Harris S, Morley S, Barton SB.
Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, LS2 9JT, Leeds, UK

They tested chronic pain patients on measure of pain, disability, depression, and anxiety. They also tested them for personal role and attribute loss, and current and past self-concept differentiation, and predicted their adjustment based on measures of depression.

Their conclusion was that CHRONIC PAIN CAN AFFECT A PERSON'S SENSE OF SELF, THEIR VERY SELF-IDENTITY.

According to the authors of this study, chronic pain interrupts behaviour, interferes with functioning, and may cause people to 'suffer great losses in their friendships'.

Sharon
.

Re: Disturbing trend - the need to vent

Sher A on 10/15/03 at 18:48 (134075)

I very sincerely appreciate your help and I have noted the web site. Where I work I have chosen the PPO insurance so that I could pick my doctor. I thought that the more expensive option would assure better treatment. What a joke. I plan to switch to the cheaper HMO. I had been going to a so called pain management doctor/office here, who finally blew me off today with a letter and more or less told me to go fly a kite. He never believed I had this pain to start with. You see, if they can't see evidence of the pain they can't be bothered and you become a liar and a user. This one told me that they will no longer see me due to 'issues of non-compliance with our office protocols' whatever that means. That is a very broad term. And further, if I am referred to them, I should ask for an alternate provider. When I twisted my ankle last summer I called them to ask for a perscription - I guess that labelled me as abuser. I missed 5 days of work because I couldn't walk. It's been a bad year. Yes, I have sought out pain meds where ever I could, good lord, I can barely stand. I became desperate enough to order them from a website which cost a goodly amount of my check. Maybe that's where I screwed up. When you get desperate you go to desperate means. So now you could say I'm out in the cold. Doctors don't want to help with this issue and they don't want to be bothered. Yes, I had the nerve conduction tests, that was normal, naturally. My feet are the cause of my agony. You know, if they don't help you, then you have to go elsewhere. This place has jerked me around for a long time now and all I want is relief no matter what. I have done everything. A good portion of my non work time is spent stretching, heating, I've had ART, physical therapy. No thanks to the surgery, I don't want to be left suffering. What do they want from me? If 1 or 2 of these vicodins don't work, what choice do I have but to take more? Why don't these doctors work with you? Personally I think we should be able to sue for malpractice when they turn a deaf ear towards pain and suffering. I'm sorry, I'm just at the end of my rope and my nerves are shot too. Time for something for that. As for the PF I hope from the bottom of my heart that it goes away on its own so I can get my sanity back. As for these doctors, shame on them for giving us no choice but to do whatever we have to do for relief. I'm just going back to lurking for awhile. Thanks for everything.

Re: Disturbing trend - the need to vent

Dorothy on 10/15/03 at 19:04 (134077)

Sher A ~ You are having a hard time! There are some amazing stories 'out there' about how doctors treat patients and they can amaze for the good and also for the bad that they do. You probably have no interest in hearing someone else's and I don't blame you - plus this does not compare with what you have have been experiencing - but it just illustrates some of the 'bad' behavior. A number of years ago, I had been seeing a doctor for a year or more for some serious health issues and had had a bunch of tests and was at a point where I was waiting to hear from him with a diagnosis. The diagnosis turned out to be bad news. Anyway, he called me very late afternoon the day before Thanksgiving on the telephone, said who it was, said he had the diagnosis and gave it to me, and then said, I'm going to be leaving the practice and won't be here any longer. But good luck! I don't have time to take any questions. Good bye.

All this just boom-boom-boom. And goodbye. It may not sound like a big deal, and it doesn't to me now either, but then it was. I wish there were some way to publish PATIENT evaluations of physicians, good and bad. I have a couple of friends who have stories that would just knock you out with the treatment they have gotten from physicians (in and out of surgery).

So I don't know what all is going on with your situation, but I hope you can find something and someone that will help you through your troubles. Brian, on this Message Board, is very knowledgable about pain management and meds and such so maybe he can offer you some advice. Best wishes to you.

Re: Disturbing trend - the need to vent

Sher A on 10/15/03 at 19:41 (134080)

Thanks Sharon.. I printed it out. But you know what? These doctors don't give a crap. (And the ones who do suffer endless torment by the do-gooders.) They would look at that and tell you to go see someone else. It's a terrible nightmare and I give up. I also think that males have a much easier time getting medications and help than females. After all, they are always the head of the household and are responsible for supporting the family. Right, and on what planet is this still the case? I'm sorry to repeat this, but when you are starving you will do anything for food. You will eat grass, you will eat the leather on your shoes. It's the same thing with pain. But the second they see you went somewhere else, that's it - you are now officially black listed. They don't have the time to work with you and adjust a dosage. They sure have time to stuff their wallets though. Is it just the US that has this problem? Maybe I could fly somewhere else and find someone who is sympathetic, compassionate, and patient, knows that we aren't all perfect, and understands that pain slowly destroys your life. This is not a good year and not a good night. Hey, maybe all the doctors should just go to Iraq. Ok, enough..

Re: Disturbing trend - the need to vent

Sharon W on 10/15/03 at 22:28 (134089)

Sher,

NO, it is NOT just in the US that we have this problem... check THIS out!

Survey Shows One Third of Europeans Suffer Constant Pain

'LONDON (Reuters) - A third of Europeans suffer pain every minute of their lives and chronic pain accounts for nearly 500 million lost working days a year, costing Europe 34 billion euros, according to a survey published Monday.'

'A third of those questioned reported being in pain every minute of their lives and one fifth said they had been in pain for 20 years or more.'

'One fifth of those questioned said they had lost a job as a result of their pain, 21 percent had been diagnosed with depression and 16 percent said their pain was sometimes so bad they wanted to die.'

http://story.news.yahoo.com/news?tmpl=story2&u=/nm/20031013/hl_nm/health_pain_dc&e=2&ncid=751

Sharon
.

Re: Disturbing trend - the need to vent

Sharon W on 10/16/03 at 09:41 (134117)

Dorothy,

What you just said there is very interesting... because ALMOST exactly the same thing happened to my husband, just before we were leaving on our 'vacation' trip this summer to go help put my sister's effects in order. His endocrinologist told him he has diabetes on his LAST appointment with the man... JUST as the doctor was leaving the practice and moving to another state! Worse, my hubby did NOT like his partner, and they were the only two endos in town at the time... so he ended up going back to our family Dr. to handle the diabetes thing.

But there was a difference... this endo was nice about it, and apologized for having to leave him in that situation, and gave him a machine to check his blood sugar with and a prescription for the test strips so he could get started, and then he DID take time to answer whatever questions he could... so even though the situation was quite similar to what you described, my husband didn't feel the way you did about it.

I think most of us, as patients, are like that -- whether the problem is our feet or our hearts or WHATEVER. If doctors will only take the time to treat US as PEOPLE, we will understand that THEY are people, too.

Sharon
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Re: They are out there

BrianG on 10/16/03 at 17:01 (134161)

Hi Sher,

There are good and compassionate doctors out there, trust me. A lot of times it does not just happen overninght, but with some patience and persistance, you will find a doctor to treat your pain. It took me 2-3 years before I could get my doctor to treat my chronic pain !!!!!

If you tell me what state you live in, and the nearest large city, I'll do what I can to find a pain management clinic (or doctor) for you.

Hang in there,
BrianG

Re: They are out there

Sher A on 10/16/03 at 21:07 (134210)

You folks are wonderful, I'm glad _somebody_ cares and I love you all. One day I hope to post something really positive, when I get over this depression. So I guess I won't hop (crawl to) a flight to Europe then. How about Canada? Mexico? India? I'm serious. I'll go anywhere to get help.

I live in north Virginia, the DC metro area. You'd think we'd have everything here, right? Wrong? We have plenty of pod's, but I question how many actually know their stuff. The pain management clinics are a pitiful joke here, after all, I just got blacklisted from one and was told not to return. You have to be post-surgery, splayed open, or be on your death bed to even qualify to go to one. For the rest of us, well you know the story, they blow it off and refuse to treat it. They proceeded to inform my regular doctor that I had asked for a perscription. My regular doctor is now too far to drive to without living in traffic all day and having to take the day off. So I'm doomed to suffer. I'm not whining, I just hurt, and am ticked. Maybe if something were invented that actually works, then we wouldn't have to grovel for opiates.

Excuse me for asking another question, especially when I said I'd just lurk for awhile. What is all this privacy act bs I've had to sign at doctor and dentist offices lately? They cover up the list when you sign in. This is it, so you can't see who else is there? Like who cares anyway? I didn't think they could go calling your doctors, telling them what a stinking rat you are. What's happened to our privacy? Orwell should have called his story '2003'.

Re: They are out there

Dorothy on 10/16/03 at 22:01 (134218)

There is a podiatrist (I think that is his specialty) who posts here occasionally who must be in Arlington, VA because his website address includes that. Maybe a search on the board will lead you to his name if Arlington is within your range. I understand your bitter feelings because of what has happened to you, but it will probably be in YOUR best interest if you can figure out ways to approach any new doctor as a new, fresh start and as an individual. Brian's words about there being many compassionate, fair doctors out there are true; when you can find the energy and readiness, you will find one that fits your needs and condition. I think it is difficult myself, but you do need help and so you will have to find ways to trust and try. Good luck..

Re: They are out there

Dorothy on 10/16/03 at 23:22 (134237)

Re. the privacy of your patient information: it depends on what releases you have signed as to with whom your information can be shared - and the doctors offices you have visited may be stretching the point if you did sign a release for them to share info. with other doctors. Do you really think you are being blackballed or blacklisted? Do you have any proof of that? If so, there must surely be some recourse for you. I hope you can find some peace of mind because all of this emotional pain can't be helping your physical pain.

As for all the 'privacy bs' you have to sign - you know that any new regulation, law, policy generates 4 million new forms for everybody to sign. Any place that I have had to sign these has actually said, 'you don't have to read it; just sign here that you received it.' Again and again, the unfortunate triumph of form over substance (no pun intended!).

Re: Disturbing trend - the need to vent

Susan J. on 10/17/03 at 08:24 (134266)

I also have so much empathy for your pain. I suffered from PF for over a year. My podiatrist tried everything she knew and finally gave up. She practically admitted this to me. I tried the ESWT on both feet and what a painful experience that was. Although I will admit that it might have helped some by stimulating the growth of new, healing blood vessels. What finally worked for me was starting treatment with a new chiropractor. I have mentioned this before on this site, but feel the need to share this again. Don't ever underestimate what chiropractic care can do for you!! My chiropractor taught me stretches that increase the flexibility in my feet and completely eliminate the tightness that is at the root of this condition. He also applies a transverse massage with his thumbs and uses a massage machine that looks and sounds like a table saw on the bottoms of my feet. I am convinced that he is gradually breaking up the heel spur calcifications in my feet. He is also dealing with the subluxations in my spine that cause nerves to be pinched. Every organ and limb of our bodies depend on healthy nerve function. Part of my problem is having subluxations in my lower back which affect the nerves in my feet. After a long year of pain, discouragement, and increasing hopelessness, I have had many pain free days. Other days, I only have slight twinges in one foot only. I have been running again and life is good!!! Please don't give up until you find a doctor that will treat the causes of your PF and not just the pain and symptoms. Good Luck and God bless you.

Re: Try this

BrianG on 10/17/03 at 21:44 (134478)

Hi Sher,

I've got a couple web sites for you to start, in looking for a compassionate doctor to treat your pain. Got to Google.com and type in one of the following:
'Pain physicians' and 'alexandria VA.'
or
'Pain physicians' and 'Fredericksburg VA.'
Then hit return, and a LOT of web sites will come up. This is where you could use some help, someone to help you make phone calls. It's perfectly all right to call ahead, and ask what type of treatment they offer. Once you get that information, and if they do not mention pain meds, it's Ok to ask them if they prescribe daily pain medication, IF nothing else is working. Some of these docs and treatment centers may want to try some other things first. You should go along with their program, as long as you feel comfertable with it. If you don't want epidurals, tell them! Also keep the doctors updated as to your pain. Write it down, and bring it in for the docs. I always let them keep my notes, for my records. Try to make a photo copy if you think of it. You'll know within the first couple appointments, what type of doctor you have found.

So, the plan is to use the telephone to weed out the doc's that are not going to help you. Try to get some help during this phase. Also, you can change the city, in the original Google quest, as you can look back to see how I did it. If you have an questions, just ask.

Good luck
BrianG

PS: Here is another good web site: http://painfoundation.org/

Re: Disturbing trend - the need to vent

stephanie on 11/22/03 at 21:55 (138407)

I was sent for standing xrays and MRI of lumbar spine, hips and legs and
now a problem is discovered. Ive had lower back pain on and off for
years, usually with the foot pain. Nobody every metioned having my back
looked at. I was sent to a Chiropracter on Nov. 10, 2003 and he did
xrays of entire spine and BINGO, I have a problem with L5/L4 vertabrea &
S1 vertabrea and a problem with cervical neck. I've started going to a
chiropracter Nov. 10, 2003, 2 weeks now and I see a change with my feet
for the better. I have foot pain. Started seeing a podiatrist Dec 2000
but should have seeked doctors attention way prior to that. I had PF,
tried everything there was to try for 1 year. They deciced on surgery,
Nov. 2001. It's been 2 years since having PF surgery on both feet and I
still have pain. Prior to surgery I had 15 minutes and pain set in and
now days, 2 hrs till pain starts. Ive tried every conservative
treatment prior to surgery, saw 5 doctors since surgery, more xrays & MRI's of feet and nothing showed a problem, and then my back and
neck were looked at. BINGO. Makes a lot of sence now. If your neck or
back is off anywhere, it throws your entire body off. Ive had so many
test, and medications for 3 years and nothing was helping. Ive been off all medication for 2 months now and I am so happy for that.

Re: Disturbing trend - the need to vent

Julie on 11/23/03 at 04:35 (138430)

Stephanie

Yes, it does make sense. The human body isn't made up of separate, isolated bits (though the specialisation of medicine leads us to think it is!). It's a unified whole, and whatever happens in any part of it affects every other part. This is particularly true of the foot/leg/hip/back continuum. In your case, the L4/L5/S1 problem may have been putting pressure on your sciatic nerve, branches of which supply the lower leg and the foot. So it stands to reason that sorting that problem out would have an effect on your feet.

It can work the other way too, of course: problems with the foot and lower leg can and do affect the hips and the spine. The difficulty with treatment, as you have discovered, is the specialisation (one could call it fragmentation, and I think that would be accurate) of medical care. A really good podiatrist would automatically consider a patient's back, but probably few do (mine did, and I had osteopathic treatment for my lower back, which was the trigger for my PF, as well as podiatric care).

This is an important and interesting topic, but you made your post at the end of a 'dead' thread (I wonder how you found it!). But I hope people will see it, because others may find it useful to investigate whether back issues are affecting their feet.

I'm very glad you have discovered the cause of your foot problems, and hope your improvement continues.

.