If you’re visiting a pain management specialist (PMS) or even your primary care physician (PCP), for some sort of chronic pain or even a non-chronic issue, is this sign correct? Can you trust it? The reason I ask this is a situation I recently ran into with my own PCP and pain management specialist, both who have known me and my condition (chronic low back pain) for more than eighteen years. Here’s my back ground so you can get the full story, just months away from 23 years ago a drunk driver rear ended me while at a full stop doing approximately 75 mph. The impact bent my van’s frame 7”. This accident caused a rotational tear in the nerves surrounding my lower Lumbar Vertebra (L1-L5) and the Sacral Spine (S1-S4). This caused the blood pressure in my legs to be lower than normal which also is causing edema and several other issues I would not have if not for the accident. I currently am on eight different medications, some to relieve side effects from others and I also have an internal medication device which is putting Fentynal directly into my lower spinal column 24 hrs a day, 7 days a week, all year long and have been using this device for about seventeen years now, which it has its own list of side effects and down falls (another story). My injury started with the chronic pain from about middle back down and at times it would flare up and cause major pain shooting down my right leg to the knee and into the left leg to about mid-thigh. Then over the years I have been having more and more things joining in the list of medical issues (insomnia, edema, memory issues, ED, balance issues, blood vessel valves failed in both legs, and more). All of which pertaining to my PCP and my Pain Management Specialist are being related back to or are a cause of either the spiral injury itself or one of, or a combination of the medications they have me taking.
The most recent issue occurred back at the beginning of 2015, when my mom and myself were enjoying one of our lunch outings at our local four letter pancake establishment. After we were done eating she asked me how my leg was doing and when I stood up to show her about where (right above the left ankle) it was I pointed down to and blood started shooting (1-1/2’) out of my leg and into the walk way. I immediately grabbed a napkin and applied pressure to the site and waved for the waitress to come over. When she did I asked if she could bring some more napkins and if possible a bandage, her response surprised me when she said she would check on the bandage but was pretty sure they didn’t have any, per the waitress then the assistant manager there was no 1st Aid Box anywhere. This was a shock to both of us, so with her walker and oxygen tank mom had to drive to the nearest Target and purchase gauze, gauze wrap and tape so I could do first aid right there in the second booth from the front door and the register of IH_P.
On with my story, within six to eights weeks I was in Kaisers Surgical Department having surgery to close off a faulty blood vessel valve and perform a vein closing 4” above the faulty valve. What’s a bit funny is that the day prior to the surgery the same thing occurred on my right leg, so as the doctor was checking my left leg, marking where the surgery sites were located and signing it, I mentioned the issue with my right leg. He thought I was kidding until I pulled my leg from under the sheet, pulled off the 2″ x 4” bandage and showed him the site. His response was, “Don’t enter that paperwork, we’re doing both legs.” So now the surgeries are over and two months later, both sites on the left leg became infected with five (5) different bacteria and with this the most excruciating pain ever. I make sure they know that I’m already on Fentynal (in spine), and Hydrocodone and would prefer to not be on anything else, narcotic. Been There Done That, Never Again, Sorry Trish, Rachel, Caty and Chris. So my PCP does some research and decides to put me on Gabapentin, which he says is unlike Hydrocodone in it is for the localized, tingling, spiky pain some patients obtain with this type of procedure. One of his nurses who first started doing the wound therapy to try and get it to heal correctly, when asked the same thing answered the same way. It has been seven months now and I’m still going to wound therapy. It is very slow going at this point. Finally, at the end of 2015 my doctor agreed to send me, with the wound therapies nurses request to their, Pain Management Class. The class is for patients who have been experiencing pain for more than six months and is designed to be a one-year program. The first part is an eight-week class, with ongoing appointments with physical therapy, a nurse assigned to you, psychologist, workout programs, pharmacist and dietitian. I am currently in the middle of the eight-week class and todays was on opioids, sleep and eastern medications. In the first five minutes the instructor mentions, “Hydrocodone, Vicodin, Gabapentin and Norco are all in the same family of prescription drugs.” I of course raise my hand to clarify and when asked I repeated what the instructor said and she shook her head and said, “That is correct, why do you ask?” I mention it due to I’ve been on Norco, 3x a day for going on, easy fifteen and yes, I said (15) years and recently they added a prescription for Gabapentin, also 3x a day. The only thing she could say was, “tapper off the Gabapentin, or reduce the dosage to 2x a day for 3 days then 1x a day for 3 days, starting today and call her first thing Monday morning. That it is way too much of the same family of narcotics and can cause all of the side effects. Also with that line of narcotics after extended use it can cause your pain to feel worse.”
I am experiencing some of them as well and have also read on several internet sites and the most recent “POSSIBLE SIDE EFFECTS, WARNING” sheet that came with this month’s prescription that they can cause liver and kidney damage. I am very frustrated with not only my Pain Management Specialists, my primary care physician (PCP) but also the pharmacist who all know what my medications are and the amounts I’ve been taking. These questions have been asked on “MANY” occasions over the past almost 2-1/2 decades. My desire from the very start of this journey was to be on as little narcotics as possible, or better yet to not be on them at all. At least I thought it was clear especially after the events of September 2013 (another story). I am now on the internal pain management pump (IPMP), “NO” Gabapentin and have even reduced my Norco dosage by ½ a pill. In fact, here’s to Trish, my lovely wife and my PCP at Kaiser who both suggested several years ago and recently that I might want to try going off of my medications, which I take a total of twelve pills or capsules a day on top of the IPMP which flows 24/7/365. I am going to try to lower the dosages of my medications slowly and not go all out cold
Toferky, hey we’re vegetarians and we do have lots of left overs if you want some. This is just one of the many reasons that we as patients need to take control of our medical treatment and ensure that what needs to get taken care of in fact does. I will keep you up to date as to how it’s going and what the end result is regarding the combining of the two medications.
*No animals were hurt or tested on in the writing of this blog post.