Email Me

Email me

Thursday, August 28, 2014

Pain Management

I had finally broke down and decided to try some low dose narcotics to help me get through my days more easily. Late last week I saw my PCP who is more than supportive of me getting the proper pain man't with me having hip dysplasia, very large orthopedic surgeries, and working 80 hours a week.

I was very reluctant to go the opioid way. This is almost entirely due to societies stigma on narcotics and chronic pain. Many people often believe that people who take pain medications are the people who want to go through life numb. People have a tendency to look down on people who take narcotics daily as wimps who automatically want disability, social security, etc. I will admit, many healthcare professionals think this way as well. I see it day in and day out:  residents and attendings automatically writing off patients when they see they take opioids. It is an absolute shame. What is also a shame, and what I believe has made it (the daily use of narcotics) social taboo, is those chronic pain patients who rely solely on medication to help their pain.  It's those people with chronic pain who neglect to try to be participating members of society. Some people cannot work due to chronic pain, but when one fails to even try to take care of themselves, when they refuse to so physical therapy, refuse to ice, and refuse to do anything that may help their pain except to take pain medications; it is this group of people who ruin it for the rest of the people who legitimately need pain medications.

Personally, I have tried my very hardest to avoid going this route in fear of being seen as the girl, the doctor, the daughter, the friend who is on narcotics. I have been really struggling with this for a long time. I was thinking the other day, if I had a friend, doctor, patient, collegue who was in my particular situation, I would encourage that individual to seek proper pain management. Why was I withholding this relief from myself? It made absolutely no sense whatsoever. I had a doctor willing to write me the script, I had a supportive family, I had significant pain, what was holding me back? Stigma. I should have known better than this, I am a healthcare professional. In any event, I went to my PCP last Friday and agreed to try the Butrans patches. It was such a big step for me, I was so proud of myself for taking this step. And when I went to fill the script I had been debating over for the last several months, the unthinkable happened: the pharmacist refused to fill it!

I am not joking, the pharmacist looked at my script, looked into the computer, and said that they don't carry this medication and that he would not order it in for me, I had to go elsewhere. Talk about a slap in the face: I had been so brave to actually ask for the patch and now the pharmacist was saying he refused to fill it. He made me feel like I was asking for heroin or something outrageous. I politely retrieved my script from him and went to my hospital's pharmacy. They ordered it in for the next business day, no questions asked.

I started my butrans patch on Monday. Immediately I didn't notice anything. I went to bed and slept relatively decently, but nothing I could attribute to more than being exhausted and sleeping well. It wasn't until I was at work the next even when I realized that it had kicked in: I could walk relatively quickly to retrieve my pager and not limp! I worked 16 consecutive hours and barely had to limp at all. My pain isn't 100% gone but I can stand, walk, bend easier because I have significantly less pain. And my mind is not all gorked out. I feel mentally sharp.  I may even feel more energized because my mind isn't totally consumed by pain. I can't remember feeling like this before. I anticipate being on this patch for a while since I will be working a lot all year and will be having major surgery in a month. And I am OK with that. Which is a huge thing.

Wednesday, August 6, 2014

Stupid Crazy Hips

It gets to a point, during such a long and arduous surgical process, where one wants to throw in the towel, call it quits, be done and over with the entire ordeal. I won't lie, I feel like that often. I'll out on a happy face and go about my normal activities, but deep down, it truly is frustrating.  I have had so many surgeries on my left hip, the last being the most brutal, and it still hurts. Which is disheartening. The left hip may actually still hurt more than my non-PAO'd hip.  It's scary. I am hoping when I get the screws out in September, that it will alleviate some of this pain.  The fact that it hurts to weight bear is worrisome bc I know it will need a THR, just when?

As for my right hip, it's been alright. The deep ache is constant, but I've been lucky as it hasn't slipped out in six weeks or so. Now that I've jinxed myself....

Medication-wise, things are still so-so.  My new PCP was more than supportive to help manage my pain.  During my original appointment, he was pushing for Butrans patches and I was hesitant.  I chose the Tramadol ER. Which kind of does work, but I wouldn't disagree that I need more pain relief to properly function at work. In hindsight, I wish I had taken him up on the Butrans patch offer, but hindsight is 20/20. I suppose I should call to see if he would write a script for me prior to my next appointment with him on August 22nd. I will have to gather up enough courage to call. I have no problems calling for other people, or dishing out advice to people, but when it comes to me and my own health and doctors, I hate it.

But on a happier note, the proper Neurontin dosage has done wonders! I can touch my inner thigh skin and not cringe. I don't get those sharp electrocuting pains down my leg anymore. Thank goodness. Hopefully I won't be needing 300mg TID for too too long, but I'm expecting to need it up to and through a while of my right PAO recovery.

Speaking of which, the RPAO is coming up. In 54 days I'll be getting ready to go to the OR for my (hopefully) last big operation for a while.  I know it needs to be done, it's such a daunting task. And the fact that I have only 3 weeks scheduled off is worrisome. I know that is almost next to impossible, but the fact I will be returning back to work shortly after the surgery has me stressed.