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Thread: ER pain treatment

  1. #1

    Red face ER pain treatment

    As a mom, I frequently have to do things that push my body too far, and put me in an incredible amount of pain. I end up in the emergency room for severe pain almost every week or two because of it.

    When I go in, they almost always give me a shot of 3 different things in my less painful buttock. ( norflex, torradol, and a narcotic-which depends on the doc in the Er at the time.) I end up with a large swollen painful lump on my butt for the next several days. (and with pinched nerves in my low back that area is already sensitive) I want to ask the doc to order the meds IV, as that is much less painful, and the meds work faster, but I am afraid that they will think I'm a drug seeker, and will stop helping with my pain.

    I bring a printed med list and a copy of my most recent MRI report with me if I have to go in, and I refuse to go in at all until my pain is at least a 9 out of ten.

    Does any one have any thoughts on this?

    I have my first appt. with a surgeon in about two weeks, but I don't know yet if he is going to be able to help yet.

  2. #2
    Do you have a spinal cord injury? Your profile didn't give much information. If you can provide more information, people will be able to give you better advice.

  3. #3
    I don't know if I have an SCI yet- I had to get another MRI because the conus was too high to see on the lumbar scan. I am seing a spinal surgeon in two weeks, and will get more info then.
    I do have problems getting around, as any type of physical activity puts my pain well over my ability to deal with despite all the meds I take-neurontin 300 mg 3xday, flexaril 10mg 3xday, Ibuprofen 800mg 3xday, and vicodin 5/500 1-2 tabs 3xday.
    The lumbar scan showed a lot of probs, including 3 bulging discs, stenosis, foraminal encroachment, thecal sac deformity, and epidural lipomatosis.
    I am also having bowel and bladder issues that are probably related to the back problem.

    Hope this helps to clarify things for you
    Last edited by truebansidhe; 10-10-2008 at 12:53 AM.

  4. #4
    I'm not sure what all this means...except for the buldging discs and stenosis. My SCI was caused by a calcified disc herniation that caused bone spurs to break off and compress my spinal cord...I have severe degenerative disc disease. I was in pain for a long time and could not find a doctor to take me seriously until I was in the ER loosing control of my bladder and losing sensation from my mid-abdomen down.

    Make sure you keep your doctor's visit...at least it sounds like someone's taking your symptoms seriously.

    Sorry I can't help more. Hopefully, Dr. Young or one of the nurses will respond. Good luck.

  5. #5
    the one big thing you just HAVE to do for yourself is just simply know your own limitations. we all suffer with varying levels of pain but if you are forced to have to seek out the ER at least once a week,you are probably pushing yourself way too hard or are undermedicated for your pain needs right now,ya know? yea,it does suck to have to live with some serious chronic pain,but you have to also be very realistic here too. are you currently seeing a pain management doc for your pain? if not,you really do need to just to see what modalities can actually work for you in manitainig at least a more tolerable level.

    it sounds like you are currently in a holding pattern for a possible surgery right now? am i right? in the interum,it would really be most beneficial to you at this point to either have a very in depth chat with whoever is in charge of your pain and tell them just how bad your situation really is. no one should have to actually go to the ER to manage a level of pain that could be managed at home with the right meds and modalities to keep it better controllled for you.while you are awaiting surgery at least,it would be a much better idea and just keep you on a much better pain level to go with a longer acting narcotic than the hydro based med you are currently taking. it just sounds like your pain is way beyond the capabilities of the hydro right now so it would make sense to at least treat your pain more appropriately while you are just awaiting the surgery that will make this level much more tolerable. like i mentioned above,if you are simply having to turn to the ER trying to live out your daily activities,your treating doc just NEEDS to do what is called for right now and just treat your current pain accordingly. i can handle a ten plus at home with all the tools(found when i simply tried other modalities for my pain) and meds i have been rxed by my pain doc. believe me,i don;t hit the meds til i absolutely have to only becasue of being on a very limited supply of them that cannot for any reason be gone over just becasue my pain is once again over the freaking top(i am under contract with my PM and have to be accountable for every single pill). its trying the other options i have found that actually do work that i turn to first,before any narcitics get tried for me and my pain.

    you just need some good solid options here while trying to deal with pre op pain, wheher that occurs ith your current doc or with a pain management oc is up to you and your treating doc,but something just simply has to change here. you just should not have to keep spending huge amounts of money every time your pain gets ut of control,ya know? believe me,i DO know what you are going thru here. but something just has to change in your pain management ogram. i do hope your surgery is soon.you do deserve not to have to suffer. please keep us posted on how things go, and do look into other ways to manage your pain that just don't involve any meds,options are out there,you just have to seek them out. good luck to ou with this, marcia

  6. #6
    My pain gets to a 10 on very simple actions-I walked a few blocks, and pain shot thru the roof. I sat in a hard chair for 15 min-same result. My gp doesn't seem to get it, and is only prescribing tramadol and nsiads. She won't send me to a pain clinic until after I see the surgeon, and I'm kinda stuck with the weekly ER visits for the moment.

  7. #7
    I'm really sorry about your pain. I know it's very hard to cope with.

    I agree with Firesmurf about not pushing yourself above your limitations. It sounds like you may have a very serious problem that the surgeon will hopefully be able to help with, but you've got to make it through two more weeks before seeing him/her. That can seem like an eternity when you're in pain.

    I'd really encourage you to be VERY careful for the next couple of weeks to prevent hurting yourself further. I don't know the specifics of your family situation, but perhaps arranging child care and getting help with cleaning, cooking, etc. until you know exactly what's wrong might be advisable.

    Good luck and keep us up to date on how things are going.

  8. #8
    Quote Originally Posted by truebansidhe
    My pain gets to a 10 on very simple actions-I walked a few blocks, and pain shot thru the roof. I sat in a hard chair for 15 min-same result.
    So you can walk a few blocks and then you are left basically unable to walk or function at all? That's what "10" is supposed to represent. I'm not trying to minimize your pain. I'm sure it that it is incapacitating on many, many levels, but I think that the pain scales are misrepresented on a regular basis. Regardless of all that, it sounds like your pain is chronic and severe enough that I wonder why it isn't being managed better. Utilizing the ER as a pain management clinic seems extremely inefficient all around. The fact that your regular doctor hasn't given you a script for a drug to manage your pain when it escalates is nearly criminal. You need to get angry and self-righteous. You can't care for your family like this. You aren't drug seeking. You are seeking a stable path.

    C.

  9. #9
    Quote Originally Posted by truebansidhe
    As a mom, I frequently have to do things that push my body too far, and put me in an incredible amount of pain. I end up in the emergency room for severe pain almost every week or two because of it.

    When I go in, they almost always give me a shot of 3 different things in my less painful buttock. ( norflex, torradol, and a narcotic-which depends on the doc in the Er at the time.) I end up with a large swollen painful lump on my butt for the next several days. (and with pinched nerves in my low back that area is already sensitive) I want to ask the doc to order the meds IV, as that is much less painful, and the meds work faster, but I am afraid that they will think I'm a drug seeker, and will stop helping with my pain.

    I bring a printed med list and a copy of my most recent MRI report with me if I have to go in, and I refuse to go in at all until my pain is at least a 9 out of ten.

    Does any one have any thoughts on this?

    I have my first appt. with a surgeon in about two weeks, but I don't know yet if he is going to be able to help yet.
    Truebansidhe,

    I don't know what to suggest. Based on your description, you may or may not have neuropathic pain, i.e. a pain that originates from spontaneous excitability of neurons in the nervous system itself. It seems that your pain can be induced by physical activity and you do have low back pain. The pain may result from compression of one or more spinal roots. On the other hand, you are not describing a specific pattern or anatomic distribution of pain that would indicate a specific spinal root being compressed.

    Emergency room doctors are of course not experts on the causes of pain. They will only give shots to reduce pain and presumably then refer you to a neurologist or appropriate surgical specialist for longer term relief of the pain. I assume that you have seen both neurologists and orthopedic surgeons because of your descriptions of your back pain and the medications that you are taking. You are taking quite a lot of ibuprofen, a relatively low does of neurontin, and a fair amount of vicodin. Is the ibuprofen is for arthritis?

    So, I am not sure what to advise. If I were you, I would be trying my best to get to find out the cause of the pain. If it is due to compression of spinal roots, I would try to identify the specific root and get it decompressed. I don't know how old you are but because you say that you are a "mom", I assume that you are young (in your 30's or 40's). You need a solution to this pain. As you are aware, drugs are not the solution.

    Wise.

  10. #10
    About a year and a half ago, I had been having 2-3 wk periods where I was incapable of doing any thing as far as motion due to back and leg pain every few months. My then Gp sent me for an MRI which found a concentric bulging disc at L4-5 after several episodes. I was then diagnosed with DDD.

    I have done 3 rounds of PT, and they only made it worse instead of better-the electric stimulation unit caused some serios agony-even at the lowest setting, so I refused that part after the first time. I did all the little exercises, and deep breathing, and even some traction. (6wks x 3 rotations.)

    About 3 months ago, my back started up again, and the pain was more severe than ever-I went to my new GP -after the pain did not get any better even with rest and painkillers (those helped considerably in the past.) She sent me for a new Mri. (below)

    I can't seem to do any of my normal activities-housework, standing, walking, or sitting without a huge increase in the pain

    I get low back pain, and pain in my buttocks which shoots down both legs. Also get some mid-back pain, but the low back is much worse. About 8 wks ago, my bladder and bowels started leaking a bit as well. And the last 2 wks or so, it has been difficult to empty them.

    The pain is also causing my BP to skyrocket as well-usually 90/50-now138/87

    I am 31 yrs old, 6 ft, and 198lbs, and also suffer from fibromyalgia.
    Any advice?

    Will update after I get the report from the thoracic MRI on thurs.

    I got this report 2 weeks ago from the MRI I had done a month ago.


    MRI lumbar spine:

    Multiplanar sequencing performed. No IV contrast administered.

    Indication: Radiculopathy. Low back pain

    Findings: There is disc desiccation involving L3-4, L4-5. There is no evidence of focal vertebral body height loss or marrow edema. The conus appears to be high riding and is higher than T12. I would reccomend correlation with thoracic spine MRI to delineate the conus and it's integrity.

    L1-2: There is no evidence of disc protrusion. There is mild facet hypertrophy. There is sparing of the neural foramina and no central spine stenosis.

    L2-3: There is no evidence of disc protrusion. There is mild facet hypertrophy. There is sparing of the neural foramina and no central spine stenosis.

    L3-4: Broad-based posterior disc bulge and mild thecal sac deformity. There is facet hypertrophy and ligamentum flavium thickening. There is mild bilateral neural foraminal encroachment and no central spinal canal stenosis.

    L4-5: Broad-based posterior disc bulge. There is facet hypertrophy and ligamentum flavium thickening. There is sparing of the neural foramina and mild central spinal canal stenosis.

    L5-S1: There is epidural lipomatosis. There is broad-based posterior disc bulge. There is facet hypertrophy and ligamentum flavium thickening.There is sparing of the neural foramina and mild central spinal canal narrowing primarily due to epidural lipomatosis.

    Impression: The conus higher than T12. Correlation with thoracic MRI advised. Mild degenerative features otherwise outlined as described above.
    Last edited by truebansidhe; 10-12-2008 at 09:12 PM.

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