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Thread: Who to see to manage pain?

  1. #1

    Who to see to manage pain?

    Who should I take my mother to see to help her manage her pain. Last month she suffered burst fracture , sacral fracture and had a T12-L1 fusion. She has been on neurontin, lyrica, oxyco, and flexeral. Last week the neurosurgeon added Lortab and stopped neurontin. A clinic doctor said to stop all the medications. The internal medicine doctor has no opinion. She reports significant pain, sleeps most of the day, and voices that she is better off dead. Please give me advice as I'm not sure what to do to help her. Should I take her to a pain specialist, aphysical rehab doctor or find another internist?

  2. #2
    Senior Member
    Join Date
    Jul 2012
    Pennsylvania, U.S.
    We've had pretty bad luck with PCP's of all types... We were referred to a pain clinic (pain management) - and it turned out to be a pretty good thing.. The guy seems pretty knowledgable about "nerve pain" and has been working with us and trying different things... Definitely a pain specialist...

  3. #3
    Senior Member
    Join Date
    May 2010
    Chesapeake, VA
    If you can find a pain management specialist who is also a physical medicine/rehab doc, you will have found what you need. Depending on where you are, you may or may not be able to find said doctor. Your mom may have to try different combinations of medications to find the one that works best for her. She may also be well served to keep a log of her pain and what activities or weather conditions or anything that may impact her pain levels. If you are able to recognize patterns that that you can influence, her quality of life can greatly improve. --eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

  4. #4
    I agree with the other posters... find a pain clinic or a rehab doctor (physiatrist). Neurosurgeons don't want to follow you long term for pain and can be sloppy. Primary care doctors are not experienced enough. You definitely need a specialist.

    Sounds like she is over-sedated from her medicines.

    I would try to find a good physiatrist with an interest in spine. She may benefit from more physical therapy, alternative treatments as well as pain medicines, and they will know bests about these combos.

  5. #5
    ttn - you say that she is just one month post op from spine surgery?
    What are her and your expectations of how she is supposed to feel one month post op? What have your doctors or nurses discussed with you regarding the recovery of said surgery?
    Is she getting PT and rehab?
    How long does it take to heal from fusion surgery? one month, three months, half a year , a year, two years?

  6. #6
    I realize my mom will be in pain since she is 1 month post op spinal fusion and has a spinal cord injury. Yes, she went to rehab and now is in outpatient PT. I just want her to have less pain than she is in so that she wants to live. Thank you for the comments. I will look for a pain management clinic as she has have already seen a physical rehab doctor. This forum has been helpful as it's hard to know where or who to go for advice.

  7. #7
    Did you find a decent wheelchair?

  8. #8
    ttn - I would just be encouraging as possible to get her through the difficult perioperative period. Things will get better by 3 months. Tell her it takes a good six months before you see light at the end of the tunnel. The sacral fracture can knock out the important nerves to the bowel and bladder so if those are okay, that is a good thing. But it is healing without stabilization so that takes three months, I don't know how extensive the sacral fracture is. But I have gone through all this many times. They may be asking her to do to much in PT possibly. She is lucky to have such a caring daughter/son that is caring for her. I found that the horizon should be a year before you feel that the fusion is really solid. Even two years for more extensive fusions (hers is only one level), it may be two years to really heal a five or six level fusion.
    Good luck to you and her.

  9. #9
    Senior Member SuprSi's Avatar
    Join Date
    Jan 2012
    Southampton UK
    Wow, only a month post burst fracture and fusion and she's an outpatient.. seems a bit rushed, as others have said it's going to take her a long time to recover.
    Last edited by SuprSi; 03-28-2013 at 04:38 PM. Reason: missunderstood ttn.
    T11 Asia A after near-fatal bike crash.. Just happy to still be here

    No, I didn't loose my mind... It got scared and ran away!!

  10. #10
    Thanks for the responses and encouragement. While her injury was in Feb, it feels to me and to her that it seems longer as the days can be long.

    We are going to get her a TiLite chair since she was measured last week.
    She is attending PT to address her spinal cord injury T12 incomplete paraplegia.

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