DrugBuyers.Com: First time going to a pain clinic

Hi VicodinDream,

Regarding the cortisone shot...cortisone is a naturally produced steroid that comes from the adrenal gland, so to be allergic to cortisone itself (in injectable form, other forms are a different story) is almost impossible. When people are allergic to the shot, they are allergic to other components of the shot, which could be betadine (used to clean the skin), the anesthetic (or a bad reaction, but not an allergic one, to the epinephrine that is sometimes mixed in), the preservatives in the shot, etc. There are a variety of side effects that can occur with a cortisone shot, but they are not allergic reactions. Many times if there is one of these adverse reactions, the doctor will simply tell you it was an allergic reaction because it is a hassle to explain exactly what happened.

I'm of course not doubting your mom, I'm just giving you a FYI on this and the difference between an adverse reaction and a true, anaphylactoid allergic reaction. If the doctor wants to give you one, there is no need to freak out. Explain that you are willing to get the shot, but your mom had some bad side effects from it. Explain what side effects she got, and the doctor may very well be able to give you something that will work for you without the other stuff that can cause adverse reactions.

I'm assuming, based on what you've said, that your pain is caused by previous injuries that have built up over time, but correct me if I am wrong.

What is your situation on meds? Have you only been prescribed opiates by OP's, or has another doctor had you on long-term prescriptions for opiates? If you have been prescribed opiates by brick-and-mortar doctors, were they just for the acute injuries and the ensuing pain?

The problem with being 25 is not that the doctor thinks you are really a drug addict, but that he wants to avoid a lifetime of opiate dependence if it all possible. That explains the physical therapy, right? You've been in physical therapy (I'm assuming active PT) for a long time- does it help at all?

You have given alternatives to opiate a fair shot. 6 years of PT, surgery, cortisone shots, etc. It is important to make this clear to the PM doc without actually saying "so...the next step is opiates, right?" A good rule of thumb, which you probably already know, is to never mention a medication by name. You want it to look like you know nothing of pharmacology and abusable medications, so play dumb without making it obvious. People on this board seem to be split on the issue of whether or not to tell a PM doc about OP's...I personally wouldn't...but the doc does need to know you're on 60 mg of hydro if he does prescribe opiates, so he knows you already have some tolerance. I would bring an old prescription bottle (used up and from more than 30 days ago) that shows that you've been prescribed a good dosage of hydro- but if you were also receiving scripts from your local doctor for an opiate, then that's not an option. I'm sure there are some members who are veterans of PM that can give you better advice on how to negotiate with a PM doc based on their experience- this is the best I can do based on what you've told us so far.

Good luck, feel free to PM me if you want more explicit advice.

-yawkaw