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zorg
Veteran
Reged: 04/29/02
Posts: 559
Loc: Midwest
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Heya offto:
If you experience chronic moderate to severe pain, you should be an Oxycontin candidate. Technically. Now, given your pain would appear to be neurological in nature, you will most likely be driven away from opioids within the first tier of treatment, and pushed towards interstim/nerve blocks etc; as neurological pain generally (supposedly) does not respond as well as any other extra-neural pain sources. I do wonder how much of that is hype. You have every right to speak openly and fully about why you feel opioids should be of first consideration, which actually makes far more sense to me than jabbing 4" needles (time and time again) into neural pathways and flooding them with lidocaine. I saw a pain doc who offered to do nothing but a nerve block for a bladder disease called IC, which is a textbook case for visceral opioid treatment. There is a pain patient bill of rights out there that supposedly carries at least a bit of sway if you apply it. I can tell you this, the better your documentation of past treatments and related detail, the better your case for influencing the doctor decision on what treatment(s) are to be tried first. Of course, your mileage may vary.
Good luck,
J
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 894
Loc: usa
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Quote:
Heya offto:
If you experience chronic moderate to severe pain, you should be an Oxycontin candidate. Technically. Now, given your pain would appear to be neurological in nature, you will most likely be driven away from opioids within the first tier of treatment, and pushed towards interstim/nerve blocks etc; as neurological pain generally (supposedly) does not respond as well as any other extra-neural pain sources. I do wonder how much of that is hype. You have every right to speak openly and fully about why you feel opioids should be of first consideration, which actually makes far more sense to me than jabbing 4" needles (time and time again) into neural pathways and flooding them with lidocaine. I saw a pain doc who offered to do nothing but a nerve block for a bladder disease called IC, which is a textbook case for visceral opioid treatment. There is a pain patient bill of rights out there that supposedly carries at least a bit of sway if you apply it. I can tell you this, the better your documentation of past treatments and related detail, the better your case for influencing the doctor decision on what treatment(s) are to be tried first. Of course, your mileage may vary.
Good luck,
J
Sonick....just wanted to clarify a few things....unless there's another thread I'm unsure what kind of neurological pain our fellow DB'r is experiencing.....if it's back pain/neck pain with problems of pain radiating down the extremeties(radicular pain), epidural injections or "nerve Blocks" are very effective and can provide a considerable amount of relief for this type of pain....And the lidocaine is only used as a local anesthetic to numb the injection site and to reduce the pain caused by the increased pressure placed on the nerve roots as the steroid is infused.. The purpose of the epidural is not to get the anesthetic into the dural space, as the numbing effect is short lived..The purpose is to to get the steroid into the dural space and arround the inflammed nerve roots that are causing the pain. Usually a longer acting anesthetic, such as marcaine is infused into the dural space...with the steroid. The long acting anesthetic actually only works for about 30-60 minutes. But the steroid reduces inflammation and calms those nerve roots down, and that translates to real pain relief for probably 75 - 80% of the patients treated...
If our friend is seeing a doc who takes the position that opiates are not effective for treating pain caused by damage to the nerve roots, it's probably time to change doctors...as that theory is outdated, you are absolutely right about that! ... When you talk about "visceral opioid treatment" I'm not sure what your referring to...I'm a nurse...viscera refers to internal organs within a cavity....usually refers to the abdominal contents...can you clarify?
Fortunately, Pain Management Specialists are becomming better educated...and oxycontin is recognized as an excellent modality for treatment of radicular pain....although even as I say this, I gotta tell you I have to fly to another state to see one of those more advanced PM specialists....
I just didn't want people who weren't familiar with epidurals, or "nerve blocks" to dismiss them as a treatment modality without understanding them...because they are often very effective, and can provide relief for up to six months or more....
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zorg
Veteran
Reged: 04/29/02
Posts: 559
Loc: Midwest
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Thank you very much for the info, much appreciated. I just learned more in a few seconds than three hurried 15-minute sessions with my ex "pain doctor". I absolutely refuse to risk a nerve block right now (hypogastric plexus), deep punctures into nerve conduit is just not in the cards right now. No way. I've done the invasive high-profit attempts at root cause treatment (questionable science IMO), now it's time to treat some symptoms while poring over white papers. Millions of dollars in research money is unaccountable when I request data, so I have to troubleshoot myself now. OK I'm gaining momentum, better stop for now.
Thanks again for the great info.
Hmmm, this was an oxycontin thread wasn't it... albeit oft-seen and probably not mangled beyond repair yet.
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rootloot
Stranger
Reged: 08/23/03
Posts: 15
Loc: Minnesota
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those nerve blocks....oh i can't tell you the anger i had after that job.
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