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Pain Control Plan
Pain Control Plan-
I took the initiative to design a Pain Control Plan with my PCP. I have had chronic pain for 6 years. Diagnosed with Connective Tissue Disease with several joints reconstructed over the years. I am an RN for 35+ years. I have had several ER visits over the years due to acute on chronic
Last week when I saw my PCP I finally told him we need a pain plan. After we both agreed I have several conditions that cause pain and especially since my RA is erosive and extensive. I asked my PCP if he would consider a pain control plan. I think he hesitated at first but after some discussion he agreed to a plan. My plan is more for emergent pain control or acute on chronic pain flares. I have pain all the time and can usually find relief by using what I learned in the pain program/clinic with Mayo in Rochester MN. I take one day at a time but at times, usually with
Inflammation flares, I get severe pain that needs to be managed before it turns to a pain crisis. I think of a pain crisis of when the acute on chronic pain that makes me spiral into depression, extreme anxiety, sleeplessness and thoughts of suicide. These thoughts put me into a vicious tailspin where I seek pain relief, I think this is normal reaction to severe pain . I have never been an addict or ever used anything that was not ordered for me but in a “tailspin” of pain I need pain relief. I can’t function or process normally when I am in extreme pain. I am allergic to most pain medication which make management of my chronic pain difficult to say the least. Fentanyl and Morphine and all derivatives are out. Even planned surgeries are difficult for pain control. Over the counter anti inflammatories are out due to allergies.
Anyway, my PCP and I decided that I can have on hand 10 Oxycodone and some flexril, for “pain crisis” I also have trazodone 1 to 3 tablets as needed. When I need pain medication I will alert my PCP of symptoms activation of plan control plan via the patient portal if the treatment works I let him know if it does I let him know that as well and attempt to get an appointment before the medication is gone. It may or may not be the best plan but it is a start for me. Usually my pain is muscle spasms around my spinal column that if I can’t get relaxed cause massive pain. I am willing to use the medication on hand as a last resort or as the last tool in my toolbox. I just want relief of pain when I am at my most vulnerable to be with dignity.
My rant:
BEING IN PAIN IS NOT A CRIMINAL ACT,
NEEDING HELP WITH PAUN RELIEF IS NOT A CRIMINAL ACT,
BEING HUMAN AND SEEKING PAIN RELIEF IS NOT A CRIMINAL ACT.
I am not a criminal, I am a human, I come to my doctor for help in managing a medical condition. Being treated like a criminal is NOT ACCEPTABLE!
Am I wrong ???
Sheri
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Sherri, No you are not wrong. I think you are very smart to be your own advocate and prepare a plan with your PCP.
People that have abused pain meds have made it so hard on others that need it to function. I am afraid they have clamped down too much on those that truly need them.
Bless you dear lady. I am praying for you right now for relief and that this new plan will work for you. Blessings & Prayers....
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3 ReactionsI also have cronic pain in my feet. months ago i had ECT treatments,and due to a side affect from that i have sharp pains in my toes every day, Its considered body myalga. Gabapentin does nothing for me. The only thing that helps very little is Hemp extract, I have to rub my feet every morning,And have insoles in my shoes
@fanning, I hear the frustration and fed-up-ness (is that a word?) in the tone of your message. You sound like you were at the end of your rope. Yes, you deserve dignity and living with pain is awful.
I agree with @covidstinks2023. You and your PCP have developed a really good pain plan. What initiative and gumption to bring this idea to your doctor and kudos to him for working with you, led by you! Wow. This is example others can adapt. I appreciate your sharing the plan.
How did you present your idea to the doctor so that he would work with you? What tips would you share with others about building a pain plan with their doctor?
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3 ReactionsI would love to know more about your approach as well, @fanning! Also, can you point me to where I can learn more about the Rochester pain program? This sounds like something that would be helpful to me.
@sj10, I believe @fanning may be referring to Mayo Clinic's Pain Rehabilitation Center/Program, which is available at all Mayo Clinic locations. Read more here:
https://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/sections/overview/ovc-20481691
Additionally, here are a couple of discussions where members talk about the program:
- Mayo Clinic Pain Rehab Center (PRC) - What’s Your Experience?
https://connect.mayoclinic.org/discussion/mayo-clinic-prc-whats-your-experience/
- Questions about Mayo Clinic Pain Rehab Center
https://connect.mayoclinic.org/discussion/status-of-mayo-clinic-pain-rehab-program/
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5 ReactionsI just felt like I needed to find a way to find quality in my life pain is not the quality I want. I just told him I needed a plan going forward.
I thought about what I felt I needed and what I would get in the ER. I presented my PCP with what I thought was a realistic plan for a “pain crisis” (what I call it). I asked if he trusted me, which I was pretty sure he did. If my PCP said is he didn’t then I knew I needed to find a doctor, there has to be trust. I also noted with just 10 pain pills would help my pain but would not lead to addiction or death but would allow me relief while getting a message or an appointment to him for further treatment or evaluation.
I really looked at the bigger picture of my pain patterns and what had previously worked to relieve pain and what a realistic plan for my pain pattern would look like. I even wrote it down for him.
I really hope others will do this with their PCP or other specialist you feel would work with you. I feel good just knowing I have away to control my pain when it gets into a crisis situation. There is something to knowing you have a pain plan and control.
Sheri
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6 ReactionsWow can I identify with everything you said- the pain spiral of sleeplessness anxiety depression suicidal thoughts. My pain is mostly from the maladaptive reaction from numerous surgeries after major car accident years ago I also lost my thyroaid after surgery for thyroid cancer. And I also was treated for her cirrhosis. Plus I’m almost 69 years old. Oh and I totally agree with your rant!! Maybe knowing we are not alone is some small comfort. Best of luck to you and all of us chronic pain sufferers
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3 ReactionsNo, you are not wrong. You are brave to say it like it is. Hang in there!
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1 ReactionJudy Ann. High Blood Pressure. Lots of Medication is not working. Staying very High prescriptions by Nurse Practitioner. Need Advice to get it down soon. Will be having Ankle replacement Soon. Afraid if my Blood pressure does not come down two prescriptions added to the few I am presently taking. Lots of meds not working. Also have chronic pain in Hips Knees ankle. I was taken off anti inflamatories due to Blood Pressure medication. I am afraid of having a Heart Attack or Stroke. I am also very stressed. I am 72 years old and need advice. HELP!!!!!!!!
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2 ReactionsI feel I am at that point too. Would you suggest I start a daily journal before seeking a pain management doctor? For how long? Thanks
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