@laughlin1947 Hi, and thanks for responding. This is only my opinion, but I believe some physicians are protecting themselves more than their patients by keeping them on minimal dosages of medications that don’t provide relief. It sounds like I should consider myself fortunate that I can take a therapeutic dose of Tramadol that allows me to function. My primary physician approves of the Acetaminophen I take in the morning; she said it helps ‘jump-start’ the relief I do get with Tramadol. The people who make these rules don’t live with chronic pain. I heard of one government official stating that people should just take an aspirin.

For what it’s worth, I’ve been to physical therapy, and continue to practice the PT exercises at home. I think this is helpful. Something else I do is force myself to move when I would rather sit. That’s easier said than done when you’re in pain. I also have a supportive husband. I’m not sure how I would manage without him, and I’m grateful for that.

I’ve also seen a Pain Management Specialist, where I received epidural steroid injections. Sometimes they’ve helped immensely, and sometimes I’ve had no relief at all. Even the pain doctor raised his eyebrows at my dosage of Tramadol.

Like you, I average about five hours sleep at night, and it’s not enough. If you wish to be seen by a Nephrologist, why would your Primary object? It’s your health and your life. My GFR (kidney function) is on the low side, and that’s likely why I was referred to a Nephrologist. Ask your Primary to at least run some kidney function tests for you. Best wishes. SJD