Opioid Induced Hyperalgesia: Clinical Implications for the Pain Practitioner

[scduggan]

Thanks SO MUCH Justin and Kathy. This info helps a lot. I will talk to my doctor about this tomorrow. I will be more active and will therefore be able to heal faster if I can function. You pretty much have to cattle prod me to go outside to walk, even though that is exactly what I need. Thanks Guys!
CD

[Jack-of-all-trades]

Ditto what Justin said. I would think you are somewhat under medicated as seems to be the case with a lot of surgeons. It is hard to get the exercise that you need if you are in pain. When I had my back surgery, I had my pain management doc follow me post-op for pain meds.

Can you find out if a local pain management doc who is an anesthesiologist with specialized training in pain management can see you if your surgeon dumps you? After working for a surgeon, I found out their speciality and interest is cutting not writing scripts for pain meds. One size doesn't fit all.

[KBear]

Ditto what Justin said. I would think you are somewhat under medicated as seems to be the case with a lot of surgeons. It is hard to get the exercise that you need if you are in pain. When I had my back surgery, I had my pain management doc follow me post-op for pain meds.

Can you find out if a local pain management doc who is an anesthesiologist with specialized training in pain management can see you if your surgeon dumps you? After working for a surgeon, I found out their speciality and interest is cutting not writing scripts for pain meds. One size doesn't fit all.

I second having a pain management doctor. I saw (see) both my surgeon and pain management doctor post op. My pm is a physiatrist as well. I really like him.

[scduggan]

Dear Spine Friends,
Thank you for your insight. I started seeing a PM last November after the cold bucket of water....the third denial from UnitedHealthcare. At this point, I had no path and was not sure what my next step would be. They had me on UltramER, robaxin and lortab for breakthrough. I had breakthrough every day because I insisted on getting all my stuff done each day with my life, house, three boys, pets...etc. Two weeks before my surgery I decided (on my own) to taper off the Ultram. This proved to be a big nightmare but relatively short in duration.

The good news is I followed your advice and my surgeon just changed me to percocet for the short term future. I can tell already my body recognizes it as something different and therefore it is better. What is strange is it also seems to be COMPLETELY gone at 4 1/2 hours (I take it every 6). This is still better than the inadequacy of the Lortab. I just have to put on my big girl pants and get through it. I am wondering if my body processes it faster than most.

I was thinking I would be done with the PM now that I have had surgery. After what you guys have said, I think I will stay. Who knows what the future holds.

Here is to all of us getting better and stronger each day! I feel very lucky I got to be in the trial. I am determined to find that perfect mix of rest and exercise. Looking back I realize I have been extremely disrespectful of my spine. We will all have to be diligent with protecting it for the rest of our lives.
CD

[muddywaters]

I agree with KBear. Good luck!

K: Interesting that tapering helped you. I may try it.

Best to all.