I might start off with my issue. About 3 years ago I had my l4/5 disk replaced with a prodisk 2. For the past 4 or 5 years now I have had pain in that region and about 3 years ago they replaced the disk. For about 6 months or so I was good to go, but something is wrong and it likely happened because of that disk replacement. At any rate I have been taking hydros for about 5 years now on a daily basis. I started off with fairly small doses, but I am up to about 5x 10/325 tabs daily. I rarely have enough to get me to the next script since I always lie about the number I am taking and they never give me enough. I fear I am taking too many of them and hate to tell the truth about how many I actually take. Every 6 months or so I have to fess up and get the script bumped up because they are less and less effective so I have to take more and more. Same old adage. I fear I am taking too many. 50 milligrams of codeine seems awfully high to me. I hear addicts take 20 or 30 pills a day which is way more then I can take but when I look back 5 years ago I could barely handle 1/2 tab of 2.5's. Now I take two 10's as my initial dosage. 1 won’t cut it.
About 2 months ago I told my orthopedic surgeon I was done seeing him. He has not been able to figure out my issue. He can’t decide if the issue is the facet joint or something else in that same area. The pain is very isolated but radiates out. I can tell exactly where it originates though. I have had mri's and x-rays which don’t tell much since my back is loaded with chromium and it throws off the mri pretty good. He says that everything looks good to him from what he can see. Last year they decided to start the injections once again this time around the facet joints and those worked for about 4 hours. Apparently they inject novocain in there first and then something else right after. The novocain was working better then the other stuff. There were 2 sets of those about 4 months apart and neither did any good. The next thing was a ryesotomy. That was another injection where they used hot needles or something similar to deaden the area around the joints. That was supposed to do the trick but it was only supposed to work for a couple of years and then it would have to be done again as needed. Of course it too only worked for about 4 hours. Once the novocain wore off, the pain started up again. I went to my doc a couple times after that last injection (december 05?) and he told me to keep hanging on and see what time would do. The last visit was about 3 months ago and he told me that he wanted to try the ryzotomy again. The last procedure really scared the [censored] out of me and I swore then that I wasn’t going to do it again. I had fewer mental issues from the surgery, which really messed me up for months, then I did from the hot poker surgery. I told him that I was done with those and that I wanted to see a pain management guy. He sent me next door to his pain management doc and said that he was real good with that sort of thing. It sounded promising. I might add that I go to a clinic that specializes in back pain (texas back institute) and they have an entire suite of docs under one roof. I have been going there for 5 years now.
The pm guy ended up being a loser in my opinion. First off he is a do which I swore off years and years ago when I accidentally went to one when my issues first started. I had no idea what my problems where at the time and so I was searching for a doc and came across a do. They are not doctors by any stretch of the term and only go to med school for 2 years I think. Some are fine i’m sure, but most pretend to know everything including spinal adjustments. The one I went too tried to give me an adjustment, but asked me to take my shirt off first. She stood there and watched me as I did this. Then nearly broke my neck as she tried to adjust my spine. Afterwards she was the one that collected my co-pay for the visit. It turned out that she was the only one that worked in the office. I swore do's off at that very minute for her lack of medical knowledge and her total lack of professionalism.
At any rate, the pm do started off by saying that he wanted to get me off the norco's. I have mixed feelings about that and I will tell you why in a sec. The next thing he gave me was a lidocaine patch and finely he said that my si joint was misaligned and that was likely the cause of my problems. The do could tell what my issue was because my hips weren’t the same height. He could tell what my issue was in 5 minutes when my ortho couldn’t do it after 2 years and 3 surgeries, yea right! He sent me next door to his chiropractic for adjustments. The first visit was terrible. I was in so much pain and thought he really broke something in there. I thought about it and realized after a day or so that perhaps that joint is really messed up and that’s why it hurt so much. I went again and this time a little easier. The third visit was of no benefit at all and the pain was the same as before. His solution was to adjust me and then give me the sonic electrode therapy even though I keep telling them that the muscles aren’t all that cramped up. He then told me that if the adjustments didn’t work, he would recommend a series of injections on the facet joint. That would likely fix me for sure he said. I had to point out to him on my charts (page whatever) where I had already had 3 series of them from the real doc (the ortho primary). Obviously he hadn’t even read my 1.5 inch thick medical history from the very clinic he works for. This was about 1 week ago. I am supposed to go 3 more times, but I didn’t go at all last week. I don’t see the point. I don’t feel any better after 3 visits and one of those actually made me feel worse. Why go for another 3? It's going to cost me 75 dollars in co-pays and the only reason I would go is so that I can tell the pm that I went and we can cross it off the list.
Now for my dilemma. At what point do I give up on all this and concede to the probability that I am going to need norco or something like it for god knows how long? I have been on this stuff for nearly 5 years. I can be honest here and say that at times, I do take too many. We all know why. Most of the time I take what I need and that’s all. Am I addicted? Yes and no. I can go several days without them and it’s not a problem in terms of withdraws. We are going to see just how long I can go without starting tomorrow since I took too many on a couple of different days as well as the fact that I require at least 5 per day and my script is for 4. I am about 1 week shy of my next refill. I believe I will be able to make it, but I am certain to be miserable from the back pain. I don’t think I am actually chemically dependant on them. I do believe that I am addicted to them as a tool to fix my pain though. You see no matter what I do I can not relieve the pain on my own. There is no position I can lie/sit in, stretch or exercise I can perform, or over the counter med I can take to relieve my back pain when it gets bad. I have maybe 3 levels of pain and number 3 is the one that sets me off. I can’t relieve number 3 and have no choice, but to take a pill. I have become dependant on those pills to relieve number 3. If I had something else then maybe I wouldn’t be so dependant on them, but I don’t and the docs can’t find a solution for me.
I believe that they are fast approaching the point of no longer believing me. My story has not changed and my wife believes me. I have seen only one doctor and have put myself through quite a bit of procedures in an effort to fix my back. Since the last round of mri's and x-rays didn’t find anything I wonder if they are starting to think I am lying. My script isn’t that heavy in my opinion, but since the do mentioned wanting to drop me from them, I truly believe that I am now in trouble. The lidocaine patch only works to a point, but it won’t work instead of the pills. The pills don’t work 100 percent either, but the two together works really well. The patch deadens local pain and the norco hits the moderate pain at the edges of the circle of pain but neither works for the deepest part of the pain. I can tolerate that though since the hydro dulls it down enough.
At any rate, what do I do at this point? I will go see the pm again after I have gone to the chiropractic 3 more times this next week. I am going to do all of this in the next 2 weeks before my last refill ends in case he doesn’t give me any more, this way I can find a new doc if it comes down to that. I feel like an addict when I go in his office. He doesn’t give me the business, but I wonder if he thinks poorly of me. I can’t let them stop the norco or I am boned 4 hours after I run out. How long can I keep taking them? 10/325 is a strong pill and as far as I know it’s the highest dosage for hydro. The next step is oxycodone and who knows where from there. How long can I take these things? I am only 32 and time and again I hear my doc say I am too young to be taking these things for the rest of my life. He obviously doesn’t want to leave me on them too much longer. On the flip side, how long do I let them keep poking at me and trying procedure after procedure with no results? My co-pays are 25 each, but going to a chiro 3 times a week and then the doc once a month and then the refills at $10 and then $30 for the patches adds up. Ok so the insurance hates it more then i, but my end still adds up to at least 1 to 2 hundred a month at the current rates. I can’t afford to keep this up. I can however afford 10 bucks for refills and a visit to the doc every couple of months. How much more should I be required to do? When do I say enough is enough and then what do I do? Where do I go then? I hear there is a real nice pm center in dallas (i live in dallas) called the madison clinic. Do I go there? I looked into them some and they seem a little shady to me by only accepting cash and credit. Can I go the rest of my life taking pills and when do they finally get the better of me. I can stay in control of the norco for now, but will I stay in control of the oxy? I doubt it. Even if I do my tolerance levels will surely rise as they have already risen several times over the last 5 years. I started on 1.25 tabs every 12 hours or so. Now I take 5 to 6 tabs of 10's.
What to do, what to do? I hope you read some of this and give me some ideas.