I have a problem with a pain management Nurse paractioner.?

Question

Hello,

I have a 5 year history of chronic pain. I was found to have peripheral neuropathy with Allodynia, herniated cervical discs (C3- C5 that impinges upon the thecal sac) Inflammatory Arthritis in my knees, and Fibromyalgia. I have been going to a pain management clinic and have been Rx'd Oxycontin 60mg every 12 hours, Oxycodone 15mg 3 x day for BT pain and lidoderm 3 x day.

While this has not stopped all my pain it has reduced it from a 8-9 to a 4-5 on most days. I could not live a decent life without these meds.

Recently I was tested for Lyme disease and the tests came back positive, I am now on Antibiotics. I have been going to a pain clinic for a few months and I see a Nurse Practitioner there and she was the one who ordered the Lyme testing and told me to see a Lyme doctor.

She recently told me that narcotics do not work for Lyme pain and that they don't work on me. I tried to tell her differently but she would not listen. She said that my meds need to be tapered and stopped. When I again mentioned my bad discs she said that Lyme is causing it. Everything I have is now due to Lyme disease at least according to her. If she stops these meds I do not want to think about how bad my life will become. I have tried just about everything under the sun from NSAIDS to Biofeedback and everything in between and nothing else has reduced this GOD Awful pain.

How can someone act like this and work for a pain clinic? Am I missing something here? The pain I have has not changed. I have been lead to believe that Lyme can be as painful as cancer pain, yet cancer pain is treated.

Does anyone have any suggestions? Would it be a wise idea to speak to the actual Doctor and tell him what is going on? I saw him before I saw the NP and he was very understanding.

Answer 1

I wonder why the NP is saying that your pain is caused by Lymes Disease. Lymes Disease is caused by a being bitten by infected blacklegged ticks and symptoms include fever, headache, fatigue, and skin rash. None of the symptoms should increase your pain, or really even give your body the type of pain you are talking about.

Did you have any of these symptoms for her to request a Lyme test? If not, then I would seriously consider going to see another doctor as well as talking to the head doctor at the pain clinic.

I do think pain clinics do a wonderful job. I attended a course about 5 years back now and learned different ways to adapt my life around my pain, meditation techniques and many other helpful things.

I'm not saying that a pain clinic is for everyone. It's not.

I'm surprised that the NP can change your medications. I would have thought that would be entirely up to the MD.

Definately talk to the MD about your concerns and if you are not happy, then go to another MD.

Answer 2

Pain management clinics can be very useful and can help you to find the most appropriate, for you and for now, combination of management tools. Anyone who tells you otherwise has either been to an insurance-funded clinic (in which the idea is to get you to ignore your pain and get back to work) or is simply completely clueless as to pain management.

Also, you have mentioned FM. This is a real illness, but managing the pain is extremely difficult. Usually, if you have multiple problems that include FM, you are helped with the pain that is appropriate to those other problems only. That's simply because FM isn't easy to manage, and it responds much better to non-drug management tools.

Just because you have tested positive for Lyme disease doesn't mean that you don't also have other types of arthritis. The fact that you have diagnoses of other types of arthritis, based on what I'm sure is a number of imaging tests, among other things, certainly points to probable the need for continuing your pain meds.

All of this, though, doesn't necessarily mean that you are seeing the correct practitioner in that clinic. Talk with your family doctor about seeing someone else at the clinic. And do make an appointment with the doctor whom you first saw at the clinic. He needs to know that this going on. Who knows, she might be doing this to other patients as well, and the idea is to "first do no harm".

Answer 3

As you are experiencing, Lyme Disease can cause excruciating pain. I'm sure that your NP is thinking that with the appropriate antibiotics, it can be very beneficial to decreasing joint pain associated with Lyme disease and she is correct. However, additional medications can be used to manage the pain from chronic Lyme disease that include NSAIDS, anticonvulsants, antidepressants, opioids, and muscle relaxants. I am a registered nurse, but I do not have as much knowledge in treating Lyme Disease as your NP does. But yes, I do suggest that you speak to the MD if you feel your pain is not being managed appropriately. I hope everything works out for the better for you. Good luck.

Answer 4

Lyme disease can cause and effect your condition but once a disc is damaged even from the Lyme Disease it can not be repaired just managed. Look at her tell her MY pain My back and your not and MD. Remember YOU ARE THE PATIENT! if she does not like it tell her You only want a direct MD from now on to see you. You do not have to see a practitioner there glorified nurses is all they are and I would never in trust my care to one.

Answer 5

I would consult with that doctor who seemed to have a clue. Frankly I'm surprised that that nurse dismissed your pain without a second thought - Shame on her!

Answer 6

get a second opinon.. while some of your symptoms are attirubted to lymes disease not all of them will go away when you get treated for lymes disease. there has to be a way to settle disagreements at the pain clinic ... find out what that is and follow it through. she may be underinformed about the chronic natures of lymes disease... hopefullly with the right treatment things will improve and you can taper off some of the meds.

Answer 7

Yes you should def. speak with the actual doctor and also one who specializes in lyme disease. I would think that the lyme disease will clear with the antibiotics and if you still have pain you will then know it was not due to lyme disease and you can then tackle the problem of pain and management.

Answer 8

Pain management clinics aren't worth a crap to anyone.

I have two deteriorating discs in my lower back and they tried to give me tramadol.

Try to go to a private doctor...keep in mind though that before any of them will see you that you'll have to get a letter stating that you've been released from care by them...

Or if you think talking to the doctor might help, definitely give it a try.

Answer 9

That's a fairly large amount of narcotics. The problem with pain management is that only you know how much pain you're in, and if you'll step back from the situation a bit you'll see that you can't be allowed to have all the narcotics you want. Friction is perfectly normal in this circumstance, and there's no point in getting angry.

Answer 10

you get off one poke with any sausage firmly or limp and that will be the last sausage you'll ever hold in your hand.