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Suggest treatment for severe pain due to arthritis in spine and both hands

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Posted on Thu, 27 Nov 2014
Question: In need of a compassionate pain management doctor as I want off my fentanyl 100 mcg patches 2 every 2 days. They wash off sweat off with hot flashes and I often forget to change them until its to late. I have nothing for breakthrough pain because every doctor I see thinks I don't need any as my dosage of patches is too high to need anything. I've been on same dosage since 2007. I have 2 immune deficiency diseases I get IVIG every 21 days for, Chronic Anemia, Arthritis in spine and both hands, 3 MI with stents by 46 7 umbilical hernia repairs,gastric bypass, and two intestinal surgeries since full perforation at 12, and 2 failed lumbar fusions and rt. arm non union and complete nerve severing above elbow. Lots of things that won't get better.
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Answered by Dr. Kathy Robinson (18 minutes later)
Brief Answer:
Complicated problem

Detailed Answer:
Hello XXXXXXX I am sorry that you are having some many medical problems and so much pain. It would be very good for you to have a pain management doctor and a good rheumatologist. I am going to give you some suggestions that might help. The biofeedback and other procedures are helpful in some cases but as you say you can't stay in a trance. In most cases of complex pain, treating the pain using multiple medication strategies is helpful. While no single medication may help you adding these medications together with your narcotic pain medications may give you some relief and minimize the narcotic side effects. Adding an antiinflammatory and/or a muscle relaxant to the narcotic can be helpful. In nerve pain there are several classes of anticonvulsants that may calm down the nerve pain, examples are lyrica, gabapentin, carbamazapine. Physical therapists have many modalities like ultrasound and electrical stimulation that may decrease pain. I hope some of these suggestions are helpful to you and I hope you can find an excellent local pain management specialst soon.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Kathy Robinson (1 hour later)
Thank you for answering. I do use a tens unit often and had ultrasound many times. You are right about the other medications. Prior to my heart attacks and GI problems I took arthritis medicines. No one will prescribed them for me again. I take something called zanafex for my spasms and that keeps the spasms to a minimum. I'm only being given one 100mcg patch every two days for the rest of pain and certainly isn't enough to allow enough comfort to function as I did for years. There is a difference. Here in Kentucky I seem to have a huge problem. No one wants to document and prove their patients have issues and then prescribe for the issues. If you know of any one that is a real doctor that knows what they are truely doing I would appreciate a way to contact them. At 55 I am so ready to just give up. I can't immagine doing this year after year.
Thanks.
XXXXXX
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Answered by Dr. Kathy Robinson (2 hours later)
Brief Answer:
See help

Detailed Answer:
Hello XXXXXXX
I am sorry that you are having so much trouble finding adequate care for your medical problems. You might try contacting the College of Medicine at the University of Kentucky and see if they have any suggestions for specialists you. I wish you the best in your search for adequate healthcare.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Kathy Robinson

General & Family Physician

Practicing since :1989

Answered : 3535 Questions

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Suggest treatment for severe pain due to arthritis in spine and both hands

Brief Answer: Complicated problem Detailed Answer: Hello XXXXXXX I am sorry that you are having some many medical problems and so much pain. It would be very good for you to have a pain management doctor and a good rheumatologist. I am going to give you some suggestions that might help. The biofeedback and other procedures are helpful in some cases but as you say you can't stay in a trance. In most cases of complex pain, treating the pain using multiple medication strategies is helpful. While no single medication may help you adding these medications together with your narcotic pain medications may give you some relief and minimize the narcotic side effects. Adding an antiinflammatory and/or a muscle relaxant to the narcotic can be helpful. In nerve pain there are several classes of anticonvulsants that may calm down the nerve pain, examples are lyrica, gabapentin, carbamazapine. Physical therapists have many modalities like ultrasound and electrical stimulation that may decrease pain. I hope some of these suggestions are helpful to you and I hope you can find an excellent local pain management specialst soon.