Those Of You Who Have To Work Through The Pain....

[SpcDearman]

Can anyone that is currently working through the pain of your service connected injury help me find ways to manage pain. i really hate to put this out there but i am at a point to where if I dont manage it I WILL be involuntarily looking for different employment.

I wake up at 5:00 am every morning with both shoulders locked up. I take about 100 mg's of ibuprophen (I refuse to take tramadol at 6:00 am) to attempt to alleviate the pain. I attempt to use my artic thunder (ok i got that from Tropic Thunder) cream about 10 times a day to maintain but its starting to not take affect as quickly and intensely. I maintain a work cubicle and do have to type quite a bit which does add strain to my traps. After about 6 hours, i literally have to type two sentences and relax for 5 minutes and then continue.

I am not rich. I have never been able to afford health coverage. I have dealt with the pain for 15 years but it is becoming quite unbearable.

I just want to be able to take care of my family by working until the VA sees fit to award me. If i cannot sit here then I cannot take care of my family.

[john999]

Have you been to the VA's pain clinic?

[deanbrt]

Do you have a claim in process or are you already service connected?

[abadboy]

Osteo Bi-Flex / Triple Strength / 2 caps a day works good after a week or two of taking it.

[Hoppy]

I had the same problem caused by an high neck injury. My entire upper back would go out. I told the doctor it feels like there is a 150 lb person sitting on my shoulders. When I woke up in the morning my arms would be locked against my chest and my wrists would be locked and my fists clenched. . The only way I could manage the pain is with bed rest. I would spend 16 hours a day in the prone position. I quit working because there were not enough hours in the day for me to commute to work, work and deal with daily activities. The symptoms did resolve to some degree over time. However, I continue to have excurbations that level me from time to time

I went to the VA pain clinic and rehab medicine and they gave me braces to wear on my wrists while I was sleeping. I started seeing people in the cafeteria wearing the same braces. I guess it is a pretty common problem. The folks I talked to in the cafateria did not have carpal tunnel. It was caused by neck injuries.

I applied for social security disability and was awarded. I had a diagnosis of disc herniation confirmed by MRI and ridiculopathy confirmed by EMG. I know four other people who were awarded ssd for a neck injury. I do not know what your diagnosis is. However, it sounds like you are dealing with a severe disability. Consider social security if you decide you cannot work.

[rdawg]

ibprofen 800mg every 6 hours. alternated with tylenol 1000mg every 4 hours. nyquill at night dayquill during the day. tiger balm. hot massaging shower. massage chair (not the vibration one) with heat.

[SpcDearman]

I apologize for the late reply. Yes I do have an active claim in process. i have not been able to use the VA's pain clinic. i have a comp and pen appointment on Friday and will ask what this is. Thanks for the advice guys. I am going to speak with VA to see if i can use the pain clinic. I have shoulder issues so I dont think that I can get a brace for that. lol

[StreetWalker]

I've got a lower back injury and I worked through the pain for many years. I delivered mail on a walking route.

Finally this year it got to the point where I was taking 5mg of Vicodin every four hours just to take the edge off.

Right now I've been out of work since the end of July. I've been awarded SSDI that will start paying out in January. I've filed for TDIU and OPM Disability Retirement.

I'm currently taking 5mg of Oxycodone every 5-6 hours along with 600mg a day of Lyrica.

If you're having the level of pain you describe then I'd guess that you're only causing more and more problems by continuing to work.

[SpcDearman]

i am waiting for my claim to be decided. I have so many complex issues that I keep having to get reexamined for C&P. I have lived my life by one Mantra that my father taught me. If you dont work you dont eat. i dont really have a choice. If i dont work t hen bills arent paid and my family is on the street. I am deathly afraid of Oxy's. I was taking Tramadol HCl but could feel myself becoming dependant on it. I have started back on Motrin but I cannot take much due to my stomach hurting. Funny how 15 years of heay Ibuprophen usage makes your stomach feel. I had a talking to about me missing days due to my shoulder issue. Needless to say if I cannot find a better way to manage pain then I wont have to worry about working. My job may make that decision for me.

[Gridsmasher11]

Ask your primary care physician for a prescription for Diclofenac it is used for athritis and pain management.It is not an opiate.I was prescribed it when 800mg Ibuprofen wasn't working very well anymore. And I preferred not to take the Tramadol as often. It works pretty well for me, it reduces inflamation and eases the pain.I now very rarely take Tramadol anymore. I do still have some pain but it is manageable and I am not as stiff.When my refill is slow getting to me and I run out I can tell the difference.Also consider a claim for Depression caused by the constant pain.Being in constant pain tends to make one depressed and that goes hand in hand to make you hurt worse.I hope you get some relief........Grid

[SpcDearman]

Thank you for your words. I am now really supposed to take two medications daily. i only take one. i am to take Etodolac (Naproxen ripped a new one in my stomach) and Tramadol. the Etodolac is twice a day (my stomach doesnt like it either) and the Tramadol HCL is for extreme pain. I really do think arthritis is setting into the actual joints worse now. I am going to file for Depression but get this. I have been researching and finding instances of soldiers that arent as bad as me getting TDIU. Here is one.

His left shoulder disability is rated as 50 percent disabling and his

gastrointestinal disorder is rated as 10 percent disabling.

His combined service-connected disability rating is 60

percent. ---Issue " I have worse issues with both shoulders"

Entitlement to a total disability rating for compensation

purposes based on individual unemployability due to service-

connected disabilities is granted, subject to the laws and

regulations governing the award of monetary benefits. --Synopsis

Is that a light at the end of this tunnel?

[john999]

I was a postal worker suffering from chronic pain. I was taking vicodin about three times a day. It started to affect my moods and thinking. You are really not safe working or driving taking a lot of this stuff like I was. I retired on OPM, SSD and got TDIU. I did get fired and went through many months of anxiety. When you body tells you that you have had it you should listen.

[StreetWalker]

Before the Vicodin I was taking Tramadol like candy. It's a good drug. But if it's not helping it's time to move up the ladder.

Good advice about filing for depression.

You can file a claim for TDIU. However you can't be working when you file. You could also possibly file for SSDI.

Like john999 I'm a Postal Worker, just taking LWOP right now. Waiting for them to fire me is what it amounts too.

The combo of TDIU, SSDI and OPM disability retirement will give me an take home income double what I was making in the Postal Service.

At what point in the process is your claim right now?

[john999]

I think just about every vet who has a serious disability probably suffers from some form of depression. I would get a referral to psychiatry and get evaluated. Then as I build up some documentation I would file for depression. At one point I was taking morphine and oxycodone via the VA. If that does not depress you nothing will. Just the meds they give you for pain will depress you.

[SpcDearman]

Before the Vicodin I was taking Tramadol like candy. It's a good drug. But if it's not helping it's time to move up the ladder.

Good advice about filing for depression. - You can file a claim for TDIU. However you can't be working when you file. You could also possibly file for SSDI.

Like john999 I'm a Postal Worker, just taking LWOP right now. Waiting for them to fire me is what it amounts too.

The combo of TDIU, SSDI and OPM disability retirement will give me an take home income double what I was making in the Postal Service.

At what point in the process is your claim right now? I am in the preperation for decision phase. I am claiming Bilateral shoulders (my shoulders are really jacked up) lung condition, and bilateral knees. I just had my last C&P claim for my right knee yesterday. Why is it after that test is done that my knees lock up the next day.

[Capt.]

Hello All,,,,

This is a very good topic and I am very pleased to see so many of our folks are trying to help you and being open with their answers and suggestions. Mainly because many folks will not talk openly about their service connected disability. It is something that many veterans view as private. I also was not wanting to discuss it but have changed my entire thinking , especially with the number of folks here that are dealing with the same issues. Trying to manage pain can lead one on a long and strenuous journey. Here are some thoughts that I have and suggestions because of my long journey of seeking relief from pain. This is from my own personal experience and you may glean and use what may be fitting to your needs at present. It may also help another Veteran that is watching or reading our fine board.

List of diseases are ;

Peripheral Neuropathy of all extremities

AO Ischemic Heart Disease

Pulmonary Hypertension

COPD

Chronic Cough

Restricted Lung disease

IBD

Rheumatoid Arthritis

Loss of Muscle mass

Dry Eyes

Ok first ,

I started out not knowing fully what would work and what did not from about 1997 when the diseases first started to make their debut. The main problem was the Peripheral Neuropathy and is very painful.

After 7-8 years of misdiagnosis of Gout due to pain and swelling of legs, feet arms and hands it took that long to get me to Podiatry and then Neurology. I am NOT diabetic. Big red flag for chemical exposures. Medications for Colchicine and other Gout Meds did not work. Tramadol also did nothing and Hydrocodone did give tempoary relief. But it still was not enough

Second ,

After correct diagnosis of Muscle Mass and PN , I was prescribed by VA and Private Doctor to use a TENS unit. The main drawback with a TENS UNIT and I am talking about a very good one that has 8 point contacts is that your muscles and nerves will develope a resistive signal to the treatment and just like taking antibiotics , eventually it will loose its effectiveness when used daily. However it did work for awhile until my body learned how to adapt to the current flow pulses and then lost its effectiveness.

Third,

Peripheral Neuropathy will include the muscles and joints you have described. I was started on Gabapentine(Neurontin) which is a medication originally used for Epilepsy. After no luck at all and increased doses over a year, I started having reactions of forgetfulness, lose of coordination and timing and mental lapses. Severe enough that doctors took me off of it. Lyraca was started and after some use of that ,,,same thing. I was having reactions to the meds. Though it may and has worked for some of our Veterans , I was not fortunate to be one of those.

Ibuprofen gave some , but not much relief and due to IBD it ripped my stomach and digestive system and as you are aware of it has its own set of drawbacks.

Fourth ,

It was suggested by my Podiatrist to use a Hot Tub , HYDROTHERAPY. I experimented using those at motels , and at some Hot Tub companies that had floor models to try out . I mean hot at 103-104 for 10-15 minutes a day. This was about 5-6 years ago.

Bingo....... I found relief , for the PN and my muscle aches and extremity swelling.

After checking VA programs , I discovered the HISSA program( you can research this at Hadit). It would allow for me to get a jacuzzi but the contractor signoffs and remodeling of my bathroom proved to be prohibitive for my needs. So I could not use this program. However it is a thought for you.

I ended up having to pay out of pocket for it . 10k and had it put on my back porch. My VA Podiatrist and Neurologist prescribed it , which helped me to not have to pay sales tax. They also noted that I was getting TEMPORARY RELIEF from the pain and record that in my Progress Reports. I will say that it helps me for about an 1 1/2 to 2 hours just before bedtime and allows me to get to sleep. Somedays I use it 2-3 times a day , if I am having a rough day.

So at present my pain level is around 7-8 daily. Using Hydrocodone is all that "takes the edge off" I have been told that as it continues to get worse , I will have to probably go to stronger. This is not what I want and am fighting this off. The Hydrotherapy is one thing to consider for your needs.

5th,

The Depression is normal with pain. I do not think that taking pain meds will cause the depression per say. It is a proven fact that Pain will cause depression because of our bodies are trying to defend against it.

When I was in the Cardio Intensive care Operating Room the surgeons noting that I was slipping away and gave me Morphine. I later asked the surgeon why did they do that and he said that pain causes your body to loose blood pressure and that this was done to bring up my blood pressure relieve the STRESS from the pain and save my life in the OR. So pain DOES cause depression and I know all about that. Any depression claim can be supported because of diseases that cause pain.If Stress can be reduced through medications then the real culprit is stress because the by product of it is pain. Usually it will be done as secondary. And now we know that stress causes pain and pain causes depression. We have some archived files on this subject also.

As I told my VA Psycologist and a Neurologist and Podiatrist.

" I am not hurting because I am depressed. I am depressed because I am hurting" I would try and remember this. It is a big difference. Especially when trying to have your doctors EFFECTIVELY treat you.

Yes I understand that you are trying to work and not take pain medications and deal with this but I will tell you from experience of dealing with it for nearly 15 years that eventually you will get so bad that it will be your only avenue . I would consider the Hydrotherapy and pain medication to help you and plan on the worse.

Oh yes another thing . I was trying to man up and defeat this stuff and found myself in DENIAL. That I was going to work until I was at least 70 yrs old and because I have not thought of anything other than work. I love to work. But after going thru some major health related setbacks I finally had to admit to myself that I was sick. Unfortunately the DENIAL was also keeping me from PLANNING how was I going to exist , both physically and financially. There is NO embarrasment for being sick , especially when you had nothing to do with it . It will also help you to deal with the reality of having a disease that could cause you to leave the workforce. Johns point below , I agree with totally and think that many of our folks here can atest to the depression because of the disability and the pain that can come from it.

john999

Posted 18 October 2012 - 01:44 PM

I think just about every vet who has a serious disability probably suffers from some form of depression. I would get a referral to psychiatry and get evaluated. Then as I build up some documentation I would file for depression.

I think this topic is so vital to be discussed among our Veteran Community and I hope that maybe what I have expressed here can help you in some way or some other Veteran that is going thru this journey dealing with it . I would talk to your VA PCP and let him know that you are struggling with this. I don't think you can deal with having a heart issue or some other disease spring up from the pain and stress of trying to tough it out .Our bodies will talk to us and let us know what is wrong if we don't just ignore the issue until it is too late.

Remember that most of us here are either in a long battle with the VA or have been thru one, so I would also agree with our others here and file your necessary claims as soon as possible because there will not be a decision in a month or so two. Also remember that it is going to take much patience , hard work and your positve attitude to NEVER GIVE UP. God Bless, C.C.

Edited October 22, 2012 by Capt.Contaminate (see edit history)

[GuaymasJim]

I have been on pain medications for the past 40+ years. My expectations have really changed during that time; and I know now that there is no one medication that will work the same way (or at all) every time or forever.

In addition to the other great advice on hadit, I suggest that you work with your PCP and change pain medications every so often. Also, if at all possible and only with consent from your PCP, take a pain medication holiday every so often. Your acquired tolerance to the medications is slowed down. At least that has been my experience.

The DEA is drastically changing the way opiates are prescribed. The VA approach runs in cycles from generous prescriptions to strict limitations on prescriptions. The new DEA regulations haven’t seemed to change the my prescriptions, but they are very new and it might take some time to filter down to the various clinics. I hope not, but I expect that we will all run into difficulties about this in the future.

The stomach problems that pain medications can cause are significant! I was given this tip years ago by a doctor and it works for me. I wash down pain medications with APPLE JUICE. I was told that the sugar in apple juice if different than that found in other fruits. Supposedly, the pills break up faster and the pain medication attaches to the sugar in apple juice which gets it into your blood stream and out of your stomach faster. I honestly don’t know if this is an accurate picture of what happens, but I do know that I suffer far fewer stomach upsets from medications and they at least seem to kick in faster.

Hope this helps!

[SpcDearman]

All of the information provided is really going to help me. i just have this thing that i have to work. I have been working all of my life and really seem depressed that I wont be able to much longer. I have really thought this out. If i am 39 now and cannot simply type for half a day before I have to stop then i would be ok. I just dont like how I lose strength and feel like i have been lifting weights all day long. I am hiding my pain from my supervisors for as long as I can. I just hope my claim is up soon so that I may have some options if I cannot work anymore.

[justrluk]

The hardest conversation I've ever had was with my PCP and wife on this topic. He asked my wife: "Are you prepared for the day he (me) can no longer work?" That hurt. I realized that I might be the single biggest drain on my family at some point in the near future. I'm the primary income for my family, and now the certainty of this continuing was in doubt. The VAMC we use is 3 hours from home, so we talked the whole way about it. It was really tough. I got depressed for awhile about it, then started accepting the fact. So, we came up with some strategies: sell the house and rent (frees me from maintenance labor), move closer to medical facilities I use, discuss with the kids (They're 11 and 7, and know very little about what I go through every day), etc...

I started back to school (online only) to hopefully prepare to teach other online courses. My concentration comes and goes, so I figured this would work best and at least I'd have some sort of income.

What I'm trying to say is discussing it on the forums is great, but won't fix your future. Sit down with your spouse (if you're married) and work through this. If your employee health plan offers therapy, go and work through a plan of emotional support. I've not had to quit yet, but have used a great deal of leave. I've also not discussed with my boss. I figure he doesn't need to know at this point until it becomes an issue.

I feel for you, man. Once you get your rating, you will at least know what sort of financial position you'll be in and hopefully this will help you in your planning. Like I said, though: make a plan, discuss w/family and get support. You deserve it. Also, if you can still work, figure out if your organization can let you job-share or work part time. Telework might also be an option. I work for the FED and figure if I can't do what I'm doing, they will at least look into options before sending me out the door.

Best of luck to you.

[ks1k]

I just stumbled on this thread. I do not frequent this forum often (enough).

I agree with the poster that suggested Pain Management. There are so many things that can be done to manage pain. You may have to try a number of them before finding one that will work for you. What works for one person does not necessarily work for others.

I have been service connected for low back pain for 20 years or so. I tried many different prescribed and non prescribed methods. The opiates and other pain killers scare the crap our of me. I got hooked on opiates while on active duty. Never again.

The thing that has worked best for me is acupuncture. I have had the same VA acupuncturist in Connecticut for many years now and dread the thought of the day when he retires.

I now live in Central Florida in the winter and the VA has no acupuncturists that I know of. I have had to deal with Fee Basis to get the necessary and proven treatment. The Fee Basis people are very difficult to deal with and I have had to involve the VAMC Director and my Congress person to get acupuncture treatment approved via fee basis and see a local acupuncturist.

The Fee Basis problem became a bit easier when the Pain Management department became involved last year.

Try everything that you can and hopefully something will work for you.

[SpcDearman]

Guys thanks for all of the advice. I honestly did not expect to receive this type of support from people that I dont even know. Kinda breaks me up a bit. Then the pain brings me back. i try to use humor to maintain my sanity. i honestly cannot believe that i made it out of the army with an honorable discharge with my injuries. i have worked for so long that i know i need to have the come to jesus meeting with myself on possibly not being able to work anymore even if I do not get the rating that i deserve. We will let the process go for now. Wish me luck.