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]

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

[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.