ptsd Need Help With Chronic Service Connected Pain Issues.

[carlie]

It just sucks. Injuries and Wounds aside, I am still a relatively young man, I am not working, and I feel like my house is my own personal prison. I know I won't ever be able to comfortably do certain things,

but I would like to be able to do SOME things. Keeping a clean house and yard would be one...

Doing some of the above usually results in quick exacerbation of several

of my conditions. So . . . I decided to use some of my 100 percent compensation

and pay someone to take care of those issues.

Very glad I made that choice and now I only risk exacerbating my conditions for

something more valuable to me than cleaning house and yard work.

JMHO

[AMMOroadkill]

Man... I feel your pain and frustration.

Im in a similar situation here except VA is my only medical care option at this point and has been since my separation from active duty 6 years ago.

I complained of thoracic/upper back pain for years both on active duty and after I separated. The doctors never even attempted to diagnose any problems with my upper back until the end of last year when I was finally authorized to see a specialist. Prior to that, I was told on numerous occasions that thoracic injuries were rare... I was told it was probably a pulled muscle or that it was possibly gall bladder/GI issues as I have a hiatal hernia/GERD as well. I was also told that it was somatic complaints after I screamed at my dr to do his f#$%ing job which had unintended results to say the least...

After finally seeing the specialist they found mild to moderate damage on every single disk and vertebra in my thoracic spine and a long since healed compression fracture at t-12. Since that time they just refill my oxycodone prescription and send me out the door. I have been taking them as prescribed since my separation in Nov of 06. They are/were the only thing that would touch the pain but with the side effects I am having now I wouldnt suggest them to anyone long term... but honestly when I started taking them it was the first relief I had had in years and I probably would do it again.

The drug list that I have been prescribed sounds similar to yours with the exception of gabapentin (Id have to recheck for the doses) and methocarbomol after I started having allergic reactions to the cyclobenzaprine and they had me on morphine for a while as well too. I have never tried the lidocaine patches.

Im not a doctor so take the rest of this with a grain of salt and discuss it with your primary care doc...

The only thing that helped the pain other than opiates was the gabapentin. It took a while to get through the titration period and become effective but it noticeably numbed the pain... It turned the volume down to background noise if that makes sense. I experienced some fairly significant psychological and cognitive side effects though so I stopped taking it (cold turkey per Dr.s orders which was a huge mistake...) I have talked to a few other chronic pain patients who have taken gabapentin with little or no side effects though and they say that its a life saver.

Do you experience frequent heartburn and or does your pain flare up after you eat greasy food?

My gallbladder functions improperly, it "works" except that it holds bile until I eat something and then releases it all at once. It does not do it all the time but occasionally, after eating, the pain in my back will be literally very close to the intensity of passing a kidney stone. I switched to a more natural nearly 100% organic diet and cut out nearly all artificial sweeteners and preservatives and it doesnt happen anywhere near as often now. If I go out to dinner at a restaurant (applebees is the worst for some reason) it will take me out within 20 minutes after eating.

Gerd flare ups or heartburn also cause me significant upper back pain as well but I am able to keep it somewhat under control with ranitidine and omeaprezol (both prescribed by the VA) Nexium works significantly better but it is expensive and the VA will not prescribe it to me so at this time I take what I can get. It seems that it takes an act of God to get anything that is not offered in a generic... If you do have heartburn, buy some over the counter nexium and see if it helps with the back pain. Take it as directed not as needed because it has to build up in your system for a bit to take full effect.

Also low impact aerobic exercise helps get the endorphins flowing and masks it for a bit as well it will improve your mood as well.

It might not be a bad idea to try and keep a journal of activities and foods to see what might be triggers for the pain...

Hope this helps you out some

[LivingInPain0341]

Interesting that they at least found something wrong with you, that seems way out of the norm for a VA doctor...

For me, the Gabapentin was mentioned briefly, but they said that I was drinking too much at that time for them to prescribe me. Because I admitted to drinking 3 days a week (fri/sat/sun sometimes) To me it's like, find a goddamn veteran out there, especially one that's been deployed in a forward AO that doesn't drink... Hell, find a single MARINE deployed or not who doesn't drink, good luck. So I guess from now on lying to them about what I do in my free time seems like the best option, then I can use my own due dilligence to ensure no interactions between medicines occur.

I do experience heartburn and indigestion, and constant abdominal turmoil of one kind or another (upset stomach, gas, constipation, diarhhea etc) but I can't really tie it to any specific food group or set of conditions that 'set it off'... I am prescribed the Omeprazole as a 'lets see if this works' medicine.

The thing that doesn't make sense to me though, is that the pain is noticeably worse when I do anything physical... so doesn't that kind of rule out anything (in terms of the back pain) that is GI related??

[uPDATE]

I don't think I mentioned this, but I have strange and undiagnosed Neck issues as well... Does anybody know if this can tie in, or is it again, a completely independent issue? I am noticing that I have heartburn real bad right now (the dummy I am I ate some pizza) and am noticing that my neck is feeling very strange..

• Right quadrant, back of neck, where spine connects to skull
  
• Pain is I guess sharp... hard to describe. Doesn't hurt as bad as my back, maybe a 6
  
• Strange sensations. 'Electric Shock' sensation periodically, as well as a slight numbness
  

The neck issues I have brought up to the Doctors, they did the CT Scan in that area, and located a cyst on my Thyroid gland that they said isn't dangerous.

Lastly, my scheduled tests (biopsies of stomach and throat) aren't until JULY... Pain clinic re-scheduled for early December at least, I hope they will finally do something besides needling me with stuff...

[john999]

I use cymbalta and that helps some. It takes my mind of the pain. You can get your shrink to prescribe it. 60mg of cymbalta does help but it is no cure. If you do things that aggravate your pain then you will suffer. Hire someone to clean house or do the yard. Massage helped my neck pain for a short while.

John

[LivingInPain0341]

The point I am making is that I shouldn't have to hire people to clean my house and do my yard work... I am capable, I just need a reliable means of reducing the pain once I do said work... It's also kind of a pride thing, I have always been one to want my dwelling and belongings to be neat, the Marine Corps further ingrained that in my head. Not to mention, but with the being unemployable, and then not being able to do the upkeep on my property, its like, what CAN I do, I get frustrated and feel useless. It's unacceptable to just 'avoid doing things that aggrevate the problem' because that is almost everything besides laying on my couch. It's not like I am complaining because I can't go out and BMX bike, or mountain climb, or play football without being in misery, it's just basic things that I want to do without fearing the pain, things like my household chores, or a walk with my girlfriend and the puppy, or spending a day at the zoo with family or something. I'm not asking for a lot. I'm not asking for an instant cure, or magic pill that will eliminate my symptoms, that's unrealistic, I just want what I know works.

I'm tired of jumping through the VA hoops, and trying all these ridiculous 'maybe treatments,' it's been far too long, and I am just plain sick of it. It's easy for a doc to say 'try this, and follow up in 3 months' because they aren't living in pain for those 3 months. It's like my entire life is a waiting game, waiting for the next appointment, or follow up, or specialist to try and get some answers... I don't have to tell you all this, you all know how it works... I'm just venting at this point. For my GI issues, which they said probably are NOT contributing to my back issues, I have to wait till MID SUMMER for the appointment!!! That's MADNESS. So in the meantime, I have no diagnosis on it, nothing. Esophagus biopsy and stomach lining biopsy as well as a scope, which will provide answers on that matter are in JULY!!!!

I might sound stubborn, but I just want to find out what the underlying issue is, and until then, I want a means to reduce the symptoms. I don't want to even take meds for it everyday because I have heard horror stories (referring to my back again now) about drug reliance or possible addiction (though studies suggest that those who really NEED the pain medications are far less likely to become addicted) but knowing that nothing that I tried on my own helped, none of what the doctors suggested have helped, and that their are meds out there that did help me, and knowing that it's such a battle to get those same medicines again is what bothers me. Isn't this the entire reason this class of meds exists?

I haven't heard of the Cymbalta thing before, but when I looked it up, it is similar to Venlafaxine, which i had been prescribed but for one reason or another, it was stopped. I can't recall if it was bad side effects, or if it didn't yield positive results.

[LivingInPain0341]

Alright here's a quick update.

Went to a follow up Pain Management appointment... Well what I thought was a follow up anyways. I get there and they tell me that I am scheduled for the trigger point injections, I immediately tell them that that is not what I wanted at all, and I still do not want them, and see if I can change this appt over to just a follow up, they are confused but agree.

I speak to the first Doctor, a younger lady, she has me start from square one and go over my entire back history... OK... I happened to bring in a bunch of medical documents form when I was being seen by a local civvie doctor, including a CD full of imaging results. She asks what I've done so far for pain management and I tell her, she then asks if the only thing that has helped me out was the Percocet... I feel it's a trick question, but I reply in the affirmative and tell her that even that doesn't get me down to a 0 on the pain scale when it's bad, it just dulls it enough to make life manageable when my back is acting up. After a while she goes to get the 'real' doctor. She comes in and immediately says

"Well, I think that the best approach for you is going to be a hollistic approach... have you tried PT?"

Me: "Yes, I did while still active duty, and it didn't help, plus I live 90+ minutes away each way, so there is no way I will be able to do structured PT here."

Dr: "Oh I see... well, you're going to need to go to at least 1 appointment so they can give you a *Tens* (not sure if thats how it's spelled) unit, that will be good to try, but besides that, just do stretches at home, and try a deep tissue massage or yoga, there is no magical cure, and I'm no Harry Potter with a magic wand to heal you, so it's going to take a long time and be a slow process, but do not let the pain get the best of you. And we will also now try you on Gabapentin, but I won't prescribe it, you need to have your Primary Care Physician prescribe it."

Me: "umm, why can't you prescribe it? And I guess I can try that stuff, but if the VA isn't offering the massage and yoga, then I can't do it, as I don't have the money for it, and I'm not sold on those ideas anyways"

Dr: "Well, I'd just rather have your primary care prescribe it."

And that's that... No idea when I even get this gabapentin crap, no idea if it will work, and told to try Yoga.... I asked if there is ANYTHING they can do or prescribe me for the pain when it gets bad, so I can have something for those bad days so I can still get some stuff done if I need to. They said that there is nothing they can do. Basically just deal with it.

xxxxxxx YOGA? Really?

I'm literally about to lose my mother xxxxxxx mind. So instead of letting me get the meds that I already know work, and am comfortable with the side effects, they give me a medicine for neuropathic pain??? They are literally doing everything in their power to not prescribe me any form of pain medication, not even Tramadol.

I have no idea what to expect from the Gabapentin, she didn't even go over what it is, or how it works or side effects. If it works then fantastic, but nerve damage wasn't determined or really discussed, so I dunno how this medicine will help me.

I am seriously contemplating finding a shady online pharmacy so I can get some kind of relief... So goddamn fed up.