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[Red]

Bebpo, my wife had a fall a few years ago that left her with neck and back pain. She faced resistance from doctors who thought she was a drug seeker and we saw several physicians before finding one who took her seriously. Truth is, I was myself worried she was seeking. I did my best to make her comfortable but felt anxious every time she took a Vicodin or dilaudid. She is doing better now. No pills. The pain has either receded or she has adjusted to the point where she can function without giving it much thought.

I can't give you better advice than see more doctors and hope for the best, and I'm sorry for that. But I can sympathize.

 

[Jado]

OP, I deal with some chronic neck/shoulder issues and deal with pain that has made me think mimicked heart attacks, affected my breathing (tight muscles in the chest and ribcage), caused difficulty with regular exercise, bothered me to the point of being unable to focus on work, given me vertigo/dizziness and made me want to quit my job and just stay indoors like a recluse. Trigger point physical therapy, both from a trained professional and done by myself, has helped immensely whenever I have moments when it feels worse. Stretching/yoga has also been beneficial. I've actually been lazy about it recently because I've mostly been okay, but I'll get serious again soon to improve even more.

Some tips:

-See a very good physical therapist who knows all about myofascial/trigger point pain, one who is an absolute expert of Travell and Simons' work and won't resort to drugs and other unproven shortcuts/gimmicks.

-Get the The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. Amazing book, will show you the techniques for self-applied massage techniques. I've had extremely tender/painful spots and learned to work through the pain to get better overall.

-The author of the above book is deceased, but his daughter is the expert in this now. Contact the author's daughter and see about traveling to her center in Louisville, Kentucky (if financial viable). I've read she's the absolute best and they've helped people that were in WORSE shape than your fiancee go back to leading normal lives.
https://www.facebook.com/pages/Amber-Davies-New-Day-Myopain-Center-LLC/148135171939305
http://www.newdaymyopain.com/

From her FB page:

I am reminded again tonight of how a simple incident or accident or sports injury can lead to and intense battle with one of life's bigger demons: addiction. It never ceases to surprise me how quickly many doctors prescribe narcotics or other addictive medications for common pain. Too many people fall into a long term major addiction as a result. Chronic pain is real and real pain deserves a solution not just a distraction. Don't get me wrong, distraction is an important tool and sometimes very necessary during a process of healing. Here is a good rule: try the least invasive intervention first whenever possible.

-For self therapy at home, buy a Theracane and Knobble to do some of the book's exercises.

-Take up yoga/light exercise. Your fiancee's muscles are out of alignment and either overstretched/fatigued in some places, very tight/overworked in other spots. Massaging and releasing trigger points is only part of it. After that, you have to make them healthy and strong again to restore normal posture and not encourage the trigger points to return.

The truth is most doctors are ill-equipped or entirely ignorant in this line of treatment. I too had numerous doctors tell me I was "stressed out/depressed," only wanted to prescribe me useless meds, or practically shoo'd me away and implying I was a hypochondriac/liar. A good orthopedist noticed the rigidity and minimal curvature in my neck, the neuro saw the pinched nerves/bulging discs, and a skilled physical therapist revealed the root causes that led to these problems. Long, frustrating revelation that took a couple of years.
I hope you find the right kind of help much sooner.

 

[bigmit3737]

Try acupuncture but you need to find a traditional one that isn't afraid to go deeper with the needles for some real benefits .

The session will hurt like crazy but a few days later the pain should subside.

 

[Bebpo]

OP, does her psychiatrist know that she is actively suicidal? Why is nothing specific being done about that fact?

This is where I'm in a hard place. She doesn't want her psych or doctors to know things like that she's suicidal or cut her wrist. She says her psychiatrist will place her in a psych ward if I tell him. Which combined with her threat that she will kill herself out of rebellion if she gets locked in a psych ward, makes it so it would be an EXTREMELY heavy decision to make.

If reporting would get her locked up in a mental institution, I don't know if it's really my place to make that decision. She's not suicidal because she's crazy, she's suicidal because she's rational and feels like she's tried every option and nothing worked and she can't endure the pain she has.

It's not off the table, just it's not a decision I want to make lightly while there's still options.

 

[A Fish Aficionado]

Suicide watch is no joke, so I can totally understand that. I wouldn't have faith in most hospitals to have a nurturing environment.

Try acupuncture but you need to find a traditional one that isn't afraid to go deeper with the needles for some real benefits .

The session will hurt like crazy but a few days later the pain should subside.

That's called a placebo.

And I really do think Trigger Point is what she needs for her back injury. But her pain tolerance has gotten so low and she's so afraid of trying anything painful that doesn't give instant results. It's why I haven't been able to get her to even just go try acupuncture. She's afraid it'll hurt too much and has this irrational fear she can't overcome.

I wouldn't waste time on alternative medicine. Just on trying to find a good specialist or a group of specialists.

Let me rephrase that, if it helps her relax along with conventional medicine (which you should focus first on) then by all means, but it is at this desperation point where people do seek out unprofessional and unlicensed practitioners in hope that something will change without focusing first on what is a right course of treatment.

 

[Bebpo]

OP, I deal with some chronic neck/shoulder issues and deal with pain that has made me think mimicked heart attacks, affected my breathing (tight muscles in the chest and ribcage), caused difficulty with regular exercise, bothered me to the point of being unable to focus on work, given me vertigo/dizziness and made me want to quit my job and just stay indoors like a recluse. Trigger point physical therapy, both from a trained professional and done by myself, has helped immensely whenever I have moments when it feels worse. Stretching/yoga has also been beneficial. I've actually been lazy about it recently because I've mostly been okay, but I'll get serious again soon to improve even more.

Some tips:

-See a very good physical therapist who knows all about myofascial/trigger point pain, one who is an absolute expert of Travell and Simons' work and won't resort to drugs and other unproven shortcuts/gimmicks.

-Get the The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. Amazing book, will show you the techniques for self-applied massage techniques. I've had extremely tender/painful spots and learned to work through the pain to get better overall.

-The author of the above book is deceased, but his daughter is the expert in this now. Contact the author's daughter and see about traveling to her center in Louisville, Kentucky (if financial viable). I've read she's the absolute best and they've helped people that were in WORSE shape than your fiancee go back to leading normal lives.
https://www.facebook.com/pages/Amber-Davies-New-Day-Myopain-Center-LLC/148135171939305
http://www.newdaymyopain.com/

From her FB page:


-For self therapy at home, buy a Theracane and Knobble to do some of the book's exercises.

-Take up yoga/light exercise. Your fiancee's muscles are out of alignment and either overstretched/fatigued in some places, very tight/overworked in other spots. Massaging and releasing trigger points is only part of it. After that, you have to make them healthy and strong again to restore normal posture and not encourage the trigger points to return.

The truth is most doctors are ill-equipped or entirely ignorant in this line of treatment. I too had numerous doctors tell me I was "stressed out/depressed," only wanted to prescribe me useless meds, or practically shoo'd me away and implying I was a hypochondriac/liar. A good orthopedist noticed the rigidity and minimal curvature in my neck, the neuro saw the pinched nerves/bulging discs, and a skilled physical therapist revealed the root causes that led to these problems. Long, frustrating revelation that took a couple of years.
I hope you find the right kind of help much sooner.

That reminds me, one of the things she said that's brought her down recently is her body has adjusted so that her posture is off. She can't stand straight, she's always slouched. :\

How come the Neuro caught the pinched nerves/bulging discs but the ortho didn't? Yeah I'd definitely like to get her to a neuro and bring the images or more preferably get current MRIs.

And I really do think Trigger Point is what she needs for her back injury. But her pain tolerance has gotten so low and she's so afraid of trying anything painful that doesn't give instant results. It's why I haven't been able to get her to even just go try acupuncture. She's afraid it'll hurt too much and has this irrational fear she can't overcome.

 

[Emerson]

This is where I'm in a hard place. She doesn't want her psych or doctors to know things like that she's suicidal or cut her wrist. She says her psychiatrist will place her in a psych ward if I tell him. Which combined with her threat that she will kill herself out of rebellion if she gets locked in a psych ward, makes it so it would be an EXTREMELY heavy decision to make.

If reporting would get her locked up in a mental institution, I don't know if it's really my place to make that decision. She's not suicidal because she's crazy, she's suicidal because she's rational and feels like she's tried every option and nothing worked and she can't endure the pain she has.

It's not off the table, just it's not a decision I want to make lightly while there's still options.

Let me start this post again by saying this is an incredibly difficult situation for you and I'm not saying these choices should be easy.

That being said, your fiance is right, her psychiatrist would commit her if the doc found out, and he'd do it because it's the right thing to do. I'm not trying to tell you she is crazy, but she is actively suicidal and has expressed specific plans of how she would kill herself. It is the responsibility of every person who cares about her to make sure she gets the proper psychiatric care and this is considered a legal and medical emergency. I am not a psychiatrist and I have not evaluated her, but you cannot rationalize this as her making a reasoned decision to end her life.

It's natural for there to be a ton of mixed emotions, including guilt, in you contemplating having her hospitalized. You can't take her threats to kill herself in retaliation as a reason not to get her help. You can live with her anger at turning her in while she gets help. What you won't be able to live with is if you put this off and she kills herself, and you had the power to try and prevent it.

 

[useyourfist]

Have you considered getting her to see a psychologist incase it is a mental health issue? Edit seems she has one sorry missed that, though she needs to tell them everything despite how scary that may be, it will help them diagnose her.

I assume they have checked her blood work etc and ruled out any disease or autoimmune conditions.

The problem is that there is literally so much it could be, I feel sympathy for you both nut your just going to have to persist with nagging the doctors. Shame the system is so bad in USA.

 

[Jado]

That reminds me, one of the things she said that's brought her down recently is her body has adjusted so that her posture is off. She can't stand straight, she's always slouched. :

How come the Neuro caught the pinched nerves/bulging discs but the ortho didn't? Yeah I'd definitely like to get her to a neuro and bring the images or more preferably get current MRIs.

And I really do think Trigger Point is what she needs for her back injury. But her pain tolerance has gotten so low and she's so afraid of trying anything painful that doesn't give instant results. It's why I haven't been able to get her to even just go try acupuncture. She's afraid it'll hurt too much and has this irrational fear she can't overcome.

The ortho was doing shoulder and chest xrays and MRI with contrast, could not find anything which was disappointment. Last minute, noticed my rigid neck and recommended neck MRI and a visit to a neuro to analyze the results. But the slipped discs are the final result. Few people who get neck surgery for problematic discs seem to be fine/get any relief, some get worse. The better solution is to treat the root cause, what pulled the neck out of alignment in the first place. Your gf has to work through the pain of trigger point therapy or she won't get well. I've had spots I could not apply pressure for more than a few seconds because of the excrucaliating pain... but maintained my resolve and slowly worked on it for days/weeks til it improved.

Acupuncture, and for whatever reason fake acupuncture, actually works in relaxing chronically tense muscles. The mysticism angle some places have is placebo, but not the procedure itself.

 

[Norml]

Tried med marijuana, didn't help at all and just caused side effects like hunger cravings and increased anxiety.

I would try again with different strains. Better that than the ability to OD on those pain meds.

 

[kirblar]

What region of the country are you in?

 

[Red]

Being submitted to a psych ward does not mean you are crazy. That is a backwards social stigma. Seeking help to avoid killing yourself, regardless of the reasons behind that compulsion, is not a moral failure. If she is seriously at risk of suicide it is very important that she seek help. You need to influence her toward treatment. You don't want to look down at a casket and regret not doing more.

 

[icecream]

Which combined with her threat that she will kill herself out of rebellion if she gets locked in a psych ward, makes it so it would be an EXTREMELY heavy decision to make.

People who are suicidal don't automatically get 'locked up' in a psychiatry ward. A good hospital should have a Psychiatric Emergency Department where she could go to be monitored and evaluated first, before the decision to send her to inpatient wards or discharge her home.

You've mentioned neurologists and orthopedists, have you tried going to a PM&R doctor yet?

 

[B-B-Bomba!]

No, I can't support her wish to give up as much as I try to support her.

She's 21, has a near 4.0 gpa, a clear career she loves on a very reachable path, has friends and is engaged to me in a great relationship. She also has what I believe are diagnosable and curable conditions that can be fixed within 6-12 months with the right doctor and effort.

I do not want her to throw her life away. I know lots of people who lived through chronic pain for years and now lead a pain free great life. Life is a great thing and at 20 you're just getting started and have so much to get out of life.

I know. It's clear as day how much you love her and the rightly sacred value you place on her life. Clear also that when she gets through this she has an amazing life ahead, and that the barrier between there and here is not insurmountable.

 

[MC Safety]

This is where I'm in a hard place. She doesn't want her psych or doctors to know things like that she's suicidal or cut her wrist. She says her psychiatrist will place her in a psych ward if I tell him. Which combined with her threat that she will kill herself out of rebellion if she gets locked in a psych ward, makes it so it would be an EXTREMELY heavy decision to make.

If reporting would get her locked up in a mental institution, I don't know if it's really my place to make that decision. She's not suicidal because she's crazy, she's suicidal because she's rational and feels like she's tried every option and nothing worked and she can't endure the pain she has.

It's not off the table, just it's not a decision I want to make lightly while there's still options.

Why do you assume disclosing you have suicidal thoughts means you'll automatically be committed to a psychological treatment center somewhere?

Psychiatric treatment may help your friend deal with her physical and emotional pain.

 

[Chris R]

I would try again with different strains. Better that than the ability to OD on those pain meds.

Yep, I'd give it another go with a high CBD strain if you hadn't tried that previously.

 

[stormthecastle]

Very sorry to hear about the troubles you and your partner have been facing. I don't have much advice on the medical front as I'm not familiar with the American health care system, but I would like to second a comment I saw about giving yoga a shot.

I would specifically recommend Moksha/Modo restorative yoga, which my wife teaches. Its a form of hot yoga, but not the heatstroke inducing kind like Bikram. It's focus is on letting the heat open up the muscles and giving them a healthy stretch, rather than pushing the practitioner to try and burn as many calories as possible. They have a lot of chronic pain sufferers as clients and some of them just lay on their mats the entire time and just enjoy the heat.

Lastly, I'd encourage you to help your fiancé be as honest as possible with every avenue of medical assistance she can find.

 

[CrankyJay]

Are these regular doctors or has she been referred to a neurologist yet? She should probably be seeking 2nd, 3rd, 4th opinions.

 

[GJS]

Psych input should be sought promptly, this needs to be addressed not avoided. If she is at risk and she gets admitted then the inpatient unit will help her with getting her pain medicines sorted out also.

At one point you stated she was taking "11 extra strength tylenol at a time to even make a dent on the pain". That is 5.5g of acetaminophen(paracetamol), she should never be taking that much, not at one time or over the day. The maximum should be 4grams daily, anything higher can lead to liver failure quickly.

Tramadol likely caused seizures because she is taking prozac, your pharmacist should really have picked up on that and warned you.

The US approach to pain control seems to be pretty convoluted due to prevalance of branded combination products, and doctors for some reason being pressured not to prescribe analgesics. Do american doctors not have a representing body with sufficient clout to protect themselves?

The UK uses the WHO pain ladder, so the typical approach would be:

Start baseline pain control with 1g (acetaminophen) paracetamol four times a day, regularly every day.
Add in topical anti-inflammatories, such as ibuprofen gel to the neck.
Add in oral anti-inflammatories if appropriate and risk low.
Add in a lower potency opioid such as codeine 15-60mg up to four times a day.
If that's not enough switch to Morphine modified release or oxycodone modified release twice daily.
Switch to buprenorphine or fentanyl patches when appropriate (i.e. chronic/stable and no longer acute in nature or worsening)
If the pain is nerve related, consider adding in tramadol, amitriptyline, duloxetine, or neuroleptics such as gabapentin, pregabalin, carbamazepine.

I don't really like the product vicodin nor hydrocodone itself, USA is pretty much one of the only countries in the world that uses hydrocodone, and then they go and pair it with odd doses of acetaminophen or ibuprofen. They say it reduces side effects, but combination products also limit titration of pain control.

From what I can see the switch from schedule 3 to schedule 2 doesn't come into effect until October so nothing should be different in terms of how difficult it is for doctors to prescribe yet.

What really needs to happen is a proper sit down with a doctor, not an assistant. Have a list of what is regularly taken, what works and improves the pain control, a description of the pain and how it impacts on daily living, and then work out a new approach to the pain, with a ladder for further escalation.

Good luck.

 

[Durask]

The US approach to pain control seems to be pretty convoluted due to prevalance of branded combination products, and doctors for some reason being pressured not to prescribe analgesics. Do american doctors not have a representing body with sufficient clout to protect themselves?

Most insurances don't like to pay for branded products and most combination products I think are generic.

Just to put things into perspective:

The US is by far the world's leading consumer of opioid pain medications. According to INCB figures, for every pain pill consumed per capita in Asia, Africa, or Latin America, 50 are consumed in Europe, and 300 in North America. The US alone, with 5% of the world population, consumed 56% of the world's pain pills.

This would be an interesting topic to discuss but I think may be a bit OT

 

[Scalpel Knight]

First of all I'm really sorry to hear about your situation, it's tough to say the least. As a young doctor myself I feel bad that you've had to go through this. Not to mention, problems directly affecting the nerves are the hardest to treat in terms of pain relief.
OP, when last has she had an MRI? They've never found any bulging/herniated intervertebral discs or areas of nerve root impingement?

 

[Dai Kaiju]

Just to put things into perspective:

The US is by far the world's leading consumer of opioid pain medications. According to INCB figures, for every pain pill consumed per capita in Asia, Africa, or Latin America, 50 are consumed in Europe, and 300 in North America. The US alone, with 5% of the world population, consumed 56% of the world's pain pills.


This would be an interesting topic to discuss but I think may be a bit OT

That's fucking insane. I was a pharmacy tech for the last 9 years. I always assumed it was just as much an issue in other countries as it was in the U.S.

Dealing with addicts is tough situation, especially when you know what it feels like to be one. I can't for the life of me stop drinking, so I could kind of empathize with customers/patients who got really upset when their prescription for painkillers couldn't be filled for whatever reason. My coworkers just dismissed them as being druggies, but I tried to be as nice as possible unless they were being verbally abusive. Crap, I'm getting off topic...

Bebpo, I honestly wish I could come up with some worthwhile advice. Normally, I would say that the best way to help someone who is suicidal, is to keep showing them that you care. Being suicidal from physical (as opposed to emotional) pain is something else entirely.
I'm sorry if I missed anything from your initial post, but are you certain her suicidal tendencies aren't more related to the mental withdrawal symptoms that often accompany suddenly stopping a narcotic?

 

[jb1234]

People will inevitably freak out and get offended by a statement like this but the fact of the matter is that a very high percentage if not majority of physicians and other medical professionals believe this or a variation on it (e.g. fibromyalgia is a somatic or sleep disturbance related syndrome rather than a specific organic disease).

That belief is changing as more and more evidence piles up that fibromyalgia is a distinct and very debilitating condition. It certainly decimated my life.

OP, I don't have a lot of great advice for you, as I'm very much in the position that your fiance is in. I had no choice but to get on stronger pain meds and I hope that's a route you don't have to take because it's a massive double-edged sword and I'm always aware that the hourglass is running out.

 

[mattiewheels]

First of all, I'll say I'm glad that she has someone with her that cares about her as much as you obviously do, and I'm sure she is too.

Reading this is scary to me, because after ten years of very random but insignificant back pain, the last month has brought a permanent back pain that has only worsened, to the point that the usual laying down for a while didn't make it go away. Now, intense pain even when laying down and feeling like I'm being torn apart when I try to move in bed, and walking was almost impossible without triggering spasms in my back.

It's pretty obvious from the shooting pain from back to legs that I have a sciatic nerve pinch, but because my appointments with an orthopedic and neurosurgeon are still a week away I was forced to go to the ER because of a couple of sleepless nights due to a pain I've never dealt with till now, and not even being able to get in a car to get an important MRI done. Luckily they gave me a steroid shot that brought me back to "normal", and a cat scan that showed the herniated discs.

I really do fear a situation like your fiancée is in, where after whatever treatment you have wears off and you're left pretty much a cripple because the doctors can't find a solution. After looking up "sciatica" and reading the untreatable cases that sound just like your fiancée's case, and knowing that if I had to live a life like the last couple days where even laying still was that painful, I would hope there was a second, third, etc opinion that could recommend surgery or some solution.

One thing I might reccomend to her is to try getting a stand-up MRI done if it's possible. I've seen cases where they can spot problems that the prone MRIs sometimes miss. Knowing how bad her problem is, maybe it would help spot something.

 

[SquiddyCracker]

GFs who threaten to kill themselves and get locked up in psychiatric facilities are the worst, OP.
You need to leave her to fix herself, because you're not her psychiatrist/physician - you're only meant to be her boyfriend.

 

[Tesseract]

your girl sounds exactly like me, it's freaky. i don't have the answers, chronic pain of significant magnitude is very tough to beat into submission. physical therapy is really the only successful out, combined with osteopathic massage, electrical stimulation, and meditation. painkillers ultimately decrease your pain threshold, so the goal should be to use them with (after) physical therapy to manage short turn spikes.

how's her diet? she needs lots of protein, and vitamin b12.

but yeah i've been there dude, i am there. i've thought about eating a bullet every day for the last 3 years. chronic pain syndrome is a beast like no other, i've said that before on this board.

GFs who threaten to kill themselves and get locked up in psychiatric facilities are the worst, OP.
You need to leave her to fix herself, because you're not her psychiatrist/physician - you're only meant to be her boyfriend.

imagine living with the pain of an acute fracture every day for the rest of your life. you too would threaten to kill yourself.

 

[Blargonaut]

GFs who threaten to kill themselves and get locked up in psychiatric facilities are the worst, OP.
You need to leave her to fix herself, because you're not her psychiatrist/physician - you're only meant to be her boyfriend.

I just popped in here to mention that I strongly disagree with you, but I apologize as I'm not prepared for a long discussion about why, sorry.

 

[WorriedCitizen]

I had a friend who was in a corset for months after a traffic accidents. He also was in severe depression afterwards but that was a actualy withdrawal symptoms from the opiates.

You need to seek professional help when she's so serious about suicide. What's worse losing her or pissing her off for temporarely? They will evaluate her for a couple days and i'm certain that will lead to doctors actualy taking her condition more serious.

 

[TheVampire]

So whats worse?

Chronic pain or chronic tinnitus? (ringing in your ears which I have)

 

[maximum360]

So I posted a thread about my fiance a few months ago and some of her first suicide attempts because she has chronic back and neck pain from a car accident almost 2 years ago that she can't live with and can't get help because doctors don't believe her.

Thread Pt.1: http://www.neogaf.com/forum/showthread.php?t=833290

I was always there giving her full emotional support and trying to help as much as I could and then some, and a month after she got out of her clinical depression and though she was still in pain all the time, she was getting out, spending time with friends and happy, optimistic and coping.

Then in mid-August we were on a vacation and she had a grand-mal major 3-4 min convulsions seizure because of a pain medication she tried (Tramadol while being on Prozac + some coffee that day) in order to conserve her minimal vicodin prescription. This was her first seizure and it fucked up everything. The muscle soreness from the convulsions and falling on the ground caused her pain level to elevate to the highest it'd be in the last 2 years. She had to go from taking two 5mg vicodin/day to six per day to get through the pain. But burning through the prescription at 3x the amount prescribed was not going to lead to a good place.

Well she saw some docs and got an appointment with some pain doctors in the hopes one would be able to help her. Got her hopes up. One doc's first opening was a month away, one was a week away. She had 1.5 weeks worth of prescription vicodin left. She pinned all her hopes on the earlier one that had been recommended by a local doc as a very understanding and helpful pain doc.

In prep for the appointment and since I can't be there due to work, I work with one of her gps whose known her a while to produce a detailed 4 page "medical evaluation letter" signed by the doctor explaining the long history of her medical stuff since the accident because her injury is one of the 10-20% of injuries that don't show on the x-ray/mris (and why so many doctors had not taken her seriously and even accused her of being a drug seeker)

She goes and sees the doc and he's not there so they put her with his assistant. The assistant looks at her x-rays and mris and says she seems like a normal 21 year old girl, here's some tramadol. She says "did you even listen? Tramadol was what gave me a SEIZURE" and he's like oh whatever, here's some advil++, your test reports look fine. And she tells him of her suicide attempts, of having to take 11 extra strength tylenol at a time to even make a dent on the pain, of not sleeping, etc...she's like it's all in this doctor letter I gave you and...he doesn't even read the letter! He says he's not giving her narcotics because she's young and looks healthy to him and he literally walks out of the office.

[From what I've been able to figure out the cause of her chronic 11/10 constant pain is:

1) A bad whiplash healed improperly neck injury with reversal of the curvature of her neck spine along with shortening of her neck muscles which can be healed through physical therapy but since she's in so much pain she needs pain killers to even do any PT; and

2) her back pain which is even worse is likely Myofascial pain syndrome of a excruciating muscle knot in her mid-back near her spine that probably needs trigger point injections -> physical therapy after the knot has loosened and maaaybe even a good trigger point acupuncture could help loosen the knot.

But no doctor's been able to diagnose #2 and #1 they just say do PT but she can't without at least 1 pain killer before PT to be able to do the exercises, 1 after for the immediate pain and 1 at night to sleep and no one is willing to prescribe her 3 a day for a few months of PT.]

Anyhow, after having gotten her hopes up, been almost out of pain killers and in heightened pain from the seizure (plus the doctor squeezed on the trigger areas causing a flare up of even MORE pain), and the mental defeat of another doctor not believing her because she's young and looks generally ok in her xrays/mris and another doctor accusing her of just being a druggie...she gave up completely. She fell back into a depression, gave up on believing she'd ever get better or anyone would ever believe her and was really wanting to die. Instead to get through the night of intense chronic pain (since she couldn't sleep from it) she cut up her wrist with a knife so at least she could focus on her wrist pain and for once not be focused on her back/neck pain. Also she wanted the natural endorphin pain killer effect from a wound.

That was bad.

That was Tuesday.

Wednesday and Thursday were really hard (she'd stopped cold turkey even taking her last handful of vicodin because she didn't know if she'd ever get anymore, plus she hated herself and her life at this point and wanted to try to endure the pain). She hardly slept more than 4-5 hours a night, was crying and crying in pain screaming all night. But during the day she'd get out, be social and her mood was good. She hadn't fallen back into a clinical depression thankfully and she was fighting.

Oh and we got rear-ended on Wed night (light impact, about 10mph, but still enough for me in healthy condition to have a sore neck/back for a couple days), which of course just made her pain even worse.

Friday (yesterday) was just bad. Either the rear-end aggravated her injuries or her tossing and turning in her sleep the night before, but she was in excruciating tremendous pain and she just couldn't take it. She decided she was either 1) going to kill herself by smashing her car into a wall, 2) was going to throw herself down a set of stairs so she'd finally have something that would show on x-rays/mris or 3) was going to drive at 3am to the seediest part of town and look for drug dealers to see if she could buy pain killers off the street since doctors won't help her. I spent hours all night/morning blocking her physically while pleading with reason and logic and trying to be supportive and asking her to hold on and not give up.

Eventually I succeeded but she was in so much pain and broken she went into bed and called the suicide hotline for the first time. Told them her story and asked what she was supposed to do living in chronic horrible pain that's not visible from just looking at her or in her xrays/mris and no doctor believes her and every night she doesn't want to wake up in the morning. They tried to be helpful but there's no much they can do. I was holding her the whole time but when they asked if there was someone there who cares for her she said "There is but I don't want him to be involved. He's missed so much work and I'm making him miserable and ruining his life" (and I was giving no, c'mon that's not true signals).

She gave the hotline an ultimatum, she'd be dead at the end of December when the year ends unless she miraculously got better.

The thing is, she doesn't bluff. She also said if she gets committed to a psych ward or institute she'll find a way to kill herself and I know she will.

Since I couldn't do anything about the December suicide deadline (no pressure, right), I was like at least don't give up, see doctors, try everything, TRY until then and she's like "no, I'm not seeing anymore doctors or trying anything else; every time I see them they never believe me and it hurts so much and everything they give me doesn't work for the pain and only gives me bad side effects like hallucinations or seizures. I mean the medication THEY gave me gave me a seizure and caused my pain to now be as horrible as it is" and I ask about 4 months then and she says she decided December so she has time to sort out all her stuff before she kills herself. She's given up and knows she's not getting better.

She passed out a bit after that.


She has an appointment with a pain doc on Wednesday. It was the highly recommended guy she was going to see when she got the assistant. The doctor who referred her to him said it was bad luck that she got the assistant as the assistant is new and very strict and that the doc would talk to the good pain doc about her case and clear things up. But she was still worried the assistant will poison the well and tell the guy that she was just another drug seeker with nothing wrong. I'm going this time to be there. I've taken videos and audio when my fiance wasn't looking at times while she's been breaking down crying and suicidal because the pain hurts so much so I can show the doc. But right now the hard part is 1) Getting her to make it until Wed, 2) Getting her to GO to the appointment.

And then if he doesn't want to help her (apparently the doc referring said because of a brand new drug law upping the classification of vicodin from class 2 -> class 3 drug, it's now getting hard for a doctor to prescribe it so even if he's sympathetic there's only a 60% chance he'll prescribe pain killers to help her get back to physical therapy and to manage day to day)...well if it doesn't go well there's another appointment in like 3 weeks but I don't even want to think about her surviving until then.

Despite her December deadline, the matter of fact is that each night without pain medication she literally just can't survive the pain. She crawls into a fetal position and just cries and hurts all night and thinks about suicide until maybe she passes out at 5-8am for a few hours.

She was talking about driving to Mexico on her own to see if people in that country would be more sympathetic and willing to help her. Needless to say, I don't think this is a good idea or would even work.

I'm really at a loss on what to do here. She's trying to be cold and push me away so I'll leave her and she can just kill herself, but I'm gonna do everything in my power to prevent that from happening. I'm thinking about taking a 3 month sabbatical from work to do everything I can and try to stop her from suicide. I'd call 911 when she attempts but she is so stubborn and prideful that I really belief her when she says she'll kill herself if they put her in a psych ward or mental institution.

I love her so much and she feels the same. When she at least HAS pain meds she can function and live a good life while coping with moderate but not soul-destroying pain. But without pain meds she can't even think because she's in so much pain and it's constantly in her mind, which is why she goes crazy like last night. She just can't think straight in this pain and can only think about dying to end the pain or getting pain killers to stop the pain.

I feel like it's wrong-time, wrong-place. With celebrity deaths like Phillip Seymour Hoffman and such, the government/DEA is tightening the grip more and more and pain killer prescriptions so doctors are afraid to prescribe them and when you're young and one of the 10-20% of muscle/nerve type odd injuries that don't really show on standard tests, well the docs say "sure you say you're in excruciating pain, but you're young, get some exercise and you'll be fine" and then they kill themselves.

Being completely open and honest here: I don't want my fiance to die. She's the most brilliant, hilarious, fun and amazing person I've ever known and I can't wait to spend the rest of my life together with her. I want to grow old together. I don't know what to do. I have 4 months, or more likely about a week or two.

Sounds like central sensitization in all it's glory: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/

It call be very challenging to manage especially when this have progressed to this extent. All clinicians involved in her case need to first be aware of what's going on to be able to treat her effectively. Treatment will involve a multimodal approach of physical therapy, medication, and cognitive behavioral therapy.

A good book to read on the subject is explain pain.

She of course has to get over the emotional distress to get to this point where she can be treated and then finally clinicians that are educated on identifying central sensitization and treating it is the other challenge. Good luck.

 

[Durask]

Sounds like central sensitization in all it's glory: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/

It call be very challenging to manage especially when this have progressed to this extent. All clinicians involved in her case need to first be aware of what's going on to be able to treat her effectively. Treatment will involve a multimodal approach of physical therapy, medication, and cognitive behavioral therapy.

A good book to read on the subject is explain pain.

She of course has to get over the emotional distress to get to this point where she can be treated and then finally clinicians that are educated on identifying central sensitization and treating it is the other challenge. Good luck.

I am a big fan of this theory.

Unfortunately...

IMHO, a lot of pain specialists just want to do procedures (meaning stick a needle into someone, charge the insurance anywhere between 1 and 5 thousand bucks and then run away). When it comes to prescribing medications, especially opiates - "Oh, no, I don't prescribe this kind of medication, you go back to your primary care physician if you want any medications, shoo, shoo."

In addition, it seems that a large portion of people with chronic pain also have various mental health ailments, which makes them very difficult to treat because not only they need a very good pain specialist but also a good psychiatrist.

 

[Bebpo]

So things got better for a day, but then tonight they got really bad again. She took a tramadol without telling me, even though that's what caused her seizure just to get some relief from a pain killer similar to vicodin. When it wore off she knicked herself with a knife too. She went into despair again, cancelled all her doctor appointments and gave up on everything.

She finally started believe that in addition to her chronic pain injury, that she may be suffering withdrawal from a vicodin addiction. She got pretty destroyed for a second and started doubting herself that maybe the shitty doctors were right that just threw her out and she isn't injured, but I know she is and every doc who touches her back/neck knows she is. She just might be addicted to vicodin on top which is making it worse.

For a half second she said "what do I do now? Go to rehab?" and I started looking at detox places. But quickly that few seconds of admittal of a problem vanished and she started going with the thinking that "Ok, if I am addicted than I accept that and I need to get more vicodin" and is refusing to think about fighting the addiction and getting off it instead.

From my research...a person can only detox at a center if they personally want it. Family and fiances and stuff can't force someone to stay at a detox center, right?

And from what I'm reading a psych ward 48 hour detention won't help at most places for suffering from an opiate withdrawal? I'm not sure if 911 would even come as she isn't actively suicidal and only knicked herself with a knife and took a pain med that only "rarely" causes seizures.

She needs a really good emergency treatment place that can take care of her actual injuries in her back and neck while detoxing her off opiate. And she will be fighting all of this every second of the way. So it needs to be something that is unfortunately done against her will, but otherwise she's going to be suicidal or do something really stupid to feed her addiction.

This is bad.

 

[Deleted member 102362]

I read your first thread a while back, and I am so sorry that this is happening. I wish I could offer something other than words of support.

 

[Ecto311]

Ever consider Kratom? I used it and my wife used it to get away from opiates and as a pain killer for various reasons. Worked well to get away from tramadol specifically for me. I learned about it from a story on vice about heroin addiction. It is super easy to get and even easier to get off of when/if you can.

 

[Bebpo]

The cops just took her away after she tried to drive into a wall and I stopped her and called 911. I don't know what is going to happen. It could help or it could just make things worse. :\

I'm going to the hospital in a few mins and they'll tell me what's going on.

 

[Kwixotik]

If you can find her some good indica, it might help.

Edit: didn't read the update. Good luck man, I hope she will get the help she needs

 

[SRG01]

OP, I'm reading the thread and:

1) A bad whiplash healed improperly neck injury with reversal of the curvature of her neck spine along with shortening of her neck muscles which can be healed through physical therapy but since she's in so much pain she needs pain killers to even do any PT; and

How on earth was this missed by the doctors, with MRIs and X-Rays? A reversal in curvature will show up quite easily on the X-Ray.

The cynical part of me thinks that no doctor is willing to give her a real diagnosis because they don't want to be liable for misdiagnosing her condition.

 

[yonder]

I have no words. Hang in there and do your best. Really hope that it gets better.

 

[Smiley90]

That belief is changing as more and more evidence piles up that fibromyalgia is a distinct and very debilitating condition. It certainly decimated my life.

OP, I don't have a lot of great advice for you, as I'm very much in the position that your fiance is in. I had no choice but to get on stronger pain meds and I hope that's a route you don't have to take because it's a massive double-edged sword and I'm always aware that the hourglass is running out.

I actually ctrl-f'd this thread for your nick to see if you'd posted. :x

 

[Tesseract]

we should start a chronic pain support thread, maybe i'll give it a go

 

[Koomaster]

It may seem odd, but perhaps seeking legal council would be beneficial? She may not be having problems with her insurance covering medical bills, but a lawyer who specializes in patient's rights could give advice about what to do about doctors/assistants who refuse to treat/prescribe medicine for her. That and also put you in contact with a doctor who may be more sympathetic to her condition.

See if there is any who will offer a free/cheap consultation. But even if you are out a couple hundred bucks, at this point it's worth it to try. And maybe a letter from a lawyer would ignite a fire under some asses and prove your fiance is in pain and serious about getting treatment and not another druggie.

 

[jb1234]

we should start a chronic pain support thread, maybe i'll give it a go

I'd be game.

 

[MarzipaNMOS]

Damn OP, wish you the best. I had a suicidal GF in college, bad grades, internship hunts, seemingly random social interactions gone badly, hard homework sets, family problems... would just cause that night to be hell. Had to talk her out of so many things, and found cuts in numerous places when meeting up with her if I hadn't seen her in a few days. She showed up once at my apartment just sobbing uncontrollably, I found out she had downed like half a bottle of vodka... spent the rest of the night vomitting in the bathroom. Its the toughest situation because emotionally you just can't relate, and the one thing you want for them is the opposite of what they want. She's better now but its hard to tell how long it lasts, because the warning signs and ability to snap back into that unhealthy mentality always seems to be lingering. It sounds like you're still in the thick of things, I really hope some kind of help or relief is found for her.

 

[Bebpo]

Went to the hospital but the ER is so backed up they said come back in a couple of hours so I got some food since I haven't ate and caffiene and gathered up all her meds and am going back. I hope this helps. My worry is that even if she's there 2-3 days, nothing will change and she'll just be more pissed off and determined to kill herself and she'll leave my place and I won't be able to stop her next time. The alternative was not any better since she kept trying to end it and it just got too close. This time she was sitting in her car faced at a wall and told me to take care of the cats before I jumped in front of her car to stop her.

OP, I'm reading the thread and:



How on earth was this missed by the doctors, with MRIs and X-Rays? A reversal in curvature will show up quite easily on the X-Ray.

The cynical part of me thinks that no doctor is willing to give her a real diagnosis because they don't want to be liable for misdiagnosing her condition.

It shows on the x-ray. Says slight reverse curvature of the spine in her neck area. But doctors are seriously like "eh, it's minor; no big deal".

 

[Liljagare]

Those traddies.. Tramadol does have a effect on your brain too, I went completely bonkers after getting them during recovery from surgery. I became a different person when I took them, just a thought here.

Sad story, and hope it works out well for you, life is hard enough as it is normally!!

 

[DEAD RABBIT]

Hi OP, let me say this first, I am not a doctor but I have a few uncles with medical specializations. One of them is a neurosurgical anesthesiologist. He is basically a paindoctor who utilizes medication and surgery of the nerves to alleviate pain. As you might imagine, this is a very very very specialized area of medicine with quite some risks involved. In the worst case scenarios they try to cut nerves through which cause the (excrutiating) pain without paralyzing the patient. A typical patient could be one with untreatable (through surgery/medication/therapy) back and/or neck pain. Now I am not saying that your SO should get this kind of surgery (I repeat I am not a doctor), but this kind of doctor is not going to cut up anyone's nerves without being absolutely one hundred fucking percent sure that there is no other way. These specialists know other doctors/specialists that treat patients with these kinds of problems from whom they get the referrals if their treatments do not work. Therefore there is a much better chance that they will treat your SO with more respect and seriousness for her symptoms. So try to find a couple of these paindoctor specialists (will not be easy) and ask them for the best course of action and the contact info of therapists and doctors who they recommend. I am not going to say this is a sure thing, but this is what seems logical to me.

 

[jb1234]

Those traddies.. Tramadol does have a effect on your brain too, I went completely bonkers after getting them during recovery from surgery. I became a different person when I took them, just a thought here.

Sad story, and hope it works out well for you, life is hard enough as it is normally!!

Tramadol has SSRI-like qualities, which is why it's dangerous to mix them with an antidepressant. I take them semi-regularly and experience no side-effects but I know a lot of people who have.

 

[Irnbru]

That really sucks man. Part of the reason my brother hasn't moved up here to the US to be a doctor in the states instead of Mexico ( he's a chief radiologist ) is exactly due to that attitude, well if I can't see it then fuck you I'm right becuase otherwise you can sue me and I don't have time for you because xyz. I hope she gets the kind of attention she truly needs and a specialist that can actually help man.

 

[Bebpo]

Was at the ER until 5am. The orderly first came out and didn't write anything much down and told me to repeat it all when the doctor comes out to talk to me and her dad. Hours later a nurse came out and said it had been really busy and the doctor would see us soon. At 4:45am a nurse came out and said the doctor went home...and this was at a pretty good hospital in the area. Medical efficient treatment is pretty bad in the US :\ There's so many people and everyone's busy and it's so hard to get good personal attention. I was like "uhh, the docs need to know certain stuff about her perscription psych meds, the name of her psychiatrist, stuff that aggravates the injury, stuff about HER SUICIDE ATTEMPTS" and the nurse is like "well, you can write it down on a piece of paper and I'll attach it to her charts".

When I asked if I'd get to talk to the doctor tomorrow then to tell him about everything that's been going on she couldn't give me an answer. She also said because I'm not married to her, she's not sure if I'll be able to talk to anyone. Which is fucked up as I'm the one who knows all her medical history for the past 2 years. I'm going back in 8 hours with her dad and I'll spend the next 2 days sitting in the ER room I guess.

I really hope they give her good medical attention and treatment. If they just keep her locked up, ignore her and treat her like a criminal and then let her out 2 days later, this will not have helped at all and only make things worse.

I didn't reply to my fiance's texts or her many, many calls because she was angry, they were angry and I thought anything I said right now would escalate and make her more pissed.

When I left I let her know that we'd been there all night, that they were kicking us out and I left detailed notes to support her facts, that me and her dad would be back tomorrow and we're there for her and to try to stay strong.

This is a shitty situation.

 

[Flambe]

Hope your gf gets the help she needs, Bebpo. I know firsthand how hard it is to be the 'rock' in this kind of situation and how emotionally draining it can be over prolonged periods of time.

If it's possible to trade off with her family or whatnot please try and take a breather and do something for yourself. It's tough and you'll probably feel selfish but it's a tall order to take care of someone all the time and be 100%. A little recharging can help you refocus and do a better job in the end.

I know you're worried about her suicidal threats but if your hospital's psych department is worth a damn she will hopefully get some of the help she needs. It's a good thing that she's in a place where she's under watch by trained staff and if they see her obvious pain they can refer her to someone that can assess that part of it.

She might be pissed off but you absolutely did the right thing in calling 911. You can't be expected to watch her 24/7 through numerous suicidal attempts and no help.