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02 May 2006

Relief

Relief:The easing of a burden or distress, such as pain, anxiety, or oppression. OR Something that alleviates pain or distress.

Relief is a wonderful thing. Pain is distressful. Distress leads to more pain. Vicious cycle. But when you finally find someone willing to listen, belive and treat your pain, they become an important member of your healthcare team.

I've struggled for some time finding docs who not only listen to me but actually believe my pain. A doc may listen, but not feel I'm in pain because lab tests don't show a reason for that pain. Another doc may fully believe me but not believe in doing what is needed to treat my pain because of fear of addiction, which is another story in and of itself. I've been shown to have no addictive tendancies. I had no problems going of of medications when I lost health insurance. I went cold turkey without withdrawal from the ones that were safe to do so and I weaned off of the ones that needed to be removed slowly.

In March, I saw a doctor so uncaring that she refused to treat my RA because of medicine toxicity. Yet her notes say it is because there is no current indication of disease activity. I'd told her there wouldn't be any from my lab work as my labs are always good. It's part of having sero-negative JRA! That whole sero-negative thing is something some doctors tend to ignore! The only thing this doctor would do is give me an anti-depressant for treatment of fibro. And a script for water aerobics. Now, how is someone who is in enough pain that they do not do not go to the grocery store without someone else to be able to do a water aerobics class three days a week? I also told this doctor that anti-depressants have done nothing for me in the past except make me nervous, jittery and caused me to clench my jaw in my sleep. She insisted this was the way to go. I asked for muscle relaxers. Her only offering was one that never helped me. But when I mentioned a specific one that I know worked she said no. Then put in my records that I reported no help from any muscle relaxants.

Needless to say, she is no longer a doctor I visit. I found a pain management specialist to treat what was the biggest problem for me. Pain. He started out by first listening to me, then asking what had helped in the past. He then examined me and we discussed his thoughts on treatment. He wanted an MRI as soon as possible and asked me to see a different rheumatologist. He then gave me the medications that have helped me in the past. He called me not more than three days after the MRI to give me the results. I've never had a doctor personally call me with results. He also asked how I was doing, if the meds were helping etc. When I said that they were but that one is not covered by my insurance, we discussed alternatives. He offered to do more for my back but I was leaving for a trip so I declined at the time. I was asked to call him when I ran out of one of the medications so he could give me the replacement medication. I did as he asked and the nurse didn't think he'd call it in since it's a medication used to treat pain, although it isn't a pain medication specifically. He returned my call and again asked how things were going. Asked about the new rheumatologist.

At my second visit we looked at the MRI results which is something no doctor has done with me since childhood. During my childhood, I got to see the films as the doctors discussed them with my mother and me. But ever since, I've not seen the films and only received reports of tests but never a discussion of them. Part of that is my own fault for not speaking up. We then discussed that while the discs etc all look good, I do have a problem with lumbar facet joint arthritis that seems to be the cause of the pain in my lower back. We decided to try nerve blocks and if those were successful, we would then do a radio frequency neurotomy.

I had the first set of nerve blocks last week, and today I have the second set. So far the first set has provided quite a bit of relief. Things are not perfect by any means but I've been able to do more bending and things like that. I do find that this is one doctor I trust. Well enough to "jab needles in my back" after 2 visits. I described the procedure that way for effect to my close friends and family. He seems aggressive at treating my pain to an extent but not more aggressive than I am comfortable with. We discuss things together. He fully explains things to me as well. Although I could do without hearing "Hand me a 6 inch needle" as he's doing nerve blocks.

I also visited the new rheumatologist last week. He seems wonderful as well. He also listened. Then we discussed why the last rheumatologist didn't give me meds for RA. I explained to him that for me, I know all to well the consequences of not properly and agressively treating RA. I have less worries about medication side effects than I do untreated RA. We discussed results of the last set of x-rays, doing more x-rays, the treatment plan in place by the pain doc. And even where he wants to start with treatment. So, as soon as my labwork is in to make sure I have no liver issues, I start 10 mgs of Methotrexate weekly by injection. Then we will raise it and add more if need be. He also decided to give me a cortisone injection in my right shoulder and ordered 8 new x-rays as well as a Dexa scan for osteoporosis.

I'm hoping today goes as well as last week and then we can go from there. But feeling relief is a wonderful thing.

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