I am employed by the Postal Service. My original onset of pain was accredited to Repetitive Motion. OWCP accepted the original condition of Cervical-Thoracic Sprain/Strain. I started out going to the Company Doctor, who was under contract . He was an Occupational Medicine Doctor, so I thought this would work out. After a few months had gone by, he frequently would change my prognosis and treatment after phone calls from my supervisors. Finally one day, I challenged him on that practise. He was outraged that I would even think to question his professional integrity. I told him I would be finding a new doctor that I could trust.
Doctor two was the greatest. He was one of those doctors you only hear about in fairy tales. If I wanted to sit and chat with him for 45 minutes, he sat and chatted. I never left his office with an unanswered question. I never doubted my treatment or the medications he prescribed. He did prescribe a few treatments that OWCP would not agree to. I really believe that if they had just allowed those treatments way back then, that I may have been able to go back to my job. Without the treatments, (all OWCP would allow was medications & Physical Therapy), my condition just continued to get worse. This doctor retired after I had been seeing him for over 3 years, and I had to find a new doctor. I had gone to Massage Therapy which was the most beneficial for pain relief even though that relief was short term. I also went for PT (three different times), Bio-Feedback, accupuncture (Out of pocket), pain management, MRI and Cat Scan. This doctor also sent me to four specialists for their opinions.
Doctor three was picked out of a list of possibilities given to me when #2 retired. He was an orthopedic Surgeon (So was #2). OWCP felt that since my condition involved a bone (SPINE) that I should see a bone doctor! This new doctor thought I should be at a neurologist, and sent me to one on a consult as soon as I started to see him. The neurologist felt that the MRI did not show enough damage or nerve impingement, so he ruled out surgery. He sent me to another doctor who was a Pain Specialist/ Anesthesiologist for a couple rounds of spinal injections. Both caused such severe headaches for 2-3 days that he decided not to do any more. Back to #3 for more of the "STANDARD PAIN MANAGEMENT", pain medications and muscle relaxants. I saw doctor #3 for a few years of pain management, but no other treatment beside the regular, "Let's try some more PT.". Doctor 3 went to Switzerland for a vacation and decided he might not come back for a while. This office also held up most of my paperwork, OWCP didn't like that, and I made another doctor switch.
I am currently seeing doctor #4. 1, 2, 3, & 4 were my "Treating Physicians", and beside them, I saw many others for second opinions and consultations. #4 is a Pain Management Physician, and is an AAPM doctor. He came highly recommended for a couple reasons. He is a professional witness in many cases concerning patient's rights and pain medication usage. OWCP agreed to him because by now my condition was accepted as chronic and permanent. Through #4 I have been continuing to use pain medications and muscle relaxants. He also lets me come in whenever I am in a pain flare up and get trigger point injections. He is my current treating physician. He also sends me to a chiropractor as often as I desire to go. As long as it helps even just a little bit, I will go.
The Vicodin has been about the only pain med I have ever used. I use Oxycodone, but it makes my stomach churn. Not like nauseated, but some weird reaction to the stuff. I had used oxycodone once when I broke some fingers and toes, and I had some very vivid hallucinations. I do not get pain relief from the Vicodin to a point where the pain is gone. I do get enough relief to carry on a sub-normal life. I go to work for eight hours a day, where I do very little physical work. If I was not able to take the Vicodin, I do not believe I would be able to continue going to work. I do not get high from the medications I take. I don't get even slightly buzzed, I just use them to relieve the pain enough to make it through a day.
The Soma relaxes the muscles in my back and shoulders to a degree. They do not help with spasticity at all. I have a constant battle in my shoulder and neck region. There is a tug of war from one side then the other, and then the muscles in my entire back react to that tug of war. I had tried ZANFLEX 4 mg, but got so drugged that I couldn't function at all. I would take 1/2 of a pill, and would fall to sleep. I tried to take it down to 1/4 of the pill four or five times a day, but never got the needed effect unless I took to whole pill QID. That was too much. So I tried BACLOFEN 10 mg. Same thing as the Zanaflex. I couldn't function if I took the dose needed to get the Anti-spasticity effect. It made me too sleepy. Then I tried Chlonidine 0.1 mg. It is usually a hypertension medication, but is used as a adjunct with pain meds. It made my heartbeat drop to about 45 beats a minute, and caused my blood pressure to bottom out. So, after trying all these other things, I am back to the Soma.
The Ambien 10 mg is one of the best things that ever happened to me as far as treatments go. I sleep pretty good with Ambien. Without it, I was sleeping poorly, and never getting any rest. I do seem to be more rested in the morning now, but think I could do a lot better. I also have sleep apnea, and can't sleep on my back at all. Sleeping on your stomach is the worst thing you can do when you have a bad back, but I would rather do that than stop breathing. I have been to two sleep studies, and have tried the CPAP without success. So, I am destined to poor sleep as long as I live unless they come up with something better. CAUTION. Ambien can make you do some pretty weird things. When I first started taking it, I had five episodes of blackout. The 1st night I took it, I sat on the edge of the bed to take off my shoes and went out like a light. I woke up at 5:30 AM still on the edge of the bed. The lights were still on, and it dawned on me I never made it to bed. I sent e-mail that I don't remember sending. I bought some things with my credit card that I don't remember buying. I'm glad I never got in the car while under the influence of Ambien. I have been taking it for four months now, and those side effects seem to have disappeared. My advice to anyone starting Ambien would be, take in while you are in your bed. It works so fast, that you could fall down and not make it to the bed otherwise.
I go for trigger point injections as often as needed. There are about four points that seem to bother me more than the others, and lately I go in about once every three weeks for injections.
I use a Saunders Cervical Hometrac. It's a pneumatic cervical
traction device. It's kind of bulky, but it does what the old over
the door traction unit does without pulling on a jaw harness and
causing TMJ on top of everything else. You lay on the floor and
set your neck in a cradle, and then put on a headband which is
attached to the unit. Then you pump up this hand held (bike pump)
pump until the proper weight in pounds is reached, and lay there for
10 minutes or so. It has provided some relief from stiff neck.
I also use a Thera-Cane. This is a hook shaped stick. You position
the end of it over pain or trigger points and apply pressure. It's
like a self-administered massage or accupressure treatment. I've had
this thing for about seven years, and use it daily.
Finally, I use a TENS unit. I would use it daily, and all day, except the adhesive on the pads makes my skin itch after a while. I have had the tens for nine years. I use it mainly on days when I am having an accute flare up of pain. I put on four pads, and set the tens to where it is just barely at a point where I can feel the buzz from it. I keep it on all work day if my skin can handle it. It takes the pain down to tolerable. When I am at home, I use it for the same purpose, the flare ups. When it's real bad, I turn the tens up until just under the muscle spasm level and leave it on for 10 -20 minutes. It helps a great deal.
ROLFING - I can't believe I didn't put this in here earlier. This is torture. I guess the theory here is to realign the body and posture so everything will work under the least strain. It's a manipulation that you might compare to a massage for torture purposes. The practitioner, in my case anyway, used his elbow to dig in at certain places where there was a supposed buildup of scar tissue. The manipulation was going to break up the tissue, and it was supposed to return to a more flacid, or relaxed state. The Rolfing was on one side of my back one week, and the other side the next week, so the normal balance could be restored to my body and posture. He also worked on my legs and arms, and for the most part, almost every part of my body was manipulated at one time or another during months of treatment. Some days I would go home feeling pretty good, only to have such intense pain the next day, that I wondered why I ever kept going back. What made me decide to quit this torture was, he put all his weight on one elbow, directly on my spine. I told him it was hurting, but that was supposed to hurt, as he was breaking up the tissue. My back has hurt worse than ever since that "treatment". I don't really care if my posture is good, if it means being tortured one day a week, and hurting for 2-3 days afterward. Want my opinion on ROLFING? Keep your money and go get a nice relaxing massage instead. It's more beneficial. I think Rolfing is another one of those new treatments someone made up to get some more of our money. It hurts, and you lose a lot of money.
ACCUPUNCTURE - Never felt any relief from this. I went for three months, so I can say I gave it a good chance. There may be more experienced practitioners than the one I went to, but since I never felt any kind of relief, I would never go again.
BIO-FEEDBACK - This is great for relaxing, but BS as far as pain relief goes. I had a portable unit to connect myself to, but since I was at work, and not in a Lazy-Boy in a warm dark room, I couldn't get comfortable or relaxed. When I went to try this in the lab for the first time, I was told I could "Will" my body temperature to change by seven degrees, and would do excellently at it. Sure, as long as I was in their lab, but out in the real world you can't find the same conditions to relax in.
I USE THE FOLLOWING, BUT YOU CAN'T JUST JUMP IN AND TRY THEM WITHOUT DOING A LOT OF STUDYING FIRST.
HERBS & "DIETARY SUPPLEMENTS" - Don't get me wrong on this. There
are many herbs that have potent properties. I studied herbology,
herb-collecting, and mushroom-collecting for a couple years. I even
did a field study for two months as part of this education process.
The problem with using herbs and supplements is, for every this you
take, you might need to take two thats to counter some effect of the
this. Did you get that? Some vitamins or minerals totally block the
effect of herbs and supplements. It's just that by the time you get
everything together to get the effect you are after, you have spent a
fortune, and you are taking capsules, decoctions, and potions all
hours of the day. Many of the herbs you buy that aren't regulated by
anyone are dangerous and or poisonous. Some that you buy are totally
worthless, because you would need to use the whole bottle at one time
to get the needed dosage, but the seller couldn't tell you that or you
wouldn't buy his product. So, he says just take one or two a day with
meals and it'll build up in your system and give you the proper
effect. Not true. This is something that you have to put your mind
to. Don't ever take something you haven't studied about. The worst
thing you can do is listen to someone who really believes they are
giving you good advice, and start self-medicating based on their well
intentioned, but often bad advice. I was an emergency room paramedic
while in the service. I was stationed in Italy, and treated a lot of
young GIs that had used some "natural" herbs they had heard about from
Italian aquaintances. These herbs were hallucinogenics when taken in
very small doses, but deadly poison when taken if slightly higher
doses. "Natural" can still kill. It doesn't always equate to healthy
just because it's natural.
I do use vitamins and minerals, and continue to try the latest releases
as far as supplements go. Like everything else, what works for some
might not work for others. It seems like whatever gets on 20/20 or one
of the shows like it becomes the hottest item and wonder cure. Like
St. John's Wort. It used to be in most health food stores for about
$2 or $3 a bottle. It showed up on TV with all the latest claims, and
now you pay $8-$10 for the same thing. Same with DHEA, 5 HTP, and
some other recently touted wonder medicines. I won't suggest you don't
try them, just be ready to pay big money for them, and don't get too
excited about being cured right away. Also remember, like any other
drug you introduce into your body, there may be precautions you need
to know about. Just study them before you start popping them into your
mouth.
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