Baxter's not the only one with problems

Peggy had an ovarian cancer scare last month after her yearly physical, but blood tests, two ultrasounds, and a visit to a surgical gynecologist made it seem unlikely. The only way to rule cancer out completely would be an ovariectomy, but her surgeon recommended against it. Peggy had initially said, “Get this thing out of me!” but she trusted her doctor enough to leave it in.

Yesterday, I went to my orthopedist, Mark (see photo), because my own pain has been through the roof lately. Of the many narcotics I’ve tried, I still have a good supply of Vicodin, Norco, Percocet, and Demerol, but none of them help much, and they sometimes make me very ill. I also have the sleeping pills Ambien, Lunesta, Restoril, and Dalmane, all of which work better than the narcotics.

When I go to a doctor, I usually give him a written overview of why I am there, and what I want done. Mark usually does everything I ask. Yesterday, he gave me a steroid shot in my left shoulder, a prescription for Tramadol (a painkiller), and a humongous prescription for the sleeping pill Dalmane (Dalmane is so good that I call it "The Great God Dalmane.") He also agreed to hyaluronate injections (a joint lubricant).

I love Mark. If there were only one thing that I could counsel you to do if you should need surgery, it would be to find a surgeon whom you trust technically and as a caring human being. I’ve had the uncaring kind twice, and I promise you, if you don’t like your surgeon before surgery (no matter how good everyone says he is), you will want to murder him after surgery when you are overwhelmed with pain and despair, and he doesn’t give a rip. I can’t overemphasize the importance of having a good rapport with your doctor. The following is what I wrote for Mark yesterday.

“Pain in my left shoulder still awakens me many times each night and requires ice. Pain in my right shoulder also continues to be a problem. At times, it bothers me almost as much as the left. Bilateral shoulder pain in combination with bilateral knee pain has made both hiking and handyman projects disagreeable if not impossible.

“I saw a pain specialist in April due to shoulder pain and to sunburn-like pain in both shins. My internist said I had Chronic Regional Pain Syndrome, but the pain specialist suspected syringomyelia, and prescribed Neurontin and Tofranil. They helped the shin pain but did nothing for the shoulder or knee pain.

“I am here to get your thoughts about the continued left shoulder pain in particular, and a recent and severe increase in pain in both knees and both shoulders.

“I would also like to discuss alternatives for pain relief. The narcotics I’ve tried don’t help much, and they make me itch too much to sleep. Sleeping pills continue to be my best option—especially Dalmane—but the pain still awakens me ten times or more times each night.

“I read that Tramadol is sometimes used for moderate to severe arthritic pain, and would like to try it. Ultrasound is another option, but I haven’t found anyone who uses it, and my PT said the home units are a waste of money. I would also like to talk about hyaluronate injections—read the enclosed info at your convenience.

“I’m wondering if steroid shots might also help, although I’ve had mixed results from them in the past. I’m especially concerned about any harm they might do to joints.

“I’m now more open to the possibility of partial shoulder replacements, although I had rather pursue any reasonable option before agreeing to a joint replacement.

“In the last nine days, I’ve intentionally lost four pounds to make things easier on my knees, and I’m experimenting with a gluten-free diet. Other ideas would be appreciated.”


The Bipolar Diva said...

Geeze Snow, you've had much more than your share of crap happening lately. I think about you all the time, well everyday to be truthful. That's a great idea writing everything that you want to discuss with your Doc. I seem to forget half of what I want to say.
Thank goodness you like your Ortho. We have a great one too, it's a good feeling to know that someone in that position really cares.

<3 Teri

Sonia ;) said...

I always walk in there with notes to discuss with my doctors, I learned that from you back last year buddy. It has helped alot because of the fibro fog my memory is pathetic most times short term any way. Been better lately but Im at the highest dosage right now of that new drug "Savella" for the fibro. Works great. I still get aches and pains but not like it would be without it.

Went to Dr on tuesday for the allergies that have been kicking my ass. Im allergic to mold and we have had a lot of rain here. So nasonex to the that shit. LOL....Went over the usual and how Im back home now working thank gawd. That office was killing me being cooped up in the cubicle. Not like a cubicle u see on the office smaller enough for a chair and the desk built in.

But Im home again in my jammies and free to move around and cuss when no one can hear me. LOL

Love ya buddy..think of you everyday, ok every other day...LMFAO...kisses xoxox

Myrna R. said...

I hope your writing distracts you from your pain. Pain is so pervasive. May you feel better soon.

All Consuming said...

I know where Peggy is coming from, however sounds like her doc has made a good call there. Much love to her.

“Dalmane is so good that I call it "The Great God Dalmane” ….tell me more of this god of yours.

“I promise you, if you don’t like your surgeon before surgery (no matter how good everyone says he is), you will want to murder him after surgery when you are overwhelmed with pain and despair, and he doesn’t give a rip. I can’t overemphasize the importance of having a good rapport with your doctor”

I guess in a way it’s trial and error whether you pay or not. I’ve had no choice in my surgeons, one made a mess over 4 ops one kept me here; I put all my trust in the consultant, of whom I now have a brilliant one…. Lord, it’s all ‘me, me,me’, back to you hon, I get the itching from pills too, drives me nuts mc nuts, tsk, sometimes the side effects are almost as bad as the damn pain. Not often though.

Great to hear about your relationship with Mark, he sounds like one of the good guys, and there aren’t all that many in my experience. For the record, you’re one too, no, no, you are, stop denying it…. hahahah.

Have you had much in the way of physiotherapy? I have always hated it myself as it doesn’t make my condition better, though it does I have to grudgingly admit mean I can move more. I can move more with the same pain. That is better though. Gah.

My thoughts are with you sweetie, and lots of others are thinking of you too… positive-vibes Ville, Tennessee. Love Michelle xxx

kylie said...

"Say what you will, much of life is lose/lose. Much of life is about making the best of the worst."

lucky you're good at making the best then, snow cos you're having a rough ride. this too will pass


Marion said...

Bless your heart, Snow! I sincerely hope you can get some relief. I'm really depressed about my knees/back. My sleep medicine no longer works and now I'll have to try yet another drug. It's frustrating to not sleep or wake up feeling groggy/drugged. I know you understand how that is. My pain is manageable in the daytime, but at night it just screams for attention, as you know that, too! I hope you get some results from your doctor. I hate that you're still feeling so badly. Sending your good thoughts, vibes and prayers for recovery. Love & Blessings, my Friend! xoxo

Lorraina said...

Botox injections. It's said to work wonders for pain.
I was scheduled to get it and waited almost a yr for the apt.only to find out that even though my pcp specifically requested it; it wasn't available at the hospital that she had sent me to!
Ask if it's available and don't let them talk you into substituting epidurals instead (they didn't work for me)
Botox works by freezing the offending pain nerves with no bad side effects. (or very few) Google it. Hope that helps.

Crazed Nitwit said...

Tramadol is a non narcotic drug and is supposedly non addicting. From medication is used to relieve moderate pain. It is similar to narcotic pain medications. It works on certain nerves in the brain that control how you experience pain. It is not even a schedule 2 med. Just FYI.

Elisabeth said...

This is scary stuff, Snow. You sound like a walking pharmacy. I hate to think what pain can do to an otherwise fit and healthy person.

At this stage I do not warm to my orthopaedic surgeon for all the reasons you suggest, but hopefully I won't need surgery for my fractured tibia.

However, if the bone moves and I need surgery, on the basis of your advice here, I'd better start looking elsewhere.


Bernie said...

So glad all worked out well for Peggy....phew that would of been frightening.
I don't think anyone could suggest anything for you Snow, you know more about pain and medications than my family doctor. I do hope you are feeling better now...Hugs

RNSANE said...

Well, Snow, you know best how to take care of yourself and, through trial and error, you seem to come up with a medication regimen. You seem to do your doc's work for him. Maybe that's how it has to be, really. I have sort of given up on physicians! I take Tramadol myself in the evening and Vicodin at bedtime. I do all right sleeping a few hours a night. Once in awhile, I take an Ambien. If I could afford it, I'd get a massage every day!

Zuzana said...

I am happy that your wife is fine. I am sure it is a relief for you both... And I am so sorry that you ailing health is such a contributing factor to prevent you from smiling...
Mark seems like a nice guy - he listens and pay attention. That is very vital in a physician. My parents were both loved doctors and that is what the patient would always appreciated most about them - they listened...
Thank you for your kind recent comment on my blog.;) Have a nice weekend,

Betsy said...

Hi! Thanks for visiting my blog and commenting! Now I can come over and meet you! :)

Looks like you're dealing with some serious pain! I have arthritis in my thumbs that keeps me awake. I got cortizone shots in them last year which helped immensely. Now I can magage fairly well with Advil.

Your Baxter is a sweetheart! :)

Pat - Arkansas said...

I'm glad Peggy's scare was only a "scare," but I trust she and her physicians will be keeping their eyes open for any changes.

I am so sorry to know that you continue to be in pain despite some powerful medications.

Just_because_today said...

Gluten free...Snow, won't Vodka work better?
I know what you are saying about doctors. I had the ortho doc who talked to me everytime as if it were the first time, he never read my chart. I also have a specialist (for something else) who makes me feel I am his favorite and only patient even though he works for one of the better known places in country if not the world. What they have, it's not learned in school, it's the human nature they posses.

Simone said...

Hi Snowbrush,
Thank you for dropping by my blog and saying 'hi', I appreciate it, hope you will come by again when I have it more together.

So sorry to hear about all your pain, physically and emotionally. None of it seems fair somehow. Thinking of you.

Snowbrush said...

Oi, I am so far behind with my work that I'm just going to address questions this time.

All Consuming said: "“Dalmane is so good that I call it "The Great God Dalmane” ….tell me more of this god of yours.'"

Dalmane is in the same class of drugs as Valium. It's strong, it's mellow, it's cheap, and it doesn't leave me hung over the next day. It also works all night long instead of for four hours like some sleeping pills. I don't know why you don't already have it. Restoril is similar to Dalmane, but I like Dalmane better. Maybe you would prefer Restoril--who knows. The advantage of Restoril is that I can take two of them if the first one doesn't do the trick, whereas I'm already at the maximum strength for Dalmane. However, I got the two mixed up for two nights in a row while camping, and both nights I double-dosed on Dalmane with no apparent ill-effects.

Just_because said: "Gluten free...Snow, won't Vodka work better?"

The theory behind avoiding gluten is that gluten promotes inflammation, but I can't find any evidence to support this effect in relationship to osteoarthritis. Rheumatoid arthritis is another matter, and avoiding gluten is a medically established way of dealing with it. However, I live in a city in which all kinds of gluten-free grains are available, and I love to bake, so going off gluten for a month won't be a hardship. As for vodka, alcohol interferes with REM sleep. In my experience, it kills pain rather well, but I don't like the prospect of waking up at 4:00 a.m. and having to pour myself a couple of stiff ones to get back to sleep.

Marion said...

What a relief for Peggy and you! I trust the physicians will keep on top of the ovarian cancer scare.

Mark looks far nicer than most of the doctors I've seen...he looks like someone who is easy to talk to.

I like the idea of your letter. I'm going to try it. My mind goes completely blank when I visit my doctor and you'd think I had not a thing wrong with me.

Love to both you and Peggy...

Leah said...

Hi Snow--I've read back a few posts. I really enjoy your religion posts, and the comments and responses (although the term "zionist" used as an epithet has some negative resonance for me...but that's a discussion for another time). I love opinions different from my own, especially on that topic, and especially when they are well-reasoned.

I am very sorry to hear about Baxter, though. Very sorry indeed. It is gut-wrenching, truly.

Also sorry about the pain.

I have to agree--lose-lose and make the best of it. I think more and more that life is pain and suffering, fragile and difficult. I am constantly looking over my shoulder, so to speak.

Laggy said...

Hey Snowbrush, I saw you commented on my page. In response:

I was thinking Bend, Oregon Coast, Northern Idaho, Big Sky Montana, Snoqualmie/Northern Cascades even Girdwood or Alyeska, AK..I just need to find some part of myself that can't possibly exist in a city.

I never own a house, always rent, because I don't find any solace in owning a piece of city property. I would rather "own" a spot in nature for a few days, then move on.

A lot of my struggle involves letting go of unnecessary material goods. My last big thing is my car loan which is $400/month. I would kill to have a mid-90's Toyota 4x4 and $5K in my pocket.

I'm sorry to hear about your chronic pain. My older sister has been embittered by chronic pain and illness. At least you try to get out and fight it. The healing is in the hope and the effort. The healing is in knowing that one good move, will net another.

Snowbrush said...

Thanks for stopping by, Laggy. I too used to envision a simple rural existence, and even built a house in the woods in which to pursue it. I later discovered though that, for me, it's better to live in town and visit the woods than to endure the isolation of the woods and visit town. Also, at age 61, I need both health insurance and ready access to good hospitals and diverse medical specialists. It's funny how inconsequential such things once seemed.

A reader of my blog recommended a book to me recently, and I will now recommend it to you: "The philosopher and the wolf: lessons from the wild on love, death, and happiness" by Mark Rowlands. His thoughts about our society being based upon legal contracts and why that's a bad thing represent the first ideas I've come across in a long time that I had neither thought of nor read about.

Simone said: "...hope you will come by again when I have it more together."

Yourself or your blog? Ha.

Marion said: "Mark looks far nicer than most of the doctors I've seen...he looks like someone who is easy to talk to."

He's not moody for one, and that's damn important to me because I've had a couple of moody surgeons by now. I approach doctors whom I respect with the thought that I need them more than they need me.

Betsy, I'm delighted that the cortisone helped so much. It apparently got you over some kind of a hump.

Snowbrush said...

Sonia said: "I always walk in there with notes to discuss with my doctors, I learned that from you back last year buddy."

I don't just take notes, I take readouts for the doctor to read! I edit them carefully though.

Marion, I'm so sorry for your pain/sleep problems.

Kylie said: "this too will pass"

Or get worse. The downside of many chronic problems is that time, drugs, surgeries, physical therapy, etc. don't heal.

Snowbrush said...

Nitwit said: "Tramadol is a non narcotic drug and is supposedly non addicting."

Interesting. I read that it's very addicting (especially when combined with alcohol), but I don't worry too much about that kind of thing since I've never had to face it. It's funny, though, how I had to go to the pharmacy in person for the Dalmane but could have the Tramadol prescription faxed. I used to think that any prescription that had to be hand delivered must be some kind of good shit, but I've rather lost confidence in anything being all that good. I mean, it's not like you can take these drugs and not even notice if someone sets your arm on fire.

Pamela Terry and Edward said...

I cannot imagine how difficult it must be to live with that kind of pain. I had migraines for years and often thought, in the midst of one, that life would really be not worth it if this was my everyday situation.

You are fortunate to have a doctor you like as well as admire. My internist is that way and I'm grateful to have him in my corner. He's been my doctor for years and I can communicate with him, which is a big deal.
He's also someone I actually like. Bonus.

dana said...

This is the first time I've ever read anyone mention "sunburn" like pain!!! I've even avoided mentioning that to anyone because it sounds crazy, but the pain in my joints can start out feeling like I've been injected with acid. It BURNS horribly! Then the pain switches from burning to jabbing and you know what I'm saying.

As for tramadol, like all narcotic pain relief, I always start out liking one, then either nausea comes, or intense itching, or it stops working.

Cortisone injections for our joints is painful to have done, brings relief, but are limited to how often and how many you can take, AND AND AND, cause irreparable osteoporosis and YOU CANNOT HAVE JOINT REPLACEMENT IF YOUR JOINTS ARE DISINTEGRATING.

hope I helped and caused no damage.

Snowbrush said...

Lorraina, thanks for the botox tip. I have no idea if that would be appropriate, but I will look into it.

Elisabeth, thanks you for doing me the honor of taking my advice seriously in regard to choosing a surgeon you trust. I'm up to maybe 15-20 surgeries by now, most of them over the past ten years, and that gives a person a lot of time to learn and reflect.

Sonia said: "my memory is pathetic most times short term any way."

And then there's the emotional element. ANOTHER THING PEGGY AND I DO THAT HELPS TREMENDOUSLY IS TO GO TO THE DOCTOR TOGETHER. This gives us two heads to remember and two heads to formulate questions.

Pamela, Peggy has migraines. I would guess she gets about three a month, but each one can keep her miserable for days. Do you have any good tips? The best thing she has found so far is a drug called Zomig, but she has to take it before the headache gets too bad.

Dana, my sunburn-like pain is along both shin bones as if the bones themselves are burned. As for cortisone, I've had needles stuck in my joints that all but left me in tears, but Mark has a good way of doing it. He first sprays the area with the cold stuff; then he injects the joint with lidocaine, and then he injects the steroid. Part of what hurts about steroid injections is that the stuff is really thick and the needle is really fat, but, this way, the lidocaine shot--through a little needle--is the worst part of the ordeal, and it's not too bad at all.

nollyposh said...

i know exactly what you mean i have a wonderful surgeon who is also a fabulous human being... This is the way it should always be in my book but sadly i hear too many tragic stories

Winifred said...

Take care with the tramadol. My husband took it in hospital after his operation and he had hallucinations. At home he was terrified, as he was dropping off to sleep he thought he was drowning. Think it affects everyone differently.

Snowbrush said...

Winifred, you were right about the Tramadol. That stuff kicked my butt. First, I was euphoric, which wasn't bad at all, of course, until it went on well past my bedtime. I was wide awake most of the night as images passed through my mind so vividly that they almost qualified as hallucinations. Then came the dizziness, the nausea, and a generally unwell feeling that continued for the next two days. Now, I have a bottle with 89 Tramadol that I'll never take. Great!

babbler said...

Mr. Snowbrush,
I am delighted to report that you are #100 on Adventures of Mr. Slug and Friends. Mr. Slug is now in school again and appreciates your visit greatly. We are apart tonight as school is 3 hours away by car. I will now have more time to post new entries, so I look forward to your visits in the future. It may interest you to know that I played a tympani very loudly last Thursday evening during a concert that featured the music from Man of La Mancha. It made my week. You should try hitting some drums from time to time, you may find solace in music, a pleasure that exists nowhere else that I have found on Earth. Congrats for being my #100 milestone! That should improve things for you in one way or another, yes? Sending extra slimy and comforting goo your way! Love, Mrs. Slug

Snowbrush said...

Mrs. Slug said: "...I am delighted to report that you are #100 on Adventures of Mr. Slug and Friends."

Why thank you so much for pointing this out, Mrs. Slug. I never win anything, and here I've won jury duty and your 100th follower award in just three days.

Mrs. Slug said: "You should try hitting some drums from time to time, you may find solace in music..."

That's all very well and good, I'm sure, but the neighbors might not find it so solaceful. Besides, the last person who recommended that I take up a musical instrument is dead. Of course, he played the guitar and died of cancer, so there's no obvious connection, yet I can't completely rule out a non-obvious connection.

Mrs. Slug said: "Congrats for being my #100 milestone! That should improve things for you in one way or another, yes?"

If not in EVERY way, my dear Mrs. Slug. By the way, I recommended that someone who responded to another blog today visit your blog. I did this because she likes slugs.