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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.”
