Thursday, March 11, 2010

And now, the medical report...

The reality of yesterday's events is that I went to see TWO doctors. First was my PCP, and the other was the pain specialist.

Early in the day, I saw my PCP and cleared up some of the facts about my knee. It is, in fact, the right knee with the tear in the medial meniscus. This means we are all officially baffled as to what's going on with my left knee. Once again, I reviewed the fact that I'm in pain perpetually, and that one of them there bones is shifting around. The NPR that I see said it all sounds like a tear, but there's nothing showing on the right side. As for the right knee, I made it clear that unless I make a specific move, it doesn't bother nearly as much. So I will engage in physical therapy while we seek a different specialist...

...because there is no way on Earth I'm going back to see that callus S.O.B. You want me to be a good patient? Treat me with respect. Don't act as though I'm stupid. And don't contradict my every complaint. When I say it hurts, it hurts, and all the reports you have that tell you nothing is there mean very little to me. I'm in pain. I'm taking FAR too many pills to get relief. When I plead for help, don't dismiss me as though I'm idiot who "obviously doesn't know what he's feeling."

We discussed the potential danger of seeing the pain specialist and getting an argument over my pain meds. The fact of the matter is that I've been on them for two years. There's a good chance stopping them rather suddenly would be outright dangerous. So just to cover my bases, the NPR wrote for more of my pain meds, as well as insulin, a VERY small script for Valium for my next eye appointment, and penicillin.

*sigh* Here's why I can't go to the GitP meet-up. My mouth is in bad shape. My gums are receding so much that my teeth are coming loose, rotting, and becoming infected. This is a combination of genetics and diabetes, so I need to get my mouth...replaced. I refuse to be a toothless wonder, unable to chew real food. And the cost of replacing my mouth, according to what I was told at the dental clinic, would be close to $2,000. I'm in a bad way now, so G-d only knows how much discomfort I'll be experiencing by the time I have all the money saved up. Add the fact that I'll pretty much need every single tooth pulled, and I'm going to be a miserable camper for about a month or so sometime in the future.

Back to doctor visits...

The pain doctor was an okay guy, with an accent I couldn't place, and a slightly offbeat sense of humor. While trying to explain some of the things I've done for pain management, and what I've been told by doctors, he said some of it were the dumbest explanations he'd ever heard. He also tried to correct me several times while discussing my symptoms. That's what brought me to tell him that I can only use my own words to tell him what's happening; it's easy for me to say something wrong because I'm not the expert. "I didn't go to med school to learn all the proper language," I said. His humorous response was, "Neither did I."

For the last few years, I've been pointing to areas on my hands and telling folks that what I'm showing them are muscles atrophied by diabetic neuropathy. It seems that there's a SMALL chance I'm right on that, but the doc pointed out that if it was neuropathy, other muscles would ALSO be dying on me. In fact, my recent hobby of playing console video games would not be causing me to get "gamers' thumb" if diabetes was to blame.

Something else is up, and he wants it investigated. He wants an MRI of my upper spine and an EMG of my upper body. The latter is a lot of fun...being poked with an electric prod, with the occasional needle inserted to have electricity jolting a muscle here and there. (Good times, good times.)

Then came the prescriptions. First of all, he was instantly agreeable that the morphine I take doesn't last 12 hours. He's never heard of it actually lasting 12 hours, and anyone who says it does it a moron. However, I told him that the strength leaps taken made little sense to me. I started at a 15 mg. dose, then went up to 30 mg. Instead of there being a step with a 45 mg pill, the next leap is 60 mg. It seemed stupid to both of us, so he wrote prescriptions for 15 and 30 mg. tablets, one of each to be taken three times a day. With 45 mg. taken regularly, I will hopefully not be nearly as spaced out and in far better control on a constant basis.

But to handle breakthrough pain, he's taking me off percocet. I could be wrong, but I believe he went with something even stringer...a drug called dilaudid. According to my reading, it's used for moderate to sever pain, which sounds right up my alley. I haven't filled it yet, but will likely do so tomorrow. Then we shall see what we shall see.

Finally, the reasons behind my not taking Ultram were INCREDIBLY dumb. Being told not to take it because it would keep too many of my opiate receptors dancing was one of the most ridiculous things this new doc heard. He said almost exactly what I've been saying for YEARS! "Percocet is fine when dealing with physio-mechanical pain, but Ultram is infinitely better on neurological pain." After telling the doc that I would rather take this non-narcotic for neuropathy discomfort instead of reaching for the percocet each time, he was VERY agreeable to the plan.

I'm hoping I made it clear to him. I want to live with a degree of comfort, and I am willing to do anything he asks of me to do so. When he said he wanted the MRI and the EMG, my response was, "Great. I'd rather know what's wrong than live with mystery pains." When handed a contract about narcotics, saying I wouldn't accept other pain meds, with the exception of when/if I have surgery, I signed without making an issue of it...

...although I did talk to the nurse afterward about getting quantities properly filled. Sometimes a pharmacy doesn't have the amount of pills that are written on the prescription, and so I might have to seek out someplace other than the two pharmacies I listed on the contract. The nurse said that was fine, as long as I called to let them know what was happening.

And that's the medical report for the time being, folks. Monday will bring my next laser surgery for my right eye, and I'll have six tablets of a low dose of Valium to help avoid another anxiety attack. (I told the NPR that I wanted something I could take without falling asleep, and that I could take a second time in short order should one prove not to be enough.) I'll try to keep everyone posted on what else happens in my life.

Be well, all! =)

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