Medication - Chronic Pain Review
[ Tuesday September 29th 2020 at 3:25 pm ]
My medical appointment today went really well. It has been a while since I said this about a medical appointment. Switching doctors is providing to be a like a breath of fresh air. I'm willing to bet the new family doctor read the one page summary about me prepared by my previous family doctor and proceeded to decide to do their own thorough assessment. It is really proving helpful to me.
The appointment was scheduled to be an hour. It lasted 85 minutes. The medical secretary told me a hard and fast rule (what you'd find in a text book about medicine review appointments.) It didn't seem this would apply to me. I was correct. The member of staff who will be advising on managing my chronic pain is practical in scheduling clients and their individual needs. It is apparent that she had planned to spend more than an hour with me.
The initial 30 minutes was about getting to know me as a person, my life goals, the parts of my life impacted by my physical challenges and how the physical disability is impacting me. I am rather pleased about the time spent getting to understand me. In all practical terms managing chronic pain is about improving function in life. (In common language being able to do more because your pain is controlled and not wrecked by severe pain.) When you are in my situation this is the correct assessment for eliminating mental illness. The effects of chronic pain have overlapping symptoms of mental illness (such as depression). When I showed her photos of sewing I did yesterday and a photo of the concrete yard drain I designed I'm demonstrating that I am engaged in life to the capacity that is practical. They are able to justify some of the pain medication being prescribed when she see how it is aiding me in quality of life. Essentially this amounts to having a realistic functional skill set.
I was also really pleased when she acknowledged my positive attitude to life and just how much of a different this can make when living with chronic pain. It tells me she is listening to me, understanding me as a person and are really focusing in on where I'm at right now. I didn't find the change in family doctor's easy. The unknown was huge. I obviously was heard when I highlighted what it was that needed to be dealt with first. I'm becoming more at ease with trusting the intake process. I should be able to let go of my medical treatment not going well between 2015 to present and accept this as a fresh start.
Then she wanted to know what medication I was using and why. I went over it this with her. She was a good listener. I explained how each medication was introduced into my case and how it worked. I never experimented with street drugs at any point in my life. I'm just trying to make my life work. I have the sense that she appreciated this.
Finally we get into what to do for me. They expect what is wrong with my legs to be getting worse. It isn't a surprise that my pain control isn't going well. Based on how I'm using break through pain medication they believe there is more pain in my body than 18 months ago when I underwent a similar pain control review. She is recommending a modest increase of the long lasting pain medication. The idea is that I won't need as much break through pain medication. In turn this should give me more stamina to do things each day.
I find this very reasonable. I can always go back to what I'm doing now. I said I was only agreeable to this with follow up in place in 10 days. I also stated I am only agreeable to one change at a time. It doesn't end well for me when making too many changes at a time. This doctor office does trials for 7 days. I'm fine with this. They are very supportive of me requesting follow up appointments be in place for making changes. There will be a follow up meeting about me where this is discussed.
We had a lengthy discussion about the stem cell transplants being offered where I live. Unfortunately what is presently available aren't high quality stem cell transplants. A positive regenerative response isn't guaranteed. The point of these comments was for me to have realistic expectations. Not all of this procedure is covered by Ontario Canada's health insurance. I've been asked to consider if I think this is likely.
My hip joint muscles and outer thigh muscles contract and they just won't let go. The symptoms in my hips can be treated with magnesium. They want me to start on 200mg magnesium bisglycinate by Webber. This is taken orally at bed time. If it works this will promote better quality sleep. I can't begin to tell you how happy I am that they want to help me sleep better. They also want me to start using Epson salts in my nightly both. They think this should get my hip muscle end. If this starts to work then there is a neurologist in the teaching university hospital that performs intramuscular magnesium injections. You only end up with this particular specialist in very special and rare circumstances. If my body responds to the oral magnesium it is justification to request he inject magnesium into my hip muscles.
I have also e-mailed the administrator for the surgeon who did my viscosupplementation injections in 2018. I asked if he has the skill set to do the required magnesium injections. It would make sense to get this done locally if possible. He is willing to see my again with a fresh referral for the areas he is suppose to be assessing. His administrative assistant has been open to questions.
Overall it seems like they want to help me. It is still going to be a process. I am hopeful. It has been a while since there have been options for helping my pain and better managing my physical disability. In turn this should help me in my pursuit of self employment.