Giving credit where credit is due

Today I ran into the doctor that treated me for the first weeks of my inpatient stay here – the regular doctor was on vacation at this time. In hindsight, I was very lucky to meet her, because she is specialized in pain management and insisted that I quit taking opiates. I already knew that, but I was so afraid I would end up in more pain than I could handle.

I approached her and thanked her for getting this process started. She asked about my current medication and was very pleased that I am nearly finished weaning myself from opiates and will start an opiate-free life on Monday.

I told her that I am feeling very well. She smiled and said: “See? And you were so afraid at the beginning.”

Of course I had been afraid! Afraid of taking opiates, afraid of not taking them. Afraid that I had to live a life with more pain than I could take.

Well, I was lucky and nothing really bad happened. The process of tapering the opiates was hard sometimes, but it was possible.

It was really important for me to say Thank You to this doctor in person. Sometimes I just need a push to get going, but she always dealt honestly with my fears and concerns. She always talked eye to eye to me. And to be honest, treating patients with chronic pain surely is difficult.

Little Tasks

A few days ago I saw my pain doctor for our quarterly meeting. We quickly agreed we won’t change the medication. Something is special about this doctor: She always gives me little tasks I have to fulfill until our next meeting. Mostly it’s about walking. This time was no exeption, I am supposed to hike to a restaurant that is located in the woods.

This will be bittersweet. The landscape is beautiful, but it is near my last workplace. And this is a place that holds bad memories.

I will never forget what my boss said to me why he wouldn’t give me an unlimited work contract. “I don’t hire disabled employees permanently. It’s to difficult to fire them.”

At this time, he knew me for a year. I was the one with the least sick time in accounting. I really thought he knew me better. And not everything about me is disabled! It hurt to be told that so bluntly in my face. Something inside of me broke this day for sure.

Pain management, Part 2

If everything is under control, I have an appointment at my pain clinic every three months. First, the patient is given a tablet-PC and asked to answer questions concerning the pain. How bad is it on a scale of 0 to 10? Is the pain persistent, or are there bouts of pain? How much are sleep and everyday life effected by the pain? After that, the patient meets with the doctor. This consultation can focus on the real problems, because many questions has been answered before at the tablet-PC.

I wanted to change the fentanyl patches for less potent pain meds this time. My doctor suggested I stay on the fentanyl for now, of course she noticed that I am not feeling well at the moment. She recommended I change meds later, when I am more stable and can deal better with potential withdrawal problems. But according to her I really should consider an outpatient or inpatient treatment (again, sigh) to help with the issues that are still bothering me.

Anyway, I left the clinic with a good feeling, I am so glad I have found this team. My well-being is put first, and even psychological issues are considered. Sadly, this is not the rule – I know this from experience.

Well, if my other problems could magically disappear now…? This won’t happen, of course. The side effects of milnacipran continue to lessen (I fell twice due to the dizziness, that’s enough). I am still waiting for the posive effects to kick in, though.

Tomorrow I will go to the hairdresser. It’s time for something nice.

 

Pain management, Part 1

In two of the blogs I follow the topic pain was mentioned recently. I am a pain patient myself, because my lower back acts like it is older than the rest of the body and developed arthrosis.

Pain is very difficult to judge from the outside. This is why doctors usually ask their patients to grade their pain on a scale from 0 (no pain) to 10 (unbearable pain). How much you suffer from pain also depends on your general mood – in a good mood, you can cope better.

Acute pain e.g. from an injury, has to be treated differently than chronic pain. In my opinion, doctors who know how to treat chronic pain, and all the problems that come along with it, are very rare here in Germany. Treating my back pain was like patchwork for years – six sessions of physical therapy and thoughts about surgery from my orthopedist here, tilidine tablets from my primary care physician there, but nothing consistent. Somehow I found out that there are doctors who specialise in pain management, and my orthopedist gave me a phone number. When I called, I was told that this hospital doesn’t offer pain management on an outpatient basis any longer. But they told me of two hospitals that still do. So I contacted the one clinic nearest to me (about 28 km). Before I got an appointment with one of the doctors, I had to fill in a pain questionnaire and add medical records. The receptionist called me a few days later to schedule an appointment, which of course was two months later.

I felt at ease there from the beginning. The staff is friendly, and the patients are not just given pills, they are offered talk therapy with a specialised psychologist also. My soul, alredy burdened with depression, anxiety and Borderline was also seen, not just my aching back. We tried to find a solution until I, the patient, said, “This is it!” At the beginning of the therapy and during changing meds, I went there every few weeks. When everything is alright, I have an appointment every three months. Prescriptions for long-term medication are sent via mail, and they really try to squeeze you in when it is an emergency. One of the two doctors is availible every day until midday. Sadly, as my treating physician confirmed, there are less of these pain management centres. A big part of pain therapy is talking to the patients, and the health insurance does not pay for that.

I am very grateful I found this kind of assistence. I now spend less energy on dealing with my pain, this makes life so much easier. During my last inpatient stay on the psychiatric ward, pain medication was of subject of discussion, but a change didn’t feel right at this time. But it will be adressed on my next appointment, which will be at the end of the month.