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Dr's messed up, lead to chronic pain, now may need knee surgury

2young4allThis22young4allThis Posts: 1
edited 04/26/2018 - 3:07 PM in Sacroiliac (SI) Joint Problems

Hi out there, 

As mich as it sucks to see so many people in pain, it's nice to know I am not alone. so briefly, I am in my mid 30s, in my late 20s I was in a bad skiing accident. Sacral Aka in my sacrum and my illiac (wing ) of the pelvis, problem was.drs missed the fractures, they say it's common cause of all the connecting plates.dowm there, but bottom line they messed up.should have sued, has caused working problems.and gemerally.bad life, I even though the fractures were "undisplaced" mean g they didn't shift, there is a huge nerve cluster right where I fractured and I know the inflammation from an improperly healed fracture is causing lots of problems. 

I see a good pain dr, but like everyone , he is slowly (thankfully) tapering me.down cause of DEA and other regulations, I am on a high dose but compares to where I started I am on loke a 1/4 of what I was taking 5yrs ago now I am on 4, 30mg oxy IR, and 2, 30mg oxymorphone generic ER. down from morphine, methadone , oxycontin, and oxy ir, so yea...i am down a ton.

Here's the rub , I am a very good patient. over thebheads I have seen him I have had to fill my meds early maybe 2 or 3 times, once.from getting 2md and 3rd degree burns and his office never back.

I have been having some really bad knee problems he past few years amwhich have gotten terrible thenpast.month, I have an apt in a couple days with an orthopedic, he has do e 3 different surguries, taught his daughter piano, I absolutely trust him. more then o can say for most of these "gods" that play with medicine, it's called practicing for a reason. Anyway, I was pre med at school, not a total laymen when it comes to Dr stuff, I am having clicking and lots of pain in my knee, Ian's it's the size of a softball by evenimg. i think it's my medial meniscus.

So being on pain meds already, this situation is causing a lot more pain, and if I have to get surgury, which from my research is thw directipn i think i am heading, this has heen my.worse fear.of.being a chronic pain patient , if something else goes wrong. So if o habe surgery I knw I'll get a dilaudid drip, won't he enough andnwill have to take.kymown meds too, but what's the best way to approach my dr. 

I have epidurals set up in a week plus, and he wants to slowly ween me down on the meds, which I am ok with,but I need more meds to function temporarily. depending if my orthopedic looks in the online prescription registry, I mightnbebablento get something from him, but I doubt he will give dilaudid, which sux btw, so I am hoping to ask my pain guy when I get shots to up my extended to a 3o and a 40 a day, and see ifnhebwill give me like 14 or 20 of another breakthrough, just for a month or 2. 

Does anyone have experience being a pain patient and having to get a surgury, I dont want to come off as beging for more meds, but what approach would work the best, granted it's only a temporary increase, but he used to be super cool amd woukd give me anything i asked for, notnso mich now. would a couple fentanyl pattches be good fore post surgical pain control? what about the fentanyl suckers, or (I knownhe won't give it to me) but injectable dilaudid? or jist upping my e.r.'s to 40mg instead of 30? I am just really concerned, and should it be dealtnwith by the orthopedistic surgeon, or my pain Dr? I havent gonenthrogmigh this b4, so any advice woukd be appreciated. very mich for taking thebtime to read this post.

Regards, 2young4this

Please avoid the use of short-text, it can become very confusing... ie    apt  is that for apartment? ,  appointment if used short-text would be appt  .  I would also suggest spell checking before posting.   Lot of run on words, that some people may not understand
Ron DiLauro, Veritas-Health Forums manager



  • robmjrrobmj Posts: 46
    edited 04/27/2018 - 1:40 AM

    Should be dealt with your pain doctor. Definitely go to your PMP for a pain med plan. Wishing you well -

  • dilauroddilauro ConnecticutPosts: 12,125
    edited Today 10:54 AM

    I have been on opioids for 10 straight years and on/off for over 30 years.  I've also had many surgeries while being on my normal dosage of opioids.

    The procedure that has been followed in each surgery is

    • Cut down on as much opioids as you can prior to surgery, that will allow for better pain management in the hospital
    • My physiatrist would stop providing opioids while I was in the hospital and until the surgeon dismissed me
    • The surgeon would provide me with opioids while in the hospital
    • My physiatrist would the pick up providing me with opioids

    For example, I have been talking 40mg of Oxycodone 5mg IR a day.  Prior to going into surgery, I cut down to 20mg.   During my hospital stay they bumped me up to 60mg of Oxycodone IR per day.    After I was release, the surgeon provided me with 5 days with of Oxycodone IR for total of 30 pills, 30mg per day.   Then  when my physiatrist picked up again, I have a script for PRN of 40mg per day, but I am doing my best to stick with 20mg per day.

    A similar approach would happen for me if any knee surgery was a one day surgery.  Depending on the type of knee surgery , the surgeon may have only prescribed low-medium dosages of Percocet or Vicodin.    Make sure the doctor who is currently providing you with opioids is aware that the surgeon is prescribing a 

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