A couple of weeks ago, I had an incredibly painful flare-up of my chronic neck pain.  My local California pain doctor refused to prescribe me meds, and I wrote about my frustrations with that decision, thinking that as soon as I got to my regular pain doctor in Texas, something would be done.

Oh Lord, what a naive boob I was!

I met with my "regular" pain doctor last week (who is different from my GP). He has been my chronic pain physician for 6 or 7 years, and has been a lot of help in treating my pain. But a couple of years ago, we sort of reached the limit of the things he could or was willing to do, and it's been a bit difficult since then.

(One small example: he prescribes Ultram for my pain. For a period of several weeks, because of modifying the dosages, I had both 200mg and 100mg caplets. I found that if I took 200mg at night and 100mg in the morning, that controlled my pain much better than 300mg once a day. This Austin doctor refused to prescribe it to me that way. "That's not the way you're supposed to be taking it." My feeling was, who gives a shit? If it works, and as long as it's not dangerous--300mg is the daily limit--why not?)

Anyway, when I met with my Austin doctor--after my GP had taken mercy onme and prescribed a few Lortabs for my pain--he informed me that he wouldn't have given me additional hydrocodone for my pain, but would have required me take over-the-pain anti-inflammatories, after which he would give me prescription anti-inflammatories, after which ("as a last resort") he would give me additional anti-pain meds.  When I told him that I had been taking 6 or more advil and tylenol a day, he shrugged and told me that chronic pain sufferers frequently have 3-5 "flare-ups," and that only after a 2 week period of pain would my "flare-up" be "genuine" enough for him to do something like prescribe steroids, give me a nerve block, or do something more dangerous or pervasive.

I did ask that he give me Lortab rather than Hydrocodone, as I was taking 2 of the 5/500 tablets, which I felt was too much. The Lortab (7.5/300) works quite well, and doesn't have as much Tylenol in it (I think Vicoprofin would be ideal, but then, I'm not an MD). He agreed, but required me to see him in 5 weeks rather than 4. (Or to put it another way, as my wife says, he punished me.) He feels narcotics are a bad idea, because all they do is "mask the pain."

(Since I suffer from chronic pain--i.e., it never goes completely away--I guess I don't really understand why I shouldn't "mask" the pain on a regular basis. I mean, the pain's always there; I don't think "living with it" is really necessary.)

The end-result is that I'm looking for a new pain doctor, and hope that my California pain doctor (who is giving me a "radio frequency" treatment tomorrow) will fill that need. I certainly don't want a pain doctor who's going to refuse me prescriptions and force me to do whippets/smoke dope/drink lots of alcohol for two weeks before my pain becomes "genuine" enough to treat. Wish me luck.