Why won't doctors give stronger pain meds?

[Phoebe M]

I was wondering if anyone is frustrated about not getting enough pain meds prescribed.

At the walk-in they gave me naproxen with helps but doesn't take all the pain away. They also gave me amitryptaline. works well but is only for night time.

The problem is the day time. Pain gets worse as the day goes by. I found myself taking too much naproxen so I went to the emergency at the hospital.

The doctor I saw there didn't know about IC so he looked it up on the internet. He bumped up the amitryptaline to 25mg or take more if I need and gave me T3 and is doing bladder instills every 2 days for 2 weeks of lidocaine, heparin and sodium bicarbonate.

The instills give me amazingly bad pain after and for the next day. And I have to go to work where I can hardly walk and its a job where Im standing and walking some too.

Today I asked him for something stronger and he said, obviously the pain meds arent working and if you take too much you will damage your liver and kidneys. So dont keep taking them.

Im so frustrated and stressed about being in pain all the time. Anyone else not getting help with pain that they need?

(hopefully the urologist will help, ive been waiting 3 months for my appointment on March 29)

[Linda May]

i was diagnosed end of april or may of 2010 the uro i had gave me no relief at all i suffered excruiting pain for three months. i could not eat, sleep, 24/7 agonizing pain. i found a different uro that did not give me pain meds because of a rectocele. but he found the right treatment plan and was extrremely sympathetic to my condition. after the 3 instill i started feelin some relief by my 6th i was 95% normal. I pray i will never get that bad again. i found out later when it gets that bad it is compared to cancer pain. can you imagine doctors denying a cancer patient pain meds. well that is what alot of doctors do to us. i think if i was to get that bad again i believe he would give me pain med. it was because firsttime i needed a rectocele repair; and pain meds would have made my rectocele worse.but at least he explained it all to me.

[Phoebe M]

thanks for replying Linda

the pain thing is horrible. its hard to live day to day like this. i cannot understand why the doctors dont want to help though. i wish they knew how bad it can be. instead they make you feel like youre making it up

[ICNDonna]

My suggestion is to see a pain management specialist. They are specifically trained in the management of pain and very often are able to help.

Warm hugs,
Donna

[jenjen05]

Not all pain drugs cause a problem with the liver and kidneys. You can obtain pain pills without tylenol and ibuprofen in them.

If you want something stronger for pain you will probably need to go into pain management. Most regular doctors will not prescribe pain meds (and if they do, they are wimpy ones) long term. Why? Because your pain may change. Thus the reason for a pain management doctor. There is a list of them by state you can obtain from the ICA or you can ask on here if anyone knows of a good one in your area.

When looking for a pain management doctor be sure to do the following so you don't waste your time and money: CALL AND ASK if the doctor you are going to see knows what IC even is! I found when I was looking for a PMD that the first two I visited didn't even know what IC was so they couldn't be my PMD. I finally called around to six different pain management doctors before I found one that knew what IC was and had other IC patients he treated. I now have an amazing doctor who understands the pain of IC and has 100% worked with me to give me my life back.

Please be aware that when seeing a pain management doctor you will be required to sign a contract stating you will not get any controlled substances from any other doctor other than your pain management doctor. It is a felony to "doctor shop." Also, you will be required to take mandatory drug tests to make sure you are taking your drugs correctly and as prescribed (too little or too much drug detected in the urine) and that you are not on anything else you aren't supposed to be on (drugs from other doctors, illegal substances).

Good luck!

[Phoebe M]

Hi Jennifer

Your dog is so cute!!!

Thank you for the advice. I wonder if we have those pain clinics in Canada. I imagine we do.

All of the doctors Ive seen havent wanted to give me anything stronger. What I can't figure out is why they don't automatically give a referal to a pain clinic when I tell them I've been in serious pain since December.

[jleblanc]

Definitely try to find a pain clinic. I would imagine they exist in Canada. And most definitely, you can prescribed pain meds without acetaminophen in them. I go to a pain clinic...I have to go once per month and signed a pain contract. I was originally taking percocet (oxycodone with acetaminophen) but when I was needing more and more for relief, I was switched to pure oxycodone, which has essentially no upper limit for the amount you can take, provided you are increased very gradually. Pure narcotics are a lot safer than those mixed with acetaminophen or other things, and if I need some extra relief, I will take an extra strength tylenol with them, but no more than about 4-6 per day.

[jenjen05]

Most likely they haven't referred you because they don't feel you have exhausted all other options yet. I suffered for a year and a half before I went into pain management.

Another reason could be... have you asked for something stronger? Sometimes being in so much pain can make you seem desperate to a doctor (and rightly so IMHO) but unfortunately this can make you look like a "drug seeker." Google "drug seeking behavior" and make sure you read about it before asking for stronger pain medicine.

I'm not sure how everything works there in Canada, but I know here in the US not all pain management doctors require a referral. For me to see my pain management doctor all I needed was:
1- a definitive diagnosis from a specialist (urologist or urogyno in our cases)
2- proof that I was willing to continue to try other treatments while on narcotic therapy (in other words that I was not a "drug seeker" and truly wanted to treat my condition in the best way possible)
3- 6 months worth of my medical records from all my doctors I was currently seeing
4- 6 months worth of pharmacy logs from every pharmacy I had a RX filled at

Also, if I were you, I would stop the installs you are currently getting since they seem to be making you worse. My urologist just did straight 10,000 units of Heparin into my bladder which I held for 30 minutes and then peed it out. It got rid of my pain for 6-8 hours but then it would bounce back stronger for about 2 days. That's just me though. A lot of people have much better luck with just plain Heparin and nothing else in the installation. It's worth a shot :-)

I would definately get into pain management ASAP if I were you. If anything, it's something to hold you over until you can find another treatment or combination of treatments that works for you. Then if you do find another treatment that works well you can taper off of pain pills or just taper down to a lower dose.

Feel free to PM me if you ever want to talk. Good luck!