That is the question for many of us suffering with chronic pain, isn't it? I went to see a new pain doctor last Thursday. Surprisingly I made the 5 hour round trip in one day without too much flare up, although today I am feeling the effects of the trip and a busier weekend than normal for me.
So I told my story again to this new doctor. Every doctor has their opinions which is always interesting. She thinks a spinal cord stimulator, as suggested by my previous pain doctor, is not a good idea. I am young and it is likely that within 5 years my brain will find a way to work around the stimulator, which "tricks" your brain instead of feeling pain you feel a tingling sensation. She also thinks pudendal nerve decompression surgery is not a good idea - what pain doctor does really recommend surgery? They see hundreds of failed surgeries every year. She really thinks since my debilitating pain began after aggressive sacroiliac joint manipulations that maybe I can get some relief with the correct type of manipulation to get my pelvis back in alignment. This was encouraging since in 2 weeks we travel to Gainesville, GA to see one of the nation's best PTs in hopes that I will be able to avoid surgery and that the proper alignment will get my pain to a more tolerable level. I am of course doubtful however because the pain has gone on for so long now and I have already seen 6 PTs who were unsuccessful in fixing my pain.
This new pain doctor prescribed a new pain medication for me Nucynta (don't tell me all your bad experiences with this drug!). I was previously trying to manage my pain with Neurontin, Baclofen, and various other pain medications on an as needed basis. This doctor thinks I should take Nucynta twice a day and in between as needed to try to get my pain under control. She thinks it is better to take medication and be up doing things than to not and lay around on the couch. I'd like to think she is right, but if my root cause of pain is nerve entrapment or SI joint dysfunction then the pain medication will only mask the pain and I will do things (such as sitting, bending, twisting, etc) that will really make the root of the pain worse. The other problem with this medication is that it is brand new so it will cost us around $76 a month. Thankfully for the first three months we found a prescription saving card making it only $25.
This medication is supposed to have the effectiveness of some of the more powerful narcotics with more tolerable side effects. As with any opioid drug there is the potential for needing more and more of the medication to get the same desirable effect over time because our body builds up resistance. The way the spinal cord and brain perceive pain is a mysterious thing. While the nurse in me knows there is a root cause of my pain (likely sacroiliac joint dysfunction and pudendal nerve entrapment) I have to get over my preconceived notions about pain medications because the pain itself has become a problem. Pain in the Mom, a fellow pudendal neuralgia/chronic pain sufferer, wrote an interesting post here about how pain is often the problem.
So I am going to take the medicine as long as I can tolerate the side effects. I can't worry about building up a tolerance or making my root problem worse right now. I have to try my best to get the pain under control because in reality the pain is controlling my life. I will continue to work at fixing the root of the pain, but until that day comes (whether it be here or in heaven) I have to to try to live each day as best I can. If pain medication helps I'll take it (unfortunately so far the nucynta has done very little for my pain, even the most powerful narcotics often do not help nerve pain). Worrying about things that may or may not happen in the future, like tolerance, withdrawal, or even tomorrow, do not make the problem any better. Today, this moment, is all we are promised and it has enough trouble of it's own (Matthew 6:34).