After meeting with the Neurosurgeon in Santa Barbara, I decided to try to see someone at the Stanford Pain Management Clinic (I asked to be seen by the doctor Sean Mackey, MD, Ph.D. himself because I've read about him, and watched his lectures, and I'm in love). Unfortunately, the new patient coordinator told me he'd call back in about two or three weeks, and yes, Stanford Pain Managment wouldn't be able to see me until February or even possibly March (he said it would take longer to see Dr. Mackey).
My GP wants to stop prescribing me Norcos because, as he's explained, he's concerned that I'm developing a "dependency" (I've written about this before). So, he's passing me off on a pain management specialist here locally until I can be seen by Stanford. My experience with pain management clinics has not been positive. They see patients in pain (obviously), and I believe that the patients all tend to blend in together after a while. Dr. Mackey has stated (one reason why I love him) that if you don't believe your patient is in pain or don't believe that they are telling the truth about the extent of their pain, you as a doctor shouldn't be treating them, and should send them to someone else. I believe in that wholeheartedly, and wish I had the power and means to make every doctor I see live up to that example. "If you don't believe me, fuck you, send me to someone better."
The Neurologist completed a nerve conduction test on my legs (which, by the way, feels like you're being shocked by an electric fence), and quickly became bored, and said out loud for her notes, "Nothing remarkable." Now, she's debating if I had any neuropathy at all (it was either Dr. Allan Basbaum or Dr. Mackey who said that any time you have a burning, stinging pain, it's neuropathy). If it's not neuropathy, what the fuck is it? The paresthesia is extremely painful, and that symptom alone is worth a several month wait to see a real pain specialist at Stanford.
At one point, while in debate with him over the dosage of the Norco, my GP refused to refill my prescription at all. I thought that my argument was rather sound and logical. Every seven days, I refill my Norco prescription; it's ten pills that is prescribed for one per day for ten days. Obviously, I'm taking more than one a day (I prefer to take two, as this is about the amount to suppress the pain). My doctor knows that, and in not complaining or refusing to refill my prescription every seven days, he is indirectly condoning it. However, the pharmacy started asking questions as to why I'm refilling my prescription early (they will only allow it to be refilled three days early). I asked my mother if the pharmacy could refuse to fill it, and she said yes, if they suspect abuse. So, I called my GP, and asked if he could please write the prescription for one to two pills daily, this way I'm not refilling "early," and the pharmacy will be reassured. I told him I'm not going to take more pills per day, and that I'm not going to refill the prescription any earlier than I already do. He refused. So, we got into a fight, via leaving messages with each other. He told me to go see a Pain Management Specialist.
The Neurosurgeon I spoke to said that taking one to two Norco's per day (especially the fact that they are five's; I indirectly--I swear!--found a message board that was selling five's--illegally, and the people remarked that no one who likes opiates will even buy Norco #5 since they are so weak--I had to agree with that assessment).
The interesting conclusion I've reached after reading and listening to Dr. Allan Basbaum and Dr. Mackey is that the pain killers work in two ways. One, it lessens the physical sensation of pain. That part is obvious. However, also because the opioids work on the brain, it lessens the emotional suffering of the pain. Perhaps this is why even when my Norco doesn't lessen the pain, I feel better because the emotional consequence of this trial has been reduced. With this logic, I don't see any harm in "getting high" while taking opioids as long as you're not taking the opioids just to get high. Getting high, as stigmatized as it is (no chronic pain patient I've ever read has dealt with this subject directly since we're all supposed to pretend that we don't get high because getting high would mean we're all drug addicts), helps with dealing with the psychological impact of the pain. Chronic pain patients will say, over and over again, that their pain interferes with their life. Often it's impacting their emotional health as well as their physical fitness. Honestly, opioids numb the experience of being in physical and psychological pain.
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