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Ask Dr. Gott 11/02
Patient denied pain medication
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    DEAR DR. GOTT: I am a 53-year-old cancer survivor. I had a laryngectomy to remove my vocal cords. I went through chemotherapy and radiation before the surgery but had to have the cords removed anyway. As you can imagine, I was in extreme pain for weeks and weeks and was on Demerol and IV morphine.
    About a year ago, I hurt my back at work and had an MRI that showed I had a bulging herniated disc with degenerative disc disease. I have not worked since.
    I went through weeks of therapy that helped some, but I am still in a lot of pain. My primary care doctor now refuses to give me pain meds.
    My doctor had me on two 500 milligrams of Vicodin per day and two 600-milligram ibuprofen, but I am not taking anything now because he won't prescribe me anything. I've seen a pain-management doctor and am to see a surgeon in another two weeks, but surgery is not an option due to my track record of pain shots.
    My question is, should I be able to tolerate pain better since I've been through so much already? I feel like a baby because my doctor thinks I'm not in pain and that I should "suck it up" and go on.
    DEAR READER: Doctors must be cautious in prescribing narcotics. If not, they face potential legal consequences and loss of license. As a result, patients with chronic pain often get short shrift.
    In your case, I am relieved that you have made numerous attempts to resolve the pain issue. One of your options was to see a pain management specialist, but you don't indicate follow-up appointments, what his or her recommendations were and what other options were made available to you. This distresses me because it seems that you are not as candid as you should be with your physician. Pain specialists are very likely to prescribe adequate amounts of narcotic analgesics, yet you persist in attempting to obtain further supplies from your family physician.
    It is not for me to come to any conclusions. However, in my practice, I would never prescribe pain-relieving drugs to a patient who is being seen by a pain-management specialist.
    Meet with your pain specialist to address your situation frankly. You don't need to "suck it up," but you need to know the limits and what your choices are.
    To give you related information, I am sending you a copy of my Health Report "Managing Chronic Pain."

    DEAR DR. GOTT: In response to the 83-year-old lady's facial hair, drug stores and beauty-supply houses sell Cream Hair Remover. It works well and is reasonably inexpensive, costing from $8 to $15.
    DEAR READER: Thanks for the tip.
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