Posted by bleauberry on April 8, 2011, at 16:49:51
In reply to value of pain management specialist: experience?, posted by floatingbridge on April 8, 2011, at 15:46:14
If you want a successful pain management system, then just pretend you have Lyme disease. And treat it. Who knows, 1 in 10 people who do have a Lyme-like or Lyme-related problem have not been diagnosed. Instead they got a diagnosis of: depression, anxiety, schizo, arthritis, lupus, ms, on and on.
Interesting note. The Lyme specialist I used to see did not start out as an infection expert. He started out as a pain management specialist. Being an observant and curious intelligent man, he noted that over the years the patients who had the most stunning unexpected improvement were the ones that took antibiotics for other unrelated problems. It was from there that he was able to put two and two together and draw the links. So while his former pain medicines used to include the common pain meds that all today's specialists use, and antidepressants, and such, today his most successful weapon against pain is....antibiotics.
He told me stories of other patients who didn't have Lyme...for example a man who presented with arthritic like pain that began a few months after a barnacle scratch while swimming. He was totally cured....on a hunch...with antibiotics.
So I guess there are two ways to look at this. On one hand, you can ignore what is causing the pain and instead take drugs that dull it but not stop it. Or you can stop the cause. Not quite as simple as is sounds, because to do so requires treating things on a hunch or as a probing experiment. Diagnosis is not likely, probable, or realistic. We aren't there yet in medicine. You'll know you got better for sure, but you may never know exactly what the culprit was.
Think about it. Pain is basically inflammation. What causes inflammation? Irritation. What causes irritation? Most likely cause....an organism of some kind. Not only their excretions and living habits and eating, but the cascade of cytokines and such provoked by your immune system. Sometimes so much so that your immune system can't tell the difference anymore between the invader on your own flesh, and thus starts attacking your own self. Pain.
Of course, if there was a prior broken bone, torn ligament, sports injury, or whatever, then that would explain the pain too. But that would be a different kind of pain.....localized, not generalized.
The Lyme doctor did use pain meds though. While improvement can happen within a few weeks, it takes months to really get a handle on it. In the meantime he uses pain meds and Gabapentin. Gabapentin was one of his favorite meds actually. But he absolutely stressed it has to be brand not generic. On the other hand, he found generic pain meds to work better than brand. No matter, either way, they are only temporary tools until progress is made.
The only time he would treat patients any differently is if they tested positive for Rheumatoid Arthritis. I don't know enough about that topic so I can't comment, other than in his experience that type of arthritis was definitely a totally different beast that required a referral to a specialist in that field.
Some of the most effective, cheapest, and healthy choices for chronic pain are within the Lyme herbal protocols. These herbs are amazing at how they calm down an overstressed immune system or turn it up where it is weak....simultaneously....in addition to wide spectrum anti-inflammatory mechanisms and built-in analgesic action. In that category I can personally suggest from my own experience the power of Japanese Knotweed and Stephania Root. Stephania root actually has more anti-inflammatory action and anti-pain action than steroids, but is not a steroid. I have not tried Devil's Claw, but that is supposed to be fairly decent. These herbs actually do similar things as COX inhibitors and such, only different, and much better and more wide spectrum.
If you wanted to probe into the infection stuff, that's easy. Both of the above herbs are fairly potent antimicrobials. For more oomph, you would want to look at things like raw garlic, berberine, pau d'arco tea, grapefruit seed extract, and actually quite a few decent choices. Teasel root tincture works very well for pain symptoms in Lyme patients, for some reason better on the West coast than the East. Maybe different infections. With any of these herbs, there is a pattern to look for....maybe an initial period of a few days where you think you feel better than you have in a while, followed abrupty by a worsening of all your symptoms and maybe some new ones. That is called a Herxheimer reaction....simple....too much death going on and the body's detox systems are overloaded. Traffic jam of cellular debris. Back off on the dose or temporarily stop to allow the liver, kidneys, and lymph glands to catch up and mop up.
Anyway....food for thought. I don't know, if I were in your shoes, and actually I am, I do not want to be sentenced to a life in prison of pain and rely only on pain blockers forever. I want to get to the root of it. I want to stop the progression of disease, arrest it, not just cover it up so I can't feel it. I do not want to allow it to dominate more destruction on my tissues.
On a more mainstream note, the combination of tylenol and advil is far more pain relieving than either alone. Synergy. I learned that from a dentist after a tooth removal. The combo worked a lot better than opiates on pain.
Final note. Low doses of some antibiotics, for example Doxycycline, have fairly good anti-inflammatory and anti-pain mechanisms on their own. I remember even at a subclinical dose of 25mg or 50mg, my longstanding chronic headaches were gone
My overall message....I am not a doctor and I don't know the details of your case but I would certainly try more sensible strategies that actually make a ton of sense and work in real doctor's offices before submitting myself to a pain specialist. That is, unless he is one that has also seen the connection between infection, immune system, and pain. Those kinds of doctors are sadly in short supply.
I hope you find something here helpful!
poster:bleauberry
thread:982266
URL: http://www.dr-bob.org/babble/20110406/msgs/982268.html