Paul’s story

My little journey started in my late twenties in the US Navy. I am of Dutch descent, male, with otherwise good to excellent health. I am now 55 ... A Long Strange trip it’s been. I failed my re-enlistment physical due to a rather large "lump" and enlarged "cords" in my right hand. The Navy decided (after an incredibly long ordeal involving every Navy hospital on the east coast, including a 3 month "examination" and medical board at Bethesda) that 12 hours a day of twisting screwdrivers had somehow at least contributed to my being unfit for duty. Long story short, retirement.

Next, lump in arch of right foot, followed by spreading of Dupuytren’s to my left hand, and then "Ledderhose" in the left foot. Around age 35 Dupuytren’s curled my fingers up on my left hand to the extent that I had two surgeries within three years to release the contracted fingers. So far my right hand, which started this mess, is a bunch of lumps and cords but has never contracted. Over time, the little lumps on my feet evolved into Nodular Plantar Fibromatosis, a funny little disease no one has ever heard of, which grows over time, is very resistant to treatment, and by my age is a major, painful, pain in the ass. I have been refused major surgery by reputable osteopathic surgeons and offered it readily by starving podiatrists.

I have had the cryosurgery in Tampa by Dr. Katz. Who is a very cool guy by the way and knows his stuff. The treatment was unsuccessful for me, causing temporary (about 3 months) relief and then the fibroma he attacked grew back with a vengeance. He declines me as a candidate for further surgery. He is an ethical guy. So where to now. Pain Control. OMG, what a nightmare in the US to compete for necessary, ethical pain control with thousands of junkies running around pulling every trick in the book. I finally found an arthritis MD, courtesy of his longstanding relationship with my wife, who agreed to prescribe for me. We started with Ultram (tramadol) with poor results. A course of Ultram ER. Then moved on to DarvocetN. A little help but not great. Then moved on to Vicodin (hydrocodone/ apap) 5.0/500 3-4 tid. Some major relief here for a while but with some stomach upset. Then onto a month of Percocet (oxycodone) 5.0/500. Major stomach cramping, some nausea, no better pain control. On to Narco (hydrocodone/ apap) 7.5/325 3-4 TID. AH Hah!! Major pain relief. No side effects. Much less Tylenol than 7.5 Vicodin. Restored to daily activities and very thankful. Of course you still feel the nodules (uncomfortable) but the shooting pain upon walking is GONE. Now my only problem is tolerance. Develops with every form of narcotic. So I developed a procedure of 5-10 days Norco, followed by 2-3 days of half or less dosage and sitting on the couch lowering my tolerance. Naturally, any withdrawal is kind of uncomfortable, (irritability, trouble sleeping, and a general feeling of mild flu and depression.) Luckily I have a primary care doc that prescribes a small dose of xanax for these days. And good luck with that too, because every doc out there thinks you may have a benzo habit. Pray for a good primary doc who will work with your pain doc.

Speaking of Pain Doctors. I thought I might find a way to avoid those days on the couch in semi-withdrawel, so I went to a "Famous around Here" Pain Clinic. First thing he wants to do (after my bringing him my entire medical history including MRI cd's) is perform major surgery to implant neurostimulation devices in my stomach and spinal cord to block the pain. I am given a brochure and prescription for pain control while I "research" it on the web and make a decision. The script is for Opana 10mg Extended release. This I find out is time release hydromorphone, sometimes known as Diladid. For ME, this drug is a waste of time. It takes away the aching pain in feet (and hands) at rest but forget about walking anywhere or working. I'm back on the couch, full time instead of twice a month. I complain and the good doctor tells me I'm not a good candidate for pain control and must have the operation. (I'm thinking 10's of thousands of dollars for him by this point.) So, long story short, I D/C the Opana and go back on the Norco (with permission from arthritis doc). OH,Man, What a difference, I'm back on my feet and feeling normal. So I make an appointment with my arthritis doc to see if we can use this experience to either find another pain specialist or find a way to make couch withdrawals less frequent or more comfortable. (I drive my wife crazy when I'm cranky).

So here I am, I guess I'm going to have to submit to a wheelchair if really long walking is mandated. I've had surgery and I'm not ready for "neurostimulation" on my spine yet. Possibility of paralysis and this pain doc has a big notice in his office that he doesn't carry malpractice insurance. He also doesn't personally return phone calls even with new patients. Oh, well. So, for me Norco 7.5/325 3-4 tid does the job except when it doesn't. Surgery is medically out unless I can no longer walk at all even with pain meds. I'm going to pursue a way to ease the withdrawals, or maybe find a way to get round the clock relief adding hydrocodone for work periods. (It just occurred to me that perhaps Ultram ER combined with Norco might do the job without adding additional narcotics).

That’s my story so far... Thanks for reading and maybe I helped someone else,

Paul