Hello All,

I wanted to get some thoughts over an issue I am having with using an anti inflammatory as part of my pain control regime.

I have TOS, RSD, fibro, Occipital Neuralgia, Bulging discs and DDD, Osteoarthritis of the back and knees, bursitis in both hips and one elbow,

My pain meds include MS Contin, Norco, Piroxicam, and Neurontin. My neurologist has been writing for the narcotics, and my primary writes for the other meds.....scripts she 'inherited' from my previous primary.

I also have high blood pressure, type 2 diabetes, and high chol.....so I do have some cardiac risks.

My primary has been on a crusade to get me off the anti inflammatory med (Piroxicam) since I started seeing her 1.5 years ago. She is concerned about the cardiac risks. I TOTALLY understand that concern and the risks. My concern is that tampering with the pain management regime will increase my pain (I admit, this is my main concern) and end up making my blood pressure/cardiac risk worse because of the severe stress on my body.

She had been suggesting that only take the anti inflammatory when the pain is really bad or take it for a month and then skip a month, and repeat that cycle.

I have been putting off doing that. I consider it, but then I think "I'd rather not be in worse pain today, so I'll just take it today and re evaluate tomorrow"

We discused it again at my visit this week. I explained that I have a hard 'picking' which month is going to stink because of more pain.

She said she'd make the choice for me...and just stop prescribing it (which she did) Then she berated me for not being more proactive in my own health care and chosing to limit it myself.

I look at it is I am proactive. I'm saying I would rather croak from a heart attack while I was TRYING to lead a life as normal as possible, managing the pain as best I can and be able to leave the house on occassion and enjoy life. I truly feel like I will be at risk for the same heart attack due to increased pain than will also curtail my efforts to try to enjoy life.

I do understand that docs have to feel comfortable with the plan of care. I'm angry because I feel like she wasn't listening to my concerns.....like it would be one thing if she said "I just think the risks of the anti inflammatory are too great, let's try not using it and if the pain is worse we will see what we can do with other meds, and we'll keep an eye on your bp to see if it does go up with increased pain." but the whole belittling thing wasn't very professional, in my opinion.

Am I griping because I'm not getting my way ? Or should I be in the market for a new primary ?

Thoughts ?

I'm planning on seeing how it goes. Trying to remember where I put my bp cuff so I can monitor it on my own, or wondering if I should even bother.

My neuro WOULD write for it, I'm sure, but I wouldn't play that game.

Another option is asking again for a referral to see the orthopedist (by the end of my visit, both she and I forgot about it) about my knees. The pain/stiffness/inflammation has come and gone for years, but it has been BAD since March/April. I can't stand up from a chair or the toilet unless I have something to push off of or pull myself up with. And of course, doing that just flares my neck issues