Rebecca P - I need your help

[tommyboy]

my name is Shane, I'm the wife of Tom (tommyboy) he is currently admitted into Acute Care unit of a psychiatric ward.
I am trying to get him pain mgmt help - but don't know where to go. Please help!!

[littlemermaid]

call Rebecca 877-693-7939 - contact details on DryEyeZone, click blue bar bottom right (I'm so sorry - I think he needs good cornea opthalmologists to get the eye surface under control right now while he is in the hospital - can you call the people he has been seeing at Mass Eye or Boston or local? Rather than 'dry eye' maybe call it something like inflammation and pain control for 'severe corneal neuralgia' after surgery if you are talking to new eye doctors.)

[Rebecca Petris]

I've spoken with Shane and hopefully will be speaking with Tom who's being discharged today. A few things for y'all -

1) For those of you who pray... please pray for them both, very challenging situation. 1 year out from LASIK with no nerve regeneration, dryness and A LOT of pain is a really, really bad place to be. Those of us who have been there, or near there, and come out the other side know that it really does get better but it's virtually impossible to see that when you're there.
2) If there is anyone who feels have experienced things in common with Tom and are well past the brunt of it, and who could possibly provide some personal support (phone? email? in person even if you're in CT?) could you let me know?
3) I am not really up on pain management facilities/strategies and I know this is an area where DEZ could hopefully become more helpful to people. Am working on a new section of the site dedicated entirely to corneal pain issues. But meantime if have any experience of inpatient pain management facilities on the east coast could you please post?

[Guest]

Hi Shane,

Tell him to hang in there... this phase will pass - I had LASIK in 2005, eyes went to hell in 2009 and were so bad I wouldn't even have been able to work (was on mat leave at the time luckily) but today they are functional and I can do most of the stuff I want to do. He'll get better too... it just takes time...

(((hugs)))

For pain mgt. help, the hospital pharmacist ought to be able to look into which pain meds are the least drying... I'd ask about meds for neuropathic pain.

Also, once he's out of the hospital, he could do a trial of plain over-the-counter dextromethorphan cough syrup (ex. Benylin DM), taken as directed on the label. It's not first choice for neuropathic pain due to its abuse potential, but assuming your husband has no history of drug abuse or anything like that, it's worth a try - he'd just take it as directed on the label 4 times per day (every 6 hours). I started this per Dr. Rosenthal at Boston Foundation for Sight and to my shock, it helped me - I get less foreign body sensation, less itchiness, less burning when I'm on it - it's not a cure all of course, but one more tool to consider. A friend of mine that works in hospital confirmed that they sometimes use it at her workplace for neuropathic pain, but it's maybe 4th or 5th line due to abuse potential. You won't see anything on the product label that it's good for pain... all you'll see it that it's good for cough... but this is an off-label use, so that's why.

Also, if he likes to read, maybe you could look into getting him some audiobooks while he's in hospital - when my eyes went to hell, my hubby looked into ipods for me (I ended up getting and ipod Touch), figured out how to set it up on the computer, and where to get audiobooks (I got mine from audible.com and online from our public library) - it was soooo helpful to have him do that since my eyes would have hurt soooo bad if I'd had to research it all the computer myself. The audiobooks were a godsend since they gave me something to pass the time that didn't hurt my eyes.

Good luck!

[No tears in ATL]

Hi, Shane. We are all thinking of you both and wishing you well.

[PAllen]

I didn't have LASIK induced dry eyes, so I can't give advice on that, but I did have very dry eyes and I can tell you that my husband's support helped me through some severe bouts of depression. Just having someone believe me and listen to me and offer support was a big help. Sending you both good thoughts.

[Colin P]

Anadin Extra, over the counter was the only thing that could numb the pain, available pretty much everywhere, very cheap! a reputable name + you can take 2x at a time every 4 hrs for ever if you wanted?. Never dried me out, where as Codine DID!...
Must be Anadin-- "EXTRA" and not Anadin regular.. I have took them for 15-20 yrs now. They cure (for me anyway) Migraine (proper migraine- not "oh i've got a migraine!!") and even a hangover!. There is some mention in the instructions about how the pain cure happens (nerves)...

[littlemermaid]

Colin, have you ever had the migraines looked at eg MRI or CT scan? http://www.nhs.uk/conditions/headach...roduction.aspx Or even painkillers could be contributory, old bean http://www.brainandspine.org.uk/help...dache_new.html

[Joseph]

It will get better believe that with all of your heart.. I had bad pain for one year after lasik and I thought that it would never go away. Believe me it will get better.. I will pray for your full recovery and your emotional well being.. P.S Feel free to P.M. me about the lasik recovery process.. I have been through the pain..

[LauraK]

Thinking of you. I have spoken to Tom in the past and thought he was out of the woods early summer. My heart goes out to him. I know this can't be easy for you. I had Lasik in January and have had a terrible recovery - it has been hard on my family, too.

[Cali]

Shane - I am so sorry you and Tommyboy are going through this.

I would immediately start Googling "pain management Boston." I think you're in Boston? I'd find the top specialist in your area. Maybe someone Harvard trained. Look for someone with a body of work online, maybe speaking at pain management conferences or mentioned in clinical trial drug studies. Someone who is very active and stands out in their field. Find the #1 person. If you want my help, just write me a Private Message. Then I'd contact their office and explain your situation. Grab Tommyboy out for an hour hall pass to see the specialist ASAP.

Think "core competencies."

You're right to target a "pain management" specialist. This person will only be focused on pain, how the nerves are firing and signaling pain.

You need the trifecta all 3 disciplines to get him through this: Psychiatric, Cornea, Pain.

He is in a psych ward, so that's covered right now but you may need to line up someone to help him once he is released. A good psychiatrist that he can see weekly will help him emotionally cope until he is over this horrible hump. You have Dr. Hamrah as your cornea specialist, so that's covered. Now you just need the pain management specialist.

I know you are extremely worried. He just has to get over the "horror" part, which is the debilitating pain he is in right now. Please know that most people on this site do find some equilibrium and stabilize. It just takes time, which is horrible as you're living through it (trust me, I understand).

[Tanner]

Cali,

Dr. Hamarah is a pain mgt specialist at mass eye and ear.

[Cali]

Tanner, this is a tricky one.

I think Dr. Hamarah is "Board Certified in Ophthalmology." He specializes in diseases of the cornea and refractive surgery. He is an ophthalmologist. Although he can prescribe pain meds for cornea pain and diagnose/treat cornea neuralgia, I think it's important to choose physicians based on "core competencies." When you look at "core competencies" you look at "Board Certification." Pain Specialists are certified by the "American Board of Anesthesiology and Pain Medicine." These doctors focus on managing pain. That's all they do all day long - manage pain.

Chronic pain is a whole other animal. Cornea neuralgia is a chronic pain. A pain specialist would ideally take the cornea neuralgia diagnosis and work with a patient to manage the condition via interventional therapies that give the patient "quality of life" (QOL). That's what you're after with acute, chronic pain - quality of life. Chronic pain affects your ability to function, your ability to have a normal life.

Dr. Hamarah, I believe, would provide a cornea neuralgia diagnosis and prescribe immediate pain relief meds, but perhaps not manage chronic pain over the long haul or understand its impact on the psyche (just my opinion). The good, fellowship-trained, pain specialists have additional certifications in psychology. They are current with the latest drugs and therapies that treat pain - that is their focus.

Tommyboy was hospitalized because that's what intense, acute, chronic pain does to you. It affects you mentally - you crack.

[Tanner]

Cali,

I understand I do. I don't want to sound like I know more than I do about doctors but I know pain and the sobbing. Whatever helps we all agree to that. I know you know pain too.

[emeraldile]

Feel so bad for you both. My husband helped me by putting podcasts on my phone and ipod. I was perched in the corner of the sofa for two days with no sleep because I couldn't close my eyes for the pain. But I wore Tranquileyes and listened to podcasts non-stop. It was really helpful for me too.

Gosh, I wish I could be more helpful. I know it will get better. Please keep us posted.

Hi Shane,

Tell him to hang in there... this phase will pass - I had LASIK in 2005, eyes went to hell in 2009 and were so bad I wouldn't even have been able to work (was on mat leave at the time luckily) but today they are functional and I can do most of the stuff I want to do. He'll get better too... it just takes time...

(((hugs)))

For pain mgt. help, the hospital pharmacist ought to be able to look into which pain meds are the least drying... I'd ask about meds for neuropathic pain.

Also, once he's out of the hospital, he could do a trial of plain over-the-counter dextromethorphan cough syrup (ex. Benylin DM), taken as directed on the label. It's not first choice for neuropathic pain due to its abuse potential, but assuming your husband has no history of drug abuse or anything like that, it's worth a try - he'd just take it as directed on the label 4 times per day (every 6 hours). I started this per Dr. Rosenthal at Boston Foundation for Sight and to my shock, it helped me - I get less foreign body sensation, less itchiness, less burning when I'm on it - it's not a cure all of course, but one more tool to consider. A friend of mine that works in hospital confirmed that they sometimes use it at her workplace for neuropathic pain, but it's maybe 4th or 5th line due to abuse potential. You won't see anything on the product label that it's good for pain... all you'll see it that it's good for cough... but this is an off-label use, so that's why.

Also, if he likes to read, maybe you could look into getting him some audiobooks while he's in hospital - when my eyes went to hell, my hubby looked into ipods for me (I ended up getting and ipod Touch), figured out how to set it up on the computer, and where to get audiobooks (I got mine from audible.com and online from our public library) - it was soooo helpful to have him do that since my eyes would have hurt soooo bad if I'd had to research it all the computer myself. The audiobooks were a godsend since they gave me something to pass the time that didn't hurt my eyes.

Good luck!