My story is a follow-up to the guest column by Kimberley Comfort that was recently published in Pain News Network.
I am also a patient of Dr. Forest Tennant and, after reading Kimberley’s heart-felt story, I immediately felt compelled to write mine. I am currently 67 years old and, much like Kimberley, my problems with pain started during childhood.
The pain waxed and waned until I was in my mid-20’s, when it became a daily part of my life. I tried very hard to ignore the pain and remained in denial until many years later. I did not even tell my wife at the time. I did realize that I was consuming way too much Excedrin and was aware of the dangers posed by taking too many NSAIDs.
I went to several doctors seeking help in the 1980s, but none of them could find anything wrong with me. I worked through the pain until it became impossible for me to continue doing the physical work required of an electrician. The pain was body-wide, but the worst pain of all was constant, crushing headaches that were absolutely paralyzing.
Deciding that I must change careers, I returned to college. I was accepted at James Madison University and enjoyed college life so much that after graduation I decided to stay in academia and teach. I received an academic scholarship to Syracuse University, but was not able to finish my Master’s thesis due to the excruciating pain, an inability to concentrate, and the severe chronic fatigue that often accompanies extreme pain.
Then I started searching again for a doctor that could help me. My initial diagnosis was fibromyalgia. I asked that doctor if there were anything he could give me for the pain and his exact words were, “Yes, I could, but you would be a junkie within two weeks.” He offered no medication or treatment of any kind.
I kept trying doctor after doctor, and almost every therapy and medication known to science. Nothing helped.
My search finally took me to Dr. Tennant in 2010. He is considered one of our country’s foremost experts on pain and the prescribing of opioids, having operated a pain clinic in West Covina, CA since 1975. He is also the Editor Emeritus of Practical Pain Management, a monthly medical journal about pain. His current research interests are inflammatory markers and the role of hormones in pain care. He is a frequent speaker at major pain conferences.
How could I possibly go wrong by having this expert in pain as my doctor?
When I first saw Dr. Tennant in 2010, he was very blunt with me and told me that I might not live much longer. By then my severe chronic pain had given me high blood pressure, which can cause heart failure or stroke. In addition, my lab results were not good. Dr. Tennant told me that my pain had “centralized” — meaning that I had suffered the pain so long that it had become my normal state. Pain that has not centralized will be sporadic, while centralized pain is constant.
I suffer from a post-viral autoimmune illness that first presented years ago with symptoms similar to fibromyalgia, arthritis, and myalgic encephalomyelitis. Dr. Tennant began treating me with opioid medication and titrated me to a higher dose to effectively manage my pain. I had been on a standard dose, but Dr. Tennant found through genetic testing that I have a genetic anomaly that makes me a poor metabolizer of many medications. This is why I required a high-dose therapy.
Here is where I differ from Kimberley Comfort. She metabolizes her medications so rapidly, that she could not reach a level of comfort on a standard dose. My problem is the opposite – I am a very poor metabolizer — but the outcome is the same. We both require high doses to properly treat our pain.
After years of debilitating constant pain, I began feeling much better. Opioid medication not only did a good job of relieving the pain, but along with hormone supplements and anti-inflammatory drugs, they also improved my quality of life, allowing me to do things now that I could not do before. It may sound trite, but this man “gave me my life back.”
In late 2015, I was diagnosed with cancer, the onset of which may have been facilitated by my overall disease state. More recently, imaging has shown that I have abnormalities of the cervical spine that likely contribute to my continuing complex array of symptoms. Like most of Dr. Tennant’s patients, I am an outlier – a patient whose complex disease state places me far outside the usual patient, in terms of severity and resulting disability and pain. I believe that I would probably not be alive today without the thorough assessment, evaluation, diagnosis and treatments provided by Dr. Tennant.
Now, the DEA has raided his office and seized all of his patients’ records. I have read the search warrant and was very surprised to find that a family practice physician (not a pain specialist) had advised the DEA. Dr. Timothy Munzing suggests in the warrant that any patient from out of state receiving high-dose prescriptions for opioids must be selling their medications because they could not take those doses and survive. That is absolutely not true. I’ve been taking these high doses for seven years and have had the best seven years of my adult life.
Dr. Tennant’s practice is in California and I live in Virginia, so imagine how I feel now. I am quite frankly scared to death of having my door kicked in, my medications seized, and then going into serious withdrawal. At my age and my level of pain, I could die along with many other patients of Dr. Tennant. How can the DEA practice medicine? They have no medical license. These decisions should be made by the doctor and the patient.
Dr. Tennant recently received a Lifetime Achievement Award for Pain Medicine from his colleagues at PainWeek. In making the presentation, Dr. Kevin Zacharoff described Dr. Tennant as “the kind of doctor that listens, digests, and most importantly, invests in every patient, the patient’s problems, and those of society.” Zacharoff describes him as “the true doctor’s doctor,” a term used in years past to mean the kind of physician other physicians would want to seek out for their own medical care.
Why doesn’t the DEA understand what pain physicians and patients understand about Dr. Forest Tennant?