Dr. Nikesh Seth, MD

I'm happy with my experience and his attention to my needs while I'm out of town working. What I'm not happy about is how ALL doctors and pain management people seem to compare the patient (me) to other patients instead of indiviShow moredually evaluating me based on injuries, age, prior, current, and needed opioid use and what it does in long term patient use vs. someone new or even people who have been using for a year or two. NONE of us are the same and I've been using opioids since 2013 when I had cancer, after cancer the pain in my joints increased substantially, then I had multiple surgeries 13-14 and now the Harley crash at 65 MPH over a 200' cliff. I spent months in the hospital and my body is traumatized at 58. Healing now vs. in my 20-30-or even 40's isn't close to the deterioration on a persons body at the age of 58 who has been through the trauma I have. Doctors want to compare my pain with those of younger men and younger men who haven't been through the injuries I have. Even before the cancer I had over 27 surgeries on broken bones and torn and damaged shoulders and knees, tendons, and ligaments. The GOAL is to obtain a quality of life to enjoy each day as pain free as is possible. I am aware that living pain free is impossible at this point but I do know that I can live comfortable if the Doctors would stop comparing me to "THEM" and making sure I am prescribed the medication it takes to achieve this. I have scheduled surgeries on my back, shoulder, and hamstring for 2023 and 2024. I'm doing my part and I'm asking for Dr. Seth to do his part FOR ME not the box of people i've been thrown in and compared too. In my era of the 70's, 80's, and 90's we athletes were raised and pushed hard by coaches and fathers using the "NO PAIN NO GAIN" motto on us young boys trying to please our fathers and coaches. We took that to heart in trying to prove ourselves to our fathers and coaches, then into our adult life with our wives and employers and then our own children until one day we woke up and realized that way of living was all BS. However it doesn't allow us to go backwards and change what we did to our bodies, we can only change today and move forward with all our past injuries. I am looking for a quality way of life and why i'm going through so many surgeries, but in the mean time I would really appreciate Dr. Seth reevaluating my pain and allowing me to go back to taking the pain medication where I was enjoying life and not hating it each day because of the pain I live with. I can't sleep and if I can't sleep because of the pain, I can't lay in a bed, I have to fall asleep in a recliner chair and my body won't heal without a good nights sleep, I won't take sleeping meds with opioids because its unsafe and if I don't take opioids and take only sleeping meds the pain then keeps me up anyway. Again if I don't sleep my body won't heal. If my body is not allowed to heal it perpetuates continuous damage to my body and the chronic pain, not to mention my mind is not getting time to heal either. When I showed up to Doctor Seths office I was using 120 morphine one every 4- 6 hours and I was wearing Fentanyl patches 50 mics every 72 hours. I was at least able to sleep and enjoy my days. As soon as I got to Dr. Seths office he changed my medications and I said I would try them for him but I also told him what would occur and now it is. I only quit going to my last PM company because each surgery they failed to communicate with me and the surgeons after the surgery as was prior planed and discussed. Instead they wouldn't answer or respond to either me or the surgeon so I terminated services and requested to see a new company that stayed on top of the patience needs, during surgery and recovery. I now am with Doctor Seth and I'm told that Im in excess of some federal standard and that he can only give me the 80 morphine tabs and 30 buprenorphine tabs that actually work against each other. I will explain in a minute but no one is listening because they think they know more than the patient who's injured and using the medications? . Doctor Seth, with all due respect, how many surgeries and injuries have you suffered. Have you broken your back in 5 places, fractured both legs in multiple areas, broken your shoulders, torn rotators, broken 11 of 12 ribs, punctured and collapsed your lung, inverted your elbow, shattered your knees, torn your abdominal section to a point there are no muscles in your core to be used to sustain your posture, have you ruptured discs in your neck, broken every bone in your fingers and hands, torn your pectoral muscle, torn your bicep, torn your interior hip flexor in half, Had Lymphoma cancer, and so much more? Have you had even a fraction of these injuries in your life? If not then how can you prescribe anything without serious communication with me and possibly my orthopedics and surgeons as a team? In stead I feel you are simply placing me in a box of people that the government has told you I belong and you are asking me to accept this and just deal with it so you are protected from having to explain my medical status to someone?, and you are asking me to be happy about it. The guidelines must have variables for people that are in my category, vets, pro athletes from the 90's and earlier, people of serious injuries in life. None of us asked for these injuries, but all of us are asking for people like yourself to STOP placing us in a box with people that have nothing in common with us. If you choose not to understand or at least empathize then you will never truly understand or be the best pain doctor you can be. What you will be is safe, without criticism by the agency you say are overseeing your practice. At least this is what you told me when I sat in front of you in your office when you told me you couldn't authorize what my last PM doctor had me on? Made zero sense when you didn't even know me or my injuries yet. I am only wanting to wake up and enjoy life as you do each day. Wake up and be capable of earning a living each day as you do, wake up each day and be capable of playing with my grandchildren like you hope to some day. I am asking you to really listen here and try to empathize and find a way to get me back on the minimum of what my body needs right now and that is 120 tabs of 30mg morphine and I can get by with the 50 mic fentanyl patches as long as I have the 120 tabs of morphine. But the patches stop working after two days because they stop sticking to the body and if I sweat at all they stop working sooner and why the 120 tabs of morphine are important. You and I both know nothing at this point, if not a narcotic will stop the pain, I have and many others have tried so many different drugs that whatever it is I try has to be as strong as the morphine and fentanyl combination. If not it's a waste of time, and worse than that, it hurts to try useless drugs. I went on buprenorphine prior to my accident for three years and it worked enough to make it worth switching over but I was given 4 per day and told if I needed to double up on severe moments I could but don't make it a habit. That worked enough for 3 years and allowed me to get off opioids. However, now that I have had this recent high speed crash over the 200 foot cliff its not possible to use that drug and live with any sort of quality of life, its impossible until after my surgeries and after the trauma to my spinal cord and body have healed as much as possible. The other set back of living with extreme pain is the blood pressure increases with the pain and my heart doctor has already increased my BP meds twice and to their max for this drug. Living with lower pain also is better for my heart and the stress that pain places on my mind and body. What is the number one killer of men? Stress, and its bad enough my business has suffered from the accident and not working for a year and now the added stress and no sleep has been added to the package of harmful physical ailments being caused by the pain and the fact that the pain is not being managed the best that it can be. The stress to my heart, mind, and the increased blood pressure is causing other problems to my body and brain and I'm asking that Dr. Seth reevaluate my file and removes me from this BOX that has been established by someone who isn't understanding the patients like me. Dr. Seth I have tried, like I have with 5 other pain management doctors to do things to minimize opioid use but there is a certain amount that allows my body to respond well and allows a quality of life to be sustained. There is more to this than just the doctors keeping the scrutiny down, if the use is legitimate than the scrutiny can be managed legitimately. I am asking that we manage my pain accordingly. As it stands I'm in horrible pain every day, I don't sleep, I can't work more than an hour at a time, I can mentally focus for more than an hour before the pain becomes stressful, and my blood pressure increases and everything goes to hell. I can't sleep, if I can't sleep I can't heal, with all of these ailments being caused by the pain the damage is worse in this condition than it is with the increased and good balance of opioid use. Please re-visit my file and the information I provided. If you need more back up we can get that from all the different hospitals I have been in and the operations I have had. P.S as I said I would explain about buprenorphine. Buprenorphine stops the opioid from working, it consumes the receptor and stops the opioid from doing its job and Dr. Seth you have prescribed it to be used in the morning after a nights sleep and the opioid having dissolved throughout the night and while doing it like this you are trying to minimize the receptors from getting abused by the opioid and then somehow after the 4 hours in the morning we take a opioid the opioid doesn't work, the buprenorphine stops it. So pain in the morning is not relieved from the buprenorphine your body is attempting to go into withdrawal but the withdrawal is slowed by the opioid pill taken mid morning, then another, then one more, then sleep then in the morning the cycle starts all over. Bottom line it causes nervousness, anxiety in the morning and then I take the opioid and the anxiety minimizes but the pain is still there and worse because the minimizes has been neutralized. The pain begins to slow in the afternoon and evening and then it starts all over in the morning. Its a vicious cycle. The Truth is, ask the pharmacist and they will tell you the same thing. People are not taking the pharmacist until after they run out of morphine and if they do they take the buprenorphine to stop the withdrawals from happening and wait for the next script to come out. The fact is this method is a good thought but it truly shows who ever came up with this that they know nothing about how these two medications work together, maybe in theory they work but ask your pharmacist and they will tell you its not. I like having the buprenorphine because its nice to have if and when the morphine runs out and it keeps the withdrawals from happening but the fact is the method in which you are wanting this to work doesn't''t. The pharmacist is who explained and told me why my morphine wasn't working and I was feeling anxious and having horrible anxiety every morning. I'm not using the buprenorphine and neither is anyone else if you will ask your pharmacist. I'm telling you the truth and I don't expect to be punished for sharing the truth. If my truth isn't believed ask your pharmacist, they are the ones who explained why my medications are not working and I'm in constant pain and stress. We can talk about it in my next meeting but in the mean time I would respectfully request you call and talk to a pharmacist that is handing these out and dealing with the script you're writing if you want the truth from them. thank you for reading and hopefully listening. Steve Spady Patient

Steven S. • July 05, 2023

I've been a patient of Dr. Seth for over 5 years now and I can honestly say that my quality of life has improved tremendously. I've had more than 20 surgeries so dealing with pain was just an everyday part of my life until cominShow moreg to Integrated Pain Management. Dr. Seth has listened to me describe all of my aches and pains and together we created a plan that would alleviate as much of my pain as possible. It took awhile. but it was worth it because for the first time in 48 years, I can say that I am almost pain free. Now I'm not saying that I am 100% pain free, but I'm close. Five years ago I couldn't walk without using a cane, actually 2 canes, and consuming numerous pain medications totaling more than 200 pills a month. Here I am five years later and by the first of the year I will no longer need a pain management doctor. I'm actually going to miss them, Dr. Seth and his staff have been like family to me for the last several years. Now, I can't promise that everyone will experience the same amount of pain relief that I have but if you're patient and you communicate thoroughly with Dr. Seth, he'll determine the best pain management plan available for you. I hope that everyone achieves the same amount of pain relief that I have. Remember, you're a team now and that requires good communication. You're in good hands!!

Stephen S. • November 01, 2023