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Amazon1
04-08-2004, 02:13 PM
Hi, I was wondering if anyone else here was currently in Pain Management (PM) for TMJ? I have been taking Vicopropfen (7.5/200mg) for about 8-months now which was prescribed by my GP and allowed up to 8-a day which I most always need as my TMJ pain is quite severe! I have seen several dentists and one TMJ Specialist who said he could not treat me until I got my pain under control and recently, at the request of my Insurance company, my GP refered me into PM. (Also, I feel he might no longer feel comfortable prescribing my medication)

Today was my first PM apt and after filling out all the forms and talking to the doctors aide (I never even got to see the doctor!), she said that the amount of Vicopropfen I had been taking was too high and was equal to what a cancer patient might be taking and that she didn't think I could continue...then she said they would not even take me a patient until I had an MRI to "prove" that my TMJ pain was valid! Even though I had all my documentation and xrays from a previous apt with a TMJ dentist! The doctor even refused to refill my empty bottle of Vicopropfen after my GP had said to take it with me and that they would take care care of me! When I became distressed about this and asked what I was to do (I didn't want to be in pain NOR go through WDs!!)...she said I could go to the detox center at the hospital for more advice! ( how uncaring and insensitive!!!)

Needless to say, I was very surprised at such treatment but agreed to have the MRI done, took a urine test and told them that I would just call my GP for my usual refill, which I did when I got home and they said that was fine and they would continue until I had the MRI and we would take it from there.

What I am wondering is for those who are in PM due to their TMJ pain, is this standard treatment for a first apt? What kind of pain meds do they usually prescribe for this sort of pain and should I seek out another PM facility if they are not willing to give me something equal to the pain relief I am accustomed to? Any info or advice would be appreciated!
Thanks!
Amazon1

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tchair
04-09-2004, 07:55 AM
Amazon1,
Let's see, the doctor was lacking the time or inclination to see you. A major decision was made to cut off your medications without warning, seeing the doctor or any input from you. You were given patently false information about your dosage which reveals their lack of knowlege not to mention scare tactics. You now are aware that they are "uncaring and insensitive". The very idea that you can "prove" or disprove pain through an MRI is nonsense.
You can return to them and expect more of the same treatment, or as the vetrans say - take control yourself - and seek another doctor. Your TMJ specialist may or may not have been aware of the sort of PM he was sending you to. It is up to you to look again (and again if necessary) to find proper treatment. If you must explain to the specialist simply tell him what you told us - that they changed your treatment to no treatment without any consultation with the doctor, prior notification, or plan of any sort to treat your pain in any manner.
There are good pain management centers where you are treated with respect, no asssumptions are made about you and their goals are reduction of pain and improvement of quality of life. They may find your current medications are not appropriate. They may ask for phsycological screening, a narcotics contract and compliance testing. They may use trial and error in finding the best treatment. But a good doctor will taper you off of current medications if and when other treatments are effective, not tell you to take a hike.

Amazon1
04-09-2004, 12:44 PM
Thank you tchair! :) I know all of this...I do my research, educate myself on my condition and am involved with several online Pain management forums...I know that this is not the sort of behavior that I should accept! I find myself so 'vulnrable" though when my expectations are high and then to be let down so suddenly again and again...I am just tired of the "runaround" and even though I am in abit of a funk today, I will pull myself out of it and continue on with my search! ;)

Thanks so much for your post though and I will be sure to tell my GP who refered me there exactly what you said...I did touch on this when I went to his office yesterday after the upsetting PM experience, but need to talk with him again to clarify it! I'll keep you posted what my next move is...
Take care!
Amazon1

dan44
04-13-2004, 12:41 PM
I am new here. I also suffer from tmj. What did your xrays show? Let us know if you have had your mri too. I haven't had one yet. Curious to see what they actually show.
They treated you rather badly. I would ask for an explanation. Sometimes I think they base there opinions on someone without even talking to them.
I am treated at a pm facility. I haven't been treated like that knock on wood. They seem to think my pain is valid and haven't acted like I am a drug seeker yet.
Did your doctor call and talk to them? He would be the right person to tell them about you.
Thanks for any info.
Dan44

Amazon1
04-14-2004, 11:18 AM
Hello all, well I am in a state of confusion this morning and I thought I would stop by here first and see if I could get some advice! This week is Spring Break for us and I've just been being lazy and not doing anything towards my current "situation"...dumb me! :rolleyes: I had not heard anything from the pain mangement clinic and figured they probably were not going to even call me back...until this morning when I got a call (left on my machine) from them with the date of my scheduled MRI! It is scheduled for tomorrow (Thursday) at noon!

The way I had left things with my GP was to just go ahead and have the MRI and see what the PM clinic has to offer me...my GP said not to worry and that he would continue to fill my pain medication for as long as needed, but to give this place a chance. I have alot of concerns though...I am afraid the MRI will show that nothing is wrong with my TMJ and that we would have better luck if I got the Xrays from my last dentist apt showing clear damage to the tmj and arthritis (sp?) beginning in my left side! I also feel that I should make an apt and go into talk more with my GP and let him know my fears and maybe he can answer some of my questions.(TODAY!)

The part I am most confused about is that IF my GP is willing to keep me on the pain medication for as long as needed...I am wondering if I shouldn't be looking for another TMJ Specialist or dentist to try to treat the problem rather than PM where I take the chance of getting the same sort of treatment I did this frist time! The problem here is that it was at my Insurance companies request that I was refered into PM...they began hasseling my GP and saying that they wouldn't continue to cover my medication from him...should I call my Ins.co and try to explain the situation to them? I honestly don't know what I should be doing, but I feel that I am being treated very unfairly and the upset this is causing me does not help one bit!! Any advice????
Thanks,
Amazon1

surgicaldisaster
04-14-2004, 04:20 PM
Hey Amazon! :wave: Before you call the insurance company I would speak with your gp. It may be better to have you GP call as they tend to have a lot of experience with these lovely insurance companies and would probably know exactly what to say to them to hopefully straighten out that problem. As far as that pm Dr., I would definately tell your GP what happened. That was UNREAL! I cannot believe they treated you that way...just out of curiosity, are you on the young side? I only ask because I have found that that does tend to happen to people a lot that are in the younger category which in my opinion is disgusting, and totally uncalled for. Either way, I would talk to your GP. Maybe a call from your GP to this pm Dr's office might help also(?) , or ask if there is another one that will not treat you like some bum off the street(even they should not be treated that way, but I think you know what I mean). I agree with what tchair said, often we have to be our own advocates and really speak up. If we cower, they tend to think they were right or have "won", and you don't need that. Please let us know what happens o.k.? Take care of yourself, Surgical Disaster

dan44
04-14-2004, 07:31 PM
Why is the insurance hasseling your gp for treating you. Are they requiring a specialist to be in charge of your treatment? If so you may need to find a dentist who specializes in tmj.
How old are you? Not being nosey but I agree that sometimes they treat younger people as though they couldn't possibly have the pain they say they do. I know I had that reaction with different health issues when I was younger but now that I am in my late forties doctors don't seem to question my pain as much.
I hate to say this too but after to talking to my wife and many other women it would seem as if doctors sometimes think women are just emotional and don't always take their complaints of pain as seriously as they would a man's complaint.
You need to gear up for a fight. Gather up all you have and demand the treatment that you deserve. You have records proving your diagnosis, you have your gp who believes you have this so stand up and be heard.
If your xray shows the problems the mri should show even more. I have read where the problem with mri is not what it doesn't show but what it does show. So don't worry about that.
Keep us posted on what is happening.
Dan

Amazon1
04-15-2004, 01:37 PM
Thanks Surgical and dan44! Don't mind the "age" questions...LOL...I am 41 years old, although lately I feel 60+! :rolleyes: Yesterday was just too much for me...waiting for one doctor to call back, calling another...uggg...I was soo stressed out by the end of the day and ended up going to bed early!

The MRI is canceled as of now...my insurance company refused to pay for it and that is just that! have not received a call back from the pain management place yet, nor have I called my GP to let him know what has happened! I am giving myself a day here to gather my thoughs and try to figure out what my next move is! I really do feel like I might very well have to 'go to battle" and not sure I am up for that...we'll see...

I am not sure why my insurance co is hasseling my GP...I have no documentation of it...only their word...for all I know they could just be telling me this because my GP is getting to the point where he is not comfortable prescribing my pain meds at the current dosage I am on! I feel I really need to make an apt and go in to talk with my GP and see if he has any ideas for me or can at least give me some reassurance on how long they will continue to treat me! BTW...I have tried several other treatment modes and medications...NOTHING has worked for me except the current! (Ultram and Vioxx did absolutely nothing for me and the Neurontin gave me a bad reaction the very first time I took it! Just for curiousity sakes...what do you all think...is 8-7.5/200 Vicopropfen a day too much medication for someone to be on for the last 9 months or so? I have tried to get them to switch me to something else...Norco, etc...but they refuse! I am all for taking a responsible part in my healthcare, but these doctors are just making me nuts!!!!

I really don't want to go back to that awful PM clinic...I honestly do not think they are going to help me! I know I need to treat my TMJ as well as getting my pain under control, but I live in a small town and we just don't have many places to choose from! I am really at a loss today...trying to do some research on what my next move is and looking for another PM clinic...trouble is, I had enough trouble getting my ins co to pay for my last PM apt..I fear they will not be so eager to help this time and especially since they now know this is all tmj related and which is not covered! SHEESH, why does everything always have to be so difficult? :rolleyes:
Amazon1

dan44
04-15-2004, 02:28 PM
The whole process can make you crazy but I sometimes think that is what they are trying to do. They know the weak will give up.
I have other medical problems too which I am treated for through the pm clinic so guess I should consider myself fortunate. That sounds a little ridiculous but it would seem as though I would not be able to obtain pain management if my only pain complaint was the tmj. I haven't been told that but I would assume they are not billing for treatment of that.
It is hard to answer the question about your medication as only you know how much pain you are in. If what you take keeps you comfortable and productive then I would say no. At some point you may need to be on longer acting pain medication as sooner or later what you are taking won't do the trick anymore. You will need more narcotic but taking more ibuprofen may not be a good idea so a longer acting med would be better. That is why a I think you should try very hard to find a good pain clinic as they are geared up to treat pain much more so than your gp. He will become less and less comfortable as this goes on. Take advantage of his willingness to prescribe your medication and get going on finding a place. I am not trying to minimize what you will have to go through but it is your best chance.
Yes make an appt. with him soon and lay it all out. Be honest and upfront. Show him you are an active participate on how you will be treated and not just a bystander.
Sorry this is so long. Keep us posted.
Dan

Amazon1
04-15-2004, 03:35 PM
dan44, thank you for getting back to me so quickly! I haven't been doing much today towards anything...I figure after what I went through yesterday, I am deserved a day of resting up to prepare for my "battle" that lies ahead! :rolleyes: I am abit leary as tomorrow is the end of the work week and I'll have to wait till monday to start back in...I can't decide if i should call my Gp and let them know the MRI was canceled...I am concerned they will want me to keep my scheduled apt with the PM clinic (which was to go over the MRI results) anyways and i'm not sure I want to go back there!

Yes, it all can make one quit crazy and I too, find myself wondering sometimes if it all in their plan (especially the insurance co!) to see if we will just give up and leave them alone! :rolleyes: Unfortunately I cannot do that...my pain is real as I'm sure yours is too and I'll be darned if I will be made to suffer just because they are not sure if I'm telling the truth or not! WHO would waste all this time, energy and money anyways...SHEESH! :rolleyes:

As for the Vicopropfen, it does work almost all the time...today I find myself still feeling somewhat of a dull ache in my jaw, but I am sure that is just because I have been overly stressed. I have already had to have my dose adjusted once from taking one pill to two at a time and allowed that 4 times a day which I space out over the course of the day. Honestly, sometimes it wears off and I find myself clock watching until its time to take the next dose...that is usually when it doesn't seem to work as well because I am already in pretty bad pain. I once told my GP this and asked about something for "breakthrough pain"...I am sure you can guess his reply. :rolleyes: I don't want to make him out to be a "jerk" or anything because he's not...he has been my GP for many years and we have a very good relationship...I also am on anti-anxiety medication that he prescribes and have only had to have that dosage adjusted once in 14 years...overall he's been a great doc, but I fear this is putting somewhat of a strain on our relationship and that is one reason why I know I need to get in there and discuss it with him!

One more question for you...do you think I should keep the apt with the PM clinic that treated me so bad...just to see what they have to offer? I know this is probably what my GP would wish me to do...and if I am not satisfied, I guess I need to begin looking for another, even if its 100 miles away...
Thanks,
Amazon1

dan44
04-15-2004, 05:23 PM
Yes I do think you should keep it. I think you should play by all of the rules and do all that is asked. Then you have a leg to stand on. It can take along time to build the trust but you will accomplish it much sooner if you do everything they ask you too. Then when what they have suggested isn't working they will listen as you have been eager to do everything possible to find the correct treatment for yourself.
That is just my opinion.
So keep it and don't give in.
Good luck,
Dan

Amazon1
04-15-2004, 09:51 PM
Thanks dan44! I agree and will go ahead and keep the apt with the PM clinic as I'm sure it will "work for me" in the long run! I am getting all my past documentations together and making an apt to touch bases with my GP for next week...also I got a call from the PM clinic today saying that my insurance company had sent everything to their nurse (the insurance companies nurse) for reviewal about covering my MRI...they should let me know if I am to have it done next week...not real happy about that, but as said, I will do what I have to do...claustrophobia or not!!! :rolleyes:

I'm trying to be strong...as long as I have my pain taken care of, I will be fine! Thank you for your caring replies and helpful advice! :) I'll keep you posted and hopefully will have some good news...eventually!
Amazon1

surgicaldisaster
04-16-2004, 04:29 PM
Hey Amazon, I will be thinking of you and wishing you luck with your appts. You really have nothing to loose by going back to this pm Dr. If they treat you the same, well, I think then I'd be looking elsewhere. Please let us know how things go when you can o.k.? Take care of yourself...Love, Surg

jan22
04-16-2004, 07:08 PM
Hi,
I haven't posted in along time. I have posted on the addiction forum as I am a chronic pain patient who has had that as a concern from time to time but just wanted to wish you luck and say hang in there and keep us posted on what happens. It is hard to be strong when you are suffering from chronic pain but you have too. The members here seem to be very nice and will always be here to offer support.
Hang in there.
Jan

Amazon1
04-18-2004, 11:54 AM
Thank you Surgical and jan22!! :)

I have taken this wknd to regroup and destress...I am not looking forward to the upcoming week and what it may bring! (I actually found myself "screening" my phonecalls Friday...I just could not bear discussing my situation any farther! :rolleyes: )

I did take the time to sit down for about 2-hours Friday night and "document" all that has happened since my TMJ returned in June of 2003...I think that might be useful somewhere down the line.

Well, just wanted to say THANKS and hopefully I will have some good news to post about soon...the sooner the better!
TC all!
Amazon1

Amazon1
04-20-2004, 08:29 AM
Good morning! Well, I had abit of good news to share...not much, but I went in to discuss some things with my GP yesterday and told him about my fears of being left in pain and that I was having alot of trouble dealing with all this stress...He assured me again that they would work with me for how ever long it took and said they would call me in something for "breakthrough pain" today! I finally got them to realize that once I was in bad enough pain, the Vicopropfen would not touch it!

I am still in limbo though, waiting to find out if I can have the MRI and will keep you all posted about what hapens there! TC!
Amazon1

surgicaldisaster
04-20-2004, 11:05 AM
Hey Amazon, that is some good news! At least you know your GP is there for you to help you through this maze. Just wanted to wish you luck and support for any upcoming tests/appts. Take care of yourself! Love, Surgical Disaster :wave:

susiek
04-20-2004, 11:00 PM
hey amazon...... just reading about your tmj. I was dxed w. tmj but not one test mri, xrays, brain scan, etc. turned up anything realted to tmj, though I have textbook symptoms, so don't "freak" if nothing shows up.. you're not crazy. In the interim I did find out I had neuralga (sp?) and myofacitis (sp??) spelling is not my stong point. It took a good 8 years before xrays showed my gums, teeth etc, beginning to separate from my jaw, the fun just never ends.... :bouncing: anyway, thank god your dr is the caring professoinal he is.. and after you jump through all the hoops, you may find that he becomes more comfortable (with proper documentation and his past knowledge of you) prescribing. They have to cover their butts too (we all have to eat :) My doc (after one tmj specialist (who no longer felt comfortable taking my money as tmj is not a covered dx on my ins. plan and his actupuncture txt was just not cutting it) and about five, maybe four other pm drs' all over nys and mass. stated they all felt my pain is real) though we all know no one really knows what pain is until they walk the mile.... keep your chin up amazon, jump through the hoops, but set a limit.. My limit was $23,333 I had no more money, no more patience, I was a real mess :rolleyes: when you can honestly say to yourself that you have tried every alternative take the meds..... but please watch the tylenol or whatever they want to call it ibuphren (where's that spell checker UGH)

Sweet dreams~

Amazon1
04-21-2004, 03:30 AM
Thanks surgical :) ...still no word about the MRI...I'm beginning to think they forgot about me! :rolleyes: (I'll give it till Friday and then will call to find out what the hold up is!) These doctors never cease to amaze me! My GP prescribed me "Percoset" for my "breakthrough pain"..even though I had told him awhile back that it was too strong for me! I took one about an hour ago and I still feel like a zombie! :dizzy: (LOL! Maybe that's the way they want me to be so I'll leave them alone! :rolleyes: ) It DOES knock out any pain though...so I guess I shouldn't complain too much!

Hi susiek, sounds like you have had a rough time of it! I am just trying to take things one step at a time although my patience is wavering and sometimes my stress level is crazy! Are you currently on any medication for your TMJ or having any treatment?

Amazon1





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