I am in pain, but it's nothing new except it's getting worse rather than better. I finally am ready to have my appt tomorrow at 10:15am with my primary Dr. (Internal Medicine).
I am hoping he will send me for an MRI and other tests he feels might be needed.
Should I ask for a referral for a Orthopedic Dr. or a Pain Management Dr. ? Or Both ?
Or should I just stick with my Internal Med Dr ?
If anyone has any ideas please let me know..
"For people who do not know my case history"
* 27 years old, male
*Chronic upper back pain for about 6 years, recently getting really bad, really stiff in the morning takes forever to get going, lasts all day everyday.
*Crackling sounds from rib cage area across upper and middle back when stretching.
* Pain, tightness and burning all day long, usually ranges from a 4 through 8 depending on the day and how my body wants to react. Usually it's at least a 6/7 all day recently, used to be an annoying 3/4 all day, which I lived with but hated.
*Problem areas are mainly around breastbone area of chest, across shoulder blades, dead center upper back, upper shoulders and back of neck. Feels as if it's muscles and bones/joints.
*Muscles spasms, had a couple that were severe enough to go to ER, felt like I was having a heart attack, pain radiated through upper back to chest area.
* Taking Skelaxin 800mg 3x daily, doesn't really help at all, hoping to change, maybe Flexeril or Soma, depending on what doc wants to give me. Also taking Vicodin 5/500mg which also helps somewhat but not to where I am not bothered by the pain, burning, tightness ect..
*Chiropractic 3 years, PT on and off again, all of which produces results that do not last for more than the day I have them.
*Can't remember any trauma I had that would have caused all this. Don't understand how it's getting worse.
*Can't really do anything, lifting, heavy physical ect.. Try and walk and stretch when I can.
*Still undiagnosed and waiting
L5S1
05-27-2003, 04:46 PM
Hi Hotrodd http://www.healthboards.com/ubb/wave.gif
I would first start with asking the PM doctor to get an MRI. As far as a referral to an ortho or nuero doctor, it depends on who your doctor and you both like. I had a terrible experience with a neuro which caused me to wait several more years in pain while the ortho I was referred to was excellent and immediately took action to correct my back problem. The ortho explained everything to me and spent the time to listen to me. You might visit both a neuro and a ortho to see what they say and who you might like. As far as a pain management doctor, I would wait to see the tests results and visit the ortho and neuro doctor first (in my opinion). If you went to the pain management doctor first, it might mask your symptoms and you might not be able to explain to the doctors how you feeling while you are on pain intervention.
I hope you have an excellent internal medicine doctor who will search for the cause of your pain.
Good luck tomorrow http://www.healthboards.com/ubb/t_up.gif
wbaker68
05-27-2003, 04:55 PM
First thing you have to do is have some testing done to figure out problem. If you have gone this long without diagnosis and your still treating with same dr., you need to find another. Diagnosis is only way to get started here and you have to have a dr. who is willing to take control of your case and help figure out your best avenue.
I have found in many cases that a neurologist, not neurosurgeon can be a great way to get to the problem and get you into the proper treatment. If a surgeon is suggested after testing, I would suggest both Ortho and Neuro, just to get both sides as they tend to see things differently.
Good luck and keep us up to date as to what the recommendation is from your doctor.
------------------
Auto Accident Aug 1988
L3-4 disectomy 1989
L3-4 now re-herniated
L4-5 DDD
L5-S1 herniated
5/14--trial stimulator implant(went well enough for full implant)
6/11/03--scheduled for full implant(medtronic)
Hopefully to hold on for ADR
TexMich
05-27-2003, 06:59 PM
Hottrodd,
Looks like you've been given good advice! Just to add quick suggestion - the summary of your pain & action history that you include with your posting here is so precisely & chronologicaly complete, you may want to print it & take it to your Internal Med Doc appt. tommorow & hand over a copy. (Ditto with Neuro &/or Ortho you go to later). If you've been going to this Int Med Doc for years, he/she probably has your "progress notes" scattered over many pgs in your chart - so the precise way you've listed your pertinent info into one page should be helpful in directing his attention into what's wrong & what's already been tried. If it's a new Internal Med Doc you're seeing - the one page summary will still be just as helpful. (you were probably already planning to do this- but just in case-I thought it was worth mentioning - considering the attention span of Doc's today!) Good luck with answers tomorrow!
First off I would like to thank everyone for the great advice and their listening ears. I went to my primary care doc today (internal medicine), this is the second time I have seen him with my new insurance.
I walked in, set my case, doc seemed very concerned and totally wanted to find out what the underlying problem was. So we started off slow, but this was because he wants to go down the list and rule everything out as we progress testing and treatments.
This was going very well so far...
He started off by listening to me.. then he proceeded to poke around a bit at my problem areas. He totally agreed there was something wrong and like I said wants to move slow and steady to not miss anything
He proceeded to give me 8 cortizone shots in my back and chest area, saying this is just a temp fix, let's see if it works while we see what's going on. He then ordered for x-rays to be taken tomorrow at the hospital. He said let's go from there and rule some stuff out before we go to an MRI, which will be next if x-rays aren't telling us enough.
He the sent me on my way with a 3 month supply of...
He said Vicodin for pain because I have been on them and if I needed something different we would need to dose me down gradually before we switch. I said, "I understand totally." He also said the Soma should do you good, and not to take Vicodin right after, to wait about 3 hours or I will become very sleepy.
Not sure if this is going to happen, I am new to Soma...
I was happy he was trying to keep me comfortable. I am new to those meds except the Vicodin. So if anyone knows how good the others are for pain, I would appreciate some feedback.
Doc said try this and let me know how they are working, let's see the x-rays and go from there, other tests, more opinions ect...
PERFECT... I said..
So that's about it.. I am glad he was so cool about wanting to help and also keep me comfortable while finding out what the diagnosis is.
wbaker68
05-29-2003, 03:13 PM
I am glad you are happy the way your visit went. When is your follow up appt to discuss x-rays and decide if further testing is done? Did he order flexion/extenion x-rays or just plain standard xrays?
X-rays in many cases show nothing. However, if you have any movement or narrowing of disc space they will show that. Good luck and keep us updated.
------------------
Auto Accident Aug 1988
L3-4 disectomy 1989
L3-4 now re-herniated
L4-5 DDD
L5-S1 herniated
5/14--trial stimulator implant(went well enough for full implant)
6/11/03--scheduled for full implant(medtronic)
Hopefully to hold on for ADR
