DogMom22
07-25-2006, 02:47 AM
I want to find a new PM. My existing one is not bad or horrible but I am not satisfied with him, I tell him my pain is not under control yet nothing changes. I know I need a LA med or an increase (although I have never asked out right for fear of being labeled druggie). The PM I am with now is my first one and I have been with him for about 5 months now. At my last appointment I got very clear indications that now that they are done doing all the possible injections and tests that they are not really interested in continuing to treat me. (When I went to check out with the Admin person, normally she makes another appointment for one month later. This time she didn't and when I asked, she said the doctor didn't put any instructions down other than to call and make an appointment as needed. I went home and called and made the appointment for next month to give myself time to get another PM. This PM works out of a Ortho clinic and works as a PM 2 days a week and I am thinking I need a multi-disciplinary PM clinic. I have no problems with contracts and pill counts or urinalysis - don't like it, but I understand why and will submit to whatever to keep my pain under control.
So, once I identify who (clinic) I want to go to, how do I go about the business of making my my first appointment (what do I say) and then how do I handle the first appointment? I have always gone by honesty is the best policy, but I also don't want to say anything bad about my previous PM. I know I can't except meds from a new doc without notifying (firing) the old, so I would consider the first visit a consultation. Any suggestions or advice would be welcome. One thing to keep in mind is that I have lots of tests and results that I can get a hold of but I have no diagnosis or anything that accounts for the pain that I have - so I can not explain what my condition is when I make the appointment or during my first appointment.
So, once I identify who (clinic) I want to go to, how do I go about the business of making my my first appointment (what do I say) and then how do I handle the first appointment? I have always gone by honesty is the best policy, but I also don't want to say anything bad about my previous PM. I know I can't except meds from a new doc without notifying (firing) the old, so I would consider the first visit a consultation. Any suggestions or advice would be welcome. One thing to keep in mind is that I have lots of tests and results that I can get a hold of but I have no diagnosis or anything that accounts for the pain that I have - so I can not explain what my condition is when I make the appointment or during my first appointment.
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bulletinboard25
07-25-2006, 03:49 AM
What type of pain do you have, if you don't mind me asking?
charliecat31
07-25-2006, 05:25 PM
I'm interested in how to find a new PM doc as well. I LOVE mine, but am considering moving to another state in the next year or so and have no idea how to go about finding a new doc.
Thanks for any help
Thanks for any help
mergatroy
07-25-2006, 08:18 PM
If we knew what city you were going to, we might be able to help.
[removed] I called to see if they were taking any new patients. If they were accepting new patients I told them my insurance and that was it.
They asked if I had a referral and I said I had a PPO insurance, therefore did not need a referral.
The lady was VERY nice and told me I needed a referral from my current doctor. So I got one. That was it. He brought me and my records in, I did a bunch more tests and was set up on Avinza and demerol. That was about 8 months ago.
[removed] I called to see if they were taking any new patients. If they were accepting new patients I told them my insurance and that was it.
They asked if I had a referral and I said I had a PPO insurance, therefore did not need a referral.
The lady was VERY nice and told me I needed a referral from my current doctor. So I got one. That was it. He brought me and my records in, I did a bunch more tests and was set up on Avinza and demerol. That was about 8 months ago.
hurtin4sure
07-26-2006, 10:16 AM
I guess I can only speak for myself, but I am sure that most of us at one time or another have came to the conclusion of wanting or needing another pain management doctor due to a number of reasons, mostly becuase we feel our pain isn't under control. I have been to a number of PM doctors and I have yet found one doctor that can take all of the pain away. I know it is sad to say this but I believe that you are going to have to live with a certain amount of pain, but by no means should you suffer. I always have had to have a referall from my primary doctor to get into a PM Clinic. The ones I have been too the doctors are so GUN SHY, they think every LAW ENFORCEMENT Officer in the world is going to be after thier license if they treat you properly so I can understand your situation fully. My situation got so bad that after years of use of oral Meds, they wouldn't even put a dent in my pain, and my blood pressure was escalating, I was having chest pains etc and my doctor recommended a Morphine Pump, becuase the medicine that is used in these pumps are far more effective than the oral meds or at least what the PM Doctor will give you, and my pump gives me great relief for my L5/S1 problems. It is a Codman 3000 continuous pump that always is giving me a dose of Morphine in the intrecal space of my spinal cord. No fogginess like with oral meds, and way greater relief and it certainly doesn't seem to me that the doctor is scrutized by the Law over this type of treatment as if you wanted to abuse it, I don't think abuse is possible anyway so therefore no hassles from anyone. Inquire about a pump and see if you would be a canidate for a trial, if so, let them first try an external one on you then if all goes well let them implant it. It is the best thing I ever done. Doctors that give high dosage opiods, muscle relaxers, zanax etc run the risk of causing you respitory failure in they medicate you to where you don't know if you are coming or going, sure you are out of pain but who want to run the risk of something terrible happening to someone, and doctors don't want to put them selves in that position. I hope this helps you out and good luck with your pain issues, it sure isn't a picnic in the park. Jeff
DogMom22
07-27-2006, 02:20 AM
Let's see - to answer some questions - I live in Northern VA - I have plenty to pick from from my Health Insurance coverage so my issue is not so much identifying who to go to, it is more how to approach making the switch - what to say when I make the appointment (why am I switching from one clinic to another) and how to handle the first appointment - I usually go with honesty is the best policy - but I am terribly afraid I look like a drug seeker (which I am, but for pain control).
I have undiagnosed back pain. I have had a gazillion tests and tried several treatments and I have been told I have mild disc degeneritive disease and arthritis but nothing that accounts for the intenstity or duration of pain I complain of. I have very deep, and low back pain that radiates to my buttocks, hip, front thigh and groin. It never goes down the back of my leg or below my knee. My MRI, cat scan, and ultrasounds are clean. My discogram was negative although I have severe doubts about that which was in another post but no one seemed to have any ideas about what might have really happened, but the PM doc says it's negative so that's that.
From all my research and reading I feel it is discogenic pain and I feel it as nerve pain. The reason I believe it is nerve pain is that topamax helps it - which targets nerve pain. Additionally no muscle relaxer or anti-inflamatory that I have tried ( and I have tried many) has ever helped at all, leading me to believe I am not having muscle spasms. I have had facet injectopns and the PM doc feels sure this is not my hip nor my SI joint. I am in pain most of the time.
I do not expect to get 100% pain relief from any doctor, but I am looking to switch docs because I do expect to get some level of control over the pain as I am back to almost being completely out of control and despite my efforts to communicate this to my PM it hasn't gotten me anywhere. I have clearly stated that my tolerance to the vicodin has built up and despite increasing the topamax my pain is getting worse again - the condition is not getting worse, the pain is just returning worse because my tolerance has built up and my guess is the topamax isn;t going to do much more than it already is - other than make me a complete idiot - I suffer terrible side effects from the higher dose of topamax but I take it as without it I don't think I could function at all - so I figure it is better to function as a mixed up idiot who can't remember what she did 5 minutes ago than to be in pain - choosing my poisin.
My current PM doc, I believe is a good doc, but he is not of the same culture as I am and I think we have communication problems (which I admit might be my fault.) I have decided I need someone different - someone who is more like my GP - someone who 'gets' what I am trying to explain to them who is willing to work with me and understands I am not out to take advantage of them.
I also understand part of the issue in my case is that becuase they can't find what is wrong with me it makes it a little harder to treat me and it doesn't help that I have an extreme fear that I am perceived as a drug abuser as a result. I have been suffering for 3 years now and only last year did I start to get some relief and for a while I got not complee but quite adequate relief and my life for the most part returned to normal - this is what I am after.
I am fine if the docs can't find the problem and they have ruled out that nothing serious is wrong (no cancer and no organ failure) but I want to get some level of pain control - I accepted some months ago I was going to have to live with this and deal with it - however when it is out of control then I also loose control, I start to think - well let me just say very bad thoughts about how I could hurt other parts of myself that would give me a diagnosis and then I would be treated seriously and in turn get relief for my back - however I realize how stupid an idea that is so I don't act on it, I just think about it.
So my question is what do I tell them when I make the appointment - why am I switching to another clinic? I don't want to say anything bad about the old one? How do I go about doing this?
I have undiagnosed back pain. I have had a gazillion tests and tried several treatments and I have been told I have mild disc degeneritive disease and arthritis but nothing that accounts for the intenstity or duration of pain I complain of. I have very deep, and low back pain that radiates to my buttocks, hip, front thigh and groin. It never goes down the back of my leg or below my knee. My MRI, cat scan, and ultrasounds are clean. My discogram was negative although I have severe doubts about that which was in another post but no one seemed to have any ideas about what might have really happened, but the PM doc says it's negative so that's that.
From all my research and reading I feel it is discogenic pain and I feel it as nerve pain. The reason I believe it is nerve pain is that topamax helps it - which targets nerve pain. Additionally no muscle relaxer or anti-inflamatory that I have tried ( and I have tried many) has ever helped at all, leading me to believe I am not having muscle spasms. I have had facet injectopns and the PM doc feels sure this is not my hip nor my SI joint. I am in pain most of the time.
I do not expect to get 100% pain relief from any doctor, but I am looking to switch docs because I do expect to get some level of control over the pain as I am back to almost being completely out of control and despite my efforts to communicate this to my PM it hasn't gotten me anywhere. I have clearly stated that my tolerance to the vicodin has built up and despite increasing the topamax my pain is getting worse again - the condition is not getting worse, the pain is just returning worse because my tolerance has built up and my guess is the topamax isn;t going to do much more than it already is - other than make me a complete idiot - I suffer terrible side effects from the higher dose of topamax but I take it as without it I don't think I could function at all - so I figure it is better to function as a mixed up idiot who can't remember what she did 5 minutes ago than to be in pain - choosing my poisin.
My current PM doc, I believe is a good doc, but he is not of the same culture as I am and I think we have communication problems (which I admit might be my fault.) I have decided I need someone different - someone who is more like my GP - someone who 'gets' what I am trying to explain to them who is willing to work with me and understands I am not out to take advantage of them.
I also understand part of the issue in my case is that becuase they can't find what is wrong with me it makes it a little harder to treat me and it doesn't help that I have an extreme fear that I am perceived as a drug abuser as a result. I have been suffering for 3 years now and only last year did I start to get some relief and for a while I got not complee but quite adequate relief and my life for the most part returned to normal - this is what I am after.
I am fine if the docs can't find the problem and they have ruled out that nothing serious is wrong (no cancer and no organ failure) but I want to get some level of pain control - I accepted some months ago I was going to have to live with this and deal with it - however when it is out of control then I also loose control, I start to think - well let me just say very bad thoughts about how I could hurt other parts of myself that would give me a diagnosis and then I would be treated seriously and in turn get relief for my back - however I realize how stupid an idea that is so I don't act on it, I just think about it.
So my question is what do I tell them when I make the appointment - why am I switching to another clinic? I don't want to say anything bad about the old one? How do I go about doing this?
CherryQueen
07-28-2006, 04:15 PM
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07-28-2006, 06:07 PM
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