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Old 04-30-2010, 05:43 PM   #1
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"Interventional PM" quits & send me 2 "Medical PM" difference?

Well, my new PM doctor quit today. My husband came with me to appt, kept the dr long enough to discuss all my options. Steriod injections dont work for me, tried the trial stimulator, he wanted me to do the pump, but duh, then he tells me it will only help my pain below the waist. Well, I have had thoracic pain for over 4 yrs, just recently developed it in the love handles so pump would only help that, would still have to take meds, not worth it.
He told me I need Suboxone, he cant prescribe it to me, he is only Intervention dr, I need to go to Medical PM, what the hell? What's the difference and why that drug? He says it will give better pain coverage than hydrocodone. Any comments? Anybody had this drug? Looks like Methadonish which I couldnt tolerate

 
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Old 05-01-2010, 09:47 AM   #2
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Re: "Interventional PM" quits & send me 2 "Medical PM" difference?

you may get some much better responses in posting in the pain management forum way down below here in the 'P" section? i have been in PM for about six years now and i have never ever actually ehard of an interventional PM?? thats a new one on me. to place you on sub when you just HAVE so many other possible options seems a bit insane to me too? i have no idea how that man actually thinks that sub could work better than say, getting you onto some type of a longer acting type of narcotic would?? have you ever been on anything LA or just using the shorter acting hydro?

the thing here is, sub was actually invented to kind of be a "go between' type of med that is supposed to be used when someone is trying to come off an addiction to narcotics? although i have seen posts in the pain forum where some docs have actually started using this FOR actual PM? i don't know if this even has the actual 'permission' of the FDA for it to even BE used in that type of a more "off label" use, but some are using it. but realistically here, and esp if you have never been allowed to even "try' anything but the SA meds, there just ARE so many other LA options availiable to actually(ms contin, oxycontin methadone) at least try on you just to see how your pain responds.

i seriously do not 'get" this PMs thinking on your situation either, but seeing an actual PM definitely would be what seriously sounds like a good step up for you considering who you were seeing? i have just never actually heard of the 'interventional PM" or what the real difference between that and a PM doc would be? just make CERTAIN that you actually are being referred to a real actual PM clinic. you just have alot of other options to try before even considering the stim here or the sub? from what i have heard about sub and actual good solid dependable pain management with using it really has not been anywhere near what other options such as any of the contins can do.

have you actually had any MRIs done on your full spinal at this point to really 'see' just how your whole spinal is doing and esp the area of the "newer" pain? if you have had an MRI done, what were the findings and how long ago was it done? what exact symptoms are you having? was the hydro actually working for you at all, i am assuming that was what you were on since you mentioned it in your post? are you currently taking ANY other meds to help with your pain or just hydro only? depending upon just what your actual pain generators are here, other types of meds really CAN help, in some much more effectively than narcotics possibly even can? it all depends upon whether or not your "brand' of pain actually even responds to the opiate receptor in the brain? some do some do not. i have two syndromes that narcotics will not even touch, but also have some that do? this is part of what the PM will help in determining too. marcia
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Last edited by feelbad; 05-01-2010 at 09:48 AM. Reason: cannot spell today......

 
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Old 05-01-2010, 11:17 AM   #3
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Re: "Interventional PM" quits & send me 2 "Medical PM" difference?

marcia,
I have had a recent MRI on the thoracic (old pain) and lumbar (new neuropathic pain). shows spinal stenosis, small hemangioma (sp), normal disc degeneration for a 48 yr old woman. I am currently taking other than hydrocodone, wellbutrim 100mg 2x, neurotin 100 mg 3x and Zanaflex as needed. Alot of my mid back problem is caused by muscle spasms, severe ones! My lumbar is in my "love handles", clearly a SI issue I believe but since I do not respond to steriods, everyone seems to just ignore it. When I do alot of bending over to pick stuff up, those 2 joints start on fire and it lasts for days! I have only been on hydrocodone for a couple of years due to the fact I can tolerate it. I've had 25mg & 50mg fentayl patches, didnt help, took methadone, dont remember how strong but didnt tolerate it very well. Tried the usual, tramadone, tramadol, tylenol#3, didnt work either.
I did the stimulator trial, hurt like hell! They spent 2 days trying to get me to feel it in my back, only felt it in my legs.
Nobody seems to want to treat a patient with thoracic pain. This will be the 4th dr in 4 yrs, getting scared.

 
Old 05-02-2010, 09:36 AM   #4
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Re: "Interventional PM" quits & send me 2 "Medical PM" difference?

just exactly WHERE is that hemangioma located level wise and is it inside the cord itself or ON the cord or somewhere else? if this is NOT actually in the cord, what level of your spinal is it located and 'in' what exactly? Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 05-02-2010, 07:11 PM   #5
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Re: "Interventional PM" quits & send me 2 "Medical PM" difference?

There are Pain Management practices that do both prescription and interventional pain management, there are others that only choose to do one. It took me a while but I found a PM practice that does both very strongly.
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