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Old 02-11-2011, 05:36 PM   #1
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Question The forum correct way to find a pain dr.



I'm new to these forums, so I shall start by asking the right way to do things.........

I have a decent, compassionate pain doctor, but they are not affiliated with any hospitals, has no partners so when they get hurt, decide to stay on vacation a few days longer, weather, etc (and I'm *out* of meds) I can get, and was recently in a situation of those dreaded wds.
(my specific meds require a monthly visit)

Then it's desperate measure time.
As any chronic person knows....it's humiliating to have to beg and at least where I live, the E-Rooms aren't even sympathetic even when you carry in inch thick files of documentation.
You also get the dubious distinction of being --> labeled: addictive behavior, problem patient.

What are the rools here to try and find decent pain docs, please?

Thanks forward for any suggestions, so I can become a purposeful community member.


Last edited by moderator2; 02-11-2011 at 06:24 PM.

 
Old 02-21-2011, 04:51 PM   #2
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Re: The forum correct way to find a pain dr.

Well to be honest there aren't any rules to finding a good pain doc. We all find our docs the regular way, references from our PCP's or surgeons, research on our own, references from friends. Generally if you have a great doc you don't go looking for another one because they are not easy to find.

My pain meds are handled by my PCP and have been for 11 yrs. now. My PCP is in a small country practice for the past 2 yrs. when she left the Duke University Medical system rat race. I see my doc once a month, just as it seems you do. In 11 years well acutally the last 8 have been solid heavy duty meds 24/7 I have never run out or had to go to the ER to get meds. I find it really hard to believe that your doc would knowingly just take off on vacation with you not being covered on meds......You see your dr. once a month, don't you get a month's worth of meds?

Last edited by katlin09; 02-21-2011 at 04:55 PM. Reason: added something

 
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Old 02-23-2011, 08:19 PM   #3
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Re: The forum correct way to find a pain dr.

Thank you for a reply katlin.
I was praying someone would get a dialog going with me.

I'm really too sick tonight for an elaborate reply but I really just want to talk, post, chat with someone.
I'm at my wit's end.


I know you wouldn't know, but my primary chronic problem is called Morton Neuroma and when it starts spasming like it is riiiiight NOooooW (aargh!), it gets brutal.

I was recently diagnosed by a new neurologist as having Trigeminal Neuralgia aka Tic Douloureux.
The doctor sends me home with a scheduled contrast MRI and now a three phase bone scan of my face (?) in my future.

And I have told her nurse:
While you people are scheduling things for me, which I appreciate, in the interim I am suffering!
And I'm NOT exaggerating.
This feels like someone is inserting long needles into my left eye.

I also told them up front on my charts that:
I am NOT seeking narcotic pain meds and I can't accept them anyway because of my N Contract.

When I get home from the diagnosis of course I google it.

And wiki claims what's in store for me is what the heyyy???....Suicide Pain?

I call the newrologist and ask for some other meds like anticonvulsants ?, should I increase my dose of gabapentin ? or what?

I guess she interpreted that statement I made to mean:
I'm not accepting any medications to ease this **it from you.
Her nurse tells me get a hold of my pain guy and I KNEW this was gonna happen.

I call and ask for an appt. to get some relief from my latest chronic pain problem and I told HER (the nurse) that I was NOT asking for narcotics (even though I know that they will ease my newest issue) and I get read the riot act.


Her:
Are you trying to tell us that a doctor has diagnosed this but hasn't recommended any solutions?

Me: yes.

Her, Immediately:
Dr. XXX will not give you any more pain meds until your next visit and blah blah blah.

Me:
I WASN'T ASKING FOR NARCOTICS I'M TALKING ABOUT OTHER MEDS....AND I STARTED THIS CONVERSATION THAT WAY!

Her:
Well, ask your (sarcasm in the voice) other doctor to prescribe
-Tri""""" something
--Dilantin


Get disconnected.

I really am stuck.


I have a PM doctor that either doesn't like me (or) keeps trying to come up with some notion that I'm exhibiting addictive behavior when I go out of my way to NOT do that.

I have a neurologist with diagnosis' with no solutions.

I have an orthopedic doctor who thinks the best solution for my foot is amputation at the knee.

When I even think about this (I"m sorry a John Wayne type I stopped trying to be) the tears well up in my eyes and I get this feeling of utter hopeless-ness.

The suicidal thoughts arrive.
This is not a good feeling.

I DO NOT THINK I SHOULD BE PUNISHED FOR BEING SICK!
IF I HAD IT MY WAY I WOULD *NOT* BE and I would stop BOTHERING --> you self righteous jerk offs!

Why WOULD ANYONE Voluntarily Surrender a 35 year Nuclear Digital Cosmetology Career with plenty of perks to get ...... a life like this ?

Vacillating between suicidal and homicidal.

I have to find a new PM doc.
I think I'm firing that dam newrologist

I guess I did embellish, but I tend to do that.

Thanks for reading my post, if you did.

< edited >

Last edited by painmanglement; 02-28-2011 at 08:25 PM. Reason: Please don't post unapproved website links, per Posting Policy. Thanks.

 
Old 02-24-2011, 02:46 AM   #4
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Re: The forum correct way to find a pain dr.

Sorry, nothing else i can say at this point.

Have you considered asking for referal to one of the centers of excelence, a university teaching hospital somwhere near home, even the mayo clinic?
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Last edited by jonnstar; 02-24-2011 at 02:49 AM.

 
Old 02-24-2011, 03:41 AM   #5
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Re: The forum correct way to find a pain dr.

No offense jonnstar because I do appreciate the replies.

What am I going to do with that information if I get it?

Sure, I trust the Mayo and use their online recommendations all the time.
How would they know a local PM guy?
The meds that are effective for me take a monthly visit thanks to the DEA.

The local universities around here anyway you would think would have unique ideas and fresh perspectives.
The facts around here are that the local Universities are required to treat the indigent in the metro area.

Let me say up front that I don't think I'm better than anyone and I may end up that way if I live through these health problems that keep popping up, one after another.. but .....
the reality is, since they're required to do that, they are soooooo overcrowded you end up with a bunch of angry discouraged young physicians in training who can't wait to get OUT of those places.

I used one of the local universities all last year, so that's been my experience rather than hearsay.

One of the requirements in my PM program is seeing a shrink and I have an appt today.

Maybe he can shed some light on a seemingly hopeless situation.

I have to try.
When I totally give up, then I'm in big trouble.

My best plans generally flop and certainly have.

I am so sick and tired of hurting and being sick and tired.

 
Old 02-24-2011, 04:36 AM   #6
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Re: The forum correct way to find a pain dr.

Ok - can you ask your doctor to give you an emergency script, for say 5 days of meds, which you can use in emergencies, when your regular script is delayed?

You said you dont take narcotic painkillers, may I ask what med you do take that required monthly visits?
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Old 02-24-2011, 02:31 PM   #7
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Re: The forum correct way to find a pain dr.

jonnstar, Thanks for the response.

I don't know where you got that impression or I wouldn't even need a PM doctor.
Of course I'm in a chocolate candy therapy program.

Your next ?....
I wish.

That would be the end of a part of what every person who is on this type of therapy worries about I suspect: running out.

I've asked before so there's no point in asking again.
Part of my contract is:
I will never stockpile the coconut chocolate candy ones.

In general, not always, I get quizzed about how many I have left, or when I ran out.
I'm not sure but willing to bet that if I ever had any left, he'd adjust my Russel Stovers prescription accordingly.
That's never occurred and I try my damn-dest to never even bend the truth with this doctor.
He's been my doctor in this area for a year & a half, so with monthly appointments you get to know a doctor pretty well.

I honestly think his worst fear is that patients who get large numbers of coconut chocolate candy will sell em.
The line of quizzing has been along those lines often.
I even suspect his nurse checks some of the chocolate caker forums where the sale of coconut chocolate candy runs rampant, just because she's asked if I am a member of """"""".

Yes those exist, and how the heck ppl get away with that **ap is beyond my comprehension, but it does happen.....frequently at a site I'd prefer not to name.

I get 90) 30 mg coconut chocolate candy per month and he's added an extra 0 per month since the onset of all the facial nerve pain problems ramped up.

When I'm hurting bad on both ends...foot & face...it takes about 5) a day to make my life livable.
Any less (coconut chocolate candy) when things are flaring, I'm bedridden with a warm towel over my face and my foot over the side in ice water.

Nice life huh?

Sounds korny I guess, but I am desperate for all the help I can get, since I'm sure not getting everything I need from the medical community.
And I don't mean coconut chocolate candy.
I mean emotionally, spiritually, coping skills and all aspects of coming to a level of Acceptance of my condition.


Last edited by painmanglement; 02-28-2011 at 08:31 PM.

 
Old 02-24-2011, 03:28 PM   #8
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Re: The forum correct way to find a pain dr.

Could you discuss with your doc the possability of changing from IR oxycodone to Oyxcontin, this should offer round the clock pain coverage, rather than 3 "bursts" of short lived releif throughout the day.

Re your trigeminal neuralgia, are you taking tegratol or trileptal? These arnt narcotic, and would be regarded as the gold standards for treatment
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Old 02-24-2011, 04:51 PM   #9
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Re: The forum correct way to find a pain dr.

painmanglement,

okay I read through all of the posts and here goes. You really should be on a long-acting med like Oxycontin or morphine as opposed to a short-acting med like oxycodone. And the fact that your only getting 40 oxycodone a month is ridiculous. You need to have a sit down with your doc and explain to him as calmly as possible that the pain is constant and one short acting pill a day is not covering it, that there has to be a different regimen to take care of it. Make sure you explain to him that you are willing to do any other modalities of treatment that he recommends, such as PT, injections, etc. He needs to feel comfortable that you are not just seeking drugs. He's been your doc for a year and a half, so he should be comfortable enough with you to have this type of conversation. If for whatever reason he won't do this, then you are probably to the point of finding a new pain doc. you can't be expected to live your life in this kind of pain with no treatment. You also need to make it clear to him that while trying to have a discussion with his nurse she hung up on you, and that is not professional behavior and it is unacceptable. When are your neuro tests? If at all possible you need to hang in there until you get them, as that could be some type of answer that could help you fix all of this.

Let me know what you think and how you're doing.

kat

 
Old 02-24-2011, 05:17 PM   #10
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Re: The forum correct way to find a pain dr.

I am somewhat uneasy, just because I really do not want my current doctor to find out that I'm even looking.
Does that make sense?

After none subsequent surgeries on my foot to correct the first one, I was left a permanent cripple.
So I could not keep up with the demands of my job and pain became overwhelming.
I am 85, had to retire 7 years B4 I wanted to and I collect Social Security & Medicare Coverage.
This whole fiasco has been financially devastating.
Am I a god-zillionaire from a malpractice suit?
No...the medical lobby is so Powerful there's 2) a year statute of limitations, and by the time I found out I was had for life, it was too late.

Here are some facts to clarify things:
I'm getting 90 coconut chocolate candy X 30mg per month.
They cost me $8.00 a fill, until I'm in the dang donut hole on coconut chocolate candy coverage.

Once I go to any kind(and we've tried 3) other kinds to satisfy my insurance plan's refusal to cover reeces pieces) of ER coconut chocolate candy the price rockets to $300+ per month.
And in the end......I end up with an official refusal letter for M&Ms I just can't handle.




More later,

Sorry I'm really starting to hurt.

Last edited by painmanglement; 02-28-2011 at 08:34 PM.

 
Old 02-25-2011, 12:25 AM   #11
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Re: The forum correct way to find a pain dr.

Methadone would be an obvious next step - simply substitute your three times a day oyxcodone for three times a day methadone - methadone is intrinsiicly long accting, so it will give you 24/7 pain coverage, and it is cheap cheap cheap. Adding an antiinflamatory to the regimen would also help increase the releif you're getting by perhaps 20% - that might not sound like much, but when you're in pain, its well worth having.
Meloxicam (Mobic) in generic form is a $4 prescription, and is safe for the stomach
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Old 02-25-2011, 06:03 AM   #12
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Re: The forum correct way to find a pain dr.

The doctor has asked me about that medicine and I felt it was a question designed to see if I had ever been in a detox program for street drugs.

Are you serious?

I have the same connotations about using methadone as I did when he tried repeatedly to prescribe Oxycontin:
I want to stay as afar away from abusable meds as I can.
Recreational drug use was never in my history although I am not quite like President Clinton...I did inhale.
Stopped all that type of behavior in the early 80s.

When we tried & tried in that battle against my insurance company, it was as if we had lost some battle together and he ramped up my dose to massive (my opinion and his now) of 15mg Oxycodone.

Then somewhere along the line, he gets nervous about the sheer volume of tablets and goes to 30 mg.
Very hard to split into smaller doses, which I do to conserve my supply.
On rare days when I didn't have this neuralgia to struggle with, I would take 7.5mg doses in lieu of 15 or 30.
It's a survival deal a lot of senior citizens use to make the small SS income last the month w/o dipping into the retirement funds.
I don't like to say it, but I am one.

Now I'm fighting this facial nerve disorder and the dose stays the same as it has for 5-6 months.
I know what it takes to keep me pain free and live a purposeful life.
Until they find a cause and a cure for Trigeminal neuralgia, it takes 5-6 tablets.
I can work (I have a small business), clean house, grocery shop, and get around with reasonable pain.
Which is all I've come to expect.

I get my prescription, start getting some relief for a 4-7 days hoping one of the doctors I'm seeing will find another med such as an anti-convulsant, they don't:
then it's catch up all month long and I'm under medicated.
My fault, I suppose.


Geez mornings are horrible and I just can't continue jonnstar.

I forgot to mention that I am taking inflammatory meds.
200mg X 4, every 4 hours....ibuprofen.
That was until my last PM visit, and the doctor told me to cut out the ibuprofen all together.
Why?
I don't have a clue.
I am getting so scared about my PM doctor, all I do is comply and tell them I'm grateful for the treatment, which I am.
It's soooo difficult to get into a bonefide program, I think I'd go loopy if I was discharged.


My apologies.

Maybe I can elaborate more later, if you still want to continue this dialog.

I hope so.

It helps my attitude when I can talk about my illnesses with someone, and I have no one here.

Sometime I need to get back to the original purpose of this post.
How does one find a decent PM doctor?
I keep hinting at so many other doctors and never get.....coconut chocolate candy

< edited >

Last edited by painmanglement; 02-28-2011 at 08:36 PM. Reason: Please don't post unapproved website links, per Posting Policy. Thanks.

 
Old 02-25-2011, 05:44 PM   #13
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Re: The forum correct way to find a pain dr.

You seem to be under some assumption that long acting meds like methadone, oxycontin, morphine, etc. are all addicting drugs and therefore are bad and you should stay very far away from them. Ummm...hate to break this to you but Oxycodone is the same drug as Oxycontin it's just as addicting, but for pain patients we refer to it as dependence. Vicoden, Percocet, Norco, Lortab all of these short acting meds are addicting/depedency causing. Any Chronic pain patient that is using any form of narcotics for a long time is going to become dependent on them, thats just a fact of life, theres not anything that can be done about it. Why would you continue to torture yourself with this awful pain, when you could take a longer acting med that would most likely give you some relief? I don't understand.

 
Old 02-26-2011, 01:47 AM   #14
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Re: The forum correct way to find a pain dr.

What makes yu think Oxycontin and methadone are any more abuseable than the IR oyxcodone you're already on? Oxycontin IS oxycodone, the abuse liability is the same.

The vast majority of pain patients who use these drugs dont descend into the abyss of drug abuse - if you've had no problems with the IR oxy, then its equaly unlikely that you'd have any issues with Oxycontin or methadone or whatever.
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Old 02-26-2011, 05:03 AM   #15
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Re: The forum correct way to find a pain dr.

Oycontin I could probably handle, if I could afford $3500 -$4000 per year on one medication (vs) $2-300 for IR pain meds like I'm taking now.
In case you don't know, under a Plan D medicare supplement, once you reach $2840 in ttl med costs, the entire amount comes straight out of after tax dollars on all prescriptions.

If I have to put Methadone on my list of meds for any physicians or dentist application, geez, it's bad enough to put opiates of any type on a med list.
What do you think they're gonna label me as when that appears.

Maybe I shouldn't care what other ppl think, but I am sick & tired enough of the chronic labeling to raise that kind of flag.

I went to the Emergency Room at a local hospital last summer for an unrelated matter (breathing problems) and had 2) doctors walk right past the small room I was in, curtain drawn.
They were changing shifts and filling each other in on who was there for what.

This Jack a** tells the newer physician: We have another doper in here trying to get pills."
And he made sure to say that loud enough for the entire area to hear that.

I'll never forget that incident, nor forgive that guy for saying that.

If I hadn't been raped by catheter [source 1]for not being able to urinate fast enough and was tethered to a table, I'd have bashed that young a-hole with my crutches.



I don't know what the triggers are, but the facial pain is gone today.

I almost feel high, to have little pain.

Being relatively pain free is a wonderful thing.

[source 1] Raped by catheter would be: when the nurse is trying to update her """"book page, gets annoyed when you can't urinate fast enough, and 3) male nurses charge into the room, hold you down and force-ably insert a tube into your instrument.[end Source 1]

Last edited by painmanglement; 02-28-2011 at 08:43 PM.

 
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