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Old 11-28-2003, 03:22 PM   #1
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Join Date: Nov 2003
Location: California
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ginabobinaa HB User
Arrow What can I expect at my first pain clinic appointment?

Hi everyone, this is my first time posting. Here is my brief history:

I am 20 years old and broke my ankle 4 years ago. This has led to 7 surgeries. I now have nerve pain/damage, traumatic arthritis, and of course chronic pain. My OS is treating me with lidocaine injections, percocet, vicodin, vioxx, TENS therapy@ home, bracing, and physical therapy. All of this barely takes the edge off. He has been pushing fusion for a few months now and wont change my pain treatment unless I have the procedure, but I am very reluctant to have another surgery.

I went to my GP for help, and she seemed quite irritated the OS was pushing for more surgery, and hadn't recognized the clear signs of RSD. She ordered a bone scan and reffered me to a pain clinic. The OS disagrees with a RSD diagnosis because I haven't had any major skin changes and still maintains it's *just* severe traumatic arthritis combined with neuropathic pain. <sigh> I have decided to try pain management before another surgery. (I hope I am making the right decision.)

I have my first appointment with a pain management specialist on 12/5, and I am wondering if some of you who have experience with pain management can tell me what I can expect, what to bring, wear, what are realistic goals I can set, or any other tips. (sorry I'm nervous....lol)

Thank You,

Gina

Last edited by ginabobinaa; 11-28-2003 at 03:51 PM.

 
Old 11-28-2003, 06:13 PM   #2
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Join Date: Oct 2003
Location: willis, tx.
Posts: 199
inthezone HB User
Re: .

Bring the truth.lol The test results will do just fine. The more information that he has, the better he will be able to determine an appropriate action to take. He will look at your test and the diagnosis and then ask you questions about your pain to determine if you are a candidate for pain mangement. Don't try ro BS him. He needs to know the facts concerning your problem. He will want as much information as possible to back up his decision to take over your pain mangement, if that is what he decides to do.

What you wear shouldn't make any difference at all. If it does, your in the wrong place.

What are your goals? Do you expect to be rid all of your pain? Half of your pain? Realistic goals in managing your pain is a reduction of your pain to a tolerable level without over sedation. You ahould not expect to eliminate any more than 30 to 50 percent of the pain you live with without any medication. This is the pain you feel before taking any of your percocets. I am personly happy if I can get a 35 to 40 percent reduction. Wanting to get an 80 to 100 percent reduction in pain (that would be 0 to 2 on the pain scale) is unrealistic and should not be your goal.

You are young, and starting a long term pain mangement with narcotic medication should not be entered into lightly. Your body will have to process these medications for a very long time, and you don't want to wear out some of your body parts until you are through with it. You will want to start on as light as dose as you can, but still cover enough pain to live a somewhat normal life. If you push to hard now, then by the time you are 50 you will be taking so much ocycodone or morphine that it will eat you liver out. I'm not telling you this to scare you, but letting you know that you must consider the future in your mangement goals. Due to tolorence you will continue to have to increase your dosage every 3 to 5 yrs even though your pain does not increase.

So you thought it over and decided that long term pain mangement is better than going for another operation. Many of us have made that same decision. The PM doctor that you see in Dec. will want to put you on a pain mangement schedule in that he will want you to take certain medicines at certain times. He will not want you to increase your dosage without his consent and prior knowledge. He may take tests to make sure that you are taking your medications like you are supposed to. He will let you know that your body will become dependent on these medicines, and stopping them will not be easy and will present its own set of difficulties.

You already take percocet so you already know the euphoric feeling that you can get from narcotics. In order that you not become mentally addicted to them it will be important that you not take more of the medicine than prescribed, nor more often than prescribed. I wish you did not have to start taking pain medication on a regular basis (for that matter I wish I didn't have to either), but only you know how much pain you are in and if this will help you live a more normal life...well that's why most of us are taking it. I wish you good luck in getting the relief that you are seeking.

Keep us at the board posted on your progress as time goes by. We will always try to answer any questions that you might have concerning your care or medicine.

 
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Old 11-29-2003, 02:26 AM   #3
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Join Date: Oct 2002
Posts: 182
chriztene HB User
Re: What can I expect at my first pain clinic appointment?

Hello,

Inthezone gave you great information regarding what to expect. I would like to ad you need to prepare yourself for a total physical exam. (thorough) If you are a women, this means an exam similar to a pap smear...I was really shocked when I realized the doctor went that far regarding the exam, but, they do!!

I wore a casual cotton dress ~ easy to get in and out of. If your pm doctor decides to treat you he will most likely rx you a two week supply of pain medications and have you keep a pain diary.

In two weeks you will go back in and he will titrate your medication and you will turn in your diary. It is important to communicate how the dose/meds are working in the initial few months. Once you get your meds adjusted to the right amount, you should be fine for quite some time. Everyone is different when it comes to tolerance.

I wish you the best of luck,

Chriztene

 
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