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Old 05-29-2006, 06:09 PM   #1
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Can you fire your pain man. doc??

Hi guys

Hope everyone is having a pain free evening!

I was wondering......can you fire your pain management doctor? I know that I signed several papers and agreements......but if I do not feel comfortable with her what can I do?

I am also thinking of changing doctors........I feel like I need a fresh approach to healing my problems. What do you guys think?? I am getting so depressed, as I feel they are both just masking the problem, rather than fixing the problem. On my recent MRI results, I have 4 bulging discs, and arthritis in my back. They just give me some pills, and say we will start injections in a couple of weeks.......no PT, no advice to help myself...(by the way, I have only seen the doc. 1 time, I usually only see her asst.) grrrrrrhhhhh what to do........Please tell me what you think. By the way, I would most certainly tell the new doc. what is going on, as he would probably want my records.........help!!

Thanks for listening......you guys are truly the best!!!

L,
sons2

Last edited by sons2; 05-29-2006 at 06:12 PM.

 
Old 05-29-2006, 07:10 PM   #2
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Re: Can you fire your pain man. doc??

Hello,
I read your story&I can fell for you.I don't know how you deal w/the pain.
I just had an MRI&it showed i had 1 bulging disc&some mild arthritis&i'm having alot of PAIN.Although i'm still working(someday struggling along)What kinda med.'s did they give you?Dr. put me on Lodine&Ultram,sometimes that still don't touch the pain.I was also wondering if you started going to pain management right after your MRI's or has it been awhile.I hurt my back on the job&of course it's workmen's comp(which i don't trust at times)But i'm dealing w/it.Hope to talk soon,ODDIE

 
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Old 05-29-2006, 08:16 PM   #3
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Re: Can you fire your pain man. doc??

I have 4 herniations, 2 levels of spinal stenosis, a disfigured thecal sac, sclerosis, spondylosis and DDD. I have asked myself the same question. My PM Doc has me on Kadian 60 mg bid and 30 mg Roxicodone for bt.

The Roxi works best for me and my problem is that I can't seem to find a long acting med that helps. I've tried up to 100 mg MS Contin bid and 100 mcg Duragesic, but to no avail. OxyContin is out because the Doc will not write for it. Without a good L/A base med, I am doing things backwards by relying on my bt med.

I'm not sure what to do, frankly!

 
Old 05-29-2006, 10:34 PM   #4
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Re: Can you fire your pain man. doc??

yes you can fire your pain dr.I did it about 2 months ago.Because my pain wasn't getting managed. And alot of times that all they can do is manage the pain, or do surgry(sp) and that doesn't always work.What kind of meds do they have you on and is it controling your pain? Believe me it sucks to have a pm dr that won't treat you with meds or just a small amount of meds. good luck kelsey1

 
Old 05-30-2006, 03:18 AM   #5
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Re: Can you fire your pain man. doc??

I started seeing my pm doc after my GP ref. me to her. She did the MRI and found out what the problem was. My GP had me on Vicodin 5/500 and Soma, these 2 meds worked wonders for me, but he said he thought he had done all he could do for me and sent me to the PM doc. She changed my meds all around.......she switched me over to a another kind of Vicodin, Xodol 10/300 and took me off the Soma, I have been in pain ever since, (this has been in the last 2 months). I tried to tell her what worked for me, but (well not the doc, but her assistants, I never get to see the doc) they said they are "NOT COMFORTABLE" giving the Soma, so I have spent big bucks on 3 different muscle relax. that do not do anything for my pain, as well as the Xodol, it does not touch my pain...............I did get some advice here on the back board as what to do to help heal the discs, I don't even get a chance to talk to the assistant because she is in such a flippin hurry whenever I get to see her.

I just don't get it, why not listen to the patient if she or he knows what helps them......I mean I didn't ask for anything like Morphine for heavens sake, gosh forbide if I ever need it..........that is why I asked the question if I could fire her.....Kelsey, did you have to go thru your GP to ref. you to another doc? Thanks so very much everyone, I hope you all have a wonderful painfree day
sons2

 
Old 05-30-2006, 05:43 AM   #6
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Re: Can you fire your pain man. doc??

sons,I am just wondering what your actual expectations are with regards to your PM.its just where you mentioned that you "needed a fresh approach to "healing' your problems" that has me wondering,thats all.

a PM in most cases will not be able to actually heal the types of problems you have,tho they can try and "mask' them or eliviate some of the intensity,they unfortunetly cannot do what you seem to need done.or am I wrong here?i guess what this boils down to is you need more than just your PM to really "heal" anything.you know what I mean?I really would look for a good neurosurgeon if this is up in the c spine area,or a good ortho if it is lower than that.between the two of these docs,they can both work with you and come up wiht the best type of treatment plan.unfortunetly,in most cases,espescially when you have bulginf discs,it may require surgical intervention to really "heal' the biggest pain generators.

from what you have stated,I just think you may have your expectations actually set a bit too high when it comes to what your PM is and is not actually going to be able to do for you,ya know?

good pain management combines more than just a PM in most cases.it takes a few different docs(in my case anyway)all working together for YOU with the same goal in mind.unfortunetly,just like any other speacialist out there,pain management has its limitations too.you DO have other options that you can use along with PM to really find out what really would be the best way to treat or manage your pain.I really hope you can find the right docs who are willing to really work with you to find ways,even if that involves a surgical intervention of some sort.sometimes you just reach that certain point where the surgical intervention is realistically the best possible option.I really hope things go well for you and your pain gets a bit better under control for you.good luck,Marcia
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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 05-30-2006, 07:29 AM   #7
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Re: Can you fire your pain man. doc??

Hi Sons, I agree with marcia, PM isn't about healing you, It's about giving you tools to deal with the pain you have and hopefully some coping skills to except what can't be fixed.

What I found strange is you haven't had a surgical consult What surgeon has told you that surgery isn't an ption, a GP nor a PM doc are qualified to determine if you need surgery, Even if they see something they think needs surgery, they aren't the one doing it so the surgeon still has to agree with the GP or PM doc that surgery is needed.

It sounds like the easiest way to get away from your PM doc is to ask for a surgical opinion, First you find out if there is or isn't something that requires surgery going on and second it gives you the opportunity to tell the surgeon what the PM doc is doing isn't helping and ask him what he thinks you should be doing.

He can certainly take over your case and get you in PT, do epidural steroid injections or if he thinks another modality your present doc isn't offering may help, he can direct you to a doc that can offer something your present doc isn't.

It blows me away that people except surgical opinions from non surgeons and let GP's and PM docs condemn them to a life of pain when something may be able to be surgically corected. A bulging disc doesn't neccesarrily mean you need surgery, and there is no surgical solution for arthritis but without an expert opinion you'll never know if surgery would have or could have helped with the disc problems.

If you actually do need surgery, the longer you put it off by masking the pain the worse you odds become that surgery would be a success. If a disc is compressing a nerve, pain can become so engrained and imprinted into the nerve tissue that even surgery won't relieve the pain.

These docs shouldn't even be giving you a surgical opinion and likely you will need to get several opinions if they are leaning towards surgery. There is more than one way to corect a disc impinging a nerve. You can do it with open surgery and a decompressive laminectomy and trim the disc or a doc trained in minimally invasive surgery may use an endoscopic aproach if he feels the problem is fixable without cutting you completely open and damaging the soroundng muscle..

There is also more testing that can be done aside from an MRI. Discograms can be useful to pinpoint specific disc problems, Meylography and CT's can show an impingement that won't show on an MRI because MRIs' are a static view of how things look when your flat on your back. How do things change when your standing or when you bend the area? The other diagnostic tests will show these things but there is no point in having them done if an actual surgeon will never see the films.
Good luck, Dave

 
Old 05-30-2006, 11:24 AM   #8
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Re: Can you fire your pain man. doc??

sons2
Yes,i did go back to my family dr and he gave me a referal.In my case i had a dr in mind that i knew was better.My problem was that no pm dr took my insurance so i had to find a dr that took cash .I was also on somas from my family dr but my first dr took me off of them and my new pm dr also didn't want me on them .I was ok with that. I do understand what your going thru maybe you should go to your family dr and explain whats going on and see what happens . Good luck please keep us posted. kelsey

 
Old 05-31-2006, 03:19 AM   #9
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Re: Can you fire your pain man. doc??

My expectations for my PM doc, was to start feeling better.....and also see what other options there were out there to help me. I have had problems with my back for years after a nasty fall, so I have learned to live with some of the pain, but when I can't even lift my 2yr old toddler, this is when it got to be to much for me. I don't know what to do now, I went to see my GP, I asked him if he wanted me to continue seeing the PM doc, or if he wanted me to go to a back doc. His comment was "Let's just wait and see what the PM doc wants to do". I told him I felt I was just taking a number at the deli counter when I went to see her, but he did not seem to care. He is still treating me for my migraines and I asked him about my meds, he told me to talk to her about them, he told me if he gave me any meds that she could fire me and that no other PM doc would see me in town...........I guess now my only option is to suck it up and deal with the pain.
Thanks to all.
sons2

 
Old 05-31-2006, 05:39 AM   #10
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Re: Can you fire your pain man. doc??

Hello to All of You:
I too suffer from bulging disc in my neck, and arthritis, pinched nerves, and haven't got all the tests run on my back yet. Just trying to deal with all this right now. I've been with my PM for almost 3 years, and beleive me we have butted heads a many time, and still do. Long story short I've been on all kinds of meds too. Right now for the past5-6 months I am on Methadose for my pain, and it is working for me better then the rest I tried, I need to get the milig increased next month though. But for me its helping along with the other med combo. The bt pain doesn't seem to be as bad with the methadose.
This is just my experience, this is what we all do to try to find what will work for us. Anyway hope I helped ........................................ ...................
jeanne

 
Old 05-31-2006, 06:26 AM   #11
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Re: Can you fire your pain man. doc??

Why would you not see a surgeon to see if there was a minimally invasive surgery that could help relieve your pain if you experiencing the signs of a bulging disc with symptoms like radiculopothy . You do have options, You also have the option off seeing a new PM doc, you may have to actually insist and not just wait and see like your GP suggests, but he's not the one that can't lift his child. If the roles were reversed, he wouldn't wait, he would have taken his films straight to an ortho or Neuro surgeon and have the radiologist call the wet reading over to the sugeon while you wait.

If you want to leave you PM doc, don't burn bridges, the best way to leave a doc on good terms is to be honest about wanting to try something he's not offering. People seem to think that all PM docs are alike and if one doc doesn't have the answer, no other doc will. This is crazy, there are many PM docs that do no interventional procedures, There are docs that flat out won't use specific meds. I've seen over a dozen different PM docs and been throgh 4 clinics and they all believed the methods they used would work on everyone, which is totally rediclous.

If your doc doesn't offer Botox, Trigger pont injections or teach Bio feedback or self hypnosis or you want to try acupuncture , it is your right to try any modality you want wether you resent doc thinks it will help or not.Your questioning his methods now, why wouldn't you question why you have never seen a surgeon?

It only gets slippery when you dealing with meds, but there is a proper way to transfer medication management from one PM doc to another. You don't have to accept poor treatment because you signed a contract. It would be virtually impossible for a single doc to be able to offer every modality available. Does he do Robaxin or lidocaine infusions? Does he do nerve blocks or do manipulations the way a chiro does. Does he implant and manage pumps and SCS's. A multi faceted aproach where docs from several different specialties are working together to come up with a treatment plan designed for you that also includes your headaches are going to be able to offer more than any single doc in practice can.

Not to beet a dead horse but excepting the surgical opinion from your GP would be like asking your dentist to to interpret your Xrays or MRI.. Yes, he can read an Xray of a tooth, but that doesn't make him qualified to interpret an MRI of your spine. It's not their field although I'm sure they would have an opinion If they looked at an MRI of their spouses spine. What was the last surgery your GP or PM doc performed?

It sounds like they have done a great job at brainwashing you to believe if they don't have the answer there isn't one to be found.

You have lots of choices and the contract doesn't mean squat if you plan on changing docs. If your GP won't provide the needed referall, than change GP's or call your insurance and ask why they would send you directly to PM without consulting a surgeon to see if something could be fixed.

Sorry to be blunt but you couldn't have possibly tried every method available and both docs are way out of line by not sending you for a surgical opinion just to be sure there isn't something that could eassily be fixed and prevent you from spending the rest of your life dependent on opiates and his limited ability to help your condition. Sure his methods work on some, but you can't slam every square peg through a round hole.

It's not even rational to avoid a surgical consult if it could possibly bring relief.
I can't imagine anyone with chronic pain or intractable pain that truly effects your quality of life choosing not to be fixed and simply hoping to mask the symptoms with more and more medication.

It's your life and you do have choices, your simlpy not being offered anything your doc doesn't know about or believe in the value. It's like if your PM doc doesn't do pump or SCS management, he's never going to offer it. He doesn't do surgery so he's never going to suggest it. There are plenty of PM docs that don't believe in the value of opiates for chronic pain and won't prescribe codeine for a bulging disc that doesn't need surgery.

I guess when things get bad enough you will start demanding answers your present docs can't give. Untill then, perhaps fresh daily flowers at the base of your docs pedestal will get you better treatment.
Good luck, Dave

Last edited by Shoreline; 05-31-2006 at 06:40 AM.

 
Old 05-31-2006, 06:38 AM   #12
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Re: Can you fire your pain man. doc??

jeanne - out of curiosity what mg of the methadose are you taking?

 
Old 05-31-2006, 07:43 AM   #13
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Re: Can you fire your pain man. doc??

Sons,i DO think its time to actually find a brand new GP as this one really does not appear to care one way or another about this whole nightmare you are living in.your GP is the actual person who "should" be in charge of co ordiating ALL of your healthcare.its up to HIM to make sure that you are being referred(in most cases,by him himself)to the appropriate places for your healhcare needs,he seems not too invloved with you and this is only making things much worse than they have to be.and its getting YOU absolutley nowhere except declining health and abilities.you need to at least be consulting with surgeons to see just what your options are,as shore is very very right about that nerve pain becomming "ingrained" and it will become almost impossible to rein in even after any actual "successful' surgery is even done.he is doing you no favors here by making you wait.none at all.only making things much more difficult.

you are very right tho,if you are at the point where you cannot even pick up your own child,you definitely need to get things in gear here and come up with a good treatment plan,which will most likely involve some sort of surgical intervention.like was stated before 'time is nerve function and possible long term pain".

I would keep the PM,fire your GP and get to a much more caring GP to help you with all of this your current GP does not seem at all motivated in trying to help you,so get rid of him.honestly,if my GP was like this ***,I would be sitting in a nursing home right now because of all the missed opportunitys for him to have actually gotten me referred to(and in record time) to the appropratie places for my ongoing care.and in some cases,very emergent type of treatment.

you just deserve sooo much better from a GP,really.i do wish you luck,and please get rid of that doc,you really do need to get moving on some sort of plan here as soon as you can.you also deserve to be able to pick up your own child .please keep us posted,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 06-05-2006, 12:19 AM   #14
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Re: Can you fire your pain man. doc??

Hey guys
(this is going to be long winded, just a warning
Sorry it took me so long to get back to you. Thank you all so much for the wonderful support You all have me FIRED UP! I'm going to call a new GP on Monday!! I have come to realize that my old GP does not have alot of compassion, at least for me anyway. I certainly do not wish him any ill will, but I hope he never hurts his back.....geeez........

You are all so right........it's my back.........who is going to care about it more than I? I am looking so forward to seeing a new doctor. I got on a web site that you can rate an MD, this doctor seems to be very nice, and takes his time with you, unlike my old GP and my PM doc. I just figured with you guys on my side, it gave me a little "back bone " (no pun intended to not have to put up with this. There are so many docs out there that really do want to help people, and I'm tired for feeling guilty for taking their time up with my "poor little back issues". It will also be nice to see if he wants to run any tests on me, for example a complete physical, since I have not had one in about 3 years.........gosh, that should have been a major smack on top of my head. Well, I'm getting to "blah blah blah" as my hubby puts it. Thanks to each and everyone of you from my heart. I will check in with you all in the next couple of days.

Blessings to you all!
sons2

 
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