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Old 07-05-2006, 01:47 PM   #1
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Nervous about Dr appt

I am seeing my PM doc tomorrow, because I had some injections in my back a little over a week ago, and instead of getting better, I am far worse. I am worried that he is going to think I am trying to get DRUGS rather than medicine. I know narcotics are a sensitive topic with docs, and I don't want to lose the ability to get medicine that I need.

I am taking 10/325 Norco, and some days I don't even get a 50% reduction in pain. I am being totally and completely honest with the doc, but still worried

 
Old 07-05-2006, 03:31 PM   #2
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Re: Nervous about Dr appt

hi,
i can totally relate.I am on the same meds and some days i only get a small amount of relieve .I too don't want to say anything because i have only been going to this dr for about 4 months I take 8 norcos a day 10 mg ,and when i went to him i was only taken 3 tablets of 5mg lortabs a day .So he increaed my meds alot and i am doing alot better pain was that i was,I used to be a 10on the pain scale and now i am at least a 5 on most days ,and some days i go to an 8. But i am not comfortable asking for more meds, so i will just be thankful for now for what i do get and in time i will ask . Drug seekers have make it hard for us to get pain relieve because most dr don't believe us. it not fair.. But anyway let us know what happens. good luck kelsey

 
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Old 07-05-2006, 11:56 PM   #3
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Re: Nervous about Dr appt

I take much stroner meds and still can't relief. An d it is because of the abusers.

I have 4 levels of disc herniations, 2 levels of spinal stenosis, spondylisis, scoliosis and a deformed thecal sac. I have found NONE of the long acting meds I have been rx'ed to be effective. 200 mg of MS Contin daily, 120 mg of Kadian daily and currently the 100 mcg Fentanyl patch-none of them helped. The only relief I get is with the 30 mg Roxicodone I get for bt.

So why on Gid's green earth, if Oxycodone helps me, won't my pain doc rx OxyContin? Same med after all. FEAR...in fact, he lied to my face and told me that long acting oxycodone does not exist.

Alan

 
Old 07-06-2006, 12:15 AM   #4
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Re: Nervous about Dr appt

I usually post on the spinal board but read these too. I had a nerve block done today. I'm worse than better tonight. Anyway after 5 days prior to the block I called the guy ank left message about how much pain I was in and did'nt even get a return phone call. So today before the block I told his I was'nt very happy about this. He said he could lose his lisence it he prescribed me more pain pills. The pharmacy fill an old prescription instead of my one for oxycottin that does give me some pain relief and W/c wort approve the oxycottin now because I have a bottle of these worthless tylox. I wonder If you can sue them for not giving you pain meds and controling your pain? Luckly I still have the prescription for oxycottin and I'll get it filled on friday. {payday} It's expensive but well worth it. When it comes time to settle with w/c We will deal with all the things they hav'nt paid for concerning my case I hope you are all doing well. I'd print a paig out on long lasting oxycottin and bring it with me on my next visit if I were you. Let him deny it then. We have to let these doctors know we arn't stupid and know whats going on with our bodies.

 
Old 07-09-2006, 02:16 PM   #5
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Re: Nervous about Dr appt

Mysti-
Hello. I just wanted to touch base with you and see if you were feeling any better, and also wanted to know how your appointment went with your pm doctor? Were you able to work up the courage to speak with him about your pain level?

I understand you are scared to tell him you are hurting so bad for fear of him thinking that you are looking for drugs, but sweetie, he is a pain management doctor, this is what he does. He manages pain. He wants you to be honest with him. There has to be a trust between the both of you. I know it's scary to tell a doctor that the medications you are taking are not working, but if you don't tell him he won't know. Pain management doctors are pretty good at reading people, therefore have developed a keen sense of who's looking to get drugs and who's really hurting and needs the extra help. The people who are just looking to get drugs get dismissed from the practice.

Please consider talking with your doctor about your pain. There is probably a way he can help.

Lezlee

Last edited by ozzybug; 07-09-2006 at 02:18 PM.

 
Old 07-09-2006, 09:09 PM   #6
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Re: Nervous about Dr appt

I run into this same issue - super freaked to report that my pain is not under control and feeling bad that a previous treatment or aditional non-narcotic drug didn't help. I have built the up tolerance to vicodin 3 times now (and oxycodone makes me not sleep at all for days, weeks...) and have had various injections and am taking topamax with increases to boot and can continually hit tolerance with the vicodin. Sometimes I have waited months before actually getting the courage to tell the PM that the vicodin was no longer working and the only reason I finally did was becuase the pain was completely out of control and I was getting suicidal (just thinking, not actually acting on) -which is my key that I need to do something. That has happened twice now. Now I don't do let it get to that point anymore, I need to be my own advocate - no more scardy cat (even though I am still scareed and nervous) - I just refuse, I still get nervous before and during the doctor appointment, but I report whatever the actual situation it is, usually after an increase in the previous or month or 2 I am doing ok, and then slowly the pain gets out of control again. I have been with a new PM doc now for about 4 months now and am just starting to feel comfortable which helps. On top of it all - I have no diagnosis - nothing to account for my pain so that makes it all that much harder for me, but I decided that I deserve treatment for my pain, and I know I am not just seeking drugs to get high and I figure if I don't get proper pain relief then I will just continiue and find another clinic if I have to - and thankfully that hasn't happened so far. In the meantime I do eveything the PM doctor suggests and follow the contract to the letter, which is really hard when the toleranace has built and I am in pain and can't take any more than prescribed. I guess I just decided I am going to stare my fear in the face and tell the doctor like it is and let whatever happen happen. And if something bad happens, then I will cry about it on this board.

 
Old 07-09-2006, 11:26 PM   #7
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Re: Nervous about Dr appt

hi ,
i can really relate to you dog mom,i was wondering if you told your new dr your pain wasn't under control and if you did what happened,because i am in the same boat,i would love to hear how you went about this and any other suggestions about it,thanks kelsey

 
Old 07-10-2006, 04:31 PM   #8
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Re: Nervous about Dr appt

Ok, Kelsey (and anyone who this might help) I am happy to share my most recent experience which is the result of me after previous times deciding that I need to just deal with my fear and go forward even if the result ends up with me being labeled incorrectly and having a bad outcome. I will try to make it short but give enough info to get enough details across. (With this PM, I have done several injections, all the requested tests, and previous to his care tried many alternative therapies to no avail, so I think that helps, but boy did I suffer during this time.)

My last regularly scheduled monthly appointment where I was hoping to discuss that I felt I was building tolerance up to my current dose of vicodin (which was increased just 2 months ago and I had previously reported that it was working great because it was) – was cancelled by the doctors office because I was scheduled to have a discogram by my same PM the day after the regular med refill appointment. When they called they asked if I minded canceling the appt. and they would just give me a script when I got the discogram and I said ok (although in my mind, I was a bit upset, I wasn’t thinking I was at the point where I needed an increase in meds but I new my tolerance was building and things were starting to not be controlled so well so I wanted a chance to state that to the doctor so if and when things got out of control it wouldn’t be a surprise. On the other hand I was hoping the discogram would finally tell what was wrong with me so without any argument I agreed to the cancellation and I did receive a new prescription for the same strength and amount of vicodin for another month when I went for the discogram. Also after the discogram they gave me toradol for a few days which helped my pain too. About this same time I had previously adjusted to the level of topamax I was previously taking and knew it was a low dose both for migraines and nerve pain (my GP prescribes that), so knowing my pain was getting out of control again, I proactively went to my GP and got a small increase in the topamax – to at least get that started – this is not an easy thing for me, topamax makes me really stupid, and even the 25mg a day increase really impacts me. Anyway, 2 weeks later I got back into see the PM as a follow up to the discogram and it was confirmed that the discogram was negative. Before this appointment I already made the deal with myself I was going to tell the PM where I was with my pain and by now it was worse than before as I already knew 6 weeks ago that ‘it’ was starting all over again. When he asked how I was doing I told him that I felt that my tolerance to the vicodin was building up again, just as it had the first time I came to see him. (I was very afraid to use the word ‘tolerance’ with him.) I then said, ‘it just doesn’t work like it did before and it’s just like before’; I said “for example, I have already taken 2 pills this morning “ (I am allowed 1 per 4 hours) and it was already 10 or 11 o’clock and I told him my pain was hitting a 5-6 and I wasn’t even doing much of anything and my pain is mostly aggravated by being in a standing or upright position. I then proceeded to tell him that I knew the vicodin wasn’t working as well for several weeks back and that I had gone back to my GP and had my topamax increased and had already been at the higher level for 2 weeks now and it didn’t seem to be making a difference yet, but that I realized it can take some time. My PM did hear me and he is still working with me to find out what is wrong. He did more tests (bending, lifting, moving, asking questions) and he did another diagnostic shot thing that numbs just the outer muscles which didn’t work. He then asked me if I had tried percocet and I reminded him that we had tried that back when I first came to him (switched from vic to perc and that I didn’t sleep at all for 2 weeks no matter what sleep medicines he gave me (and then he remembered all the trouble I had). Then he said at my next appointment he would change me to norco – another vicodin with less Tylenol so I can take more and in the meantime he gave me valium, I believe it is about the last muscle relaxant he has given me to try – none have worked thus far – and now neither does the valium except for great sleeping – which tells me I am not having muscle spasms. He told me I could only take the valium for a month or two anyway. My next appointment is this Wednesday and on this appointment I am hoping he will follow through on the increase in the vicodin because out of everything it works better than anything else I have tried – admittedly I haven’t tried everything. I still haven’t adjusted to the new level of topamax either and I still have lots of room to go up on that and I am willing as I feel I will adjust as I finally did to the 50 mgs and it really does help the pain – if I forget to take it, I just can’t function. I also know percocet is out for me and it is stronger than vicodin – tramadol did the same thing to me in regards to sleeping – or should I say not sleeping – and I mean NO sleeping. I could close my eyes, but I would not drift off at all. This implies to me that oxycontin (spelling) would probably not work for me since it is the same drug as percocet. I truly feel I need a LA as I have the pain most of the time but I also understand that the PM is trying to diagnosis and figure out the problem is before he goes to this resort. I am willing to try almost any drug, narcotic or otherwise with a couple exceptions: (I will stop here, I am rambling).

As another note, my personality style (I think) is that I come across as being pretty straight-forward and upfront and educated but I don’t try to ever look like I know more than the doctor. In fact, I think sometimes when I ask questions I will say, I don’t mean to imply that I understand this correctly, but I read, blah, blah, blah, and then ask my question and I usually can strike up a fairly good conversation. This PM was once drawing a picture of something of the human back, vertabraes and discs and explaining something to me and I said - oh that’s the such and such and he said – oh did you have a discogram before? And I said no, no - I explained that I do a lot of reading and that because I have suffered in pain for so long I have done a lot of studying about back problems and other potential illnesses that might cause my symptoms – I then told him the problem with that was that I had a bad habit of diagnosising myself and that was very dangerous. I also try to keep my hands in my lap (instead of in my pockets where I would like them to be) and I try really hard to make eye contact, even when I am scared. I am sure I look down when I am embarrassed, but the bottom line is that I am not lying, and I know it, so I decided to just trust in myself. Gosh I hope that makes sense and maybe this will help someone else.

 
Old 07-10-2006, 08:20 PM   #9
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Re: Nervous about Dr appt

thanks dogmom
that helps alot. I am now on narcos i take 2 10 mg tabs 4 times a day. How many did your dr put you on?I wish my dr would put me on perc they work alot better for me.i haven't said anything to him about them,but i have been on them in the past and i think he knows that. good luck,,,, kelsey

 
Old 07-11-2006, 06:10 AM   #10
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Re: Nervous about Dr appt

See, the problem with me is, I just started seeing this PM doc, and I have been on vicodin off and on for over a year, and I really think I am building a tolerance to them. But according to him, I've only been taking them through him for a little over a month. The norcos work sometimes, but I have days here and there where they don't seem to do a damn thing. It's frustrating, but I'm worried that my pm is going to think I just want more drugs, stronger drugs, etc. I think a lot of that comes from my husband. When we get into fights he likes to say that I'm a junkie, or an addict, or other things like that. I know he doesn't mean that, but it makes you wonder sometimes.

 
Old 07-11-2006, 07:21 AM   #11
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Re: Nervous about Dr appt

Oh Mysti-
I know it hurts so deeply when your husband says those awful things. It's not your fault you are in pain, and it's not right that he says those things to you. Maybe, when you two are not in an argument, you should ask if you two can talk heart to heart. Explain to him how it makes you feel when he says those things to you. When someone doesn't live in chronic, long term pain they do not and can not understand the need for pain management. You need understanding and support from him, not hurtful comments. I hope you can resolve this with him, because you should never feel or be made to feel guilty that you need pain management. The guilt could just open up the door to more depression.

As far as your pm doctor thinking you've been on vicodin for just a short while during your being his patient. Didn't he have detailed paperwork for you to fill out during or prior to your first appointment? The paperwork (seemed like hundreds of pages) I had to fill out requested detailed information about my pain. It also requested any and ALL medications I had been taking for this pain and who was the prescribing doctor. They also had me fill out a release form so they could get copies of my medical records as well. He should be aware of your previous medications. If he is aware of this, then he should certainly understand that your body may have built up a tolerance to the vicodin since this is something to be expected with long term use.

Again, I urge you to be totally honest with your pm doctor so that the two of you can work together in getting your pain levels under control. As I said before, there has to be a trust factor there. I do hope you are able to get adequate pain management sweetie. I wish you the best.

Lezlee

 
Old 07-11-2006, 09:31 AM   #12
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Re: Nervous about Dr appt

I actually managed to get an appointment today to see another one of the pm docs in the same practice as the one I've been seeing. I tried to explain to my regular pm that the meds don't seem to be working as well as before, but he said to wait until my next set of injections (Friday) to see if that helps. The only problem is, I'm waking up constantly at night in pain, I've been getting maybe three or four hours of sleep a night, and during the day I am unable to function. I plan today on making SURE that the doc understands all this, even if I have to pound it into his head.

As far as paperwork, I really didn't fill out that much, just a page or two about my actual pain, and it only asked what meds I am on currently. I know my pcp doc sent over his notes and such, but I've had insurance changes and a couple of different docs since my original injury. My problem is, I have all this stuff that I want to say planned out, but I get nervous in the appointment and forget half of it. I'm writing down all the stuff I want to say today so I don't forget anything.

And as far as my husband goes, I know he doesn't mean what he says. He's so frustrated that he can't help me when I'm in constant pain, and he directs his frustration into anger. We have had calm honest conversations about all of this, and I know he feels for me. I just think he wishes that I didn't need any meds at all (and of course I do as well), but when he's upset he has trouble voicing it. I know he loves me, and he just wants me to be better. Trust me, I've said some rather rude things to him during an argument as well...

I appreciate the advice and the concern, pray that I have the guts to speak up about the truth of my pain to the pm doc today!! I hope he helps me. I REALLY REALLY hope he helps me, I don't know how much longer I can continue like this.
---mysti---

 
Old 07-11-2006, 09:49 AM   #13
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Re: Nervous about Dr appt

Just thought I'd chime in. When I had EPI's done in my lumbar I had a similar problem, it actually increased the pain permanently instead of decreasing it. It got to the point by the end of the first week I couldn't walk and the doctor had to increase my pain medication as a whole.

The doctor isn't sure what actually happeneded as it was done under Flouroscopy and we're pretty sure no nerves were hit because I don't have any nerve pain. I know that I have problems as a whole with steriodal injections due to a connective tissue disorder and we think that may be why the injection made things worse.

I know that you are frustrated that your doctor is not willing to increase your medication and wants you to wait things out until your next appointment to see if the injection has any effect. No one likes being in pain, especially increased pain as a result of a proceedure.

I am however concerned about your new appointment with a different doctor. Did your primary PM tell you to do this and does the other PM know about you seeing his associate? If not this could bring out a big set of problems and could potentially label you as a drug seeker and remove you from the practice. No one would want that to happen, thats for sure!

If the office made the appointment for you then you are fine or should be. Not trying to worry you or cause undue stress but a little red flag just appeared and wanted to clarify things I guess.

As far as paperwork, your doctor should have gotten medical records from all prescribing doctors in the last year so that he is aware of what you have been taking and why. This would clear up any confusion about how long you've taken any medication and any potential tolerance issues.

Good luck
Barb

 
Old 07-11-2006, 10:08 AM   #14
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Re: Nervous about Dr appt

Hi Barb - A little off topic, but you said something in your post that caught my attention: You stated:

"The doctor isn't sure what actually happeneded as it was done under Flouroscopy and we're pretty sure no nerves were hit because I don't have any nerve pain. I know that I have problems as a whole with steriodal injections due to a connective tissue disorder and we think that may be why the injection made things worse."

I have scleroderma myself (connective tissue disease) and wondered if you could explain what you meant when you said the steroidal injections caused more problems because of the connective tissue disease. Thanks - KathyMac

 
Old 07-11-2006, 02:58 PM   #15
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Re: Nervous about Dr appt

The doctor's office actually recommended me to see another doc in the practice simply because my regular pm is not in the office until friday. I think after the injections I may actually change permanantly to the guy I saw today, he was really great, really friendly and understanding.

I don't think my regular pm will be upset with me, I am being totally honest and not trying to "trick" any of the docs into prescribing extra meds. I simply told the guy exactly what was going on, that my last day of work was on Saturday and I think I may have over done it and strained myself, and couldn't tough it out until Friday when I have my next set of injections.

 
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