Hi everyone, I'm reaching out for some support. I had an appt with a new PM today and he doesn't want to treat me, a copy of the letter I wrote but haven't sent is down below and explains why. I do still have other options so I'm not out in the cold but I was REALLY let down today after my visit. Here's the letter with appropriate info deleted.
Dear Dr. ,
First Iíd to say thank you for seeing me today and also to let you know how kind and compassionate your office staff was to me in my minimal dealings with them.
I really feel the need to express to you my feelings after I left your office today. First off, I went to my car and had a good long hard cryÖand am still doing just that after Iíve gotten home. I know that in your field of medicine in particular, you meet people with much more serious problems and pain than me, but even though there are people worse off than me it does not minimize the fact that I have pain and that my pain is just as difficult for me to deal with and accept.
Iíve been in pain much longer than the past year. I have been in pain prior to my neck surgery, which I finally had done after months and months of less invasive treatments, which didnít give me any relief at all. All Iíve been doing for the last several years is try to deal with the pain and work towards a permanent solution. All while keeping my medications in checkÖ.realizing that I have a diseaseÖof alcoholism and that it would be easy for me fall into the addictive category. I keep a mindful presence on that every day and even though Iíve been taking narcotic/opiate medications off and on for the last 2 years, have not abused my medications ever. Now I do know that it could happen, Iím fully aware of that and that is one of the things that keep me from doing it. If I really wanted to abuse anything all I would have to do is start drinking again.
I also respect that youíre in the field of pain management and that you deal with narcotics/opiates on a daily basis and that itís very important for to keep your risks as low as they can be. I know that if you prescribed medications to every person that came in for them that one day you would probably be out of practice and Iím sure that a great many people would suffer if that were to happen. I just wanted you to know that I understand.
But I do have a lot of emotions that came up for me after our appointment. First I was very angry at my diseaseÖand I havenít been angry at being an alcoholic for a very long time. Iím very proud of the fact that I made a life altering change nearly 18 years ago, to stop the alcoholism that Iíd seen my father progress to and felt that I would end up just like him if I didnít just take it out of my life all together. Today, I felt like I was being punished for being an alcoholic that I wasnít being allowed to be treated for my pain because of a ďpotentialĒ for abuse, when my track record has been just the opposite. Believe me, nothing would make me happier at this moment than to be off all medications and not have any pain at all. But it doesnít appear to be my lot in life, today anyway. All I want is for my pain to be treated while Iím searching for the answer to my neck and back pain.
One of the things I wanted to address with you if you had taken me as a patient was the physical dependence that has already occurred after using the Fentanyl for just one monthÖ.it scares me to be so physically dependant on a medication. I know that when I was on the 72 hour dosing that I got very sick to my stomach and had increased pain during that last 12 hours, apparently the medications went through my system quicker. And my understanding is the Methadone has the same type of physical dependence so that scares me even more to be on another medication with the same thing.
The other emotional thing that Iíve felt both today with you and when Dr.... referred me to you was that feeling of being tossed outÖnot treatable or too much trouble and the last thing I need right now is to lose hope. Every time I see a new specialist I get my hopes up that theyíll be the one to help me and it seems lately that Iím just being passed on to the next one. What I was hoping for was to have one Doctor help me with all my medical needs regarding my neck and upper back, the same one that guides me with my treatments to also be the one to help me with my medications.
I do appreciate the evaluation with you today and I will pursue to recommendations that you gave me. If you need to reach me, my cell number is
I just felt so bad after my appt today that I came here to the boards looking for some support...do you think this letter is ok for me to send to him?
Hi Jeanne: Absolutely! It's an excellent answer to a very difficult situation. A person like yourself, needs to be treated more than anyone else, as the alternative is there (God forbid!) for you to medicate yourself with alcohol. That would be terrible thing to have happen after 18 years of sobriety. Send the letter and I hope you receive a positive response. I commend you for your ability to overcome the alcohol addiction.
Thanks for the response Director. I just a can't seem to shake the down and out that I'm feeling right now...I'm sure tomorrow will bring a brighter day!!
I think the biggest thing I'm going through is the fear of it all. I keep hoping that there is some magical cure out there and there really might be. I'm nowhere near exhausting my options at this point, but as so many of you know already it's practically a fulltime job just keeping the medical appts and all the paperwork, etc in order.
He suspected the possibilty of a battered nerve...that's a new one to me, so I don't really even know what it means. He also thought that there could be scarring and if it is the case then have me look at the possibility of a C-spine dorsal column stimulator. And all that just plain scares me.
So much for a quick fix, huh? Guess that's why I'm here!!!
Anyway, I really appreciate the response and I will fax him the letter, if anything just to get it out and hopefully help the next person.
My first thought was and they wonder why alot of people dont tell things on their health historys. I work in a health care setting and I see it time and time again. People check things and for all we know it could be 18 years ago. I hold people in a higher standard that are honest. You had the option of not telling that to anyone but you were honest. It got you the exact reason why so many dont. You mention that he gave you other avenues to try, you dont mention what? Do you think any of them are even viable. Its amazing to me peoples assumtions.
I just today went to the pharmacy to get my 2nd in my life RX for MS Contin and it is a diffrent mgs and dosing, It said consult across it and the man came up and shoved it at me. I said ummm.. How should I be taking this. He looked at me all frazeled and said how have you always taken the stuff. I said well if you look at my records you can see this is all very new to me. He said "yeah, so they all say". I was mortified, I said " you should, look in to a job you like", He walked away and I left with the meds no questions answered.
I read here people get that alot, I have never scene it myself till now.
I hope your regular DR is going to give you some relief, someone has to.
I still have facet injections to try. As well as traditional accupuncture and really whatever else they have to suggest. One of my problems is that I jumped into PT, MT and IMS, which is inter muscular stimlation...needles with electrical impulses to help release the muscles. my muscles in my neck and thoracic areas are so tight...like concrete with deep spasms. Anyway I went into all that without adequate pain relief and those were just too aggressive for me, I felt much worse afterwards and then couldn't keep the pain at bay....one of my problems from early on was NOT taking my meds often enough and at the max dose...from my own fear of the addiction aspect because I do have the addictions already predisposed in me. So I was undermedicated. I also can have a CT/Myleogram and maybe that will shed some light.
So here I am now, my 1st PM put me on Fentanyl, which is helping and Hydrocodone 10/325 2 tablets twice daily, with the Fentanyl I haven't had to use the BT nearly as much, certainly not the max prescribed so I'm good with that. But the PM Dr I saw today doesn't think I should have the hydro's and that I should be on the Fentanyl and use Methadone for my BT along with increasing the Baclofen that I currently take only at bedtime, he thinks I should use it throughout the day. So I'm not undermedicated so to speak, but I guess what really bothers me is that I've been taking the hydros off and on for 2 years now with no abuse and now all of a sudden he's saying I have a high potential for abuse. And I'm scared of all these drugs and am hoping that there is an answer like the facet injections and I just need the time to try these different modalities while having adequate pain control and it just seems strange to put me on Meth and Fent at the same time...maybe someone with more experience can help me with that.
My original PM called me a few minutes ago and really laughed when I told him what today's Dr said...he said "he wants you to take Meth and Fent AND he wants ME to prescribe it?" So I told him that I'm very confused and I don't want to take anything....I just want to feel better.
I feel like the hot potato that everyone is throwing around and doesn't want to get burned. Kind of like i jumped on the crazy train...I want off!!!!
Thanks for letting me vent and get it all out...it helps so much.
Hi Jeanne, I am so sorry you are going through this! It does seem unfair that when someone is honest and forthcoming, It would be used against them. I think you should absoulutly send the letter, and hopefully you will have a good outcome from that. I did'nt quite understand, when you said your primary laughed at the idea that the pm doctor had suggested meth and the patches and also wanted him (primary) to prescribe it, was it a 'haha, yeah right thats not gonna happen' laugh or a 'you poor thing this guy was unreasonable' laugh? I want to offer you my full support, these boards have always been there for me, there are some wonderful people here who really do understand. Tia, I'm sorry the pharmacy was so rude to you, I think that is unacceptable, I would switch pharmacys if possible and write a letter to the manager or the head office, if it was a chain store. Jeanne, hang in there, and please let us know what happens, we care! Hugs, Fabby
Well today i got an appt with the pain psychologist that I'd been seeing...for Monday, so at least I'll get to unload and talk to him about these feelings, he doesn't handle meds though. And I also got an appt next Thursday for Cervical Medial Branch Blocks, so I'm hoping and praying for relief there. And I will also be going to see the PM (psychiatrist) that started me on the Fentanyl the week after the injections. So I can talk with him about (hopefully) coming off the meds altogether, which of would be the best scenario. I'm sure that everyone here feels the same way. None of us asked to have painful conditions, we just have them.
I know that if my pain was treated adequately that I would feel like I would have more time to research treatments and even do one treatment at a time so as to not overload myself, but for so long I've been acting out of desperation....willing to do and try anything to get out of the pain.
Fabby, I think that what my PM was laughing about was the fact that this new PM has the nerve to make meds recomendations....as long as someone else does the script writing. I do think that he'll work with me, he just thought it would be best for me to get all my care from one specialist. That's what I read into the laugh anyway. I hope so, because I would hate to be left hanging if I do need his help.
This board is great...I've learned so much since I've been coming here.
Tia...I'm so sorry that you had to deal with a pharmacist like that!! People can be very rude and I agree with your statement...the guy needs to get a job he likes instead of treating people that way.
Oh, I am so sorry the pm doctor refused to treat you. I just don't even know what to say sweetie. You know, we are always told to be totally honest with our pm doctors, and like you, I think I'd be feeling like I was being punished for a problem that was corrected years ago.
I do hope you will be able to find a doctor that will treat your pain. Just because they can't put a "name" or label on the exact cause of your pain, doesn't mean you aren't truly in pain. Are there other pm doctors in your area? I have to go clear into the next state to see my pm doctor. It's only an hour and 15 minute drive, but when you are in pain that hour and 15 minutes seems like a life time.
I can't even imagine the emotions that you must be feeling right now, but I am glad you wrote the pm doctor that note. He needs to know how you feel, and you expressed those feelings in a respectful manner even though you were hurt and angry.
I do hope and pray that you will be able to find concrete answers and some much needed help in managing your pain levels. Don't stop seeking help because there has to be someone out there who can and will help you.
QUOTE FROM TIA: "I just today went to the pharmacy to get my 2nd in my life RX for MS Contin and it is a diffrent mgs and dosing, It said consult across it and the man came up and shoved it at me. I said ummm.. How should I be taking this. He looked at me all frazeled and said how have you always taken the stuff. I said well if you look at my records you can see this is all very new to me. He said "yeah, so they all say". I was mortified, I said " you should, look in to a job you like", He walked away and I left with the meds no questions answered."
OMG!!!!!Tia! How crass, rude, unfeeling and unprofessional for that pharmacist to have treated you that way! Where does he get off? You know, this is one of the reasons I ALMOST didn't take the referral to pain management. There is such a stigma attached to those of us who need pain management, and it really gets my undies in a wad! He had NO right to speak to you that way, and I would have filed a complaint about him with whoever the "higher ups" are. How dare he treat you like some kind of druggie or something.
I am so sorry you were treated like that girl. He needs to be plagued with chronic pain so he will understand a bit more about our situations. I'm sorry, I shouldn't have said that, but he is the prime example that someone who doesn't live with long term, chronic pain just can't possibly understand what we go through.