Trying to get some information on Pain Management Clinics - Pain Management Message Board

jackson44 · 04-09-2008, 03:16 PM

Hello all,
Trying to get some information on Pain Management Clinics...I've had three foot surgeries (on the same foot) in three years and on back surgery in 07. I still have constant pain and now have been referred to a pain management clinic. I'm at a loss as what to expect. Your right you go to the ER room and they make you feel like a druggie. I've purposely not gone just so I won't be deemed that. Can anyone give me any insight as to what to expect. I just went and saw my back surgeon as I had fallen and now back to having back pain once again. He perscribed me lyrica and it is not doing anything. My foot they can't do anything with it anymore. Constant pain they have fused every joint they can fuse except the ankle to the foot. Can every wear anything but a certain kind of tennis shoe. I can't go barefoot and if I've been sitting for longer than 10 mins shooting pains. Now I've got pains that just happen out of the blue (never had those before) by the end of my day my foot is swollen and very painful. Any insight anyone can give me I would be happy

thanks

brianpain33 · 04-09-2008, 04:31 PM

jackson44:
Welcome to the boards although we all wish that we were not in this current pain situation. Can I ask what exactly is wrong with your feet? I have had many, many problems with my feet and involved multiple injections, procedures, and surgeries. Now I am left with chronic nerve pain in both feet which I have had to try and get under control and finally I have gotten it relatively under control(at least better than 6 months ago). I think you are definitely in need of that Pain Management doctor. To sum things up regarding PM docs. There are several different kinds:

1. Docs that only presribe and manage medications

2. Docs that only do diagnoses, procedures(especially involving the back), and injections, physical therapy, biofeedback, relaxation techniques, counseling, etc.

3. Docs that do both procedures & prescribe & manage medications

I don't suppose you know what kind of PM doc you are going to see? The other big question is whether the PM doc is willing to prescribe opiate/opiod medications. Some of them are extremely opiate phobic and just will not do it and then there are others that are relaxed about it and hand them out like candy. Of course these are the two extreme ends of the spectrum. If I were you this is what I would do to prepare.

1. Get all of your medical records from all the doctors you have seen including podiatrists, orthopedic surgeons, neurologists, etc. and send them to the PM doc. (this can usually be done by calling the docs office and asking for them to send you a release of records & tell them where to send the records). It is usually a good idea for you to have a copy of the records as well.

2. Prepare any and all questions that you may have and a little summary of your medical history

3. Take all of your medications that you are using with you

4. Get a pharmacy printout from the last 6months - 1year of the medications that you have been taking(just ask the pharmacist for a prescription print out). The PM doc will want to know what you have been on & tried

That's about all that I can think of at the moment but I know others will chime in. Oh yeah keep us posted and let us know how things go

brian

Executor · 04-09-2008, 06:36 PM

Great intro by Brian. Pain Mgt clinics can vary a lot....Simply by the "philosophy" of the lead Doc, or partner. Also, being that you've been formally "referred" is an impt aspect....Probably gives you immediate credibility, especially if you've been referred by a surgeon or some other credible Doc. Some PM clinics today won't even take patients unless you've been referred by another Doc.

A lot of your care will be determined on whether your condition is determined to be "acute" and improvement is possible, or "chronic" and/or permanent. If the former will probably involve lots of rehabilitation...maybe injections and things like that. Many PM clinics do what they call "procedures" where they have a mini OR (and I use that term very lightly) where the PM Doc does minor procedures... anesthesia & etc. Every now & then, I have an appointment on what the clinic calls "procedure day" and it's inevitable that my appt runs way behind because the Doc is performing all sorts of procedures, and they squeeze appts (mine for example) in between.

Conversely, when you are chronic and/or permanent, PM Docs primarily focus on pain control and keeping the patient comfortable, but also active as they can be. The optimal level of PM is scripting the patient enough meds to treat the pain, but no so much that they are sedated, or home bound. For example, many, many patients take narcotics and yet have important careers. Many PM patients are also on disability, and in these cases, patients usually take higher level meds due to the nature of their condition. The patient roll at most clinics can vary quite a bit.

Hope this gives you a good general overview of PM Clinics. Buyer beware....Most are very strict and have rules you must follow or you become "dismissed." Regular drug testing, no missed appointments, no early refills, & etc. The rules are there to filter out the drug seekers and diverters and protect those patients who really need PM.

Good luck.

Ex