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Old 05-20-2008, 11:07 AM   #1
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Update on today's PT and PM visit - not good

I'm at a loss. I've been trying for years to get help - when I turned 40 and after my child was born everything changed. Migraines started - 2-3 a month; I've always had back problems and had a very bad car accident in 1997. I'm trying to get of Lexapro and have a decent internist but as I'm getting pain meds from the back specialist, I cannot take pain meds from any other doctor. I think I was doing better on 40 mg of Hydrocodone than the 30mg of percocet I take now.

I asked about longer acting meds - the doctor "pretended" he didn't know what was better/stronger/longer lasting than percocet. I know he prescribes Oxycontin as I've heard him talk to other patients (they're not good at closing doors, etc. which drives me nuts - I don't want a waiting room to know about my medical problems). Anyhow he gave me another injection and told me to take 4 10 mg percocets a day but I was only prescribed 90 for the month. I said but I'll run out before the 30 days and he said we'll talk about it next week.

I just want to cry. If I kill myself will someone listen then? I asked to read my chart while I waited 2 hours to see the doctor. It says myofacial (sp) pain all over the records. He never told me this, ever! I was told it was Chronic Lumbar Strain.

With the twitching legs, I'm at a loss. I think I should go see a neurologist which has been recommended to me by this practice once before. I'm just depressed about starting over - I have no clue what a neurologist does and I have no idea what myfacial (sp) pain is. I see a long thread which I'll read when I get back from school pick up.

If anyone has advice for me I'ld be grateful forever. EG, a neurologist sounds like the right doctor? I am tried of being shunted from one doctor to another and living like this - having a little pity party. I'm so glad I found others who are going through the same thing - I feel so alone. I'm scheduled to go back to the back doctor next Tuesday for another injection and I guess we'll talk in more detail about how 90 pills at 4 a day is supposed to last 30 days. Even my kid can figure out that math.
Thanks in advance.

 
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Old 05-20-2008, 11:33 AM   #2
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Re: Update on today's PT and PM visit - not good

Tarajb, I have been where you are. If I had a buck for every doctor I've seen, you get the idea. All I can say is DON"T give up. I felt as you did , that when I died and it was going to be soon I wanted them to do a complete autopsy on me because then they'd know how bad I was and WHAT it was. It took me 20 years to get diagnosed and 12 years before I was on anything at all for pain. Please keep looking. You know your own body and you will find a doc to help you. It might be a neurologist, a pain management doc, a pcp, but keep looking until you find that compassionate doc who will treat you appropriately. When I had my first PM appointment I was crying when the doc came in(I don't recommend this, he looked at me like I was nuts at first). I told him that I had been treated so bad my doctors, nurses, front office staff, pharmacists, that his caring staff caught me off guard and I lost it, after years of being treated so bad.

This is the hard part you are going through right now and I think we all have been through it. I know it isn't easy to keep going to all these different docs, but try that neurologist and see what happens, and see about looking into finding a PM doc. In the meantime I hope next week he gives you the extra.

Take care
Melissa

 
Old 05-20-2008, 12:24 PM   #3
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Re: Update on today's PT and PM visit - not good

Sorry to hear about things, but you've got to hang in there.

The positive- He upped you to 4 Percs per day....He's trying to address your pain. He obviously has something against Oxycontin. Maybe it's your local law enforcement....Who knows. OC does carry a bad name in certain places just because of the name. Maybe the other patients you've heard about have been on it a while and he can't change them...Or it would be bad to. But, he's not going to add any other patients to the drug.

He does want to see you next week to monitor your pain...That is also good. At that point, you have to decide whether to grab the bull by the horns or not. I'd be tempted to come right out and tell him you've done some research, and there are long acting meds like OC, the patch, MS Contin, & etc. If he's got something against OC, he could use one of the others. As many know, I'm a big proponent of the patch.

Anyway, hang in there best you can. Stay positive!

Ex

 
Old 05-20-2008, 01:18 PM   #4
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Re: Update on today's PT and PM visit - not good

Thank you Melissa - 20 years, oh my gosh. I've just read the thread on myofascial pain and I'll spend some time researching it. I am with a pain med doctor - he has a license to prescribe pain meds but PT is also required, which I do and the injection was decent 2 weeks ago so I'm hoping it works again.

Ex, you've been great at giving me direction. I will stay positive as I have so much to be positive about. Great husband, kid, a good life but a good deal of pain. I learned a bit on the thread re myofascial pain. I will return next Tuesday but I don't know that I'll continue with this doctor. I'll stay with him until I can find the *right* doctor. I'll interview the osteo's or anesthesiologist or neuro's, whomever I find to help me figure this out.

I can see how deep tissue massage would help - I had one once but then I couldn't walk for 2 days - she went way to deep. It was in fact the same area I am still suffering from some 6 six years later as I don't think my daughter was born when I saw that massage therapist.

Between this and regular peri-menopause, I'm going insane at times. I'm going to fix my husband and kid a nice dinner and put it out of my head for now. Ex, he's a "conservative" PM doctor (per the Chiro in the practice) and the discussion I overhead was someone who was getting scripts for Oxy's from 3 different doctors so he cut him off and threw him out. Yikes, it's people like this who make people like me feel like I'm drug seeking when I am willing to TRY ANYTHING. For now I'll keep the perc's until I figure out what the heck to do next.
Thanks so much.

 
Old 05-20-2008, 06:25 PM   #5
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Re: Update on today's PT and PM visit - not good

Thanks Juliet - the thought has crossed my mind but my a family member did kill himself and it has wreaked havoc on my family. I would never and don't have any concern about that - it was a poorly phased tongue in check statement. Apologies if I have offended anyone.

I looked up doctors in my PPO (afraid of being accused of doctor shopping but I refuse to take any prescription expect the PM doc's scripts). I have an appt. with a neuro/anethisiologist (sp)/surgeon this upcoming Saturday. Someone cancelled and the receptionist slotted me in. I thought for sure it would take longer than 5 days. I'm nervous and will bring notes with me to go over the last few years.

Juliet, I am confused about the doctor testing me. Do you mean he expects me to take the 3 10 mg daily (not take a 4th unless desparate)? If that is the case, he has nothing to worry about because I won't put myself in the position of being in withdrawals (major or minor). I've experienced reduced usage both tapered and abrupt and neither was fun. I'm grateful for the experience - mostly mild - I chalk that to taking my meds as prescribed but percocet over hydrocodone worries me and LA worries me even more. I worry a lot lol. Ah, a laugh.

Thank you all for replying. Off the research MFP now.
My husband cooked dinner, I've been a bit detached thinking about everything but he understand and believes a good deal has to do with peri.
Thanks.

Last edited by kim46; 05-21-2008 at 06:50 AM. Reason: spelling

 
Old 05-20-2008, 06:51 PM   #6
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Re: Update on today's PT and PM visit - not good

Quote:
Originally Posted by tarajb View Post
Ex, you've been great at giving me direction. I will stay positive as I have so much to be positive about....................... I will return next Tuesday but I don't know that I'll continue with this doctor. I'll stay with him until I can find the *right* doctor. I'll interview the osteo's or anesthesiologist or neuro's, whomever I find to help me figure this out.
You never know....He may come around, especially if you stay persistent. Is this Doc a PM specialist or a GP? Also, how did you find him? Referred by another Doc? I ask because the answer effects my future recommendation(s).

Quote:
Ex, he's a "conservative" PM doctor (per the Chiro in the practice)
I don't understand what this means.

Quote:
I overhead was someone who was getting scripts for Oxy's from 3 different doctors so he cut him off and threw him out. Yikes, it's people like this who make people like me feel like I'm drug seeking when I am willing to TRY ANYTHING.
It's patients like this that unfortunately, make life much tougher for the rest of us. All it takes is one guy like this, and the rest of the patents in the practice are treated differently thereafter.

Quote:
For now I'll keep the perc's until I figure out what the heck to do next. Thanks so much.
Hang in there for now. I know you're not thrilled with how things are going, but it could be much worse. As you know, lots of patients come on this board and can't get any meds. Try to work with the Doc and see where it takes you after the next couple of appointments. When you go in, try not to act like the sky is falling. I think sometimes Docs don't take patients as seriously as they should, especially women, who complain about lots and lots of different things. I'm not saying you are, but rather just keep it in mind.

Ex

 
Old 05-20-2008, 07:46 PM   #7
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Re: Update on today's PT and PM visit - not good

I lost my post.

I started with you seem so knowledge and a real advocate for yourself and it's admirable.

To answer your questions:

The doctor is a Pain Management doctor. He must be near 70. He works 1 day a week at the physical therapy clinic. That clinic is run on the PT side by a Chiro but they invoice my insurance for physical therapy. I found him on my PPO plan. My former interest suggested that I see an orthopedist in 2006 which I did but because I have nothing operable I was told to do PT 2x weekly and I was prescribed about 40 hydros 10 mg monthly plus a few muscle relaxants. I stayed with them for about 4 months. I saw a different physical therapist every week and repeated the same exercises which I practiced at home too. But the PT didn't help my pain level. In May of 2007 I looked a new doctor, specifically pain managment and he was 1 of 2 in my plan. He asks me every week/bi-weekly if I work. He doesn't remember much of what we discussed the previous visit but the PT is pretty good at this place and I now only get 90 tabs of 10mg generic percocet monthly. In February he wrote DAW on the script (in March as well) and in April my insurance company wrote to him and my other doctors (allergist, GYNO and pcp). The insurance company's primary concern is whether or not I can take generic verusu brand. I have no issue taking the generic. I also called them when I got home and asked them had they even bothered to check the medical side of my history, would the prefer a $50K surgery,I was angry but civil and got the gentleman's name and id number (my script company is a huge drug chain, effective January 2008). Prior to the switch I've never had a problem with RX.

I asked the Chiro (who promised to help me get to the bottom of *this*) if he thought the doctor would script long acting meds. He said he would talk to the doctor after my injection. He outright told me that they have had 6 people come in - some with serious pain who have been getting narcotics from more than one doctor. I don't know if these patients are doctor shopping or suffering from chronic pain. I've been with this practice for just over a year now.When I asked about long acting meds to the Pain Managment doctor he said there was nothing long acting or stronger than percocet and to take an extra pill if needed. He also suggested I visit a neuro.

I don't need referals as I'm on a PPO. I haven't had great experience with referrals any how so sometimes I'll find a specialist via the network.

It sometimes feels like a continuous line of patients getting various things such as Narco, percs, Oxycontin on the days he's in the office. I attend PT when he's not there and it is 50% quieter than when he's in.

Duly noted on the sky falling. I limit my issues to back, numb calf, low and mid back pain. I don't discuss the migraines, endo or peri with him.
Thanks again. Sorry for write a book. I am wondering if you agree with me booking an appt. with the neuro/anesthesiologist surgeon - I just want to hear what he has to say. Why are my legs restless at night and does he treat myofascial pain. Every muscle hurts - I'm willing to try massage, injections - anything to bring back my quality of life.

As for the board members who are still fighting for pain relief my heart goes out to all of you. I'm a member of the Pain Foundation which I joined as I watched my Dad die a miserable long death without adequate end of life painkillers. It was horrid and that's when I started to learn about the vast amounts of peoplle who suffer from CP daily. I do count my blessings to have found a doctor willing to give me something to help my pain levels. I live life around a 7 to 8 scale and would love to move down to 4-5.
Thanks again. Sorry again for the book.

 
Old 05-20-2008, 08:42 PM   #8
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Re: Update on today's PT and PM visit - not good

I'm here to help, as are others....You don't have to apologize for writing a long post....The additional information you provided is very helpful, especially the part about your 70 yr old Doc....Makes much more sense now.


Quote:
Originally Posted by tarajb View Post
I asked the Chiro (who promised to help me get to the bottom of *this*) if he thought the doctor would script long acting meds. He said he would talk to the doctor after my injection.
This is excellent news. An internal advocate is always your best asset. I'd keep using him as a resource, including unofficial referrals to other Docs. These people in the field all know each other and know which Docs are med friendly, and which ones aren't. Sounds like he's definitely on your side.

Quote:
He outright told me that they have had 6 people come in - some with seriousus pain who have been getting narcotics from more than one doctor. I don't know if patients are doctor shopping or suffering from chronic pain. I've been with this practice for just over a year now.When I asked about long acting meds to the Pain Managment doctor he said there was nothing long acting or stronger than percocet and to take an extra pill if needed.
Well.....There's your answer right there:
He outright told me that they have had 6 people come in - some with seriousus pain who have been getting narcotics from more than one doctor.
As I said before, all it takes is one or two people to screw it up for everyone. I'm sure they are gun shy.

Quote:
He also suggested I visit a neuro.
It's possible that he may just not understand your condition, therefore, he's under treating you.

Quote:
I don't need referals as I'm on a PPO. I haven't had great experience with referrals any how so sometimes I'll find a specialist via the network.
Please keep in mind though that referrals are instant credibility with other Docs....If your Chiro refers you for example, the new Doc will worry much less about drug seeking than if you just showed up on your own. Additionally, the referring person should pick someone who they know will meet your particular needs. A good referral is worth it's wait in gold.

Quote:
It sometimes feels like a continuous line of patients getting various things such as Narco, percs, Oxycontin on the days he's in the office. I attend PT when he's not there and it is 50% quieter than when he's in.
He's probably been burned a few times (at least) due to the sheer volume you describe.

Quote:
I am wondering if you agree with me booking an appt. with the neuro/anesthesiologist surgeon - I just want to hear what he has to say. Why are my legs restless at night and does he treat myofascial pain. Every muscle hurts - I'm willing to try massage, injections - anything to bring back my quality of life.
Couldn't hurt....I'd tell them exactly what you just said, that you're looking for more information because something is wrong and you don't feel like everything is right. Who knows, you may have luck of the draw and run across someone who will either treat you, or can refer you to someone who will. Knowledge is power! Conversely, if you get bad vibes from this Doc, then play it safe.

Hope this helps. Good luck!!!

Ex

 
Old 05-21-2008, 06:49 AM   #9
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Re: Update on today's PT and PM visit - not good

Thanks Ex and thanks Juliet.

Mentally I'm in a better place today. I am going to call my insurance company and advise them that I will be seeing a neuro at the recommendation of my PM doctor. I will also advise the PM doctor that I am taking his advice and seeing a neuro. I've always provided full disclosure to my doctors. My husband and I had a long talk and he sees what I deal with daily - he's my biggest supporter. Juliet, please update after your visit and I'll let you all know how it goes with the neuro.
Gratefully yours!

 
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