PM doc issues - Pain Management Message Board

MikeZ · 09-23-2003, 09:09 AM

I've been lurking for awhile, learning from everyone's experiences. Need input from all on my situation.
I've had back related problems for years (10+), but those always appeared muscle spasm in nature. Three years ago, the pain got much more severe and I finally had an MRI. The MRI found that I have multiple buldging discs and Degenerative Disc Disease, but no nerve root impingement. My primary doc's response was basically "learn to live with it, you'll have bad days and good days" and here's some Celebrex. I then went to a Nuerologist and got a similar response from her. Then onto an Ortho doc, who did trigger point injections, physical therapy, and gave me a TENS unit. I went this route for approximately 3 years. Denial is a great thing ... I pushed myself through each day, even though I was miserable and in pain. Finally had it out with my primary (who I've since left) and demanded that he do something, anything, as I was near insane with pain. He referred me to a PM doc. Finally, some relief. He likened my condition as to having asthma and a doc telling me "learn to live with it, you'll have good/bad days" and offering no further treatment, and that he could help me. He put me on 10mg Oxy 3 time daily and soon started on some diagnostic testing. That lead to RadioFrequency nerve ablation at the facets (had 3 rounds of that) and 3 instances of select nerve blocks. I've had some relief from the constant pain, but it usually rebounds and is back after a few months (which lead to repeating the RF). The one positive issue is that the sciatic pain and the feeling that my foot/ankle/leg is being twisted had gone away. But, I am having all that low back pain,leg heavyness, and ankle pain is making a return and I'm being advised to have a sacroiliac joint block in case this is referred pain, which scares the heck out of me (told to anticipate 3-5 days of significantly increased pain following the injection ... which, translating the doctor speak, means knocked down and out in pain). Save for the first visit, I have not seen the PM doc during any of my visits as they are handled by a nurse practioner. I do see him in the OR, but I'm sedated, face down and can usually manage a grunt or two to acknowledge him. And, that's where my trouble lies. The nurse/prac is the one determining what the next procedure will be, what next process will happen. The first two nerve blocks I had without issue. The last one really threw me for a loop. I had significant chest pain for days, muscle soreness/spasm from my neck to feet (couldn't turn my neck, had to rotate entire body) and was just out of sorts mentally. One of the other nurses thought I had a conflict with my pottasium levels and the block. I'm also seeing an Internist for uncontrollable (so far) high blood pressure and during the never block problems timeframe, was diagnosed with low testosterone. The nurse/prac is basically shuffling through my file and saying "let's try this next". When I reference all the side-affects I had from the last nerve block and my hesitancy of repeating it, she poo-poo's it and doesn't want to listen. When I once questioned what the overall goal of my treatment was and phrased it as "what's the eventual goal, are we going to be chasing a nerve here, a nerve there ... can I anticipate getting better, wouldn't it be better to attack the pain's source, what's the treatment plan?", the nurse/prac marched out, dragged the PM doc out of his office surgical suite and while he's all gowned and masked up, he proceeds to read me the riot act ... screams at me that he could give me a back full of hardware, but it wouldn't make any difference, that this is the way I'm going to be. So, I'm still experiencing most of my original pain, have pursued all treatments they've suggested (at significant cost to myself and my insurance) and the nurse/prac now wants to reduce my Oxy 10 mg to twice daily, nevermind that I'm still in pain any not fully able to function in life.

Suggestions/Comments? Is it time to drop this PM doc and find another? I have an appt with my internist tomorrow and plan on discussing these issues, maybe he can help. This PM doc was the first doc to take my pain seriously.

[This message has been edited by MikeZ (edited 09-24-2003).]

[This message has been edited by MikeZ (edited 09-24-2003).]

Tony111 · 09-23-2003, 10:38 AM

Hi Mike,

I have been there and done that, too. You are in what is called a 'Block Shop'. The doc has no compassion. You have a choice here, you have these procedures or not. Especially since you have tried the injections and abalation procedures....it's time to find a new Pain Management doc. Take care and good luck!

Tony

grizzk62 · 09-23-2003, 12:09 PM

MikeZ,

Hello and welcome to the board. I have heard of these kind of PM doc. I have a friend who went to one just exactly how you desricbed it. He too went in and the only time he ever saw the doc was during a proceedure and those were so multiple that he couldn't afford it after a while even w/insurance. These kind of doc are only out for the money. He to was told off by the doc when he question why everytime he came in he saw the nurse prat. Not him. And when he asked one to many questions they dismissed him as a patient. Fortunately enough I was able to get him in to see the PM doc that I see. In my opinion those knid of docs have no business in practicing in medicine of any sorts. They are unethical. They put their pocket book a head of the patients needs. I would diffinately move on and find another doc. Take care and by all means keep us informed...

Matt

lindao1 · 09-23-2003, 01:36 PM

Hi there Mike!

I have to agree with the others - please find a new PM dr. As we've all experienced, there are too many so-called PM drs. that need to be in another line of work.

Please run, don't walk, to another PM clinic. You deserve pain relief just like anyone else, and as was mentioned, so many PM dr's focus is on the "bottom line" and not with the patient's best interest.

I've had the experience of dealing with the PA and not the dr. himself. But fortunately, I do see the dr. from time to time and the PA always consults with him prior to offering any treatment options. But to consistently have to see the NP and not the dr. and then to have the dr. admonish you, it is tantamount to neglect. So please find a caring and compassionate PM dr. It may not be easy, but it can be done.

I wish you the best of luck in your pursuit of deserving pain relief, my friend. And I would like to welcome you to these boards. You will find alot of caring people here whenever you need us. Your pal, Linda

MikeZ · 09-23-2003, 02:47 PM

Thanks to all for your responses and kindness. I guess it takes hearing it from others to validate the direction my thoughts were moving towards. Family and friends were troubled by the past screaming episode and advised me to drop him then. But in the three years of suffering and dragging myself from doctor to doctor in search of relief and looking for someone to take me seriously (heard "learn to live with it" repeatedly) his was the first real offer of help. He was the first doc to take my pain seriously. But, in the year and a half that I've been his patient, many issues have troubled me and made me think twice. As I've stated previously, I've only seen the actual doc once. Everything else is handled and decided solely by the nurse/prac (well, one of the docs does sign the prescriptions). Well, wish me luck, off to seach out another PM doctor.