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Old 06-29-2012, 05:45 AM   #1
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Question First PM apt next wk

Hello all. My first PM visit is next Thursday and I was just curious what to expect. I have a lot to say. I hope he plans on talking to me for a bit, not just in n out, not on the first visit I hope. I'm in Ca. And my surgeon faxed everything the pain doc needs. Thank you for any advice.

 
Old 06-29-2012, 07:44 AM   #2
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Re: First PM apt next wk

Bring a list of al medications you are taing or better yet, take your bottles with you. Betweenn ow and then keep a pain diary so you can let him or her know what your pain levels are at various times during the day. Be prepared to provide a UA and they will want to test you for any illegal substances and to check you are using your presribed meds.

 
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Old 06-29-2012, 10:26 AM   #3
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Re: First PM apt next wk

I hope you have a good appointment. Typically they do schedule you for a long appointment the first time so the doctor has time to go over your history and come up with a treatment plan, but some doctors are better than others. The previous poster had some good suggestions. I'd bring the med list with name, dose, doctor prescribing, what you are taking it for, etc, and only bring bottles for any pain meds you may be taking. If you only take the bottles you will probably just have to write out the list when you get there.

I'd expect to answer a lot of questions such as the type of your pain, when it started, what diagnostic tests and treatments have been tried, etc, then discussion of the doctor's treatment plan. Depending on your pain type, they may do a limited physical exam, such as pressing in certain areas and asking if that intensifies the pain. I think the best plans are those that have several approaches, such as additional testing, injections, alternative treatments, pain meds, and adjunct pain meds.

My pain specialist requires everyone to get a psych exam, to see if they could benefit from any treatment (depression and anxiety are common with chronic pain), and also probably to see if they have addiction tendencies, as a large percent of folks who see a pain specialist are continued on or put on opiates. A lot will depend on how much you have already tried and how many tests have already been done. They usually have a step therapy program, for example, they are going to try you on something like physical therapy and muscle relaxers before they put you on long acting narcotics.

Often they won't prescribe anything the first visit (to wait for the UA to come back or for whatever reason), but sometimes they will, especially if they are taking over prescribing pain meds you are already on (assumign your prescription is due that day). I'd go in with an open mind and maybe even some paper & pen to take notes. Most of the time a pain specialist will be a big step in the right direction for those with chronic pain. Often they have spent years on ineffective treatment by their family doctor or non pain specialist.

I suggest however to think of this as an interview. If you don't get a good vibe from this doctor, such as they just hand you some prescriptions and push you out the door, you can definitely try out some others. I think some folks think they are stuck with a doctor just because another doctor referred them there. Even if you do stay with this doctor, you are still open to see other doctors, as long as you don't get pain meds from them until you cancel any contract you may have to sign with this one.

Also, if they didn't send you paperwork in the mail or instruct you to print it from the internet, be prepared to fill out a bunch of forms when you come in. Its quite typical for you to have to give a complete medical history, list everything you have tried for the pain, shade in a picture of where your pain is, etc. Keep in mind that if you are already on pain meds, this doctor may decide to change your treatment. Different doctors have different opinions on what is appropriate, and just because you are on a certain med doesn't automatically mean it will be continued. Best wishes.
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Old 06-29-2012, 11:57 AM   #4
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Re: First PM apt next wk

Thank you. I will have my meds ready, prescriptions, OTC and herbal. My brace. I did get a fat packet to fill out by mail. Did that. I will start keeping a log. Thanks for that advice. I will encourage drug testing, I don't mess around. I hope I get a doctor who listens because I have a lot to say. I don't drink, smoke, no bad habits so my addictive traits are low I guess. I want to get his opinion on the wrist fusion subject. And I like the interview idea. But i don't have much choice, it would be tough to get a new referral and waiting another lord knows how long to be seen. Thats why I pray I get a good doc. He has only had his practice for a year or so. I like that idea, he will be around for a while. He is a DO. Are they good pain docs? Thank you all again, the help is appreciated.

 
Old 06-29-2012, 12:42 PM   #5
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Re: First PM apt next wk

Not sure you can make any conclusions based on that he is a DO. I believe pain management doctors are most commonly anesthesiologists by training, but it does vary. I'd just see how it goes and not try to be too anxious about everything. Best wishes.
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Old 06-29-2012, 12:51 PM   #6
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Re: First PM apt next wk

hi, not sure if anyone else stated this i just skimmed it, but I'd bring any MRI's, xrays too. My PM likes to see them. I'd also write a list of things I'd like to discuss and leave room there for his answers. They seem to talk so fast! Good luck and let us know how it goes. CJ

 
Old 06-30-2012, 06:09 AM   #7
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Re: First PM apt next wk

Quote:
Originally Posted by lake county View Post
Thank you. I will have my meds ready, prescriptions, OTC and herbal. My brace. I did get a fat packet to fill out by mail. Did that. I will start keeping a log. Thanks for that advice. I will encourage drug testing, I don't mess around. I hope I get a doctor who listens because I have a lot to say. I don't drink, smoke, no bad habits so my addictive traits are low I guess. I want to get his opinion on the wrist fusion subject. And I like the interview idea. But i don't have much choice, it would be tough to get a new referral and waiting another lord knows how long to be seen. Thats why I pray I get a good doc. He has only had his practice for a year or so. I like that idea, he will be around for a while. He is a DO. Are they good pain docs? Thank you all again, the help is appreciated.
My PM Dr is a DO, I don't notice any difference between them and regular doctors. I started PM recently. I was not prescribed any meds on my first visit, and did run into a problem with lack of communication in my practice, but it worked out and I am now feeling a lot better with the injections and pain meds that I am on. I agree with what people here say about it being trial and error. Even if you are not 100% happy after the first visit, stick with it. I feel like a lot of Drs try to weed out the fakers and medication seekers.

 
Old 07-03-2012, 02:16 AM   #8
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Re: First PM apt next wk

I want to apologize about how long this is but I wanted to make sure that I covered everything. Hello to all I read all of the post which they are all right. You are going to need to bring any records you may have,MRI,CT SCANS,bloodwork,etc. You are going to bring your insurance information. Most PMP work on referral based not all but most so be sure to take the referral if you have one and your insurance information. Take a list of all the meds that you take EVERYTHING because they don't know if something that he wants to prescribe will interact with a med that you are already taking. Then He will sit and talk to you about what the reason that you are here to see a PMP. Be completely honest. Tell him how your pain is. Don't lie and say its a 8-9 and it's not cause they find ways of knowing and trust mje they do. One guy got kicked out the PMP I was seeing and Its was because He asked him about his pain scale and he said a 8 then a few minutes later the doctor asked him a question about a basketball game that came on and the dude got so excited talking about the game. Making jokes on the team, acting really amped and The doctor took notes in his chart because when you are at a 8-9 you don't even want to talk. That's when I worked for a PMP before I got on disability and had to go to the same PMP doctor myself. But just be honest. Then he'sd gonna wanna know type of day that makes the pain worst,or better. Activities that you do that make it worst. Then you may have to sign a contact. Read it very carefully. It is the Do'd and Don'ts of the PMP. You break it your out. In that contract it'll probably say something about any methods that he want to try you will have to be willing to work with him. Which means Therapy's,injections,creams, ice packs, massages,etc. But then also different test is mandatory with a contract like U/A's. You will never know when you will get one but they are looking to see if you have the meds that are prescribed in your system and how much of that meds you have in that system. And as far as a psychyiatry goes you may see one and you may not. They like to send people who are appointment after appointment is not getting any better. So they want that doctor to talk with you see if maybe you are going to need some meds for depression and the psychyiatryist (sorry about spelling) will also talk about what is your plans on taking all those narcotics. Do you see your self tampering down try to give you ways to try and bring it down. That is if he feels you don't need all the meds and that you are dependent on it. Not addicted. I know alot about it cause I worked in the office of a PMP this was before My Lupus took my body for a ride and I ended up on disability. I have been on disability for almost 6 years now. I can tell you now I am on the other end as a PM patient. I have been diagnosed with Lupus for 15 Years and went through he** the whole way. But I did try my best not to give up working. I went to college, and got an associate degree. The first month of school I had to take 3 weeks off and was hospital due to my Lupus. I wont get into my health problems or we will be here all night and trust me I have seen and heard it all. So that part wont happen unless you are a patient that always saying the meds aint working,they change them,giving you stronger ones, and still no change. That happend after you have been going for a few month and the doctor gets an understanding of you. Other than that I think you will be fine. Please let me know what happens? Good luck and I am praying everything will go smooth.
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Last edited by luvinmusiq; 07-03-2012 at 06:30 AM.

 
Old 07-03-2012, 05:51 AM   #9
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Re: First PM apt next wk

Hello everyone,

I too have another suggestion, the doctor will also ask you what else do you do to try to get your pain down with methods other than pain medicine. For example do you use ice packs, heating pads etc. And may i also suggest Ben-Gay cold therapy, i think its called. You keep it in the freezer and its feels amazing, especially after a long day at work. 8-) Best of luck to you!

Also, don't expect to get 100% relief, its not realistic, if you can decrease your pain by 50% that would be a good goal to set, no doctor will be able to get you completely pain free.

Last edited by Paininohio; 07-03-2012 at 05:54 AM.

 
Old 07-04-2012, 07:53 AM   #10
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Re: First PM apt next wk

Thank you all for the replies. I was just skimming through the tv and came across MTV which I never watch. And thriller was just starting, so I had to watch it.

Anywho, my apt is tomorrow. My surgeon faxed everything the PM needs. All I need to bring in is the paperwork they mailed me and my medication. I've learned a lot from you folks and I really appreciate the advice. I know some don't prescribe on the first visit, but my surgeon has had me on norco for 7 months, I really don't see the new doctor at least not giving me those. I think I lucked out though because I have a legit referral from a respected surgeon and all the charts and info about my situation are already on the PMs desk. My system is clean. I really have a good feeling about it.

So I will update tomorrow. Hopefully it will be one of the good stories. Thank you healthboards. Wishes for a pain free day.

 
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