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Old 09-07-2012, 05:27 PM   #1
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Concerns about upcoming PM appt

I have my first ever upcoming appt with a PM doc in a bit over a week. It took me MONTHS to get over the mental "block" I had about going/needing to go to see a PM doc. I don't know if I can explain that...just how I felt. But I came here to ask a few questions and read some things that have scared me to DEATH. Patients are in a national system and any/all of our info is available to any doc anywhere? What? I have nothing to hide and don't mind voluntarily divulging anything they ask. But being made to is just scary....feels a bit violating although I should add that I can see why it's come to this - it just feels so invasive.

Anyway - on to my issues. : ) I'm 46 and have been told I have fibromyalgia although I'm beginning to think it's NOT that but other issues. I have L4/L5 Degenerative Disc, fatty lipomas (very painful), bone sput/achilles tendon repair after debridement, now I have tarsal tunnel and they just discovered axonal and/or demyelinating neuropathy in the foot and right knee, and to top it off my MRI just showed I have bone on bone contact (forgot the actual name of the issue). I have a deep, DEEP aching pain in both of my legs that has been going on for years and no one can figure that out. Neuro surgeon says that the amount of disc space lost doesn't correlate with the pain I'm in, although thankfully he always adds that he doesn't doubt I'm IN that much pain...it just doesn't correlate to the spine. So...I don't know what to make of the legs aching. My internist DOES believe it stems from the spine and wants that reconsidered. I have never been one to sit. I am a stay at home mom - but not a sit at home mom. I like to go and DO. I like to work out (although I haven't in a long time) and shop and fix up my house and do crafts and I even stage manage community theatre (or did). But I am in so much pain - my day typically goes like this. Drop son at school, rest. Put clothes in washer. REst. Take bath. Rest. Run ONE errand (about 20 minutes), rest. Wash. Rinse. Repeat. It's awful. My quality of life has PLUMMETED in the past two years. I want my life back. I WANT to be off pain meds. I cannot tolerate most of the meds they've tried. And over the counter analgesics and anti inflammatories either don't touch the pain and/or cause me terrible stomach issues (I've had polyps and ulcers). I have had several Rx's for Hydrocodone 5/500 and they always last me WAAAAAY longer than they were prescribed for. I take anywhere from 1 to 1.5 a day. I never feel full relief - but I'm so afraid of "addiction" that I try and not take until I'm desperate.

I don't know what to make of some of these reports that PM docs can be mean. That's the last thing I need and I'm considering not going. I am wondering this....can family docs/internists not prescribe ANY pain meds any more? Or they just have a certain number they can't go over? Because at the dosage I'm taking I would think that is NOTHING compared to most people and would just hope to have this managed by my family doc. Help! : ) Thanks!

 
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Old 09-08-2012, 09:49 AM   #2
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Re: Concerns about upcoming PM appt

Hi Dunkin nut, I think like you said, if you have nothing to hide you have nothing to fear about the data base. It's not something I would bring up to your doc as far as feeling it's too invasive. UA's, Pill counts,Psych testing, contracts and data bases are the only way they can determine those that need and those that see PM as a finincial venture or just as bad, as a way to get high.

Their are several diseases that can cause nerve damages in the extremties. For one their is Charcot marie tooth or hand and motor sensory neuropothy. That ones genetic and was passed down from my wifes dad to her but requires gentic testing to diagose. The nerves and muscles in her extrematies have slowly been detieororating since she was 14, Her Dads been in braces for the last 35 years, She has had both feet fused from both arches collapsing and the muscle damage done by the disease. PM docs aren't really diagnostic guys, I would think you would have seen a Neuro by this point and he would normally be the one to run the battery of test looking for things like CMT, MS or any other degenerative disease. My wife also has some pretty bad disc issues which mimic her disease. It's not realy crucial to her care to determine whether the complete loss of feeling and reflexes from the knees down is spine related or CMT related. It just is and the effects can be treated and the pain managed once the instability has been surgically corected.

Please understand that not all PM docs use pain meds, if you have tried everything else and opiates are the only thing that works I dont doubt you could find a PM doc but it's pretty mportant to try the alternative methods before a doc can safely prescribe on a long term basis if that's what is required. Finding proper relief was a long road for many of us and for others, the first PM docs they see through the kichen sink at them. If your told to take the kitchen sink it's important that you do so, if you pick and choose what meds you take when a doc prescribes them, selecting the meds you want and refusing the rest can be seen as being non compliant with meds and will show up in a UA. The most important thing is to have a transparent relationship with your PM doc and the wilingnes to try anything and everything if the pain is so bad you need a PM doc. His ability to see if other docs are also prescribing at the same time is paramount in preventing abuse and diversion.

Good luck and take care, Dave

Last edited by Shoreline; 09-08-2012 at 10:38 AM. Reason: spelling and grammer.

 
Old 09-08-2012, 10:02 AM   #3
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Re: Concerns about upcoming PM appt

Hi, The Dr. I was seeing for my knee and giving me Supartz injections in it also prescribed me Lortab. He wrote a script for a weeks supply for about 3 weeks in a row. My knee is pretty well shot and I,ve been told by several drs. that its time for a replacement. The Lortab works for me. Maybe a combo of the injections and the pain pills. I can,t have the surgery until after the new year. Walk all the time with my work. The dr. told me he can,t keep prescribing the lortab because of DEA regulations. He did not elaborate about it further. He suggested the PM dr. and was the one who set up appointment. I told PM dr. my concerns about becoming addicted to the pills and that when it came close to time for surgery I want to taper down on doses. He said we could do this. This works for me because I,ve had addiction problems in past. This dr. will call patients in for random pill counts and drug tests. In my case I consider this a good thing. Sorry I don,t have a good answer why PCP drs. won,t prescribe for long periods of time. Another thing you said is that you only take medicine when pain is real bad and you have pills left over. I,ve had several surgerys in past for different things and was told by more then one surgeon to take the pain meds as perscribed for best results. Another words if it says take 1 every 4-6hrs. for pain to do it. I,m not sure why. Maybe it works better if you keep dose steady in your system. Sorry I couldn,t be more help. Maybe someone else on here has better answers. I hope you feel better.

 
Old 09-08-2012, 08:14 PM   #4
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Re: Concerns about upcoming PM appt

Thanks for your reply! I thought I'd add that I will be seeing a neuro - but have not, yet, simply because I just got the test results back on the EMG & MRI late this week. Those tests were ordered by my orthopedist (after my prior foot surgery) and he did NOT expect there to show a problem. t He was very resistant to running the tests but I insisted as I instinctively knew something was wrong. I will also be meeting with my internist next week to get her take on things. My gut says there is a bigger picture we are all just missing....I just want to the bottom of it.

In regards to my pain...I've been in ghastly pain since I was about 23. "All over" pain is the only way to describe one aspect of my pain. About 3 years ago I decided to start working out and see if that helped as I had been told for years that the endorphins that are released act as natural pain killers - and I figured I could lose a few pounds as a bonus. Well, I lost MAYBE a pound in a year and a half - but I kept plugging away at it because I felt SUCH benefit from the exercisde alone. Helped my fibro, helped me sleep better, etc. But then my body just started to "break"....first L4/L5 which gives me immense pain in my thighs/legs/lower back (mostly legs), then my right foot (achilles)...then tarsal tunnel in the same foot...and now neuropathy in the right leg (knee down) and chondromalacia stage IV of the left knee. The last 3 dx have been since April - so I"m pretty stunned. If I could get back in the gym - it would help a lot. But I really can't. I might TRY water aerobics at some point - but I really hate it (have tried before). Sorry to drone on. Helps to talk it out. Anyway - I have so many painful issues....I just get overwhelmed. Thanks for listening.

Last edited by DunkinNut; 09-08-2012 at 08:16 PM.

 
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