Over the years as my RSD has progressed it has become extremely apparent that my pain has enhanced and the feeling of my ankle/leg has become more extreme. My PM doc hasn't given me the care that I feel is acceptable since day one. Of course, let's say it has been due to the fact that I was covered by WC. Even being covered by WC my doc NEVER took vitals.....no bp, no temperatures of comparision of my legs or ankles, no regular temperature, no pulse rate, no info taken on my current pain levels NOTHING. I've always felt that he is the fly by nite doc.....he swoops into the room and asks the same ole questions like before and touches my foot without a care to the pain I am in. I love it when he asks me how I'm doing as if I going to say my pain is gone! He will order bloodwork, but never gets back to me if there is a problem. He always waits till I come in for my quarterly visits then attempts to discuss bloodwork done months earlier. Huhmmmm, wonder if there is a problem how do you address the concern months later? He feels that RSD doesn't spread after so many years. He feels that RSD doesn't affect the parts of your body if you fly to the point of swelling. He feels that RSD doesn't really cause discoloration to the skin. Shall I go on?
I've tried to contact the doc when I've had severe issues only to be held back by his staff. He flatly refuses to see me and when I call he is always on vacation when I need his help. Now this is far and few between, but when you need help you expect to get it. At this point I need to find another doc for pain management, but is this change going to make me have to go thru a whole set of tests? Has anyone had to change only to find out they have to go thru more tests before a new doc can help them out? I'm at my wits end and I need someone to help me drastically. Please weigh in on this to help me out. Your input is essential and it will guide me accordingly.
Location: San Francisco, California, United States
Posts: 701
Re: The Switching pains of RSD
I don't know the rules for WC in your state. If his treatment is funded by WC, then you should check with WC to find out how to change doctors.
Many pain management centers will require a referral from another doctor. I have been to two: both required a referral. One doesn't write prescriptions on your first visit; the other writes no prescriptions. I settled on the center that writes no prescriptions and make sure to schedule a visit with my primary care doctor a day or two after my pain management visit in case they recommend a new medication.
Any tests or visit records belong to you. You can ask for a copy of them at any time, even if you have not yet had the visit with the doctor to go over the results. If you go to an outside vendor, you may be able to have them send you a copy of the results directly from the lab. Once you locate a new doctor, he/she might require additional or updated tests. If your current doctor isn't ordering relevant tests then you may end up taking a series of tests. The new doctor should not require tests that are merely repetitive.
Since you have had specific concerns, be sure to ask how any new offices handle those situations. For example, can you e-mail the doctor directly? Does he/she have a back-up during vacations? Is there someone on-call on weekends? (If you have an injury to your affected limb, a local ER or urgent care may need to consult with your pain management doctor in giving any treatment.)
Last edited by SweetPeainSF; 06-20-2012 at 12:37 AM.
Reason: Clarify
I am WC to and I have to say it does at times seem like we get substandard treatment, if it isn't the clinic taking too long to bill, it's WC denying any type of new treatment or change in Rx's.
My first pain management Dr. was horrible, I left the first visit in tears ( I waited till I was in the car.) We went round and round about spreads-I was seeing a PA who really didn't understand RSD-as a result I have had a spread to my entire right side, anyway one thing after another and I was at a 10 level pain and I called on Monday because had changed my meds-on Fri they called me back. I was done I called my primary and told them what was going on and they were able to petition for me to see someone else. Things are better I see the Dr. not a PA and he listens and is knowledgable about RSD. If it is a bad fit you need to change the stress alone can make the RSD worse. I didn't have to under go any tests, we just talked about my history. Still waiting for slllloooowww W/C approval on things but hey, you can't win them all.
Hang in there, People here told me to find a new Dr. and it was stressful but well worth it, also if you have had test and blood work done WC probably won't pay for them again. I have a history in the health care field so I know when thing are how they should or shouldn't be.
I am going through the worker's comp system also. This is very frustrating.
I slipped on ice and fell on my knee in February of this year. My employer uses a clinic with only nurse practitioners on staff. I originally had 2 weeks off and by the time I went back for a follow up I had burning pain in my knee and up and down the inside of my leg. She told me I needed more time off, physical therapy and an MRI. By the time I spoke with my employer's HR person, this turned into me going back to work with no physical therapy and no MRI and that I should go see my primary care doc to be evaluated for something not related to the fall, but neurological in nature. I do have fibromyalgia, so I think they were trying to blame it on that. My immediate actions were to see my primary care doc and get a lawyer. Needless to say I got my MRI which was clean except for a bone bruise which can be extremely painful in and of itself but it does not explain the pain that I have and fibromyalgia does not localize and I have never complained of knee pain of any kind before I fell.
Physical therapy was making the pain worse and working was too. I went back to the OS that I had been referred to after the MRI at the advice of my PT. That's when CRPS/RSD was brought up. He noticed the discoloration on the knee that I fell on and there was a temp difference also. Nothing else can explain this awful pain and it is well out of proportion to the injury. He ordered a bone scan, continued physical therapy but now treating it as it is CRPS, and a referral to the pain clinic. This was June 13th and I have not gotten any word from WP at all, not even word that they know any of this. On June 16th I had my IME, which I guess we all know is not really independent. This guy spent about 5 minutes with me. He did say that he noticed a color difference. When he left the room he told me to take care of "it" and keep "it" moving or "it" could get bad, which makes me think he agreed with my OS but who knows about these guys? What a mess.
It all boils down to CRPS needs to be treated aggressively and early also for treatment to be affective and this whole WC process just slows it all down. It can stop it cold too. I am hoping it doesn't do that for any of us.
Last edited by fluttersby; 06-26-2012 at 11:53 AM.
Reason: typo
Dude!!! its tim for a real Dr. I had an issue with a PRN. in a dr,s office where he said he didn't believe in RSD as a dx. he said it is made up to make patients feel better that the dr,s are taking the patient seriously.. low and behold he ****** me off. he is no longer practicing in my dr,s office. My pm dr just lets me talk and refills my scripts and sends me home.. I mean REALLY!!!! why isn't he more active in trying to get me the care I need.. maybe he is ****** that I won't do the scs... Idk I too am a comp RSD er. so many hoops in front of me.. and RSD stops me from jumping.. one
The following user gives a hug of support to painman2009: SweetPeainSF (06-29-2012)
Location: San Francisco, California, United States
Posts: 701
Re: The Switching pains of RSD
Sounds like the PRN should not be treating patients with this disease process and that this doctor might not have any further treatment suggestions -- which is a problem.
I started physical therapy. Two visits so far, which have focused on slow, slow desensitization. We have worked on this through both direct touch to the affected limb -- little things like sitting and placing a cheap towel under both feet and scrunching it with my toes. The therapist explained to try to keep the pain between a 2 and a 4. Another project is to put on shoes I can't wear and just look at them on both feet without standing or walking.
(If these exercises are too painful, you can also do the same with the unaffected foot/limb in a mirror. There are some good videos on the internet explaining how mirror therapy works. A lot of insurance won't pay for mirror therapy, but you can always do it at home. I figure anything that carries low risk and low cost is worth trying!)
