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HELP - What should I expect from Rheumatologists

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Old 06-15-2010, 10:26 PM   #1
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HELP - What should I expect from Rheumatologists

I've finally got a referral to a rheumy because I haven't gotten a firm diagnosis. I wanted to get as much comments as possible to know what to expect. I'm currently seeing a pain management (pm) and I'm hoping I'll get more help in reducing my pain level.

The meds I'm currently on makes my pain tolerable, but if I try to do minimal housework or go shopping w my wife my pain level shoots up. I'm presently taking 20 mg Opana ER (am & pm), 15 mg oxycodone (1 every 4 hrs), 10 mg baclofen (1 every 4 hrs), 450 mg Lyrica, & 60 mg Cymbalta. I tried Savella (even as little as like 6 mg; smallest dosage broken in half w permission of my pm doctor) it really helped my pain but because of side effects I had to discontinue. I'm taking vit supplements, but I'm so discouraged because I want to be more active and not a bump on a log .. Never thought I'd use that expression .. lol

I was told by the nurse practioner at my pm doc office that if after increasing the Lyrica to 450 mg if it didn't significantly reduce my pain level that we may have to increase my extended release meds. After trying the increase for a while I called them and told them the increase has reduced my burning pains in my thoracic region, lower back/hip area, and legs but it hasn't significantly reduced my pain in my muscles / joints. After waiting 2-3 days for a return call I was told that my pm doc didn't want to increase my meds because he doesn't really feel that opioids help w fibro pain. I told them that I'm tired of not being able to do anything, but all the nurse said is I'd just need to bring this up again at my next visit.

Regardless of what my pm doc thinks I KNOW my pain meds help. I've tested his theory when he initially made that comment and pretty much spent a week in bed being miserable. If pain meds are not affective against fibro pain why then am I able to get out if I take them and can't get out of bed if I do not take them. My only concern is that I've tried all the normal fibro meds and am still miserable. What are my medicinal options to reduce my pain so I can exercise and start living again?

#1. Are rheumatologists more compassionate than pm doctors?

#2. Do rheumatologist typically prescribe the same types of prescriptions as pm doctors?

Any responses are appreciated .. Thanks!!
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Old 06-16-2010, 04:43 AM   #2
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Re: HELP - What should I expect from Rheumatologists

The rheumatologist will probably try to more thoroughly rule out conditions other than FM and confirm your diagnosis. He will also want to try any typical fibro treatments that haven't been tried already.

He will most likely NOT want to start prescribing serious narcotics. That's what the PM doctor is for. Also, as long as you are getting them from pain management, you aren't allowed to get them anywhere else.

Have you tried non-drug methods? Possibly massage? It sounds like you might be too sensitive for deep tissue massage, but there are techniques aimed at calming down the nerves that use only very light touch.

If you have muscle knots in particular areas that just never seem to go away, there's a treatment called trigger point injections. I get 'em a couple times a year, and they keep the walnut-sized knots out of my back.

A few people who suffered from food allergies or nutrient deficiencies (such as Vitamin D) had a drastic improvement after a change in diet, but for most of us, a healthy diet will help a little. Eat a variety of vegetables, whole grains, not too many white starches or sweets. There is some evidence that foods high in Omega-6 fatty acids, such as most beef, can increase pain and inflammation, and foods high in Omega-3, such as fish, can decrease it.

Also, you may need to exercise just a little. Maybe a Pilates warm-up routine, or ten minutes of stretching a day.

Ask me more about any of these that sound interesting (or of course, there's lots of info out there, I don't really know any SECRETS.)

Old 06-16-2010, 08:46 PM   #3
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Re: HELP - What should I expect from Rheumatologists

In my experience, the rheumotologist has run more blood work and then ordered a sleep study.Fibro patients often don't get into stage 3 or 4 sleep which is necessary for muscles to restore. That can account for some of the fatigue and body aches. To treat that, the dr may then prescribe an anti-depressant to take at bedtime and to raise the seritonin levels.

Old 07-17-2010, 11:02 PM   #4
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Re: HELP - What should I expect from Rheumatologists

I live in a fairly small town and there are only two Rheumatologist here. The bad news is that I am very unhappy with mine! He does not listen to me and his assistant did all but accuse me of lying about my aches and pains! I wanted to ring his little neck!!! I called my regular Dr. to get a referral to the other Rhuematologist. I hope he's better than the last one.

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