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    Old 11-17-2015, 08:57 PM   #1
    Tommy153
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    Why is it so hard to find a new pain doctor

    For the last 7 years i have been in pain management for a non union foot fusion. Switching doctors 3 times never once being discharged the first one I went to i was there for 3 years and he finally found the right combination of medication for me which was 50mgs of methadone and 30 mgs of oxycodone a day. I tried everything else and nothing ever gave me the pain relief for as long as the methadone did. Unfortunately I had to leave because he stopped taking self pay patients. The next 2 I tried told me that was to much methadone and they wouldn't give it to me even after telling them that all the other stuff was making me fall asleep while i was driving and the methadone was the only medication that didn't f me up and it stopped the pain all day . But still i was there guinea pig. In January of this year i had a major spine surgery and while I was waiting to see the doctor one day i was talking to a lady that was so mad her pm doctor was giving her methadone and not what she wanted so i got his name and asked my neurosurgeon to refer me to that guy which he did no problem . Everything was going good for 9 months he would give me 3 months worth of scripts because I lived so far away well 2 months ago I went to see him and he told me he was gonna retire in a month and close his practice he offered to refer me to someone else but i told him not to worry about it I'll find someone closer to where I live so he gave me a script to whine me off which he did in case i couldn't find a new doctor in a month and half. I found 2 doctors in a 30 mile radius that would perscribe methadone and take a new Medicaid patient the first one i went to didn't perscribe anything on the first visit they have to wait for a drug test result which could take 4 weeks to get back and it would be another month before I could get in. So after running out of meds i called my neurosurgeon who also left the practice 2 days before my 6 month follow up moved out of state. Which i was told in June that there was no other dr to take his case load and I would have to find my own dr which is impossible since it hasn't been a year and no othet dr will even talk to me . So i called DUKE thats who the neurosurgeon was with so i explained my whole situation I told them ive only been seen once since my surgery and im still in alot of pain im not under contract with pain management will they perscribe me something until i get in the new pm dr i was told i would have to be seen by another dr before I can get a script but she promised she would have me in within the next 2 days. Well 5 minutes later I got a call from the head of neurosurgery at duke telling me they didn't have time to deal with someones pain problems i tried to tell him i didnt care about the meds i just need to be checked to see if i was healing after him telling me that my primary can read an xray go see him I not even realizing it I made a full sentence only using one word ( starts with F ) I was discharged. So i go to my primary who refers me to another pain management ( by the way by this point its been 2 weeks with no meds I lost my job because I can't get out of the bed long enough not to mention I have to hear my 2 young high energy boys ask why I won't take them to the park anymore). So i go to the next doctor which was the biggest joke i have ever been to the first words out of her mouth were "wow you've had a drug problem for a long time" No you stupid bi*ch I have a pain problem thats how long that appointment lasted. She told me i didn't need a pm dr i needed a drug councilor and 50mg of methadone was ridiculous after that i just walked out. So yesterday I decided to go to the methadone clinic and pay $13 a day instead of $3 a month which I don't have and also makes no sense that the clinic takes all insurance exept medicaid so they'll cover it for pain management but not for treatment. Can someone please tell me why its so hard to get a prescription for methadone these days? And does anyone live in nc that has a pm dr that perscribes methadone ? Please help losing everything because of pain!!!!

     
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    Old 11-19-2015, 08:07 AM   #2
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    Re: Why is it so hard to find a new pain doctor

    The first thing anyone who is searching for a new pm doctor needs to understand is that no matter what meds you were on, or for how long, no other doctor is obligated to continue you on those same medications.
    Your first doctor gave you enough methadone specifically to taper off until you found a new pm doctor, which is what you should have done.
    Most pm offices have a policy in place that they will not prescribe for new patients until the urine testing comes back , and even then, they may decide that the medications and dosages you were on previously are not what they recommend and change your medications completely .
    It is up to the discretion of the physician to decide what medications and dosages he /she feels are best suited for a particular patient. They may recommend previously tried therapies , nsaids, muscle relaxers,and injections as well.
    Using foul language is going to get you dismissed. There is no reason to use that when speaking to any doctor.
    Now that you have gone to and methadone clinic, you are going to find it even more difficult to find a pm doctor. Methadone clinics are for the treatment of addiction, not chronic pain, and your decision to go to one is going to make it that much more difficult to find a doctor.

     
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    Old 11-19-2015, 10:21 AM   #3
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    Re: Why is it so hard to find a new pain doctor

    Hi Tommy, Sorry you have has such a tough time, Unfortunately I agree with back hurts about the methadone clinic, That is an absolute last resort. you will have to explain to any future PM doc why you have methadone in your system and where it came from. Are you In NC or VA? There are good docs in the Tidewater area, but no way to know if they would be comfortable starting you back on methadone, You may have to try some other therapies and meds before finding someone to prescribe methadone. Its a very tricky drug with no clear cut conversion and a lot of pain management docs wont even use it. If you live in VA you can send me a PM and I may be able to recommend someone in the tidewater area, But I would stop using the clinic and give it 30 days to get out of your system, not that I know of any PM doc that could get a new patient in within 30 days. Good Luck, Dave

     
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    Old 11-20-2015, 09:19 PM   #4
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    Re: Why is it so hard to find a new pain doctor

    I may be in the minority here but the fact that you (OP) went to a methadone clinic for your meds should have no bearing in your case. You obviously have records going back years where pain docs have prescribed it for you and you obviously are not being treated for years on end for addiction. I'm sure your records back that fact up. I'd call it "doing what you have to do" when you found yourself in a BAD situation.

    I see you went to your PC doc and got a referral, which I see didn't quite meet your expectations (humor intended!). I didn't read whether you went back to the PC doc to report your experiences or not. If it were me, I would make an appointment with my PC doc and let him/her know exactly how your appointment went with the prospective pain doc. I'd also be willing to go on more "fishing trips", i.e. more prospective pain doc appointments. However, in the meantime and considering I'm doing everything you've asked of me, would you consider handling my methadone script until I can get a decent PM doc on board. Hey, it may be a "no" but it doesn't hurt to ask and like I read in your post, you've done what was asked of you and are obviously trying very hard to get things where they need to be.

    I realize that finding a good pain doc can be a very frustrating thing but you have to fight through. Be willing to do whatever they ask, follow directions to a tee and in the end, you may just have to get lucky one time. I really feel for you!

    Good docs are out there and briefly I'll share with you my "having to find a new pain doc" went for me. I don't live in your area but I was told by my pain doc, after seeing him for nearly 10 years, he was retiring. I was on my own, he couldn't provide me with any referrals and the bottomline was, he was gone. First thing I did was I got a copy of my records pronto, before my doc was sitting on a beach somewhere in Florida. Next, I hit the internet and saw I had two or three options in the nearest semi-big city about 25 minutes away. The first one I called could see me in about a week. I was ecstatic but still concerned they wouldn't pick up my scripts where I was at with my old doctor. After a complete evaluation they wanted me to do a few injections to see if they'd provide any relief at all. I told them I had tried them in the past, about 12 years ago, and all they did was hurt me more! However, I told them I was absolutely willing to try anything whatsoever if they thought it could help. So, those were scheduled and he then sat down in front of me, looked at my records to see what I was currently prescribed. He then told me they (the entire practice) did not prescribe "that" drug but he was willing to work with me and prescribe the equivalent dose of another very good pain med. They even offered to prescribe break-through meds, which my other doctor did not do. My old pain doc's alternative was to refill my 30 day script on day 28 each month. That way I would be able to have extras should the need arise.

    In the end, I think my willingness to work with them was a factor and the fact that I came to the appointment well prepared with records in-hand was also a factor in my favor. My point in all of this is that you (OP) can succeed in finding a new pain doctor. They're out there and you may have to travel or do a few things you may not want to do in a perfect world, but keep a positive outlook and keep hitting the internet and keep doing it until you can make it happen. I honestly believe you can find someone. Please don't give up and I sincerely wish for your success!

     
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    tortoisegirl (11-21-2015)
    Old 11-23-2015, 12:02 PM   #5
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    Re: Why is it so hard to find a new pain doctor

    Wow-yeah, you losing your "cool" never ends in your favor.

    Although I do understand your frustration as to why you lost it, lol. Also going to the methadone clinic, another desperate move, but I get it. It will not effect future PM care, unless you tell the next PM you went to a methadone clinic-You will have to wait for the methadone to clear your system,(like Shoreline mentioned probably 30 days) there is no other way, or you will need to explain(as already mentioned)why you have methadone in your system. Since you don't get a prescription from the methadone clinic to take to a pharmacy to fill, because folks that go there are doing so to get help with addiction, NOT chronic pain, and your dose is monitored and administered there. There won't be record in the state PMP. So you kinda shot yourself in the foot, metaphorically speaking. A reasonable PM doc may be compassionate as to why you did it, but don't count on it.

    As Whoopee points out-you have to be willing to do whatever is asked of you, even if you already tried the same treatment 5 years ago with poor results.

    You must do it their way, and hey, maybe this time you will have different results. You have to understand that the new PM doc has to get to know you, so it would be wise to not resist anything he/she suggests you try, no matter what. Also, as was already mentioned, just because you have been on a certain medication for a long time, with no complaints-you never insist, as a new patient, that that is the only medication that helps you an you have tried everything else, that's the one that works, and that's what I want. If you have that attitude, I assure you, you will get nothing.

    So, what about the new pm doc you had to leave the UDT for? Did you make another apt ?? I don't understand why you didn't just wait to be seen? And, the doc that called you a drug addict, how did that even come about? Are you saying she just walked into the exam room, and said you have had a drug problem for a long time for no reason? What pre-empted that kind of treatment, I have to wonder?

    I also get the feeling you say, the methadone is the only thing that relieves all of my pain. To expect ALL of your pain to be 100% relieved by any medication is unreasonable. If you are getting at least 50% relief-that's is considered very successful pain management. Don't misunderstand me, I don't mean it is wrong that you were getting all of your pain relieved-I am saying it is UNREASONABLE to expect it.

    I know you are adamant in that methadone was the only one that didn't make you drowsy(or f*** you up, as you put it)-but all narcotics make you drowsy to some degree-some more than others. In fact, methadone is a known culprit of being the most sedating of the narcotic analgesics. So if you are offered a trial on a medicine that you previously tried & made you drowsy-give it another FAIR chance, you are not going to know if it will work properly without some adjustments in dosing being made, and then that side effect may not be so bothersome given time.

    I am prescribed a certain narcotic medication that also makes me drowsy, but I also get really good pain relief most of the time, 50-60% relief. Unfortunately for me, this side effect didn't relent-but my doc came up with a solution for me to try, he added "Nuvigil",it's a drug designed for folks who do "shift-work" and need to be awake at odd hours(i.e. pilots, etc.)so far it does help a little. Pain Management is not perfect, but I am grateful to get some relief from the dreadful suffering=I am grateful to have a good, caring, compassionate physician, willing to help me manage some really terrible chronic pain.

    So-when you say to a new doc-I have been on methadone, it's the ONLY medicine that relieves ALL of my pain-that nasty old red flag goes up, and the new doctor may now find your expectations unreasonable, and decide not to even get involved in your care. I know it should not be like this, but that is the way it is.

    I am not trying to be overly critical, I really want to see you get the care and pain relief you certainly deserve. These days, PM doctors have to be very careful, and just as you want to be able to trust your doctor, your doctor has to be able to trust you-he/she s the one who is putting their license on the line when they prescribe any narcotic medications-Do you get what we are(all who have answered your post)trying to say and help you with?

    I believe you will get your care sorted out properly. Please let us know how it works out or if any of us can answer any more questions you may have.

    GoodLuck ; )
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    Last edited by BB07; 11-23-2015 at 01:07 PM.

     
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    Old 12-22-2015, 04:19 PM   #6
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    Re: Why is it so hard to find a new pain doctor

    I've been lucky enough that my neurologist has agreed to continue. The hospitals locally bought all the private practices. He moved his office to a hospital further away but kept majority of his long term patients. One look T my MRI & CTscans the insurance doctors are asking why I'm not on higher than I am. One reason I have not moved to OH, PA, or WV is because all they wanted to give me was Suboxone which at 6'2 300 pounds. And 15+ disc herniation or fractures was just a Waste. Even the pain specialists said it was but in order to keep their DEA permits. Was why they did it. People just wanting to get high ruined it for us that really need strong meds. People like my wife that steal meds.

     
    Old 12-26-2015, 12:28 PM   #7
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    Re: Why is it so hard to find a new pain doctor

    Wow with all this talk about how hard it is to find good PM docs when one retires makes me scared for the day I have to search for one. I'm very blessed to have my doctor who is wonderful!! It just makes me worry that when faced with impossible decisions sometimes you go to desperate measures like going to a methadone clinic. You can only do what you know that will help at that given moment. My prayers are with you and please keep us posted!

     
    Old 12-26-2015, 06:55 PM   #8
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    Re: Why is it so hard to find a new pain doctor

    I had to find a new PM doctor when the office that I was going to decided to close. We don't have an overabundance of PM doctors locally either, and I was given three weeks notice and my last month's scripts at the same time.
    I managed to make appts with four PM offices in the surrounding areas, one who offered only intervention (injections and procedures), one who offered accupuncture, and other holistic treatments and two who also offered medication management and intervention treatments.. both offered to take over my care, and I discussed my options and treatment suggestions with them and chose one.
    I had no issues with transferring my care, so it can be done successfully, without too much hassle but you can not wait until a few days before you are going to run out before you start looking to arrange a switch in physicians.

     
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