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  • What happens at a pain management clinic? a little bit of venting too.

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    Old 08-10-2004, 04:04 PM   #1
    froggy123
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    What happens at a pain management clinic? a little bit of venting too.

    Hi all,

    What actually happens at a pain management clinic? I know some doctors are pill pushers, but what about the others? I've been told that the clinic that I'm going to see has psychiatrists, social workers to help with school problems or concerns, and i dont know what else. The reason I ask is that I was scheduled for a lateral release and a tibial tubericle transfer on Thursday, but last Friday my surgeon called and asked my parents if I've gone to the pain management clinic yet. They thought that they had all agreed that I didn't really need to go because I've been to a psychiatrist, and i've learned different biofeedback techniques, and have a tens unit at home for pain, and my school is extremely supportive and knows me well because of me having to go on homebound schooling due to severe migraines. Anyways, the doc basically told my parents that he wouldn't do the surgery if I didn't see the pain management clinic. I was just wondering what they do, and if anyone has an idea why he's so ademant on me doing this. I mean, my knees been hurting since October when I fell. And I've had the migraines for 3 years prior to that, so I'm not new to pain. I just don't see why he wouldn't just do the surgery since it was already scheduled and have me see the pain management clinic as soon as I can get in, instead of waiting and having me go through the pain longer...it just doesn't make sense to me. If its any concellation, I'm a 17 y/o female. I've been diagnosed with patella femoral syndrome due to hypoplasia of the lateral facet. Basically that groove thingy in your knee that holds the knee in place...the outside didn't form which causes my knee to always be subluxated and sometimes dislocated. I'll be having the surgery up at the Children's Hospital of Phila******a, I will also be going to the Pain Management clinic through that hospital so they work with pediatrics.

    Any opinions or whatever would be great.
    Thanks
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    Old 08-10-2004, 04:38 PM   #2
    scotty12
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    Re: What happens at a pain management clinic? a little bit of venting too.

    froggy,
    a good PM clinic should have a diversified staff anthestiologists,pschyologists,physical therapists,massage therapists.rn's,nutritionist (etc)
    and multidisciplinary approach offering many pain relieving techniques.
    my pain clinic offers the following:

    major nerve blocks - epidural steroid injections
    stellate ganglion blocks
    sympathetic blocks
    Bier blocks
    trigger point injections
    intravenous sedation and monitoring with nurses (for patients who are afraid of receiving needles or injections)
    fluoroscopic guided injections
    ®SIMPL Program for RSD/CRPS
    subcutaneous infusion pumps
    intrathecal infusion pumps
    spinal cord stimulator implantation
    ®BOTOX injections
    nerve blocks
    electrical stimulation
    biofeedback and relaxation training
    psychotherapy and pain groups
    acupuncture
    myo-fascial release
    physical therapy
    deep muscle massage
    craniosacral therapy
    effective, time-based pain medications
    chiropractic care
    occupational therapy
    nutritional counseling

    i think unless the proposed surgery is not likely to alleviate your pain the surgeon wants you to be aware that there may be a less invasive way to deal with the problem.chronic pain is not without psychological factors,its a fact and maybe the dr wants you to talk to a pschologist first.why?who knows how dr's think.its possible that he doesnt want to be involved with post op care,not comfy with prescribing strong meds that youll maybe need after surgery.i would go and atleast youve met a group of drs who you may need one day,hopefully not.

    btw most pain drs are not pill pushers but rather the opposite.opiates should be tried after other therapies have failed.most cp patients will tell you they had to suffer a long ( and unnecessary ) time before finding relief.


    good luck to you........................ scotty

    Last edited by scotty12; 08-10-2004 at 05:22 PM.

     
    Old 08-10-2004, 04:51 PM   #3
    Karla
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    Re: What happens at a pain management clinic? a little bit of venting too.

    I injured my left knee skiing and had surgery on it after physical therapy failed to help it and vicodin and ibuprofin didnt help. They did a lateral release and said all the cartlege under my knee cap and on the sides of my knee we shredded really bad. So now I have no cartlege under my left knee. It doesn't hurt tho but I do have aches in it when it rains or snows. I would go for the surgery.

     
    Old 08-10-2004, 05:50 PM   #4
    froggy123
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    Re: What happens at a pain management clinic? a little bit of venting too.

    The thing is though, that the surgery was already scheduled. The doctor had said that I essentially need the surgery. If I don't get it I'll be walking with a cane when I'm older. I dont understand why he would cancell a surgery that had been scheduled for over a month and that I had already have pre-op for because we hadn't been to the pain management clinic. The clinic sounds great because I really don't like being on meds because it's hard for me to swallow pills and they just make me feel bla even if they do help the pain. Also with most of the meds that I've been on that have helped with the pain, they make me really drowsy which isn't a good thing with school starting up on August 26. I've been on Percocet, Vicodin, Hydrocodone, tylenol with codeine, and some other anti-inflamatory meds. I didn't like the narcotics, they helped the pain, but made me totally loopy! Like I'm fine with going to a pain management clinic, it just stresses me out that the surgeon would cancel like that. And that I have to go to the pain management clinic at the hospital that he works at. It's an hour and a half to two hours away depending on traffic. We are going to him because no one in Delaware could do the surgery. My primary orthopaedist wouldn't do it because he hadn't done the surgery that i need for 7 years and wasn't comfortable. Anyways, we scheduled the surgery so I would have 2 weeks to recover before school starts and so that my mom could be home those 2 weeks since I have to be supervised. If the surgery ends up being around the time school starts or after, that's really bad in my mind. I can't afford to miss a week or two of school. I'm taking mostly advanced placement courses, and I'm also planning on applying early decision to college in the fall so I can't get behind. Also once school starts, my mom can't take off, well she can, but it would be a huge financial problem since she's a contracted occupational therapist through the school district and if she doesnt work she doesnt get paid. My dad doesnt get paid if he doesnt work either. That was the whole point in scheduling the surgery when we did, and it seems like now everyting has gone to hell. I'm sure everything will work out in the end, but it's just totally stressful right now. I think i'm also kinda mad because it seems as though my knee is getting worse, and my physical therapist agrees. I've also been going to both water and land therapy for I believe 5 months now without getting better. It's getting worse, the pain has increased, the condyle thingys in my knee are now hurting and are extremely tender, my right leg is an inch and a half smaller than the left, swelling has increased, I've been having more dislocations lately than I have ever had, the back of my knee has been developing knots, and nothing is seeming to help. At PT they've used E-stem, ultrasound, some weird thing where they put a little metal thing where it's sore and hook it up to a machine and move it around, a thing where it kinda shocks the knee (not the same feeling as the e-stem tho, kinda annoying feeling) and it puts anti-inflamatory stuff into the knee, lots of ice, lots of massage, lots of stretching. I've been to a psychiatrist for like...forever it seems like and he's helped a lot with just helping me cope with everything. And it's kinda cool...i realized that I'm a lot better person because of everything that I've been through. Anyways, my chiropracter says that he can't do anything because it's not in the part of a joint that he can adjust. I know how to do biofeedback and how to relax. I even know how to hypnotize myself! I dunno, I guess I'm more stressed than anything, because if he just came out a long time ago instead of a week before surgery and said that he wouldn't do the surgery if I didn't go to the pain management we would have scheduled it a long time ago.


    Thank you both for your responses...and sorry for venting even more
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    Old 08-11-2004, 04:08 AM   #5
    scotty12
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    Re: What happens at a pain management clinic? a little bit of venting too.

    Karla,
    i miss skiing sooo much.i would rent a house for a week every year in vermont or go out to tahoe for a few days.skiing was one of those things that while on the slope you block out everything but skiing,and at the end of the day you feel achy but in a good way.nice btl of wine and a fireplace...
    scotty

     
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