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    Old 04-18-2006, 05:14 AM   #1
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    need advice, I got dumped

    Hey guys, this is Derek and I have a dilema. I need advice from those who have been here before. The sitch is that I have been going to a Rehab Specialist for 13 months now to no avail, she been great but I can't say the same for me we tried all the standard modalities for pain relief. At my last visit she said "there's nothing more I can do for you, and I don't manage chronic pain". So I've seen a PCP once (for general health stuff), and I recently saw a sergeon for a consult, well sorta saw when he was actually in the room I blinked and think I missed him

    I'm in a tough spot with debilitating pain that keeps me from functioning, I operate at 60% according to the PT I went to, whatever that mean. One issue is that every test I have done shows that everything is considered normal according to the inturpreting radiologist. The docs say that the things that do show up like sacralization and spondylylosis are not "pain generators".

    Anyway, my rehab doc helped knock down my pain level with 40mg oxy IR daily, 10mg q 6H, along with Lyrica 75mg q 12H and a tens unit. However now that I am not seeing her anymore who to I ask to manage my meds Do I aproach my pcp who I've seen once or the sergeon that I was told I had seen. I've gone to the pain clinic for a SI injection which helped for a couple of days and the shot was buffered with Lidocaine and that provided some temp relief. I asked them (pain clinic) to refill my meds and was told they don't write scripts for meds and that I should be getting them from my pcp.

    So do I call the sergons office (who didn't seem very interested in my case) or to I call the pcp I've seen once? I've tried to find a multidisiplinary pain clinic in my area (Metro-Detroit) that my insurance would cover (not that many), I went to one where the so called doc stuck acupuncture needles in my butt, lit them on fire, and afterwards told me I should feel better in 6 days and to come back in a month

    So as you can see I could benefit from some advice. If anyone wants more specifics I'm happy to elaborate, but in a effort to keep this post minimal, I'll end it here.

    Thanks guys and gals,

    okay, so I guess I'm actually ending it here

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    Old 04-18-2006, 11:54 AM   #2
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    Re: need advice, I got dumped

    Hi Derek, and welcome to the pain boards. My advice to you would be to make an emergency appointment with your PCP and take in all your info about the meds your rehab person had you on, If you don't have all the bottles, your pharmacy can give you a printout of your meds for the past few months. I would show the PCP all that you were on, explain that your pain has NOT changed, and ask him or her to prescribe for you at least until they can help you get into a pain clinic. It is going to be much harder for you to find permanent pain control without a DX, so I suggest you keep fighting for more tests and try and do some research on your own using your symtoms as a base. If the surgeon found you to be a non surgical patient, it is most unlikely he would prescribe for you, So again I feel the PCP doc is your best bet, Hang in there, Don't let anyone tell you you dont hurt, and let us know how it's going. Your Friend, Fabby

    Old 04-18-2006, 12:41 PM   #3
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    Re: need advice, I got dumped

    I agree that your best option is your PCP.

    While surgeons often Rx pre or post op they wont take care of you for long.

    It is not going to be easy to find a pain center to take you on without a diagnosis so i would use your primary doc as a stepping stone.

    Maybe your doc could refer you to a pain clinic or help you manage your pain while finding one. being as youve only seen the dr once i doubt he will handle your meds for long.My guess is a Rx for more physical therapy and maybe a script for vicodin for a few weeks.

    Then again the PCP may be able to help you seek a diagnosis.Bring your records and explain whats been going on and hope he helps you.

    Im sure there are dr's in your area that can help you.Just dont give up and as Fab said keep a record of everything you have tried in the past like PT and the injections along with a printout of all your meds.

    Im suprised the flaming needles in your butt didnt help(LOL).
    hang in there and keep at it for more diagnostic tests.You really need a diagnosis before finding a dr to treat your pain with pain meds long term.

    There may be a cure for what ails you if only you knew what is causing you pain.

    Besides,without a diagnosis being dependent on opiates is not going to be a picnic.Sooner or later that dr is going to drop you to cover his butt,simply because you dont have a diagnosis.
    why set yourself up to be in that position.

    I know it sucks to live with pain everyday and hope you find some relief very soon.


    Old 04-18-2006, 07:21 PM   #4
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    Re: need advice, I got dumped

    Thanks guys,
    I did call the sergeons office to see what he would say. He told me to go through my PCP as well, So I will make an apointment and hope for the best. thanks guys for the input

    Old 04-18-2006, 08:55 PM   #5
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    Re: need advice, I got dumped

    Hey derek, Every Pm doc and clinic will likly hav something different to offer. I would start a dworord duc that you can keep a runnng tab with pescise dates, anames and contact nfo, along with ther modalities tha were tried and the sucess or lack of. T would be great if you could find a multi gaceted clinic that can offer everything there is to try, but it's just not likely and I know everyne isn't as fortunate to hasve one in their area. By compiling the data, you rerally have an introduction to any new surgeon, or doc and if tests that should have ben doone or methods that shoul;d be tried that they offer, it will come straight to mind.

    If it's docuamented well he can staple a complet and concise record of your reatment in your file and it helps in many ways. You need it for yourself and it's not hard to do when it's fresh in your head, you know the name of meds, the name of the specific injection, who did it, etc. It really is a process of elimination. Some people find a doc willing to mask their pain with opiates before trying other methods, It's not the way the clinical trial that produced very low addictin rates was done so your more likely to se different results from what that trial produced. If you can find a cure, like surgey, and you can't let one or two docs convince you that your OK when you know your not. You have to educate yourself and ask for the diagnostics if necesarry. You may need to get an Indpendenmt medical eval done by a doc at a major university to get things moving in the right direction. There is no short cut to managing a lifelong problem and there is a cost when you try and short cut things with modrn chemistry when the problem can be corected mechanically. Spondy not causing pain is redicluous? It's not the opinion of every doc although your doc may present it that ay. It's his opinion and his alone. Everyone has there own. IMO it would scare me that a surgeon relied on a radilogist report and actually quoted it.

    I've seen GP's refer a patients t o PM and the two docs together both convince the patient they don't need surgery without ever getting a surgical consult. That's crazy IMO. They aren't qualified to condemn the patient to a life of chrnic pain or pain managment. Jst like one doc that hasn't managed it or isn't willing to doesn't mean pain an't be. But those meds are the last esort when you can't be fixed. They will always b there, but the price people pay is extreme and sometimes it's your only choice.

    Start back at your GP, he needs a comprehensive history, bnecause you would be surprised by how poorly your PM doc may have comnicated with the referring doc. You probably want to get a copy of your files or sign a release to have it at least sent to the GP. IF he
    ''s your referral person, he needs to be on board. Some GP's know exactly the PM method they are sending you for and if they don't believe in pain meds, they can be hesitant to refer you to a doc they know manages the more severe cases and has a different view of the use of opiates. The meds used to treat CP now have only been around 10 years. Temos docs were tought opiates equate to addiction and they should be used sparingly. The manufacturer reps have done a great snow job quoting a report on patients that had tried every other method of pain management and produced an extremely low # of patient crosng the line from simple pysical dependnece to actual addiction. This was when 5mg percocet was the strongest thing you got post op or outside a hospital if you weren't dying and people suffered terribly and tried anything that was offerd because an alternative wasn't availabe. I have quoted that report myself but have since read enough that this wasn't a patient like you that ws tested, even though you feel you have tried everything.Itr's just not possible to try evrythibg in 2 years.

    I totally understand you would do anything for pain relief, but if you find you simply masked a problem that could have been and should have been fixed before you have more problems than you ever thought possible. If you stop looing for a cure simply because someone will give you meds, you can loose the oportunity for a cure 5 years down the road when he meds just don't do what you want them to do. Just something to think about aside from running out of meds.

    I know that's a major problem and you will be sick but it's much easier now than after a few years of Long acting meds around the clock. Good luck and I hope you find an answer you can live with. Just remeber that the doc your talking to is only giving you their opinion.
    Take care, Dave

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