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Need answeres to some pain management questions...

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Old 11-07-2007, 01:17 PM   #1
Join Date: Nov 2007
Location: Lawndale, CA, USA
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disabledgrl HB User
Question Need answeres to some pain management questions...

Hi all...I am new to this board. I am getting ready to visit a pm doctor via IM doctor refferal. My IM doc wants me to go on a more long acting medication as I am taking Ultram 350mg per day, and it is not working. I have SEVERE pain due to spina bifida, scoliosis, and hip dysplasia. As a result, I have had 30 surgeries to correct these issues. My questions are: What should I expect at my first PM visit? Will the doctor listen to what my doctor suggested? Will I go through withdrawals from the ultram if I am switched to another med, and if so how bad will they be? Any answeres are very much appreciated. Thanks!!!

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Old 11-07-2007, 03:47 PM   #2
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Boxerluver HB UserBoxerluver HB UserBoxerluver HB UserBoxerluver HB UserBoxerluver HB UserBoxerluver HB UserBoxerluver HB UserBoxerluver HB User
Re: Need answeres to some pain management questions...

Hi and welcome. There is a lot of knowledgable people here and you'll get answers. From my experience, it's a lot like any other doc appointment. When you get there(or they might send them to you) they will have you fill out forms on your health, surgeries, what meds you are on etc. Usually there is a picture of a human figure for you to label all the places you have pain. They will want to know what your pain is on a scale from 1 to 10, what helps your pain, what makes it worse. Depending on the doc, they will do an exam. Some places you'll have to give a urine sample so they know that you are taking what you prescribed. You may have to sign a pain contract which usually states that you will only get pain medication from your pain doc, that you won't take illegal drugs, that you will submit to medication counts, etc. I personally have never had to do that but I've heard of some who have, it just depends on the doc. Depending on the meds you are given you will have to be seen either every month or every 2-3.

Again depending on the doc whether or not he will take your other docs reccomendations.

That's all I can think of, if I missed anything someone will add it.

Good luck!

Old 11-08-2007, 06:08 AM   #3
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Re: Need answeres to some pain management questions...

I was born with a bone disease (I have no idea what it is) and am in a lot of pain too. I've had over 2 dozen surgeries to help correct some of the problems.

I complained to my acting primary, who was also my pulmonary specialist, and he didn't feel comfortable giving me anything over Darvocet with strict instructions to take no more than 1 a day (um... ) Luckily his nurse recommended a PM doctor and I made an appointment.

My first visit was pretty simple. I filled out the usual forms and paperwork, then spent the next hour talking to her about what was wrong and what my pain was like. Thankfully she was very sympathetic and sent me home with a script for Percocet to try out. I also signed a contract stating how and what I will do to continue using any prescribed narcotics (agreeing to pill counts, urinary analysis and anything she deems necessary). At the next appointment I was switched to long acting Morphine and have been on it for the past 4.5 years.

The PM doctor may agree with your other doctor, or they might want to try out their own plan.

Switching to another opiate from Ultram shouldn't cause withdrawls. You could always taper down the dose if you do. Most doctors wouldn't want you to suffer (but of course there are some that don't seem to care ). I used Ultram as a breakthrough med for a while, but didn't like how sick it made me feel.

Old 11-08-2007, 09:11 AM   #4
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Re: Need answeres to some pain management questions...

Hi Fibbles! Please tell me that you DO KNOW the name of your bone disease!!! I wouldn't want to be suffering from a chronic pain condition without knowing everything there is to know about it!!! Take care - Memere

Old 11-08-2007, 04:34 PM   #5
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Talking Re: Need answeres to some pain management questions...

Hi disabledgirl:
Boxerlover and fibbles have done an excellent job at explaining what to expect at the appointment. I would like to mention please take all of your medication with you so they can see exactly what you are taking and all the dosages. Plus it helps immensly when you are filling out the paperwork and you dont have to rely on your memory (because I know for me my memory is not good especially on all the meds)

If you have had any x-rays or mri's you should take those along with you to the appointment as well. Also, write down all of the doctor's that you are currently going to and have seen in the past. I typed mine all down with addresses, phone numbers, fax numbers (for release information), and the dates that I saw them.

I would like to mention that you should DEFINITELY titrate down on the Ultram. I was on 400mg day and started to titrate down 2 months ago. Even if you start on another narcotic you will probably suffer depression (and it can be severe) if you just stop the Ultram. The reason being is that the Ultram is not only a narcotic but also has anti-depressant effects so it's like two in one. I just don't want to see someone else suffer the crushing depression that can occur with stopping Ultram.


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