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  • So this is what Pain Management Doctors do???????

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    Old 02-28-2008, 08:16 AM   #1
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    So this is what Pain Management Doctors do???????

    My second vist to the PM doc and I now realize that they are only there to Treat Your pain. I mean Dumb me, I thought that they would tell me that we need to do some more testing blood work, scans etc. Lets see if we can get you better. I was seen for all of 5 minutes, given a script for 90 oxy and sent home until my next vist. [ oh yeah, did need to pee in a cup] I am depressed. Does the reason your primary doc sends you to a PM doc because they feel you will NEVER get better? Don't get me wrong, I am so glad to be understood that I DO have pain and am pleased that I am getting help for my pain, but ....... I guess I need to get a grip that this may be forever and I may not EVER work again. When you visit your PM doctor is it like my visit???
    ps Sorry if I am coming across scattered, because at the moment, I am feeling that way.

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    Old 02-28-2008, 09:10 AM   #2
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    Re: So this is what Pain Management Doctors do???????

    I know you were hoping for some kind of hope that something can be done to "fix" your pain other than taking medications. I also know how upsetting it can be to face the fact that you may have to be on medications for the rest of your life. It's almost a situation of mixed emotions because although like you said, we are thankful that someone understands we actually are in real pain and is willing & able to help, we are still left with the frustrations and disappointments that come because we are physically not able to do some/many of the things that bring us enjoyment in life.

    There are many different ways doctors work with pain management issues. Some doctors will absolutely not prescribe opiate meds. Some will prescribe them freely with almost little or no "guidelines". Some will try and perform tests to further investigate the cause of our pain. There are so, SO many modalities that can be employed such as trigger point injections, steriod injections, bio-feedback, E-stim, physical therapy. Oh, the list goes on and on. Some doctors employ medicinal treatment as well as some of the other things listed above.

    You mentioned you had to do a urinalysis. Did your doctor have you sign a pain management contract, or explain the pros & cons of medications or his rules regarding your roll & responsibilities as a patient? It really sounds like it was a short visit.

    I can only tell you that my first appointment with my PM doctor was several hours long. It included paperwork requiring my medical background with full details of my chronic pain issues, past doctors who have treated me, a full prescription back-ground, and other forms of paperwork along with me signing the pain management contract, urinalysis, etc. The doctor then spent a LONG time examining me and even made me watch a video about his practice that covered each detail of the contract I signed. It was exhausting, but it had to be done.

    I can't tell you other people's experiences, but they will chime in. I do have to say that each doctor has his or her own way of treating patients as well as their own philosophy on how to treat pain. Just because one doctor does xy or z, doesn't mean that all PM doctors are going to do the same thing.

    I really am sorry your appointment didn't go as you had hoped. If you have concerns, or questions about further testing you might want to write them down and take that information with you to your next appointment. This way, you will remember everything and will be able to get some more answers. I think that if you want further testing, your doctor should at least take the time to address those concerns and if he chooses NOT to refer you for those tests, he should explain why he feels you don't need them.

    Communication is key. There may be a valid reason why your doctor didn't recommend further testing. Have you had any kind of diagnostic tests run by other doctors? If so, he may feel that there's no reason to have them done again.

    I wish you the best. Please keep checking back because others will chime in and more than likely be able to give you better advice/info than me. Sorry if I haven't helped much here. Keep us posted. And please, don't ever give up hope!!

    Last edited by ozzybug; 02-29-2008 at 03:48 AM.

    Old 02-28-2008, 11:01 AM   #3
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    Re: So this is what Pain Management Doctors do???????

    Hey Georgi:
    So sorry you had a bummer of a visit with PM. I know it can be frustrating to find out that you are "stuck" with chronic pain. I went through it, as I'm sure everyone here has. The best advice I can give, and I'm not an expert either, is that if it does turn out that there is nothing more that can be done than to manage your pain, there is a process each of us has to go through. I've found over the years that acceptance is for most people just as difficult a process as the pain itself.

    A relative of mine, who has lived with CP for many more years than I, told me back in the beginning, that you almost have to "mourn the old you". Let yourself have the pity parties etc for a while. In a way, not to sound morbid, the old you doesn't really exist anymore. That doesn't mean your life is over. It just means it has changed. Even though you see and hear about all of our struggles on this board, the fact remains, we are all still here, pushing on, and living our lives as best we can.

    The best part is, we have this place to support each other. I know it has made a positive difference in my day to day, since joining this site. I will keep you in my thoughts and prayers and don't give up hope. You may not have the right doc, or he may have been having a busy day (not that I consider it an excuse) but Ozzybug was absolutely right. Write things down and next appointment, ask your doc questions. That's what he's getting paid for and he should be listening to you. (and all his patients)

    Keep plugging on and God Bless, cmpgirl

    Old 02-28-2008, 12:44 PM   #4
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    Re: So this is what Pain Management Doctors do???????


    Here's my PM experience. I went to 2 who wanted to inject everything that had been injected already and give NO meds. Seemed not to care at all about treating my pain. Finally, last December, I went to my third & final. I LOVE him. My first visit I waited a good 30 minutes for him, but he also was in my room for 45 minutes. He did a thorough physical & neurological exam, he read everything I brought with me (all old tests, injections, surgery op reports, etc.), and talked. He assured me that all was not lost, that there were many other options for me (procedure-wise), unlike my orthopod who said fusion (at 27) or nothing. He changed my meds from short-actiong to long-acting. We scheduled procedure #1. I can't tell you how thrilled I am with him. And, he's a cool guy. This AM we talked for a good 10 minutes after the "appointment" was over about books, and medicine, and the pharmaceutical industry.... Anyway, my point is, I think that depending on your condition, PM's can, will & should TREAT you to the best of their ability. When they no longer can, they should refer you to the appropriate physician who can, and then only manage your pain for you. I think it takes a long time of trying before you can give up and say there's nothing anyone can do for you. Whether the PM can do any of the invasive things you might need depends on his/her training & how they run their practice. There are lots of different PM's & lots of different PM practices. I'll stop, b/c I'm rambling. If you have any more questions, don't hesitate to ask. -Liz
    Back pain since March 2005
    2 ESI's - Feb. 2006
    Discograms 11/16/06 & 7/10/07
    End. Discectomy - July 2007 (L4/5)
    3-level Foraminal Inj. - Jan. 2008 (L3/4, L4/5, L5/S1)
    IDET - 1/25/08 (L3/4)

    Old 02-28-2008, 08:52 PM   #5
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    Re: So this is what Pain Management Doctors do???????

    Ozzy- I wish more Docs would do what yours did....This would weed out a lot of the drug seekers and thus, lessen the hassle on legitimate pain patients.

    Thanks for sharing.

    Old 02-29-2008, 02:00 PM   #6
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    Re: So this is what Pain Management Doctors do???????

    I have been to several different kinds of PM doctor and as others have said there are different PM docs and their philosophies. I group them into 3 different kinds:

    1. only medication management

    2. medication manangement and surgical procedures (epidurals, steroid, trigger point injections)

    3. only surgical procedures and NO medication

    You may have very well see option 1. My first experience was just like yours and the PM doc acutally said I don't see any reason your family doctor could not prescribe these meds and sent me back. The second PM doc I saw was #2 and it was similar to ozzbug's experience where each visit was at minimum 3 hours and maximum of 4 1/2 hours. I could not and would not put up with this one especially since he would not prescribe me anything stronger than Ultram and the epidural steroid injections did nothing at all for me. Have you had any type of injections in your back. First of all you should be grateful for getting your meds because as you have heard many, many, many people can not find doctors to prescribe opiates/opiods. However, I know the disappointment you are feeling because I remember well after my podiatrist, and an orthopedic surgeon said "there is nothing more we can do and you will have to do pain management" I didn't want to live and resorted to using illegal drugs for quite some time before I said this is rediculous and I am slowly killin myself. So, I had to accept the fact that:
    1. I would always have pain
    2. I would always need to manage my pain
    3. I would not be able to do the things that I used to do
    4. I am still alive and need to be grateful for the things that I can do because there are alot of people that are alot worse off than me.

    The "acceptance" of chronic pain is very difficult and it has taken me a long, painful journey and something I am slowly working on day by day.


    Old 02-29-2008, 03:36 PM   #7
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    Re: So this is what Pain Management Doctors do???????

    Thanks for the responses. I do need to get a grip on my pain and the situation that I now find myself in. I still need to find the dosage that is right for me. I am on oxy 20mg 3 times a day. I really feel that I need something a bit stronger. Just does not seem to take my pain away. I still have some old norco's left from the doctor that sent me to the PM doc. I am afraid to take them for break thru pain until I talk to the PM guy. I did sign a contract and I don't want to do anything wrong to get me into trouble. Geesh, didn't life use to be so simple before pain???? I need to give this new pain management office a second chance. They were really busy the day I was there and I felt rushed through my appointment. I will write down my questions for next visit. I called and asked for an appt next week to adjust these meds. Guess I'll live with the pain until then. I do realize that I do have it better than many on this board, in that I am being treated for my pain.

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