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Whats the best way to go about finding a good pm

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Old 04-23-2008, 06:15 AM   #1
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Whats the best way to go about finding a good pm

I am taking the advice, if I can get the surgeon to cooperate & asking for a PM to step in. I am worried of course.
Have an appointment with the surgeon monday, after reading the thread on PMs (thanks for putting it up) I realize that there are things to consider.

So what advice can you give me to approach the surgeon with this & how to look for a good PM. After reading the thread I realize I will need a referral. That alone has me worried, never know if your pain will be taken seriously enough.
I am really relying on the pt's notes here to help the surgeon understand.
I have expressed to her how important it is that her notes include her concerns for the surgeon to see. The pt is really concerned about the whole rib & chest thing & has commented how much that must be causing me pain.
I no longer believe that doctors take your word alone.
So any advice on how to approach this monday with the surgeon will be appreciated. The most important things to me is that who ever it is will continue to investigate any other possable causes & of course help me to manage this pain.
My biggest concern is will the surgeon help me until I get into a PM? My pcps office does not do pm for anyone. Would they just kind of leave me in pain?
I can't express to you all how bad this can get. It scares the daylights out of me. If I can't control the pain I can't breathe. Its not anxiety, I just can't breathe. My guess is because the ribs are so hypermobile. Its hard for me to believe that any doctor would kind of abandon me in this situation, but realistcally I know it can happen.
The only hope I have is that rehabilatation for my shoulder is drastically slowed down (according to the pt) due to the chest/rib problem & pain & the surgeon of course is treating the shoulder.
I am hoping that that will allow for the surgeon to continue treating me until I can get into a PM.
So please any advice on how to approach the surgeon about this will be appreciated. Sammy

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Old 04-23-2008, 06:18 AM   #2
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Re: Whats the best way to go about finding a good pm

Good Luck , all the PM's around here are afraid to prescribe pain killers here in Pennsylvania .. Thats the first thing I would want to know.. Here all they offer is steriod injections .. But hey !! If they work thats cool

Old 04-23-2008, 07:26 AM   #3
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Re: Whats the best way to go about finding a good pm

Sammy- I would take your husband with you so he can also listen....Sometimes two sets of ears is better than one! Also, maybe he can add to the discussion and help describe how you've been suffering.

I would simply tell the surgeon that it's no secret that you're in a lot of pain, and does he think it's feasible for you to be referred to a PM Doc? Tell him that you realize that he's a surgeon and probably not set up for seeing patients for ongoing care, and thus, would a PM Doc be appropriate? See what he says. If he says you shouldn't be in this much pain and that the surgery should have fixed everything, then unfortunately, there is a major disconnect somewhere and you need to move in a different direction...New Doc and etc. However, if he agrees, then you're in good shape.

Tell him also that there may be some transition period involved and could he care for you until you can be seen? Additionally, tell him you'd like to continue to see him for the main issues, but have someone else treat the pain. This is what I do for my ENT issues....I see an ENT for all my infections, sinus / head problems, but my PM Doc treats my pain. My ENT was the one who referred me. In your case, if would be very appropriate for the surgeon to refer you. After all, a lot of what he's involved in is the underlying cause of your pain.

Lastly, I would stress to him that you'd like to see a PM Doc who isn't afraid to be aggressive where necessary...Meaning meds. Tell him that at this point in your life, you're interested in quality over quantity. I would just really emphasize how much pain you're in and how you suffer day by day.

Hope this helps.


Old 04-23-2008, 08:58 AM   #4
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Re: Whats the best way to go about finding a good pm

sorry i wasn't in this situation therefore I can't give you suggestion how to ask your surgeon. My surgeon sent me to PM a month after surgery, so i had not problem with it.
I would be very happy if you would be able to get yourself a good PM Dr - such a big difference! My PM keeps my treatments under control, changes or adds my meds. I have such a confidence in him and feels good to know that you have someone knowledgeable, experienced who is there for you when you need him.

Feel strong about asking your surgeon to refer you to one, anyway they refer patients to PM sooner or later since they are not trained to be PM DR.

I wish you good luck and please let us know how did it go.
Best of luck!

Old 04-23-2008, 10:54 AM   #5
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Re: Whats the best way to go about finding a good pm

Hey Sammy: I am so glad you have decided it is time for a PM. It certainly looks to me as if your surgeon has no desire to do any kind of PM. From my experience and from what I've read in other's posts here, surgeons generally refer patients to PM's after a certain period of time.

If he does not feel comfortable doing this referral, maybe your PCP can do it. I get all of my referrals from my PCP, because my insurance requiers me to. I would think your PT person would know of some good PM's. They must have many clients that go to one. Maybe she could give you some names.

Ex is exactly right about the quality vs. quantity aspect of this. I know when I first asked about PM, I told my PCP that I had almost no quality of life anymore and I just needed someone to help me regain some of that. It was also the first thing I said to my PM at my initial appointment.

I wish you the very best of luck with your appointment next week. Stand strong, because we will all be there with you in spirit. I will be sending positive thoughts and prayers your way. Hugs, cmpgirl

Old 04-24-2008, 10:52 AM   #6
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Re: Whats the best way to go about finding a good pm

Thanks so much, Executer you are corrrect, because he is dealing with the shoulder & movement of that shoulder/arm is limited because of the rib/chest pain he is somewhat involved. I am still having some issues with the shoulder so lets hope that will be enough for the surgeon to stay involved till I can get into PM. At this point there is no way I can get that shoulder the PT it needs with the chest/rib thing going on.
I have been told this can be a really long recovery & can take longer then the estimated time given by the surgeon. The surgeon has also told me he did not know how long it would take me to recover or how much relief I would get because I came in with so much secondary pain. So he is aware of others problems, hopefully this all is considered.

Good advice. I have asked my husband to come to the appointment on monday & that is excellant advice on how to approach the surgeon.

I am really going to need someone to step in for this pain.
I can't seem to get much movement without the pain flaring up. Had to go to a viewing, had a very old family friend pass on, could not last more then 45 minutes with out pain & throbbing & I took the pain med right before going.
It is worrying me that I can't get much relief or control of this pain, almost done with the steroid pack.
I have kept a journal & am going to continue to do so.
At this point I think I am going to have to stay pretty inactive, more or less just off my feet & just ice.

If nothing comes from the cardiac testing friday I really feel that I am going to have to push for an MRI on that rib/chest area, which my insurance declined in the past.
I know exactly when I injured myself & that was 3yrs. ago, if it was going to heal I think it would have done so by now, I had a decent amount of rest after the shoulder surgery & in between, you would think that the rib area would have calmed down, they say thats all that can be done pretty much, but it has been brought up that perhaps there is a tear of something in that area, had a ct done but nothing showed. The pain has just continued to spread downwards to pretty much encompass the entire rib area. Guessing by the doctors has not gotten me anywhere at all & I am sick of it.

Pt mentioned I may have to have PM just to get through the therapy & the ribs will have to be dealt with in order to continue working on the shoulder.
She made it clear that the ribs are most definantly hypermobile & it has to be addressed. She is sending just enough of a report to let the surgeon know about the ribs & how it is holding back the shoulder pt. She wants to see if I can get a script for the ribs themselves so that we can try working on the ribs then moving to the shoulder, which is the only way it could be done at this time. May have to have one week off of pt & everything just to get the ribs to try to calm down. Once again she said the chest area is extremely tight & with the ribs the way they are thay can cause alot of problems & pain.

I never had anything like this till I moved in my new home. I remember injuring myself lifting overhead, my shoulder hurt like crazy for months, but of course I ignored it. Last april/may is when it just became chronic, every single day. Because it was effecting pretty much the whole left side I think it threw the doctors off, but from day one I complained about the chest pain, & how it was causing me problems breathing. Then came the asthma dx. I am beginning to wonder.
When will doctors realize that we know our own bodies & listen.
I swear if someone would have taken me serioulsy in the beginning I would not be suffering today. I have a feeling the last test they do, which will probably be the MRI will show what is going on after all these years. It should have been the first test done. After the last couple days of worrying I find that I am going to have to push, push & push.
This has cost me so much, being a wife, mother, missing my own daughters birthday celebrations, school events, my whole families life has been put on hold on & off for three years & I am fed up. I can never go back & make up for that time I have lost, missing my sister in laws funeral will always bother me. I know I am venting & I thank you for your patience.

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