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  • New PM doc, same old bias...:(

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    Old 09-04-2010, 02:30 AM   #1
    Brokend
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    New PM doc, same old bias...:(

    Bias: a particular tendency or inclination, esp. one that prevents unprejudiced consideration of a question; prejudice.

    Discrimination: treatment or consideration of, or making a distinction in favor of or against, a person or thing based on the group, class, or category to which that person or thing belongs rather than on individual merit: racial and religious intolerance and discrimination.


    You know, I hate to use the terms bias and discrimination, but if the definition fits...

    And I know that in the medical world things are different, but they really shouldn't be, right? At least I don't think so, anyway.

    So I finally got my referral last month and was scheduled for my first appointment today. My primary care physician has been treating me for chronic pain off and on for years now, but he has always said that he was uncomfortable doing so due to the fact that he wasn't a pain specialist and he preferred to have people see specialists in many cases because they can offer better care and expertise. And I certainly understand and believe that to be perfectly reasonable/acceptable.

    Despite my doctor's apprehension to prescribe pain medication and his strict and conservative rules in doing so, I have always been very grateful for what he HAS been willing to prescribe. I know that he doesn't like to and I am very lucky that he has done so anyway.

    But anyway, in the past when I have seen pain specialists, every single one of them has cited my age first and foremost and the opinion that I am "too young" to be taking narcotic pain relievers. I am currently 35 years old. Now, I do agree that I am young and that I shouldn't "need" to be on these meds, but I didn't exactly ask for my condition and the pain that goes with it either. If I could change it, I would.

    This new PM doctor was no different. In fact, with a sigh, it was the very first thing that he mentioned as he looked through my records.
    He stated, verbatim:
    "I see that you are on a considerable amount of narcotic medication for pain. You are far too young to be taking the narcotics now... but, it is what it is I guess." He sighed and shook his head. It wasn't polite, but it wasn't as rude as other PM doctors have been, either. Plus, he was foreign and I just assumed his mannerisms were perhaps different than ours and I tried to tell myself that he didn't mean to sound rude, but it came across that way due to the cultural differences. I was honestly trying to give the man the benefit of the doubt and not go into the meeting assuming that it would be just like the rest, previously.

    He did state shortly after that, though, that the goal was to reduce the amount to zero, rather than 15mg/12hrs, or 4 pills a day of the Oxycodone.
    I know that I am pretty young to be in the condition that I am in and needing pain killers to control it, but still, I don't think that 30mg a day is THAT significant of an amount, is it?

    We then went into my condition. He pointed out the obvious arthritis in my spine, the disc that wasn't just degenerating, but had pretty much degenerated into nothing, which he agreed was causing a good deal of "discomfort". (I think discomfort was putting it mildly, to say the least. More like a screwdriver in the back most of the time.) a lot of scar tissue from my surgery in 2004 (I forget the exact term, but he said that it looked like the surgeon "gouged" out a good chunk.) as well as, on the MRI, a mess of swirls and discoloration in an area that was supposed to be smooth and the same color. I'm waiting for the report with the exact medical terms but when I get it I'll post the correct information.
    He said that the only way to correct it would be another surgery but I was too young to be doing that again right now. Ugh.

    What he wants to do is burn off the nerves in a trial series of two sessions to see if it works, in which case I would experience immediate relief from my pain as soon as the procedure was overwith and then he would schedule another session that was more "permanent" and would last a year or so, he said. Then every so often I would come in and he would re-do it as needed.
    I'm pretty reluctant to try this, but as I am sure many of you can relate, if you don't try what they suggest (more like demand, if you want to continue seeing them) then you're non-compliant or just looking for the meds. Not sure if that is what many of you have been through, too, but all of my experience thus far has been that way.

    I made it a point NOT to talk about pain meds unless he brought it up. I let him ask all the questions, as when I had asked previously and with other PM doctors... well, it didn't go over very good. I had one call me a drug seeker right to my face (honest to God) when I asked if she would take over prescribing the same medication that I was currently on, and write it in my medical records that went back to my primary care doctor to boot, and another just get up and walk out of the room.

    Sooo... I tried my new approach this time. The only problem was that he didn't want to talk about it and he didn't even bring it up other than to tell me I was too young for what I was currently prescribed at the very beginning of the appointment, plus he asked me if some of the specific non-narcotic medication worked, and if not, why. lol... I don't know "why", maybe because it wasn't strong enough? I mean, what did he expect me to say? I'm not a doctor.
    At the very end of the appointment, when he asked if there was anything else, I simply said yes, and that my doctor that referred me to him requested that he take over prescribing medication and that he prescribed me enough to last one more day, apparently assuming that the prescriptions would promptly be taken over... He said that is usually the case and that he can prescribe for up to 3 months worth at a time.
    He then said I could go, so I did. I scheduled my nerve burning procedures for the first available date, which was a month away, the nurse said thanks and have a nice day.
    I was waiting for my prescriptions, still, and when I asked her, the nurse said that he didn't write any. So... ok? I asked if there was a mistake or if maybe he forgot somehow, but she assured me I could go.
    I turned around and walked out. But then, at the risk of being that dirty dang drug seeker, I went back in and said that my understanding from my primary doctor was that he would be writing my scripts from now on, and if she could ask him again if that were the case or if he wasn't going to be writing for anything at all. I had to wait another half hour or so, but she came back out with scripts for the same thing that my primary care doc had been writing in the past. Same medication, dose, amount, etc. He gave me enough for a month and the nurse said that we would see how things went after the procedure.

    Now, I don't want to come across as saying that my only goal for the day with the new doctor was to get my pain medication, because it wasn't, and I was sure not to constantly mention it; my goal was to get his opinion(s) and see where I stood with my condition and see what my options for recovery were going forward - surgery, injections, whatever.
    Yet, as I am sure you can all relate here again, the pain medication is pretty much an essential if we want to go about our every day lives, work, family, etc.
    I mean, I was sent to a pain management facility for chronic pain, and while it would be awesome if I didn't need the medication, the reason I was there in the first place was because I DO need the medication. It's really that simple, yet that complicated.

    So I guess my question now is: At what age are we old enough to have our pain treated and kept under control? Is there a magic number? Is it 40? 50? 60? Elderly and dying?
    I seriously do not understand why a 50 year old man or woman is old enough for pain medication, but someone younger is too young for it. I understand that in the grand scheme of things a doctor doesn't want someone that is my age having to be on pain medication for the next 50 years, but that should really be the secondary concern and not the first, right? Or am I wrong? Is it or is it not bias and discrimination?

     
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    Old 09-04-2010, 12:09 PM   #2
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    Re: New PM doc, same old bias...:(

    Quote:
    Originally Posted by Brokend View Post
    Bias: a particular tendency or inclination, esp. one that prevents unprejudiced consideration of a question; prejudice.

    Discrimination: treatment or consideration of, or making a distinction in favor of or against, a person or thing based on the group, class, or category to which that person or thing belongs rather than on individual merit: racial and religious intolerance and discrimination.


    You know, I hate to use the terms bias and discrimination, but if the definition fits...

    And I know that in the medical world things are different, but they really shouldn't be, right? At least I don't think so, anyway.

    So I finally got my referral last month and was scheduled for my first appointment today. My primary care physician has been treating me for chronic pain off and on for years now, but he has always said that he was uncomfortable doing so due to the fact that he wasn't a pain specialist and he preferred to have people see specialists in many cases because they can offer better care and expertise. And I certainly understand and believe that to be perfectly reasonable/acceptable.

    Despite my doctor's apprehension to prescribe pain medication and his strict and conservative rules in doing so, I have always been very grateful for what he HAS been willing to prescribe. I know that he doesn't like to and I am very lucky that he has done so anyway.

    But anyway, in the past when I have seen pain specialists, every single one of them has cited my age first and foremost and the opinion that I am "too young" to be taking narcotic pain relievers. I am currently 35 years old. Now, I do agree that I am young and that I shouldn't "need" to be on these meds, but I didn't exactly ask for my condition and the pain that goes with it either. If I could change it, I would.

    This new PM doctor was no different. In fact, with a sigh, it was the very first thing that he mentioned as he looked through my records.
    He stated, verbatim:
    "I see that you are on a considerable amount of narcotic medication for pain. You are far too young to be taking the narcotics now... but, it is what it is I guess." He sighed and shook his head. It wasn't polite, but it wasn't as rude as other PM doctors have been, either. Plus, he was foreign and I just assumed his mannerisms were perhaps different than ours and I tried to tell myself that he didn't mean to sound rude, but it came across that way due to the cultural differences. I was honestly trying to give the man the benefit of the doubt and not go into the meeting assuming that it would be just like the rest, previously.

    He did state shortly after that, though, that the goal was to reduce the amount to zero, rather than 15mg/12hrs, or 4 pills a day of the Oxycodone.
    I know that I am pretty young to be in the condition that I am in and needing pain killers to control it, but still, I don't think that 30mg a day is THAT significant of an amount, is it?

    We then went into my condition. He pointed out the obvious arthritis in my spine, the disc that wasn't just degenerating, but had pretty much degenerated into nothing, which he agreed was causing a good deal of "discomfort". (I think discomfort was putting it mildly, to say the least. More like a screwdriver in the back most of the time.) a lot of scar tissue from my surgery in 2004 (I forget the exact term, but he said that it looked like the surgeon "gouged" out a good chunk.) as well as, on the MRI, a mess of swirls and discoloration in an area that was supposed to be smooth and the same color. I'm waiting for the report with the exact medical terms but when I get it I'll post the correct information.
    He said that the only way to correct it would be another surgery but I was too young to be doing that again right now. Ugh.

    What he wants to do is burn off the nerves in a trial series of two sessions to see if it works, in which case I would experience immediate relief from my pain as soon as the procedure was overwith and then he would schedule another session that was more "permanent" and would last a year or so, he said. Then every so often I would come in and he would re-do it as needed.
    I'm pretty reluctant to try this, but as I am sure many of you can relate, if you don't try what they suggest (more like demand, if you want to continue seeing them) then you're non-compliant or just looking for the meds. Not sure if that is what many of you have been through, too, but all of my experience thus far has been that way.

    I made it a point NOT to talk about pain meds unless he brought it up. I let him ask all the questions, as when I had asked previously and with other PM doctors... well, it didn't go over very good. I had one call me a drug seeker right to my face (honest to God) when I asked if she would take over prescribing the same medication that I was currently on, and write it in my medical records that went back to my primary care doctor to boot, and another just get up and walk out of the room.

    Sooo... I tried my new approach this time. The only problem was that he didn't want to talk about it and he didn't even bring it up other than to tell me I was too young for what I was currently prescribed at the very beginning of the appointment, plus he asked me if some of the specific non-narcotic medication worked, and if not, why. lol... I don't know "why", maybe because it wasn't strong enough? I mean, what did he expect me to say? I'm not a doctor.
    At the very end of the appointment, when he asked if there was anything else, I simply said yes, and that my doctor that referred me to him requested that he take over prescribing medication and that he prescribed me enough to last one more day, apparently assuming that the prescriptions would promptly be taken over... He said that is usually the case and that he can prescribe for up to 3 months worth at a time.
    He then said I could go, so I did. I scheduled my nerve burning procedures for the first available date, which was a month away, the nurse said thanks and have a nice day.
    I was waiting for my prescriptions, still, and when I asked her, the nurse said that he didn't write any. So... ok? I asked if there was a mistake or if maybe he forgot somehow, but she assured me I could go.
    I turned around and walked out. But then, at the risk of being that dirty dang drug seeker, I went back in and said that my understanding from my primary doctor was that he would be writing my scripts from now on, and if she could ask him again if that were the case or if he wasn't going to be writing for anything at all. I had to wait another half hour or so, but she came back out with scripts for the same thing that my primary care doc had been writing in the past. Same medication, dose, amount, etc. He gave me enough for a month and the nurse said that we would see how things went after the procedure.

    Now, I don't want to come across as saying that my only goal for the day with the new doctor was to get my pain medication, because it wasn't, and I was sure not to constantly mention it; my goal was to get his opinion(s) and see where I stood with my condition and see what my options for recovery were going forward - surgery, injections, whatever.
    Yet, as I am sure you can all relate here again, the pain medication is pretty much an essential if we want to go about our every day lives, work, family, etc.
    I mean, I was sent to a pain management facility for chronic pain, and while it would be awesome if I didn't need the medication, the reason I was there in the first place was because I DO need the medication. It's really that simple, yet that complicated.

    So I guess my question now is: At what age are we old enough to have our pain treated and kept under control? Is there a magic number? Is it 40? 50? 60? Elderly and dying?
    I seriously do not understand why a 50 year old man or woman is old enough for pain medication, but someone younger is too young for it. I understand that in the grand scheme of things a doctor doesn't want someone that is my age having to be on pain medication for the next 50 years, but that should really be the secondary concern and not the first, right? Or am I wrong? Is it or is it not bias and discrimination?



    >>>>>>>>>> I am so totally in agreement with you! There is bias when it comes to age and narcotic prescriptions and it's unfair. I am an "older" woman and about 10 years ago I was sent to my first pm doctor. He wrote me scripts for the meds I was presently taking; meanwhile, I went through several procedures, none of which helped. He then talked to me about the "morphine pump" implant. Told me I was a good candidate and showed me a film. Promised me I was under no pressure to do it, but to think about it over the next couple of weeks.

    Well, I did think about it seriously and decided against it; whereupon he accused me of liking my narcotics and said it was obvious I had an addiction problem and that he would not be prescribing any more for me. No pressure??

    I immediately went to my ortho spine specialist who had referred me there. Was lucky enough to get to talk to him right away and he was absolutely furious at the way I was treated. At that point, this dr. was placed on his No referral" list and to this day, he continues to prescribe my oral meds.

    I think because of the rampant drug use these days, doctors are overly sensitive to the possibility of addiction. For the life of me, I don't know what they think people who are "young" are supposed to do when they have serious problems that cause serious pain. I believe it drives some folks to seek out drugs off the street, such as maryjane, since they can't get anything legally.

    At the same time, I know plenty of younger people (under 50) who are given some pretty strong medication. Perhaps it has something to do with the area you are in. Don't know the answer, but I do know it needs to change. No doctor should withhold badly needed meds and allow a pt to suffer, especially a doctor who deals with pain on a daily basis. I honestly wish that every doctor in the country would have to suffer a solid week of moderate to severe pain before being allowed to practice. Might help them be more compassionate!

    Keep looking for a doctor who doesn't see "age" where he should see "need". and let us know.

    Carol

     
    Old 09-09-2010, 12:20 PM   #3
    oldbackbone
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    Re: New PM doc, same old bias...:(

    I can so relate to this. These doctors can't seem to understand that a procedure you are going to receive in a month does absolutely nothing for you today. Also they don't comprehend that having them carve pieces off our bodies or deliberately damage our nerves does not seem better to us than taking a couple of pills.

     
    Old 09-09-2010, 02:25 PM   #4
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    Re: New PM doc, same old bias...:(

    Excellent thread!! I completely agree with everyone's post and well said indeed!

    Bullymom

     
    Old 09-13-2010, 07:05 PM   #5
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    Re: New PM doc, same old bias...:(

    hi,
    well that is bull.. this shouldnt be the case. i have been in pain mangement for about 7 years and i am 37 years old right now. i think that over the years i have only had 1 dr tell me that i was too young.and i have a couple that treated my pain with just lortab 10mg 4 times a day and they thought that was a high dose..and wouldnt change or up it. BUT I KEEP LOOKING AND DIDNT STOP TIL I GOT WHAT A DESERVED . the last 2 pm dr i have have treated my pain with 30 mg of oxcodone 240 a month, no promblem i was TREATED with diginty and respect and i didnt have to beg... they wanted to treat my pain, they wanted me to live my life, they were top notch.. and that is HOW EVERYONE OF US SHOULD BE TREATED. IF MY MEDS ARENT WORKING THEY FIXED THE PROBLEM. I KNOW IT IS SCARY BUT THE GOOD DR R OUT THERE AND IF U DONT STAND UP FOR YOUR SELF NOONE ELSE WILL. pm is just that they work for us so we have a better quality of life... dont stop looking til u get that.... you r worth it... good luck sorry about spelling i only have one arm now

     
    Old 09-13-2010, 07:27 PM   #6
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    Re: New PM doc, same old bias...:(

    hi,
    well that is bull.. this shouldnt be the case. i have been in pain mangement for about 7 years and i am 37 years old right now. i think that over the years i have only had 1 dr tell me that i was too young.and i have a couple that treated my pain with just lortab 10mg 4 times a day and they thought that was a high dose..and wouldnt change or up it. BUT I KEEP LOOKING AND DIDNT STOP TIL I GOT WHAT A DESERVED . the last 2 pm dr i have have treated my pain with 30 mg of oxcodone 240 a month, no promblem i was TREATED with diginty and respect and i didnt have to beg... they wanted to treat my pain, they wanted me to live my life, they were top notch.. and that is HOW EVERYONE OF US SHOULD BE TREATED. IF MY MEDS ARENT WORKING THEY FIXED THE PROBLEM. I KNOW IT IS SCARY BUT THE GOOD DR R OUT THERE AND IF U DONT STAND UP FOR YOUR SELF NOONE ELSE WILL. pm is just that they work for us so we have a better quality of life... dont stop looking til u get that.... you r worth it... good luck sorry about spelling i only have one arm now

     
    Old 09-15-2010, 02:04 PM   #7
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    Re: New PM doc, same old bias...:(

    I absolutely agree too. I am 25 years old but my serious back problems where I had to have surgery and pain management started when I was 22 (I had pain before but not as bad) and I cannot tell you the amount of times I have been looked at as a drug seeker just because of my age. Nobody has ever said anything outright about me taking this medicine at my age (except my mom hates it!) but I have been told I am too young to be having so many back problems and pain. I mean, it is not like I want to be young and in pain. I feel like I have no life. Nobody-no matter if you are 20, 30, 40, 50, 60 or older wants to be in pain and wants to have to take this kind of medicine for the rest of their lives and people just don't seem to understand that. We take our medicine for RELIEF not to get high, so I am with you 100%.

     
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