Pain Management-How do you change doctors?

[Eddie G]

Im going through this too, after almost 9 years with the same pill pusher it's time to move on. He's an internist and I need a pain manager. I've found a pain management doctor on the NJ DHSS registry and I keep telling my lawyer to make the insurance co. send me there. I have to find a doctor soon before I run out of pills. My old one wont see me anymore (long story). I take alot of Roxicodone (90mg every 3 hours) Exalgo & Lyrica and I have enough to hold me for a while but they better hurry up! Nobody does anything quick unless there's $$$ involved. I'll call the lawyers again tomorrow. What a pain in the back, leg, hip, and ass.

[jsewell]

I feel your pain. I once a few years ago was fired by my pain management doctor. He never liked my spine surgeon and told me at the first appointment that he works closely with spine surgeons . When he asked who mine was he said "I don't work with him" so rocky start, things got OK and then one day when i had discography with another doc, he fired me , told me he couldn't treat me anymore.
Fortunately my spine surgeon found me a new pain management doctor right away.
But i did have a few weeks of panic wondering if i would have to endure pain without medication for a while.

Good luck to you in finding a new doctor
judy

[mmglobal]

Wow! I think that most of us who are chronic pain patients for a substantial length of time could write a book. I alreay have a title and I've asked my pain management doctor about making a presentation to his staff. It's called, "the indignities of being a chronic pain patient".

Having said that... Lisa, your story is really bad. There is no excuse for this type of treatment. I would consider writing the doctor a letter that expresses your concerns BRIEFLY. But, the letter would contain the threats and the fact that they changed your medications WITHOUT YOU HAVING A DISCUSSION WITH YOUR DOCTOR, and for no medical reason; seemingly in retaliation for the offence of insisting on seeing the doctor and for talking about seeking a second opinion.

If you have a change in symptoms and there is no doctor to consider the new symptoms and diagnose them appropriately, that is dangerous. It's possible that the new symptoms could be related to a problem separate from your source of chronic pain. (eg. diabetic neuropathy?)

Good luck... please keep us posted. If you don't get any appropriate response, I would switch to a new doctor AND file a complaint with the state medical board.

All the best,

Mark

PS... Eddie, IMHO we should be with a pain management doc when we get into the mode of maintenance meds instead of investigating procedure options. The only problem is that they are skewed to meds and procedure and don't have enough 'balance'. We are all in such a tough spot.

[mmglobal]

I was fired by my pain management doc after about 8 months with him.

"You are too mobile to be having the kind or pain you are reporting", he said.

About a month later, I leaned my head forward to rinse my hair in the shower and my left leg went numb. Thanks Doc. I liked getting some vindication, but that is worth little after the humiliation of being fired by the doc and the indignities I ran into when shopping for another. I can't write more now, but there is another worthwhile story there.

Mark

[Maria]

I adore him.. 8 years still seeing same person in San Diego. He likes that I'm as functional as I am and still writes my pain med script. I asked him point blank last visit if it was OK that I don't see him but every 5 or 6 months actually as the scripts written for every 3 months last me that long and he said "no of course not."

More to say tho back is killing me sitting since I've not been able to bear wt. on right foot this past week and am not cleared to do so until next Friday.

argghhhhhh.... back pain stinks

[Hooch]

Originally Posted by mmglobal

"You are too mobile to be having the kind or pain you are reporting", he said.

This is the crux of pain treatment, and why it is treated so poorly.

It is self-reported, and a treating doc has zero insight into the level of pain. Zero, nada, nothing.

The med profession gives lip service to this, but at the end of the day they are in it for the power and ego gratification the position provides. There is nothing gratifying to the ego about having a patient tell you what level his pain is at.

It is far more gratifying to use your 'experience' and any other bollocks you care to come up with to interpret the patients pain.

If your interpretation is patently false, well, tough titties to the patient.

This is actually demonstrable incompetence, but a medical relationship is a power relationship, and the role of a patient is to be compliant and have no power over their own treatment.


So the problem is obviously the relationship, and the lack of power the patient has over their own treatment.

The solution involves empowering the patient, by actually giving them control over what goes into their bodies.

This would never happen, not because of the potential for proliferation of addiction, but because it is anathema to the medical profession that the patient knows their body and condition better than the doctor, and has a far deeper insight into what works and what doesn't.


You could argue with me on the last point, but I have dealt with enough dickheads in white coats to know that many of these twangers are in love with power and status more than they are with serving the needs of someone in strife as best they can.

Pain Management is one of the aspects of the profession where this relationship becomes amplified because

a) it is palliative
b) it lacks the status of the other disciplines, and probably attracts more also rans
c) the patients are mostly desperate and in terrible pain
d) there is no objective indication of successful treatment (similar to the mental health disciplines).


The answer to this problem lies something along the line of a fundamental shake up of the doctor/patient relationship, and the establishment of something similar to a patient bill of rights.

Something has to be done alter the balance of power in this relationship, as it is far too skewed.

The role of the doctor should be to advise the patient on the available medications and their long term effects and addictiveness. The choice should then be the patients to try certain medications.

If people want to abuse the system to obtain narcotics for recreational drug use, I am of the opinion that they should be allowed to. I would rather have a few more addicts rorting drugs out of the system than have people in genuine need be put aside. There is no way to tell the difference between the two. No way at all. Addiction is a choice you make when you ingest a drug: untreated pain is not a choice.

*****

It is unfortunate that such changes will not be made or even attempted, due simply to the arrogance and conceit of the medical profession.

[Hooch]

I know that seems like a crazy rant but jeeze at some point a doctor has to be judged on their performance.

If you call a plumber to your house for a broken dunny and he turns a spanner a few times, gives it a kick, flushes it, watches it overflow all over the floor, then turns to you and says 'job done mate', you'd boot him up the arse and turf him out the front door and never hire the incompetent fool again.

But if you go to a doc and say ' I am in severe pain ', and he goes, 'nah you're alright', well everythings ok because it's the doc who decides what pain you are in not yourself!! patently ridiculous!!

And in everyones viewpoint it's the doc who is right, in society at large, the doc is a protected species.

As for the poor bugger who is disabled by pain, can't work, going down the toilet financially and may or may not have a family to help him out... well tough titties mate.

Most people in severe chronic pain are impoverished or rely on a family member to earn an income. Just a ridiculous situation, and totally avoidable.

[cherylstewart67]

Okay: Acute is sudden on-set like from an injury or surgery..
Chronic; which is what most of us here are; it's everyday, continual, constant, and must be managed. Most doctors will only treat acute pain now or they will refer you to a "pain management doctor". The reason is simply that pmd most follow certain guidelines, screening, and testing of their patients. You must have urine tested every 3 months to make certain that you are actually taking the meds and not selling them. They look for certain levels based on you dosage so they can tell if you are taking it daily as Rx.

[karreymetris]

Does acute pain mean in a small area? And chronic means a long time? I'm trying to learn my medical terms with you guys

[Maria]

Acute is rapid/sudden onset pain. Generally when discussing acute onset pain it means that it happened quickly. Not slow in development.

If pain is short lived and will recur esp. multiple times it's called "episodic"

If pain is ongoing for a period of time I think being 6 months to a year more or less every day then it's considered chronic in nature.

Another word used in pain management is intractable pain .. pain which can't be controlled or is very difficult to control.

Generally if one has a sprain, fracture, or broken bone they will have acute pain which will heal hopefully and not become chronic.

People who have a multiple back surgeries sometimes end up in chronic pain secondary to various reasons... whereas their intial back problem may have started with an acute onset of back pain and for a period of time a person may have had episodes of painful flareups and then may at some point progress to chronic pain (pain that is there all the time)...

Is this helpful? Hope so.

[Eddie G]

Went to workers comp court hoping the could find me a pain manager. Me & my attorney were yelling at each other because I told him he would be defending me harder aginst a detox had we had more face time together. He was offended by that as much as I was offended he went along with the 10 detox. I detoxed 2x this month and told the judge that. She said its the worst thing I can do and also said LYRICA is a widely abused drug too and I need to come off of that also. The ONLY doctor who has seen me in thae past 5 months (my primary care) wrote me a letter for court advocating pain management for me.
The judge said Liberty Mutual can pick whoever they want for me and they want me at a "clean slate". Easy for them to say. If you treat patients like a piece of meat maybe they;ll act like it eventually?

So Im preparing for detox AGAIN and the 9/10 pain that accompanies it. Im going to have to warn them that I tend to bang my head against the floor when I dont sleep for days and have horrible pain that make me want to die... FUN FUN 6-10 days for me but eventually I may get my surgeon.....after I get my pain manager.....after I get detoxed from deadly Lyrica (and Roxicodone which I will be detoxed from by the time I get to detox)
Whats worse is how money rules the system. I was told by this detox that they dont take people who are already detoxed. They take people in "crisis mode" but since my insurance prepaid they'll make a bed for me and the poor junkies or tweakers who may die without detox cant get a bed....Typical.....

[Eddie G]

Detoxing today to be detoxed for detox on Monday LOL!

I hope after these 10 day this pmd that they send me to will refer me to Dr. Goldstein. He's my only hope of getting out of this pain. I want them to fuse my Prodisc. They say its already autofused but I want pins & screws dammit! Autofusion isnt perfect! I need to get Goldstein to write me a letter saying he can help me! I think this new pmd will want to try antidepressants which I HATE! and the TENS implant! (Im not that lazy I cant remove TENS pads)
I cant believe Im going into a Detox even though Ive only been taking 15mg. Roxi ... THATS an ADDICT? My script was for 90mg. Roxi. Thats a healthy dose but I can get by on alot less BUT NOT NONE! Im afraid I may end up in a straight jacket fro the pain. It makes me literally bang my head on the floor when off my meds....

scary....

[jsewell]

Eddie i wish you no head banging. I can totally relate to what you are going through. Although i did not have to come totally off meds, i developed a sciatic pain so severe that i couldn't walk and my old pm did nothing for me. So almost 6 weeks of the head banging pain.
Good luck with it all and i hope you get the referral soon to DrGoldstein.
judy