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first pain management experience

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:23 AM in Pain Management
And not a good one.

I had my first pm appt today - full of hopes of advice and a kindly ear and some input on proactive ways forward.

Instead I have come back and cried for about half an hour. He didn't really want to hear what my pain situation was and interrupted every time I was answering his questions on my history and current symptoms. Then he just said I have nerve pain from scar tissue and either have to accept it and find ways to live a life less - well I don't like using the word he used so I won't - or have injections and maybe an SCS in 3 years time.

I know this may be the reality and I don't want someone to lie to me but my consultant hadn't seemed to concerned by the scan results on friday and felt I was in the right hands with my physio and working on a proactive regime so to hear such "hopeless" news in such a blunt unpleasant way has really upset me.:-(

Sorry for the rant - I am just so disappointed and sad that I put my hope it getting help from this guy and having another person on "team get better" when it really just felt like a waste of time. Are all pms the same?!



  • Not all PM's are the same. Just like not all docs are the same. It's just the nature of the beast.

    One thing that I had to learn early on was to not have expectations when going to see any doc, no matter what the problem or what the specialty. Otherwise I was almost guaranteed to be disappointed.

    The other thing I had to learn is that we all have good days and bad days and so do docs. There have been a few docs I have seen that my first visit was a huge disappointment and if I were to judge that doc on that visit alone, of course it wouldn't be pretty. Fortunately I went back to the same docs and found that they are actually very excellent docs.

    I'm really sorry that you had a bad experience. I hope that things work out for you better than you see them at the moment.

    Hang in there,

  • I'm sorry again for the way you were treated. I PM'd you earlier with suggestions on how to deal with this rat if you're stuck with him. If you can see someone else, jump off this shipwreck of a doctor. I know how lousy it feels to be let down. You go in with expectations and wanting positivity, and instead you get the live with the pain talk. Try to do a lot of research on the neurostimulator trial, and look up experiences; there's lots of them. You can PM Milliekeylargo, she is a great success story.
  • I understand your PAIN. It is very hard to find compassionate Doc's that really care! It is even harder to find a good Doctor that will prescribe you the medication that you need to manage your pain. I recently started recieving treatment at***EDITED***. Their staff is very nice and the Doctor is very understanding of chronic pain. The website is ***EDITED***

    Good Luck with your treatment!!!! and please remember that tomorrow is a new day and you can always make it to tomorrow

    Doctors name and contact details removed by forum Moderator (paulgla). We do not permit publishing specific doctor's or institution names and contact details.
  • Hey, I am sorry to hear about your PM appt. My first PM appt went the same way... do we have the same doctor???? LOL I saw him once again for an ESI, and once more for NOTHING. I wont go back!! I am currently searching for a PM who has experience treating pregnant women... starting to think they don't exist.

    If you can, seek out another PM... I know that when I went to my appointment, I went with all these hopes of finally seeing a doctor who understands what I am going through. I ended up with another "deal with it"

    Good Luck, and keep trying =)
  • Hey guys thanks for the input.

    Well interestingly a friend of my family had seen this guy also (I didn't find this out til yesterday) and had the same bad experience and never went back.

    I do wonder sometimes if some of these doctors dismiss us because we are women. I am pretty certain they wouldn't pay such little heed to men complaining of chronic pain.

    Manalerie - I read some of your entries - boy did they strike a chord. Sometimes its like we are just bounced from person to person - the pm doctor wouldn't advise me on my meds as he said that was being prescribed by the neuro - well the main reason the neuro bounced me was so I could discuss my pain meds with a pain management specialist!! Aaaaaaaaargh! Have you had any luck finding anyone more specialised?

    Hagland - I shall keep my fingers crossed I find someone who helps as much as your one has.


  • I have seen many Drs and specialists that treat women differently. When I first started this chronic pain journey, I was very optomistic, thinking maybe there is someone out there that will help me with this. Here it is four years later, and besides having the greatest general dr in the world, I have yet to find a specialist that would give me the time of day. I dont mean to sound sexist here, but every single person I have seen has been male. When I go to visit these specialists or Drs, they dont even do an examination on me, simply told me Im too young to think about any treatments (Im 27) and to increase my anti-depressant medication. ~X( It is very trying to find someone that will take the time of day to listen to you, but it is VERY IMPORTANT that you find someone who does. The problem I have here where I live is there are no pain management clinics, only our general drs. I actually saw other drs and specialists before I even turned to my general dr, and am kicking myself in the butt now for not turning to her sooner. She has been the biggest blessing to me. She is taking control of my medications and going up to bat for me with this new surgeon, as well as trying to get me in to have a discogram in the next 2 weeks before I go to see this surgeon who is in a different town a couple hours away. She basically told this surgeon that unless he thinks he can do something for me, don't waste her time! :D She is absolutely wonderful! I wish it werent true that some drs out there werent bias and took both men and women seriously, but that is just not the case as many can probably attest to. But you need to find someone who will listen to you, and quick. I stuck with a Dr that told me to "deal with the pain" for awhile, and he never did one thing for me, not even physical therapy! He even suggested that I am just depressed and possibly going through some post-partum depression! =)) (My baby girl is 10 months old) Not that it might not even matter, but seriously, this chronic pain doesnt just happen with men. Good luck to you and I hope you find someone that will give you the answers you deserve. If you need anyone to talk to, PM me! Would love to chat! :H
  • I actually think PM docs are not as well trained in their specialty as other specialists. I may be wrong but I don't even think there is a board certification in this field. I don't know if they have developed their bad attitudes because they are constantly encountering people who are just using them to get drugs or because their patients so seldom get better but I am of the opinion that this group of docs really does have a generally poor bedside manner. On the other hand, I have found some who are really nice and caring and I do agree that you can't lump them all together (even though i just did.) I agree with the others who recommend you find a new doc. The last thing you need with all your pain problems is a PM dude with an attitude.
  • Actually, there have been multiple studies that have shown it IS gender-based and that doctors are more likely to attribute women's pain to psychological causes; are more likely to treat women's pain with psychotropic medications; and prescribe less potent pain medications at lower doses for women regardless of effectiveness compared to men. As a result, women are often forced to endure higher levels or pain for a longer period of time before receiving adequate treatment compared to men.

    I don't have links, but here are some excerpts from a printed copy of an article titled "The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain" published in the Journal of Law, Medicine, and Ethics:

    "Faherty and Grier studied the administration of pain medication after abdominal surgery and found that, controlling for patient weight, physicians prescribed less pain medication for women aged 55 or older than for men in the same age group, and that nurses gave less pain medication to women aged 25 to 54.55 Calderone found that male patients undergoing a coronary artery bypass graft received narcotics more often than female patients, although the female patients received sedative agents more often, suggesting that female patients were more often perceived as anxious rather than in pain. Another study, examining post-operative pain in children, found that significantly more codeine was given to boys than girls and that girls were more likely to be given acetaminophen."

    "The authors attributed the differences in treatment to the 'Yentl Syndrome,' i.e., women are more likely to be treated less aggressively in their initial encounters with the health-care system until they 'prove that they are as sick as male patients.' Once they are perceived to be as ill as similarly situated males, they are likely to be treated similarly.

    The 'Yentl Syndrome' hypothesis fits well with the results of a study by Weir and colleagues, which found that of chronic pain patients who were referred to a specialty pain clinic, men were more likely to have been referred by a general practitioner, and women, by a specialist. The results suggest that women experience disbelief or other obstacles at their initial encounters with health-care providers. An older study (1982) also found that of 188 patients treated at a pain clinic, the women were older and had experienced pain for a longer duration prior to being referred to the clinic than the men. In addition, the researchers found that women were given 'more minor tranquilizers, antidepressants, and non-opioid analgesics than men. Men received more opioids than did women.' These findings are consistent with those reported by Elderkin Thompson and Waitzkin, who reviewed evidence from the American Medical Association’s Task Force on Gender Disparities in Clinical Decision-Making. Physicians were found to consistently view women’s (but not men’s) symptom reports as caused by emotional factors, even in the presence of positive clinical tests."

    The irony of the whole thing is that because of gender and hormonal differences, women suffer from a wider range of illnesses that have the potential to result in chronic pain. :??

    From the International Association for the Study of Pain:

    "Age and sex specific prevalence patterns differ for different pain conditions. However, prevalence rates of most common chronic pain conditions are higher among women than among men. For example, in population based studies of adults, the female:male ratios for headache, neck, shoulder, knee and back pain average around 1.5:1; for orofacial pain conditions the ratios are about 2:1; for migraine headache the ratio is 2.5:1; and for fibromyalgia (a less prevalent but often disabling condition) the gender ratio is over 4:1."

    Just some fun facts from a past research project. :B

    And, stockbroker, in the United States there is board certification for pain management specialists. Personally, I wouldn't dream of seeing a pain management doctor that wasn't board certified.
  • I would not want to be a Pain Management Dr for all the tea in China. Can you imagine listening to all of us all day long?? :))( Just kidding. My first PM dr was a woman who was so uncaring. Just the way she treated me in the office, like I was wasting her time. I did some resesrch and fortunately we have many PM Dr in my area ( Phila suburbs) and I went out and interviewd Dr's all day long. I found the right one, or actually 2. I have one for all of my meds and one for proceedures. They are both FANTASTIC. They actually hug me on my way out. The one Dr actually holds my hand during visits and not in a creepy way, he is very sincere. I wish all of you could have the best Dr's and make the pain a little less.
  • And not for lack of trying. I just can't seem to find information anywhere. If I google Pain Management, all I come up with is sites trying to sell me meds.

    I ask my doctors for help referring, and have come up empty handed. I am actually considering looking into other nearby states. I live in Mass, and my insurance is out of Connecticut, so I think that's where I will look next.

    It seems a common theme on this site that women are treated differently than men.

    Bionic: I would really like to read more on what you posted... VERY INTERESTING!! I'd like to bring that into my doctors sometime. I am so tired of being told that I am depressed, I know that isn't the case!!!
  • Nicola, did you read my post about my first PM experience??? I swear it went the same exact way!!! He would ask me a question, then interrupt me with a new question while I was answering!
  • Bionic woman - that info was REALLY interesting. Its so good to see something I have long suspected evidenced. Thanks so much for posting it.

    Manalerie - yes I read your post - its amazing how similar our experiences were! Good luck in finding someone who can provide the specific help you need. The only good thing to come out of my experience was that I have been referred to a female "chronic pain physio". I have my first appt on thursday so we will see how that goes and if she is any more supportive.

    I am also going to try and find another PM - but there aren't that many here in london.it doesn't seem to be so much of a specialty over here.

  • I had the same rotten experience with my first PM doc. I was 39 when I first sought out a PM specialist, and he constantly made references to the fact that I was "getting older" and that I was stressed or depressed. I was lucky enough to have a friend who worked in health care admin, who knew a PM doc in a larger city about 50 miles away.

    I was so frustrated and in so much pain all the time, that I went to see him. That was 8 years ago and I'd go 100 miles to see him if I had to. He uses all modalities to treat pain (including meds) and does not treat me like a drug seeker or hysterical housewife. He has been a Godsend! He also happens to be board certified. So, I can attest to the fact that a board exists. My doc is a physiatrist, (not to be confused with psychiatrist) who specializes in physical medicine and rehabilitation. Unfortunately, so was the first jerk that I saw, so I can't say that one specialty is a better option than the other. But, from what I've read and heard this specialty is supposed to be one of the best choices for chronic pain patients.

    I know it can be hard for most of us to drive long distances, but my PM only requires that I go in every 3 months and I call for my scripts and have them mailed to me the other 2 months. My dear husband will take a day or a half day off to bring me to my appointments, so that part isn't an issue for me.

    I know several women, unfortunately, who have had to start bringing their husbands or signif. others to their appointments, in order to be taken seriously. As rediculous as that is, it really seems to be more the rule than the exception. The info posted by BionicWoman, while being informative, is shocking and sad. I truly hope to see the day when women will recieve the respect and be treated with the dignity that we deserve.

    Nicola, I wish you the best of luck in your search for a new doc. I know it is a process, but there are good ones out there. I'll keep my fingers crossed for you. Take care, Mitzi
  • My PM walks in, does a quick review of things, and asks me if I have questions. Of course I do! I ask him about the procedure and if it would hurt. He lied and said it might hurt a little bit. (I posted the story about that in the injections section of the boards) Then he's like any more questions. Yes. What happens IF this doesn't work? He tells me that I need to be optimistic and that my neuro says I'm not a surgical candidate (neuro told me that I'm too young). The PM then asked me if I wanted to be a surgical candidate. I said no but I need honest answers. Don't blow sunshine at me. I want to be optimistic but more so I need to be real. I'm 40, have 2 kids (5 and 3), work part-time, have a husband, take care of my own home, and am a Full Time college student that is trying to become an elementary school teacher.

    After my horrific injection experience, I called and spoke to a nurse the other day to find out that this doctor is pretty new out of school. Then she goes but that's good because he believes in different things. I'm starting to wonder if I'm on the job training. ~X( I get to go back on Wednesday and am praying that round 2 goes better than the first one.
  • well i saw the chronic pain physio and she was great. Couldnt have been MORE different from the PM doc. She isnt "hands on" like my rehab physio but more about getting me back to doing things I am afraid of or avoid and teaching me how to live my life in a more "normal" way bearing in mind my pain has given me a whole lot of psychological issues to deal with! She has written quite a lot of articles and books on living with chronic pain but is quite young and as a woman understands things that a man wouldnt even think of but are really relevant for me. Such a shame I couldnt have seen her first but I guess if I hadnt seen him I wouldnt have known about her.

    Interestingly I made a comment about the PM docs abrupt manner and she said "oh you arent the first person to comment on it" - which led to a more detailed conversation from which I got that a LOT of people felt that way. I have resolved to write a letter to him. It will help me feel better and if no one tells them they will always say "oh I didnt know anything was wrong" :^o
  • From my experiance there are 2 different kinds of pain docs out there.

    1.) The kind that want to do shots and other proceedures. these normally do not prescibe meds.

    2.) The other kind is the ones that handle pain through narcotics. They require a referal and clear cut documentation from other doctors stating you are pain management only.

    If you are looking for the second of the two start calling all the pm doctors listed for your insurance. Ask them what they do and what it takes to get an appt.This will save you alot of time and money.


  • N,
    However upsetting the truth is, nobody wants to hear it and it does not make it false because we would not rather hear it. No surgery is going to improve scar tissue as we all seek hope in the next current procedure.

    You are entitled to cry it is upsetting, should he have said come this way have has many operations as you fancy and we will see how it goes, many are in the mode of hope and prayers for a successful outcome and nobody has any guarantees.

    Some multiple surgeries do work but evidence here would suggest that the more invasive and continuing surgery a satisfactory outcome is always risky.

    My professor told me as you nothing could be done, would I have wanted him to say all will be Ok when he knew it would not, looking for that illusive miracle cure, based on the next intervention may give us some hope, but is it true or reality.

    I understanding this is not the information that you thought you would be getting and who could have envisaged it anyway, rather than integrating PM over the length of our journey in England it is used at the end, the last resort, and it is no wonder it is less successful. It is less invasive and as Sternbach said, requires us to become more accepting of our situation and “stoic”.

    You as me, may never know if just another operation may improve our quality of life and plight and I can live with that on the basis that it could be worse, some days I cannot walk and climbing stairs impossible, finding who and what I am from the new me is never easy and takes some mental strength, this is not just about me, all my family have been tainted by my condition and continue to live through my limitations, not simple for anyone. Time and waiting for some improvement takes some acceptance I had two epidurals it is invasive and does increase the pain, we sometimes expect instant results, which no procedure can supply.

    I had a four week residential PM assistance and it did help me to help myself.

    Take care. John. :W
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