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How do I talk to my doctor?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:36 AM in Lower Back Pain
When I first went to my doctor ( 6 months ago), the first thing she recomended is that I go to foot solutions and have an x-ray. So I went to foot solutions and had an x-ray. Then of course the pain still continued so I started to see the chiropractor there. That did help. But, of course, it did not solve the issue. Recently my family and I moved two hours away, leaving me to find a new doctor. I found one, scheduled an appointment, explained my history and told him I would like to get an MRI. He thought that was a good idea. So I did. Those results came back negative. After I got my results, I called the doctor's office wanting to know what the next step was for me to take and explained the meds that I was taking now Naproxen doesn't always cut it, and that my last doctor had proscribed me viccodine (sp?) to use on the days that the Naproxen didn't help. Immediatly, he cut me off in my tracks and said I will not proscribe that to you. Your results are normal. I explained that I am not asking for a narcotic, that I was just trying to let him know what my last doctor did. Again, he interupted and said "well I am not your last doctor." I explained to him that there are tons of different pain medicine that is non narcotic that he could perscribe to me. His words then were "If what your taking now isn't helping then neither will anything else. And if your in pain then you need to go to the er." Well first of all, my insurance sucks. I have a five thousand dollar deductible. My er copays are $100 a pop, plus what ever they charge is on me until my deductible is met. Not to mention, but they would run the exact same test and send me right home. Every test I have had I paid for out of pocket. Including a $1600.00 MRI. Of course the doctor new that wouldn't be an option for me. The end result was I just found a new doctor. Hopefully he will trust me. I just feel like because I am so young doctors don't take me seriously. They think that I am a "drug seeker" They don't seem to realize that I am willing to do anything they recomend. Finding a doctor that will trust a young person is tough. From the doctors point of view, I can see why he would be skeptical, but he didn't have to treat me with so much disrespect.
I go to my new doctor on Monday. I do want to do further treatment but in the mean time I would like something to help minimize the pain on bad days. I could care less if it is a narcotic perscribed or a non narcotic as long as it is something stronger then Naproxen that will help. But I am scared to bring this up to the doctor; I am worried he will label me the same way the previous doctor did. Not to mention, but he is going to ask me why I came to him. Should I be honest to him and tell him what happened with the other doctor or just tell him I wasn't pleased with my last doctor?



  • if you want a dr for the long term then honestly lay it all out. tell the truth just as you were so truthful with the last dr. eventually you will find dr who believes you need the relief you seek. you might also tell him you are aware that minor disc problems not seen on mri can cause major pain...honesty is the best policy....pete
  • Thank you so much. Your words are encourageing. My plans were to go in there monday and be honest with him. But I wasn't sure if that was the best way for me to do it. It is so nice to be able to have people that don't judge you to talk to and get advice from.
  • Even though doctors may get similar medical training, they can have their own opinions and thoughts about how to practice medicine. They can have different ideas about how to diagnose and treat conditions or diseases. Some doctors take a more conservative, or traditional, approach to treating their patients. Other doctors are more aggressive and use the newest tests and therapies.

    My doctor falls in the "complacent" catagory, by not answering any concerning tests or questions, failing to provide adequate treatment for my severe pain, rushing me out the door to collect his next paycheck, er, patient and it just feels like he kicked my case under the carpet.

    My advice to you is to say...you'd like a second opinion...from your new doctor. You should be honest with him/her about what your previous doctor found but I don't think slandering your previous doctor would help you when speaking to your new doctor. That's like bashing a collegue & if you can bash the previous doctor, he might think you MAY bash him someday too. Not that you would, it's just not advisable.

    Just be careful how you approch your new doctor & tell him you are willing to start fresh with a new set of eyes to get to the bottom of your problem.

    That's exactly what I intend to do myself, just hard to find one these days. Let alone a good one!!!

    Good luck & let us know how it went.
  • ... that is the polite way of describing whether your doctor is just a plain jerk to deal with. Some are on an ego trip and don't like questions. Down to earth ones realize you are trying to understand your own body and need their help.

    You want at least 2 opinions before you do anything beyond PT.
  • really are discriminated against when it comes to treatment of chronic pain. Don't give up on finding a doc that you will be able to build a relationship of mutual trust. Good luck and let us know how it goes on Monday.
  • I would have told that doctor "what is that you do, if you don't make your patients feel better?" What a jerk! I would tell your new doctor what you just explained to us. That you are in a lot of pain, here is what you are currently taking and it's not working, so where do you go from here? Just be honest, and open with him/her. Tell him that you are looking for something to help with the pain until you can treat and fix what is going on? I wouldn't ask for any particular med, just say that the Naproxen is just not enough relief. Good luck to you! I know the feeling being degraded by your docotr b/c they think you are too young to have this kind of pain.
  • I would have told that doctor "what is that you do, if you don't make your patients feel better?" What a jerk! I would tell your new doctor what you just explained to us. That you are in a lot of pain, here is what you are currently taking and it's not working, so where do you go from here? Just be honest, and open with him/her. Tell him that you are looking for something to help with the pain until you can treat and fix what is going on? I wouldn't ask for any particular med, just say that the Naproxen is just not enough relief. Good luck to you! I know the feeling being degraded by your docotr b/c they think you are too young to have this kind of pain.
  • I also agree you shouldn't give up because MRI's don't pick up everything and you may need additional testing. Ultram (tramadol) is a non narcotic pain reliever that may be an option for you if your doctor thinks it's appropriate. Let us know how your appt goes tomorrow; take care
  • Thank you guys for your advice. The last doctor was a jerk. Oh, and believe me, when the doc and I had that conversation I wanted to say much more than I did. But it probably wouldn't have helped.
  • AleyJ - you say you are young... How young are we talking? I'm young (relatively - I'm 46) and have back problems. PLUS they started almost 10 years ago. I'm a babe in the woods compared to some back pain sufferers here...

    What happened, in your opinion, to cause your back to hurt? Is it your upper, middle or lower back? Are your arms, hands, legs and/or feet affected? Is there weakness anywhere?

    Is it just the joints that hurt?

    Do you have a family history of back pain, or arthritis (rheumatoid, osteo, etc)?

    Naproxyn is an anti inflammatory medication. Does the current doc feel your problems are due to inflammation of some sort? If so, where?

    The other posters have good advice for you: be polite, tell this new guy you would like a new set of eyes to have a look see at you... this is what you are currently taking without much relief, and where do we go from here? Ask if physical therapy would help?

    Do you mind sharing exactly what your symptoms are and where you experience the pain?

    Even though the others have really given some really good advice, the more we know about you and your situation, the better we can assist.

  • Hello,

    First, I am sorry to hear that you are getting push-back for simply explaining what your previous doctor did for you regarding treatment. That seems odd to me because generally speaking it is when we DON'T share what our past physicians have done, that we are in trouble. And there you were, just being honest, and you were cut-off and judged (and make no mistake about it, you were judged) as a "seeker."

    My advice is based on nothing more than my own experiences. I recognize that each case is different so to the extent that I can, I'll share with you how I've approached doctors, what has worked and what has not.

    1. Be HONEST! I'm not suggesting that you were not, or that you aren't being honest now. I am however suggesting that the first time a doctor catches a person telling two stories, trust is VERY tough to recapture. Sounds like you (and I'm sure the majority, if not all, of the community) knows this and so I know I run the risk of stating the obvious. Still, I think it's worth pointing out.

    2. Suggesting medication can be a two edged sword. Sometimes suggesting what has worked in the past is helpful because it lets a physician (who is, in all likelihood just trying to move along with his/her day) make a decision in a more efficient manner. If you are allergic to something, or if something makes you pass out, it is a good idea to mention that. Sometimes, as you no doubt realize, narrowing down medications is tricky work. Saving the doctor time by sharing what typically works, is a good idea. On the other hand, it can (and here it appears that you found this out) backfire. Suggesting (or simply mentioning) Vicodin can raise red flags. It can (though I think this is often done unfairly) make a doctor think you are fishing for narcotics. I have adopted a method of simply stating the desired outcome. For example. If Ultram is working (and for me, it does) I simply stay with it. If it is not working and I need something else, I simply say something like: "I'm having a lot of breakthrough pain and the Ultram is not controlling my pain, is there something else we can try that is more effective?" This allows the physician the option of considering all possibilities without you having to go out on a limb and ask for a specific medication. In my experience (and here I've been with the same primary care doctor for over seven years) this seems to work very well.

    3. Remind, remind, remind. If I had been on the other end of the phone with your doctor, I would have had fun with the idea of going to the ER. I would have said, "Great, I'll tell the ER that you recommended that I come in." ERs HATE dealing with chronic pain patients. They are not designed for that and often want to call the patient's primary care doctor to verify and figure out what is going on. By letting the ER know that your PCP (primary care physician) suggested you see the ER, you put him/her in the bind, not yourself.

    4. Be willing. It sounds as if you already are, but always be willing to try something new as far as medications go, especially if you've not tried it in the past. I'm NOT suggesting here that you take something you KNOW will cause you issues, but often times patients are too quick to say, "No, that won't work," having never tried it. If you want to give your PCP reason to believe you are seeking, refusing to try medications that you've not yet tried is a GREAT way to accomplish that.

    5. Be aware. It's easy (especially when we are in pain) to blame doctors for not making us comfortable, and for being leery of Rx-ing narcotics. But doctors are in an impossible situation, and sometimes they don't do a good job of explaining that to us. They are regulated heavily, don't want to get the reputation of handing out Percocet like they were sour Skittles, and above all, don't want to see their patients addicted. I know that there are some jerk doctors out there who never Rx pain medication. And I know that there are some who dole them out in scripts of 5, with instructions to take one per day. But there are also some doctors out there who are trying really hard to walk that line, to make sure they are helping, but not at the expense of creating addicts. Showing that you understand that the doctor has pressures to deal with (just like you) is a good way to show the doctor that you understand (at least a little) and might make he/she feel better about short-term narcotic use. I am not suggesting that every doctor (or even most doctors) would agree with me here, only that my experience has been such that if I meet them halfway, he seems to do the same.

    6. Don't be afraid. If you doctor is being completely unreasonable, refusing to discuss with you different options (including the use of pain killers) you can, if you feel there is no other option, find a new doctor. Sometimes that is a good thing, and you can explain to your new doctor what happened, and why you are now requesting a different doctor. It also lets the doctor know that you care about your health and that you are paying for their services, not the other way around. It is tough to stand up to doctors sometimes, and tougher still to battle the stigmas that accompany back/neck pain. But you are the patient, and you do not have to put up with being treated poorly.

    I realize that none of this helps you right now. I am sorry you are in pain, and I am sorry too that the doctor you spoke with cut you off before hearing you--I mean, really listening to you. I hope that moving forward you are able to find a doctor that listens, and who, despite the difficulties inherent in Rx-ing pain medication, is willing to help you feel more comfortable.

    Best of luck.
  • Well i am glad to find people that really know how you feel when you're hurting. I had L5s1 spinal fusion on dec.23 last year and i am in worse shape than i was before the surgery, after 6 months of short term disability I was fired from my job,after 15 years!, but anyway my doctor has put me on Lyrica and Darvocet(lowest dose there is) I can feel the effect of the drugs,which isnt much but there is no pain relief, I want to make it clear to him that the medication is not working but i dont want him to think i am just pushing for stronger drugs, I went from percocet to hydrocodone to darvocet and lyrica. the percocet and hydrocodone really worked and as soon as he took me off those i went downhill from there. how should I let him know? I also have narrowing of the neural foramina bilaterally and degenerative discs at the mid level and lower level.
  • Hello,
    I am twenty-two years old. I have had lower back pain since I was a young teenager (only during my menstral cycle). I had my first child at sixteen years old and my second at twenty-one. I also had constant lower back pain during both pregnancies. However,it was not until after I had my second child that my back pain increased significantly.

    As for what caused my lower back pain, I really am not sure. Some guesses that I have is:

    1) When I was in labor with my first child (at age sixteen), I had an epidoral. And I still remember that experiance like it happened yesterday. When the anestegiolosist was giving me the epidoral I started jumping and having uncontrollable movements( almost like really bad twitches). The nurse yelled at me to hold still, but I couldn't, I had no control over my movements. I know this is normal, but I am wondering if maybe she hit some nerves when she gave this to me. I also read that whenever an epidoral is given without a camera, 30% of the time nerves are hit. I am not sure if that would cause me problems so many years later, but that is the first thing I can think of.

    2) I am 4'11" and I am about thirty pounds over-weight. Therefore, I am seeing a nutritionist this evening to have her come up with a diet plan. Maybe getting fit will help. However, I am not sure that being over-weight can cause constant lower back pain.

    3) I have been in a few car accidants, one of which was very bad. I was nineteen when I had this car accidant. However, from what I can remember, I did not have very bad back pain afterwords.

    4) When I was with my youngest daughters father ( we are split up now, he was physically abusive. He would throw me around like a dog wrestling a toy. Maybe he could have injured something than. I was fifteen when we began dating and eighteen years old when I left him. But once again, I do not remember having to much back trouble than.

    5) When I was twenty-one years old I had a 8lbs 6oz and 23" long baby. She was huge. So maybe being pregnant with a large baby pinched a nerve.

    My lower back, about one inch away from my spine on both sides, hurts and my sacrum area. My symptoms are:

    1) Of course, lower back pain. Sometimes it aches very badly from the entire lower back to around my waist on both sides. I also get a throbbing pain in my lower back that is about 1" away from spine on both sides. It feels like something is there to me. When I arch my back, it feels like something is there. While that bothers me on both sides the worst side is my left lower back. I hurst to bend over, to lay down, and even standing makes it worse.

    2) My sacrum area hurts as well. This part hurts on the left side. Again, it kinda feels like something is there when I arch my back. This is a throbbing pain as well and sometimes I get a light sharp throbbing pain there as well.

    3) Every once in a while when I have walked long periods of ttime, I have noticed my toes get tingly. This does not happen all the time, but it does happen.

    4) This has happend to me twice now recently. When I am driving in the car my right thigh (the front left hand side) gets a sharp throbbing pain. Almost like I am being shocked there.

    I have not experiance any weakness. So I am guessing that is a good sign, but who knows.

    Lastly, I am not sure if anyone in my family has had arthritus. My family is not very close, so unfortanately, I really do not get a chance to talk with any of them. However, I have had x-ray's on both my lower back, my sacrum, and my pelvis and they all came back normal. And recently, I had an MRI on my lower back. If I had arthritus, wouldn't it have shown up on those things?

    Thank you very much for your concern in what I am going through.
  • Hi Drew,

    I really appreciate all of your advice on everything. It is going to help me a lot in terms of approching my doctor.

    Your right. Being honest with your doctor is the only way to build a relationship with he/she. I have always believed in being honest with my doctor for the same reason as you; it is the only way to build a relationship. And While most of us are honest with our doctor's, I am sure there are those who are not honest. Maybe some people feel they can not be.

    As for as the meds go. I am always willing to try anything the doctor throse at me. I know you were not saying that I wasn't, but it is still very good advice. There are some people who are not willing to try new things.I know people who complain about what their doctor perscribes them because it isn't what they want. But, those people that I know, are also the people who really don't need what they are trying to get.

    Over the weekend my mother in-law came over and brought me a lidoderm patch. It did not help, but it just showed me that there were other options for me besides narcotics that the last doctor could have given me. I also heard that some people get cortizone shots in their back.I know it does not always help, but maybe it will for me.

    When I saw my new doctor on Monday, he seemed to take me a little more serious. How serious? I don't know yet. I did tell the doctor what I am currently taking is not helping and I asked if I could get a shot in my back for the pain. He said " I am not sure if anyone is going to want to do that." And he left it at that and so did I. I was to scared to ask "well what are my other options for pain medication?" However, he did have me get x-ray's on my pelvis and my sacrum. I had not been x-rayed there before. It has been three days now since I had the x-ray's completed. I called the doctors office and spoke with the receptionist. I asked for the results, to find out what the next step is, regardless if the results come back negative, and if they can give me a shot in the back for pain, becuase it is really bothering me. She put me on hold. When she picked up the phone again she said " Doctor Kohl is in a meeting right now. I spoke with his assistant and he said they are still deciding what they are going to do and that they will get back to me tomorrow evening."

    What the hell is that suppose to mean? I would assume that since I have not recieved a call from the doctor yet that my x-ray results came back normal. The receptionist did not even tell me whether they are normal or not. Meanwhile I am in pain. But, I guess I will find out everything tonight.

    I have thought about explaining to the doctor that I understand the pressure he is under when perscribing pain meds. But I thought it would make me look like a "drug seeker". Maybe it is a good idea that I express that to him. I would even be willing to got to his office once a week for a med check, so they can make sure I am taking them responsibly. I do not know if that is something they would be interested in doing? Do you think it is worth asking?

    I did not even think about handeling the ER situation like you would have. That is an awesome way to handle that. When he told me "if you are in that much pain than you need to go to the ER," I thought to myself; what the hell are they going to do for me? They are there to handle emergency situations. I am not an emergency situation. But I think if I am told that again I will do exactly what you said. That is just an awesome way to handle that.

    Thanks for your great advice on everything. Believe me when I say this,it really did help me.It gave me some doctor handling tools. It has really encouraged me to stand up for myself more. I always say to myslef, I am going to be straight up with my doctor and not let he/she walk all over me because I am young, but when I am in front of them I back down like a coward. After reading your techniques I think I can stand up for myself a little more. And, please, if you have any other advice for me, please give it to me. Every word counts.
  • I am sorry to hear that your pain got worse after the surgery and that you lost your job after fifteen years. That must be hard to cope with.I am sure it is hard to believe, but keep in mind that things will get better.I don't know I am the one to be giving you advice on how to talk to your doctor; I can't even talk to my own, but hopefully the advice I give you is good. Be honest with your doctor. Tell he/she that the meds you are on isn't helping and let your doc know what you were on before helped.

    I hope everything gets better for you!
  • Do you know that you can go to the place where you had your X-rays taken and get a copy of the report they sent to your doctor? You are entitled to it. You will have to sign a form, but that is for your protection. It is a good idea for a chronic pain pt. or anyone for that matter, to start a medical file with copies of any bloodwork, MRI's, X-rays, etc. Since you are young and in chronic pain, this may be valuable to you in future years.
  • Hi Aleyj, I don't have any suggestions but I just wanted to let you know that you're not alone. I'm 26 years old and I've been suffering from chronic pain due to 2 herniated discs for 10 years now. No doctor has ever taken me seriously until I tried some crappy pain meds and tried physical therapy. Now after doing all that, I finally found a surgeon willing to listen to me. I just had a discogram and am scheduled for surgery on November 3rd and they STILL won't give me anything stronger than Tramadol. It took me a long time to take care of this due to crappy insurance, having no insurance, having doctors that wouldn't help me at all (I had several tell me I'm too young to have back problems and refuse to treat me!). Hang in there. Someone will believe you eventually, just make sure you go through all the motions first. Good luck! You can also message me if you need to talk.
  • Jennifer ~ Most offices have a strict policy about who can comment on the results of testing. It is frustrating when we are eager to know test results, but that is standard policy.

    I hope the X-rays will show something that has not been visible before and that the new doctor will be able to provide some treatment for you.

    Please let us know about the results.

  • Hei Aleya!

    After you gave births did u have therapy exercises to build the pelvic floor muscles back up to speed? If not, that could be part
    of the problem. Pelvic floor is part of the core muscles that stabilize your spine. If they don't work like they should that can cause back pain as well...

    Maybe you should bring that up with your doctor and physio?
  • Thank you for giving me all of this advice. I went to my doctor on Monday and had two cortizone shots near my S1 joints (one on each side). When I went there my back was not bothering me much that day, and now a few days later, my back still is not bothering me. Hopefully this means that the shots have helped. I guess it will take a couple of weeks to know if it is the shot that is helping, or if I am going through my "feel good cycle." Time will tell.
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