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PM Doc no diagnosis

healthanglehhealthangle Posts: 7
edited 06/11/2012 - 8:43 AM in Chronic Pain
HELLO I AM SO FRUSTRATED about my pm doc he never talks to me first appt put me on 10mg methadone for pain and from ther one test after another had radiofrequency all kind of shots ,a discogram ,wanted to do idet but insurance wouldnt pay now he wants to put a spinal cord stimulator in me and i dont even know what my diagnosis is at this moment soooo.... frustrating i do not want a scs he said he would pre cert my insurance for the procedure and hasnt said anything else about that i told him i could not afford to be off work i am a state tested nursing assistant have been for 18 years i have low back pain constatly even with the methadone been 3 years i have been on that same med one time he came in and was like why are you on such strong pain med i was like yoou perscribed it and he handed me my script and left room. my hips and low back keep me from cleaning and family gets upset with me but they do not understand. and with the scs when i asked him that he said i would have no out of pocket expense what world is hee in and to top it off he was taking carte of my dad at 1 time in his 70s, dad had wen tto him for over a year one day he walked in to see my dad and asked himn if he had seen him before made my mom mad they went to get a sec opinion and 2 weeks after that he had a total hip replacement it was his hips causing the pain and he was giving him injections in the back at sergery center now i do wonder if he knows what is wrong with me or just sucking money from insurance company and me


  • First off, a hearty Welcome to the Site!! Use the box on the top and you will find a wealth of information that may be of help.

    As to your situation with your PM doctor. I don't know your insurance or its need or requirement for a referral or not? If I were in the same boat given what you posted, I think I would try to see if you can get with another PM. It could be a better fix, and you might get the answers you seek. As you know, doctors are like any of us in that they have their own personalities and likes and such. Please keep us posted on how it goes. Again, Welcome!!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • hi brenda thanks for replying he wasnt a new doctor i have been going to him for the last 3 plus years. what i meant to say earyler about the questions i asked him about the cost of the scs and he told me i would have no out of ppocket,to me that sounded crazy.. and i have blue cross blue shield. well anyway i just joined the forum and it feels like a great place for postive info ..wishing all pain free days
  • So what is it he is treating you for? How can he do all these treatments but you don't know why? My opinion, and it sounds like yours also, is this guy is a revolving door of billable treatment. The first time a doctor asked me why I'm taking a med he prescribed I'd be out the door for good.

    If you haven't already done so find a good orthopedist or neurologist to find out what is wrong. Then you can explore the proper treatment.
  • First let me say welcome to spine-health. Have a look around and check out the literature here as well. You may also want to check out the post in the SCS forum. As far as getting the diagnoses, do you have copies of your medical records. In order to get payment through the insurance company he would have to be turning in diagnoses codes. But if I were in your shoes and had no idea what a doctor was treating me for, I would be looking for a new doctor. But I would also get copies of all my medical records, which will help when seeing a new doctor.

    As far as the scs typically those are placed when there i no further surgery that is viable. But in your case sense we don't know the diagnoses it is kind of hard to comment anyway to help.

    Just thought I would stop by and welcome you to spine-health. Keep us posted. Take care.
  • i have been trying to my family doc had referred me to him. my fam doc said to wait and see if the scs goes thru insurance then tell him you are not want ing it and see what he does and my fam doc said he would find a new pm doc i think i am gonna do sum calling around how do i approach the situation with a new doc
  • I guess maybe I am a little confused. I do understand your having questions about the out of pocket for the SCS, but of all the medications and such, no diagnosis? That is why I would seek out another doctor. If I had a doctor give me something and not tell me what it is for, I guess that is where my confusion is?

    If you want to stay with him, then of course, that is your decision....but have you considered seeing either a Neurologist or Orthopedist who specialize in spine issues? Me? I would have a hard time letting someone cut on me to put in the SCS with no diagnosis given to me. Just my opinion, my thoughts. I hope it all works out for you. :-)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • approaching a new pm with all this he will think im crazy i need the pain relief and i have signed a new pain contract with him in jan. i am just niave about all this all i want is t6o be able to live without pain or kive with it comfortably . well one time he said i had buldge l5 and another time he had student with him he said ddd and now i just dont know what the heck to say cause he is in for like 2 min and gone doesnt even say goodby i feel so little when i leave his office but i have noone to confide in without hearing i told you so by my family
  • and i was at his office at the beginning of the month and i asked the pa that came and got me for appoinment she took me to the room i asked if i could look at my records whaile i waited and she said she was not allowed to let me look at them and walked out i get treated good from everybody ther except him (pm).
  • Since you said you have BlueCross BlueShield, you normally don't need a referral unless you have the HMO coverage (then a referral is needed). I would try and get a hold of all my medical records from your present doctor (by law they are yours if you want them!), and either get some suggestions from your GP, or look through the physician listing (or go on-line to BCBS) for Neurology/Orthopedist specializing in the spine.

    Bring all the records with you on that first appointment and see how it goes from there. From what you have described, you have had diagnostic testing done, and as such there should be reports from them, exam notes, films etc. I hope that helps.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • You are entitled to a copy of your medical records. You will have to pay a fee to get these records unless they are being forwarded to another Doctor. All you need to do is call his office and request to speak to someone in records and they'll be able to tell you how to proceed.

    As for seeing another Doctor, Brenda is not suggesting you go to another PM but rather make an appointment with a Neurosurgeon or an Orthopaedic Surgeon that specializes in the spine. Your family Doctor should be able to assist in identifying someone to see. Don't be scared by the term surgeon. Most of the time, these type of Doctors prefer to start conservative before pulling out the knife.

    You might be getting the best possible care already, but it can't hurt to have a second set of eyes check you out to provide some piece of mind. I highly recommend you take someone with you when you go to appointments to help ask questions.

  • i am thankful for all the replies and i no she was suggesting my looking at other options buti dont want to be left with nothing for pain cause if we go to sumone else wont they just term me from going to a diff pain mangment that is what i dont want to happen if a new pm doc would happen to call and ask for record what would happen then im sorry i have just started this pain journey a few yrs ago but am really upset cause he treats me like im nothing and i think i will take your advice and take my mom with me from now on thanks so much. god bless all that are in our situations

    discogram, radiofrequency, shots at surgery center 3 plus,shots at office in surgical room, mris bone scan
  • I think I understand your fear. He has you on certain drugs and you are afraid that if you go to another doctor they won't give you the same or enough. That alone scares me and should scare you. No reputable doctor will cut you off cold turkey, it's not ethical. If they feel you are taking too much or the wrong drugs they will help you make the necessary changes in a controlled medical environment.

    Sounds like you have had all the tests but don't have the right doctor to interpret them. Only an orthopedist or neurologist is qualified to look at all those reports and tell you what your options are.

    So you have an easy way to approach this. First you go to an ortho or neuro and still go to your PM. Most people see both regularly. Once you have some better info the new doc can refer you to a better PM. When you make the appointment give them the name of your GP and PM so they can get the records. You might need to stop in the office to sign some release records but your current doctors will have no problem releasing your records.

    PS you are right to question your current PM's motives. He is playing an insurance game. WHen he says you will have no out-of-pocket it means he is manipulating his fees to get you to do this. On most insurances doing this could get him kicked off their panel. But it keeps him working.

    Please find a reputable doctor. No one will leave you hurting and hopefully they will find an answer for you.
  • welcome to the site, i am new here to. you absolutely must put your foot down and find out what your condition is. i know your anguish i have been there. i was fiddled around with for 5 plus years with meds , treatments shots, and my fear was the same as yours. when i found myself on depression meds because of my quality of life and wishing i would die, i finaaly realized i was allowing this to continue by being a sheep and just following the instructions. i finally, in a firm but nice way collared my pm doc and held him hostage, lol in the exam room until i knew what is all was about. that is when he finally send me to a neurosurgeon for consult. the result of my sheepish ways was a firm addiction to narcotics,which i had to recover from AFTER i recovered from the surgery. do not let this situation spiral out of YOUR control. i am happy to say, there is light at the end of the tunnel. after the surgery and consequent detox, i have had a pain free life for the past 2 and a half years. recent developments changed the unfortunately, but that is another story. good luck and please its your body take control. john
  • Welcome to Spine-Health. You'll find a wealth of information on this site and as you already know, the members are supportive, knowledgeable and friendly.

    I have to second everyone else here - it's time to be your own advocate and find out what the heck is going on before you even consider an SCS. The SCS, like Tam said, is considered a very last resort for those that have usually been through surgery among many other treatments and continue to have pain regardless.

    Finding a fellowship-trained spine surgeon (ortho or neuro), but someone who only looks at spines, is what I would suggest. If there was a point where your doc wanted to do an IDET then he knows that there is some way out there to relieve your disc problem before trying an SCS. An IDET is not the only way to get relief from disc pain, not even close.

    Like John said, it's time to stand up for yourself, be strong, and Kris is right that you can continue with your present PM and seek more opinions for your pain and what treatments are available. Please don't just settle because it's easy - so many of us here have to search around to find the right surgeon or doctor and there should be no way you should have any treatment done until you know what's wrong! You should have a diagnosis in hand with options on the table, so get some more opinions from specialized surgeons who are very familiar with spine problems.

    Another important part of the equation is that you must have complete confidence in your spine doctor, surgeon and all the others that have something to do with diagnosing and treating your problems.

    Take care and keep us posted.
  • im glad i found this forum and all of you have been helpful, i am going to go in his office with a mindset of finding what is wrong with me. its just gettin harder everyday with the pain and looking normal but on the inside u no that u are not smiling i needed a few words of wisdom so thanks and hope all good luck in life and pain


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