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how to get along with pm

terror8396tterror8396 Posts: 1,832
edited 06/11/2012 - 8:51 AM in Chronic Pain
the years that i have been on this site, i think the main or major topic or tone are patients not getting along or not having a good relationship with their pain drs. it seems to be the main issue and the main incident with depression and pain. why does there seem to be so many posts about bad things with pm's. i don't know and maybe it is just the nature of the beast with this site, venting about bad things. the main problems with pms seem to be treating us like drug seekers, not enough meds to help, not believing us, talking down to us, etc etc. is there a magic panacea that can help? all i know is i will try to offer a few suggestions without sounding like a know it all. maybe these are a few reasons we feel negative

1. maybe tension with the patient when one is going to a new pm
2. feeling like i won't be believed
3. there is no proof with tests
4 , dr is a jerk with a know it all personality and comes accross as he knows it all and you know nothing.
5 signing a pain contract, having blood test and counting meds
6.bad relationships in the past with pm's

these seem to be the main issues or reasons with patients with pain drs. i am
sure there are a lot i missed.

well how do we solve these problems or issues?
i can only offer a few suggestions that have helped me i am not trying to come across as a know it all and i am perfect, but this is what i do and have done with pm's

1. go in to the office with a smile for all, receptionist, nurse, dr all people
2.not telling my life story and my relationship with pain. i have come across with patients sitting in the office telling each other horror stories and asking what meds they are on. remember the front desk can hear this and it can get back to the dr.
3 not complaining if dr is late. i know most pms are chronically late and mine has been up to 1 and 1/2 hours. i just sit and smile
4.smilling and shaking the hand of dr even if he is 8 hours late
5. when he asks what is the problem and why are you here, don't come over as a whinner or complainer. be brief. yes you are in pain but dr hears stories like this all day.
6. remember you are not the only one in pain there are others out there so don't keep the dr busy and away from other patients. even if we feel it, we are not the center of the universe
7. when he examines you, don't be dramatic and a drama queen or king. drs use this as a tool because most things they do don't cause extreem pain. if it starts to tell him or her and stop what you are doing
8 don't say only narcotics help me and i can't take naisd's-major red flag
9 don't say meds i am on don't work and i need something stronger. if they don't then phrase it in a way that won't make dr feel like you are there for meds only.
10 treat him like a partner not an adversary. always be pleasant and nice.
11. listen to him and his advice and don't interrupt and say that won't work, i have tried it.
12 if he has rules, don't complain, say yes i will follow and do sign the contract, it won't kill you.
13. always be on time and never ever miss appointments even if he gave you a script for meds, oh boy i got my narcotics, now i won't have to see him
14. if he wants to do a procedure, do it, steroid injection, discography etc even if you know it will be painful
15. when over, say thanks, smile thank him and be pleasant.
16. if he says something that really pisses you off like giving you less meds or strengths etc, don't be angry say i will try and make an appt in a couple of weeks to let him know if it helps or not

these are not things that will always help, but i try to do these. i always try to be agreeable and nice and not argumentative. shake his hand thank him and when you leave thank the staff also. you will be surprised how their input is valued by the dr. remember these are just suggestions and not an i know it all attitude. i try to do these and like i have said, for the most part, i have had excellent relationships with my pm's
just ideas to throw out there. try and see if they help, if not so be it, it seems to work for me.
I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.


  • dilaurodilauro ConnecticutPosts: 9,842
    There is no question you have been around a long time and know so much about Pain Management doctors and the various Medications we need to continue enjoying a fine quality of life and being productive.

    And yes, there have been times when you have been accused of being too blunt, telling people what they should be doing, etc. Much of that I know comes from the experiences you have and also how you would like to see people avoid some common pitfalls.

    I read your points on why there is a lot of negativity when we mentioned the word Pain Management doctor. So much if that is very true.

    I like your points on how to best get along with your PM.

    The only thing I can add...

    Dealing with a Pain management and/or Physiatrist for a long time requires a mutual level of Trust and Confidence.
    Just as it is in life, Trust and Confidence isnt something that you buy, its something that you have to earn.

    No different with these doctors. What sometimes separates us is the fear many people have of doctors.
    They are different then us, they have gone to many years of schooling, worked many long around the clock shifts and for many have given up their 20 to 35 year old time frame.

    But, we, are also important. Jon as a teacher, he could out teach any doctor in his subject areas, I am a computer specialist and wine guru. I could talk circles around any doctor in those areas. And I am sure that can continue for almost all of us.

    Trust and Confidence. It doesnt happen over night and you have to work at it. Also, its not a one way street. You could be doing everything right, but the person on the other end is not receiving or listening. Thats when there could be problems.

    Honesty.. You will never go wrong by telling the truth!
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Honesty and respect. Honesty you can give and give but may never get back, the same can be said for respect. Also, like Ron said, this is a two way street and the patient (at least in my case) would want to be shown the respect that I give and deserve.

    Jon, as a teacher you might be getting respect right out of the box so to speak. My Dr(s) don't know (at first) that who I am now is not all I am or all I ever was. In our society I'm afraid, it seems as though many people value folks by how much money they make, what type of insurance they have, house they live in, etc., and many people have to break these barriers before they can even begin to earn a Drs trust.

    I am a 'real' person regardless of who I am talking to, be it my Dr., or a clerk at the grocery store, and to pretend to be something else for any reason makes me feel as though I am compromising my principles/values. Fortunately for me, I have Dr(s) who took the time to get to know *me* and I don't have to smile if I don't feel like it, and can just relax and be myself. The Dr may have a lot of patients, but I don't have a lot of Drs, so I do expect my Dr to listen to me when I go to see him, because my problems and me deserve the time to be treated.
  • dilaurodilauro ConnecticutPosts: 9,842
    I remember about two years ago when I was having a follow up with my physiatrist and I told her:

    You are not just a doctor, you are a person. That allows us to discuss things and develop action plans based on that same plane.

    She told me that, that was one of the biggest compliments she ever has received.

    I am a very lucky patient
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Very nice post and helpful as well. I also have noticed how difficult it is for some patients to build a good relationship with their PM, whether it's a true PM or their surgeon who is still managing their pain, and you've made some great points. It's a difficult thing dealing with doctors sometimes and it's not always because of the patient and how they talk to them. Sometimes it truly is just a bad doc and a change needs to be made, but with a good doc, your points are well taken.

    Ron has also made a good addition and for me, I believe it has mostly come down to trust and honesty. I remember before my lumbar surgery when we were still just dealing with my post ACDF pain, I was talking with my surgeon's PA about various things. She was always willing to listen to every question, answered best she could and never doubted my complaints or questioned my feelings (actually, all the PAs and my surgeon were that way).

    At the end of the meeting, I said "Now I'd like to talk about meds." I could see her visibly slump, almost rolling her eyes, and say, "Ok, what do you want to talk about?" I asked to change my meds to remove some of the APAP because I was having some severe stomach pains and believed it was coming from the APAP. She perked right up and pulled out her little med book and suggested an alternative. I said that was great and that I appreciated it very much. When I left, we were both happy - her having not to deal with my wanting something stronger and me not having any more stomach problems.

    The key was asking to change my meds for a specific reason, not because I thought something else would work better. I had a specific problem with my meds and asked her to find a solution. She said that actually, the med with more APAP was better for pain relief, but understood my problem with the stomach aches, so was willing to change. It has ended up helping tremendously.

    So again, thanks for your post. It's got to be a give and take between doctor and patient and honesty and trust are definitely the key. Once you build that relationship, you should be able to get the pain relief that is needed.

  • cath you are correct, change in meds should be for a reason not because something else would work better. he tried to put me on morphine or dialudid but i told him they give me nightmares and i can't take them. if i said morphine is better, he would have rolled his eyes and probably put me on aspirin. i have never asked for a specific med. my dr prescribed them. in fact he started me out on methadone but put me on oxy and fenatyl when he saw the mri and discography results, he had a valid point of reference to change my meds, he could see how screwed up my discs were. when he downed my dose of oxy, i just kept my mouth shut and tried it out. now i take 4 a day and not 5. no problem. in fact i tried to down my dose of lollipops due to expenses. no problem
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Good thread. Everyone here has made valid issues. When I first arrived at spine-health, I was having issues dealing with a doctor and questioning wether or not he heard me. I didn't look at the doctor as the source of the problem I looked at me as maybe I wasn't communicating my issues clearly. There never was really a problem it was my perceived problem cause I was having so much pain. Anyway I can add one thing now that I am with a physiatrist on a permanent basis. Every month I have to see him for the meds I take. So every month I take my day scheduler with me to the appointment. On my way checking out, I make the next months appointment. There is never a question about the appointment, as if they try and schedule longer than 30 days out I say no we have to be inside of 30 days. I am right there and there is no room for that mis understanding.

    I might also add on the medication fronts I have never asked to up my narcotics, muscle relaxer or adding a anti-inflammatory in, I have asked for those. But when the pain got out of control he suggested the med. Typically he will suggest some meds let me go home and research them and the risk of them and then the next month if I want to try them. My last visit he suggested we move to fentanyl and due to the level of pain I was in, I said okay lets do it. I wasn't asking for more meds, but it was clear I wasn't doing well on what I had either. But that relationship has been built up over the years and it didn't happen over night. I have to actually say the physiatrist I have I have been blessed, as I read so many stories on here. Honestly I never have a need to call him half way through the month but surely am prepared when I see him once a month.
  • I've only had one contact with the PM doc thus far & it went quite well. He's knowledgeable & compassionate. He certainly understood my condition & explained it better than my GP had.

    I read alot of postings here about what to say to PM docs so they will understand us. What is interesting is that the posters will explain their situation to us quite well.

    I wonder sometimes if it would be helpful to print out your posts from here & use that as your outline when you see the PM doc.

    Many posts are fact based & well written. I know it's easy to forget things under the stress of a doctor's visit. Maybe your own words are your best resource!
  • if it is legal and not an issue with spinal health, feel free to print it out if you want to. glad to be of help
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • jlrfryejjlrfrye ohioPosts: 1,110
    BUT like I have said in previous post I have a good relationship with my doctor and have always been honest. That hurt me on my last visit. My new meds were not working and I told her so. This is the first time she has ever been rude with me. I have a appointment with her again in 2 weeks and I plan on asking if I said something or did something that upset her. It has had me upset all weekend how my appointment went. She did change the mgs on my meds and now they work wonderful. I have to drop off my old prescription (unused meds) today after work and I am hoping I can get a chance to talk to her. Maybe she had a bad day and I am hoping that is what it was because this is one relationship I dont want to damage. I have always been compliant, passed all my drug screens and have done all procedures they have requested. The appointment like I said has me upset and instead of hoping the issue will go away I plan on speaking to my doc about it.
  • I think respect goes both ways. I was to the point that I WAS most definitely considering biting the bullet because I couldn’t stand it anymore. I had talked, pleaded, discussed and begged my doctor for months to switch up my meds. Her comments were constantly “well I’m sure it would be nice to be out of pain all the time”. NO, but it would be nice to keep it between a 2 and 4 level which is manageable. I finally went in pissed off! I told her about all the things I must do in a day, which includes working 9 hours a day, being here at 6:30 in the morning and how GD hard it was for me to do it. I also told her that I was ready to bite the bullet because I could not stand one more GD day of this 2 hour wait between doses of pain meds because they did NOT last the 6 hours that she thought they should. She finally gave me one every 4 hours instead of 6 and it is finally decent for the most part. I still deal with joint pain that is a burning painful mess when it is cold, but I can deal with that. The nerve pain however was a totally different ballgame. My doctor did not want to talk about it, she didn’t want to hear about it, and she didn’t really care. Until I blew a gasket, she never really listened. I am not normally like that but I was just fed up with the whole thing. How would a 29 year old chick that feels great have any concept of what I feel like? I do believe there are some doctors who really do care and do try to do what is best. I also believe there are many more who are all about the money. As long as my insurance is paying her 200 bucks a pop for a visit each month and almost 1,000 every 3 months for a ridiculous unnecessary urine test – that is ALL they care about. The almighty buck. You won’t ever change my mind about that. I’m sure there are a few that actually “care” but they are few and far between. I see it where I work. We are public servants, sworn to take care of the public in the best possible way. You know how many people actually give a rats a$$ about assisting people, or doing the right thing? In my group there are about 2. The rest don’t do their jobs, don’t care if Jim Smith is getting screwed over royally because they aren’t going to do their job and correct the situation. That’s life… It ain’t like it used to be when people worked off ethics, principals, actually cared about doing the right thing and each other. I’m not jaded, I’ve lived it my entire life – people just don’t really care and it is all about the money…
  • =)) =)) Dont hold nothin back. Love it.
  • I went to a PM for two years. I never asked for pain meds. I endured every injection you can possibly think of including botox into my upper back trying to deaden a nerve that was damaged due to my own stuborness and not getting surgery for two years after I was told it was needed. Only after 18 month did he perscribe pain medicine and it was such a light dose it did no good. I did not sign a contract or have a urinalysis but would of gladly done so to get relief.
    About the same time I developed a yet to be identified form of inflammatory arthritis that has required 5 knee surgeries in the span of 18 months. Before each surgery I reported to the PM that I was having surgery, all logged in my medical record. Just before I had my partial knee replacement my PM came in with a print out of all the narcotics I had been perscribed following surgery and accused me of commiting a felony. I was stunned, shocked and couldn't hardly speak. I told him that all the perscriptions were in conjunction with surgeries that I had reported to him. He then went on and did his usual examination and when he got to my right knee he said "damn that's hot and swollen" I wanted to say "no xxxx sherlock" but didn't say anything.
    He then said I needed to sign a contract which I did. I then said what am I supposed to do when I have the knee replacement and he said, "the surgeon takes care of pain management following surgery, all you have to do is let us know." I was dumbstruck.
    Then I got mad and wrote a very professional letter thanking him for his efforts in trying to solve my pain problems but seeing that I had no relief in the previous 2 years I was cancelling the PM contract.
    My primary care physican got a copy of the letter and has agreed to take over my pain management once I am no longer under the care of the surgeon.
    I had done everything you have in your suggestion list. Some doctors are not professionals, just because they have a little schooling doesn't make them any better than anyone else. I truly believe there will come a time when karma will bite him in the butt and he will see what it's like to live in pain with no relief.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • That is exactly my experiences in a nutshell. It is truly unbelievable the level of NONexpertise and uncaring in this field of medicine. However, working for the fed, I see it all the time. Makes me laugh to myself when people are so excited about this new healthcare system that is supposedly going to happen. People like my boss will be in charge of your healthcare and if you think it's bad now, you ain't seen nothing yet baby! I would stake my life on that. Gov in charge of healthcare is not going to be good for anyone...
  • I served 20+ years in the service and have Tricare. The reason I stuck with the idiot PM is that he was the only one who would take tricare. When I was first referred to a physiatrist I had to travel 95 miles to a small city. I live in Memphis which has numerous hospitals and Drs but they don't want to take government insurance.
    I still work 40+ hours a week and have the option ofpurchasing a different insurance but was promised when I joined that I would have lifetime healthcare. When the government takes over everyone will have lifetime healthcare, they just aren't telling you your life will be over sooner.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • Well Mouse and DAvrunner I can assure there are caring doctors out there. As I said before I truly feel blessed, with my doctors. But for anyone new reading this thread as Jon stated never ever turn down a procedure or say a med doesn't work. If you have tried a med and had a bad side effect be sure to make them aware of the fact and the exact reaction you had. It also helps to add in whom prescribed and when it was prescribed.

    Mouse sounds like you and your pm are becoming buddies now, JK, couldn't resist.
  • personally and this is my own opinion, i don't think pain drs are in if for the money. they get more hassles and grief than any other type of dr. first of all most are anathesiologist and they have one the highest insurance rates of any dr due to they are sued a lot. i think baby drs are up there but i could be wrong. and please you don't have to research the facts, spare me. they have to deal with the dea, demanding patients, patients who lie to get meds, they also have to deal with workman comp issues etc and etc. i know other drs do also but they don't get more or less with respect to dollars. most make money through proceedures done. my dr is always telling me horror stories with the dea and patients. i would rather be a family dr any time.remember my own opinion so those who like to flame don't. if you disagree fine then do it in a respectful way. for those who have had bad relationships with pain drs, maybe it is ones attitude that causes the friction. like i said, in my opinion, going in pissed off does not help anyone. if you don't like him, then change doctors. why go in angry. the dr will get defensive also and no one wins. that's why go in with a smile say thanks, then get out and find a new dr.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • But, my doc is the only gig in town and I'm not driving 100 miles every month one way to see a new one that may or may not be any better. I have too much going on outside of working 9 hours a day. I have a farm of rescue animals to care for and a son.
    By the way - I never went in being anything but nice until I got a gutfull. I never treat people like crap unless they give me a pretty good reason too.
  • I am also on TriCare after a successful military career and so is my husband. Both of us have had excellent results getting referrals.

    I did experience first hand a pain clinic that was really not in it for the patient and when I asked my PCP for another referral he had no problem putting it in. TriCare initially denied it saying the first clinic was capable of handling everything in the referral. The local TriCare manager suggested the PCP submit the new referral as a request for a second opinion. It was approved the next day and I have since been going to a fantastic pain clinic. I do have to drive about 80 miles one way, but it is worth it.

    My husband had to be referred to a vascular surgeon and a cardiologist. He is seen locally and both docs are fantastic.

    So TriCare albeit not perfect, can and does have good results. I found that a little persistence and patience can go a long way towards decent to spectacular health care.

    Jon, I agree with much of what you are saying. Basically I feel it boils down to me taking a responsible role in my own health care and pain management. Also what I was taught as a youngster, "treat others as you would have them treat you".

  • i think some patients go in with an attitude whether from past experiences or just out of nervousness. I still am a believer that the majority of pm's are professional and nice and caring and if they are not, there must be something that is said or done that might make them that way. even if i got the brush off and a crappy feeling, i still smile and say thanks then politely leave and get another one. why get pissy when the dr gets that way. it does not help and sometimes word will get around about i saw so and so and they were a real jerk. if they come in watch out and try to get them to leave and the same goes for drs who feel they are dealing with drug seekers. word will and has gotten around about patients, pm is a small market and the drs know each other well. by the way i used to drive from san jose ca to lake tahoe to see my old pain dr, 250 miles. so sometimes one has to sacrifice to get good treatment.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Would make an intersting book. I'm not driving 100 miles, let alone 250. I have a life and a busy one at that.
  • I think I'm safe from them "talking" about me. I just deal with that at work...
  • There was never a time when I wasn't professional. I always dressed for my appointments like I dress for work as an executive. I always talked to the nurses and never complained about waiting either in the Operating Room for an hour waiting for a very painful nerve block or waiting in the exam room for 2 hours. When my Dr accused me of committing a felony I was shocked which was probably good as it prevented me from saying what I normally would have.
    I wrote and rewrote the letter I sent the Dr at least 10 times to make sure it was professional. It was the letter that made my primary care physician take over my pain management. It is amazing that when other Drs saw my records from the pain management clinic they were apalled at how I was treated. Thank goodness my primary care physician cares about his patients.
    I agree that you have to work Tricare to get what you need and be your own advocate. I had/have a recurring tumor in my knee and even drove to Vanderbilt to see the head of ortho oncology they worked the paperwork for me and got Tricare to cover. It shouldn't be this difficult to get the help that you need.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • not to be rendundant, but one never hears of horror stories on this site with dentist, gynocologists, onocologists, neurologists, proctologists, etc. It seems to only be with pain drs. One has pain with a dentist or a kidney dr who treats stones, etc but it seems only with pain drs that people have issues. most drs treat pain to some degree and they give out pain meds when necessary, but like i said only pain drs do we have problems with. i don't hear i went to my kidney dr and he treated me like crap when i had a stone, and he thought it was not too bad when i had an cat scan or i had a bad ingrown toe and my foot dr was a jerk because he did not believe me.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • "one never hears of horror stories on this site with dentist, gynocologists, onocologists, neurologists, proctologists, etc."

    I beg to differ. I had a humongous fight with a Neurologist and so posted it on this site. I damn near kicked the jerks backside! He has since been removed from "my" real Neurologist's practice. :) Jerks come from every profession. It isn't a PM only quality.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • You don't really hear about the other doctors as this is a spine web site. I mean I didn't post about a dentist who tried to do a root canal through a infection. Or a when I recently had my gall bladder removed and they refused my normal meds and how I almost went from my room in the hospital down to the ER. Trust me you don't send someone fresh out of surgery to fin for themselves in every sense from ice to food, or threaten them with security if they use their meds. But the point is you don't hear those stories as this is a spine web site. But I have lots to say about dentist, but feel blessed with my pm doctor without a doubt. Getting that kind of care made me feel even more blessed just how good he is along with my spine surgeon. I do see plenty of stories on this web site about doctors that care for spine patients in all disciplines. I have read countless stories from members saying their surgeon did surgery then acted like they didn't exist once surgery was over. Those still left in pain for the most part get dumped then at pain management. But in defense of the pm doctors they get the tail end of the problem and then have to figure out what to do to make the person feel better, in lots of cases. When as my pm said to me, he likes patients prior to surgery to keep them out of surgery.
  • Jon, I am being respectful here, but in all honesty I am confused. Nobody here is really complaining about their PMDrs., but discussing instances maybe when things were not always perfect. Just because things are not perfect, or perhaps a person had an issue with their Dr (at one time), does not mean that people are not getting along with their Dr(s). In all relationships there might be a misunderstanding, and no person should ever be completely 100% subserviant where their pain Dr (or anyone for that matter) is concerned simply because you might be seen as a seeker for not going along with every thing a Dr suggests. A professional would discuss the care he wishes to provide and ask your thoughts, not expect you to not have a mind of your own. We do have a say in our own care.

    You say that most PMDrs are professional, and I am not trying to be arguementative at all here, but I do not think that your Dr is very professional at all if he is talking to you about other patients and the DEA whenever you are there as a patient, paying for a service. I read this over and over in your posts where your Dr is concerned, and I suppose if your time with the Dr is well spent discussing those issues then that is fine for you. I go to see my Dr and want him to discuss me and my care. I'm sorry if the DEA and other patients are troubling him, but it's not my job to listen to his problems and I would feel disrepected, not trusted more, as a result of that kind of communication.

    I think the reason a lot of people post about the PM part of their care is because this is a Spine site where a lot of people are in pain, and that pain is often undermedicated. People who are happy with their PMDrs (for the record I am) might not know or understand what it is like to be UNhappy with one, but if you really listen to the stories and try to put yourself in their shoes (go without meds for instance), you might start to see things from anothers perspective. Another perspective.
  • I agree with what tamtam and Robin said.
    I went to 4 different back specialist before I had a lamenectomy mainly because they couldn't explain to me fully why I needed surgery, they couldn't pinpoint the problem. The surgeon who did the surgery took the time to investigate where the problem came from, it took a myleogram and a ct with contrast to find the pinched nerve root. He did though dump me to pain management when the pain didn't go away after surgery. He did explain before the surgery his primary reason for recommending surgery wasn't the pain I was in but to prevent further nerve damage. That to me is a professional who explained everything.
    The PM through his hands up on more then one occasion as I was one that didn't respond to the normal "tricks in his bag." Since I have lived with varying degrees of chronic pain for over 7 years I stayed with the same PM until it became obvious he wasn't going to be able to help and when he treated me with disrespect that's when I finally had enough.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • what is the problem with talking about patients? He does not use names, only incidences that have to do with a topic. If he does not use names then why is it not professional. If he is trying to make a point, why can't he use a story that has happened when i don't know who it is or i will never meet them. If it is a point to get across and he needs to use an ancendote then i have no problem at all. in fact if he used an incident about me but not mentioned my name i still would not have a problem especially if he is trying to help someone. I disagree that pm's are bad. in part the patient's attitude is why they might be disagreeable. it is not a one way street. even if this is a pain back site, i have read others dissing other doctors who are not pm's. imho, 95% of pain drs are compassionate, caring, friendly and not the other way some of th epeople here catagorize them. like i said before, it is a 2 way street. most drs are in it because they want to help and cure. same with teachers. most teachers are in the profession obviously not for the money but they want to help kids learn and be successful in life. this really goes true with special ed teachers, which i am. i deal with kids who have learning disabilities and i try to help them graduate and go on to college. same with doctors, they want to help, not be jerks
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I think this thread was started with good intentions to help members whom maybe having issues getting along with a pm dr. To give them some insight on things that might help in dealing with the dr. Of course not everyone is going to be able to fix a relationship. Just as in life not every relationship is fixable. But I think the idea was to help members who might be starting with a pm, or are having issues with the pm doctor they are seeing. For the most part those of us posting in this thread have no issue, or the issue has been fixed. But I think it serves as a good guideline to help members understand using a pm doctor. Many members whom are new to the whole pm idea are confused about the what it is at a pm office. Everyone would have to agree for the most part the situation is different than any other medical professional you are going to see. Just given the ideas like DEA, pain contracts, pill counts and so on. Most patients don't go to their primary doctors and say they are on cholestrol meds and the doctor says bring your bottle in I want to count the pills? Or you need to sign a contract with me before I will give you these statins. Or same goes for a diabetic. Even if one see's a surgeon and they give you pain meds to get you through surgery, you still don't go through all of that. So the relationship of pm doctor is just different. Some think they are going to a doctor to make them better, still. Not a maintenance program to maintain them at a specific level.

    So I think this thread started off great teaching members how and what to expect at a pm office, but we(including myself), have gotten off track. All of us experienced pain management patients have a lot to teach those who just beginning this journey. Everyone may have a little different approach but it doesn't make one person right and the other one wrong. The whole objective is to get the pain under control, so you can lead the most productive life as possible.
  • That is so true tamtam, and I do not wish to take the thread off topic. I agree completely with what you said, however I sometimes get concerned when teaching a person how to talk to their PMDr.

    I think it is a process and going in knowing too much too soon might not be helpful in the long run. When we go get our drivers license, the teacher is watching us closely and can often tell if we have been driving longer than we should have been-if you know what I mean. The same can be said for these PMDrs who are listening to us, and what we learn or know should come from our own experiences, not something learned or taught to us to make it easier to obtain medication.

    It is a subject near to my heart. I am passionate about it and especially when a person takes something said out of context, or completely changes my, or someones words. I read nowhere that PMs are all bad, but then I come back and see that this is said; " I disagree that pm's are bad. in part the patient's attitude is why they might be disagreeable." In fact, there are both good and bad people in all walks of life, Drs (PMDrs too) are no exception to this. So whenever I hear a person come in who has been treated poorly and it happens to have been by a PMDr, I am not going to automatically think that this person is not worth listening to because they are talking about a PMDr,..and there is no such thing as a bad PMDr..because that is ludicrous.

    It is a good thread that jon started, but by his rational, any person complaining about their PMDr must be disagreeable, because he disagrees that there are bad PMs??? This is the exact mentality that has the patient feeling helpless in this DR/Patient relationship, and I am so thankful that I get along with my Dr(s) and that my PMDr does not have this mindset.
    It was hard for me to imagine because I have always been treated for my pain, and until I actually learned it I don't know if I would really understand, but there are actually people out there, in even more pain than me, who are suffering because they cannot find a good pain management Dr.They are not disagreeable, bad, or mean people, but they are hurting people who just have not been as fortunate as some of us. I use to feel bad that I had to go through so much pain in this life day after day, now I am so grateful that at least I can manage the pain I have. So many people don't even have that. It breaks my heart if I think about it for long.

    Of course there are people who are disagreeable, but those people can be anyone, Pain Drs are no exception.
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