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Need pain management advice

I dont know if this is the right forum for this, but here goes,I missed an appointment with my orthopaedic dr, because he rescheduled me and I couldnt make the appointment the next week, that he gave me. Needless to say the first appointment was scheduled three months before I left his office, so he wont refill my pain meds. So, I have a few questions, Should I change doctors, because this isnt the first time he has done this to me, sometimes he is great and sometimes he is a jerk? My PM doctor doesnt prescribe pain meds. And also, without pain meds, how do you sleep with the pain? I have slept maybe 12 hours out of the past four days. I've tried ice, heat, rest. I'm at a loss on what to do. I take trazadone to help me sleep and its not helping.
The orthopeadic dr's nurse told me that my pain management doctor doesnt prescribe pain meds, but maybe they lied. I told them I didnt want to do anything that would be considered doctor shopping since my pain med is a schedule II drug. I just know I cant handle many more nights with just motrin for pain. It hasnt helped in the 4 years I've been dealing with this. I have OA in my knees and back and neck, chrondomalachia in my knees, a bakers cyst in my knee, and sciatica and a herniated L4/L5 and L5/S1. I think the problem is that they think I'm too young to have these problems. I had atroscopy on my knee three years ago and its been swollen and inflammed since the surgery. The orthopaedeic surgeon doesnt understand why. I just wanted to know if anyone had any suggestion, because I have no more ideas.AS I said before he is great sometimes and sometimes he is a jerk. One time, I went for an appointment and he told me that if I lost weight I'd feel better, needless to say this man is about 4 inches shorter than me and a good 100 pounds heavier, but I didn't say anything), and one time I went and I asked if he could change my meds or up the dosage or something, because I'm on the lowest dose you can get and he told me if changed the medicine or the dosage that I run the risk of becoming a pill head. Mind you, I'm the mother of 3 kids under 8, and try to run a home daycare as well. I don't have time to be a pill head. My family says I need to just change doctors but I don't want to be labeled as a pill head or doctor shopper.


  • It isn't surprising that the ortho doctor won't refill your pain medications because you missed the appointment. In most all of the surgeon's or PM doctors offices these days, the patient must be seen on a regular basis, meaning monthly in many cases before a refill of pain medications will be given. Missing an appointment means no pain meds and can also result in dismissal if you miss too many appointments.
    If the PM doctor doesn't prescribe your pain medications, is he/she offering you other treatments for your pain? Many interventional PM doctors just do injections or therapies directed at reducing pain but won't write prescriptions for pain medications.
    As for whether or not you should change doctors, that is totally dependent upon what you feel is the right choice for you, but you should consider that doing this may mean having to start all over again with a new ortho doctor, going through the testing to confirm your diagnosis again, and possibly redoing treatments that you have done already because many times, a new doctor wants to see for themselves the effectiveness of a treatment or therapy before moving into prescribing any pain medications.
    good luck with your decision,
  • JslimjeffJJslimjeff Posts: 3
    edited 09/27/2012 - 3:15 PM
    I first started going to my orthopedic doctor and still having pain after surgery I had tremendous problems receiving pain medicine also. I ended up contacting another doctor Which was not another orthopedic but actually a pain management doctor. He would not immediately refill prescriptions but after several visits and evaluations and reading my records began prescribing medicine it took me three tries to find management doctor I was comfortable with and that was comfortable with. Where are you located in the US and maybe I am Can help you find a new pain management doctor. Also have you contacted your general physician.
    Jeff f.
    Milwaukee, WI
    Medtronic's since 2007
    35 yrs old
  • I too take Trazadone to help me sleep. I have found it helps so much better if I take one Unisom jell cap with it. I do fine on it by taking it this way.
    Hope this helps.

    Patsy W
  • The whole point of seeing a PM is to manage your pain, and it doesn't seem like that's happening. Perhaps you can find someone who is a better fit, and who has evening office hours since I'm sure it's hard for you to make your appointments during the day due to your home daycare.

    I had been seeing a PM and my regular family physician monthly. My family physician took care of my prescriptions. I had several issues with him, and it finally came to a head after about a year. I had gone in for an appointment and we did the usual, then he gave me my scripts and hurried me out the door (he only scheduled appointments in 15 minute blocks, so he was always in a hurry to get me out). When I got home, I noticed that he had only given me my Percocet script, but not my morphine. I wasn't too worried, as I had another appointment scheduled for the following week to fill out leave paperwork for work, so I figured I had enough morphine to last until then, so I would say something about the script when I went in.

    Well....first of all, he refused to complete my paperwork. Keep in mind, I scheduled the appointment specifically for paperwork. He claimed he had already done it that morning, yet there was no copy in my file, and the nurses couldn't find it. One of them even said he completed similar paperwork for another patient, not me, but he would not budge. Said he didn't have time. Then I asked him for some sick notes for work for a handful of days I had missed. I was already on FMLA, and I needed notes to submit to workers comp for wage reimbursement. He had done this in the past - I gave him the dates, and as long as they fell within the guidelines he had given for my FMLA, it was no problem. Well, this time it was a problem. He said he had already done enough for my employer and he refused to do any more. I explained that it wasn't for my employer, it was for wc so I could get paid, and he still refused. Finally I brought up the morphine script. He checked the computer and said he had already given me one. I explained that he never gave me the script, only Percocet, and could he check with a nurse to see if perhaps it had been left behind on the printer when he grabbed the other script. Nope, too bad, so sad. He said I would have to make due with the Percocet until the following month. So I asked if he wanted me to just go cold turkey on the morphine, and wasn't that dangerous, to which he replied that I wouldn't be going cold turkey, since I had the script he had given me the week before, and he wasn't stupid so I wasn't going to play him like that. By then I was sobbing and begging him to just pick up the phone and call the front desk to see if the script was there do he would see I wasn't just some junkie trying to get a fix. He simply picked up his laptop, stood up and said to me that there would be no charge for the appointment since I didn't get what I wanted. Then he walked out of the room and left the door wide open to the hallway, so everybody walking past could see me sitting there bawling!

    I didn't know what to do - I could not believe I had been treated like that! Finally after a few minutes I composed myself somewhat and walked up to the front desk. Asked about the script. Lo and behold, they had it sitting right there! They said they had tried to call me the previous week about it. I had returned the call, but when I did they didn't know why I had been called in the first place! So I went through all of that because of a communication breakdown. And had he simply made a call to the front desk, he would have seen that I wasn't lying. But I guess after accusing me of being a junkie, it would have been too humiliating to be proven wrong because HE had left the script behind on the damn printer.

    When I scheduled my follow up appointment for the next month, I told them to make it with a different doctor in the practice - anybody but HIM. And then I filed a complaint against him through the office manager. I could not believe that he treated me like that - after seeing him for over a year, and him writing me the same scripts every month, he treated me like some piece of crap junkie who had just wandered in off the streets looking for a fix!

    Needless to say, the new dr said he felt more comfortable with my PM handling my scripts, which was fine with me, but the jerk dr had insisted that HE be the one to write my scripts all along. I had no idea why he did that. Needless to say, things have been much better since I got rid of him. I have had issues with my PM under dosing me, but that's a whole other story. I'd rather deal with that than his awful attitude.

    Ps sorry for any typos - I'm in a rush and typing on my phone. :)
    L5-S1 Fusion, Discectomy on 7/10/12
    Herniated Discs at L3-L4-L5-S1, Spondylosis, Spondylolethesis at L5, DDD, Partial CES, Lumbar Facet Arthropathy
    Chronic back pain since 12/2010 (slip and fall on ice)
  • davrunnerddavrunner Posts: 478
    edited 10/21/2012 - 5:05 AM
    When I read your post the issues with your knee hit me. Having arthoscopic surgery and still having pain and swelling 3 years later is not normal. Have you had another MRI? Do you have other swollen joints?
    My knee saga started 4 years ago with a arthoscopic minesectomy and will conclude this week with the 5th surgery on this knee in 4 years, they are going to remove a patial replacement and put in a full knee replacement.
    In the interim I was diagnosed with Rhuematoid arthritis. My knee has bee constantly swollen for over two years so I feel for you, it is no fun.
    Have you seen a rhuematologist? there are hundreds of different types of arthritis that may be causing your knee swelling. There are also a couple of non-arthritic conditions that could account for your knee swelling and pain. I had a very rare one called lipoma arboresence (a fatty tumor that took over the synovial space of my knee)

    I also get baker cysts from time to time, it is a build up of fluid in the back of your knee joint usually caused by some sort of blockage, having constant swelling can cause the cysts to act up. There is a good website search for bonesmart . org there is a lot of information on knee issues and wonderful support similar to this site.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
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