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any tips when seeing new pain management doc

hey there spineys,
I am giving in and seeing yet another pain m. docs, I have not been lucky in the past.
Last one gave me a lot more stuff when had the esi's I ask the rn that was in procedure room due to I had more bandaids.
So I swelled up.
That was 2nd one and of course I told her not doing 3rd and I want a emg...she got such an attitude she wrote 5 meds on one script handed it to me and said see you in month. No discussion on meds. I was lucky at the time had a great doc whom I called and asked what are these meds.
He said get staff make a copy, then hand her back original and get out of there.
I saw doc in hallway and ripped it up and handed to her.

I feel they all start out nice but once you ?? anything they get defensive.
I have my medical huge binder, with all my info from cd's of mri's and meds tried,

I hope and pray this doc can help, ya never know.
So then if I like this doc I have to choose, him or my new GP both take different insurances. So one will have to pay outta pocket.
I don't like going in and saying what didn't work, Oh I dislike the hope we have before seeing new docs.

Have good day
And those of you in winter wonder freeze stay warm
neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
daily goal do good thing for someone.


  • dilaurodilauro ConnecticutPosts: 9,877
    I like my Physiatrist vs a pain management doctor. Over the years, I have found most pain management doctors geared up for spinal injections and some degree of medications. Some PM's I've had setup for ESIs at the first meeting with the doctor. Then they write a number of scripts and off you go.

    Why I like the Physiatrist, is because the can take 'total' control of your situation. They coordinate all treatments that you may need. I've been with mine for the past 5 years and we have an excellent relationship. We've talked about various treatments, the pro's and con's of all of them. What diagnostic tests might be in order, etc I am lucky because of the trust we have, I can 'ask' her if she thinks such and such diagnostic test might be in order, what treatments work and which ones dont etc.

    But that took time to develop. I have found that one of the most important aspects in dealing with any doctor, is that you want them to be in control, you want them to be the ones decide on what actions should be taken. I have heard from so many that once a patient 'tells' the doctor they want this or that, the doctor almost begins to write them off and is not interested in any trust and confidence.

    But there are so many ways you can get your message across. I just try to do it in a way that they doctor makes the decision (and it would be the one I would be asking for)

    Another trusting piece is agreeing to what the doctor is saying and providing. If the doctor wants you to try this Physical Therapy and perhaps medication "A", go with it. Try it out, to see if it works.. Then if it does, you thank the doctor and if it doesnt work, you have discussions on what you think went wrong. Bottom line, when some of my doctors tell me to stand on my toes, jump to the ceiling and then land on my fingers, I will try it.

    Never Say I Want
    Never Say I Have to
    Never Say I Need a xxxx


    I have this problem, it is getting worse, what do YOU think would be the best tings to do.?

    I want my doctors to fully understand that I have 100% trust and confidence in them and put myself in their hands. But they also know, that I have done all my homework, I know about things that could or should work, etc

    Mary, I dont know if any of this makes sense, but it is what has worked for me all these years

    Good luck
    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
  • alexhurtingaalexhurting Posts: 1,991
    edited 01/07/2013 - 4:52 PM
    Best tip= Wear clean underwear !
    Good luck,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • I totally agree with Dilauro. My PM doctor is a physiatrist specializing in spinal cord injury. I have been with the same practice since 2005 , so I have built a relationship with my doctor like the one that Dilauro has with his. It does take time but I have found much more consistent care with my physiatrist over just a pain management interventionalist.....they are the ones who like/prefer injections rather than pain meds, especially when you are new to them.
    Check with your insurance about a physiatrist and see what you can find.......
  • with Ron and Sandi. I go to my Internist for all issues regarding my back. That's where I get my pain meds and, if needed, some referrals for more PT. He did send me to a PM once, and all the guy had to offer me was a spinal cord stimulator. I refused and went back to my Internist. I'll never go to another PM again.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Well was long drive for me, Just to find out the lady made error and they don't take my insurance. I was already in pain from the 45 minute drive.
    The receptionist said oh we don't take your insurance I said thats bull. She also said they tried to call you she proceeds to tell me a number, I said thats not my number and the lady on the phone repeated it to me.
    So I said who made this appt. she says she thinks was the cma...
    I looked around and realize this was a chiro office, so I asked if it was...I told her I wanted to talk to person who schd. my appt. I didn't want to see a chiro and online said nothing about this doc being a chiro.

    By now my feet were numb, I used the ladies room, when I came out their was a doc behind counter, and he said he would see me and they would take payments. I said well i asked on phone if was chiro cause a chiro doc made me worse.

    But still the receptionist still never apologized, I said to him" you should really have your appointment setters trained. she put me on hold to see if they take my insurance.

    Waste of time and in pain n driving is hell when sitting makes pain worse.

    Back to drawing board.

    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • Make the appointment in Orland where i told you to go by now they would have your appointment coming up soon and you. be that much closer to your appointment date with pain specialist,

    You could of made the appointment and kept a date even if you decided to cancel it for some reason,
    If i made it from our house near your house in less then 45 min you can make it to my doctor in 35 to 40 min tops,

    Just because he was booked up always take the date thats open and many times the date comes up sooner then you think, I often made appointments knowing its long ways away but i rather have the option to either keep it or cancel it or set it up for another appointment,

    Damn Mary you want be to call the office and talk to the chick at my dr office ? She will get you in by tomorow if i ask her nice lol.

    If you dont want a pain specialist then find what Ron and others mentioned as i am not familiar with who they refering to but Jim told me he has seeing a physio here in newlenox who he said was good,
    I myself though of talking to that physio but not realy sure what he can do for me other then what my pain dr is already doing,

    When i told you i met just about every pain specialist already in the area and who i decided to stay with now is because i like him beter then any other dr that treated me all these years so i am taking the guessing game out of it for ya as my mom i took to my pain dr for her stenosis and she got beter !

    So do i have to hit you over the head and drag you in his office ?

    I can send you to 5 or 6 other pain doctors who are not as good as Kevin my friend went seen some of them and ended up changing over to my dr,

    Just make the appointment !
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Never Say I Want
    Never Say I Have to
    Never Say I Need a xxxx

    This is so true even if you do need any of these docs will rest easier and be a lot more at ease when suggesting meds if they dont already think you are a drug seeker none of us want to be on pills all the time we only want to have a normal life. Let the doc know that all you want is to be able to do normal things again at least it worked for me
  • i still don't know why so many people have negative experiences with pain drs. I have had 2 in 12 years. the first retired and referred me to my second. like ron said, don't use the quotations that he said not to use. i still think the issue is narcotic related with negative experiences. some people go to pain drs expecting or wanting narcotics and it is not that easy. most pain drs will start a new patient off with weaker meds and go up to stronger ones eventually to narcotics depending on if the meds work. don't expect narcotics from your first visit. it probably won't happen and pain drs are on the look out for narcotic seekers. like i said i don't know why so many negative experiences and i don't profess to know the answer but i have gotten
    on with all of mine.
    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 just scheduled for a march 4th L4-L5 fusion after becoming disabled following a failed microdiscectomy 8/11. at that time,the surgeon planned a fusion for 2 months later, and i had a massive saddle embolus and almost checked out.

    my saving grace was my physiatrist/ pain management at the spine center. prescribed me comprehensive pain control, and was supportive as she increased my visits and encouraged me. i was on coumadin, and it was too much of a risk to attempt the fusion at that time.

    i used to commute from san francisco to maine 10 days/ month when i was working, so all the treatment had been there. when the disability ran out and i was released from PT, i gave up my little studio and hung out in maine until our new house in phoenix was ready. well, NOBODY would prescribe my pain meds. i had to fly to san francisco to return to the physiatrist twice cross country to get them. (oxycontin 20 2x/ day)

    so, my initial pain management appt. at the neurosurgeons' office is friday. i just hope she leaves my meds alone, and i will be more than happy to work with her after the fusion to taper.

    my suggestion to you would be to look for a physiatrist/ pain management specialist. it was the only positive experience i have had in a sea of doctors since my initial injury in '98.

    i wish you the best of luck in finding someone who will work with you.

  • When I was first referred it went like this: my family doc who is also an osteopath first prescribed my pain medication and referred me to pain management (after my x-rays came back much worse than he thought they would). My first appointment was an exam, a script for a muscle relaxer, and he told me to take some time to think if I wanted him to prescribe my pain meds or if I wanted my regular doc to continue, at the next appointment I told him that I preferred him to handle everything, one reason being is family doc is in his late 70’s (and yes still practicing – very well) so he gave me the contract, gave me a UA, and wrote my scripts, he actually kept me on what my family doc had me on, which is 3 10/325 Percocet’s a day. (Well he gave me Ibuprofen 800 also) and I have been on that for a year now. I actually seen the pain doctor for my first 2 visits, then was assigned his NP, she is fantastic, and the Doctor is there just in case. I had to do a Psych exam, and now I only see her every two months instead of every month. My appointments are scattered a bit so I’m not out of pills on my appointment days because they do a pill count at every visit, and have random UA’s. But I don’t think of it as a negative experience, they just have to cover their rear ends because it’s their medical licenses that are on the line. Of course I have heard the horror stories as well, but I guess I got lucky. Also this particular doctor requires proof (x-rays, scans etc.) BEFORE they will even accept you as a patient.
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