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Same office, completely new regime

oncetwiceooncetwice Posts: 9
edited 04/21/2015 - 5:06 PM in Pain Management
I'm a chronic pain patient in NYC. I've been going to the same pain management office since Feb 2013, that's over two years. I was officially a patient of a doctor, but I only saw him once. Every other time I saw the PA, who'd listen to my symptoms (my nerve pain seems to travel) and refill my meds and tell me to come back in one month. Once in a while I'd get an injection here or there.

My most recent appointment was supposed to be last thursday, but on wednesday the receptionist called to cancel and reschedule because the PA and the Dr were not going to be there -- ever again. There was a new doctor and a new PA and my new appointment was for today.

So I went. I arrived at 4pm for my 4:15 appointment and didn't leave until 8pm. This was because "each person is being treated like a new patient." So I met the PA. Right off the bat he tells me that "our method is not to prescribe narcotics to treat pain, we try to heal the problem." He suggested I get an epidural directly into my spine, which I'm frankly not comfortable with. I'm afraid of becoming paralyzed or losing feeling. My last PA said that this was a possibility, and this PA says that's not likely. The whole time he was basically talking out of both sides of his mouth, contradicting himself. He said several times that "we don't do that here (give out narcotics on a long term basis), we prefer to heal" -- but he also said "Your discs are not going to heal, and you don't have to find other treatment options or medication if you don't want to." So which is it?

Long story short, he didn't actually cut my meds, yet. He gave me a two week supply equal to what I'd normally get, but he refused me an injection until I get another MRI done. Fine, no problem.

But I'm concerned that he's going to try to cut me off sooner or later. Probably sooner. He gave me the whole "you're too young" speech (I'm 28 now), and the dependency and tolerance spiel. I had to give urine, and I'm expecting him to give me a hard time in two weeks because I smoke pot, which was never a problem with my last Dr/PA.

I get 120 5mg oxy per month, plus colace and gabapentin. He initially forgot to write me the gabapentin and colace, but I waited and asked for it. He had asked me "why 120 oxy? That seems excessive." I told him the truth, which is that I take 5, 10, or 15 as needed depending on the level of pain I am in. That I've been taking this for 2 years and I've learned my own body and how the medicine affects it. That when needed I supplement with tylenol too. He seemed to take issue with me taking 15 at once. I told him that there are times I only take 5 mg, and there are days where I take zero mg, and that I was prescribed by the previous PA/Dr 10mg 2x per day, but my insurance doesn't pay for 10s, they pay for 5s, and 15s and up, so the script is written for one 5mg every 6 hours, or 4 5mgs (20 total) per day . He challenged me on the validity of that, saying "it makes no sense" which I agree, but it's not my place to justify the health insurance's policies -- all I know is that I had to pay out of pocket the first month when I was prescribed 10s.

He seemed to have only some of my records. He had the MRI report for my back, but not the MRI report for my neck and none of the computer information about the medicated special formula cream I've been getting, or the two years worth of paperwork detailing my back pain, nerve pain in the legs, hip pain, etc, but he did have the past few months of my complaints about a new shoulder pain, which my last PA/Dr attributed to my neck (but he has no paperwork explaining the PA's rationale re: the neck/shoulder) -- it's all very inconsistent.

He basically contradicted everything that my last PA was telling me. My stenosis isn't that bad, and stenosis is not that bone-grinding feeling. He even challenged me on the meloxicam/prednisone usage, which -- when I first came out of the hospital after my initial back injury I was in such severe pain I couldn't sit or lay down and I'd just stand bracing myself at a wall, my GP put me on a 3, 2, 1 course of prednisone and it knocked out that intense, constantly crying pain. Every once in a while I feel something slip out of place in my spine and I have a repeat of that severe, bring me to tears pain, and my GP gave me a script for 10 prednisone and a few refills and instructions to take two for two days when I need it.

I suppose I was "lucky" because in the 4 hours I was there, I'm the only person to come out of the exam room NOT complaining that he "cut my meds" or altered the dosage or cut me off completely. There were a few people who simply walked out and then several who came out cursing and declaring "this is criminal, it isn't right, etc."

But still, I feel that I am being put under undeserved scrutiny. I don't want to lie to the doctor, but I don't want anything changed. He was pushing really hard for me to go get an epidural and try other things and just kept saying "we don't do that here (give narcotics long term)." I even told him something along the lines of "I've found a balance of meds and exercise and stretches that work, why should I have to chance my treatment course?"

Honestly I'd much prefer to follow the PA who has been treating me for the past two years, but the receptionists and chiropractor and physical therapists working there refuse to offer any information about why he left or where he's gone. I have no way of knowing and I feel that's really unfair. My doctor and PA of 2 years just up and leaves with no notice and no forwarding address, no way for me to get the rest of my records which I may need for a disability claim. Is that even legal, for them to disappear like that and leave the patients in the dust? Is there anyone I can contact for an explanation? Am I wrong to think I deserve one?

And what's the deal with this new PA? Is he just breaking my balls to see if I'm a "drug seeker" or a junkie or whatever? Is he really going to be content if I decide against an epidural and wish to continue my current regimen of oxy and gabapentin? What can I do if he decides to refuse me the oxy?


  • Not really sure what to say except it sounds like your office is cracking down. Can you look into going someplace else?
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • The new PA that I met today actually mentioned something along those lines in the first few minutes of the... appointment? session? exam?

    He started out with something like "well I've looked over your record and noticed you're on narcotics and we don't really do that, blablabla, so we're here now to discuss treatment and you can decide if you want to stay with us or go to XYZ (he even named one or two other PM doctors/clinics/whatever they're called)."

    I'm intimidated by the thought of going to a new/different pain doctor. That's kind of the problem here and now I suppose.
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