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Going to a new PM

brandysue50bbrandysue50 Baldwinsville NYPosts: 46
I am going to a new Pain Management in 3 weeks. I've been taking Codiene that my dr gave me 3 years ago. I was wondering a few questions.
1. Do they do a drug screening the first appt?
2. Is it ok to have this in my system when I go to the first appt?
3. I got a huge packet of forms to fill out. Including what I've tried for pain in the past. They said they will not be giving medicine the first appt because its a evaluation. Is this true? My last pm gave me oxys the first appt.


I know nobody knows what they do. But what would be your best guess on this?
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Comments

  • The first visit is an evaluation ,discussion and review of your medical records and symptoms.
    As far as urine testing goes, some do and some don't test on the first visit.
    Most pm offices do not give prescriptions for opiates on the first visit.


  • SavageSavage United StatesPosts: 5,940
    You are right. Not all PM docs are created equal.

    I was seeing my primary for chronic pain for two years before she referred me to PM.
    She must have done a great referral since my initial appointment with PM, doctor started me on fentanyl patch and told me I would be treated as if I had cancer.

    Initially, PM did urine test sporadically. This year, all of us have to give urine sample with each visit.

    Since you are seeing new PM doc, it would make sense you have prescribed meds in your system from your former PM doc.
    Or are these three year old meds? That you were using to self medicate?
    Were they originally prescribed for current condition? Or for another issue altogether...such as a tooth pulled?

    With previous PM doc and again with new doc, you probably signed agreement to only take pain meds prescribed by PM doc.
    Was codeine current med from former PM doc?

    Best of luck with new eyes finding relief for your pain!

    Sue
    Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

  • dilaurodilauro ConnecticutPosts: 10,045
    Different pain management offices handle things differently.
    What would alarm me and I believe the doctor is the taking of old pain medication
    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
  • is that taking old meds that are no longer being prescribed to you ,after being dismissed from your previous pm is a problem. They are not meds that were given by her previous pm.


  • brandysue50bbrandysue50 Baldwinsville NYPosts: 46
    I went to the PM appointment. They told me the only thing they can offer me is a nerve block. I told them I don't want to do needles. Not only because Im on blood thinners. I don't like needles. Also at the end of the apointment they wanted me to do drug screen at the end of the appointment. I questioned it! I knew I'd pass. But I don't like my insurance company being billed for no reason. I feel insulted!
  • The urine test? It is a new pm office and since you know you would pass it, it shouldn't have been a big deal. Why are you insulted?
    Everyone has to go through urine screens at the doctors office, whether it's your primary or a pm office. The only difference is what they are testing it for.


  • dezine2shine210ddezine2shine210 Posts: 2
    edited 07/09/2015 - 8:18 AM
    Im new to this whole forum thing but i too am going to new pm in a couple weeks. I was seeing pm 2 years ago and was getting hydrocodone and tizanidine for sleep with topical ointment for inflammation. I was dismissed from office not from dirty urine screen but rescheduling 2 much. I had alot going on in my life at the time and just had to. Well, this is the problem...i am greatly mistreated medically because i am 24 years old. I am definitly not acting or making this up. I was a skateboarder who shattered pieces of my tailbone at age 12. I have been in chronic pain for 8 years already. But since im young everyone assumes i should be fine..( why is He in here ) is the looks i get.. 24 years old and is a necessity that i use a cane to walk. Im embarresed. I start new pm but i have been on tylonol codeine 3 from pcp since new law came into affect with hydrocodone moving schedule 3 to 2 or something like that. I am not a drug addict i just want my life back.. ive been tjrough countless injections and procedures with no help. So far hydrocodone, tizanidine, and anti inflammatory are ONLY thing in 8 years too help but i cant be honest with new doctor at such a young age.. im automatically labeled as drug user. What should i do. The tylonol codeine does not help and i only want some of my life back.. i dont go begging for opioids but i do just want to be understood. I cannot, absolutly cannot help that my chronic pain started as a child. Any advise please.. sorry this is long i have no one who understands what i go through.

    Moderator's message...Please click on link for helpful information
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  • I believe that the current enviroment regarding prescription meds in the USA does effect patient care but that's a different conversation, it really is! Pain is pain at any age.

    The way you present to a pain management doctor does make a difference. I completely understand what you're saying but if I were you I'd try to let it go. (or at least pretend to). At the end of the day you're in pain. You've tried some things. Your GP has tried to help but can't so he's sending you to a specialist. Just get all of your records in order. Make sure you have the actual images of your diagnostic tests. Go to your appointment & be honest. You're in pain & need help. The PM will come-up with an action plan for you. What they suggest may help even MORE than things you've tried in the past.
    Coming here to vent is great but if you portray that attitude you're going to start on the wrong foot with any specialist. It's fine to say what has helped & what hasn't but no doc wants to be told how to treat you, particularly when it comes to narcotic meds. Please try to keep an open mind. I know you've had bad PM experiences. So have I. I've got a great one now! There are fantastic ones out there who just want to help people in any way they can. Try not to be bias & just ask for help. You need it & I hope you get it but it might not be the meds you think you need. Just give it a try. Say what you've said here about desperately wanting, NEEDING your life back. That's the most compelling part of your story.

    I honestly know where you're coming from. I've been on this not so merry, merry-go-around for a very long time. I know what it feels like to live in constant, unrelenting pain. It effects every aspect of our lives. It can be physical & mental torture. I hope you're about to meet the great specialist that you deserve. Just keep in mind he's not the only specialist out there. Don't give-up on the system just advocate for yourself. Is there a surgical solution available?
    Osteoarthritis & DDD.
  • dezine2shine210ddezine2shine210 Posts: 2
    edited 07/09/2015 - 10:25 AM
    My pm docter 2 years ago at that particular time said he did not feel surgery would benefit me at such an early age. Too im going to be honest, it scares the living crap out of me. I have researched my new doctor and he seems like he will be the one with more than outstanding reviews from other patients. Truth is i am really willing to take any plan of action that a good doctor has. I do not want to depend on narcotics my whole life, its just as far as i know what 8 years of trial and error those medications give me my life back for a couple of hours and honestly i hate to have to say that narcotics give me some value of life back. Too ,my first pm told me " you know your screwed.. you will be on pain meds and procedures all your life" but like u said he is not the only pm and am very grateful that i will begin a new pm doctor soon.. any plan of action is a good one for me and i will not come right off the bat saying this and this helps. My first pm i went 1 and half years without asking for meds. Im assuming that the doctor saw i was more than willing to comply with anything but also nothing was working and hasnt so far. But thank u For words of encouragement. I hope all that are in the same boat Find the help they need. I guess im just afraid of being stereotyped forr being so young ...again thank u
  • I have to take narcotic meds to function. I've tried living without them on a couple of occasions. We do what we need to! Unmanaged pain is incredibly damaging to our bodies in its own ways. For me it's been about finding lots of different ways, big & small, to keep my pain as controlled as possible. I still find distraction the best pain management tool. Sitting around focusing on my pain is the worst possible thing. Nothing is ever going to take all of my pain away, not close (if I want to be conscious!) but it has to be managed. When it goes above a certain level everything falls apart. Once I can't sleep for more than an hour or 2 at a time I know I'm in trouble....

    Best of luck with your new doc. They make all the difference.
    Osteoarthritis & DDD.
  • dilaurodilauro ConnecticutPosts: 10,045
    Ok, so you have pain.. I am not questioning that.

    But now in terms of the medication you are getting, are you and your doctor in agreement as to what that is and to what dosage?

    It sounds like some of the medications you have taken really have not helped you. That is something that needs to be discussed with your doctor.

    Being young, does present a problem I can not deny that. But if you demonstrate the condition and your doctor agrees to your situation, age should not come into play. Some doctors may shy away from writing scripts for younger folks, only because they might need to do some more justifications. But, if a patient needs a specific medication and the doctor recognizes that, then shey would be able to justify and rationalize it to anyone, far above the DEA.
    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
  • WolfpackSVBWWolfpackSVB Posts: 216
    edited 07/09/2015 - 5:06 PM
    Don't beat yourself up about the narcotics. You are doing the right thing. Sit down and try to figure out what is it that is bugging you about it? Are you taking too much? I doubt it. Are you feeling guilty that you are getting relief while many others are still in pain either from lack of access or knowledge, maybe. Are you tired of taking the damn things, me too.

    During those times I usually find that a few hours of deep thought culminating in a quickly written contract to myself about why I take them and how long I Intend to do so settles the matter. I usually keep them at 3 months.

    Cheers
  • itsautonomicitsautonomic LouisianaPosts: 1,941
    Everyone knows my opinion on being young in pain and doctors prescribing meds. Something ive noticed in the past was that the doctor may not have been concerned with DEA and maybe just with health in general. When a PM doctor says he just wouldnt feel right prescribing a person your age pain meds due to the long term effects its really hard to tell if they are just using that to avoid the hassle or the DEA has them scared. But I do believe pain is pain and giving someone quality of life they may not have otherwise is worth the shot, I would say if you took a poll of chronic pain patients and told them you can have quality of life or live longer without it , the overwhelming answer would be quality of life for the short time I am here.
    I say this and i hope it does not offend anyone, but if I was putting myself in a PM doctors shoes I would much rather have on my concious a person who OD on my pain meds I had prescribed because they could not follow the rules and take as directed or ended up being an addict that i did not detect vs. some young kid who kills himself because his pain has gotten to bad to deal with on his own and I did not give him the attention he needed and potentially tried pain meds as an option when I could monitor/control it and know under that realm the chance for addiction is low.

    Something I have done is list all that I have done , the amount of times Ive done it , meds I have tried and bring that list with me and proof if first visit. It lets the doctor know you are trying on your own to beat this because it is a huge effort to fight pain with many different treatments and approaches.
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
  • I found that having a daily pain log and showing the doctor can be a great help. Include what your pain level (1 - 10 ) before you take your medication, then the level about 2 hours later. Also if you have big increase of pain and what were doing at the time. Writing how many hours you sleep each night also helps tell your pain story. Then writing a few sentences about the events of the day can also help you see were you are in your life. Which may seem very down right now but sometimes we miss it when things are getting better. It is always a positive even though the progress may seem very small. Let us know how it goes.
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