Pain Management- MAJOR PROBLEMS

Pain Management- MAJOR PROBLEMS

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rosa-lynn
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Joined: 03/16/2011 - 11:27am
Pain Management- MAJOR PROBLEMS

Mom's neurosurgeon has referred her to another neurosurgeon who specializes in implants- stimulator and morph. pump.
She has also seen 2 pain Drs who DO NOT use meds- one only does the stimulator BUT the TRIAL SHE ATTEMPTED FAILED. So mom is down to the one remaining Dr. who DOES NOT PRESCRIBE meds-which she wants to find a Dr. who believes in breakthrough meds. She cannot get an appt. w/ a third pain Dr. to interview until June 6th. Her last surgery in Dec. has left her in terrible pain which prompted her surgeon to refer her the the 1st pain Dr. for the failed stimulator attempted. She has lived the last 6 months on Percacept or Loratabs for the pain and is terrified by the thought of not having the meds to get her through til she can find a permanent pain Dr. Her neurosurgeon says this week is the last week of medication he will give her. In the process of maiking the appt. with the THIRD pain Dr. she asked if he did the implants- stim. and pump- and the nurse said she couldn't address that my mom would have to see the Dr.
1) How in the world can you have a "failed back" and NOBODY will give you meds while you can find a GOOD perm. pain Dr.??
2)How can a Dr's. office not advise you that they are capable of a specific procedure?? TWO neurosurgeons have said "find a pain Dr. that will install a pump or a stim as those are two of the most viable pain manangement options you have" yet this Dr. won't answer that question w/out her coming into the office...

Robin
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rosa-lynn, The truth is,

rosa-lynn, The truth is, most PMDrs actually do treat with medication but will sometimes say that they don't over the phone, or even in person after the initial office visit.

If your mother wants a Dr who will Rx her the medication that she needs/wants, she is going to have to go to the appt./s and find a Dr. who will treat her. She is not going to find out any information over the phone, and even if she did, it would not necessarily apply to her.

It would be helpful if you knew someone who could refer you to a Dr., and perhaps your mother could ask her PCPs office about that.

rosa-lynn
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response to truth is...

So should she make appts. with numerous Drs til she finds one that she feels a good rapport with?? She's afraid her ins. won't pay for that...

Robin
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She needs and deserves pain

She needs and deserves pain management correct, and in this day & age this is what it has come to. Has she asked her PCP about PMDrs. I don't have a good PMDr in my area, so I drive about an hour away (each way), but he is worth it. I still have all the hoops (UAs, contract and pill counts), but when you have a Dr who listens, it doesn't matter.

This is nothing personal to your post, but just in general. If everyone would keep taking their medication as prescribed, quit calling in between visits for early refills, and 'losing', having meds 'stolen', and/or 'dropping' them in the sink, we would not have such a hard time finding good PMDrs. Instead we read a hundred threads where everyone blames it all on the addicts when the truth is, *most* of the kind of addicts they mention don't bother with Drs appts.

Today I had an appt with my PMDr. The nurse was putting everything on computer because as she said, "by next year everything from the office has to be accessible to the gov't". She told me that the gov't will tell my Dr if I need an MRI, and other diagnostic tests, and that it will be out of the Drs hands soon. The gov't will soon be telling our Drs a lot of things concerning our treatment.

rosa-lynn
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Joined: 03/16/2011 - 11:27am
Follow-up...

PCP recommended one of the PMD's that she's already seen- one who does the pump but not the stim NOR will he gives meds. She is excellent w/ her meds. They don't give her but 30 and she takes them every 4-6 hrs- she has too because she's only 6 mos post-op and she's fused through 3/4 of her back. After 13 yrs of back problems- and only using meds very sporadically- she is just now being told it's "failed back syndrome" and she needs a PMD. Obviously finding one hasn't been easy so far.

I WISH I could comment on healthcare reform but I will get in trouble...:o(

THANK YOU SO MUCH FOR YOUR FEEDBACK ON THIS.

DDDBACK
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Joined: 02/02/2009 - 10:45am
PM

PM 101 never call any Dr. looking for meds. They will turn you away or have you come in for a consult then deny just to take your money. By asking over the phone or asking for a particular med is just as bad. RED FLAG ALL DAY!

Example: I was waiting at the desk at my PM and the girl took a call and she said sorry this clinic doesn't RX schedule 2 narcs. Sorry no doctors here can write that type of perscription.

Which I thought was funny because there I was picking up my written script for OXY.

Lastly, If they are true PM doc's no matter wait they will RX narc meds if needed. They can tell people who are in true pain. My doctor admitted to me he has his girls up front send text notes back to him as they watch patiance in waiting room.

It may take 2 or 3 meeting with dr. before the pad comes out. Whether us PM patients like it or not we get judged by the DR. as well as the non users.
It's all about TRUST. And in your moms case thats just what might be needed. Trust!

I have FBS. X2 DX from Ortho not Neuro. Orthos like to pawn you off their plate. Where Neuro's tend to listen more.
Maybe seeing a Ortho first then have them refer you to PM with a DX of FBS.
Then she won't have any problems.

My doc must see to things before RXing a heavy meds
1. FILMS! MRI only! W and Without contrast. Films don't lie.
2. Up front drug screen. So Lay low follow the course of action and it will happen. But never give up!!!!!!!!!!!! If she truly needs it.

Lastly, I feel for your mom. I read her condition and it's just like me. So I know she is in pain. If your in the mid west PM me.

davrunner
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Joined: 02/18/2011 - 8:11am
Have her Primary Care

Have your mom talk to her Primary Care Doctor about managing her pain until she can find a pain DR. Some will and some won't. I have a horror story of a time with PM who went so far as to accuse me of committing a felony. It's a story for another time.
I talked with my primary care doc and he took over my pain management completely. He has given me the right pain patch and it has allowed me to reduce the number of pills to 1 a day, on a rare occasion I need 2.
I'll pray for your mom that she gets the relief she deserves.

laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched

rosa-lynn
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Last seen: 3 years 3 months ago
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Joined: 03/16/2011 - 11:27am
Pain Mngt. issues

I wish my mom had internet. You all have been great. thank you for the information and the encouragement. She is so depressed that this last surgery didn't work and the pain is so intense. She stays on zoloft for the depression but It is horrible to see someone who is so young(58) and used to be such a workhorse reduced to tears just going to the bathroom. I'll keep you posted and ask addtl. questions as we go through this. Thanks again & GOD BLESS!!

Robin
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Joined: 08/17/2008 - 9:45pm
Warning: May cause sadness (from House Calls)

A man walks into a doctor's office and says his antidepressants aren't working.

"Let's see," says the doc, consulting his chart. "Are you sad?"

"Yes," says the patient.

"Unable to sleep?" asks the doc.

"Yes," says the patient, starting to think his doc is on the right track.

"Difficulty concentrating?" asks the doc.

"Exactly!" exclaims the patient, now convinced his doctor knows exactly what's going on and is ready to help. "Do you have anything that works?"

"Anything that works?" replies the doctor, incredulously. "What more do you want--the drug IS working!"

It sounds like a joke, but it's not. Because the fact is, patients who take antidepressant drugs continue to suffer these and other symptoms, even in cases in which the drug is considered "effective."

Researchers examined data on 2,876 patients in the STAR*D trial who took selective serotonin reuptake inhibitors (SSRIs) for 12 weeks.

They found that every single patient reported at least three residual depression symptoms, with 75 percent experiencing five or more and some having up to 13 lingering depression symptoms, according to the study in the Journal of Clinical Psychopharmacology.

Overall, the researchers say 71 percent reported sadness, 79 percent experienced insomnia, and 70 percent reported concentration problems--all classic depression symptoms.

Yet the researchers said these drugs worked--they just happened to "miss" a few symptoms.

Miss a few symptoms? Sadness IS depression--and any drug that somehow manages to "miss" it is the very definition of ineffective.

And that's not the only evidence against these meds--because the researchers also found that only a third of all patients who took the SSRIs went into remission within 12 weeks.

That means two-thirds of all patients on these meds are still battling depression months later... and even if the severity is reduced a little in some, why bother with drugs at all if they're not going to do the job?

Most cases of depression have a real answer--one you can find and fix completely without SSRIs or any other mainstream antidepressant drug.

In some cases, it's a matter of getting over one of life's many humps and bumps-- and if you're going through that, try St. John's wort or the amino acid SAMe.

In other cases, you may be suffering from a nutritional deficiency or a hormonal problem--and a skilled naturopathic physician can help find the source and fix it without any lingering sadness.

.......but of course, pain can cause depression too.

MsHumptyDumpty
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What I don't understand (

What I don't understand ( but I am easily confused lol ) is why is her Dr not telling her who to see for the treatments he thinks she should be getting?

My Dr says "you need to get x type of treatment and here is Dr z that does this type of care.

I don't think it's fair she is left on her own to find the right Dr. when she has been told what specific treatments to get.

L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.

rosa-lynn
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Joined: 03/16/2011 - 11:27am
Response: what I don't understand...

Her neurosurgeon referred her told her a morph. pump or stim. were her best options after the pain from her Dec. surgery was so great. PMP he referred her to was unable to instal the stim. for trial because of all her scar tissue. At that point she was referred to another neurosurgeon who does the more complex stim implant or pump installation. Her original NS doesn't do those. She's been told by both NS's that she needs a PMP regardless of what route she takes as she will always need one to maintain her implants and/or meds. She just has to find a PMP she likes and does all that, which is taking so long. GOOD NEWS tho- her PCP gave her some meds to keep her going til she finds the PMP- PRAISE THE LORD! She is in enough pain without going into agony...

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