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Where does the PM fit in?



  • Oh man. Selling my bike is NOT like selling a horse! I have a brand new road bike that I paid $1300 for and I got all of 200 miles on it (which is nothing). Every time I look at it I'm sad that that part of my life is probably over. That's just a stupid bike. I can't imagine the feeling associated with having to give up a horse. I would imagine that's almost like losing a family member.

    HappyMom, so far all of the PM docs I've talked to DON'T prescribe narcotics, they just do injections. They must have figured out their little niche where they can make a lot of money and not deal with all of the narcotic regulation hassles.

    I do think I found someone who will manage the whole picture, including narcotics if necessary, so I'm a little more hopeful that I could have him take over my entire treatment plan.

    Anyhow, back to Kris, good luck with your PM appointment. Please don't shy away from injections!
    They may very well help you.

    Take Care,
  • dilaurodilauro ConnecticutPosts: 13,435
    You will see that many people use these terms interchangeable. I know I have, probably because I always had trouble spelling physiatrist.

    Dealing with Spinal Issues, I see these following medical professions and their roles:

    Might just be the first doctor you saw after visiting your Primary Care Physician. The Neurologist might be the one to start setting up the initial diagnostic testing. They do not perform any surgery

    Are the ones that will actually do the spinal surgery, many times accompanied by an Orthopedic surgeon.

    Pain Management
    Are the doctors that generally perform the various set of Spinal Injections, EMG testing, etc

    Like the captain of a team. They should be coordinating everything about your situation.
    Prescribing medications, setting up diagnostic tests, making recommendations to see other specialists, etc.

    For me, my physiatrist has total control of my medical , physical and emotional condition. I've been seeing her for over three years and it was only after seeing her for a while and getting the various treatments required, did I start to show signs of improvement.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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  • I'm lauging Ron, not at you, mind you, but with you. I can never spell Physiatrist either. Thank goodness you had it right there for me to copy and paste.

    Kris, I'm glad you are giving this PM a try. Just like the many nero's you have seen sometimes you may have to see more than one before you find one that works for you.

    I use my Physiatrist for my PM and he is wonderful. He coordinates all my spinal issues, refers me to surgeons when necessary collects their notes, we talk about it and he recommends from there. Sometimes I listen. Sometimes I don't. He also manages all my meds. I am currently working with a surgeon but still see my Physiatrist regularly.

    Everyone has spelled out their experience with their PM well so I've really no need to add to this thread except to say this about the disability forms.

    I provide my disability company with the names of all doctors I have been seeing. They then contact them and collect the medical records and request updates on my condition, usually including those ridiculous functions and abilities forms.

    My Physiatrist has been the primary doctor to update them on my condition but they have collected records from every doctor I have seen related to my condition. Even if it's just 2nd opinion's (and 3rd and 4th) My guess is if you make them aware you are now seeing a PM they will take it from there.

    They then have ALL of your medical records. This comes in handy if and when it becomes necessary to extend your benefits to LTD if you are eligible and find yourself needing to file for SSD should they require it. (At least it did for me.)

    Take the monkey off your back.

  • I go to the PM tomorrow. I've given up on my neurologist so I am hoping they will have a recommendation. My appt is actually with the nurse practitioner but the PM will be there and available. But I may do better with her since she will know which offices are better to work with for the paper work. I am also going to ask her about a physiatrist. I did a google search but they seem to be chiropractic or PT based offices.

    I just read the independent review of my MRIs. There are several problems around my surgery site involving the facet joints and the costrovertebral joints. Basically what made me better (the surgery) caused all kinds of issues with the connection of the vertebra and the ribs. Nothing that can be fixed without doing a major fusion with all kinds of hardware and there is probably a very small chance that it would work. So it looks like I will be very good friends with the PM group.

    Thank you all for your thoughts and suggestions. I guess I have my answer.... PM will be a very large part of my life.
  • I hope this doesn't mean that you are giving up trying to find a complete answer to all that is going on with you still? My last Neurologist was *cough* a piece of work as you probably remember, but aside from my post retirement doctor break, I am getting back on the 'start over' mode (for a new Neurologist).

    Like I've seen on here with many who were either ignored, or moved to the mystery diagnosis side of the house, most don't give in or give up. From what I've seen of you in the threads, and to PM, you aren't a give up type. Hopefully you're just taking a step back as I have only to mentally and physically regroup! Still keeping positive thoughts heading your way woman!!! *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • Well the visit went fine. I like the nurse practitioner which is a huge plus. She spent most of the time shaking her head about the crazy reports from different doctors.

    Their opinion is that for now the only treatment option is pain management and possibly PT if the physiatrist agrees. So I signed my contract and join the ranks of pain management patients.

    PS Brenda it's not that I am giving up. But the report shows several issues in the facet joints, vertebra and costrovertebral joint which connects to the ribs. There just isn't any way to fix them, not even a fusion. So I can try to strengthen the surrounding muscle and then just treat the pain. I wish there was an answer.
  • Kris,

    I guess I look at it this way based on your appointment today, you are at least getting more detailed answers to what all is going on. I think that was the hope/goal? :)

    Unfortunately I am still a work in progress. I've already been told by 3 neck and back are still on the future 'to do' list. *sigh* Please let us know if the PM side of the house is a 'helper', okay? *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Most of us have issues with our backs that aren't fixable. So, at least you know you're not alone! DDD in general isn't really a reversible process, so there are many people wandering around with problems nobody can fix :)

    Not that that helps, but what's that saying? A problem shared... something something.

    Hopefully you'll get some steady pain control now, and be able to get back to your life.
  • Kris,

    I'm glad to hear that you are moving forward. I'm meeting with a "real" PM doctor on the 10th, so I have been paying close attention to your thoughts/concerns/hopes in doing so yourself. I was told upfront, though, that this doctor will help manage my whole pain management picture except that he won't prescribe narcotics. Huh???? I asked his receptionist if he only does injections and she said "yes". How is that comprehensive pain management? At that point I didn't move forward. However, I got a call a couple of days later from his nurse and she said that he will indeed take care of everything as long as it is coordinated with my current doctor. Okay, I thought that was a given. I wasn't expecting to get narcotic prescriptions from two different doctors.

    My goal is to get off of narcotics by finding the root cause of my pain and addressing it. Even if he can address it through non-narcotic meds, I would be fine with that. I just thought it was odd that some of the office staff were not on the same page. It seems like a red flag to me, but I cannot find any other comprehensive PM doctor in my state. It's very hard for me to drive more than 30-45 minutes, so going out of state doesn't seem very realistic.

    Anyhow, Kris, I hope my experience goes anywhere near as well as yours.

    Take Care,
  • Yes, when I got out of Kaiser I went through a lot of confusion about who would prescribe my narcotics. I figured it would be my ortho, but they were like... nooooo! OK then. The first PM doc I went to was like "Lose weight and go to physical therapy" (he also ran his fingers down my back and said "I don't see anything wrong there." I have one vertebrae that is basically missing. What a maroon.).

    But the last two PM docs were comprehensive. Both really like their injections, but they do meds as well.
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