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Primary Care Physician for Pain Management?



  • You hit on it there. I don't know what I'll feel like with fewer medications, and don't know how much the current medications are helping. My pain is as low as a 3 when I've been taking it easy, been to PT, had a massage and a hot bath...and as high as 9. Big fluctuations in spite of taking medications, including long-acting ones, as prescribed.

    The time I described above is the only time I've run out early by not following directions. I'm not worried about repeating that. But am worried that this huge investment of effort, thought, time, and money hasn't made pain more livable.

    In an earlier string, I described the multi-faceted approach I've taken: PT; home exercise and stretching twice per day; massage; acupuncture; biofeedback; on and on and on.

    Can't imagine I'm alone in not liking the idea of having a great big medical file in the absence of a serious accident or illness. But no, I don't fear that it's public. I hate the idea of being a chronic patient. (That feeling, at least, is one I know most people here share!)

    Your reaction is helpful to read. Especially if it reflects the thoughts my PM doctor might have at this month's appointment.

    This is the long and the short of it: I don't feel better. I've engaged in this process earnestly for more than three years, to little effect. So I need to find a way to feel more in control of my pain, and less the product of a complicated system that hasn't worked for me.

  • Still not sure how I'm going to frame the final PM discussion. Feeling a little unsure of myself and the best-case-scenario given the feedback I've gotten here. I think I can only lay it out for him the way I've described in these posts, then be prepared for a similar reaction.

    Also have an appointment next week with my (fantastic) physical therapist for more dry needling. For those of you who haven't had it done, let me share my experience: it's the most sickening pain during the procedure and for a day afterward, just as bad as labor for me, but a great relief two days later. The only drawback (aside from not being covered by my insurance through this provider) is that it's limited to the single area of focus described on the referral; in my case, that's the right SI joint. And unless I book a double appointment (which would be $350 out of pocket), there's no time left over for other manipulations. Actually, there is another drawback: husband and kids have to drop me off and wait in the car for 75 minutes so he can work remotely while I'm inside and then I can take him straight to his train...no kids allowed in the office.

    Going to hold off on asking for another chiropractic referral based on what I've read of others' experiences and my own back's lukewarm response in the past.

    The medication issue will go in one of a few directions depending on next week's PM appointment:

    1. Maintain the status quo (many medications, yoyo pain, but few side effects)

    2. Cut back to one strong opiate and one strong anti-inflammatory taken as-needed instead of round-the-clock (who knows if it's enough and whether I'd regret the request in short order)

    3. Referral to another pain management doc (starting fresh would be an enormous hassle, which I truly dread, but would give a new set of eyes on the overall situation and my MRIs and treatment records)

    4. Or some solution I haven't thought of yet.
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