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1st Pain Mgmt Appt Friday

After 14 months of hell following a lumbar fusion with complications, my ortho finally referred me to pain management. He has prescribed me my meds before now;gabapentin,dilaudid, mobic and mscontin. Between him and the neorologist, I've had every test and procedure that could possibly be run, and have even had a spinal cord stimulator implant and physical therapy is a nightmare.

I am a little nervous about going to pain management after hearing some horror stories of how some people are treated like drug addicts. I have had at least 12 injections and those don't work, so I'm not sure how this doctor is going to feel about getting a patient who has undergone pretty much all of the normal "alternative" treatments.

One question I have though.. My ortho told me "you can go to him and see if you like him.. if not, I can refer you to someone else". If I don't like this doctor and I go to another PM, will it be considered doctor shopping, or is it only considered so if that doctor gives you pain medications? If I don't like this doctor, believe me, he won't be giving me any medications!


  • airborne72airborne72 Posts: 245
    edited 09/11/2012 - 2:36 PM

    Our situation's are similar. I had a two level TLIF in January 2011. My pain level has gradually increased and my ortho surgeon (loyal person) has prescribed all diagnostic and therapeutic interventions since to seek a solution. Now he wants to declare me a "failure" and do an exploratory surgery. Because of this I got a second opinion from a NS. He recommended that I not undergo another surgery "yet" as my adjoining discs are still healthy. However, he recommended that I go to pain management.

    I was not comfortable with this for a couple of reasons. 1) I did not want to get distanced from my surgeon as I really believe that something biologically is happening in my spine and he is the best person to monitor the change. 2) I am currently prescribed adequate pain medication from my surgeon and I am very hesitant to "start anew" with a PM doctor (credibility; determination of pain threshold; exploration of alternative modalities; etc.). I presented this to my surgeon and he said he could keep me in the fold. However, I will most likely have to make a decision in December (surgery or PM) as I can't continue being treated for pain by a surgeon. "We" both know this and will address the situation in December after I exhaust the life span of my bone growth stimulator, diagnostically evaluate my spine with a current MRI, and I "put on my big boy pants" and address the fact that I may have to have a revision fusion. I just have a greater fear/dread of checking into the PM camp. It just seems so fatalistic and capitulating to me.

    Completly on another subject - are you a Parrot Head?

  • Finzzzup, you are correct, as long as you don't get a prescription, you can be referred to a different PM if this one doesn't "click". Many PM doctors usually won't give narcotics on the first visit anyway. But for your appointment, just be honest, that's the best advice i can give you. Good luck and please update us with how it went.
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  • I wish I could say mine was only a two-level fusion! I have a full lumbar fusion. Unfortunately, I cannot say I have much loyalty left for my ortho as he is likely the reason I am suffering most of the problems I'm having today. During my fusion I suffered severe damage to my L-4 Nerve which resulted in Partial paralysis on my right side, for starters. I've undergone various procedures, the largest being a spinal cord stimulator implant in hopes of finding that "Miracle Cure", but to no avail! I've "tolerated" him since out of necessity because of my insurance and disability, but after so many failures, I had to start finding answers elsewhere.

    I am very happy to say that my appointment with PM was awesome and I think I will continue with him. He spent an hour with me going over my medical history and then we discussed what had worked and what hadn't in the past The treatment plan we came up with is something I WISH the ortho had done! We decided to stick with the meds that were working and ditch those that weren't. Imagine that! I'm also having a SJ Injection w/a spinal cord injection on the 27th to see if that will help with the pain. All I can say is my prayers were answered with this doctor it seems. ;) Time will tell, I suppose.

    In answer to your question... Yes, you would be correct. I am a Parrothead! Lived in Cincinnati before moving to Tampa in 2006 "Where the Weather Suits My Clothes" ;)
  • I must have got lucky... as this PM doctor was awesome!!! After going over my records and looking at some ct scans he looked at me and told me he had all the info he needed. It's pretty much black/white in my case as the damage is visual in some aspects. I guess I am one of the rare patients that was given narcotics first visit as we replaced my dilaudid with Mscontin IR to go along with the Mscontin ER I have been taking all along and tolerated well. We also ditched some meds that were not helping that he felt were of no benefit. At the moment, this new PM doctor seem to be an answer to my prayers... I pray it continues, !!!

    Where in Ohio are you/?
  • "Where the Weather Suits My Clothes" I like that saying.
    C3-4-5 fusion 2005
    C-5-T-1 disk bulged
    L-4-5 bulge to the right, with Microdiscectomy, failed
    L5- Bi-Lateral bulge
    Pain in right foot -loss of feeling
    Left butt, hip and front thigh pain with bad shooting pain into inside ankle sometimes
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