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I have a question about PM Dr.'s

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Posted 7/7/2010 4:40 PM (GMT 0)
 I have a question about PM Dr's. I have been to 2 and the last one has really upset me. Now I went there to see the Dr. he is cool and dose work with people to a point but still he want do a lot of shots. But I saw him the first 3 times then they gave me a nurse that is a want a Dr. now the only time I saw the real Dr. was if something changed and then it is only about the shots. Even If we wanted our meds up we had to wait another 2-3 week another 170 mile round trip just to make an appt for shots. Is this normal or is his what I call a cattle drive?

 Thanks, Butterflyrose

Posted 7/7/2010 4:58 PM (GMT 0)
I find with my PM dr in the very beginging I felt like all he did was injections, and nerve blocks and such things. Now that I have been dealing with him for about 12-18 months I have asked his nurses alot of questions. I dont know if this is the same with all PM dr but mine does everything posible not to have to be anymore invasive than injections. When they all dont work then my dr will try something else like we just did a scs. As for the meds my PM dr for the most part does not write scripts for pain meds. He has given me some for after a procedure but thats it. Hes ok with me taking them but wont give them to me he has I belive they call my primary caregiver dr. (the dr that has been there since day one of my injury) deal wih all my medications. Not sure if thaat helps at all im sure all PM dr are different but thats my experience with mine. I hope they find something that works soon.

peace and much love
Wisco
Posted 7/7/2010 6:12 PM (GMT 0)
I wouldn't accept seeing only a nurse for pain management. Even the n. "practitioners' don't have enough training or knowledge in my book!

There are several types of pain docs. The anesthesiologist has one point of view and does injections and knows lots of medicines. Physiatrists may or may not have specialized training (I'm not sure) and do injections. Some do massage stuff, I've heard, but mine basically does the injections and nerve conduction studies. Then there are neurologists, neurosurgeons and orthopedists. You kind of have to go to the individual and decide for yourself if you are getting the treatment you need.

I haven't found any so far who can deal with my medication sensitivities and fibro on top of spinal arthritis, sciatica, bulging disks ... I've had to stop meds on my own when they don't believe me about reactions.

Frankly, I'm waiting for my rheumatologist to come back. He's been out with cancer for several months and is now working 2 hours a day. He's at least had 2 residencies and knows more about pain, although he did send me to a pain doc for injections. Well, the injections did work for a couple of years, but now don't. Meds aren't working too well right now either.
Posted 7/7/2010 9:20 PM (GMT 0)
Hi, Butterflyrose,
This is my chance to welcome you to the CP forum since I don't think I've done so yet. Beautiful name!

Most of us learn the hard way just what you're learning. More and more "pain management" specialists are moving into the field of interventional medicine, which means they mainly or only do injections, stimulators, maybe pain pumps, etc. but don't want to prescribe meds long term. So when you're making an appointment or looking for a PM doc, it's best to call and ask first if they do follow someone with long term narcotic medications, if needed. It's ok to try the interventional procedures (injections and such), and PT can be very useful, but some of us need medications, too. And it's good to know in advance if a doctor does that in the event these treatments don't work.

Sometimes your PCP may be willing to prescribe your medications if your PM doctor has made that recommendation, and maybe you just see the PM doc once or twice a year for a re-evaluation, whatever your PCP and the PM require. You could ask your PCP about that. Not all are willing to do that.

As far as seeing a nurse practitioner, if he/she is working with a pain management doctor they probably know enough of the basics of pain management. The doctor is probably off quite frankly making more money doing procedures. But if the office is willing to follow you and provide the medications you need through a nurse practitioner, that's better than nothing. Sometimes it may be the only choice you have.

Do you have any other PM doctors that are closer? You could check, and then make some phone calls to see if they also prescribe medications. You could also talk to your PCP and see if he/she is willing to prescribe the medications if you visit the PM doctor periodically.

Wish it was easier for all of us. I have to go 3 hours for my PM doctor.

PaLady
Posted 7/8/2010 11:08 AM (GMT 0)

I'm kind of in the same boat as you, butterfly.  I been going to the same PM for a year now and have only seen the doctor on my first visit and during injections or follow-up visits after injections.  Other than that I see a physicians assistant.  I also have to go every month because they will not give refills for meds but I think it is against the law to give refills for the stronger narcotics.  They do seem to get injection crazy sometimes though cause I think that is where the money is.

My PCP will not prescribe narcotics for long term use though so I am at the mercy of the PM doctor.  I also am seeing a rheumatologist for my Polymyalgia Rheumatica and I asked her to take over for my PM doctor but she won't because she said I have to many things going on in my spine that cause pain.  My PM doctor is over an hours drive one way and the rheumy is local.  Would have been nice not to drive so far.  My insurance doesn't have any PM doctors closer that are in network.  So now I'm stuck paying two co-pays for the time being.

Posted 7/8/2010 11:45 AM (GMT 0)
Good morning everyone, that is the same here. I started with my pm from my BF. He was injured at work and a year after he last surgery he was sent to a pm until his case was settled. During that year the pm dr. saw him every month and was real good. I talked to the pm about my pain and my problems. The pm assured me he would take care of me. So I started seeing him. He did shots to my upper neck and I was out of alot of pain. I went from a 10 all the time even with norco 10's to 5 or below and cutting back to vicodan 5/500 at my request at the time with the understanding I can go back up if I need to. At the time that pain was way over riding any other pain I was having. With that pain down to managemnet level the other pains started in, again I was told he could bring them down. his is where the problem started. the shots has not worked on the rest and they failed to tell me what they were treating me for. The PA/nurse took over the care and it has been a mess sence. If she would get her own note right it would be a miracle. To make a long story short My BF and I was messed up with the reports that the pm and nurse gave. I don't mind the "nurse/pa, but aleast she could get her note a least right. On one page she was my on narco and the second page she has me on vicoden 5/500. Realy the meds she gives a pcp can give and is half the trip.

I am trying to find a pm closer and refferd by his pcp so he can better care.His is under W/C settlement. I do believe I can change his Dr. as he has not asked for a changed his whole case. Even the meds they have him on a pcp can write. I feel what is the sence of going there? Also as long as his W/C nurse was involved they did a good job. When she had to leave him to go onto the settlement part is when it all blew up.

Thanks for the input of all. It is helping me alot. I don't feel as furstrated, but I know what I am up aginst. I can not thank you all enough.

Butterflyrose
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