PM pain in my......

Hi all-
Well found a PM doc who was actually understanding what my pain was like with the nerves in my ribs. Had a cryo-ablation done and it worked for just about 3 weeks. Called back to give them an update and found out my attending had left. Leaving me with 2 pm doctors left there. Went for a follow up appointment and got told she won't prescribe narcotics and doesn't do any type of ablations either. Sends me home with another anti convulsive. Here we go again. Not a huge deal since my surgeon was still willing to prescribe the pain meds and actually he and the PM center had somewhat of an agreement to do it this way. Well since they did the ablation and it didn't work the surgeon thinks all the pain management should be on them now and won't refill my pain meds anymore. Well I call my PM and ask about continuing these. I get a short answer of "no, ask your PCP".
Now this is getting to be a pain. I have had some serious depression lately and my psychiatrist knows it is mostly pain related and had offered while I was in the hospital lately to prescribe it if neither would. So I call him and he gives me a short lecture about how surgeons always do this, get patients "hooked" on pain meds and then dump them. Anyway he does agree to write a script and while I was in the hospital he had them switch me to 2 every 6 hours instead of PRN and it really helped a lot. When my wife picks up the prescription from him it's for 1 every 6 hours. My wife reminds him I have been on 2 for over 2 years and he just tells her I have been taking too much and that's all he will prescribe a month. Wow, what an irritating thing to cut your meds in half after 2 plus tears.
Also, the PM center told me that if the ablation worked at all they would titrate me down, so I called and asked about at least doing that and got the same answer as before... she doesn't prescribe narcotics. But I am welcome to bring it up to her directly at my appointment on the 23rd if I like.
Sometimes I feel like they enjoy kicking us to the curb.


Take care,
Bill

Ps. I was taking 10/650 lorcet and was lowered to 10/325 both 2 every 4 hours as needed before the psychiatrist took over.

 Bill,

I am so sorry to hear what you are going through. These Dr.'s that treat CP patients, for the most part, are a joke. They have no compassion for what anyone is going through. They are not doing the job that they were hired to do. Yes, hired. You hired them and pay for them to treat you. If they aren't I would remind them of what they are there for and how recluss(sp?) it is for them to allow you to go through withdraws and be in constant pain. If they refuse to do anything, I would fire them. Yep..fire them. Get refferals from anywhere. People you know, hospitals, etc. When you call for your innital app. ask the questions. How do they treat people with your conditions? Do they prescribe meds? What is there practice if a patient has severe issues after hours? I hope you can find some relief. No-one should have to suffer like you are. Good luck!! Heather

*shakes head* Gosh, Bill, I find it impossible, though unfortunately not surprising how they just shift responsibilities and let you suffer the consequences. Unfortunately, I don't have any advice, but I hope that it will work out for your best somehow. Doctors generally don't seem to be the most understanding people.

 

   Dear Bill,

 

    It is nice to hear from you. I am sorry to hear you were in the hospital and worse to be treated like that while in the hospital must have been terrible. Is anyone taking responsibility for your care atall? I would be very upset if I were in your shoes. To be dropped like that for no reason is every chronic pain patients worse nightmare.

 

     What are you going to do about your care from here on out? Are you going to change all of your doctors or try to get down to the bottom of "why" they wont perscribe your medicine anymore? I just dont know what to say. I am shocked they would do this to you. I really hope that someone can help you. I am so sorry you have to deal with all of it.

 

*hugg*
  dani

Hi, Bill,
I'm late coming to the party, as usual, but sorry to read you really have joined the maze of the CP world. I would first suggest you call either your psychiatrist, your old PM's office and/or your PCP and see if you can get some help with withdrawals, and stepping down more gradually from that dose. Your psychiatrist should have known better - especially if he's going to even attempt to prescribe pain meds. Shame on him! I actually am working with a psychiatrist for PM and he's had extra training for it because he has so many CP patients, and he knows how difficult it is for us to get decent care. He at least listens to my input, but unfortunately he's a solo practitioner and is extremely busy, so he doesn't always get back to me right away. That's what I've accepted in return for his knowledge and kindness in taking me on as a pain patient who also has depression.

You know doctors can and do leave hospital clinics all the time - either to go to other places, or to set up a private practice. You first PM may have done that, or joined a group practice. Problem is the place she used to work may not tell you where she's gone - especially if she's now become competition in the local area. You could try seeing if there's a new phone listing under her name, or call other pain docs in the area and see if she may have joined a practice. While you're doing that, you can also investigate what services each of the pain management docs do. Not all PM docs are created equal, so to speak. Many now only do interventional procedures (like the ablation you had) and don't like prescribing meds at all. So you want someone that is willing ideally to do both, but definitely is willing to look at and follow you for medication. You shouldn't have to suffer. I know you're still trying to work and enjoy life with the baseball team, and I'd hate to see that affected (any more than it already is) when it doesn't have to be.

Don't give up! It takes many of us a lot of tries to find the right PM doctor. Many, many tries!

PaLady

PaLady-
Thanks for your great advice. I do now really understand the frustration of just wanting relief and how hard it can be to get.

Alcie- I have had injections at the pain site and close to the spine and I got much better results closer to the spine also. Unfortunately mine no longer lasted months or even weeks, just a few days. Glad you found someone who can help.

Take care,
Bill

Bill
Most of the time the injections work better near the spine because that is where the actual cause of the pain is, irritation or inflamation of the nerve roots, but you rarely actually feel the pain at that spot, you usually feel the pain some where down the path way of that nerve. Like epidurals they inject the steroid to reduce the inflamation that occurs where the nerve root is injured. It blocks the inflamation process, and thus reduced inflamation, which reduces the swelling, and thus reduces the pressure on the nerve and thus less pain! That is why allot of times the surgeons often use the epidural injections as a diagnostic tool, if the injection reduces the pain, then that indicates that is the spot or the nerve that is bad, and thus that is the place that needs the surgery done. as in diskectomy or laminectomy or what ever.

It is to bad that more Doctors ( especially Pain Doctors) are not more aware on the proper procedures of weaning a patient down to a lower dosage of pain med. Or even completely off of them! Most are aware of doing it with prednisone, or other steroids, but not with pain meds! Unfortunately the patient is the one that suffers!

White Beard