second opinion

Squid,

I am in agreement with you. If you feel that you need better pain management then you need to seek it. You obviously are only seeking a second opinion and if this new doctor feels that you should be better managed then I would go with him. You know your body and you know that you aren't getting the relief you need. If your previous doctor who has known you for 25 years and still isn't willing to trust you then there is something wrong there. I know you are doing the right thing for you and I hope that the new doctor will be able to get your pain levels to a more manageable level.

Best of luck
Morgan

My PM dr is awesome and if I ever move / leave I'll send him a letter thanking him for everything he's done. Like mentioned you never know if you'll have to come back or he holds they key to your life.

hi stray dog
im in Australia it all works different here our local DR can pretty much prescribe anything here short term but to get anything long term say butrans its called norspan here he applies the the drug of dependence authority . he states your case why you need the meds and they say yay or nay . usually yay but its getting your dr to want to do it that's the problem ..

he can send you too a pain clinic but you could wait yrs too see anyone if your in the public medicare system or you could be seen in 4 weeks if you have taken out private health cover like I have . once you go thru a pain clinic and say they recommend you should be on x y and z meds they then give your dr approval to write it up . again it's finding a dr who will help you do this or give you reasonable meds to start with ..

another I find different in our medical systems is no pharmacist will refuse to fill a script that a dr is written. our pharmacies' order what stock they need from the drug supplies they don't get told to can only oreder so much a month . also if we have 3 different meds on the same script you don't have to fill all of them you might say can you one of the meds or two of them but I have enough of the other don't supply that one they then cross offwhat they have supplied then give you back the script for you to present when you want the next item off the script .

with my butans they write up a 3 months supply u get them to supply me one months worth 4 patches they cross that off the script and next month I give them the script and they fill that months and so on till all have been supplied then they keep the the script and you go back to the dr for another script with 3 repeats on it .

if a chemist refused to supply what a dr had prescribed the poo would hit the fan big time here a pharmacist may ring your dr to confirm the script but ive only ever had that done once in 10 yrs or so. another thing we can take the script to any pharmacists even if you have had part of the order filled elsewhere you can use that script anywhere in the country and its accepted .

but the one thing we have in common is finding a dr who understands pain management and is willing to write up what you need .

sorry if ive gone off topic but when I read some of the post about people getting refused there meds by a pharmacists that a dr has written up I just shake my head in disbelief how can they over ride what a dr has ordered that's sheer madness

cheers dean

Hello Dean,

Above, Vickie said:

"If you do decide to switch to your wife's Dr then I would put together a letter to your old Dr thanking them for their many years of care.."

I think that is very good advice. One thing I learned in my 61 years, is you never want to burn bridges. I too have had a long term relationship with my PCP/Family Doctor, believe its getting close to 15 years. He knows me inside and out. If I ever had to switch, I would want to leave in good terms with him, as he has been through all 4 of my cancer events, my many ops, both radiation events, plus a number of injuries, etc.

It's too bad your current doctor either can't or won't help to do more with your CP issues, so checking out the other doctor makes perfect sense.

I hope that visit goes well for you, let us know what happens.

David

dean I can understand your feelings, but one way or the other, I think even in Australia your paying him for his services, aren't you? You have taxes or something don't you? I mean he is getting paid to take care of you some way, and that money has to come from somewhere??? If it comes from your government, they get it from the people don't they? Anyway the thing I am trying to get at, is if you used a auto mechanic, and he no longer serviced your car the way you wanted, wouldn't you go to a different mechanic? and would you feel like a "traitor" for doing that? Isn't it kind of the same thing?

Anyway I think your doing the right thing, and I hope it all works out for the best for you!

White Beard

Dean, best of luck with the new appointment. I must admit I'm lucky with my GP (I'm in Australia too). I do also see a PM doctor because of my intrathecal pump and SCS, but it's my GP who prescribes all my meds because he's five minutes away vs. more than an hour away - and is an amazingly kind man who has even given me his private mobile number for emergencies. Although of course my PM is overseeing everything, my GP just gets me to have a review with one of the other GPs in the clinic to satisfy the Prescribing Drugs of Addiction guidelines.

If things don't work out as you hope with your wife's doctor, it might be worthwhile looking in on the Chronic Pain Australia page? They have a forum there that I visit from time to time. It's nowhere near as active as this one, but still a very friendly bunch and if you were willing to let on where in Australia you are it might be that someone could help you out with suggestions for a GP or PM to help you.

Laura

ok all
had my appointment for a second opinion and I felt it was productive but more importantly I felt I was listen too . after chatting about the my injuries cause treatments meds ect ect he gave me a good examination and said gee your a bit of a train wreck arnt you . I said I just want to know if you would treat me me any differently than my current dr and if so what would your plan of attack be to offer me some relief . he asked if I would be willing to go for some x rays and further scans so he had a clearer pic of what was going on and I agreed so he wrote up for me to have a xray left hip just to check my hip replacement is ok . followed by C-Tscan of my spine& lumber area following that up with a bone scan of my spine pelvis and hips /femur.
he said my current level of meds is obviously not giving me the relief I need to make my life comfortable as best it can be and would be happy to treat my pain after getting the scans done . he suggested cortisone injections into the spine but he suspects the facets joints are wherea lot of my pain is coming from and my last lot of scans are 6 yrs old and they mentioned then of problems there.

so all in all I felt positive leaving his rooms and he said just keep going to by dr im seeing atm for my pain meds till after we get the results back from the scans .I didn't ask him for any meds and none where offered but he could see I was in pain when he started pressing my back in places so in the next few weeks I will get these scans done and get back to him and then see what his plan of attack is . he did mention that maybe my level of norspan atm was not enough to do the job and im hoping my original dr will increase the dosage up to a 30 mg patch on Friday .

so at least he is willing to investigate me further and hopefully come up with a plan of attack . I must admit I felt a bit guilty seeing another dr after been with the same one for so long but im glad I did seek a second opinion now .will keep all informed as my journey continues

cheers dean

well I got my butrans upped from 20 mg to 30 mg I was quite surprised my old patch comes off on sunday it will be interesting to see if I notice any improvement fingers crossed .

cheers dean

Dean as for the guilt? Wouldn't worry too much as Drs are like any other service provider. We tend to go with who offers the best value.

You didn't mention whether you told him you were seeking a second opinion and I know here anytime I have anything done at the hospital no matter who orders it my Dr of record also gets a copy of any reports. Don't be surprised if its the case there as well and upon the next visit he inquires.
Just a heads up and good luck on your increase, hopefully you will see some difference soon after.

hi all

well my butrans "norspan" has been increased from 20 mg too 30 mg now ive had the extra 10 mg patch on now for a couple of days and my pain level seems a bit lower I wouldn't say by a great deal but enough to notice a difference .

but its making me feel quite tired and lazy and a little bit queasy not enough to want to throw up but the feelings there if that makes sense.

im hoping that feeling will pass as my body adapts to the dosage  .

I don't know if 30 mg is considered a high dosage or not or what other people are on . I have a good friend who has been on 10 mg for pain for a few yrs and he says the 10 mg is plenty to control his pain.

so if you don't mind me asking what dosages are other people on . ?

cheers dean

hi dean,
you seem to have quite a journey there. really hope you get some good results out of your scans, your new dr and all of that. Just wanted to suggest to maybe use a pain diary. did you ever try that? A friend of mine was doing that for his arm and shoulder pain and after a while had quite a nice representation of his pain and how bad it felt. he was able to communicate it better to his doctors and actually eventually his physical therapist recognised a pattern and adjusted treatment and it really made it better for him. also heard about another guy who had quite similar problems like you - trying to explain his pain to his doctors but was with him already for quite some time and their way of communicating and understanding each other and also the dr's treatment was already so clear that they hardly were able to think in new directions. when he showed him though the pain diary the dr understood in how much pain the guy actually was and based on that rethought his approach and changed the meds. maybe worth a try. if you want I'll ask my friend which pain diary he used?
cheers,
jaszy

hi all

well results from my scans are in and had my apt with the dr giving me the second opinion so here are the results he said not as bad as he was fearing so that's good I guess lol

ct scan

1  alignment from L3 down is normal

  

2 at L5/4 there is annular laxity the facet joints are mildy degenerative changes noted but there is no central canal or foraminal stenosis

3 at L4/5 there is generalized annular laxity

4 at L5/ S1 the disc is reduced in height and there is annular bulging and osteophyte formation . there is mild degenerative changes within the right facet joint.

5 pelvis shows signs of previous fractures and sciatic nerve infringement  . left  total hip replacement looks tight and in good alignment

bone scan

there is moderate uptake seen at L5/S1  finger at the endplate corresponding to the region of abnormal disc and endplate sclerosis as seen on ct scan

there is no uptake abnormality seen associated with the facet joints . increased uptake at the right patellofemoral compartment of the left knee most likely degenerative in origin.

conclusion left L5/S1 disc and endplate changes. bilateral knee oa changes as described .sciatic pain caused by infringement in left side of pelvis due to previous  injury    

so there ya go folks make of it as you will he has made a another 1/2 hr appointment to discuss pain meds as he agrees the level im on at the moment is suitable . he is working out a pain med schedule and will explain it too me next time we meet then it's up to me to decide to go with him or stay with the dr im with atm

hope your all having a pain free day

cheers dean