HealingWell
Search Close Search
☰

Finding a new PM

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 9/1/2015 12:51 PM (GMT 0)
I have been with this PM for about 2 years. He is my first PM doctor since moving from just suffering through not knowing what was going on to accepting that this is my life and I need some medication to cope. He has sent me to PT 3 times (I'm in it right now for the third time) Otherwise nothing has changed in 2 years since he put me on Robaxin, Relafen and Norco (2 per day, 5/325) The last 3 months I have been nearly out of norco by the end of the month (insurance will only fill it once a month) I told him I wasn't interested in PT, but he talked me into trying it again. When I called yesterday for more Norco, I asked for 3 per day so I am not running out. The nurses checked and they said he said no, stay at 2 per day. So now I have 5 pills left and insurance isn't going to fill it before Friday. I'm doing everything I can to conserve those pills in case I have a severe flare, and in the meantime I'm living with a 5-6 pain level. I tell a friend this and he is an epic failure at empathy. He told me I sound like an addict and I should take an advil. I told him to spend 15 years at a 5 pain level and then call me an addict. He apologized.

So I'm just looking for some advice. How do you find a new PM doctor? I have started taking my treatment into my own hands. The last 4 doctors I've gone to for various things have not been referrals. I found them on my own. I'm just tired of dealing with all of this crap.
Posted 9/1/2015 2:59 PM (GMT 0)
Hi Countrydad.

I'm not sure where you live, but at least in some places, there will be 10+ PM doctors within 20 miles. A google search or ratemds.com could help you find the right one.

Of course, you can also discuss it with your primary care doctor. They should know of the practices around that prescribe.


In my own case, I found my first PM via my PCP. Dissatisfied with him, I found my next via ratemds.com. I've been with him now for 6 years and his office is less than 2 miles away :)
Posted 9/1/2015 3:23 PM (GMT 0)
Hey countrydad.2 Norco 5 mg a day isn't much to try to manage pain with.

My PCP was prescribing me 90 Norco 10 mg a month when I was in between Pain Managements.

My PMD doesn't write anything with tylenol in it.

I'd definitely call around.Look at reviews.When I was looking for a PMD 3 years ago I found the people I talked to on the phone pretty informative especially in knowing which ones I didn't want to see.

It took me 5 years and a few bad experiences to get in with the PMD I'm with now.It was worth the trouble.

I wish you the best.

Rick
Posted 9/1/2015 3:24 PM (GMT 0)
A huge part of learning to live with chronic pain is adjusting our expectations regarding successful pain management, and that includes learning to cope with a certain level of constant pain. My pain levels , with meds are around a 4-5. For me, that is a level that I can and do cope with, and have for at least a decade now.
There are some things to keep in mind when it comes to pain management- each doctor is going to make his treatment recommendations on his exam of you, and your results /surgical recommendations from imaging and other consults. He may recommend previously tried therapies, change medications or eliminate them completely. Injections, other therapies may be recommended as well. Medication only management is not typical, at least until all the other options have been explored, sometimes, multiple times.
The other thing that you really need to consider is that taking more than you are prescribed ever, without the consent of your doctor prior to the increase is automatic grounds for dismissal, so you need to take medications exactly as prescribed.
A pain reduction of 50% of your unmedicated pain levels is considered good/effective pain management
When my pm's office was closing and I needed to find a new pm doctor, I used my insurance website and checked the in network providers for one..
Posted 9/1/2015 4:04 PM (GMT 0)
I should add my detail on my 2 years with this doctor. We have tried injections (some steroid mix) that helps for 2-4 weeks. I was on Prednisone from my PCP when he sent me to the PM dr and that worked. I was on it again when I was diagnosed with RA and again, it takes care of all my trouble down to 10mg per day. The scripts he writes me are "as needed" and not take them on a regular basis. He is aware that on good days I don't take any and on bad days I take as many as 4-6 norco. It has only been the past 2 months or so, I've been having more and more trouble, and I've been running out in the last week before I can fill it.

I just got back from PT. It definitely took the edge off, but I can already feel the pain returning in the occipital nerve area where it seems to stem from. They spent an hour massaging that area and down my shoulder blades before doing exercises for 30 minutes.

I realize I will never be pain free. I consider 3 to be pain free. I can handle 4-5 in certain types of pain, but when it comes to headaches, 5 makes it hard for me to focus and be productive. My job is pretty high pressure, so much pain at all becomes distracting and I feel effects my performance.
Posted 9/1/2015 4:24 PM (GMT 0)
CD, first thing I would do is go online to my private insurance & see what PM drs are listed on the plan. Then take this list & go to Vitals.com, fill in the info about your location & see what they show for PM drs. Read up on the reviews of these drs. I do not rely totally on reviews as being the gospel truth simply because if its a negative one out of a bunch of positive it could be an unfair bad review. Thats a pretty good starting point. You can also do a google search for PM drs to see what you find there.

Also, I added this to my post, call the ones listed on your insurance & ask whoever answers the phone if the drs does injections & procedures only. All you have to explain to this person is that you know some pain mgt drs does this only & will not rx prescriptions. Basically, there are two types of pain mgt drs out there & the one you want does it all including writing scripts.

Keep us posted.
Posted 9/2/2015 12:33 AM (GMT 0)
Straydog/Susie, not to be rude but "vitals" is not to be trusted I went to an allergy doctor based on that and he confessed to me that he wrote all the reviews on there. So that can be a mixed bag of hodged podge reviews...not worth anything...
Go to your insurance website like the other's said find a doctor and then google the doctor's name and look to where he went to school and then ask your pcp what pm doctor he would use if he needed one, or ask your RA doctor. RA doctor's can prescribe pain meds and you could possible ask your RA doctor to take over, but again that would mean a new contract and paperwork like what your pm has...
Posted 9/2/2015 1:39 AM (GMT 0)
Thanks Char. I really like my RA so I might talk to him about it.

I'm so frustrated with all of this. It is so mentally draining. Support is so hit and miss. Truly nobody understands what we go through.
Posted 9/2/2015 8:59 AM (GMT 0)
Anytime you use a review site you have to add some common sense to the mix. PM drs get bad reviews because ppl go in expecting and wanting some ungodly amounts of opiates and remember your diverters and addicts use drs as well and they don't get what they want,there's your bad reviews! Its a place in the process merely an not a sure thing. Doing your homework and finding a PM that works well for you is important but finding one that works well with your healthcare team is even more so. Talk to your other Drs,if you have a RA definitely get his recommendation,your primary care physician and any other specialists that you have an see on a regular basis. Hopefully they will all give you at least one that they have a good relationship with and that is going to make the overall experience with the new doc somewhat better. The best PM experience is one in which can work with you not against you and certainly with your other Drs and not against. Then when you have a name talk to your Rph and get a feel for how they think,,then online search reading reviews but definitely checking sites such as the medical society and licensing board for any sanctions against him and any pending litigation.
Posted 9/2/2015 3:20 PM (GMT 0)
Hey Chart, no offensive taken, this is why I stated in my post above that what is written in those reviews should not be taken as gospel truth. Anyone can go in & write a review whether they have seen the dr or not. What I like with Vitals is being able to plug in your info to pull up specialists in your area. There are a;; sorts of info available online to check drs out, it depends on how well people do their homework & how much effort they are willing to put into it.
Posted 9/3/2015 4:15 AM (GMT 0)
Countrydad do they do a tens unit on u at physical therapy? Feels like electrical impulses on you. If so ur pain management doctor can prescribe you one. Just a thought of something that may help. If they do use it on you and you know that's what helps at PT and that is what is giving you relief you can get one for home and that may be what the answer you needed.
Posted 9/3/2015 10:37 AM (GMT 0)
It's so ironic that you posed that! I saw them yesterday at the drug store when I was getting my Norco filled (they filled them!) I haven't used one in years, so I thought I should try one. I ordered a different one on Amazon last night. Should have it Saturday. Here's hoping I'm one of the people who sees a night and day difference with it!
Posted 9/3/2015 7:12 PM (GMT 0)
We will keep our fingers crossed that this works for you. Many of us have had success with the Tens Unit. The newer ones today are so much better than the old style. Keep us posted.
Posted 9/4/2015 10:15 AM (GMT 0)
Thanks. Amazon promised Saturday delivery but as frequently happens, they shipped it for Friday delivery instead. :) So I will give that a go tonight. I also ordered a neck brace to wear while I'm driving. We'll see how feasible that is. I just feel that the constant tweaking on the supporting muscles is increasing my pain while I drive. That and extending my arms up to hold the wheel is straining on the shoulder muscles that are already tense.
Posted 9/4/2015 3:46 PM (GMT 0)
Will pass this tidbit on to you about wearing a brace. Some drs will rx a brace to wear right after having a cervical fusion, same with lumbar fusions. Use to everyone was put in braces right after fusions, but not anymore. The main purpose of the brace is to protect the fusion process, especially when riding in a vehicle & if they were to have an accident.

Before wearing the brace I would check with my dr.. Here is why, drs now say that bracing often causes the muscles to weaken & they are rxing them as they did years ago unless the person just had fusion surgery.

I think I have asked you before not sure, lol. Are you on any preventative meds for your migraines?

Take care.
Posted 9/5/2015 4:27 AM (GMT 0)
Some pain Dr won't prescribe more than 2 Norco a day. Although I don't understand why he wasn't prescribing Norco 10/325.
Posted 9/5/2015 8:19 AM (GMT 0)
Some drs wont prescribe anything for people with migraines she to the high risk of chasing rebound headache's. He may be one of them.
Posted 9/5/2015 11:30 AM (GMT 0)
Headaches are kind of secondary for me, but more debilitating. My primary pain is in my neck, shoulders and occipital nerves and sub occipital muscles.

The tens unit is helping a bit. Need to find the magic spot... But this is getting really old. I've woken up the past 3 or 4 mornings in a row in bad shape. Need to change something about my sleeping.
Posted 9/5/2015 9:59 PM (GMT 0)
CD, have you ever had Botox injections for your neck pain? If not then this may be something to discuss with your dr. My neighbor had a great deal of success with Botox for her neck problems which are very similar to yours. Botox is also being used to treat migraines with success. However, for migraines some insurance companies require that the patient has tried the usual migraines along with the preventative meds with no success.
Posted 9/14/2015 12:14 AM (GMT 0)
Well the last week has been even worse. This weekend has been horrible. They really pushed me at PT on Thursday and I think I'm going to call them and throw in the towel on the PT. As my wife pointed out, I have gotten worse since I started it. Then I have an appointment in 2 weeks with my current PM doc. I'm going to be pretty forward and a grown man may cry in front of another grown man. I just can't keep living like this. It's having an effect on every part of my life; husband, dad, provider, engineer, house upkeep, car upkeep. I can't live the life I used to live. I have been coming to terms with it. But the quality of what is left has gone down so much the past few months that I need to change course. I've been on the same muscle relaxer, anti inflammatory and 5/325 Norco for 2 years. The only thing that really helps is the norco. I am prescribed "1 pill, 2 times per day as needed." I have talked to my doctor in the past that some days I don't need it, and others I need more. This week I have been holding myself to 2 per day and just dealing with the overflow. Saturday I took 6 and I was still at an unacceptable pain level all day.

My wife has been the absolute best through all of this. She has more on her plate than just about any other woman I know and yet she knows what I am dealing with and has gone above and beyond to be supportive. She got most of the kids out of the house most of the weekend because she knew I didn't feel well.

I just can't do it any more. I have a lot on my plate and I can't do all of it at an acceptable level right now.

No, I haven't tried botox...
Posted 9/14/2015 4:22 AM (GMT 0)
I have severe head pain due to bilateral TMJ replacements. Botox has helped, but it can be tricky to get insurance approval. Dry needling has helped me the most. This is done by a PT and is similar to acupuncture. The difference is that the needle is inserted into the muscle knot itself. The goal is to get the muscle to twitch and release. Sometimes a small current is added using an e-stem machine.

Nerve blocks have provided some relief as well.
Posted 9/29/2015 2:23 AM (GMT 0)
My appointment was this afternoon. My current doctor responded exactly as I needed him to. He listened and looked at my history and said yeah, you've tried everything. In the end he is sending me to try facet nerve blocks. He switched my pain medication to Percocet. I took my first one tonight and so far it does not seem to have effected my pain as much as Norco did. Hopefully I will adjust to it and it will help more. Ultimately hopefully the blocks work and I get relief for a year or so!
Posted 9/29/2015 2:30 AM (GMT 0)
Glad you had a pretty good appointment.
I've had pretty good results with facet nerve blocks and I hope you get the same result.
Posted 9/29/2015 4:57 PM (GMT 0)
CD, I hope you can get some relief with the blocks. Its a gamble but worth trying. Anything we try to combat pain is a gamble for us. You still have some other options on the table too. Will keep our fingers crossed this one is a success.
Posted 9/29/2015 7:56 PM (GMT 0)
CD, I'm hoping the facet joint injections help you. I had them in the lumbar spine for nerve pain down the leg, not sciatic but another nearby nerve, each time helped for a year!

I get the 'neck headaches' too. They're awful. I put a tennis ball in a pillow case, lay on the floor and 'roll' the ball under my neck. It helps. Just the past few days I've noticed the knot starting again in my trapezius muscle. My daughter massaged it for half an hour last night but it's still there. The auto insurance won't pay for more treatments (I think it was dry needling, but it didn't help me anyway). I'm interested that you found a tens unit at the pharmacy. Guess I'll be heading there later! My PM was supposed to get one for me, the woman called, but never called again!

I have not found any medications that help with this at all! I'll be following your case!
✚ New Topic ✚ Reply
12