Bad appointment at Pain Management today.

Seashell,

Hallelujah!

I might have written your reply myself ... well in part. I am pretty thick skinned. People who would treat me with distain can kiss my butt (excuse my French) family or not, however I do feel bad if you have callous family members. Fortunately, I don't have that worry. My main family is the small mixed race, black/Latino child I adopted at age three, 20 years ago, who is grown up now and has 2 babies of his own. They don't judge me at all. He or the babies.

My pharmacy is cool. It's a big CVS. I gave them a 5 star review last year as they had a couple of reviews that were 1 star and fairly petty. Yes, sometimes you do have to wait in line for 15 minutes when they are busy. I don't like it either but they always have all my medications when I get to the counter.

I notice a few members immediately jumping to the defense of doctors no matter how awful the stories are. (especially my post worst pain doctor on the planet) I didn't expect that. I guess some people must have always have had a friendly helpful doctor, and I am happy for them. Really. They don't know how lucky they are. However, one nasty, inhuman, sadist with an MD will change their opinion that maybe some doctors really aren't worth the paper their diplomas are printed on.

One member mentioned it was a shame that the people who were satisfied didn't leave good reviews. Just people who were angry. (or something like that, I need to go read that post again) Those people do. I have. The 'worst pain doctor on the planet' doesn't get good reviews because evidently he is just plain venal and nasty and a total dick to all his patients.

My first review was a lengthy 5 star on my clinic. I mentioned all the doctors and staff by name and gave them a sterling write-up in 2015 because there were several 1 star reviews. Perhaps the 1 stars people had a point. The office management turned over a lot and it could have been organized better by upper management. But the people were good people.

I gave my primary a 5 star review too. RNP. Crusty older guy like me. Best primary I have ever had, hands down. You wouldn't know it by looking at his sour puss but he is a healer. He just can't write for opioids anymore. His DEA number quit working one day last year, which is why he referred me to pain management. He was somewhat philosophical. The DEA just wants to drive pain suffers to illicit use with the excess control. Other, more secret arms of the government apparently oversee and protect the cartels anyway. So, the g'ment gets it's cut either way.

However this isn't a conspiracy board, so I'll deal with pain here.

Being beholding to a medical professional, going hat in hand to beg for pain meds is an unfortunate reality. There are healers (as I mentioned) and there are medical corporations in the form of an MD. Oddly, not many healers show up in pain management. My RN at the clinic was. But's she's gone now and Attila the PA showed up instead.

Interestingly, I talked the pain management racket over with my neurological orthopedic surgeon with the cool title (Diplomate American Board of Neurological and Orthopedic Surgery) the one that said I was a candidate for disk fusion and 4 screws, and who had a very low opinion of pain doctors in general. "they are usually anesthesiologists' he opined "they aren't real doctors anyway"

So, there you have it. Rather low in the pecking order are most pain doctors. Maybe they have inferiority complexes.

However, I don't care about the status, only the care they provide.

Necrosis, huh? Crap. Sorry.

Palliative care? My father went that way.

Karen, Spirit is watching over you, of that you can be sure. We are all loved by our higher power, even if many can't or won't feel it. I wish I had some suggestions for you about your conditions. I am a layman, but an educated one. I can't speak to the medical issues of others except to say 'food is medicine'.

That's a rule I try to live by in my life. Well sometimes, anyway.... I manage to go raw food and steamed veggies for a while but human frailty usually catches up with me. Fresh ginger, turmeric, garlic, raw honey yada yada yada. You probably know this already but it never hurts to mention the medicinal properties of some food.

BTW, I am a jazz guitarist and I am working with a world renowned jazz/soul/gospel/blues diva (a highly spiritual black lady with incredible pipes and 'soul' that goes on forever) She is a vegan so I have a bit of a role model. I think it's important to have evolved beings around you. Hopefully you have some in your circle of family and friends?

It is easy to say you will pray for someone as a platitude, however if I can share any experience, strength and hope with you on the forum, I certainly will. My tongue can slice and dice those who deserve a good tongue lashing, but I can manage words support too. My condition is painful but nowhere near as debilitating as yours. In the words of Chief Dan George (from a Clint Eastwood movie) - "Endeavor to persevere"

The quote is humorous and ironic, I suppose:

"When we finished he shook our hands and said, "endeavor to persevere!" They stood us in a line: John Jumper, Chili McIntosh, Buffalo Hump, Jim Buckmark, and me — I am Lone Watie. They took our pictures. And the newspapers said, "Indians vow to endeavor to persevere."

Great quote! We should all "endeavor to persevere" in our own way. (don't know why in the world I thought of this quote now, but I have always liked it)

Thanks for responding. A few others wrote lengthy answers and suggestions. I think I have dumped what I need to about my rotten experience with pain management. Maybe I can try to be a ray of sunshine....

Post Edited (jazzer) : 11/19/2016 1:03:16 PM (GMT-7)

Jazzer:
I can identify with almost everything that putting to words.

I am a physical therapist by profession with two master's degrees in business administration. I spent a good portion of my career working as a consultant in health care and designing care delivery models.

For anyone who thinks that physicians are enlightened and all-knowing, I urge you to pause and re-assess your position.

Physicians are human and are no less fallible than any one else with an equal or lesser degree of education.

Not all physicians are equal in acumen and insight. Remember, not every physician graduates at the top of his/her class.

In my own academia leading to my master's in physical therapy, I saw firsthand how the university felt obligation to prop up and support students in the program who were underperforming. These students were provided with 1:1 study coaches and clinical mentors. No student, once admitted into the professional program, was allowed to fail - although some students would have been better served in being allowed to fail.

In my own professional working, I came upon situations time and time again where I was in disbelief that the clinician before me was actually licensed. The person's clinical skill set was so inept that I could only shake my head in disbelief.

The lesson being: There are any number of inept and uninformed health care professionals - physicians, nurses, physical therapists, et. al - at work in hospitals and out-patient clinics.

Due your due diligence. As a patient, take time to interview any new physician or ancillary clinician that you come to meet.

Do not blindly accept any physician's or ancillary clinician's advice or recommendation. Take time to learn about and study any diagnosis or finding that a physician or other may assign you or label you.

Physicians do best with the diagnosis and treatment of common ailments that have their own inherent, natural course of recovery - where, honestly, physician input has little bearing on whether or not one recovers or not.

Specialist physicians are particularly limited in their scope and knowledge. Have you ever gone to one specialist only to find that you are referred to another specialist . . . and yet another specialist? It is troubling that physicians are increasingly more specialized and unable to view the body and body systems as an integral whole.

My interaction with pain management physicians has been limited. A one visit consultation that was billed at $685, with a complimentary urine toxicology screen for $1,500.

I was, and remain, appalled at the lack of concrete benefit or value from the visit. I was, and remain, appalled at the pricing model. Where, but in healthcare or legal services, can a person charge such outlandish prices?

And, please, do not tell me that physicians and lawyers justify their exorbitant prices due to their years of schooling and opportunity costs.
There is no justification for taking blatant advantage of people who are sick and unwell and at their most vulnerable. I have three master's degrees . . . I have spent years in the library of academia . . . and I have never milked the public and the sick and vulnerable as does the mainstream healthcare industry.

I am 56 years of age. I have had the fortune of top notch medical insurance and access to top notch medical care living in a large metropolitan city on the west coast. But for all of my fortune, I have had the worst of physicians and the worst of care in solving the complex and complicated puzzles of auto-immune and endocrine/pituitary disorders. I am a shell of my former self. I live a quiet and contained life, constrained by fragile health.

I deserved better from medical professionals and health care than I received. My life has been forever altered. There is no "getter better" for me.

Am I angry? You betcha. My life, and any hopes and dreams that I may have had, have vanished.

The lesson: Good health is the foundation for one's life. Without a modicum of health, the prospects of higher education, a fulfilling career, financial security, relationships with friends and family, avocations and hobbies, travel and fun . . . disappear.

Chronic pain is tough. Of the ailments that plague my tiny body, I would cite ongoing and unrelenting pain as the most derailing. Unrelenting pain has no endpoint. It has no finale, no finish. Pain interferes with every fiber of my being.

I do get some relief with the narcotic cocktail that I am prescribed. It does not eliminate the pain but rather takes the pain from the forefront of my being to an ongoing annoyance. Relief comes in 2-3 hour increments.

How is one to survive unrelenting pain? The emotional and physical toll.

I find it reprehensible the legal hoops that I must jump through each month to refill my narcotic prescriptions. I find it reprehensible that the government has decided how much pain I am to endure by setting limits on prescription dosing. True, I am able to petition my insurance for higher prescription dosing because I am in palliative care. But the approval process takes away from my limited energy to pursue the maze of policy restrictions for access.

I consider pain control to be a basic right. Anyone who does not consider pain control to be a basic humanitarian right has not yet experienced unrelenting, severe pain. Pain control is as basic a need as is the need for clear air and clean water. I would consider pain control to be one of Maslow's most basic of needs.

I have been told that I will need to be on narcotics until I die, as there will be no better state for my physical body. It leaves me shuttering. Because I do not believe that the government nor physicians has any read concern as to my well being or pain control.

In the darkness of the night, we are each alone. Alone in our broken
bodies. Alone in our own pain.
- Karen -

I just finished reading through this thread. I thought I kept things prepared, but, I have to say Jazzer, it sounds like you have me beat. I am 52 and live in constant fear of this kind of thing. It is hard to give an opinion of what to do next, butFor me some of it would depend on how hard it is to get in with another doc. I have heard that being fired by one can lead to issues being accepted by a new one.

I agree with your assessment of the contract. By stating 'abuse' as the definition, they left this open. From the National Institute of Health (NIH): "According to the "Dietary Guidelines for Americans 2015-2020,” U.S. Department of Health and Human Services and U.S. Department of Agriculture, moderate drinking is up to 1 drink per day for women and up to 2 drinks per day for men."

By that definition, one drink per night should not be an abuse. My contract says that I may not have ANY alcohol unless my doctor tells me to. (I have been wondering how that works, btw - "you were a good patient this week - you can have a lollipop or a coupon for one allowed drink" ???). If that were Jazzer's contract, then he would have an issue.

My pain doc has also added questions about whether I have been sexually abused, a question on whether I have abused drugs in the last 3 days and questions on whether my family abuses drugs. I am also not allowed to leave town as I have to be available on 24 hours notice to present for a pee test. I find their questions disturbing. My neurologist took over my meds and I no longer see a pain doc, but I am only taking Lyrica 150 and a Tramadol ER from them.

Pit mom - sadly, that goes with the old joke "what do they call the doctor who graduated bottom of his class? ...... Doctor". I have had a few of those. We have to kiss a lot of frogs to find our medical team.

Mercy&Grace made one very good point in assuming what is in you records. I pull my electronic file all the time to check and am amazed at how frequently they either cover nothing we talked about or they have been "sanitized" to report what the doctor should have said but didn't. I have a love hate relationship with my sleep doc, but her PA is wonderful. I just print the records that they put in and add my own annotations so I remember what did happen.

Last note...regarding doctors education which was mentioned above. Doctors have to complete continuing education units to keep their license. I don't remember how many units, but I know they had to take more than I did in order to maintain my project management certification on top of my company's requirents for CEUs.

In addition, Doctors have to retake their board exams every ten years. It is a very long exam and they have to study for it for a long time. My best friend just took hers in May and told me it was for the last time. It isn't as easy to test once you are in your mid fifties and she didn't want to take it again at 65 in order to work longer.

I agree some PAs are very knowledgeable and sometimes have more experience in certain areas. My pain PA could always find my pain spots and knew what to do with my headaches. She was also better at nerve blocks. When she did them, I hurt for just a day or two - and she did 9 at once. He did two and I spent a month in agony.

Thanks all, I am finding this thread very informative.

You are most certainly right! I agree there are some PA's who are wonderful. However, there are also ones who are not so bright. I used hate NP's but I have found a couple I actually like and they know their stuff. Our schooling is much different, we are taught like doctors. As NP's are nurses. But, they also have more power so to speak than we do. They don't also have to have a supervising Doctor they're allowed practice more independently. But, they do have a doc review their records like every 3 months. So who do you think would be better to see? We are under the state medical bored and they're under the nursing board.

Firefly18 said...
I just finished reading through this thread. I thought I kept things prepared, but, I have to say Jazzer, it sounds like you have me beat. I am 52 and live in constant fear of this kind of thing. It is hard to give an opinion of what to do next, butFor me some of it would depend on how hard it is to get in with another doc. I have heard that being fired by one can lead to issues being accepted by a new one.

I agree with your assessment of the contract. By stating 'abuse' as the definition, they left this open. From the National Institute of Health (NIH): "According to the "Dietary Guidelines for Americans 2015-2020,” U.S. Department of Health and Human Services and U.S. Department of Agriculture, moderate drinking is up to 1 drink per day for women and up to 2 drinks per day for men."

By that definition, one drink per night should not be an abuse. My contract says that I may not have ANY alcohol unless my doctor tells me to. (I have been wondering how that works, btw - "you were a good patient this week - you can have a lollipop or a coupon for one allowed drink" ???). If that were Jazzer's contract, then he would have an issue.

My pain doc has also added questions about whether I have been sexually abused, a question on whether I have abused drugs in the last 3 days and questions on whether my family abuses drugs. I am also not allowed to leave town as I have to be available on 24 hours notice to present for a pee test. I find their questions disturbing. My neurologist took over my meds and I no longer see a pain doc, but I am only taking Lyrica 150 and a Tramadol ER from them.

Pit mom - sadly, that goes with the old joke "what do they call the doctor who graduated bottom of his class? ...... Doctor". I have had a few of those. We have to kiss a lot of frogs to find our medical team.

Mercy&Grace made one very good point in assuming what is in you records. I pull my electronic file all the time to check and am amazed at how frequently they either cover nothing we talked about or they have been "sanitized" to report what the doctor should have said but didn't. I have a love hate relationship with my sleep doc, but her PA is wonderful. I just print the records that they put in and add my own annotations so I remember what did happen.

Last note...regarding doctors education which was mentioned above. Doctors have to complete continuing education units to keep their license. I don't remember how many units, but I know they had to take more than I did in order to maintain my project management certification on top of my company's requirents for CEUs.

In addition, Doctors have to retake their board exams every ten years. It is a very long exam and they have to study for it for a long time. My best friend just took hers in May and told me it was for the last time. It isn't as easy to test once you are in your mid fifties and she didn't want to take it again at 65 in order to work longer.

I agree some PAs are very knowledgeable and sometimes have more experience in certain areas. My pain PA could always find my pain spots and knew what to do with my headaches. She was also better at nerve blocks. When she did them, I hurt for just a day or two - and she did 9 at once. He did two and I spent a month in agony.

Thanks all, I am finding this thread very informative.

Post Edited (PA Timberman) : 11/29/2016 8:26:31 PM (GMT-7)