Discouraging appointment

I had an appointment with the physiatrist today. He is sort of a PM - does injections and can prescribe pain meds but prefers not to.

He did a thorough physical exam. Seemed very concerned I have groin pain and pain in my left lower abdomen and that it may be a hip problem. Seemed less concerned with my main complaint of worsening back pain. I showed him the lab work my PCP did and told him I thought it was time for imaging. He ordered labs and x-rays but says he expects them to come back normal. I am starting physical therapy on November 2nd, and he seems to hope that is going to "help".

I pushed him a bit more about the pain, and he asked me if I'd tried Neurontin, Lyrica, or Cymbalta. I told him I'm on Cymbalta 90mg and Neurontin made me put on 20 lbs in 2 months. At that point he didn't seem to have anything else to do for me. Mentioned we could re-inject my SI joint, but didn't ask me if I wanted to do it, just that it was a possibility but he didn't seem in favor of it. He told me to go to PT and he'd see me in 2 to 3 months.

It wasn't until I left that I realized he basically had said his plan is to do nothing. I'm just very discouraged. I've already done two months of physical therapy that failed to resolve my symptoms - that is when we decided to do the injection. I feel like maybe I should have pushed for another injection, but I'm not sure. I have breakthrough meds, but I'm worried no one will renew my prescription when I run out because my PCP is not managing my back pain and the physiatrist doesn't want to prescribe.

My wife wants me to get another opinion, but we are moving in two months so I feel like I'll just get new doctors there. But I am kind of out of luck, unless PT miraculously helps even though it hasn't yet.

Heather,

I am sorry that your doctor was not more encouraging, or had a ready answer for your pain. I have been through three PM docs, two that only do injections and my last, who does trigger point injections in office and prescribes meds. It took me 2 years to find him, and my PCP's office staff worked hard to find one for me that would prescribe for my particular issues. I hope you find a new one when you move, one that is able to provide you with what you need. Good ones are out there.

The doctor I have now was chilly at first, very vague, mentioning the injections and then acting like they weren't a ready option. From how you described your visit, I could picture the doc I see now! My 3rd visit, I just asked him why he mentions the injections but never asks what I want. His response was that he was giving me options for treatment, and I should tell him which ones I want to try when I want to try them. He was aware that most doctor's approach is to tell you what you need and that is it, just do as you are told. His approach is to give me options and let me choose. If yours is anything like mine, maybe he is waiting for you to say, give me injections! I want to try them.

I too have pain in the groin and hip area with endo and adhesions. My doc reminds me all the time to do stretches to improve the muscle, and we do trigger point injections into them and the SI joints. I don't know if this is an option, but I hope you get relief soon.

Hugs,
Mindy

Hi Heatherlynn, I think you should get another opinion, I dont know if you can wait until you move or not.  But the pm doc you are seeing now does not seem to have your best interest.  I dont like to hear of doctor who wont prescribe, that makes me nervous right away, there is no reason for not prescribing when you have documentation of your disabilities.

Have you had an mri, xray wont show much, but mri's will, thats probably what you need to get.  Well good luck to you and I hope you find a better pm doctor when you move, this one is not doing you much good, worring about getting your scripts filled is very stressfull and you should not have to go thru that.

Take care and good luck,

Kat

Thank you everyone for your support. Mindy, I do wonder if he's sort of like your doctor - mentions things and then waits for me to say "yes, let's do that!". That is sort of how I ended up getting the injections for hip bursitis.

Right now I am torn between getting a second opinion and going back to my PCP and seeing what she says. I really need better pain control - the pain is affecting my work, never mind my quality of life - and I'm most likely to get that from my PCP. The person I would seek a second opinion from is also a colleague of mine. I am hesitating because even though I know he's the best, I am very hesitant sharing medical information with someone I work with.

Hi Heather I'm so sorry that you're having such bad pain. How did it go at the urgent care? I hope they were able to help you to feel better. Take care.

hugs
Loretta

Hi Heather,

Working at a cancer center, I work with alot of other MDs from almost every background imaginable. A couple of them have became good friends over time, even though we started out as colleagues. While I too was hesitant to share my medical info with others, I have found they're input and advice invaluable. If your colleague is someone you can trust, then go for it....it'll likely be the most honest opinion you'll get!