pain managment...leary

There was a huge mix up at my Dr office. during a conversation with the nurse on the phone I mentioned that the pain meds did not work. I didn't ask for anything just a comment. The next thing I know I get a huffy call saying the dr has nothing stronger for me. I explained that I hadn't asked for anything stronger. I merely mentioned that the opiate he gave me does not work on nerve pain.

The next call was to tell me that because I cant see the specialist until March I am being sent to pain management. Instead of arguing or trying to clarify my statement I just said okay. I figured I would talk to the PM doc and explain that meds don't usually work right with me and that narcotics aren't effective on my nerve pain. Sounds rational. right? I have gone almost a year without pharmaceutical pain relief

I go online to look this place up and find the FIRST page they advise you of the demand for a narcotics contract. It is huge & covers the entire page. There is no mention of any other treatment. I whipped out an email to ask if they are familiar with, have they treated and/or been successful in helping folks with my issue. I also mentioned that I don't take narcotics and was not interested in pain meds of that nature. What other options do they offer.

I have all these alarm bells and red flags going off and I don't know if its just me being cranky over not being listened to by the Dr....I feel like I am being thrown into a snakes pit. Thoughts?

I'm trying to remember if it was the 4th or 5th surgery? Really doesn't matter. I had called the doctors office and told them I was calling about the pain medication. Immediate reply was "You're not getting anything stronger!" I replied, "That's the problem, this stuff is TOO strong! Can he give me something less?" Now, count about 10 seconds of silence..........then, "Oh, we usually get calls for something stronger. Let me put you on hold and check with the doctor." Sorry you are having troubles. I like my pain management guy, so far. Good luck.

I can see why such emphasis on the contract would be worrisome, but it may be that they do offer other avenues, it's just that they're not worried about federal regulations for those, so they may not make such a big deal. But I'd definitely suggest talking on the first visit.

Anecdote: I was getting poor pain control, so my first PM place wanted to put me on a stronger narcotic regimen, even though I had a nerve block scheduled a couple weeks away. I didn't want to switch because, like you, I've had weird reactions to narcotics and I could stand a couple more weeks on what I was taking. They really wanted me to try the higher dose, but reluctantly agreed to keep it the same.

Long story short, my wife went in without me to pick up the prescriptions that we thought were a repeat of my old ones.

Nope. Oops. They were the stronger narcotics the doctor had been recommending. My wife said there was a mistake, but the lady behind the counter insisted the prescriptions were right and after a bit of back-and-forth, she told my wife that it was either those prescriptions or nothing.

My wife, bless her heart, said it would be nothing then, and put the prescriptions back on the counter. Then she said she would mention to everyone that I wanted less narcotics, but my PM place insisted I take more.

After a staredown, the bluff worked. The lady behind the counter went and got the nurse, who got the doctor, who wrote new prescriptions for the smaller amount I was already taking. They got the idea that I wanted to be very careful when tinkering around with doses.

The point is, it may take a bit of "training," but you might be able to get a PM place to understand your unique needs.

Yes, I agree, I don't think you should be put off by the contract. I'm sure it is there to fend off drug seekers, who would love to flock to PM in droves if they could. Since that's not you, just pay no attention and understand that sadly, that's the way it has to be these days.

You'll be their favorite patient by far, no want or need for opiates! I don't understand though why your GP or ortho won't prescribe lyrica or an anti-convulsant or some other more effective treatment for nerve pain. That's probably why people who go to PM aren't usually JUST taking a med like that. And you probably won't have to sign the contract if you're not being prescribed narcotics. I could be wrong but I believe those contracts are specifically "narcotic medication contracts."

Daesin, I just saw this & can understand why you felt like you were being thrown in a "snake pit" after reading online about this dr.. But, I think more than anything the dr is just trying to send a message to those that are drug seekers. I can think of a lot of better ways to advertise than that though, lol.

Do not take it personal as it was not directed at you. I have been seeing PM drs since the early 90's & never were UA's part of the program. The first time I had to do a UA I was offended let me tell you. I had nothing to hide but like your reaction I didn't like it. My prior PM dr that retired a year ago did not have her patients do UA's until the last year she was in practice & we did only 1 UA that year, lol. She did not believe in them & felt like it was wrong to ask her patients to do them. She was old school & relied on her instincts about who was the good patient & who would not become a patient of hers. The PM dr before her, I saw him for 4 years & I did 1 random UA, that was my first one.

If nothing else, look at it this way, if you at some point need a PM dr in your corner by going for a consult with this one, you will know I think if he would be a dr you would consider treating with if necessary. Let us know what you think & make it clear to him you have a pending appt with the specialist. Take care.

Pain Managemment Drs aren't required by Federal Law and so far I haven't seen any state laws that mandate Pain Contracts or drug screens. They are recommended, but not mandated. If anyone has a link to a state law that mandates pain contracts and/or drug screens, I would appreciate the link.