Is there a limit on how often we can see the pain doc?

Alcie, look in your new Medicare book & see if there is a limit. My prior PM dr saw me once a month to refill my pain pump & Medicare never balked on paying her. This was when I had a Medtronics pump that could be filled every 3 months. She preferred changing the meds monthly because she said the meds became ineffective sitting in these things for months at a time. My current PM dr fills this Codman monthly & still no grief from Medicare.

I think what you are dealing with is a PM dr that is not interested in helping you any longer. Perhaps its time to start looking for another PM dr. Is there a chance of seeing a different PM dr in the group?

Susie had some good things to say because I do not know why you would be limited in this way if your pain is not well controlled. Not the nicest think for the Dr. to say. Always amazes me. Rufous

See, and I read it as 'I hope what we are doing today/have done has been so effective that you don't need to come in for quite some time'.

What occurred the last time or two that you were I the office? Injections? New prescription?

The reason I think it's this is because normally a doc would straight up say 'I don't think there is anymore that we can do for you. Let me know if you'd like a referral to _____.' Or something that actually closes out the relationship.

Thanks crew, for the support.

Susie, I don't have a pain pump, so no "visible" reason to see the pain doc. Central cord and pain syndromes don't show up on imaging.
My current doc is the anesthesiologist. He took me away from the physiatrist when I came in after the broken neck. The phys does lumbar injections, prescribes meds, deals with rehab. The anesthesiologist injects all levels, does ablations, prescribes. He's very caring but a little gruff. I think he was serious about not coming in. I wonder if he's thinking I'm there for attention and should just learn to live with pain like many people do.

I haven't found anything in the paper stuff Medicare sends. I've searched online with no results so far, just mealy-mouth words like "necessary."

I've been thinking maybe I need some other kind of doctor to put in 2 cents, so I saw a new neurologist, just for the very painful spasticity and muscle spasms. I made it clear I am in pain management and am not looking for pain meds. He looked over my list of what I've tried for the spaz and said I've already tried mos things (1/4 dose baclofen = sleeping all day and night). His Rx: very low dose clonazepam.

Dixie, I read your posts and wish you well!

Rufous and pitmom, Doc was not being flippant. I think he really meant staying away, as he's done all he can do, not that I am cured, but I won't get anything more out of ablations. I can't understand why there isn't someplace he can hit that will put the nerves to sleep. He doesn't want me to have any higher meds either. They don't do much anyway.

Annabanana, my last visit was a lumbar ablation for sciatic pain. It helped for that, but you should see me in the morning trying to get out of bed and walk to the kitchen. I can't bend over for a couple of hours until half a Norco, a tramadol and a cup of decaf on the couch with my heating pad.
My doc gives me 3 new scripts for the Norco every 3 months, just calls in the tramadol.
There isn't really anyone else to refer me to, except maybe the neurologist I just went to, but I'm not expecting much from that. Surgeon said there's nothing to do surgery on. (So now my spine is fusing itself.)

Rick, yes, as I mentioned above. I've seen this pain group since rheumatologist referred me 8 years ago. Pain mgt seems only to be concerned or specialized in spinal issues. I see an orthopod for my knee and shoulder. I want to wait for shoulder surgery until after vacation with the kids and grands. I volunteered to babysit.


Well, it looks like there are no written limits, but I suspect docs get harassed for treating too much.

Hi Alcie. I think maybe your doc does not want to script you meds anymore. If you work with your current doc to get a referral to a next step -- pm doctor -- he would be pleasant and helpful.

Sometimes questions don't really help.

They should, but they don't.

ClaireS

Is it possible that he wants you to see the physiatrist again? Or that he gave instructions to a staff member and it was accidentally not passed on to you? None of that letters, because we can't say for sure what his motivation was. I think calling his office and asking is your best course of action.