finding new pm dr.

Hello & welcome to the chronic pain forum. Sorry to read what you are dealing with for a pain mgt dr.. Unfortunately, you have several obstacles in your path. It is probably going to be very difficult finding a good dr to get in with. The biggest problem is because of all the changes that have taken place in pain mgt the last few years, it is restrictive & getting worse every day. The DEA is involved, drs are being monitored, scared of losing their licenses, many are leaving pain mgt because they are tired of the BS they are put through. I am talking reputable drs here, not pill mills. Many of are no longer taking new patients. Its a very real & a big problem.

I would not go to this cash only place because probably before long this clinic will get shut down & I doubt very seriously if another dr would touch you after being connected with a clinic like that. Because you are in Florida makes you finding a good reputable PM dr that is taking new patients a tough one. People today if they have a dr they better hang on to him/her.

Finding a dr that understands tolerance these days especially a new one, good luck. Everything in PM today is geared towards the patients being on lower doses or being taken off completely. I am not trying to scare you here, its just the environment we have now being a long term chronic pain patient.

Not knowing the meds you are on or what your medical problems are but we look for ways to distract ourselves from our pain. We do not solely rely on our meds to get us through the day. We are aware at any time we could get them yanked as quick as we given them.

I don't know how long this new dr has been at your clinic, but something you may want to consider is doing a couple of injections if they help fine, if not then you have done your part to show you are willing to try things. When a patient starts refusing things it can go bad. This new dr can very well be weeding patients out that he thinks are questionable.

Other than getting online & looking for a PM dr & calling & finding out what their requirements are to get an appt you can go in for a meet & greet appt to get a feel for the dr & staff. Make it clear that you are looking for a new dr, do not accept any scripts from them. You are probably under a Contract with your clinic now. Some drs require a referral from a dr so be sure to find out what is required.

I am not trying to persuade you one way or the other but PM today is so different. I think eventually we will not be seeing many of them & unless someone is terminal or has a catastrophic illness we are going to be on our own. Sure isn't what it use to be thats for sure.

Weekends here tend to be slow so keep checking back.

It sounds like you might need to switch meds. Its going to be very hard to find a new doc who will start you on a dose that high of anything.

There comes a point when tolerance overrides relief no matter how high you try and go.

Maybe ask this existing doc if there's anything other than the fentanyl that he would recommend switching to?

What makes this guy a jerk? Sometimes the grass is greener, sometimes not. So it might be worth trying to come to an understanding with this guy if you can.

Welcome to the forum PF. I am not at all surprised that the Dr is giving you a hard time about meds but I am surprised at how much your on. That amount exceeds every governing agencies recommended daily allowance for noncancer related chronic pain. Those types of prescribing get those ever watchful eyes of those governing boards at their door. I'm also really surprised you've been able to get a pharmacy here to fill that amount.

I am not trying to be harsh but in reality for your own benefit I'm going to say from your username your expectations of pain management may be too much, "painfree" is not something we are ever going to have the pleasure of meeting and today more than a year or two ago its even more unrealistic to hope for.

Painfree is not something we even work towards anymore instead we have to strive to find many different things that cut a piece out of our daily pain levels and take each piece and build the best pain relief regimen we can and today opiates only play a very small role in the overall regimen. There's not a Dr legitimately ever going to be able to hand over enough narcotics to give us pain freedom. Those of us who have been in the game of CP long enough have had to come to terms with that and adjusted our way of thinking so that we are not disappointed with the outcome of our expectations.

That being said with all the changes thus far in PM and all that's still to come I would be preparing myself for getting less meds not looking for a way to get more. Your not going to continue to be left on that kind of dose forever and believe me they do not care about whether your getting relief or not.

Take a look at the last 15-20 pages in this forum and the posts from folks who have been dropped down, decreased, titrated off and discharged from PM over the last six months even. It's coming to the point that the majority of folks like you and I will be pain pump candidate's or will be fighting for what small amount of meds they are going to allow us.

I would with the state of pain management where it is today be terribly afraid to be dependant on the amount of meds your currently on because in the not so far future they're going to take it away, cut it in half, make it impossible to get, something to leave you in a horrible position.

Simple answer to your question would be its in your best interest to put up with a jerk and be thankful your not here today asking us what to do for withdrawals from that higher than recommended dose because your Dr can nolonger prescribe it or your pharmacy can nolonger fill it.

The FDA Guidelnes that drs are going by now is 120 mg Morphine/Morphine Equivelent Daily. And there is a new suggested guideline from the CDC that takes it down to 90 mg, but that has a ways to go before it goes into effect, if it does. In all honesty if you find a dr that does do it, he won't be doing it much longer. And when they close him down, if he doesn't reduce the amount his patients are taking, no dr will want you for a patient. I doubt that you can find a dr now that will take you with you taking such a high dose.

You need to adjust your life style. I understand you have to take care of your father soon. But, you may need to either get others to help with his care or pay someone. I can guarantee that having to take care of him won't get you anymore pain meds. You also might want to see a pain psychologist that helps with non medication ways to manage your pain along with the reduced meds. You also need to be prepared for the dr to lower your meds even more.

In some states paying cash isn't always a sign of pill mills, but you have to be careful. We have a dr where I live that has been in practice for a number of years and he takes cash patients. A friend of mine goes to him and he is very strict, but very good.

One resource that is frequently overlooked is your pharmacist. Why not have a chat with them as see what they think of the local practitioners? No one is more up to date on the latest recommendations for prescribing pain medications. They may also know of other methods that have been successful for other of their chronic pain patients.

Just an aside, I started getting awful morning headaches and needed to look no further than my own pillow! I had bought a new one because my old one was all flattened out. Well, turns out, flat is what I need! I was lucky. I hadn't thrown the old one out. When I went shopping again, I looked for a new 'flat' pillow! No more neck headaches in the morning!

painfree??, your age is also against you. Many drs are also reducing the pain meds when a person gets close to 65. Even though someone may have taken meds before this age and had no problems, getting older cam complicate matters. Seniors usually take more meds for varies conditions that can affect how the pain meds affect you. Our metabolism changes are we get older. Things like falls also usually increase when you get older. The thing is that the drs are being reminded of these things now days. In the past they may have not looked at the whole picture as much as at the individual senior. But 2015 is most definitely
not the past.