Doctor question

Hey folks -

I'm having a bit of a tough time finding a pain management doctor. First off, I have fibromyalgia and medullary sponge kidney - I actually had a pain mgmt doc BEFORE I was diagnosed with fibro (she's the one who diagnosed me) for the kidney pain and kidney stone pain associated with MSK. Now the two conditions sort of overlap and feed off each other so it's difficult to separate the symptoms and associate them with either one or the other condition. So, I started at the pain doc in mid 2007 for MSK then was diagnosed with fibro in late 2008, then moved to Virginia (from NYC) in 2009. It took a WHILE to find a doc here in Richmond but finally I found a rheumatologist - of course she wouldn't prescribe anything with narcotics (because that would be too easy, right?) mostly because I had originally been using them for a kidney condition, not fibromyalgia (and because she just didn't want to deal with narcotics). Fortunately she knew of a pain management doctor, a wife and husband that were both doctors and they ran a pain mgmt clinic out of their home. That was great for the last 2 yrs but now they have decided to close down their practice and I'm doctor-less again. I've tried contacting the two other pain clinics in town and neither of them will accept me (because they don't treat fibro or they don't believe my MSK causes pain - I have the fun fun time of having TWO pain conditions that can be construed as "in your head" by some doctors). I won't get into the whole argument of how I could get turned away when I have a four year history with pain mgmt docs - the one in NYC belonging to a very well respected hospital. Moving on - I've made an appt with the rheumatologist I saw 2 yrs ago that referred me to the pain mgmt doc in the hopes that she can help in some way (seeing her on Monday) but I only have enough medicine to last until the end of January so I really need to get going on this.

Other factors I have to consider: 1) I may be losing my insurance at the end of this month so I'm not sure what that's going to mean (My ex-boss won't let me have COBRA and I'm working on looking into getting my own policy but I'm not sure about fibromyalgia as a pre-existing condition). And 2) I'm in the process of applying for disability and I don't even really have a primary care doc at the moment (well technically I do but it's really just a primary care clinic - not really a specific person) - so I need to quickly find someone who can be my reference for disability who will agree with my claims. Sure I have my medical records that back up my claims but I need a human being too.

So - long story I know - but basically my question is, when looking for a pain mgmt doc online I'm finding all these listings for pain management doctors that are also anesthesiologists. I'm assuming this is not what I need - am I wrong? I don't need to be anesthetized - I just need to manage the pain of two chronic pain conditions. Oh and I have a urologist and a nephrologist (kidney doc) but both of them say they won't prescribe pain meds and that I need to see a pain mgmt doc for that - same with my primary care doc. Every non-pain mgmt doc I see just keeps saying the same thing. I suppose if nothing else I'll check with my rheumatologist - but I figured I'd ask you guys. Part of me thinks I'd be better off just moving back to NYC... better doctors and the social services there are far superior for someone who is jobless and waiting for social security. AND NY has "healthy NY" insurance for all residents with low income and interim support for folks waiting for disability. Why did I leave NY? Okay - that's beside the point... if anyone has any suggestions on where to find a pain mgmt doc specifically please let me know. I had thought I'd found the perfect place but just found out today I was rejected so I'm kinda flipping out a bit.

Thanks :)
Bridget

You really need to find a Dr. that your going to be comfortable with for your disability. Hopefully your reum. Dr. will give refer you to another pain management. Most Dr's dont mind that as long as they are not resposible for writing the narcotics. I have an anesthiologist as pain management Dr. There are several in our town that run a pain management clinics now. They also do injections for pain control. I know mine doesn't do any disability paper work. So you might want to ask before getting to involved with the Dr. I was lucky because I got my disbility before I started to see him. I have long term insurance and he doesn't want to fill it out. I have so many others Dr's that it wasn't a problem for me. My Dr. gives me subutex for pain. I just love it. I am down to one tablet a day. I am very happy with myself. I have learned so many ways to help control my pain on this forum. It's a great site!

Thank you guys - those are good tips - and it's really good to know that about anesthesiologists because I've found a ton of those but haven't tried them because I figured it was just ppl who knock you out during surgery - but their listings say pain mgmt / anesthesiology so that should possibly work. And that's a good point about making sure they'll help me with disability.

As for COBRA - I'm screwed because my employer has less than 20 employees and they don't have to follow COBRA rules... there's now a mini-COBRA program that includes small businesses but it's decided by the state and Virginia doesn't have it... so legally speaking my employer is in no way required to keep me on their policy. I still think it's so messed up that he's dropping me - it's not like it costs him anything! It's still expensive but I would've begged my dad for help to pay it if my ex-boss would keep me on the plan... dork. But it is what it is. I still have insurance this month and so I'm trying to find a doc while I can and then maybe self pay or get some kind of gov't / charity health.

Thanks again for your help :)

I must be missing something because I live outside of the U.S. My Rheumatologist IS my pain specialist. He gives me local injections of Marcaine into my various pressure points, as well as prescriptions for Cymbalta, Lyrica, Cesamet, Nasonex, and Reactin, and I'm pretty sure the only narcotic on this list is Cesamet as it's a synthetic cannabinoid.

I'm kind of shocked that your Rheumy hasn't done anything prescription wise for you. You'd think they'd be your first line of defense against pain, especially knowing that your body can attack itself, followed by your M.D. But I know a lot of people fight with their M.D. to get a referral, never-mind a prescription!