1st pain management appt.. disappointed

Perhaps not. Most pain facilities will never give narcotics to anyone on a first visit. It's not you--it's anyone.

If you are having back pain, an MRI is standard before treatment.

There is no guarantee that injections will affect the pain in your hands.

It's like most other first visits--a jumping-off point. Once you are in the system, it's easier to get appointments.

Once you have been in the health care 'system' a little longer, you will see how this scenario is played out over and over. This is especially true in recent years, due to the more stringent rules affecting prescriptions.

I know how frustrating this is--and how hard it is to get any headway. But, it is not really you. Chronic pain has become so endemic that most facilities that work with patients have become very cautious. Also, comparisons between patients are very seductive in theory--but not at all useful. There are too many variables between people, cases, conditions, everything to make a comparison on treatments.

So, move on, and explore some other treatments while you wait for the MRI results. Personally, I tout the benefits of exercise and movement as a very effective tool.

Good luck!

Thanks for the response.. This isn't a simple case of treating me like everyone else..I knew I would not get narcotics my first visit, that wasn't even my goal. My goal was to get answers, have my options explained to me and find out if they can offer me help, BEING SHOVED OFF WAS NOT MY GOAL. She didn't offer me anything, I had to ask about injections and if they were possible..as a matter of fact we talked about them as she was walking me out of the office down the hallway. She did not want a follow up appointment and she didn't really want my MRI either, how do I know this? My PCP called me this morning with the report from the PM nurse.. That's how. She sent "recommendations" to my PCP on what she thought. Her thoughts are "trying a different muscle relaxer, rest and no narcotic pain medication."

Now why would she even mention narcotic pain medication to my PCP? I didn't ask her about them, we didn't even talk about them, but I did list them as one of my current medications on my paperwork(PCP prescribed them.) Its very obvious what she thought of me from the get go. I got treated like a 26 year old male that's after drugs.. Not a 26 year old who struggles with everyday life, about to quit their job and is almost done dealing all of this.

People who have become addicted and are narcotic seeking.. Have made it harder for people with real pain to get the help they need..

Ok so what will your dr do to help? I agree with sherrine about the dr seeing you..when i tried pain management i saw him each time... However he wanted to give me darvon and i know i cannot take the strong meds so i stopped going..i need medicines that still let me function.which heavy drugs do not...

What are you on from your dr now? Yes. It can be very frustrating getting the help you need, but you will just have to stay on it.. And work to find the right professional that will work with you

Nooneknows,

I really feel for you. If I had to do the physical job you're doing - well, I couldn't.

So many things wrong with that appointment. The fact that they didn't even have your MRI is pretty bad. I think the nurse practitioner should have offered to get you back in asap after they receive it, considering how long you've waited.

I've never been to a pain clinic, and I'm sure they're under lots of stress too, trying to fit in so many hurting people. What I don't understand is what's happened to common politeness, to assuming one is innocent until proven "guilty."

My daughter was having serious gallbladder pain at age 25 and was at the ER, where she made the mistake of being honest and telling them she had had a couple of drinks the night before. Right away, the doctor started making light of it, "Oh, you kids - - it's a hangover." I about flew into his face and started telling him about my daughter, how she is a marathon runner and not one to blow pain out of proportion....so reluctantly, he ordered a simple scan (why not before?) Gallbladder out, pain gone.

I really hope things start turning around, now that more people are getting insurance and medical costs are coming down.

Debbie

That's nonsense! My first pain/arthritis appointment, the doctor spent lots of time with me, maybe a half hour at least going over all sorts of things. He paid a lot of attention to details. I had made a comment on my paperwork I had just filled out mentioning I was ready to try voodoo. He had noticed that and joked about having a voodoo clinic next door--the sleep clinic.

He spent a shorter time the second appointment, and more time was spent with the PA, but that was fine. The first meds he prescribed worked well, all things considered.

Consider a second opinion.

Well earlier when I spoke with my PCP I asked why they didn't want to give me hand injections and my PCP said she'll try to find out. My PCP must have done something because the pain clinic just called me to set up an appointment to get it done.. So I guess I wasn't totally written off like I thought.

Has anyone here had any kind of steroid injection?? EBay should I expect?

Nooneknows,
I'm sorry you had such a bad experience with your PM speciallist. I was refered to one back in ~ Oct, and it went fairly well. I met with the doc for ~ 20 mins, also the nurses before and after for another 20 mins or so each. Was there about an hour total. In that time I got a fairly thourough exam, discussed options and possible treatments, and explanations of those.

The doc said they can't really do a lot for the Fibro, but that he felt my pain was being agravated by bursitis in my hips and what amounts to arthritis (though he used a diff term) in my lower back. He submitted requests to my insurance for injections to address those, as well as presriptions for a back brace, TENS unit, and Lidoderm pain patches.

I've had 2 sets of injections (one in hips and one in back) and go for another tomorrow. They seem to help. At least now the pain in those areas is down into the general background pain levels all over my body instead of spiking way above the rest. The injections process hurt, but afterwards it wasn't too bad.

I've also had cortizone shots in the past in my shoulders, and after each of those I had about 8 hrs of wonderful numbness, then about 2 days of massive pain flare ups, then things settled down and improved pain levels for about 3 months. (Not sure which type of shots you are discussing, so thought I'd share this expereince too.)

As for the Fibro pain, like I said, the PM doc said they can't do a lot to help with that. However, the Lidoderm patches are really the ONLY help I've found to date in 2 yrs of dealing with Fibro. They are only about 3x5 inches, and I can only use 3 at a time for 12 hrs out of every 24. So they aren't a perfect solution, but I can at least put them on the areas of worst pain and get a little relief for a little while. :)

Anyway, I hope you have better luck going forward with your PM. I would ask they office mgr about seeing the other doc if I were you.

Good luck and have a blessed day!
Mari

nooneknows, I know what you mean. I felt a bit the same way after my first visit to pain management. Then again I had no desire to go to pain management ( didn't want narcotics or injections, just wanted answers and someone to FIX the problem rather than throwing something at it). Most of the PM clinics it seems have gone to the format of having an NP do everything except surgeries and injections, and I think that's frustrating. At the same time I'm realizing that in some cases the NPs know more than the Drs.

When I first went to PM a year ago they were quick to direct me to the injections, and also offered me a compounded cream for the pain. I can't take Nsaids and they didn't offer narcotics (which I was fine with). I wasn't really comfortable with the idea of the injections and ended up cancelling the appt. I pursued other Drs and possible casues for my pain. The problem is still not really clear, although I do have a couple of herniated disks, they keep telling me my MRI is "not that bad". My Chiro swears it's my neck, but the spine doc says it's not and he can't do anything (he's the one who sent me to PM first). It started seeming like it was my shoulder so I pursued that route and it turned up nothing. Finally, a year later I ended up back at PM and signed up for an injection. It didn't work.

Oh, and when I went back a year later, the NP was more than happy to give me Norco, which I found humorous. I never asked for it either time.

Hopefully, once they get your back MRI they'll be able to figure out how to best help you.

Nooneknows -

Good luck tomorrow. I'm hoping your doc has a better answer. I know how tough it is to get another appointment.

I know I left a wall of text before, but one suggestion might help - ask the doc if he might be willing to consider Lidocaine patches. You can only use them 12 hours a day. I get relief within 1/2 hour and they work all day long. Lidocaine is not a schedule drug. It's just a topical anesthetic. If you are asking for something like this, they won't bug you about the drugs. Plus these are pretty safe - very few side effects.

This saved me at times when I need a full day out of my day. It might help.

Good luck tomorrow.

Also you should look into FMLA for your job your primary can fill out the paperwork and you can figure out what's going on while you are on leave. Check out the government website or/and my previous post about it.

Sorry you are having so much trouble-it bites, sadly a lot of issues are not due to you, but more due to past history of pain management in general-especially re: narcotics.

A lot of times the doctor want to treat you but they can't due to the DEA-The pressure docs get from them out weigh proper treatment in many cases.

The drug seekers have done a great deal of damage for the chronic pain suffer too, however, some get labeled a drug seeker when in fact they are a pain relief seeker-Its a fine line and sadly most doctors will err on the side of caution and the pain relief seeker gets labeled a drug seeker-sadly that is how it is-its not right just reality....

Then you have the added issues of your age and while I agree, pain doesn't see age-it can be harder for a doc to Rx narcotics for chronic pain and it can even be unethical to some degree as well-Its important to understand when dealing with chronic pain-it can be a lifetime-especially when you don't really have a Dx-Most good doctors won't start narcotics until they have tried everything else on a person under 40-Its not fair, I know-that just how it is.

With all the legal issues a doc has to deal with these days on top of the DEA breathing down their necks-Proper pain management for many can be a real challenge-especially when you are so young. Sadly, a doc will chose themselves over a client, its not right-but that is just how it is in todays world-Proper treatment of a person in pain or their license to practice. In reality, should we expect a doctor to risk their livelyhood-The DEA can shut them down and even if they win-their medical malpractice insurance can go through the roof-some topping 6 figures a year.

I am lucky that I have a great pain management team and it did take me time to accept chronic pain and what pain medication could do for me and most important-what it couldn't do-Proper management with narcotic isn't 100% pain free provide that you still want to function-Getting 50% relief along with being able to function-without euphoric feelings and to regain some quality of life-IMO is what good pain management is. I still have to do my part-life style changes, exercise, heat, ice, OTC products...etc....

What is your bottom line diagnosis, what else do you do/tried for pain control...etc...if you don't mind sharing

Good luck in your quest for pain relief to better your quality of life

Oldanbroken, I enjoyed reading your post. My bottom line DX is actually fibromyalgia and ddd in my lower back. I've seen 2 PCPs and 2 rheumatologists for this problem over the past 1.5 years. I have tried so many things its beyond funny. I've done PT, a very long list of meds including savella, lyrica and every NSAID out there. .also tried a few muscle relaxers and antidepressants. I've had xrays, MRIs, bone scans..ect all look fine except the DDD. While I understand the whole narcotics thing, I'm honest when I say they help the most.. They are pain pills and they do their job helping the pain. My current prescription is for 2 pills a day that offer me help 6-8 hours MAX on GOOD days. On bad days, its like taking a sugar pill to be honest. I find it unethical that because of my age and not having a clear cut disorder (something they can test for and actually see) that I'm being brushed off and left in daily life altering pain. I've already got FMLA for work and I'm even considering quitting my job even though I know my wife would leave me and I'd probably end up homeless.. So tell me.. Is that a better alternative then taking a few pain pills a day to save my hard job?