Help; Talking to Doctor

I already go to my appointments with my list in hand, and any empty med bottles, needing refils, but I don't know how to talk to doctor about needing stronger pain meds. I am on low dose Tylenol, Codeine compound, have been on it for about four years. Pain is under treated here in Canada. My doc has been very good about keeping me on a regimen of medicine that takes the edge off of the pain, but somedays, none of it works. It's like chewing M&M's. If seems pointless to subject my body to large doses of Tylenol, which by the way does nothing for me, when there may be other meds, that could be used. I did request a referral to a Rheumy, but here, the don't help much with Fibro. There is still the äll in your head, stigmatization of patients complaining of "pervasive pain disorder". That's what it is often called. I don't even think my doc is treating me with the mild pain med, I'm curently on, for Fibromyalgia, at all. When I speak of pain, he says "exactly where is this pain?" When I say, "all over, my legs, lower back, both arms, knees, well  just about everywhere, doc", his lip takes on this funny shape, kinda like when my big dog doesn't want to do something and I try to make her do it. I had discussed with him, and showed him the report of my soft tissue injuries from being struck down by a truck, in 2002, and I think that is what he gives me the pain meds, for. So, because, when living in USA, I was adequately treated for pain, then returned home, due to poor health, could not afford any meds in USA, I found the best they would do for me, is this low dose Codeine/Acetominophen compound. I am not complaining, I know some folks can't even get that, but short of coming right out and saying Ï need stronger pain meds, because I hurt allover", is there any other way to handle it. I know keeping a pain journal is a good tool, but the docs here don't read that stuff. When I gave him the literature on the accident, he read part of one page, handed it back to me, and wrote the precript I am now on. They average 6 minutes per visit. I see him, tomorrow.

Thank-you Mrs. T. I will begin to ask around about docs who understand Fibromyalgia. I won't alienate this one, until I have another in hand, as believe it or not, this fellow was the best out of five I interviewed when I was doctor hunting after I returned to Canada. All the others said "Cymbalta", which doesn't help me at all as I cannot take the ephrinephrine (sends my blood pressure and anxiety through the roof). The idea of bringing literature (with the juicey parts highlighted) so's he can get the gist in his 30 second glance, is good. I see him tomorrow, and then he's going on vacation so maybe I'll luck out and he'll actually be inclined to read them, but I doubt it. One good thing about a not so good doctor, is he can be seen almost anytime, with almost no delay, and has lots of openings on his schedule.

Hi Tyno,
I know exactly what you are going through and it is so frustrating. I had a wonderful doctor for over 20 years and she retired in January and I'm now seeing her associated and you'd think their thinking would be alike? No way. She was so open to new medications. All I'd have to do is come in and discuss it with her, tell her what I had researched and she would say "Okay, let's give it a try". I have now had three visits with this guy and he has turned me down at all three visits. I have been on the same pain medication for years and years and I just don't think it is working any longer, at least at the number of pills I take a day, which is what is prescribed for me. I don't want to go over that amount. I also don't want that prescriptin in addition to another one, I'd like to try something else, and he's turning me down. I also asked about Celexa instead of Prozac, turned me down on that one too, and something else which I can't remember now, oh yes, taking Adderall or Ritalin for fatigue...won't even touch that one. I never had this feeling before, but now when I walk out of his office, I feel as if he views me as a drug seeker. I know I have to look for another doctor and I'm dragging my feet, but in any case, I certainly can empathize with you.
If it were me, I'd go in there and be honest. Bring in a list of the medications you think might work and ask him if he's willing to prescribe any of them for you. If not, maybe he would recommend a pain clinic for you to see? I think that is my next choice too.
Good luck,
Miriam

Can you just say that there are days when this medicine is not enough to reduce my pain to a bearable or functional level. Tell him how it impacts you personally, can't walk your dog, can't clean up, can't do the grocery shopping - tell him how the pain disrupts your life. I think sometimes when we just say it hurts everywhere they are more likely to dismiss your complaint.

Hope your appt goes well - good luck!

Post Edited (upbeat) : 6/1/2009 1:24:05 PM (GMT-6)

Well, I live in the US and my pain is under treated here, Docs are discontinuing opioids fro fibro patients due to the War on Drugs policy. I have seen 3 pain specialist and not one has helped. I live in Seattle where medical care is supposed to be excellent.

I do not want you to think it is only a Canadian issue, the pain relief problem exists world wide. I am a researcher so I am always checking scientific studies and journals to see which countries relive pain well. I am still looking.

Take care,

Donnaeil

Ty,
Can you take a friend in with you to the doctor's appt...I mean to the examination room. Sometimes another person's input on the pain that you're feeling is of great help to the doctor. Ok this might sound crazy but have you thought about keeping track of your blood pressure? When a person is in pain his/her blood pressure will go up.

Good Luck

Too bad they don't start a war on fibro too Donnaeil. 

 

I hope things goes okay today Tyno, maybe you should use the accident instead of fibro to get through to him. I am so blessed when it comes to doctors. I wanted to try provigil for energy so he let me try it and then adderal, even though he had to write a letter to my ins co for me to get it. Neither worked but he let me try them. Like Sherrine I have vicodin for backup but it will expire before I use it I'm sure. My rheumy is the same way as my GP and I wanted to try a little neurontin, he didn't have a problem with it, sadly I haven't tried it yet cause of my medphobia. They both work with me when I come up with a new idea that I read on here and I so wish all of you could find docs like that. They neither one work for a group that has to meet a quota either so time is never an issue.

 

luv and hugs

Marlee

Well, I held my ground, but hit a wall with the doc. He had a look of pure disdain on his face, after I waited an hour to see him, I had six things on my list and some literature for him, about Fibro. After the second question, he looked at me and said "do you have anything else on that list?"Like I was a naughty child taking to many cookies from the jar. When I described tumbling backwards out of the bath, falling on the floor and hitting my head on the door, I said, I've had neck and sciatica pain since. He said ÿour sciatic  nerve is nowhere near your neck". Well, since our BR is tinty, I explained, I hit my back on the toilet on the way down. He just stared. Thenhe oblidgingly took my bloodpressure which was high, refused me the muscle relaxers I asked for, and refused any further help with the pain. There was smoke coming out of my ears as I left. At least, this time, I didn't leave in tears, but it kind of summed up the whole issue for me. I need a new doc. He seems to consider me a hypochondriac, junkie. So, I need to  contact the Fibro Group in this area and find a doc who is a believer. This gets so tiresome, dealing with his disdain and the pain and fatique and frustration of not being able to get things done. then to top it all off, I return home to a moping 22 year old, who is  complaining about being bored as I spend my last funds on dinner for us. He's off to see some girl, says he'll be back on the weekend to help me with a flea market, but hesitantly, as he says it makes no sense to sell belongings which cost more originally, than I'll ever get for them. Where do you think the money for your car, cell phone, gas, and food and internet, and free lodging comes from, son? So as most 22 years olds, I guess he thinks I have a money tree in the backyard. Thento top it all off, I  misplaced my cell phone, left it in a gas station washroom right after my most unpleasant doctor's visit. I didn't even bother to give the doc the info on Fibro, he's made up his mind, there's no educating him. I will have to find a doc who treats Fibro. I feel like I'm trying to patch together a quilt, from fabric well past it's expiry date. Anyhow, there's always tomorrow. Thank-you all.