Pain Management Community

Tara Be open with your Doctor and tell S/He you are not getting adequate pain relief from your meds.

Such could be expressed by your needing to use your break thru Meds more and running out early.

Or you are not able to due and maintain ADL's (activities of Daily Living) that you could a year ago.

These are both great ways to signal that a change is needed without the awkward moments of saying "Dr. I need more Medication's" rather you are just stating the effect on you that to little medication can cause.

Good Luck,
let us know how it goes!
Happy Holidays season

Peace

Just ask, be honest and reasonable. If you treat the pain meds just like you would any other med for any other problem, he probably will too.

Rather than say you need more pain relief, you might tell him what kids of activities you must forego due to your pain that you would like to be able to do. Some doctors are more able to deal with function rather than just pain relief.

If you don't tell him you need more, then each time you see him, he assumes that you are doing okay??

Take care, Annette

I can understand why you would have hesitation about this. Many Dr.s in my area have been scrutinized for prescribing pain medication. I also know of people who have asked their Dr. to up their meds, only to have the Dr. take them off of them completely for fear of the patient abusing them. I have had battles with a few Dr.s over the past 4 years over pain and treatment. With all of that being said, the only way is to be honest and upfront with your Dr. Most Dr.s ask: "How are you doing with the medication?" There really is no better time to ask than that. Be sure to tell your Dr. everything that is going on with your pain, and be sure to mention if anything specific, like activities or a certain time of day, triggers your pain. I hope this helps as everyone else had good advice, too! Good luck and I hope you have pain free days!

hi ChiBearsFan6, I am new here and would like to express how discusted I am with my new pain mgmt dr. I moved out of state and am disabled with all kinds of chronic ailments, from DDD, to very High Blood Pressure to name a few. I really liked my last 2 drs who were very understanding and gave me my needed pain medication which was one long lasting and the other (4) breakthrough pain meds a day which worked out well still pain but it was ok. Well, after moving I was told that I needed to find a PMD that would prescribe my medication because the PCP (new) was not ever going to give me that even though I have evidence of condition, disabled, etc. They made me feel as though I was a criminal looking for meds unnecessarilly. AFter I was taking this medication for 8 or so years with no problems and no issues with any dr in the past. I am in severe pain most of the time and need my meds. Well, the new PCP didn't seem to care about anything either referred me to this PMD and after waiting almost a month for the apt. I went it was about 30 miles away in the country. I went into his office waited a good hr and half and he walked into the office and immediately sat down and said to me that he was not going to give me what I was getting from my former PM Doctor and that I would have to choose one or the other!! I said what do you mean? he said I'm not going to give you both it's one or the other so please choose. He didn't care to see my medical records from other drs and only wanted to puch needles and nerve medication on me. He said my pain is not pain its nerve pain. He made this assumption after not looking at any record or talking to me. I didn't want to argue for fear of not getting anything so I left with not getting sufficient long acting pain medication and not only did he make me choose which one he also lowered the amount of medication I take to 2 a day vs. 4 that I was getting. I was so humilified. I left hoping that maybe the next visit would be better. They tested me after my first visit for meds pee test. The second visit was a needle visit and I endured the painful injections in my shoulder neck region. He has no nurse in the office at all. I thought how could he even do this without viewing my prior records? Well, he did and preceeded to tell me that my pain was from nerves and it wasn't pain from pain whatever that was suppose to mean? I was dumbfounded and I told him I got sick and didn't feel wel l from the nerve medication. He told me that it wasnt an allergy it was that my body was not use to it. So he gave me less. I again took it and it made me sick throwing up stomachache etc. On the prescription it says do not fill until the date that was my first visit in otherwords you cant fill it 2 days earlier if it falls that way. I never had that happen before ever with my other drs. My third visit came and I was totally prepared as I read others on sites saying go in with notes and questions you want to discuss well he took me in right away and started telling me about how its in my nerves and after I told him that the pain meds at 2 a day were not taking care of my chronic pain and he YELLED at me and he was very intimidating speaking broken english he's from another country and got his license from another country I found out. I don't understand him very well because of this and he said that for the other 12 or so hours I would have to "Let the Pain Go"....since when was I in a rehab situation? I thought. I have never been so besides myself in a situation before and he made me feel horrible. I am in pain I asked him if he saw my records in his chart that I gave him and he said I don't need those and it doesn't matter what they say? can you believe that? I still walked out his office in bafflement and without meds for chronic pain. Please someone give me some info as to what to do in this situation. I would appreciate it has anyone else ever been through this. Any suggestions or info would be helpful.

You certainly have my sympathy Tara. I've recently been diagnosed with CRPS after so many doctors looking at me like I've got two heads when I scream from them touching my ankle. One even accused me of drug seeking when he could see my swollen foot, and other VERY classic CRPS symptoms I know about now. He even had the nuclear test proving it as well and told me I was making it all up.

What I can suggest is to be honest with your pain management doctor or your regular doctor, whichever you see to treat your pain. Show them a pain diary if possible to chart when/how you're taking your present medications, the time of day that your pain happens, as well as your activities at the time of the pain. By going properly prepared to any doctor, they will recognize the suffering that you're going through and adjust your medication accordingly, or work with you to find a solution for your pain.

I just realized you posted this a while back, but hopefully your doctor visit went well.

Some drs simply don't care about notes or how bad your pain is at certain times of the day. I tried to talk to my new PM dr. and he flatly said that he was NOT going to up my meds at all. And that is 2 pills a day. I am in severe pain and going from all day pain meds plus 4 pills a day to only 2 pills a day is really doing a number on my body and life. After I was on for my disability from my other PMdr. and my PCP from before recommendations that I be on chronic pain meds and breakthrough.
He "yelled" and said "Let the Pain Go"...what dr. says that to a person on disability and in serious pain. I don't even think he is a part of any Boards of Pain Management. He has very bad ratings from reviews on Vitals.com. and no affiliations with anyone. I don't know how he even keeps his license and doesn't get reported. My other PM dr (in different state) is a diplomat of the board of PM and he never had a problem prescribing me my chronic pain and he even upped my breakthrough pain meds. This is what I am saying. Just because I moved to another state and can't find a good PM dr. my life has to suffer. Pain can hurt and do bad things to the body.
I asked him did you look at my records and he said he didn't need to look at them and shrugged them off? He gave me injections in my back and didn't even have a nurse in room. I don't even know if the needles were clean etc. I am in a state of dispair with my health. Now, I am forced to dr. shop and not because I am looking for more meds. I just want my life back where I can sleep and live more comfortably. AFterall, I am on disability. What does that mean to this dr?
One last thing, for 8 years or so me and my old PCP dr. who gave me my pain meds and treated me for the pain, we went through a trial of meds to see what would work. After so much time, we finally got one right because I get sick from the strong pain going through my stomach(throw up) bad stomach, so got on patch. Now, this dr. undos all of that and I'm back to square one again.
I'm so discouraged.
I know I'm rambling but people that are in pain and in the same boat I am can relate to this nonsense.

I am sorry to say it but your doctor is a complete NUT! You need to find a new doctor for pain management. I wouldn't rely on your PCP to refer you to a pain management facility, I would instead start looking for a different doctor on your own. You could go to the American Pain Foundation website. They have doctors listed on there that are board certified in pain management. I would try to see one of those doctors on there that are in your area.

This doctor is not going to do anything to ever really help you. After hearing your story, this doctor is set in his ways and will never change. Find a new doctor!

thank you so much Anon for replying to my sad situation message. I really appreciate your input. I agree with you totally about what I should do but there are very few drs within a 50 mile radius believe it or not. Oh, how I wish I had my previous drs. These drs in this area are for the birds. Not nice to say, but I'm afraid it is true. What I can't understand is how does this dr not get reported or how is he still in business. Maybe it's because he is the only dr around not sure? What pain dr says "Let the Pain Go"? He told me opiates are masking the pain. Oh, that's funny any medication that fights pain is not a cure all like all the bad nerve medications out there that have so many side effects. A little update since I wrote last, I saw the dr this past week and told him about more pain in my back in a certain region and he sat there and didn't even ask me to get up on the table to look at the area at all??? again, what dr. does this. I would love to say his name but I know I can't because of the rules. He said oh ok didn't even say what he thought was wrong and pulls out a paper for me to sign, for guess what, more injections intercoastal nerve block. He doesn't even have xrays, MRI or any evidence to do this. He's making a guess at what it is. AGain what dr does this? How does he not know if there is a tumor or whatever in their causing the pain? He sat there pulled the paper out made me sign it fast I dont' even know what I signed to be done in 1 wk. I'm scared now thinking about it after I left the office. His office was packed with people. Believe it or not. I heard people complaining about how he loves to inject and use needles. I have no one to come with me afterwards. He won't let anyone in the room with you during these procedures too. There is just you and the dr. No nurse or anyone else. I thought this is against ethical and medical practice too. Is it? So it's your word against his. I really need to do more research about this procedure and whether that in fact is what I need. He told me that it's my nerves, my nerves are causing all this pain but yet I was never diagnost with Diabetes. My sugar is often at 6.0 over 3 month period. If it's my nerves etc. then why does my MRI reports evidence show DDD and lordosis, scoleoisis, and slipped disk, herniations etc. and how come he doesn't offer me some sort of anxiety medication? I also have extreme high blood pressure I was told because of pain level by numerous drs hospital, PCP, etc. runs in the 200's over the 100. But yet he doesn't want to treat my chronic pain. 2 pain pills for 24 hours. He said that is sufficient. I told him I'm up crying half the night moaning of pain he said that's ok. I must not be the only one that he tells this too and I can't believe that he still has his license. He said he's been doing this for 30 years. Really? Like I said before I've never had a problem with abuse or addiction, I don't even drink at all. I only ever took what the dr. told me. It also makes me wonder that many people on the boards and some people I know that have chronic pain or on disability and then seem to have drs that listen and give them the medications some stronger and higher doses than me and they have no problem. I tired to get into the one PM dr office recommended here like you said and they aren't taking any more patients. I know have to find another Primary care dr and PM dr. seems impossible around here. But I will take your advice and call APF. I'm seriously thinking about canceling my apt for next week for intercoastal nerve block until I find out what t an x-ray says. Oh, one more thing forgot to say I asked him that maybe I need an MRI or Xray for my back there and he said let's see about your shots first. Why so he can get more money for insurance.? There is no patient-dr relationship here at all. He doesn't care about anything I have to say. A dr. I only saw 2 times that didn't even do a physical exam.

Many Doctors like to lower your pain meds just to put right back on what you previous dose was. I was on Fentanyl 150mcg every 48 hours, was off of them for 3 weeks and then was putting me back on the Fentanyl patch but at 125mcg. I would get another pain Doctor. They work for you.

I am so sorry you are going throught this! That doctor is a greedy quack, and his office is an injection mill (where they insist on as many injections as they can, whether the patient needs them or not).....I wouldn't trust this doctor as far as I could throw him and any doctor who won't even look at your chart and/or says it doesn't matter is a quack. And a doctor that says its ok to be up all night crying in pain is a SADIST. You may have to face the fact that you may have to travel quite a ways to get decent medical treatment-this doctor(quack) does NOT have your best interest in mind, only his wallet! Does he use a fluoroscope (or xray) when he does the injections, or does he just blindly stick a needle in you? If he doesn't use something to guide him so he can see inside where he is putting the needle, RUN don't walk away as if he is just sticking the needle in blindly he could seriously injure you! Unfortunately there are some unscrupulous pain doctors that just love to do the injections whether they help the patient or not, and finding a decent doc can sometimes be challenging, but you have got to get away from this nut, he doesn't care about you .This jerk wil never help you, only make as much money off you as he can-find another doctor that is a decent human being instead of a soulless subhuman jerk . It may take a while to find another doctor, but keep looking-you deserve to be treated with dignity and compassion, not be treated like an atm machine. I wish you luck, and hope you find a good doctor and relief for your pain. Take care.

It is finally up to you if you decide to see him or not, or let him do injections or not...

Get copies of all your medical records and decide what to do.

Take care, Annette

Thank you for your response as I do know what your talking about and I know the answer to my dilema is to get a new dr far away. It is quite unbelievable isn't it the stress and nonsense that this dr is putting me through. One has to wonder though if he is doing this to others too? It just can't be me alone. Although, his office is usually packed. Honestly, there is only 2 PM drs. in this area. One of which told me that there not taking anymore new patients after being recommended to him and then this dr I am now going to only because he is the only one in the radius. It truly amazes me that he is still in business. After talking to another pm patient that I know, he doesn't go to this dr, he goes to the one that isn't taking any more patients, he told me this PM dr. is a quack too. I think I'm not going to get this procedure because I'm not comfortable with it. It is really disturbing reading about how other people have no problem with their drs understanding them and treating their pain. Well, I use to have good drs. I'm thinking something may have happened in this area and that is why there are no PM drs. I just moved here some months ago so I wouldn't know. Just seems very strange. Anyway, don't want to go on and on about the same thing. Just saying that I guess I have no choice. I really appreciate your input and replying to my concerns. Sometimes it is so sad and rediculous when these things happen and you have to turn to writing for some sort of support. I can see if I was going to this dr and was not disabled and had no records and wanted him to put me on pain meds for the first time but this is totally not the case whatsover. I am disabled for gosh sakes and been on my meds for many years with no problem. The only reason that I am going to the PM dr. is because I moved too far away from my drs. I'll keep you informed if I find another dr.

hi annette, thanks for your replies. This dr. will turn around and say he can't help me if I don't take the injections. That is his way of having the upper hand and getting his way since he gets more money for the injections and only an office visit for prescribing and handing me a script. Unfortunately, this seems to be the case if you don't do what these drs think you should do. I got the injections on my shoulder neck area and they made it feel better for only 2 days and then went back to normal. I read that this is usually the case a temporary situation. It's weird how he calls the narcotic meds temporary masking the pain when in fact the injections are temporary too. I went to a surgeon years ago who told me that a neck operation for my slipped disks etc and radiculopathies was "too risky". I also have arthritis all over too. This dr. is treating my conditions as acute only. Like I had a leg injury and then he could fix it. This is simply not the case at all. I have chronic conditions and disabled because of these conditions. In other words, he's acting like he can cure my conditions by taking nerve meds. Here's another question I have for him if you read my first message here. He tells me on my first visit that he is not going to give me both my meds that my other PM dr in other state was giving me. He then give me a choice? but if I had said the patch , the patch is a long lasting narcotic med every 72 hours. The pills were 4 times a day. Well he tricked me because when I said the pills, he didn't tell me that he was going to lower the amount of pills a day. That is how he was. I told him about my chronic pain and that is what I'm being treated for round the clock pain and then the breakthrough pain meds. He totally said I don't need them and "Let the Pain Go" as I stated, honestly he said that. I said did you read my prior evidence MRI's reports or get records from my past drs and he said he didn't need to and shrugged. I felt like I was going to a rehab center than to a real PM dr. I am not in rehab nor did any dr ever tell me to go to one or that I needed one. In fact, my PCP wanted me to take stronger medication and I told him to lower the dose when we were trying to get my pain level controlled. How I miss my old drs who were involved and cared about my health. Anyway, thanks for responding. Take care ~

I think you have a good plan. It sucks that you may have to drive a long distance to see a REAL doctor (ok?) but it could be well worth the trip. If you do happen to find a new physician that is willing to adopt your previous treatment plan that your original physician put in place before you moved, let him know how long your commute is to see him and see if you can work out a plan such that you only have to travel to appointments once a month given all is well with your pain. A true compassionate physician will work with you and meet you half way. Good luck and keep us posted.

PS: Those injections that your doctor (aka quack) is doing are very damaging to your bones over the long term. I have had 5 epidural steroid injections (ESIs) and have decided to take a break after many doctors told me that I was getting on a bad streak with these injections (a doctor doing injections not for the money will tell you that the long term effects often result in bone loss). Doctors make a fortune off of these "pain relieving" injections. I had my pain meds bumped up a lot to cover the additional pain that the injections are not taking away such that I can give my bones a rest. It is steroid component that is injected that wrecks havoc on your bones over the long term. I've decided that permanent bone loss (which could cause more pain) is not worth the measly 4 weeks of pain relief the injections provided me.