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HighnLoLita posted:
So, I'm not sure how many PM dr's I have been through in the past year but, this last one, on our first visit told me that they are not taking any patients for medication management, only for shots and a few other things that were never offered to me.

At that first visit, he went over my history and told me that the medications I am on, he would only give to a cancer patient. I am only on Narco three times a day and a muscle relaxer at night.

Needless to say, I was still searching for a new PM. My appt with the new pm is next thursday.

Is this normal for a dr to minimize pain because, one doesn't have Cancer? Thanks Lita
Life is not measured by the number of breaths we take, but by the moments that take our breath away. - Maya Angelou.
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bpcookie responded:
Oh hun, I am so sorry that you have to continue looking for the PM that will help you. Ive been through many different ones myself. For my back, shoulder and neck pain I went to this HUGE facility. They pretty much guaranteed that they could fix my pain. One year and a half later, the Dr. told me that they could do no more, so pain meds and muscle relaxers was all they gave me. I found another PM with hopes that they could do something else, but NO, just pain meds.

Its very frustrating and I understand how you feel. hugs
 
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Debb60 replied to bpcookie's response:
Totally off the topic: Love your picture. Deb
 
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HighnLoLita replied to bpcookie's response:
I got the date wrong, I thought my appoiment was Thursday but, it is tommorrow. Really all I need is for them to give me meds. My family practice dr has been writing the scripts when I need them but, she was adament that I find a PM Dr to take over. The last PM dr would only give me shots but, he said his practice was no longer accepting patients for medication managements. The only thing good about him was that he took my insurance. The shots only helped for a short time. This new PM takes my insurance, gives the shots and they will manage my meds Actually it is only a consult, they haven't accepted me yet but, the dr has read my history and is aware that I will need meds. I guess my foot is in the door. so wish me luck! Lita
Life is not measured by the number of breaths we take, but by the moments that take our breath away. - Maya Angelou.
 
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jamesp767042 replied to HighnLoLita's response:
Hey ms LoLita! Yes sad to say there are drs that try to minimize the pain that we go through. I have a torn ACL in my right knee (2nd time) along with screws, a graph, and alot of extensive damage to my discs and cartilage. My ortho told me i pretty much have the knee of a 60 year old! And im only 30!! And to add to that i also have 2 hurniated discs in my lower right back. Right now im on Oxycodone 30mg 4 times a day. Well i went to a new PM dr a few weeks ago and was told, first by a young nieve nurse practicioner, that was too much medicine for the problems that i had! I was shocked to hear that! Up until that point i had never been told that before. Then the actual dr comes in and proceeds to tell me practically the same thing! He also says that he has patients with pins and screws all up and down their spine and they dont even take that much medicine! I said but isnt that everybodys pain is different and what works for one person might not work for another! He didn really have much to say after that. So some dr def minimize your pain. I knew there were drs who didn like to prescribe pain meds, but never had one tell me in so many words "you dont have enough pain to be takin that medicine"! Anyway I hope everything goes well with your new dr and that he accepts you. Im about to probly be doin the same thing. Take care
 
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HighnLoLita replied to jamesp767042's response:
First I want to say, sorry about your bumb knee and all the disk problems you are having. Yes, I've been noticing that every doctor is different. Some look at my MRI's and say oh thats not major and shouldn't be causing you that much pain and the last Dr I went to (which was friday) was a neurosurgeon, he took one look at my MRI's and said Wow, who is treating you!!! and he explained to see where all my pain was coming from.

Last night was the worst pain! I didn't sleep a wink. I had pain up and down my whole spine. I'm just waiting for my friend to bring me something for breakfast so I can take my meds.

The new Pain Management Dr said that they don't give meds on the first visit but, they gave me a new appt in about 3 weeks and he said if he takes me on as a patient he would like to give me the fentenyl patch and the norco for break through pain. I don't have enough norco to get me through to that date so, I might go to the ER at the same hospital that the PM center is at and see if he will help. He said with the fentenyl I will no longer need any muscle relaxers, which will be wonderful because, I never get relief with them anyways. And he said that the muscle relaxers were highly adictive which I did not know.

Well thanks james for your input. i hope you have a great day...Lita
Life is not measured by the number of breaths we take, but by the moments that take our breath away. - Maya Angelou.
 
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Peter Abaci, MD responded:
Part of a strong doctor-patient relationship is having everyone comfortable working together with good, open communication. It sounds as if this particular physician primarily focuses on doing interventional procedures with his particular practice. This is a service that may benefit some patients' particular problems, but it also means that there could be a lot of patients whose situation he can't help. I wouldn't let his practice style serve as any type of judgement or rating of your pain, but rather view it as this particular doctor may not have the services available to best help you.

Remember, chronic pain is best viewed as a disease, as opposed to a symptom, which means it needs a thoughtful and comprehensive approach for treatment and management. Each person's own pain, however, is unique to them and I think the goal for each individual is to have the best tools to work through their own situation.

Also, here is some extra food for thought. I think doctors and patients have a tendency to take the prescribing and refilling of medications, of any kind, too lightly. Prescribing and taking medications should be viewed as a big responsibility, with short-term and long-term implications. Over the years, I have seen many types of medications come into the market only to find out years later that they can be dangerous or have side effects that we didn't know about when they were first prescribed.
 
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HighnLoLita replied to Peter Abaci, MD's response:
Thank you Dr Abaci, I always love you input! My new PM explained that I will take the prescription to see if it will manage my pain. Mine and his goal is that when my pain is managed I will go to pt to gain stregth. My goal is to loose 75 lbs in the next year. I also want to get off my rollerwalker and cane.

You wrote about prescibing and refilling of medications and being very responsible and the potential for dangerous side effects. What are your thoughts on fentanyl patch?? The new PM did explain the very things you are saying with your extra food for thought so thanks for your reminder. I have been doing research on opiods and my responsibilities if I am prescribed this medications so your input has been very helpful....Lita
Life is not measured by the number of breaths we take, but by the moments that take our breath away. - Maya Angelou.
 
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annette030 replied to Peter Abaci, MD's response:
I totally agree with you about the medications. I personally have decided not to even try any meds that have not been widely prescribed already for at least five years. Of course, this is for non-lethal problems, if I had AIDS or cancer, I might think differently.

I don't think I can even count on both hands the number of meds that have been withdrawn from the market entirely since I became a RN 40 years ago. It is really scary.

Thanks, Dr. A.

Take care, Annette
 
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jamesp767042 replied to HighnLoLita's response:
Hey Ms Lita. I never intended to take this long to respond back to you as ive been worrying about you and your situation. First off, I know how them sleepless nights can be, when your tossin and turnin because the pain wont let you relax. Im so sorry to hear that you've been having nights like that. Whats even worse though, is knowin your having nights like that with the possibility of runnin out of meds. I really hope that if you have to break down and go to the ER that they will help you. Ive fortunately never had to do that, but from what ive read its kinda mixed reviews. But i would still say that most come away with some meds to hold em over than those that get pushed away because they think there jus drug seeeking. You know, I never have understood the whole "we don't prescribe meds on the first visit". I mean what is up with that? Beyond me. Anyway, didnt I read on another post that your pcp has been prescribin your meds in the meantime? If so, you think he would give you so more norcos jus until your app? How short are you gonna actually be? I jus pray that for whatever reason you dont have to go without. If your like me your probly a nervous wreck waitin to here back from the PM if there gonna take you on or not. Im probly gonna be in a similar situation soon. I chose NOT to stay with the new PM that I was tellin you about. Apart from what i already told you about how i was treated, he also gave me a ultimatum that if i didnt have knee surgery within 3 months, he wouldnt treat me. So even tho he thought i was on too much medicine, he was willin to continue prescribin it to me but with the stipulation that i have the surgery within 3 months. After the 3 months he wanted to lower my dose then come off. Its alot more to the story, but im not gonna get in to all that. I did a post a couple weeks ago with the whole shabang if you wanna read the entire story. So having said all that, my pcp (or Internist) is back prescribin for me in the meantime and im back searchin for a new PM dr. I really wish he would jus handle my pain meds and keep me out of these ridiculous pain clinics. But he dosent like prescribin narcotics long term. I guess i shouldn complain cuz he at least jus this past week went up on my dosage from 4 to 5 a day until I can find a new pain clinic. Im jus really worried about not makin the right choice. I dont wanna have to go to 4 or 5 before i find one that gives me the treatment i want all the way around. Who knows, maybe when i finally find that right one it will be all worth it. I sure hope so! Oh, I wanted to ask you had you ever been on fentenyl before or will this be your first time? If you have, what did you think of it? And how did it compare to other long acting meds you've tried? Ive never been on a regimen of a long acting 2 or 3 times a day and then something like norco or like what i take the oxycodone for breakthrough. I have always thought that i would benefit from a regimen like this but have never tried it. Im hopin that the pain clinic i choose would be open to tryin me on somthing of that nature. Anyway Ms Lita I really hope they accept you into their practice and can help you out. And I also hope you can make it to the app with the medicine you have or are able to get some to hold you over if not. You will be in my thoughts and I look forward to hearing from you. Take Care Ms. Lita
 
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Peter Abaci, MD replied to HighnLoLita's response:
Lita,

First of all, kudos for having a great plan of weaning off of your walker and cane and to lose weight! I think you will be pleasantly surprised to see that these milestones can also diminish your pain.

As far as the fentanyl patch or other opioid-based medications go, I think this goes back to my comments above about being very thoughtful in your decision process. Think through the pros and cons, and also consider all of the potential long-term side effects. Again, you have made some great goals for yourself, and now is the time to think about how medications fit or don't fit with you achieving these goals.
 
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HighnLoLita replied to jamesp767042's response:
Oh my, James. I typed a reply to this message the other day but, I see it didn't go through. My grandson was messing with me that day so, I guess it got deleted or something???

I called my primary to prescribe one last script for my norco this morning so, I am waiting for them to call and let me know if it was done. She doesn't like prescribing narcotics either but, she has been a life saver b/c whenever I am between PM Drs she does take over. I don't know how long that is going to last though...

Yea I get the feeling that Dr's send us to pain management just to get us out of their hair and they don't want to be liable.. And the pain clinics are over crouded and only aloud to prescribe a certain amount or treat so many patients until they get their quota (sp?) and the leftovers don't get proper care. Just a thought...

I really feel you because, I have had the same experiences in the last year and a half. That is really crazy that the Dr gave you an ultimatum, I think it would be up to the patient to decide if they want to have any surgery. It's like they want the money for the knee surgery or they wont prescribe the meds. That blackmail!

No I have never had fentayl before. I have taken Oxycontin and that worked really well but, this new pm said the fentenyl will be a much better script because of other meds I am on..

My next appointment with the new PM is on the 18th so, I will let you know how that goes...Lita
Life is not measured by the number of breaths we take, but by the moments that take our breath away. - Maya Angelou.
 
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HighnLoLita replied to Peter Abaci, MD's response:
Yes Dr Abaci, I have been doing alot of research on different meds and their long term side effects and I am taking this time until my next appointment to learn all there is to know and to do the pros and cons thing. Thanks for your encouragement...Lita
Life is not measured by the number of breaths we take, but by the moments that take our breath away. - Maya Angelou.
 
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hogriderxp replied to Peter Abaci, MD's response:
Hi Dr. I think that if the medication helps the person thats what is most important ,because all meds have bad side effects compaired to the good they do
 
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jojoboie responded:
hi Leta( no pun intended:)
I'm not sure of your age or your ailment, but I am sure of mine: it is a crush injury to the hand/wrist area that I have had at least six surgeries for; the doctor told me my pain was permanent and not in my head. he still sent me to pain management, and gives me techniques to avoid giving me heavy narcotics. I appreciate the sensibilities involved in his decision-making, and love him for lifting my burden at least 75% of the way; I defy him, however, to try to live with my pain ( 25%). I would like to meet a doctor that can honestly evaluate pain and relate to their patients a better way to treat chronic pain. may be a doctor that has a severe injury and is living with it! my doctor supplied many drugs that were not addictive to no avail; when he prescribed oxycodone, he marveled at the management technique that I use to keep it mostly out of my system... sadly, there is a limit that forced him to send me to pain management even though he knew I still do have a significant claim with pain. pain management just drained my resources but not the pain. I have been medicine free for almost one year, and now the weather and pressures of trying" not" to use the hand are coming to get me- short sleep cycles, intense biting, throbbing pains and swelling of my fingers, wrist and elbow area, along with irritability. I hate when that happens. I have to have one final surgery to remove the titanium plate on my Ulna bone which my doctor says may be the source of my pain... the only consolation is that I'm getting another short round of narcs!!!!
I honestly believe that between prayer and distractions, you can release enough chemicals inside your body to push off 75% of your pain; however intense that 25% pain is inside of you, I feel for you; when it leaves you to tears, crying, just imagine inside your mind's eye leaning on my shoulder while I rub your back. a kiss from a friend xoxoxo hang in there, my dear; there will be better days for both of us!


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