Today was my long awaited appointment at Emory's PM Clinic. Highly recommended by top TOS Dr.s and my Denver PM guy. I spent a whole day filling out their forms, histories and wrote (painfully) descriptions of my pain and triggers. Gave them full operative reports and all med records. They are listed in the top 35 PM clinics in the US.

However...

They do not do any IV medications. No medications at all. Just perscription recommendations that they provide to your GP. They will do nerve blocks... but only on Tuesdays.

After a thorough review of my records (5min w/intern, 10 min w/Dr) she believes my arm and nerve pain are coming from C4-C6; that I have scarring at the C8 nerve root; and she can numb the neck bones to see if it relieves my arm pain. if so, then she can 'burn' the nerves, which could provide relief for up to a year. Lessee... burn, scar, regrow, burn, scar, regrow... for another 20+ years? Nothanx. Not yet anyway.

I asked about the thoracic area nerve entrapment/damage and asked if she could do blocks for this. She pulled out a book that showed the C4-C6 and what pain radiated from them. As if the brachial plexus couldn't possibly cause hand, arm or shoulder pain. Oh heck, I just had RIBS REMOVED THERE AT C7 and T1 but what the hell do I know??? When her intern pressed on my rt clavicle I almost came off of the table, but heck, maybe that was really my neck.

Sure, I agree my neck is shot. I also agree that nerve oblation may help some of that pain. But what about the rest of it? The sternum, the chest, the b.p. scarring. If she want's to ignore that, can I trust her with the crevical issues? She's got credentials out the wazoo.

For privacy and slander reasons, I'm not printing the full name of this Dr.

P.B., MD
Clinical Director of Acute Pain Service, Emory Center for Pain Management
Assistant Professor of Anesthesiology

Dr. B. is board certified in anesthesiology and pain medicine. She is a distinguished member of many professional organizations, including The American Society of Anesthesiologists and the American Pain Society. Dr. B. graduated from Emory University Medical School, where she also conducted her internship and residency. In 2001, she was voted Atlanta's Top Doctor for Pain Management by Atlanta Magazine.

She wrote a recommendation for my GP:

Impression: cervical spondylosis, upper causalga (CRPS), severe depression.

Recommends:
1. anti neuropathic pain meds (topomax, keppra)
2. voltran gel
3. phys therapy
4. anti-depressants
5. consider cervical medial branch blocks for head and neck pain
6. consider spinal cord stimulation for arm pain


I feel like I have waited 3 years for nothing.

That's it. This is the best Atlanta has to offer? There's no such place that I can go when I'm in a 10+ flareup besides the ER (who won't be able to deal with it correctly)? It's a money issue?? She did say that she could refer me on, but they would want $$ over and above Medicare and private insurance (which I can't afford). Do I continue looking for such a place and just hope that they have someone knowledgeable about TOS?

OK, I'm making myself very upset now.