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St George 2013 10-11-2013 02:18 PM

Need Help Friends..Pain Mgmt Doctors...
 
Short story (but still long) Some of you (Hey Mrs D !) have already read about my year long saga I posted as a new member a few weeks ago :)

I have SFN that was diabetic/chemo induced. Foot dr who did skin punch biopsy said nothing more can be done except pain management to give me 'some' quality of daily life back.

I went to the pain mgmt. dr my foot dr referred me to and even though I really liked the dr and he seemed to know what he was talking about, his office (converted house) was very, very nasty. He said since 1800 mg of gabapentin isn't working I would need a St Judes neurostimulator implanted and the only way to get insurance to pay for that is to have a sympathic nerve block first. Needless to say I was not going to let them stick a needle in my back in his facility.

I'm now on the hunt for a new pain mgmt. specialist......there are SO many listed within 30 miles of me but I know absolutely nothing about how to find one.
This is scary new territory for me and I would really like some input from you folks who have used one or two or three...lol.....or just know anything in general that might help.

And BTW.....the nasty facility discussed above is associated with our local Medical Center which REALLY floored me. Did not expect to see that dr when I pulled up pain mgmt. on the Medical Center's web site. Guess I need to call the hospital and let them know....nicely of course.

I have asked around but I don't know anyone that has had to use a dr like this.

HELP !

You peeps are so great....any feedback would be greatly appreciated.

Debi

Susanne C. 10-12-2013 07:39 AM

Hi Debi,
I have been fortunate in that while my neurologists dumped me, my family doctor has been willing to handle the pain meds. He actually promised me that he would stick with it even as things get worse. I felt pretty confident that he meant it.

However, at our visit last month, he was very different, and I am wondering- he is joining a group practice and perhaps they do not like chronic pain patients and prescribing opiates? I am very apprehensive about next week's visit. We have known this doctor for many years, quite well, and were totally blindsided by his attitude. (My husband was with me and did not intervene, he was so shocked.) This doctor had been the one who originally suggested methadone if the morphine did not work, and this time when we mentioned it he said that was for drug addicts and that he wasn't allowed to prescribe it. Just very strange. I know that methadone has special protocols, but as he suggested it I assumed he could prescribe it.

So I was going to say that you do not always have to go through a pain doctor to be treated, but maybe I will be looking for one soon. I have heard that many pain doctors are just out to make a fortune writing prescriptions for drug seekers, but I would not think insurance covers those? And of course it is not always easy to tell the difference between real, under treated pain and drug seeking behavior.

Dr. Smith 10-12-2013 12:29 PM

Quote:

Originally Posted by Susanne C. (Post 1021740)
This doctor had been the one who originally suggested methadone if the morphine did not work, and this time when we mentioned it he said that was for drug addicts and that he wasn't allowed to prescribe it. Just very strange. I know that methadone has special protocols, but as he suggested it I assumed he could prescribe it.

Unless his DEA license has been suspended or some new state regulation/law has changed things, he should be able to prescribe any legal medication he deems medically appropriate. I would suspect some reason other than medical (political?) for the flip-flop. It may be (as you're wondering) the policy of this new group practice, or he's been made subject of a witch-hunt, or... but who knows? :Dunno:

The current political environment (among other things) is indubitably causing the pendulum to swing the other way with regard to pain management, and as is often the case with pendulums, the swing is/may be too far. Little/no regard is being given to patients, and the consequences of inadequately treated chronic/intractable pain.

Brain Atrophy with Chronic Pain: A Call for Enhanced Treatment

Treat the Pain... Save a Heart

Brain Reorganization with Severe Pain: New Understanding and Challenges

Complications of Uncontrolled, Persistent Pain

Sudden, Unexpected Death in Chronic Pain Patients

and long term effects of pain on the body (goggle search)

Doc


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