Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

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Old 03-16-2013, 08:06 PM #1
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Frown New pain doc

I was referred by my pcp doc to a Pain Management doc in my small town. Due to new KY law HB1, my pcp doesn't want to prescribe my pain meds, which are methadone and lorcet. The new pain doc said he did not believe I had RSD because it is such a rare condition. It is as if he has already made a decision without ever speaking with me. I have been diagnosed by several tests, namely bone scan, temperature studies, and nerve blocks. I do not want to go thru these tests again so I am getting my records sent to the new doc. I've had RSD since 1995. My meds had it basically under control, but now the new doc doesn't want to prescribe them. He doesn't believe pain meds are effective. I haven't actually seen him but am supposed to on Wed the 20th. I am so stressed. I have lost faith the my rsd will be under control again.
I hope I am wrong about the new pain doc. He did mention a pain pump. Has anyone ever had one? If so, was it helpful? And do you still have it? Any advice would be appreciated. Thanks.
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Old 03-16-2013, 08:53 PM #2
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Yeah some docs just don't prescribe. Especially Ky, there are some bias doctors. You say you're from a small town, can you see another doc in another town? Hopefully this one will actually take the time to look and thoroughly examine you. IT pumps are end of the line treatment. I wonder why he brought that up when he feels you do not have RSD. He could be a "block jock" so watch out for him pressing interventional procedures you have either tried, or don't need.
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Old 03-16-2013, 09:06 PM #3
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Quote:
Originally Posted by KathyWP View Post
I was referred by my pcp doc to a Pain Management doc in my small town. Due to new KY law HB1, my pcp doesn't want to prescribe my pain meds, which are methadone and lorcet. The new pain doc said he did not believe I had RSD because it is such a rare condition. It is as if he has already made a decision without ever speaking with me. I have been diagnosed by several tests, namely bone scan, temperature studies, and nerve blocks. I do not want to go thru these tests again so I am getting my records sent to the new doc. I've had RSD since 1995. My meds had it basically under control, but now the new doc doesn't want to prescribe them. He doesn't believe pain meds are effective. I haven't actually seen him but am supposed to on Wed the 20th. I am so stressed. I have lost faith the my rsd will be under control again.
I hope I am wrong about the new pain doc. He did mention a pain pump. Has anyone ever had one? If so, was it helpful? And do you still have it? Any advice would be appreciated. Thanks.


I can't think of any possible reason that a doctor who truthfully believes pain meds are ineffective would then recommend a procedure with risks (the insertion and maintanence of a pain pump) AND the need for ongoing pain meds through said pump. What the heck is that all about ?

I'm sorry to say, I have the same reservations you are having about this new doctor. I don't care if RSD were so rare there were only 2 other known cases......you've been dx'd and have tests to back that up. This new doc hasn't even seen you yet.

I don't think we have to go too far out on a limb to guess that this new pain doc does NOT have a lot of experience with RSD patients.

None of the pain management docs that I have seen actually write prescriptions for ongoing meds (narcotics or others). They have ALL been in practices that only do procedures.....like nerve blocks, trigger point injections, or the insertion of pain pumps or SCS's. Those procedures can also help many of us, but I've had to look further to get ongoing help managing my prescriptions.

Are you near a major metropolitan area ? Have you ever been followed by a neurologist ?

Are you already off your meds ? Or just running low ?

There are a few posters here who have a pain pump. Hopefully, they'll see your post soon and respond. You might also want to do a search on this forum for "pain pumps"

I wish I could sound more hopeful about your upcoming visit. Maybe this doc will surprise you. I hope so !
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Old 03-16-2013, 11:15 PM #4
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The theory behind a pain pump is that a smaller amount of opiate is used, and since it's directed to the spine, it'll be more effective at treating pain and patients can't abuse it or get "high" from it. The reality is docs make BIG money from the pumps installation, and it's often difficult to get the suckers removed if they cause spread or other problems. I wouldn't undergo this procedure...

If you're close enough to Nashville, there is an experienced RSD doc at Vanderbilt you might want to check out.
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Old 03-18-2013, 03:44 PM #5
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Quote:
Originally Posted by KathyWP View Post
I was referred by my pcp doc to a Pain Management doc in my small town. Due to new KY law HB1, my pcp doesn't want to prescribe my pain meds, which are methadone and lorcet. The new pain doc said he did not believe I had RSD because it is such a rare condition. It is as if he has already made a decision without ever speaking with me. I have been diagnosed by several tests, namely bone scan, temperature studies, and nerve blocks. I do not want to go thru these tests again so I am getting my records sent to the new doc. I've had RSD since 1995. My meds had it basically under control, but now the new doc doesn't want to prescribe them. He doesn't believe pain meds are effective. I haven't actually seen him but am supposed to on Wed the 20th. I am so stressed. I have lost faith the my rsd will be under control again.
I hope I am wrong about the new pain doc. He did mention a pain pump. Has anyone ever had one? If so, was it helpful? And do you still have it? Any advice would be appreciated. Thanks.

I would also see of your current doctor would call up the new one, as well as having your records sent over. Arm yourself with supporting documents and hang in there! I hope this new Doc will either "see the light" or you can get to one that well help you and not be judgmental before he even see's you!! Really have your "old" doctor call and explain why you were referred to the new and that you have a REAL condition. I hate to hear when someone is treated this way!

Warmest wishes, and best of luck!
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Old 03-18-2013, 04:24 PM #6
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Default I have made a decision,

to go back to my original pain management. They are the drs that diagnosed my rsd. I wanted to see a doc in my home town, but after getting records sent and jumping through ridiculous hoops I've had enough. He doesn't believe I have rsd bc it is so "rare." I owe him nothing. So instead of waiting further I am going to be proactive and get what I need instead of trying to prove something to someone who won't believe it no matter what. I do not need the additional stress. I am done with him.
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Old 03-18-2013, 04:27 PM #7
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Default Thanks!

Your replies helped me tremendously. Do not know what I would do if I didn't have this forum and your great feedback. THANKS!!!!
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Old 03-19-2013, 11:27 PM #8
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Good luck with this Kathy.

Because of pain issues and narcotics/other meds, driving is a factor for many of us. Having a close by doc who "gets it" would be ideal, but if I had to choose between "local" and "knowledgable"......Well, I think you made the best choice
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