Pain Management

[Antheia]

I just saw my PM doctor for the first time, and had no idea what I was getting into.  Prior to that I saw a new  surgeon for a second opinion.  New surgeon wrote a prescription to PM  doc to give me facet injections, and if this doesn't work, for me to go back to surgeon to schedule surgery.

A little background:  I have a herniated disc L5 s1 with DDD.  I'm 49 and have been through 3 years of PT, acupuncture, chiropractor, breathing/relaxation exercises, and TENS, ice packs, none of which has helped with my pain, and it just keeps getting worse.  

PM doctor said he would give me the facet injections, but made me agree to do biofeedback before dispensing any meds (I take Norco 10/325 x 6/day, and I am out, so didn't have much choice, so I agreed).  I don't know much about biofeedback (I intend to look it up), but am reluctant to pay (Ins isn't going to cover 100%) for it after so many other failed alternative treatments.  I'd rather just have the surgery and be done with it.  I understand surgery might not be the answer, however, the one the surgeon recommended has a 95% success rate with this surgeon.  

Now I want to fire my PM doctor, go back to the new surgeon, have him do the facet injections, and let him take over my care.  I also don't like that I had to sign all these contracts.  OF COURSE I won't ask another Dr. for meds if I am already getting them, THAT was humiliating.   I have real pain with  years of documentation to back it up. I also have years of failed alternative therapies that cost a lot of out of pocket.    

Does anyone know how to fire a PM doc?  I mean, he does work for me, and I should be able to get out of these contracts.  I also had to give a UA, and now they want to take my blood.  I was made to feel like a drug addict.  

If anyone has advice for me, I'd greatly appreciate it.  

Thanks in advance

[Sheywh]

I’m in the same boat but the PM doctor you have to have a PM  on board now.. This is due to the new laws regarding opioids. The Pain Management doctors
Are treating us all like addicts..This is due to the new laws they can loose their license and go to prison if they don’t follow these medication quiteline to the extreme The doctors are so afraid we as patients are drug attics and are going to ruin everything they have worked so hard for..It is so bad that we have to watch everything we say!! It’s bad you can’t tell a pain management doctor that you need for instance 10mg of the Flexeril because 6 months before you had o ly 5 msg for the same pain and it didn’t work So yea you know what works right! WRONG!! ! The minute you open your mouth to tell the doctor what works for you Their mentally thinking she’s just here for the drugs she even knows the does she wants!!! Well the problem is we non addicts Do not think the way the doctors are thinking Before we blink the doctor is treating us like a addict and we are sitting their wondering why is this doctor being so mean to me !! I know this because I’ve had a PM doctor for 19 years and he use to be the best PM around now he upsets me at least every other time I see him Today he sent me home with no more Morphine and the pump only upped to 4.8 This pump has always. been on 6.0-7.0 for almost 18 years I’ve been with him for 19 years and he talks
To keep as if he doesn’t trust me Know me he talks to my husband and tell him what to tell me He’s gotten very crude and cruel this last year..I too want to change PM but there so many bad ones I don’t know what direction to turn So if you find out please let me know too..Take Care Shey

[tib791]

Hi I'm new to this forum, as I just recently was in a car accident. I went to the emergency room, nothing showed up on the Xrays, so I was sent away with no pain meds, just anti inflams. My lawyer made an appointment for me with a neurology,pain mangment doctor. I went and on the first visit I was in excrutiating pain. I informed this doctor of that, and asked that he prescribe me something for pain, I told him I had not been prescribed anything since the accident and I needed relief. He offered more anti inflams, i was extremely anxious because I could see that he had the attitude right away, then he told me no we are not that kind of clinic.
I called my lawyer right after I left, and told him how the doctor had treated me and asked that he send me to a different doctor immediately. He said he would call and try and straigten it out. But when my lawyer called me back he said the doctor already called him, and said that I put up a red flag. Even though they wouldn't prescribe anything that day, but said after the MRI I could see another doctor at their office who would. Well 2 weeks later and I still have no pain medicine because the second doctor they sent me to also did the same thing. My Mri came back that I have 3 herniated bulging disc in my neck, and two in my back. The second doctor had my results , and still sent me away with anti inflamatory meds. Is this highly unusual, or is it just the norm these days.. Now I'm starting over with another pain managment who I have to see a Chiropractor before I see the pain doctor. But I know of this new Doctor I've found, and feel safe in saying he will probably prescribe what I need.  I have seen one pain managemnt doctor in the past for Arthritis pain, for aproximately 3 years, but he needed an Mri, and I haven't seen one again until now because of the accident, because I could not afford an MRI to keep that doctor, that was the reason he released me, due to no MRI. But now that the Insurance for PIP is covering these test I was able to obtain one, but still haven't found the right doc. Do I have to do their Chiropractor first, or can I tell them I would really like to be put on medication since I've been through weeks of this pain already, then do the Chiro appointment,.    Thanks for the help

[sandee1818]

Here in Florida a law was passed where the medications we take are put into a registry. The pill law is good in that it will stop the ones who abuse the doctors and the medications but I worry about mistakes being made and having them rectified.
There was also some other laws passed for pain management doctors and how they practice but I do not know what all it entails.
These laws are good for the ones who abuse the system as they will be stopped but then the mistakes that may be made will also stop the legit Pt's who need pain management care.

[mersilkee]

I have been seeing the same pain management doctor for several years.  We use to drive 5 hours to see him and since we have moved we have to fly to New York to see him.  That is how much a good pain doctor is worth to me.  We are staying with family in an area where we originally came from and I could go back to my old pain doctor.  But, the thought of contracts, urine tests and scrimping by on the minimum amount of pain meds he would give me is just a horrific nightmare.  If my husband doesn't get a job soon, we might not be able to go back to New York and then I will have to face all of that again.  The DEA unfortunately is planning to make all pain doctors and patients jump through those hoops.  They even want to put all of us who take pain meds into a registry and then they would limit how much pain medicine we received.  But, I don't think they will be able to do that.  But, I do think they will be able to cause a lot more administrative problems and they are also focusing on any time released medications like Fentanyl patches which I take.  Will it never end.

[Mollyrae]

Hi Antheia:

Sorry to hear of the constant pain. I agree with the others. You have every right to let your PMP go. The Surgeon will not step in for long though. He will treat you until he feels that your healed which in some cases is not a long time.

Surgeons will not take the place of your Doctor, you will have to find either another PM Doc or a regular Doc to take his place.

There are many Doctors out there willing to take over your care but few that are good enough to treat you accordingly. By saying that I mean finding a good Doctor that is willing to hand out Narcotics can be difficult. I would start your search as soon as possible and not necessarily after you have fired your PMP. Start the search now so you will be set and will not have to worry.

I hope that everything works out for you. Please take care and good luck.
Mollyrae

[Antheia]

Thanks for replying.  Yes, unfortunately I do require narcotics to manage my pain.   I was offered percocet (by the Dr. who referred me to pain management), but declined after some research where I read they are even more addictive than the Norco.  

Thank you for the tip on what to include in a termination letter, and a most awesome day to you, too.  

[Antheia]

Thanks so much for your feedback.  Once I schedule my appt. with the surgeon, I will ask that the PM dr. send my records to him.   Have a most awesome day.  

[Antheia]

Thank you so much for taking the time to reply.   I hope you got a good night's sleep.  

Holy ****, 442$?  That is outrageous.  If my ins. doesn't cover the UA they did on me, I'm going to raise some hell b/c it was unnecessary, as all they're going to find is what I'm prescribed.  Thanks for the heads up on that.  

On Tuesday I am going to call the surgeon and schedule an appt.  

Thanks again for your reply.  I hope you have a marvelous day.  

[Tuckamore]

Hi Antheia,

Welcome to the Pain Mangement Forum of MedHelp. I am glad that you have found us but sorry to hear about your pain and the difficult choices it has forced into your life.

You are so correct that the PMP works for you, you hire him and he is to deliver a service...that you pay for! If you are not satisfied with his service you have every right to terminate the relationship, period. Now that said if you require narcotic's to control your pain you may have no choice but to see a PMP. No one mandates that you see the current PMP. I have heard glowing accounts of great PMP on this forum and equally frightful accounts. So you may just want to seek out another PMP. I am told there are some very good ones out there.

In my opinion you have a right to determine what will and will not happen to your body, it's your body... And/or how you will spend your money. You should not be forced to go through biofeedback and without pain medications in hope that the biofeedback will work. That does not make sense to me.

How do you terminate a PMP? I think it's our choice. I would write a professional letter explaining the disagreement you have with his POC (plan of care) and your concern about out of pocket expenses that have been unsuccessful in the past. I may add something like though he may be an excellent physician, you do not feel that he is the best physician for you. Once the letter is in the mail I would call and inform the PM Clinic staff that a termination letter is in the mail and you will not be utilizing the PMP services at this time. This is just my personal opinion. It may not be the right one.

Good luck to you. Please let us know how you are doing. I will look forward to your updates.

Take Care,
Tuck

[sandee1818]

Hi,
If your unhappy with your PM doctor then tell him you wish to be let out of your contract with him and have him send your records back to the doctor you are wanting to see.It is that simple. Your right he works for you as you hired him so you have no obligation to continue to see him if you do not wish to do so.
Alot of the pain management doctors are drug testing to weed out the ones who are abusing or diverting the medications prescribed to them. This is a hassle but it protects us as well as the doctor. Pain contracts are also normal when seeing a pain management doctor.
This does make us feel like were being seen as an abuser or someone who may divert our medications but it really is just a safe guard for us as well as the prescribing doctor.

[troubleinohio]

its late and im really tired but will try to answer your post as coherently as i can before i crawl over to the bed to read my book and zonk out, lol.. first off i HATE PM doctors, i really truly do..i know for alot of people they are the only way they can continue prolonged treatment for chronic pain because alot of family doctors dont want to, or cant RX you pain meds long term.. but , man..the PM clinics DO treat you like a drug addict whether you are one or not. The unreliable drug testing they force you to do (and btw i recently got a bill for 442$ for one urine test, not a typo, you read it right)!! I have had nothing but horrible experiences from PM doctors/clinics! Its too late for me type up my entire story regarding PMs, but i just wanted to say, if you can at all get treatment from your other doctor I would urge you to do so (this is my opinion..others may disagree here) but do your homework before taking any action so youre not stuck without ANY doctor..good luck to you.