Re: pain management specialist

October 27, 2002

Hi Steve,

I understand what you are going thru. I too am heading towards pain

management. My pcp thru my hmo has wanted me to be in it for quite a

while now, but could not send me as my whole knee thing is thru work

comp (which is almost done yea!!!) Anyways, there are different

types of pain management. Some clinics work more on cognitive

behavior therapy (learning new ways to deal with the pain, such as

imagery meditation etc) others are more heavily into medications. I

think it would be best to use both areas. I myself use hydrocodone

for pain as well as a tens unit and a kinda " zone out " time. If you

were only taking 7.5/apap you may need to increase your dose. If you

are on any med you can expect to become tolerant to it. And 7.5 is

one the lowest doses of hydrocodone apap. I myself take 10-20mg/apap

every 4-6hrs as needed. Sometimes I don't need any, and others, I

couldn't get around my own apt without.

There is a lot of information about pain management clinic on the

web. There is a board that I visit from time to time that has great

people and wonderfull information about pain managment. A lot of the

people there are in pain managment. It is at

http://www.webmd.com/roundtable_topic/83

Or if you want you can ask me specific questions. I have learned a

lot since I have been dealing with the knee of mine, (don't you just

wish sometimes you could spray it with WD40 and it would work like a

squeaky hinge would?) But the biggest thing that I would say to

remember is to check into the docs and clinics where you want to go.

Set up an initial appt with the doc for you to meet him/her and ask

questions such as: if you have a problem with your meds and he is

out of town is there someone who can take your call? If you have an

emergency and need to go to the ER is it all right? Things like

that, and remember when you are comming up with these questions, most

pain clinic docs will have you sign a pain managment contract stating

that you will not recieve any pain killers from any other doc but

them, this is standard, but make sure you are covered if you need to

go the the ER for any reason. I have had that happen to me, and it

wasn't fun. I have heard of some cases where the pain docs dropped a

patient for going to the ER because they " felt " that the patient was

abusing the meds. The contract works in your favor though. If you

have one and have it signed and with you and you do end up in the ER,

the ER docs know exactly what is going on. Kinda cool eh?

Anyways, I will answer as much as I can for you, it is hard to come

up with things off the top of my head so early in the morning. LOL

Ask away and visit the other website, the people there know a whole

lot more than I do. *S* Good luck, and I hope you find some releif.

Tigger

> I have had CP with three surgeries starting in 1993. The last one,

four years ago, I received a cleanup and a lateral release. It is

back to popping, grinding, and absolutley killing me with pain. As

well I injured my right one a year and a half ago, which is getting

worse with time. I have developed bleeding ulcers from the years on

Vioxx, Celebrex, and Aleve. After an endoscopic examination, the

gastroenterologist has forbade me from ever taking them again. The

loss of the Vioxx has been devestating in my pain management. I take

two hydrocodones (7.5-500) a day on average and am apprehensive of

taking more. I am not dependent, as three months ago I stopped

taking " everything " cold turkey for two months after I realised that

the stomach pain was from the ulcers, with postively no withdrawals.

I started back on them about month ago, but I had just as soon take

sugar pills. I assume that I have become immune to the hydrocodone.

My surgeon has referred me to a pain specialist which I see on

Monday. What can I expect from this? Do they usually go the psyco

route, acupuncture, or try to get me on the right meds to accomdate

my pain? I am apprehensive about this, but at this point I am willing

to try anything. The Chinese water torture has just about took me to

my limit. Any information about PMS's would be appreciated.

>

> Steve

October 27, 2002

Thank you for the reply, Tigger. The link didn't work, but I found some very

good information on the web site. I believe that the PM clinic will be the best

thing that has happened for me in while. At least I pray so. I will drop a line

tomorrow after the visit.

Steve

October 28, 2002

Good luck Steve!!! I am sorry the link didn't work, but at least you

got the idea from the website. Let me know how it goes at the appt.

I am very curious as to how things turn out.

Tigger

> Thank you for the reply, Tigger. The link didn't work, but I found

some very good information on the web site. I believe that the PM

clinic will be the best thing that has happened for me in while. At

least I pray so. I will drop a line tomorrow after the visit.

>

> Steve

October 28, 2002

The visit went well. He didn't crank on my knee or stick me full of holes, so I

am happy. He said that my current meds weren't nearly enough. He gave me

something for pain, insomnia, and depression. I like his attitude of my not

needing to suffer. I hope this stuff works. I will keep you posted.

Steve

October 28, 2002

Steve, I am glad that it went well for you. Nothing is worse than

being in pain, and not finding relief. I hope these meds work out

for you. And remember to be open and honest with your doc. If

something isn't working or is having side effects let them know.

There are a lot of meds out there that they can try, and it takes

time to get the right combinations at the right doses. But I am very

happy for you.

Tigger

> The visit went well. He didn't crank on my knee or stick me full of

holes, so I am happy. He said that my current meds weren't nearly

enough. He gave me something for pain, insomnia, and depression. I

like his attitude of my not needing to suffer. I hope this stuff

works. I will keep you posted.

>

> Steve

October 29, 2002

I had a good nights sleep last night, for the first time in months. I only woke

up a couple of times! The background pain has diminished somewhat and I actually

feel somewhat like a human again:)

Steve

October 29, 2002

HI Steve-

I am wondering which anti-depressant they prescribed for you. I have

asked my pain doc for an anti-depressant and he won't give me one. A

known side of narcotics is depression- not to mention the

circumstances/pain surrounding CP is depressing enough! I take Ambien

for sleep and it helps me. Thank you! Margaret

October 29, 2002

Hi Guys:

I just wanted to make a distinction (as best as I can) between the

different kinds of " Pain " doctors out there.

I don't know much about the definitions of these different types of

doctors or what kinds of degrees they have. In my mind, there are

basically two types:

- There are doctors that try to fix your joints, bones, soft tissues,

etc. to try to stop the pain at its source. I think these are the

osteopaths and applied kinesiologists of the world. They may go

by " Pain Specialists " but are better classified as " Pain RESOLUTION

Specialists. " This is what my doc calls himself.

- Then there are the guys who help alleviate your symptoms with

various medications. I think these guys are the " Pain MANAGEMENT

Specialists. "

I guess the best thing to do is seek out the first type to try to fix

your problems. If that fails, then a visit to somebody with some

good drugs couldn't hurt. It's working for Steve!

Does that make sense?

- Doug

dougfromct2002@...

> I had a good nights sleep last night, for the first time in months.

I only woke up a couple of times! The background pain has diminished

somewhat and I actually feel somewhat like a human again:)

>

> Steve

October 29, 2002

wofford99 wrote:

> HI Steve-

snip

> I am wondering which anti-depressant they prescribed for you. Margaret

He prescribed Celexa for me.

Steve

February 10, 2009

I went to a pain management specialist and after he reviewed my MRIs he

simply agreed that what I was being prescribed was reasonable. He did not want

to

take the place of my primary physician because he is too busy and really I

would rather keep it the way that it is anyway, but he had no issues with the

narcotics I was taking..

Tom

In a message dated 2/10/2009 7:58:46 A.M. Mountain Standard Time,

carrie.heflin@... writes:

Hi all!

I am wondering if any of you are under the care of a Pain Management

Specialist? If so, do they prescribe narcotics to you? Mine has prescribed

Ultram

and Norco the past few months. They both do nothing. I don't need pain meds

that often anymore as I had facet joint injections, epidural injections, and I

had my nerves carterized. I just need them when I overdo it.... How do I get

my PMS to understand??

Sent via BlackBerry by AT & T

Re:Abnormal MRI????

Hi Annie,

I agree with . Not only do us back and neck people have abnormal MRIs

but by middle age, all people have abnormal MRIs. The ones with less abnormal

may not have symptoms yet and the ones with more abnormal are more likely to

have symptoms but still may not. That you have a bone spur causing pinching

of your sciatic nerve means you've had degenerative changes in your lower

back for years and are only now getting symptoms.

However, I will add one thing. A radiologist, who is supposed to read the

mri and send a report to your doctor, generally doesn't say an MRI is

abnormal. He/she will report more or less objectively what is seen in the mri,

then

give his/her impressions of it. Then the doctor will read the report and based

on his experience with this level of degenerative changes will prescribe the

treatment. Saying something is abnormal is imprecise and a very bad choice

of words. Try to ignore it.

Rochelle

[Non-text portions of this message have been removed]

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February 10, 2009

At this point my PMS has been my primary doctor for over 3 months. The

Orthopedic sent me to a Neurosurgeon and then the Nuerosurgeon sent me to the

PMS. I already have a fusion from C5-C7, a screw loose at the C6 level, and

C3-C4 are now bulging. Oh and of course degenerative disc disease. I feel

fortunate as I am not in the same situation as many of you are. I work full

time, go to school full time, and have a husband and son to take care of. I have

been back in pain again for the past year. Now it is much more manageable and

under control with the exception of certain days. When I do have bad days

though, I have bad days and can't do anything. That is when I need stronger pain

meds but for some reason my PMS won't even prescrive hydrocodone... I just think

it is crazy and very unfair to me... Especially if it is only on occasion that I

would need them!

From: tomhfsu@... <tomhfsu@...>

Subject: Re: Pain Management Specialist

neck pain

Date: Tuesday, February 10, 2009, 10:05 AM

I went to a pain management specialist and after he reviewed my MRIs he

simply agreed that what I was being prescribed was reasonable. He did not want

to

take the place of my primary physician because he is too busy and really I

would rather keep it the way that it is anyway, but he had no issues with the

narcotics I was taking..

Tom

In a message dated 2/10/2009 7:58:46 A.M. Mountain Standard Time,

carrie.heflin writes:

Hi all!

I am wondering if any of you are under the care of a Pain Management

Specialist? If so, do they prescribe narcotics to you? Mine has prescribed

Ultram

and Norco the past few months. They both do nothing. I don't need pain meds

that often anymore as I had facet joint injections, epidural injections, and I

had my nerves carterized. I just need them when I overdo it.... How do I get

my PMS to understand??

Sent via BlackBerry by AT & T

[PainInTheNeck- Back] Re:Abnormal MRI????

Hi Annie,

I agree with . Not only do us back and neck people have abnormal MRIs

but by middle age, all people have abnormal MRIs. The ones with less abnormal

may not have symptoms yet and the ones with more abnormal are more likely to

have symptoms but still may not. That you have a bone spur causing pinching

of your sciatic nerve means you've had degenerative changes in your lower

back for years and are only now getting symptoms.

However, I will add one thing. A radiologist, who is supposed to read the

mri and send a report to your doctor, generally doesn't say an MRI is

abnormal. He/she will report more or less objectively what is seen in the mri,

then

give his/her impressions of it. Then the doctor will read the report and based

on his experience with this level of degenerative changes will prescribe the

treatment. Saying something is abnormal is imprecise and a very bad choice

of words. Try to ignore it.

Rochelle

February 10, 2009

,

Your pain doc wont RX pain medicine....huh? That sounds a little fishy...so

what is he doing for your pain? Its amazing that you are so active...you

are blessed in that situation..but never the less if you hurt you

hurt.....whats your doctors reasoning behind not rx?

Deb RN

From: neck pain

[mailto:neck pain ] On Behalf Of Heflin

Sent: Tuesday, February 10, 2009 10:07 AM

neck pain

Subject: Re: Pain Management Specialist

At this point my PMS has been my primary doctor for over 3 months. The

Orthopedic sent me to a Neurosurgeon and then the Nuerosurgeon sent me to

the PMS. I already have a fusion from C5-C7, a screw loose at the C6 level,

and C3-C4 are now bulging. Oh and of course degenerative disc disease. I

feel fortunate as I am not in the same situation as many of you are. I work

full time, go to school full time, and have a husband and son to take care

of. I have been back in pain again for the past year. Now it is much more

manageable and under control with the exception of certain days. When I do

have bad days though, I have bad days and can't do anything. That is when I

need stronger pain meds but for some reason my PMS won't even prescrive

hydrocodone... I just think it is crazy and very unfair to me... Especially

if it is only on occasion that I would need them!

From: tomhfsu@... <mailto:tomhfsu%40aol.com> <tomhfsu@...

<mailto:tomhfsu%40aol.com> >

Subject: Re: Pain Management Specialist

neck pain

<mailto:neck pain%40>

Date: Tuesday, February 10, 2009, 10:05 AM

I went to a pain management specialist and after he reviewed my MRIs he

simply agreed that what I was being prescribed was reasonable. He did not

want to

take the place of my primary physician because he is too busy and really I

would rather keep it the way that it is anyway, but he had no issues with

the

narcotics I was taking..

Tom

In a message dated 2/10/2009 7:58:46 A.M. Mountain Standard Time,

carrie.heflin writes:

Hi all!

I am wondering if any of you are under the care of a Pain Management

Specialist? If so, do they prescribe narcotics to you? Mine has prescribed

Ultram

and Norco the past few months. They both do nothing. I don't need pain meds

that often anymore as I had facet joint injections, epidural injections, and

I

had my nerves carterized. I just need them when I overdo it.... How do I get

my PMS to understand??

Sent via BlackBerry by AT & T

[PainInTheNeck- Back] Re:Abnormal MRI????

Hi Annie,

I agree with . Not only do us back and neck people have abnormal MRIs

but by middle age, all people have abnormal MRIs. The ones with less

abnormal

may not have symptoms yet and the ones with more abnormal are more likely to

have symptoms but still may not. That you have a bone spur causing pinching

of your sciatic nerve means you've had degenerative changes in your lower

back for years and are only now getting symptoms.

However, I will add one thing. A radiologist, who is supposed to read the

mri and send a report to your doctor, generally doesn't say an MRI is

abnormal. He/she will report more or less objectively what is seen in the

mri, then

give his/her impressions of it. Then the doctor will read the report and

based

on his experience with this level of degenerative changes will prescribe the

treatment. Saying something is abnormal is imprecise and a very bad choice

of words. Try to ignore it.

Rochelle

February 10, 2009

The only thing he says is that they are just not good for me. Well yeah, I know

that! I was on them for 2 years straight with no problems and now I can't even

have a script for some of the time? I just found out that my PMS left and now I

have a new one! Maybe she will help me!!

Sent via BlackBerry by AT & T

[PainInTheNeck- Back] Re:Abnormal MRI????

Hi Annie,

I agree with . Not only do us back and neck people have abnormal MRIs

but by middle age, all people have abnormal MRIs. The ones with less

abnormal

may not have symptoms yet and the ones with more abnormal are more likely to

have symptoms but still may not. That you have a bone spur causing pinching

of your sciatic nerve means you've had degenerative changes in your lower

back for years and are only now getting symptoms.

However, I will add one thing. A radiologist, who is supposed to read the

mri and send a report to your doctor, generally doesn't say an MRI is

abnormal. He/she will report more or less objectively what is seen in the

mri, then

give his/her impressions of it. Then the doctor will read the report and

based

on his experience with this level of degenerative changes will prescribe the

treatment. Saying something is abnormal is imprecise and a very bad choice

of words. Try to ignore it.

Rochelle

February 10, 2009

At 12:53 PM 2/10/2009, you wrote:

>,

>

>Your pain doc wont RX pain medicine....huh? That sounds a little fishy...so

>what is he doing for your pain?

I get my pain management narcotics from my primary physician. He has

been wonderful, but strict. I need to see him every three months, he

does blood level checks for liver damage and or abuse. I'm in no

shape to take extra or I wont have them for when I need them. He

prescribes an exact amount. But I do take them daily. I'm going to

see a new Pain Management Group soon. They told me that they do not

prescribe meds. They use behavioral modification like Bio-feedback

and other things I don't know yet. But I still have my Doctor for

the pain meds. I've been on them continuously for 8 years now. I hope

your new Doctor will prescribe the medicines you need. Dave

February 10, 2009