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Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V

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My pain doctor was talking about giving me a steroid shot for this appointment on my last one 2 months ago and she told me to call the office and have them fax my mri order when I was able to do it which she wanted me to do before my shot. I call my doctors to have them fax my mri order they transfer me to the lady who handles that she says hold on put me on hold for 20 mins so I hang up and call back only to find out she left. So I hang up and call back only to find out she left. So then I keep calling, leaving messages with her, calling again leaving my info with the lady at the front desk to give the other one. After 3-4 weeks I fucking finally get the lady who handles faxing the orders and she tells me; "I got your message but can't fax the order since your doctor didn't have it documented". She could of at least called me back to let me know so I didn't have to keep repeatedly calling for a month.

At first I was opposed to getting a steroid shot but now I'm willing to do it. I never had one before but do take 5mgs of prednisone and a prednisolone drop in each eye a day.
 
They work really well. Sadly, this kind of thing happens all the time in offices. You probably know. Some are run really well, Others are not. Now you will know to have the doctor document what he says as an order. If he mentions doing something, I would just say, "you will put the order in for that right?" Try to get one name at the office to deal with.
I understand this because when I ask for a drug from an office and they say they will call it in, you would think that will be it, right? No. I have to call back later and make sure it was done. Babysitting, imo.
You have to babysit these docs and offices to make sure shit gets done.
I have had steroid shots in my sciatic nerve and it worked so well the pain didn't return
 
I wanted to try and get the order during my visit but the appointment was so rushed due to the doctor having to leave early, and them being short staffed because the NP was away; which I can understand
 
One of the nurses at work has a son who is an acupuncturist and she passed this handout to us the other day. It may be helpful

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phenethylo J said:
I wanted to try and get the order during my visit but the appointment was so rushed due to the doctor having to leave early, and them being short staffed because the NP was away; which I can understand
Click to expand...
it takes 3 minutes to write an order
 
I didn't even get a chance to ask her for it or the various medical questions. She just quickly examined me, talked about the steroid shot, then sent me on my way and went off to her next patient. As I was walking out I was thinking it might be better to get it directly from her; but didn't want to bother her since I knew she was pressed for time and having to squeeze in a bunch of appointments before she had to leave early, and keep my ride waiting by waiting for her. I also just assumed if I called up and asked them to fax it like the doctor told me to that'd work out. It was actually in my appointment notes that she wanted an mri of my cervical spine but wasn't officially documented.

I just recently got an xray of my cervical spine from another doctor but really need to get this mri soon since it has been a while since my last mri of my cervical spine.

Overall she's a great doctor I'm just annoyed because I wanted to see if this steroid shot would work since I have been getting allot worse lately.
 
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They say to ask for extra time for appointments and tell the schedulers that you have questions. They will still get behind, but it may buy you a few minutes. Yeah, they can give those in the office as far as I know. I don't think it is any different for your c-spine. My neck is a mess too right now. Getting worse. I think I have a spur, it feels like my head is going to explode. I have been managing with some home exercises and trying to use good posture, and I take my benzos as muscle relaxers and when it is bad 800mg motrin every 6 hours. I had a bone scan for an unrelated issue, and it was fine, I would think it would have shown.....so. Necks are hard because of all the computers.
Do you get tingling in your arms? Sounds like you have been at this a while. I would just get this booked as soon as possible, and learn to ask for extra time. The medical system is so rushed anymore.
 
Phenethylo J--

The Anesthesiologist doing the injection has to have the MRI to see the levels for the injection. The only way to do this safely, is under Fluoroscope. Unless the Dr, who is going to give this injection, was the ordering physician for your MRI--they cannot get that. HIPPA law. You can sign a release at the Dr. that is going to do the injection's office, or sign a release at the Dr's office that ordered the MRI, and get the report sent over. No need for waiting a month, or being on hold forever. Just get the report to the Dr. that is doing the injection.

As far as 'extra time" for an appt--most offices will give you an extended evaluation appt to discuss your plan of care. You just have to let them know when you schedule. Honestly, most pain patients will take well over their scheduled time, because they need to go on and on about the pain. This is understandable, but it throws the schedule way behind.

--RN Ambulatory Surgery Center for Anesthesia and Pain Management Group for 7.5 years
 
Just out of interest...in America when you go and see your GP or pain doctor, how much does it cos you (with insurance and without)?

There was some talk about charging patients in the UK a nominal fee to see their GP a few years ago but nothing came of it.....kind of went against the principals of the NHS i.e. that healthcare should be free to everyone at the point of contact. Lots of people criticise the NHS but having worked in it for nearly 15 years in different positions I'm very proud of the service and the standards and principals we strive to achieve everyday......
 
I don't have insurance so the pain management clinics in my area want between $450-$900 just to walk in the door,in addition to whatever the doctor wants to do (shots,prescriptions,etc...).The shots are outrageously expensive as well.That puts pm clinics way out of my price range.I have no idea what the co-pay would be with insurance.Guess it depends one what insurance plan you have.General practitioners vary widely if you're paying out of pocket.I've payed anywhere between $55-$150 per office visit depending on the doctor.If the doctor wants to give urine screens that is more money out of pocket.Prescriptions for controlled drugs are very hard to get where I've recently moved to.Where I'm from it's easier because there's so much heroin and crack that drug addicts generally don't spend their dope money on doctors.The only prescriber I've been able to find that's willing to treat my pain has so far only given me Norco 10/325s 4x a day which is ineffective unless I take 6 or more at once.They did mention oxycodone at my last visit so hopefully I'll at least get Percocet 10/325s but I'm not holding my breath.I'm pretty sure MS Contin is out of the question but there are middle of the road pain meds like Roxicodone 20 or 30mgs.Speaking of mid level pain meds,what ever happened to Talwin?It was a very effective moderate pain med that didn't have the stigma of morphine or demerol.For that reason I would think it would be more popular with doctors as a treatment option for those fearful of giving morphine,demerol etc...but it seems to have disappeared from the market.Wish I was back home where there were more doctors who weren't so afraid to write for something more effective.Hurting constantly sucks,not to mention running low on or out of pain meds well before my next doctor visit.
 
Wow...I can't beleave its so expensive! Over people moan about paging £8 ($12) for a two months presciption (of any drug).... The doctor visits themselves are always free. There is also a huge list of exemptions from the nominal £8 prescription fee anyway Ie. under 18 and sstudying, pregant women, over 65s, on unemployment or sickness benefit. Even if you have to pay you can buy a 3 month exemption card that pcovers ALL prescription charges in that time frame for around £25 ($38) and also a yearly one for about £80 ($120}..
Of course nothing in life is truely free and we pay for it I in the way of higher taxes but,..... Well.........idk..seems a fairer system to me. Especially if you are low on money and can'tafford iinsurance.
 
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I agree with you englandgz74. Out of nowhere I started pissing blood on Friday afternoon with severe pain in kidney/bladder. Have a history of kidney stones so I knew what it was.

Went to my local A&E in London. Was put on a bed straight away and given IV Oxycodone within minutes. My urine was checked within 5 minutes, confirmed no infection but a lot of blood. Blood tests came back within 15 minutes of being admitted showing my kidneys weren't functioning properly. I was then carted round to a CT scanner and had an immediate scan. 10 minutes later they told me I have several stones in my kidneys and making their way down my urinary tract to my bladder.

So within 30 minutes of walking in, I was given sufficient pain relief by IV, had my urine tested by a junior doc, my blood tested by a phlebotamist, CT scanned by a radiographer and a conclusive diagnosis delivered by a urology consultant.

The care was second to none and I didn't have to worry about insurance/paying for it. A lot of people whinge about the NHS, but it's a bloody brilliant concept.
 
It sure is...the problem we face in the NHS is treating more and more patients with less and less money. Its always a balancing act to find new ways of treating patients that saves money and takes stress off the system but doesn't sacrifice patient care. I.e. walk in centres, care at the chemist, 111 etc.

However, when someone is in need of urgent care as you obviously were the treatment needs to be made available immediately and be of the highest standard. The thing that bothers me is when vital resources are wasted I.e. people phoning ambulances for no reason or picking drunks up off the floor outside the clubs on a saturday night.....IMO if you waste valuable emergency bservices time you should he charged for it.....that would stop it straight away and save valuable resources for the people who need them....like you did...
I'm pleased your Ok now hun.
 
downerhead said:
what ever happened to Talwin?
Click to expand...


From what I understand, many docs just don't find this to be a particularly effective pain medication. The name brand is no longer available, but the generic is. It was once heavily abused hence the addition of naltrexone like bupe. Since it is an agonist-antagonist, it is inappropriate for severe, escalating pain. Furthermore,it must be used with caution in people who are receiving mu-agonists. Because of the antagonist properties at the mu opiod receptor site (Narcan-like effect) agonist-antagonists may cause the following problems if given to a patient already taking a mu agonist
1. analgesia from the mu agonist may be reduced
2. Withdrawal symptoms may be precipitated in pts who are dependent on mu agonists.


Furthermore this drug is likely to cause psychotomimetic effects such as agitation,dysphoria and confusion. For this reason it is contraindicated in the elderly.
Also this drug has been associated with high rates of sepsis and injection site necrosis (sometimes requiring amputation of a limb)
High doses have been associated with high blood pressure and heart rate, and not safe after myocardial infarction.


SO, long story short, I would imagine the safety profile is one that doctors are uncomfortable with.
 
I was prescribed pentazocine once years ago and found it utterly useless. This was back when my gp at the time used to just close his eyes and point to a page in the pain medication section of the BNF and say "well why don't we try this one this week"..... That man was so incompetent it beggars belief
 
Hi guys, just in misery right now ? my back is throbbing, every joint hurts, I feel like I'm 150 yrs old . Oh yeah and I'm having anxiety, panic, heaviness in chest, RLS, and watery eyes from having "extenuating circumstances" this month. I hate having to take opiates just tofeelnormal.
 
^so you're in wds?

Sorry to hear.

It might be worth ringing your drs office and explaining your situation in order to get a refill. Otherwise the ER.

There is threads to read which help lighten the load of wds
 
If you absolutely can't get your meds refilled there are lots of things you can do to ease the suffering....Try using the forum search engine and looking at things like loperamide, gabapentin, pregabalin, clonidine etc. etc....
Hope you find some relied soon.
 
Hi guys, I was in rehab for a few weeks. My mom didn't approve of my opiate use, even for back pain. And sure enough, I went through WD. Really depressed now; I'm still in pain, my grandfather died yesterday, and my dad's prostate cancer came back and he needs radiation. I need to get on methadone for the back pain but I can't see anyone until Wednesday. Just smoking a lot and using muscle relaxants. But it doesn't help much with the pain.
 
Sorry xtc. Your other issues are enough without chronic pain. I hope you're taking some OTC pain meds at least, though they are prob like spitting in the wind.
 
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