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  • BDD Moderators: Keif’ Richards

First Pain Management Visit... Questions... Help..

P

PillGates

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Joined
Sep 16, 2014
Messages
39
Hey everyone-
I have a few questions, with next week being my first pain management visit, and wondering what to expect.
I have back problems/pain. I was supposed to have surgery but insurance denied it.
I have done the proactive part of it, trying physical therapy ect.
I have had soo much trouble with Trying to get drs to Rx me pain Meds. None of em will do it. And then I finally found ONE dr that wasn't all uptight and would Rx me some Meds. The problem is, one random day, they just decided to terminate me from being a patient with them.
So now, next week is my first apt. I finally got in to a pain management dr that prescribes Meds.
With it being my first time, What should I expect?
Do they do any initial drug tests or anything of that sort?
Should I get my records to bring from the dr that terminated me, so the PM Dr has proof that I was on pain Meds?? I have a high tolerance and him Rx'ing me a 5-10mg won't help what so ever.

Any info would be greatly appreciated on what to do in this situation/ what to expect in this situation. Thanks in advance.
 
The doc who did prescribe your meds before you were terminated, was it a therapeutic dose?
I can say that with any doc, coming across as serious, in chronic pain, and not an addict is important.
I suggest coming in with a printout from your pharmacy of your history . That shows you don't get them filled all over, shows you were medicated and have nothing to hide. A pain diary is also helpful, along with describing everything non medicinal you've tried like massage, physio, chiro, acupuncture, etc,
Good hygiene, well dressed, calm, well spoken, not desperate, but very firm in pain level will go a long way.
Good luck! I know how heartbreaking it is to have chronic untreated pain
 
When I was in pain management, the doctors required x-rays or MRI's. It would help if you had documentation of your physical therapy, also that your insurance company denied your surgery. Plus any doctors records would help your case. Let us know how it goes. Welcome to Bluelight!
 
Yes, I have MRI and x rays that the PM doc has.
As for the dose, it was a decent amount. I've seen more amounts Prescribed to people, but was still a good amount.
I'm kinda 50/50 in deciding if I should bring the past Rx record or not. The ones I have from that dr are only for about 4 months.
So... Should I bring them or not? And if I do, what's better, pharmacy printout or drs notes to take. ?
 
Instead of "a decent amount" what dosage and medication you actually were getting is more helpful for us to give you advice. Why did they terminate you? Did you break the patient agreement? You usually have to do something wrong for that, they don't usually randomly kick people out IME. Why do you say you have a high tolerance? Are you currently using? Many pain docs will have urine test, and coming up with anything they don't prescribe is gonna get you booted out of their program. If you think you have a high tolerance from past use, it will go down over time so go in with an open mind. If they go to script you for something and you immediately say it's too weak that's usually a red flag, especially since you're not currently Rx'd any pain meds. Don't forget, if you're truly in pain, the idea isn't to "feel" your dose, just have it reduce the pain. Too many people think if they aren't getting high off their dose they're under medicated.
 
I was getting Rx'd about 90 30mg oxycodone ir. and I have no idea why I was terminated. Once it happened I started talking around with ppl and they knew others that would randomly get terminated too.. I didn't go to that dr long enough to really know how they operated everything. Maybe they were a sketchy dr. Idk. And I still do have a script going into it,.. After the general dr terminated me, I saw a specialist, and he was able to refer me to PM dr. And since it was a 2 month wait, I was able to pry his hands to writing me a script of 60. Also, with the urine tests, would they make a big deal if cannabis showed up on them. I have my own medical card.
 
Update for u guys...
Went to PM Dr today. Turns out my friken dr is in a wheelchair! Lol
Prob not the best pm dr to have, bcuz he prob thinks that he needs Meds more than me! Haha
I've been to a lot of Drs, and for the first visit is was very rude and stern. Kinda made me nervous. Didn't reslly let me talk freely and tell him about my past history with dealing with my prob ect. When he asked me about pain I was telling him where it was and describing it to him. When i was talking to him I was beginning to tell him how I've been proactive about it and gone to physical therapy quite a bit. While I was into my first sentence he said I don't care about that, tell me how bad ur pain is and what causes it to get worse.
He also asked me how many Meds I've been taking and I told him 3-5 30mg a day and he replied back with that's too much.
In the past I've also been prescribed lyrica and cymbalta. I told him the lyrica made me sleepy, and the cymbalta didn't help. He said of course the cymbalta won't feel like working when u take a 30mg pain pill.
It wasn't easy but he ended up Rx me 3 30mg a day, and gave me some gabapentin to try as well. (I've never had that, but I'm guessing it's the same as lyrica?)


On a side note, I've been weining off cymbalta for like 3 months now. Was taking 60 mg. then did 60 ev other day for 4 wks, then down to 40mg ev other day, then 30 mg ev other day, then 20mg ev other, and now I've gotten down to 20mg once every 3 days. 20mg is the lowest they make. Any ideas or help on how to finish quitting besides just jumping off the ship with it? I have felt like crap everyday since i started lowering dose. And I just want to feel normal again!
 
Gabapentin is not the same as Lyrica, but close. Don't take them both. They are both prescribed in PM for nerve pain, even though Cymbalta is not truly for that, it does help some patients. If you're feeling 'like crap" weaning the Cymbalta, maybe you weaned too fast. You should have taken the 20mg ev other day (or QOD) for about two weeks, then went to every third day.

All of these are for nerve pain. If you weren't a candidate for surgery, you need to find out why-- do they want you to try injections first before approving surgery? The reason I say this--is because pain management Dr's now have to report 'meaningful use" when prescribing for chronic pain. There has to be a 'plan of care' in motion. For non-oncological pain--there has to be a plan, other than pain meds for life
 
Windsor -
What do u mean file for meaningful use, plan of care, and non oncological? Could u plz explain?
 
Insurance denied surgery bcuz dr wanted to do an artificial disc replacement vs a fusion because of my young age
 
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