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Old 07-23-2018, 10:01 AM
 
2,477 posts, read 1,295,805 times
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I have read some previous posts on this topic but most are pretty old. Anyways I was referred to pain management and have my first appointment tomorrow following what is either a delayed healing or unsuccessful knee surgery which had left a lot of bone pain in its wake. I have been able to squeak by with a meloxicam,Tylenol 3 and lidocaine patch combo but it doesn’t help that much.

So for those who have been to a pain management doctor what should I expect? What should I do to prepare? I have filled out all of their forms and been keeping a log of pain and what helps or doesn’t help for the past month. I have a list of all of the things we have tried. Any advice or insight on what it will be like would be appreciated. Thanks!!
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Old 07-23-2018, 10:11 AM
 
Location: Nantahala National Forest, NC
17,396 posts, read 3,537,755 times
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First visit much like any other MD visit. Discuss med history, history of injury, treatment of same, pain management techniques already tried etc.

Then after physical exam, MD will go over the likely reasons for continued pain and offer recommendations for pain relief. It could involve medications, PT, or other pain reliever treatments. Will be tailored to your specific problems. Sometimes it's trial and error in finding what might work best. Feel free to ask about anything recommended....remember you are the one who makes the final decision about your medical care.

Write down all your questions so you don't forget....good luck!
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Old 07-23-2018, 10:32 AM
 
5,458 posts, read 6,124,370 times
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Quote:
Originally Posted by greatblueheron View Post
First visit much like any other MD visit. Discuss med history, history of injury, treatment of same, pain management techniques already tried etc.

Then after physical exam, MD will go over the likely reasons for continued pain and offer recommendations for pain relief. It could involve medications, PT, or other pain reliever treatments. Will be tailored to your specific problems. Sometimes it's trial and error in finding what might work best. Feel free to ask about anything recommended....remember you are the one who makes the final decision about your medical care.

Write down all your questions so you don't forget....good luck!

Pretty much nails it.


If additional medications are prescribed, expect drug screening, and for serious meds, expect a psychiatric eval as well. All part of program to protect everyone involved. Including you.


Can't emphasize enough the above recommendation to write things down. History, Meds, Treatment, and questions. It helps a great deal.


Bring any recent X-rays/MRI's etc. or arrange to have them sent to the Pain Clinic.
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Old 07-23-2018, 10:45 AM
 
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Thank you! I’m already doing a lot of those thing like PT, cognitive behavioral therapy with meditation training, have a psychiatrist who already sent my records, records from three previous surgeries on my knee as well as MRI, CT, X-ray, bone scan and EMGs. I also have information from my acupuncturist. I’m hoping having all of this in a file will be useful to them so they can see what I’ve tried and suggest alternatives that ideally avoid opiates but if we have to go down that route keep them minimal and controlled. I do not want a pill mill and have been assured by both my psychiatrist and ortho that this is not one of those. So we’ll see!
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Old 07-24-2018, 07:13 AM
 
Location: Planet Earth
2,768 posts, read 2,312,289 times
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Quote:
Originally Posted by annabanana123 View Post
I have read some previous posts on this topic but most are pretty old. Anyways I was referred to pain management and have my first appointment tomorrow following what is either a delayed healing or unsuccessful knee surgery which had left a lot of bone pain in its wake. I have been able to squeak by with a meloxicam,Tylenol 3 and lidocaine patch combo but it doesn’t help that much.

So for those who have been to a pain management doctor what should I expect? What should I do to prepare? I have filled out all of their forms and been keeping a log of pain and what helps or doesn’t help for the past month. I have a list of all of the things we have tried. Any advice or insight on what it will be like would be appreciated. Thanks!!
Mine was an idiot and put me on gabapentin. The gabapentin made my hair fall out and caused vivid suicidal feelings. Then he suggested a cortisone shot which causes ruptured tendons. I have tendonitis to begin with, and besides that I had, already, had a shot with no positive results other than a nasty menstrual cycle.
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Old 07-24-2018, 08:12 AM
 
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Happy to say my appointment went well and she was extremely compassionate, caring and receptive to my wishes. She listened to my concerns and is overall just a wonderful compassionate provider.
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Old 07-24-2018, 08:21 AM
 
644 posts, read 142,203 times
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Quote:
Originally Posted by FlowerPower00 View Post
Mine was an idiot and put me on gabapentin. The gabapentin made my hair fall out and caused vivid suicidal feelings. Then he suggested a cortisone shot which causes ruptured tendons. I have tendonitis to begin with, and besides that I had, already, had a shot with no positive results other than a nasty menstrual cycle.
I was on gabapentin for awhile and never had any side affects.

Why in the world would it cause your hair to fall out ?
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Old 07-24-2018, 09:34 AM
 
Location: Wine Country
4,841 posts, read 5,903,461 times
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Quote:
Originally Posted by Melchisedec View Post
I was on gabapentin for awhile and never had any side affects.

Why in the world would it cause your hair to fall out ?
I cannot take gabapentin either. The side effects are horrendous. I felt like I was swimming underwater the entire time. I tried it on two separate occasions and the second time I stayed on it a little longer to see if those effects would subside. They didn't.
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Old 07-24-2018, 11:08 AM
 
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Where I took gabapentin in the past I could only take it at bedtime or else I’d fall asleep standing up. If anyone hadn’t done it yet I would highly recommend seeing a pain management provider - I was heavily skeptical due to reading various stories on the internet but it was really helpful and productive with a lot of conversation where they actually listen to you. She spent 45 minutes talking through options, pros and cons and things I’m already doing and can add.
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Old 07-25-2018, 01:33 PM
 
6,178 posts, read 1,500,623 times
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The one thing I do not like about pain management these days is that the DEA and drug laws in general are so much of a factor when the doctor is considering treatment options, it doesnt matter if the doctor believes a particular drug would help someone, its more about concern for DEA 'watching them like hawks', and whether their offices will be raided due to 'over prescribing'.

Ive even asked my own primary doctor about this, they have a big sign on the door, stating that under no circumstances, will they prescribe any opioid drug, he admitted this was due to DEA watching them so closely and he even admitted that patient care has suffered because of it.

I have never understood why we permit the DEA to come between us and our doctors, its not their place to do so imo, besides that, if we need a law enforcement agency to 'police' doctors, that means we really dont trust our doctors to the fullest extent, if they cannot be trusted to prescribe medicine, why in the world should I trust them to make other more important treatment decisions then?!!

Plus, you have to keep in mind, all the laws and regulations the DEA has had a hand in creating, they all benefit the criminal drug cartels to some degree, they are scum of the earth, lowest of the low in my book.
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