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Old 04-17-2010, 10:51 AM
 
Location: Manchester, NH
35 posts, read 86,517 times
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I'm relocating from NH to Jacksonville, hopefully just west of the inter-coastal ways around Atlantic Blvd, near the Neptune Beach area and I rely on Public Transportation. I'll probably look at the complexes off San Pablo. So considering those two details, does anyone have a good recommendation on a pain clinic or pain doctor that DOES prescribe pain meds? I see compared to where I live, there seems to be plenty of them around. We have like 10 in our entire state of NH!
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Old 04-17-2010, 02:38 PM
 
154 posts, read 323,938 times
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H Nboeck, I can't give you info on the pain clinics, but as far as depending on the buses and living on San Pablo Rd, it might be cumbersome. You mentioned Banyon Bay Apts. on another post. While I think the apartment complex might very nice (I haven't visited them), your proximity to the busline on Atlantic Blvd. looks like it might be a mile. Also, I think the shopping would be a little inconvenient there also. If you were driving I would say go for it, but depending on the buses is another story for that area.
For convenience to shopping and to the busline, I think that living in Neptune Beach would be a better idea. Also bear in mind that in addition to the hot summer weather, it rains almost every afternoon in the summer in Jacksonville. Too much walking to a bus stop might get old very quickly on San Pablo Rd.
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Old 04-18-2010, 05:59 PM
 
Location: Manchester, NH
35 posts, read 86,517 times
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Thanks...I thought I saw on google that there is a big chain Lion (?) grocery store right next to Banyon Bay, and it didn't seem like it would be a mile from their entrance up to Atlantic Blvd., I thought it appears to be maybe a quarter mile walk for the bus, afterall, google maps says it's a mere 3.5 miles from San Pablo road to 3rd avenue...but that's assuming the Bus will stop for me right at that intersection too. Thanks for letting me know about the rain every afternoon...are they thunderstorms? I love thunderstorms, they're pretty rare in NH.
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Old 04-18-2010, 06:23 PM
 
154 posts, read 323,938 times
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I did a little research on Banyon Bay and you are right. It is only a block or two from Atlantic Blvd. and there should be some shopping nearby. From the pictures I looked at it looks like a beautiful complex. You'll love the thunderstorms in Jax! The buses should run pretty frequently to the beach and to downtown.
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Old 04-18-2010, 06:35 PM
 
Location: Manchester, NH
35 posts, read 86,517 times
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I know, but it's still scary to rely on the internet for all the research which makes this site ever so helpful. I'm so glad you Jax natives actively participate in this site for those of us wanting to relocate. From everything I'm reading, Jacksonville and the Beaches sound perfect for me. And then there is the Mayo Clinic at the very least, and a bus can get me there. Does it really take 90 minutes from the downtown to the beach? Is that on the express bus too? I know how long it takes & the distance from San Pablo Rd to the beach, but I didn't study how long nor how far away I am from the Downtown via the bus. Any advice is appreciated.
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Old 04-18-2010, 08:41 PM
 
Location: Ponte Vedra Beach FL
14,617 posts, read 21,484,997 times
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Quote:
Originally Posted by nboeck View Post
I know, but it's still scary to rely on the internet for all the research which makes this site ever so helpful. I'm so glad you Jax natives actively participate in this site for those of us wanting to relocate. From everything I'm reading, Jacksonville and the Beaches sound perfect for me. And then there is the Mayo Clinic at the very least, and a bus can get me there. Does it really take 90 minutes from the downtown to the beach? Is that on the express bus too? I know how long it takes & the distance from San Pablo Rd to the beach, but I didn't study how long nor how far away I am from the Downtown via the bus. Any advice is appreciated.
Mayo does not in general provide primary care (although it has a "doc in a box" place on Marsh Landing Parkway). And - in particular - the doctors there will not give you ongoing prescriptions for pain meds (although you can get them post-op). Most doctors here are afraid of becoming known as "pill mill docs" due to problems with the DEA.

Also - what insurance will you have? Mayo does not accept Medicaid - and most HMOs and PPOs here do not participate with Mayo.

Living here and trying to rely on public transportation is foolish IMO (unless you have a lot of time on your hands). Robyn
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Old 04-18-2010, 09:24 PM
 
337 posts, read 663,497 times
Reputation: 134
Quote:
Originally Posted by nboeck View Post
I'm relocating from NH to Jacksonville, hopefully just west of the inter-coastal ways around Atlantic Blvd, near the Neptune Beach area and I rely on Public Transportation. I'll probably look at the complexes off San Pablo. So considering those two details, does anyone have a good recommendation on a pain clinic or pain doctor that DOES prescribe pain meds? I see compared to where I live, there seems to be plenty of them around. We have like 10 in our entire state of NH!
As a Pain Nurse I have to tell you that when u get online and try to Doctor shop you are bound to have a hard time when u get to Jax.

While there are many "Pain Clinic's" u will need all the health record documentation and be ready to jump thru all the same hoops you already have done w/ previous Doc's.

It has become increasingly difficult for new Pt's to just swoop in and find a Doc that will prescribe u Opiates right out the gate. They will in all likely hood want to try other things first like injections, PT, etc all before throwing you on narcotics.

If your dependent on the Meds then you will be better suited to find a Doc well before the move, and transfer your Med Rec's in advance so the new Doc can have a chance to review them, this way u wont experience any chance of he/she not prescribing you the meds and u end up in withdrawls.

On a side note more and more Docs are getting out of and away from this area of practice due to the nature of the patients it can attract, as well as the legal ramifications it can have if a Doc has to many Pt's receiving pain meds
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Old 04-18-2010, 10:16 PM
 
Location: Manchester, NH
35 posts, read 86,517 times
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Oh, being a patient already in a pain clinic, i would hope that my NH doctor's could help facilitate a transfer ahead of time...I would NEVER come down there w/o a plan of action already in place for sure. I've got titanium and fake discs in me and still deal w/pain. I've already jumped through all those hoops, and been through TPI's (which I don't mind, I'll take em if offered) but no thanks to the epidural they did in my neck twice to spew steroids over my nerves, and then I finally had the surgery. Are you saying that legitimate patients w/plenty of documentation and genuine chronic pain won't be treated w/meds? I lost the use of my left arm for awhile so the surgery was a must, but it didn't resolve all the problems. The doctors said my nerves would take a couple years maybe to stop throbbing since they were being squeezed by my spinal stenosis. But my neck itself hurts, like my head is too heavy...IDK, it's hard to explain cuz this is a different kind of pain than before the surgery.

As far as the Mayo Clinic, I have gastroparesis and require a Gastro specialist...but you're saying that they probably won't be of any help. And yes, I'll need to find a primary, but I'm not too concerned about that. I'm sure my stomach Specialist up here will help me find the proper doctor ahead of time.

My health isn't great, therefore it's paramount to me that I manage myself well. I would never move down there w/o having every doctor already set up. I'll mail the MRI's and medical records way in advance for them to study, well that's my plan at least.

So then what did you mean about doctor shopping via the internet? Are you implying I'm doing something wrong? Or that I'll be "perceived as doing something inappropriate" simply for doing an internet search? What do you mean I'd have a hard time because I looked for pain clinic options online ahead of time? So are you suggesting to just say to my doctors up here, "you find me someone, I'm staying out of it"? Because it's been my experience up here for us to call our PCP and tell them where to send the referrals because they don't even know where half the pain clinics are to begin with. But that's PCPs, not a pain doc. So are you suggesting to force my pain doctor up here to find one for me?

I most definitely appreciate your feedback, and I need to do this the correct way...but I also do need to receive adequate care. As I said though, I'd never come down w/o all this being set up in advance as you did suggest, which is why I'm asking far in advance of my move next year. But I wanted to be able to point my doctors to where they should call and start working on the process...if you understand what I'm saying.

Believe me, it's not easy or a piece of cake in NH to get into our pain clinics either. And it took them 6 years (and I actually had to switch pain cinics) & on my first appt at the second clinic he realized the problem was in my neck and all the other clinic did was CAT Scan my head, never once considering my problem could be a bit lower. That first clinic even started feeding me oxycontin twice daily whereas I had PRN percs for five years. I learned real quick about the evils of oxycontin, how 2 is never enough, and one always craves a third. Then people would steal them so I had to buy a safe, but I know what the withdrawals felt like since doctors refuse to replace stolen meds anymore (not that I blame them). Bottom line, I prefer fentanyl patches cuz no one is interested in stealing them, and they give a constant rate of meds, with some breakthrough meds ie: roxi's...that's what I have now. Is that unrealistic for me to find in advance in Jax?

Thanks so much for advising on the matter.
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Old 04-19-2010, 10:14 AM
 
337 posts, read 663,497 times
Reputation: 134
Quote:
Originally Posted by nboeck View Post
Oh, being a patient already in a pain clinic, i would hope that my NH doctor's could help facilitate a transfer ahead of time...I would NEVER come down there w/o a plan of action already in place for sure. I've got titanium and fake discs in me and still deal w/pain. I've already jumped through all those hoops, and been through TPI's (which I don't mind, I'll take em if offered) but no thanks to the epidural they did in my neck twice to spew steroids over my nerves, and then I finally had the surgery. Are you saying that legitimate patients w/plenty of documentation and genuine chronic pain won't be treated w/meds? I lost the use of my left arm for awhile so the surgery was a must, but it didn't resolve all the problems. The doctors said my nerves would take a couple years maybe to stop throbbing since they were being squeezed by my spinal stenosis. But my neck itself hurts, like my head is too heavy...IDK, it's hard to explain cuz this is a different kind of pain than before the surgery.

As far as the Mayo Clinic, I have gastroparesis and require a Gastro specialist...but you're saying that they probably won't be of any help. And yes, I'll need to find a primary, but I'm not too concerned about that. I'm sure my stomach Specialist up here will help me find the proper doctor ahead of time.

My health isn't great, therefore it's paramount to me that I manage myself well. I would never move down there w/o having every doctor already set up. I'll mail the MRI's and medical records way in advance for them to study, well that's my plan at least.

So then what did you mean about doctor shopping via the internet? Are you implying I'm doing something wrong? Or that I'll be "perceived as doing something inappropriate" simply for doing an internet search? What do you mean I'd have a hard time because I looked for pain clinic options online ahead of time? So are you suggesting to just say to my doctors up here, "you find me someone, I'm staying out of it"? Because it's been my experience up here for us to call our PCP and tell them where to send the referrals because they don't even know where half the pain clinics are to begin with. But that's PCPs, not a pain doc. So are you suggesting to force my pain doctor up here to find one for me?

I most definitely appreciate your feedback, and I need to do this the correct way...but I also do need to receive adequate care. As I said though, I'd never come down w/o all this being set up in advance as you did suggest, which is why I'm asking far in advance of my move next year. But I wanted to be able to point my doctors to where they should call and start working on the process...if you understand what I'm saying.

Believe me, it's not easy or a piece of cake in NH to get into our pain clinics either. And it took them 6 years (and I actually had to switch pain cinics) & on my first appt at the second clinic he realized the problem was in my neck and all the other clinic did was CAT Scan my head, never once considering my problem could be a bit lower. That first clinic even started feeding me oxycontin twice daily whereas I had PRN percs for five years. I learned real quick about the evils of oxycontin, how 2 is never enough, and one always craves a third. Then people would steal them so I had to buy a safe, but I know what the withdrawals felt like since doctors refuse to replace stolen meds anymore (not that I blame them). Bottom line, I prefer fentanyl patches cuz no one is interested in stealing them, and they give a constant rate of meds, with some breakthrough meds ie: roxi's...that's what I have now. Is that unrealistic for me to find in advance in Jax?

Thanks so much for advising on the matter.
First to explain myself a little better. Your in an era of Pain Med abuse, so when someone comes online to find Pain Clinics (Specificaly asking for narcotics) that will tend to raise red flags, as someone whose Doctor Shoping, in other words some one that is trying to find the easiest Doctor to give them the narcotics they are looking for.

U have to understand it from the practitoners point of view. No matter your circumstances you will end up running into road blocks.

Ex. I was in a Helicopter crash broke both my neck and spine, was in pain mgmt for years, I was at a point to where I was stable enough to move and tried to find a Doctor that would continue the course of treatment I was currently getting as it was effective. Even being a Nurse I called and called places, only to be told on the phone, sorry we wont do that (before they even knew my situation or case" I was just told nope.
So I finally settled on a Doctor deciding to mail my records to them in advance and set my first visit up, well the day before my visit I got a call and they apparently never reviewed my records until just then and saw I was a chronic pain patient, they called me to tell me in advance that "You can come in and be seen but we aren't going to prescribe you any narcotics" so I ended up taking me to go back to the military until I found someone.

This is what I was referring to, as I have similar experience as you do, only I have the knowledge of being on the other side of the fence in the health care field as well. I choose then to specialize in pain mgmt due to the constant poor treatment pain pts got, and how they were always looked at by both Doc's and Nurses and the Pharmacists who fill your meds, as someone whose just trying to get high. So I felt I would be a good advocate for patients cause I could understand where they are coming from.

U will be better suited to have your PC or the current Pain Clinic your at contact a new place you decide on in advance.

But be very careful how you search for this topic as the DEA has severely cracked down on this stuff, thus why so many Docs have avoided this line of work all together or getting mixed up w/ pt's that require pain mgmt.
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Old 04-19-2010, 11:43 AM
 
Location: Manchester, NH
35 posts, read 86,517 times
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Wow, so I too might not be able to leave this snowy north simply due to not finding a doctor if I need continuing care. That's really a sad statement, especially from my experience up here in the NE, there does seem to be a pervasive attitude that we're all scheming. But I feel it's truly a minority of patients that's there to get "high", and if so, they cannot manipulate the doctors for long without back-up...I see most being wheeled in, or walking w/the assistance of something or someone. Everyone appears to be in genuine need for pain management from my view of the waiting room only. I guess I'm very fortunate my problem doesn't affect my walking. So I do hate that they seem to treat all patients as if we're doing something wrong, assuming the worst rather than looking at the evidence in front of them. That's where the legitimate documentation comes in to back up our assertions.

That's not to say that I've ever seen the perfect Pain Clinics here either. One I went to works like a revolving door, their UAs are getting contaminated, thus up to 10 people in our small city came out publicly to complain, said all their UAs showed a false, low level of hydrocodone w/o them ever touching it & I believe them...it was really weird, and very disconcerting when I was a patient there. We wondered if it was simply a bad lab OR even scarier, was the pain clinic actually doctoring up the ua's to deliberately get rid of patients who had done nothing wrong and legally deserved continuing care?

If the Provider wants to discontinue treatment, at the very least, provide an opportunity to taper off the meds. Instead, they dump a lot of opiate dependent people on the streets, and the poor PCPs are getting pretty angry here in NH. They don't want to deal with chronic pain patients either...nor pick up the pieces and figure out how to taper one off since it's not their expertise.

When I had a UA w/the 2nd clinic, I questioned them once why they weren't putting the bar code label across the top and going down over the seal, and they said don't worry about it. I said I did worry about it, and that the other pain clinic always did that, plus went over my med list every time. In addition to not properly securing my sample, they also refused to allow me to confirm my med list w/them saying "we already know" which did turn out to be an issue afterwards as they "forgot" I had a script for Librax. You know, that clinic isn't even managed by a doctor! The Director is an ARNP...not a single MD in that clinic.

I'm just saying I've seen two very different clinics up here (we don't have many at all in NH), and they were managed quite differently than each other. To protect myself in that 2nd clinic, I was about to start going to another lab for my own UA on the same day of their random UA simply to confirm their results but then I found I private pain doctor and just left. That 2nd clinic DID diagnosis my problem immediately though, unlike the more professional, previous clinic where I had been for 5 years! So I guess that evens things out for me in the long run. Actually, I would never ever recommend that second clinic but the first clinic is first rate, as long as the patient is more pro-active in finding results.

So I understand the sentiment doctors hold regarding this issue, and even my own private pain doctor just had all his files audited by the DEA which is extremely unusual (but apparently one of his patients was busted for selling pain meds, but much more than what he prescribed for her, according to the news she was "big time"). Naturally that brought the DEA down on him though, but nothing has changed so things must be fine. IDK, difficult issue all around I suppose...people such as that woman doesn't help legitimate patients either.
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