Post Edited (PAlady) : 8/12/2008 4:20:51 PM (GMT-6)
Leigh Ann, Hi..
Your primary care physician is one of those PCP's that probably does not have too much experience with treating chronically painful conditions. He may also believe that your condition is acute, and that it really does not qualify as "chronic" pain. Either way, you have a right to have your pain treated adequately by your physician. Regardless of whether or not he is unwilling to treat you as a chronic pain patient, or whether he understands how to treat chronic pain, you are due the treatment you deserve. That being said, I think that if you value your relationship with this PCP, it is time to make your feelings very clear to him. I'm sure that he understands that you cannot keep taking acetaminophen based pain medications forever, due to its liver and kidney toxicity. He seems to understand that he is at a crossroads with you; he can longer really keep you on the Lortabs because they can really cause damage to your internal organs, on the flip side, he's obviously not comfortable with prescribing a time released opiate pain medication. Aprapoe, you must make it known to him that neither him nor you really know how long the pain issues will last, and therefore, you need to establish a long term plan for dealing with your pain. He seems all to willing to push you off on the gasterenterologist; its like he believes this specialist will take over for him for dealing with the long term pain. If your PCP is not willing to deal with your pain on a longer term basis, then you must demand a referral to a COMPREHENSIVE pain management physician, and the COMPREHENSIVE, in case you cannot tell, is vitally important. Many pain clinics will try to treat you with homeopathic and non traditional remedies; be careful, these pain clinics and docs are known as INTERVENTIONALIST pain doctors. Anyways, you need to give your PCP this option. Be prepared to leave him if he will not be reasonable about your request. Set your appointment, but do some research into other PCP's in your area. Also, do some research into Comprehensive Pain Management physicians in your area. Pick one, and be prepared to ask for a referral to this doctor. Some docs don't require a referral, but all of them require proper and complete medical records that document your condition. This is what covers their rear ends if the DEA comes a knockin. Anyways, you have gotta change your mind set. You have to get it through your head that you have a legal right to have your pain controlled by your doctor; if he's not doing the job, fire him. Finding a pain management physician that is knowledgeable about all of the peripheral issues that surround chronic pain will help you tremendously. Any educated pain management doctor knows that chronic, unrelenting, and unrelieved pain leads to stress, depression, troubles with family and friends, problems at work, financial issues, can lead to loss of employment, and too often, suicide. There are a million reasons to relieve pain, and no good reasons to not relieve pain.
I've been doing the "pain management" doctor thing for years. UNfortunately, the PM docs in these here parts are procedure happy. They only want to treat "parts" of people, and only with procedures, not medications. They LOVE sticking people with needles, anywhere, anytime. The only med I've ever gotten from a PM doctor is Ultram/Tramadol, which helps as much as eating a couple of pieces of chalk.
I'm also in a catch-22 situation because I have both chronic and acute pain. Doctors don't want to treat my acute pain because I have chronic pain. And frankly, it's taking so long to find out what is causing my acute stomach pain, it's starting to seem like it's chronic. It's been bothering me for three months or more, and I had the same pain last June that put in in the hospital for four days. Never did find the location of my GI bleed. Now it's back or something very similar pain-wise. My PCP gave me a whopping two weeks of Percocet between my seeing the nurse practioner at the GI doctor's office until I got my endoscopy yesterday. My GI didn't find anything, but scheduled me for a CAT scan, and told me to go back to my PCP for pain meds. My PCP cut off the Percocet so I'm back to the weeny dosage of Lortab. UH, HELLO...getting the edoscopy didn't lessen the pain any...DUH. Percocet works so much better for me than the Lortab, at the same dosage 5/500 which is the bottom strength on both. Oxycodone works better than the hydrocodone, but compared to the many heavier medications available, I'm not asking for something unreasonable. I'm so sick and tired of the pain and constantly having to fight with the doctors for a little relief, which is easily attainable with the flick of a pen. I'm sure I'll have to see my PCP before I find another one to transfer too. I'm going to ask him flat out why he refuses to make my life more bareable when it wouldn't cost him a thing. The answer should be interesting.
Leigh Ann (Still VERY Cranky)
Sorry Leigh Ann if you felt I was being judgemental as thats the last thing on my mind. People of this site know me well enough that I am never judgmental of anyone in these forums. We all need all the compassion and consideration we can get. Maybe you were having a bad day when you read my short post. You have a terrible problem thats not being cared for properly by your drs. So, when that happens we do have to be flexable and go others avenues such as searching for a dr that will help us and continue to search until we can get the proper help. Its not easy finding a good dr as we know.
Perhaps you are the one needing to check the attitude problem at the mat before posting. Susie
I reread my post and you are correct. I was a bit over the top in responding to your post. I was not only having a bad day, I've been having a bad life...this week in particular. However, just because you are "known" for not being judgemental, does not prevent you from posting something worded with those connotations.
My frustration this week comes from having an endoscopy which showed no explanation for my serious stomach pain. Having normally low blood presure, my BP dropped dangerously low after the procedure and the medical staff were concerned I might flatline. Luckily I rebounded, but it's pretty scary to think about. The following day I suffered through excruciating injections to my SI joints, without the benefit of anything to take the edge off of the pain. Tomorrow morning, I have a CAT scan scheduled, and have all 32oz. of that gunk to drink prior to the test. With stomach pain, not something I am looking forward to doing.
I apologize for my strong words in my prior post.