a first time pain clinic apt can anyone tell me what to expect?

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veromia333
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Date Joined Mar 2009
Total Posts : 674
   Posted 6/11/2009 10:48 PM (GMT -7)   
Hi I'm from the lyme forum. i have a pain clinic apt and i just wonder what to expect. I'm nervouse i'm in so much pain and i take care of my 94 yr old grandmother as well as my daughter 21 mnths. I cook dinner dress both clean you know everything and there is chronic fatigue nausia pain everywhere as well as migrains. I need help because they need me. I just want to know how they treat you what they do. How they confirm that you need the medicine. Do they act suspicious like your an addict. I have 120 a month of norco hydrocodone/acedam 10/325. Its not working anymore. so here i go into this world. Please let me know what happens and any advice
The line is faded not showing where Lyme came in. I became a new Mommy n my Lyme decided to show itself. Swollen elephant like knee and finger and limiting back pain. Bell's palsey, weight loss as if I had no muscle on my bones anymore. And much more text book lyme symptoms. To a Lyme doc, after alot of there is nothing wrong with you and a recommend to counceling,he said V this is Lyme. What kept me pressing on I had Lyme while I was pregnant. I know I was not infected while pregnant. I am watching her with an eagle eye. God Bless everyone. Love Veronica. Were the ones who know about Lyme not the doctors. Isnt that just mad? Backwards. Alice in wonderland.


bsjaguar
Veteran Member


Date Joined Jun 2009
Total Posts : 974
   Posted 6/12/2009 12:55 AM (GMT -7)   
Hi, Veronica. I've got my first appt. with PM on June 19th so I'm not sure what to tell you. Mine has requested notes from my doctor, any films I've had done and they sent me what looks like a book of questions to answer. Oh, also a list of all meds I've tried. I guess anything you may have to back up your pain complaints would be helpful.

I wanted to comment on the care you are giving to your grandmother. Have you considered having a home health aide come into the home for assistance. I've worked as a HHA and there are alot of programs out there to assist with payment. It could help take a load off of your back.

Good Luck

veromia333
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Date Joined Mar 2009
Total Posts : 674
   Posted 6/12/2009 9:56 AM (GMT -7)   
Thank you for your concern, I was working as a cosmetologist. My uncle and father asked me to be paid to do what i was already doing taking care of her and make it full time . So i said yes thinking it was great I was in better health then. My grandmother is a queen and while an HHA is a wonderful option she would take it personal if we didnt do everything we could to keep from handing her over to someone else.thank you jag. You helped. Anyone else have some more info about your experience
The line is faded not showing where Lyme came in. I became a new Mommy n my Lyme decided to show itself. Swollen elephant like knee and finger and limiting back pain. Bell's palsey, weight loss as if I had no muscle on my bones anymore. And much more text book lyme symptoms. To a Lyme doc, after alot of there is nothing wrong with you and a recommend to counceling,he said V this is Lyme. What kept me pressing on I had Lyme while I was pregnant. I know I was not infected while pregnant. I am watching her with an eagle eye. God Bless everyone. Love Veronica. Were the ones who know about Lyme not the doctors. Isnt that just mad? Backwards. Alice in wonderland.


fatherjohn
Veteran Member


Date Joined Feb 2009
Total Posts : 999
   Posted 6/12/2009 10:46 AM (GMT -7)   
Veromia, welcome to the pain forum. It sounds like you keep very busy and probably do more than you should. Thats is no different than most of us here. There are demands in life regardless if we have pain. It sounds like your pain is coming from the lyme disease which can definietely be painful. I don't know alot about lyme disease but I do know that it is not always transferred from the mother to an unborn baby especially if it is treated by antibiotics early. Anyway you probably know more that me. At the pain doc (PMS) several things can take place. They will have wanted to look over reports from other doctors before your appointment. The same questions about where you hurt, when is the worst, what causes it to increase and what helps relieve it. They will do an overview of the medications that you have been on and are currently on. They will try and find the cause and that can include further testing. Many PMS drs have you sign a contract that says you won't get medications from anyone else, allow only one pharmacy to be used and that you will take the medications only as prescribed. What tests they will order depends on what has already been done, what the cause of the pain is, where it is at and in my sarcastic attitude what they think they can get paid to do. Not all are the same. It seems to me that they can be good and caring or they can be total jerks. Some PMS drs will want you to give a urine sample at each office visit and that is for drug testing. I hope you have ins. that is covering all this. After examining you they will look at tests, the possibility of changing the medications, adjusting the dosages as well as other possible treatments. I hope the PMS is a good one and is very caring and personal. I hope some of this helps and I am probably leaving a few things out. Blessings!

Mystic_Duck
Regular Member


Date Joined Jun 2009
Total Posts : 52
   Posted 6/12/2009 11:24 AM (GMT -7)   
veromia, i can tell u what my exp was with my pain clinic, but i m going to warn u that i live in a small town in montana, and compared with others it seems i was lucky... but that being said, i had to get a referal to even see the doc, and also they sent me a huge packet asking every question u could imagine, plus some mor paperwork when i got there! but i also had to give them a urine sample, and sign a pain contract, which basicly said i wouldnt use recreational drugs, get all my pain meds from this clinic, use one pharmacy, and submit to random urine tests. they will ask u about ur entire story and why ur here, what uve tried what worked what didnt and what u expect... they'll discuss options with u and u need to tell them if ur comfortable trying certain meds, if u arent, u definately need to tell them... ull also probably discuss what ur pain is like just on a daily basis, if it ever changes, what aggravates it, if there is a pattern, if it spikes- how often on average... that kind of thing. most of them think diferently than other docs which is a good thing, but there r tons of ppl out there who do take advantage of these docs, and remember they dont know u yet, so a little suspicion is not unusual, but they normally hide it well...
Good luck, hope this helped some, and i wish u all the best and a great doc!
 
"In God's hands, in God's time."
 
"The scourge of life, and death's extreme disgrace, the smoke of hell, that monster called Pain."


Mrs. Dani
Veteran Member


Date Joined Jun 2009
Total Posts : 2787
   Posted 6/12/2009 5:44 PM (GMT -7)   
Hi Veromia,
 
     It is very nice to meet you. Im sorry you are going through so much pain. I see a spine specialist and he is awesome. Im not really sure about addiction suspicion, besides.. they are doctors afterall, i mean... Even if someone were they are more than capable to handle anything like that. Least I would hope so. As far as going first time, just take big deep breaths! I was so very scared, but really my doc was/is an increadibly intellgent man. It is my understanding that my X rays and other information was already sent, and the spine specialist and my primary care physician had already spoken to one another long time, before I arrived. He seemed VERY intrested in what I did to relieve my pain. In my case, wet heat. ... You know, even later, when I had to go in for my first procedure, I was so scared and frightened and they understood. They really did. And he literally tailor made a pain management programm for me that gave me back my life. You know I went to Bandolier national monument with my family few months ago? Fishing, hiking (or more like steady paced walk)I had so much fun. When the days were over all i felt was slight soreness and pressure under the skin base of my spine. That is it. Crazy no? Anyway.. there I go rambling again. Dont be worried :-) Most of these guys know whats what. But, if you get a chance after your appointment, hop online and tell us how it went. Best of luck! No worries!
*warmest huggs*
dani
:-)  
TWO roads diverged in a yellow wood,  
And sorry I could not travel both  
And be one traveler, long I stood


Tony McGuire
Regular Member


Date Joined Feb 2009
Total Posts : 483
   Posted 6/12/2009 6:26 PM (GMT -7)   
Oh, yeah. Forgot about the contract. One doc only to give out prescriptions flor any kind of pain medication. One pharmacy only to pick up pain medication prescriptions from.
Wife: Liz, the choice of a lifetime
Dogs: Koshka Prayer & Chomp Prayer
Meet My Wife And Me


veromia333
Veteran Member


Date Joined Mar 2009
Total Posts : 674
   Posted 6/12/2009 9:28 PM (GMT -7)   
Oh my gosh you are all so nice over here . Thank you so much for the wonderful responses you have given me. They are a little more grumpy over on the Lyme forum considering the who political controversy and the fear of the unknown about the disease in its chronic form. You know that if you dont catch lyme in the first few weeks by taking some strong antibiotics for at least 4 weeks better 6 it becomes nearly immpossibe to erradicate. Everyone is scared over there because alot of doctors dont believe that including infectious disease socioty. So never go to an Infectious disease doc if you suspect Lyme as a cause of your arthritis or so many other symptoms because Lyme is a spirchete bactyeria screw shaped and can go anywhere in the body and be any symptom. The infectious disease guidlines for lyme were written by 12 IDS doc who dont didnt believe in chronic lyme years ago now that new evidence proves otherwise it has been terrible changing those guidelines.
It is assumed that Lyme is signaled by a bullseye rash that is not so in 60 to 80 percent of cases partly because it is proven to be able to be transmitted from the mother in utero sexually and also in small numbers from mosquitos biting flies, dragon flies ,fleas and any insect of this nature. It is also hard to test for because it decreases immune function greatly and current tests look for lyme antibodies which are almost gone in chronic lyme because lyme and aids are the only diseases which can lower your immune systems killer cd-57 cells. SO Lyme in often diagnosed clinically.
Lyme neurotoxins can gravitate to fatty tissues like nerves, brain,lung,bile etc. And this can lead to MS,Alzheimers,Lou gehrig,parkinsons. I know this is unbelievable but it is know that these diseases are of unknown origin and many people who have these diseases are testing pos for lyme who never would have recieved long term antibiotic treatment and who would haved died without the diagnose of lyme, who has made significant recovery with the lyme diagnosis.
I reely wanted all of you to know these things so that you can help anyone who may have these diseases to be tested and properly .
Simple blood tests for lyme tell you nothing and will most likely give you a neg result unless maybe you just contracted the disease and your immune system is still strong enough to produce antibodies to show on the test. You must see a lyme doc to get a proper lyme Western blot and it must be sent to igenex in california. If you suspect lyme Email Stephanie@turnthecorner.org tell her the are you need to find a lyme doc for she will email you back and give you a doc near you.
the infectious disease society is under investigation for antitrust because member who created lyme guidelines hold patents ascociated w lyme and recieve money from insurance companies to testify against lyme docs removing their licences.
it is important to get this info out now through word of mouth now until change is made so that someone near you with these other diseases induced by undiagnosed lyme over many years can test for lyme and possibly recover instead of leaving this earth early because of not being diagnosed correctly.

thanks guys want ed you to know this sory for the book ask me any other questions would love to answer. -V
The line is faded not showing where Lyme came in. I became a new Mommy n my Lyme decided to show itself. Swollen elephant like knee and finger and limiting back pain. Bell's palsey, weight loss as if I had no muscle on my bones anymore. And much more text book lyme symptoms. To a Lyme doc, after alot of there is nothing wrong with you and a recommend to counceling,he said V this is Lyme. What kept me pressing on I had Lyme while I was pregnant. I know I was not infected while pregnant. I am watching her with an eagle eye. God Bless everyone. Love Veronica. Were the ones who know about Lyme not the doctors. Isnt that just mad? Backwards. Alice in wonderland.


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13466
   Posted 6/13/2009 12:53 AM (GMT -7)   

Hi V,

You gave some great info on Lymes. My sister in Florida has it and she has really been thru the ringer. Hers was not caught in early stages and she went undx'd for quite some time. However, she has found a great dr and he manages her care. Her Lymes has caused her to have neurological deficits and she really has a time wih the flares.

I do hope you have a good visit with the pain mgt dr. Some of the peeps have given you input on what to expect on the inital visit. Be sure to make a list of medications you have tried in the past and how they did or did not help. Its also a good thing to write down a list of questions to ask the dr, that way you don't forget to ask about something. The dr will do an eval and try to put together a plan of action on how to take care of you. Try not to worry about the appt above all. PM drs are use to PCP's referring patients for pain mgt, most PCP's do not like rxing pain meds for any length of time, thats where the pain mgt comes in and takes over that situation. I too took Norco at one time and did great but after a awhile they became ineffective for me too.

Good luck on the appt and let us know how it goes, Susie



LLPLUV
Veteran Member


Date Joined Mar 2009
Total Posts : 1158
   Posted 6/13/2009 9:07 AM (GMT -7)   
I started seeing a PM about three months ago. I had all my medical history sent to the office. The day I went in I filled out more paperwork on meds I have tried. Which ones worked and how well. When the appointment moved around to what I was currently taking I told him lortab 10's 3 x daily. He changed two things. Instead of Lortab he changed to Percocet saying it works better. Then increased to 4 x a day. That is their MAX for codiene. They can add lesser meds but not increase unless I change to a morphine type drug.

Signed a pain contract, so far had one drug test and agree to procedures when asked. (at least try them) Use one pharmacy and one doctor can prescribe pain meds.

I was scared when I first went in but now its nothing but a thing to go in for refills and a possible drug test. Which I have a problem with them. Its the first time I've been asked to come up positive for drug use feels strange..........

Good luck
Laurie
39 yr young female with,
Chronic Kidney Stones, PKD (Polycystic Kidney Disease), Chronic Kidney Failure, Severe Hypertension, Urological RSD
Also CHF (Congestive Heart Failure) and Sleep Apnea
Hopefully NO MORE........ I think I have it all


Mrs. Dani
Veteran Member


Date Joined Jun 2009
Total Posts : 2787
   Posted 6/13/2009 9:56 AM (GMT -7)   
blush   
 
 
     As a side note.. Gosh, that is crazyness. The way most people describe their pain management doctors is a lil scary. Pain contracts and drug tests and doing work of pharmacists... Just plain chaos. How, do you have time to do all these things your doctors ask you to do? Maybe I too have these same aspects of pain managemnt, but I dont think so... I mean, all of my doctors communicate with one another on a regular basis, so no need to worry about medications from other docs. They all know one another.  Refill your perscriptions, but have to do all work of the pharmacist aswell? Thats crazyness. That what Mr.Rons job is for in the first place. His job to take care of my medacine. Im no gonna do his job for him. Sometimes I wish I could scoop all of you up bring you home here to new mexico. I think only time my doctor got stern with me is when he wanted me to do all that stuff for the endoconology fellow. Hes an odd one fore sure. Okay, sorry for posting outta the blue thoughts.
 
*huggs*
dani
 


TWO roads diverged in a yellow wood,  
And sorry I could not travel both  
And be one traveler, long I stood

Post Edited (Dani Henson) : 6/13/2009 12:08:17 PM (GMT-6)


Sam Roberson Jr
Regular Member


Date Joined Apr 2009
Total Posts : 59
   Posted 6/13/2009 12:44 PM (GMT -7)   
Hey;
       Don't be nervous, a pain management Doctor is just that he or she will work with you to relieve your pain so that you can function somewhat normally day to day, if you have legitimate documentation on a medical condition that requires pain management they will prescribe the proper medicine to help relieve your pain. Be totally honest with your Doctor, tell him/her exactly what is going on in your life, I am like you I take care of my parents as well as my own family and I have my career as well so there is a lot on my plate right now, it has taken almost a year but we have finally found the right combination of meds that allows me to work all day and remain clear headed enough to make decisions. One draw back is I no longer drive because the medicine I am on has a tendency to make me nod off when I am at rest or just sitting around so to be safe I have my son or co-workers drive me to where I need to go. Honesty is best when it comes to pain management. Good luck with your appointment.
                                   Sam
tying to make it one day at a time....corney right


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 6/13/2009 8:23 PM (GMT -7)   
Hi Ver,

As the others said, don't get too hyped up about your appointment. Just because you take, or will be taking pain meds does not mean that you are, or will be come an addict. There is a HUGE difference between addiction & dependance, and the doctors know this. Only a very small percentage of people taking meds for true CP will become addicts, and many of them have a genetic predisposition for this behavior. Unfortunately, there is such a huge stigma surrounding pain meds & the people who take them. That is why a lot of this careful documentation is necessary. The few people who abuse the system truly ruin it for the many who do not abuse the system & need the meds to live.

Pain management will likely never be able to find anything (whether a med, combo of meds, treatment, etc) that will take away your pain completely. The goal of pain management is to gain sufficient relief such that you can function & continue to lead your life. There are so many different aspects to pain management, besides pain medicine. You may be prescribed meds like neurontin, or lyrica, which help reduce nerve pain. You may be prescribed muscle relaxants to try and loosen tight muscles, as well as block pain signals. You may be prescribed sleep aids, as insomnia commonly occurs with CP. You may be prescribed antidepressants, as depression is also common with CP, AND, some antidepressants (ie cymbalta, elavil) are also use to help relieve neurologic pain. Anti-inflammatories are also commonly prescribed. Long term pain medication is a lot of times used as a last resort, or you may be put on pain meds & a combination of these other meds. Your PM will discuss what is best for you, according to your situation. The PM may also want to perform some injections initially. These are things like steroid injections, epidurals, and nerve blocks - all designed to relieve certain types of pain. The PM may also send you for evaluation and/or treatment by a physical therapist, or pain psychologist. They really take a "whole body" approach to try to help give you back your quality of life. So don't worry. Go in there with an open mind & a positive attitude!

You may also want to bring with you a list of questions & a copy of your pain journal (if you keep one - if you do not, you may want to talk with your doc about starting one).

Thanks for the info on Lyme. Sounds like you are a real expert on your disease! I live in the heart of Lyme country (within the state where it "originated") & have had Lyme several times myself. I was lucky though, we always caught it early. I was one who never got a bullseye, but the aching joints of Lyme are quite distinguishable. One of my dogs actually has chronic Lyme & she has had some very serious complications from it. We were told that she was going to lose her eyesight by the only two veterinary ophthalmologists in the state. She never responded to conventional treatment, it was only by the skill of a veterinary homeopath that she didn't lose her eye sight & that her Lyme has been gotten under control.

Best of luck with your appointment! Let us know how it goes!

Skeye

veromia333
Veteran Member


Date Joined Mar 2009
Total Posts : 674
   Posted 6/13/2009 8:25 PM (GMT -7)   
Thank you everyone for the lengthy responses i like that i do the same. You all have been very helpful. Yes susie the norco just has quit on me. I love giving lyme advice anytime i know very much. thank you everyone. So helpful.
The line is faded not showing where Lyme came in. I became a new Mommy n my Lyme decided to show itself. Swollen elephant like knee and finger and limiting back pain. Bell's palsey, weight loss as if I had no muscle on my bones anymore. And much more text book lyme symptoms. To a Lyme doc, after alot of there is nothing wrong with you and a recommend to counceling,he said V this is Lyme. What kept me pressing on I had Lyme while I was pregnant. I know I was not infected while pregnant. I am watching her with an eagle eye. God Bless everyone. Love Veronica. Were the ones who know about Lyme not the doctors. Isnt that just mad? Backwards. Alice in wonderland.

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