Pain Management Clinic Question - rambling and long

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Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 3/9/2010 8:05 AM (GMT -7)   
This is probably a really stupid gripe/question/concern/vent, but here goes. 
 
I had my fusion (L5-S1) just about a year ago.  My Neuro Surgeon gave me a disability placard for six months, then another six months.  Just after issuing the second placard paperwork, he referred me on to pain management.  Since on on the CP board, you can imagine that the back pain is still here.  I've had the series of injections, to include the nerve ablation (sp?) and take Ultracet and Dalaudid (issued by my PM Dr) every day.  These still give only partial relief and I have a pain level of 3-4 all the time and a 10+ when I overdo it or when my pain feels like acting up.  I don't know the PM doctor/clinic that well because I've been seeing them only about six months.  The last appointment was at the end of December and the next is in two weeks.  During the last procedure, the PM Dr stopped and told his nurse he "saw" it and then told me he could not finish the last set of nerves (burning) but left the room and wouldn't tell me anything.  He also upped my meds that day (even though he told me before the procedure that he would not up my meds). 
 
So my placard runs out on the 15th and my appointment isn't until the 29th.  I have a real issue being able to make it in at hospitals and large functions, but no big issues in the small town where I live.  The worst is going into a place like Walmart, where I have to walk through the store and my pain gets out of control.  I can't wait until my appointment because I have to be in a very large city on two different days before then for a test on a campus and for medical procedures.  I also have a child participating in a dance program (this weekend) where the stage is at least a half mile from where "regular" parking is.
 
I went by the office last week and personally dropped of the paperwork for another card (this one from PM, since that is where the Neuro sent me) and finally the PM Dr has agreed to sign it (temporary) and ONLY ONCE!  The nurse made sure to tell me ONLY ONCE.  The way she said it sounded like they had really been discussing me "bothering" them with telephone calls....which I have done a couple of times to let them know which new meds I have been given by different Dr's.  I signed the contract, so I have to let them know.
 
I got the impression that the PM Dr was unhappy about me having called several times and that they may not continue to see me.  If this happens, I don't know what I will do.  There is no one else around here (very small town) and I don't "look" disabled, but I hurt everywhere all the time.  I've also been working to get Social Security since the first day I saw PM and I'm afraid I just look like a sorry person who doesn't want to work.  I swear that is not true, but I'm overweight and I look like I should be out exercising to fix my problems, not medically retired.  I honestly cannot stand the pain every day.  It was so bad before PM stepped in that I almost gave up.  I won't add more about that because it is in the past.  Anyway, I might could get the Ultracet again from my primary care (she gave it to me for years), but nobody else will help with the back pain!  She won't even consider giving serious pain meds on a continuous basis.
 
I know I'm rambling and sound upset for no reason, but I'm terrified that they are going to drop me on the 29th because of the way she acted today.  Obviously from this post, you can see that I have a problem with obsessive compulsive personality disorder and worry endlessly about things to come.  I simply can not go back to the pain level I had before PM.  
 
Does anyone have any suggestions on how to talk to the Dr to get him to understand?  Appointment times are limited and all this rambling just make me sound like more of an idiot.
 
Thank you for any responses (but please don't respond if you are going to be critical).  I'm not really up to it right now.
 
 


DDD, CPS, TLIF L5-S1 2009 (failed), FIBRO, MINEYER'S (SP?), MIGRAINES, GERD, NISSEN FUNDOPLICATION (failed), GAD, DEPRESSION, EXTREME ANXIETY DISORDER, OCD, PSTD, CHRONIC MUSCLE SPASMS, HUMAN GROWTH HORMONE DEFICIENCY, VITAMIN D DEFICIENCY and much, much more...


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 3/9/2010 9:00 AM (GMT -7)   
Make a list of your questions and take them with you to your doctor's appointment, I do this and when I have my list it seems like he treats me better...
I also have my Husband check over my lists for typo's and correct word usage and you'd be amazed how much I forget without my list...
Hope this info helps...Wish i could've help with your other issues but others will come by with better suggestions...
Good Luck with your next doctor's appointment, please know we care...
((((((((((((((((((((((((((((((retiredmom))))))))))))))))))))))))))))))))))))))))))))))))))))))))))
I gave up asking for a handicapped plaqured as the looks I'd get, I look younger than I am, and I use a cane and the stares I'd get and I never took a van spot,
and followed all the rules to a tee and the way people here can be mean it was not worth it....
but my pm doc and pyschologist both want me to have one...
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

********>^..^<********>^..^<********>^..^<********


Mrs. Dani
Veteran Member


Date Joined Jun 2009
Total Posts : 2787
   Posted 3/9/2010 12:00 PM (GMT -7)   
 
 
   Dear RetiredMom,
 
     Good afternoon *warm huggs* it is good to hear from you. I was wondering how you were doing. I am so sorry you have the unwarranted burdons and stress right now. I say un warranted because, really.. a parking card shouldnt be such a hassle. It really isnt approiate for the nurse to speak to you in such a manner reguardless of her "mood" or "personal feelings" towards you. You pay rather well to be seen in the facility, and she needs to remember her place. Does she have a supervisor? Goodness, I am terribly sorry you were treated in such a way *hugg*
 
     You know I live in a small town too. It is nice, but also a pain when it comes to health care. I completly understand about long drives, careful planning and doctor's / specialists being so far away. I would think that would also be a factor as to why a parking card is absolute necessity.
 
      I think the only advise I have to give is to remain cool, calm, collected... and remember. The pesky nurse works for YOU. Not the other way around. The  PM doc also works for YOU. YOU have needs that need to be met. You are not asking for the sky to be turned purple, just asking for a basic need to be met. I truly think you should tell someone about the manner that you were treated.
 
      Before I forget.... You know my spine specialist and the other two send me to alot of specialists. My doctor(s) will send introduction letters and "findings" reports long before I arrive at any new doctor. I tell the new doctor to please send a faxed letter and report to the other doctors. He/she must discuss any "reports / findings / treatment planns" with the others BEFORE speaking to me or asking me to put into action "planns".  I stress that communication is of the utmost importance. Labs, x rays, scanns, meds, ALL of it needs to be communicated by the doctors to one another. No exception. Im not a medically trained person, they are. It is their responsibility to communicate effectivly with one another. I am firm, but polite about it. I cannot imagine the stress you must be under trying to relay each doctors wishes and needs, treatment planns, test findings. That alone must be an increadibly huge burdon in your life. Im terribly sorry they are asking it of you *huggs*
 
     I have to get going. I've got a terrible case of the "wet blanket" and if I dont get my chores done I'm afraid I just wont have the energy to do it. I do hope you can find a few moments to yourself to relax. Please, take care. Stay strong
 
*hugg*
  dani

 

 

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

 

 


Stella Marie
Veteran Member


Date Joined May 2005
Total Posts : 601
   Posted 3/9/2010 12:44 PM (GMT -7)   
I am sorry about the problems you are having with your health and your PM's office. Chartreax and Dani botth offer great advice. I do try and be very organized for my visits. I always type up a list of questions and concerns too! That way I don't waste time and or forgot to ask something and have to call back. If the doctor is annoyed with the calls, ask how he would like to be informed about other Rx's. Maybe he just expects you to tell him at your next visit. This way you will know exactly what he expects of you. Ask all what information they do want to be notified by phone with and what can wait. Some offices may list many requirements on their contracts, but in the daily practice they do no expect all of the patients to call with everything. Clarify what he expects from you. Don't waste anyone's time - come prepared with a list. Keep a copy of the list for yourself too. This way you have a record of what you talked about each visit.

Gook luck and keep us posted.

Stella Marie 

Chronic Pain Forum Moderator

Progressive neurodegenerative disease called Multiple System Atroph;  muscle spasms, muscle pain, neuropathy  & neuropathic pain, central sleep apnea, osteoarthritis, and 2 pain implants – an  intrathecal pain medication pump and an SCS (spinal cord stimulator).  Extra fun little toys and gadgets; O2 generator and assorted wheelchairs, walkers, canes, and orthotic braces.  Meds - too many too list or even care about!

 

 



Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 3/9/2010 1:25 PM (GMT -7)   
Thank you all for your advice. I did pick up the document today and I was releived to get it. I'm sorry I rambled so this morning, but I had to vent and this is the only place it felt safe.

The person at the desk today never even spoke to me. She simply saw me come in, picked up a paper and handed it to me through the window. She never even acknowledged the thank you I gave her.

It never ceases to amaze me what we have to put up with simply because of office staff issues.

I'll start jotting down notes and follow your suggestions. This way I can make sure to include what I need and modify it when it is too detailed. I tend to do that when I'm nervous and this is not good either.

Thank you for your responses and your words of encouragement. I often feel like I have to justify or appologize for having chronic pain. I think that is why I worried so about this. I was honestly afraid to even drop by the office today.

I'm sorry for the rambling earlier and appreciate the support!
DDD, CPS, TLIF L5-S1 2009 (failed), FIBRO, MINEYER'S (SP?), MIGRAINES, GERD, NISSEN FUNDOPLICATION (failed), GAD, DEPRESSION, EXTREME ANXIETY DISORDER, OCD, PSTD, CHRONIC MUSCLE SPASMS, HUMAN GROWTH HORMONE DEFICIENCY, VITAMIN D DEFICIENCY and much, much more...


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 3/9/2010 9:28 PM (GMT -7)   
First of all...Welcome Retiredmom....glad that you're here, but hate that you have to be.  I too have had the exact same Fusion.....mine was 5 years ago and I have worse pain then ever...My PM Dr. gave me a Perm. Handicapp Placquard....Why only a temp one?  I don't get it?  You can get the form online for a perm. one and take it to your appt. and have them fill it out.  Then take it to the DMV.....you won't have to get it replaced for 3 years. 
PM Clinics all have there rules....He must have seen something that bothered him but he should have told you.  Not having you be upset and worried all the time.  I tell you, if you have that placquard hanging in your window they rarely look at it.  I would just stop thinking about it....keep it where it is....and get it fixed when you go back.  Have that form with you and tell them to fill it out.
I hate that you have to be here...but this is the right place...Good Luck
 
Me.

I have been a spectator for so long..Now it's time to participate.......
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/  30 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night..Glipizide 10mg. 2X in the morning
Lantus 35 units at bedtime with Solostar Pen                                                                   

 


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/9/2010 11:19 PM (GMT -7)   
Hi, Retiredmom,
You've already been given some great advice. I think StellaMarie hit some nails on the head with asking what their office expects from you re: notice of things in your contract, etc. Often offices are inundated with phone calls all day, and that's no excuse for poor treatment, but you want to call only when it's needed. If you ask them their office policies, then you'll know.

One thought I had - which I hope doesn't offend you as it's not meant to at all, but I wondered if you're seeing a therapist for some of the OCD/anxiety (along with CP) issues. Not only could the therapist be helpful to you, but could act as an intermediary with your PM doc which could give you some support in the process.

I also can't figure out why they wouldn't just give you a permanent placard. Maybe your PCP could help with that?

I live in a small town like you and others, and will have to travel nearly 3 hrs. for PM starting soon. It is tough when choices are limited.

I hope you can relax a bit tonight.

PaLady

Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 3/10/2010 3:24 AM (GMT -7)   
I too got a hanicap placquard for those especially horrible times when I just didn't think I could walk another step through places like walmart. Mine was permenant, but since I moved to KS I didn't think that this state would accept the permenant script that my previous doctor had written for me. Now having said that.....I am thinking I might try to get a copy from them of said script to see if I could possibly get a new placcard since mine rand out a year ago.

Any ideas as to whether I need a new one from my doc or whether the 99 year one that my other PCP gave me will work?

Scarred
I live to "Tame My Pain!" 


Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 3/10/2010 6:40 AM (GMT -7)   
Thanks to all and yes, I do see a very good psychiatrist for OCPD and anxiety. Most of the time it is well controlled now, but I have a very big problem when I'm out of control and (as you all are aware) we are not in control of our medical lives. Yesterday was just a bad day and I'm very anxious over the pain that is getting worse.

For those who wondered, this is only a 180 day placard. That's all they will agree to. I think the what if's get me the most and I knew I would have to have this thing in the car before next week.

The insistance on having my paperwork exactly correct is part OCPD and part that I was law-enforcement for 20 years (before my medical retirement). I have seen it all and made more arrests for stupid things than you can ever imagine. I was NOT a police officer, trooper, or sheriff's deputy, but I am not at liberty to discuss my history more than that. I don't want to be identified and you never know who reads these posts. Futher, my husband is also still in the business. I guess I always see the worst case scenario first and then hope for the best....according to the psych dr, it's a hazard of the job that I had for so long and a result of some very severe PTSD. Again, I'll refrain from further discussion on what caused that.

I do want to say how much I appreciate you all. You are wonderful!!!!
DDD, CPS, TLIF L5-S1 2009 (failed), FIBRO, MINEYER'S (SP?), MIGRAINES, GERD, NISSEN FUNDOPLICATION (failed), GAD, DEPRESSION, EXTREME ANXIETY DISORDER, OCD, PSTD, CHRONIC MUSCLE SPASMS, HUMAN GROWTH HORMONE DEFICIENCY, VITAMIN D DEFICIENCY and much, much more...


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/10/2010 1:57 PM (GMT -7)   
Retiredmom,
I completely understand not wanting to put certain details on a public forum. Sometimes it's easy to forget that anyone can read our posts and probably people who know computers can trace bunches of stuff. So I didn't mean to probe at all. Just thought maybe your psychiatrist or therapist could help coordinate with the PM doc if the PM doc's office is treating you unfairly because of the calling, etc. (although I don't think that all your anxiety and such is due to mental health issues - some is just plain normal! And I say this because that's been my professional background LOL!).

Can/will any other of your docs do the placard paperwork for you? It may just be the PM's office doesn't want to be bothered with paperwork. Not saying it's right, just that anything that makes it easier on you would be a help.

Good luck!

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13478
   Posted 3/11/2010 11:54 AM (GMT -7)   
My PCP is the one who told me to get the handicapped plates on my car. He said your condition is not going to improve enough that would warrant a temp tag to hang in the windshield. If you don't see your medical situation improving a great deal why not get your PCP to fill out the necessary papers and get license plates. Then you don't have to worry about something expiring in 180 days. It took him all of three minutes to do my papers. I had my part completely filled out and signed before handing it to him.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 3/11/2010 12:03 PM (GMT -7)   
Not exactly the same thing, but when my Mom was diagnosed with cancer and started having problems getting around her oncologist would not fill out the paperwork for a handicap placard saying that this was something my mom's PCP should be doing.

Before anyone feels the oncologist was a jerk he wasn't and it was the only time he refused to do anything. It was just something he didn't want to do because he wanted to spend that time treating patients.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 3/11/2010 12:18 PM (GMT -7)   
Thanks to all. This does make sense and I will talk to the PCP on my next visit. I printed out three pages (a little more OCPD) and had them in my purse, so I still have two left. After I discuss it with the PCP, I'll be able to gauge the best way to approach the situation. At least I have the 180 days and won't have to worry about "falling out" trying to get back to the car.

I appreciate everything!
DDD, CPS, TLIF L5-S1 2009 (failed), FIBRO, MINEYER'S (SP?), MIGRAINES, GERD, NISSEN FUNDOPLICATION (failed), GAD, DEPRESSION, EXTREME ANXIETY DISORDER, OCD, PSTD, CHRONIC MUSCLE SPASMS, HUMAN GROWTH HORMONE DEFICIENCY, VITAMIN D DEFICIENCY and much, much more...


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 3/11/2010 2:47 PM (GMT -7)   
Good Luck to you and know we'll support you...Like I said there are a lot of nice people here...
Hope you get a low pain day...
((((((((((((((((((((((((((((((((((((retiredmom))))))))))))))))))))))))))))))))))))))))))))))))))))))
hugz
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

********>^..^<********>^..^<********>^..^<********


Stella Marie
Veteran Member


Date Joined May 2005
Total Posts : 601
   Posted 3/11/2010 10:49 PM (GMT -7)   
Good luck. I like Straydog, was counciled by my PCP to get the handicapped plates. The only problem with the plates is the card has to be titled in your name. I also have the handicapped tag to hand from the rear view mirror when I am in other cars. Even though I have permanent handicapped plates, the rear view tag has holes punched over the year and month it should expire. The max the rear view mirror tag is good for is 5 years. You then have to apply for a new tag - you're paper is on file so you did not have to get a new Rx, just a new tag.

Good luck and keep us posted.

Stella Marie   Chronic Pain Forum Moderator

Progressive neurodegenerative disease called Multiple System Atrophy, muscle spasms, muscle pain, neuropathy, & neuropathic pain, central sleep apnea, osteoarthritis, and 2 pain implants – intrathecal pain medication pump and an SCS (spinal cord stimulator).  Extra fun little toys and gadgets; O2 generator and assorted wheelchairs, walkers, canes, and orthotic braces.  Med - too many too list or even care about!

 

 



uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 3/11/2010 11:44 PM (GMT -7)   
I didn't even ask about a Handicapp thingy...I went for my regular visit to the PM and she brought it up as she watched me limp down the hallway....All I did was bring in a paper I downloaded and she filled it out stating that I had Post Lamenectomy Syndrome....they didn't even look at the paper at the DMV....she just gave me a placquard.....  I hate to read that some of us have so much more difficulty then others....
 
Me.

I have been a spectator for so long..Now it's time to participate.......
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/  30 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night..Glipizide 10mg. 2X in the morning
Lantus 35 units at bedtime with Solostar Pen                                                                   

 


MIKEL99
Veteran Member


Date Joined Feb 2010
Total Posts : 914
   Posted 3/12/2010 1:38 PM (GMT -7)   
Dear retired mom , I'm sorry your dealing with a doctor who seems insensitive , I know the feeling .I think you've received advice on dealing with her so I just want to give some insite on worrying about future situations .Try to keep in mind all we ever have is the present moment we are living in right now , there isn't anything we can do about past and future only now , and focus on that .And be comforted that in the present moment we are always ok , we always have enough , and we always make it through .Best wishes to you beautiful friends
HIV+ also Hep c , need hip replacement surgery on hold because of unknown but cellulitus-like ailment  .most pain from hip condition and cellulitus-like ailment .hands numb may have carpal tunnel syndrome now . Great frustration because doctors unable to diagnos ailment              .Medecines - Oxycontin , percocet ,  Celelbrex , lasix .

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