Pain Clinic Question

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Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/18/2010 8:46 AM (GMT -6)   
Hi All,
 
Many of you have mentioned going to a pain clinic.  I just called the one that services my hospital and the women who answered said they would need a referral from my doctor, which is fine.
 
I would just like to know a little bit about the process.  Is it like going to a regular doctor's appt?  Is it a physical therapy thing?  Do you have to go more than regular checkups?  Sorry to sound so dumb.  My specialist co-pay is $40.00 and I can't afford PT or anything that requires many visits. 
 
Just curious before I ask for my docotr's referral as he has referred me to an accupuncturist.
 
Thanks!  Suzanne

Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 21765
   Posted 5/18/2010 8:57 AM (GMT -6)   
When I went to the pain clinic, it was like a regular docs office visit. But they get into a little more detail and ask you a lot more questions. If they place you on any narcotic pain meds, you may have to sign a contract that you won't abuse the medication. I can't say if it would cost more then a regular docs visit since my co-pay is $25 regardless of where I go so you may have to ask your insurance company.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma, Co-moderator for UC and Alzheimer's
~Left sided Uc-'92-Colazal(6 daily),6mp(50-100mgs),Bentyl, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate ALL mesalamines**~Allergies-Singulair, Zyrtec~Secondary Reynauds Syndrome~Sacroiliitis~bulging and herniated discs C5/C6 & C6/C7~Epidural injections (2 series of 3), OA (hands and spine)-Tylonel Arthritis, Celebrex, Fibromyalgia (diagnosis pending)
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Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/18/2010 9:06 AM (GMT -6)   
Thanks Sherry - I have no problem signing the contract - I just want to feel better and the accupuncturist wants me to come 3 times a week. He works on a sliding scale - $15.00-$35.00 per visit but right now - I can't even afford that. Plus - I do need narcotics for breakthrough pain and nobody will prescribe them for me. They all say that they can "tell" that I am not someone who would abuse drugs but then won't prescribe. Just tired of getting the runaround.

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2005
   Posted 5/18/2010 9:48 AM (GMT -6)   
Pain clinics come in all varieties. Not all of them prescribe medications. Some only make recommendations for various types of physical therapies and do injections.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


Mrs. Dani
Veteran Member


Date Joined Jun 2009
Total Posts : 2787
   Posted 5/18/2010 10:23 AM (GMT -6)   
 
 
   Dear Suzanne,
 
     I am not sure. I was sent to a pain management specialist in the beginning and I was sent back to a different doctor (spine specialist) and was told "You need to see someone else. Your primary will explain the X Ray results further. I will have your information sent to the main hospital. Can you get to albuquerque by 5pm today?"
  
      In the end they also took care of all the things that regular pain management specialists do (meds, surgicals, therapies), but also "monitor" with X Rays, MRIs, blood work and coordination with my other specialists. 
 
   ....so my experience was short lived and luckily I wasnt charged! My specialist co pays are only 30.00 but still very costly and add up! ....And just between us, I didnt like that PM fellow much. He had a very overwhelming "presence" was very angrily authorative. So, it was a good thing my experience with him only lasted 15 mins. He made me so feel drained and small after seeing him.  
 
     I did want to mention though, that maybe you could politly add in that medical costs are hard to pay for. So, perhaps when they get to know you better, you can take care of the little stuff via email or phone call. IE Refills, Labs, Xrays and monthly updates. Just thought!
 
     Oh gosh I am so excited for you! This could be it! This could be just the thing to change your life and give you your days back! You ve been in extreme pain for so long, it is high time you got some much needed help. Gosh, I sure hope they can help!! You are in our hearts and prays. Stay stong!
*hugg*
  dani

 

 

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

 

 


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 21765
   Posted 5/18/2010 11:50 AM (GMT -6)   
I can't take narcotic pain relievers because I am allergic to many of them and the ones that I am not allergic to bothers my other health conditions. So the pain doc didn't quite know what to do for me. He did send me to one of his associates for injections but it didn't help. I then started seeing this associate for accupuncture and that seemed to help a little but at $65 a visit, it became too costly. Btw, I went to a pain doc after I already have been thru tons of physical therapy.

If you do go, I wish you luck and I hope this doc can help you.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma, Co-moderator for UC and Alzheimer's
~Left sided Uc-'92-Colazal(6 daily),6mp(50-100mgs),Bentyl, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate ALL mesalamines**~Allergies-Singulair, Zyrtec~Secondary Reynauds Syndrome~Sacroiliitis~bulging and herniated discs C5/C6 & C6/C7~Epidural injections (2 series of 3), OA (hands and spine)-Tylonel Arthritis, Celebrex, Fibromyalgia (diagnosis pending)
To help Healingwell - click here: DONATE
 
 
 
 
 

 
 


Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/18/2010 1:50 PM (GMT -6)   
Thanks so much!

I started the ball rolling today. Spoke to my Rheumy and he said that he thought it was a great idea for me to go to a pain clinic as the doctors there '"Know more about pain medication than I do, if you know what I mean" - I think he was telling me in code that they would be able to prescribe what he can't (very sad - this guy's been a doctor for 33 years!) I told him that I loved the accupuncture but even at $15 a visit - that would be about $120 a month and that's without the herbs at $20 a week.

I just have to get a referral from my Primary and she wasn't in the office today so hopefully, she'll call me tomorrow.

Please keep your fingers crossed for me - I need this to work!

Keep well everyone!

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2137
   Posted 5/19/2010 6:56 AM (GMT -6)   
Keeping my fingers crossed for you.

Any doctor with a DEA number can prescribe narcotics, but most won't. They have to pay a lot more in malpractice insurance if they are prescribing certain types of meds -- including narcotic pain meds -- and many decide it's not worth it.

If your doctor is saying that they know a lot more about pain meds, then it sounds like maybe that particular pain clinic is willing to prescribe them (as Jim points out, some only do injections). Typically they will come up with a comprehensive treatment plan. It is rare that they will just write you scripts & cut you loose. Plus, most states require regular follow-up visits. Often it is every 30 days, though at least one state allows patients to go as long as 6 months between visits. Even if state law allows longer interim periods, new patients are generally expected to come for regular visits where your doctor will ask questions & probably run urine analysis (so sad that more & more doctors are now making this standard for all their patients because the test is ridiculously expensive). Since money is tight for you, you might ask the practice ahead of time how they handle the U/A testing (do they do it for all patients? how do they handle billing?). Some places will write off the difference between what your insurance covers & the actual cost. Some places will use a sliding scale for patients where the difference between insurance & what you can afford can change (reduced co-pay/co-insurance, sometimes not requiring you to pay anything, other times requiring something). And a few places charge you whatever the cost is.

My PM just jumped clinics & the new clinic uses a sliding scale. Honestly, it's just devastating to me. I need pain meds & I don't have any problem with them testing me, but the cost is just incredibly high (I have no co-pay, but have a really high deductible). They do use a sliding scale, but that's more than I was paying before.

take care,
frances

Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/19/2010 7:09 AM (GMT -6)   
Thanks for all the information Frances. I will defiinitely let them kow up front that I am having financial issues.

I assumed that I wuold probably have to go every 30 days. Which is fine. $40.00 a month is much better than $120 (at the lowest) for 2 visits a wek to the accupuncturist.

I'm waiting for my primary to call today to see if I can even get a referral. they can do as many tests as they like, I don't care, I just want some releif. it is raining here today and I am in agony.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 7670
   Posted 5/19/2010 8:06 AM (GMT -6)   
I see my Pain management Doctor once a month, as they usually only prescribe a months worth of pain medications and
every so often they do drug testing to make sure I'm taking my medicines as prescribed, I also get procedures done and it's
time for another radiofrequecy ablation which I'm not really looking forward to as the out of pocket expenses are hard to afford,
so once you start down this road you'll be getting more than just pain medications, so it can get very very expensive and that 40.
a month you'll have to pay plus the medicine co pays and some of these are on the more expensive teirs for insurance, so it
could end up costing more than your 120. for your accupuncture, plus usually you'll need to do physical therapy, I do that
once a week for now as I'm still recovering from pneumonia, but will be going twice a week again soon...
Pain management is about using a lot of different things to keep your pain in control...not just medicine, my first tens unit for use at home
costs me 90. and it helps along with a heating pad on bad days...
If your going just to get pain medicines, medicines have a draw back of cauing a lot of sleepiness, I can only take my meds twice a day and that just
barely helps as I need to be able to drive during the day, just though you should know, then as with any medicines you might have bad reactions
when i first tried Lyrica, geezee never again, 10 minutes after I took it I felt it helping really good then 30 minutes later I was throwing it up
and almost ended up in the er as I was throwing up every hour on the hour for over 12 hours 7 pm til 2 pm the next day..
just my 2 cents worth of advise to you.............pain management can be hit and miss...and I hope you can get good doctors. it took me 2 tries to get a good doctor...
Good luck in what you choose to do, and I hope pain management can help you, it has helped me...(but it has been expensive)
(((((((((((((((((((((((((((((((((((((((((Suzboop)))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))
**********************************************
* 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"...

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


Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/19/2010 8:13 AM (GMT -6)   
Hi Chartreux - I hear ya.....I know that my experience might not be the greatest at the pain Clinic but I need to try. I've tried everything else. I already pay up the wazoo in prescription copays so that's nothing new for me. I just don't know where to turn anymore. I would love it if I could hav eth accupuncture, meds for breakthrough pain, fibro massage, etc. But that's a perfect world and that's certainly not the one I'm in right now. I usually take one 5 mg hyrocodone when i get home from work because by then, the pain is unbearable. I can't take them in the daytime because I would fall aslepp at work and I know the more you take, the less it works. Sometimes on the weekend, I take 2 a day but only rarely. I've been hung out to dry for almost 2 months now. I wish I had all the copay money I paid to those idiots who did nothing to help me....

uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1036
   Posted 5/19/2010 11:39 AM (GMT -6)   
Suzboop,
As many others have said to you going to a Pain Management Dr. is pretty much like seeing any other Dr.  I was referred to mine about 6 years ago by my PCP at the time....and I've been seeing them ever since.  The only thing is the pain contract...most have one that you have to sign...it states that you have to abide by their rules, use one pharmacy only, agree to come in for pill counts when they call you, and take your meds exactly as prescribed.... It sounds easy, but sometimes it's not.... most of the time you see them once a month but if you have a vacation or any type of trip planned you have to make arrangements ahead of time....
 
Seeing my Dr. was the best thing I ever did....even though he's not technically a Pain Dr., he's a neurosurgeon specializing in pain, he has helped me so much.... I used to think I was a drug addict because of all of the pain pills I took daily....but after seeing him I realized that it's ok to "NEED" to take something......if you have to.
 
So, good luck and let us know what happens..
 
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 1700 mg. at night..Glipizide 10mg. 2X in the morning and bedtime
Lantus 50 units at bedtime with Solostar Pen
Byetta 5 mcg. 2X daily                                                                   

 


Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/19/2010 12:02 PM (GMT -6)   
Thanks Unique,

I had to sign that same contract at my former Primary's office - I have no problem with that. It's definitely not my intent to abuse whatever meds they are able to give me.

I was nervous when I went to my former Primary about being a drug addict too (on one 5 mg hydrocodone per day!) and she said that I wasn't a drug addict, that I was managing my pain and then she prescribed 2 a day for me as well as 4 mg of Zanaflex at bedtime.

Just got a call from my new primary that they are senidn the referral over to the pain clinic and then they will get in touch withme. I hope it doesn't take too long!

Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/20/2010 1:06 PM (GMT -6)   
Well, I have my pain clinic appt set up - it's for June 14th - I hope I make it that far!

Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/20/2010 1:47 PM (GMT -6)   
Don't worry - I've been burned in the last couple of months so I'm going in with my eye wide open!

BobinmidMO
Regular Member


Date Joined Mar 2010
Total Posts : 39
   Posted 5/20/2010 2:07 PM (GMT -6)   
I didn't see what the actual damage is that causing all your suffering, so I'm not sure what boat you're in 100%. For what it's worth, when it comes to heavy hitting pain medication, it's all about documentation. The better your primary has shown and listed what you're suffering with, the more understanding and easier it will be getting the relief you need.

As far as cost, be advised that even with insurance drugs like OxyContin can cost $40 or more in co-pays per month. If you could get by with something like OxyIR which is designed more for breakthrough pain, that script will only run you around $8 per month.

Depending on your income, you might qualify for Medicaid. Even when you have a buy-down, it might be worth looking into.

When it comes to pain medication, please remember that it's not that the doctor has anything against you, but because of other idiots who do abuse and use, many doctors now take their time in learning how much they can trust the patient before they'll feel more comfortable with writing the scripts you'll need to really knock down the pain. It's not your fault, but you're the one who's hurt in the end I'm sorry to say. Best of luck, Bob.
After an accident in  1997 crushed the nerves in my pelvis, halfway down the calf and at the fibular head (knee), my left leg slowly started to turn color from the foot up, along with swelling and temp change.  Within 2 weeks I was diagnosed with RSD.  By 1999 I landed in a wheelchair and started a life taking narcotics all the time. In 2004 I got an Intrathecal morphine pump &5 years ago the RSD spread to my right leg and has done around 80% of the damage it did to my left leg in half the time. 1 1/2 years ago I went septic, and the infection did go body-wide.  After 2 days in the hospital I then had a clot in my lungs.  Both should have killed me, but this time I got lucky.  Meanwhile I've been battling blood clots for the last 4 years.  A year ago my left leg was ampuated above the knee after ging septic.  Guess that about say's it all.  Bob.


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1036
   Posted 5/20/2010 3:10 PM (GMT -6)   
One more thing....Some pain meds aren't covered fully by insurance...even State run insurance like TennCare (what I have)....and sometimes you have to pay for some or most of the script....I get 150 30mg. Oxy IR's and my insurance will only cover 40 of them!!!  Anyway, with the rising cost of meds I use an insurance card I got off the internet... It sounds crazy, but it covers about half of what my insurance won't pay...If you want a list of some of them you can email me directly....I don't want to advertise them here.
 
Good Luck....and I know that June 14th seems like a lifetime away when you're in pain, but you can get through it....we are all here for you.....'
 
 
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 1700 mg. at night..Glipizide 10mg. 2X in the morning and bedtime
Lantus 50 units at bedtime with Solostar Pen
Byetta 5 mcg. 2X daily                                                                   

 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 10590
   Posted 5/20/2010 6:08 PM (GMT -6)   
Suz, it looks like everyone here has pretty much given you the ins and outs of PM care. Do you know what clinic you are being referred to? The reason I ask is many on here have got to the appt only to find out the dr does procedures and injections only and does not give rx's for meds. So, you really need to find out before your appt if the dr does in fact write scripts if he feels they are necessary. You are right, June sounds and feels like a long way off so check this clinic out. It generally takes about 6 weeks to get an appt with one and I would hate to see this being a wasted appt. and end up with further delay. One thing I suggest is you make a list of what medications you have taken in the past, what worked, what didn't work and if there was problems with the medications, adverse reactions. Also, in CP101 is a pain diary that you may want to consider using so that when you see the new dr he/she can see what is going on with you on an average day. Your dr most likely that is referring you will send a copy of your medical records, but if you have had testing like MRI's and such, you can call the facility and have them make copies of the written reports for you to pick up. Take a copy of these with you for the dr to review they are important. Many times I found out my dr sent records but for some reason they would always forget to send the written reports of my MRI's which were crucial.
 
The best thing is just be honest with the dr on what is going on with you. They have seen it all in that particular practice and they know who is there for whatever. I do hope the appt goes well for you. But, if for some reason this is not a good mix for you, don't give up, get referred to another clinic. Sometimes we have to see more than one dr to find the right fit. I have kissed more than one toad to find the prince as they say, lol.
 
By the way, how has the accupuncture been coming along? Has it helped you at all?
 

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.


Suzboop
Regular Member


Date Joined Apr 2010
Total Posts : 72
   Posted 5/21/2010 4:43 AM (GMT -6)   
Thanks so much for all of your advice everyone!

I'm a little bit afraid to ask up front whether they write scrips for narcotics - but the women I spoke to yesterday did mention prescriptions and for me to have a list with me of what I take now (I already carry one in my wallet all the times).

Straydog, thanks for the encouragement about not being discouraged - I know you have all gone through the same thing so it really helps. I'm already discouraged but less so than I was 2 months ago when this whole nightmare started. I do have hope that the pain clinic will help.

As for the accupuncture - I can't afford that right now. As soon as my husband is able to work again and we have a couple of extra bucks - I will go back.

Thanks again for everything! Suzanne

Jadensmommy
Regular Member


Date Joined Nov 2009
Total Posts : 104
   Posted 5/22/2010 11:55 PM (GMT -6)   
For me, going to see a Pain Management Specialist was the best thing I've ever done. My advice is to try to get into a Pain Clinic that is at a teaching hospital. I see mine at the IU Medical Center and they are in the top 20 Pain Clinics in the world. It did take awhile for me to get in, about a month, but it was worth it. The doctor was wonderful! He takes care of my precriptions and makes sure that I'm comfortable. I did have to sign the contracts for his office, and after the second month that I went, had the drug test, and the med count, I haven't had to have another test or count and it's been 4 months. Once they get to know you, trust you with your meds, they don't test as often, and my visits will go to every 3 months instead of once a month. That really cuts down the costs.

I've been very lucky in finding a great doctor on the first try and wish you the same luck! Let us know how it goes!

Tammy
Fibromyalgia Dx November 20, 2009

Pain issues: Pain in neck and upper/lower back, chest/ribcage pain, Degenerative joint disease in both knees, migraine headaches, very painful menstrual cramping, pelvic pain.

Meds: Neurontin 600mg. 3x daily, Methadone 5mg 4x daily, Lortab 10/500 for BT pain.


Tammy <3


thunder55
New Member


Date Joined May 2010
Total Posts : 2
   Posted 5/23/2010 12:45 AM (GMT -6)   
Hi suzboop   I have been to many pain clinics had a botched back surgery, and yes they do ask you to sign a contract so you dont take your meds more then they say and if your out even 1 day early you will not get a refill till its time, they do sometims try and give cordisone shots but only if they think it'll help, they usually are there just to help give you your pain meds, they will usually drug test you and you wont know as to what month they do it either, you will get your prescription or prescriptions, in my case it was one for sleep and one for pain then one for breakthrough pain, i would get a months worth of pills and would have to be seen every month, they would ask you how your feeling, how the meds are working,, and if you feel they arent they will discuss working with a higher dose or a lower dose which ever, anyway they are really nice people in most case's except for running out early, i did run out of my meds 3 days early and went to ER for help, Of course didnt get the help at all Er looks at you like an addict and will let you suffer so no matter what dont ever run out early, the pain clinic after that incedent increased my dose and i had to redo my contract with them but they said if i broke it again i was out. well i hated the contract situation and i would always be like one day early or even 2 so i opted out and found a Dr who gave me what i need without a contract, and i can get my meds three days early and i dont have to be seen every month either, i just call two days before i am coming to get my RX and they will have it ready when i go to pick it up, i only see the DR if i have a problem, so pain clinics and most Dr's like you to come in and be seen every month cuz they want the money and now days who can afford that? unless you have good insurance. i do for now but at times my husband gets laid off and i have no ins. so it is good that i dont need to be seen every month. but dont fear them they are generally very nice people and caring about your pain at least here in oregon.
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