Pain Management Dr - What to expect?

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txarmywife
Regular Member


Date Joined Aug 2011
Total Posts : 45
   Posted Today 3:33 PM (GMT -6)   
What should I expect from the pain managment dr?
 
I'm currently in the hospital and being treated for ureter obstruction caused by a stone/and or scar tissue from numberous procedures recently. (I've had 4 procedures on my kidneys in the past week and a half and am due for #5 this week) I've been hospitalized now for a week. I was admitted because my left ureter was completely obstructed. They did a ureteroscopy which was unsuccessful beause the scar tissue was so tight they were unable to put anything through. So the following day I had a nephrostomy to relieve the pressure/urine/blood from the kidney and prevent kidney failure. I'm still requiring heavy duty pain meds...torodol, dilaudid, norco. Due to my high white blood count they haven't been able to release me or do the final procedure. So they are sending in a pain managment doctor so I can go home. My question is what should I expect from the pain management dr? My pain goes up to 10/10. Dilaudid now is starting to not even work. (Only relieves the pain to a 5/10 for an hour or so. I'm exhausted and needing to get better! School started today which I obviously wasn't able to go since I'm hospitalized. They don't think my body is physically ready for the last procedure so they want to send me home, but they can't send me home still in so much pain.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11163
   Posted Today 3:52 PM (GMT -6)   
Hello and welcome to Healing Well's chronic pain forum. Wow, it sounds like you have been put through the wringer in a very short while. I do hope that things turn around for you soon and you can get back up on your feet.

Pain mgt drs are just that, treating pain is their specialty, meaning they are generally much better at it than say your primary care physician or your specialist that are seeing you in the hospital. They can use a variety of different medication to help get your pain level down or they may only need to give you one medication. This will totally depend on the dr. As it is now, primary care physicians do not like to rx pain meds to their patients for more than 7-10 days. They don't want to get caught up in trying to treat someone with chronic pain.

They could also be bringing this pain mgt dr in for a consult to find out what pain medications to give you to send you home with. Good luck and let us know what he has to say.
Moderator Chronic Pain Forum

txarmywife
Regular Member


Date Joined Aug 2011
Total Posts : 45
   Posted Today 6:37 PM (GMT -6)   
Well I was not too impressed. He only asked me where my pain was (Left flank) and what I've used for pain in the past during kidney problems/post op (vicodin, Norco, or percocet). He was like ok well Ill switch your Norco to percocet and see of that works and if not the only other option is morphine extended. And then he tries to leave the room and im like im just I dont understand the dilaudid was working and now isnt and he was like anything I prescribe will eventually stop working. So then I try to explain how im very anxious and he tries cutting me off and is like ok ok got it. Ergh? So my wonderful nurse comes in and gives me ativan (wow so he did listen?) and percocet. Im just getting so anxious about everything...school, not knowing when my my procedure is or when it is. Being in this hospital. I just feel so overwhelmed and now have then added aspect of my pain not being under control.

Advice? I've been dealing with kidney stones since Nov of 2010. I also have inflammatory bowel disease, carpal tunnel, osteopenia.
---
23 yr old female
2000: Inflammatory Bowel Disease Untermined Type (Age 12)
2002: Anorexia Nervosa After Strict IBD diet/weight loss
2006: RecoverED from eating disorder
2010: Kidney Stones
8/2011: Randall Plaque Disease
8/2011: Flare up immediately following 2 Kidney procedures/hospitalization

Currently on Prednisone Tapering, No liquid dairy, No raw veggies/fruits

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted Today 7:11 PM (GMT -6)   
I just love hit and run specialist/doctors. Love to hit them with a 2x4 and see them try to run away that is.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted Today 7:13 PM (GMT -6)   
Hello, you poor kid, you have really been through a lot.  I think Straydog hit it right on the head, sometimes you have to get very forceful.  This is after all your life, your body.  Also to my great surprise I totally agree with the good Dr. Requiem.
 
Its basically the luck of the draw when it comes to pm doctors.  Heres the important thing, if you are not happy with the pm you have, fire him/her and find another one.  Believe me, I know this is a big pain.  But when it comes to your health, you have to make sure you can have a good conversation with your doctor, pm doctors in particular as they will most likely be the doctors you will see the most.
 
Back some 12+ years ago, my pcp treated my pain and he was great, since I had been a patient of his almost from the start of my back problems, its just seemed easier.  He attempted to send me to a few pain management doctors, but he became so irritated with them, he just finally said, forget it, I will just treat you myself.  Then in December 2006, he got an offer as he said "he couldnt refuse" he had 2 kids to get through college, the job was to good for him to pass up.  He left me with 3 months worth of prescriptions, we cried, (well I did) said goodbye and then began the next 4 1/2 years of well hell.
 
In September 2009 I found what by now was my 5th pm doctor, I wont bore you with all the pm doctors stories before I found the one I have now, but I would not wish that on my worst enemy.  So after filling out 12 pages of information and giving him my firstborn (lol), I found a wonderful doctor, who also has a wonderful staff.  The first appt. I had with him, he was so nice and compassionate I cryed, with joy.
 
So they are out there, you just have to find them, and your life will become much easier to manage.
 
Good Luck to you, hope you will be feeling well soon,
 
Kathy/nini53
 
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

O2
New Member


Date Joined Aug 2011
Total Posts : 1
   Posted 8/30/2011 12:02 AM (GMT -6)   
I too have a hit and run PM doc. Unfortunately I can't change docs because I am in a Workmans comp case. You can only change docs once with WC. And I have already done that.

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 4981
   Posted 8/30/2011 3:59 AM (GMT -6)   
Good early morning O2!

We would love to welcome you to the Chronic Pain forum!….However we would like for all the member to have a chance to meet you, and We believe you would be better served as a new member to start a new thread, and introduce yourself there.

If you will….please select the button in the upper lefthand corner of our home page titled "Post New Topic"…..simply type in a subject such as "Hello New Member"…..then fill in the body directly below it,... and type away with an introduction of yourself!

Good luck and we will welcome you there!

SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11163
   Posted 8/30/2011 4:39 AM (GMT -6)   
TxArmyWife, when are you going to be discharged from the hospital? I am assuming your husband is in the military and this PM is a military dr and that is who takes care of your medical issues. I know if you are having to use the military drs it can be very limiting. Do you know when you are suppose to see him after you get discharged to go home. Perhaps at the time of your discharge the nurse will give you all of your follow-up instructions with the drs you are to see. If he is not mentioned, please be sure to tell the nurse you need to know how to contact him.

For the moment the only thing I can suggest is to try and calm down the best you can. Do you have crohns or UC, I noticed you have IBD listed. What meds are you taking for this? Of course, stress can trigger a flare so try to get as calm as possible.

You mentioned he did not discuss doing any procedures on you, he may very well not do them as your condition may not call for those types of procedures. They don't normally just up & do them right off the bat. They usually like to try some meds to see how you do with those.

You can only take this one day at a time and that is not much consolation I know, but that is the life of a person with chronic pain, one day at a time.

Let us know what is going on with you when you get a chance.
Moderator Chronic Pain Forum

LordWood
Regular Member


Date Joined Aug 2011
Total Posts : 59
   Posted 8/30/2011 5:10 AM (GMT -6)   
Im sorry to hear about everything being like it is for you, I hope things start to get better for you soon so you can get your procedure and be out of the hospital soon. Hospitals and ER's have always just caused more stress and pain then they are worth most of the time at least for me. I know exactly how your feeling with your pain being a 10/10 and the pain meds not working. I've been on just about every pain med imaginable and all of them are basically worthless. For me it was always either being allergic to them or they were as worthless as a glass of water.

Especially know what you mean about Dilaudid not working I've had hospital stays just for IV Dilaudid getting the whole way up to a 8mg bolus and still no relief, my oral Dilaudid I'm on right now is 8mg 4x Daily and its worthless anymore I'm put on stuff just for the doctors to believe there at least trying to help. Hopefully you will be fortunate enough for them to find something for you to help with your pain and I'm glad to hear they put you on Ativan that will help with your anxiousness and worries and help to calm your racing mind. Best of luck with everything!
I currently take: Cimzia 2-200mg injections, Zolpidem 5mg 1x daily, Vyvanse 70mg 1x daily, Dilaudid 8mg 4x daily
Health Issues: RSD, Crohns, Gastroparesis, Arthritis, Osteoporosis, Dysautonomia, & Remicade Induced Psoriasis.

txarmywife
Regular Member


Date Joined Aug 2011
Total Posts : 45
   Posted 8/30/2011 11:53 AM (GMT -6)   
straydog, thanks for your help. to answer your questions:
right now i have no idea when i'll be discharged. they have been saying "tomorrow" since last friday. but my white blood cell count keeps rising so they are unable to discharge me because of it...and of course because my pain is not controlled. yesterday my white blood cell count finally lowered...only for today it to come back super high again. sooo i'm awaiting a ct to check for infection/abcess in the kidney. my husband is active duty but currently deployed, so for deployment we moved back with family. so i'm seeing civilian doctors. it is my understanding that i will see the pm doctor after discharge because he is the only one who can prescribe the class of meds i'll need to go home with. , when

i am currently in a flare up of IBD (it resembles crohns but was never told one or the other...just inflammatory bowel disease undetermined type) due to all the physical stress my body has been under. (ive under gone 4 procedures on my kidneys in the past 2 weeks) i'm currently on prednisone for this flare...their main concern is my kidneys not my ibd. so they arent giving me much for that...haven't even had a gi come in during my entire stay.

right now the plan is to try to find the cause of the infection so they can internalize the ureteral stent (right now it exits from a whole in my back into a nephrostomy bag). after than then they plan to 1) do a urteroscopy and dialate the ureter with a balloon and cut out the stone or 2) laproscopically remove the obstructed part of the ureter with the stone inside. this second procedure is the most likely to happen because it has the highest chance of success. my ureter is completely obstructed which obviously can cause kidney damage and failure....but they do not want to do the procedure with my white blood count so high.

they are putting in a call to the pm dr again as i'm in so much pain still. so we will see what he prescribes. i just wish they could figure out the infection issues so they could do the procedure. i feel like that is the only thing that will take this pain away. but for now its a wait and see and try to find the right drug combo that will work for me :(


right now i am currently on:
oral percocet, iv toradol, iv dilaudid, oral phenergran, oral pyridium, iv zofran, oral xanax (not ativan after all), prednisone, flomax....and a bunch of others i cant even keep track of! every day they're adding something it seems.

mscrowbar
Veteran Member


Date Joined Nov 2010
Total Posts : 877
   Posted 8/30/2011 1:54 PM (GMT -6)   
I have had several kidney stones in my past along with all kinds of different procedures so I know first hand how much pain they can cause, but, nothing to the extent you are suffering. I would like to wish you well with a speedy recovery.
Denita
**************************************
Rheumatoid arthritis with secondary Sjogrens, Fibromyalgia, meniscus tears in left knee, Cancer survivor

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11163
   Posted 8/31/2011 10:20 AM (GMT -6)   
Good morning TxArmyWife, I wanted to check in on you and see how things are going. I can't even begin to fathom the pain that you are having. I know that time I passed a kidney stone I nearly passed out. It was like 2:00 in the morning and I can't even begin to describe that kind of pain.

I do hope they have been able to isolate and figure out the infection and get the correct antibiotics going to get rid of it. I am kind of like, ok, I am in the hospital now lets get this show rolling, meaning get everything under control so the procedure can be done and when you are discharged you don't have to go back in the hospital.

For a lot of people with IBD stress can trigger a flair up, been there & done that many times over the years. I am sure your current situation has contributed a lot.

Please keep us posted on how you are getting along in the hospital. I am assuming that you live in Texas. I live there too and I am so sick of the triple digit weather. Take care.
Moderator Chronic Pain Forum
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