Pain Management Centres

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tyno3
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Date Joined May 2008
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   Posted 9/30/2008 10:46 AM (GMT -7)   
Could someone please tell me what these are and what to expect if I'm referred to one. A pdoc I see has suggested I go to one. My PCP responded "they can't do anything for you we can't do". I need to know what to expect before I agree.

Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 17101
   Posted 9/30/2008 11:07 AM (GMT -7)   
I agree with your PCP.  No doctor really knows what causes fibromyalgia and all the doctors have access to the same meds and procedures. 
 
Sherrine
Forum Moderator/ Fibromyalgia
***********************
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7


QTKaren
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Date Joined Apr 2008
Total Posts : 605
   Posted 9/30/2008 11:19 AM (GMT -7)   
IN my state not all doctors have acces to all meds. The stronger narcotics such as morphine have to be set up at a pain clinic and then the reg pc doctor can write the scripts. That is a problem I am having right now. All the pain clinics in the area have gone to private ins and i have medicaid so noone will take me to get my morphine upped and I tried the big University Hospitals in Seattle and they say I live too far for reg care. I'm like hellooooooooooo I went to several doctors out there for over 2 years with no prob. I have a medical transport service to get me to any appointments but just the pain clinic said no after seeing me twice. I did write a letter to the hospital administraiter and after 2 months got a letter back saying"We are sorry that you didn't like our service. Good luck" it was outrageous but there was nothing else I could do so now I am stuck with my doc only being able to write for the origional meds the pain clinic set up 5 years ago.
Karen
 
Mom of one gramma to 4 lover to One
 
Fibromyalgia,IBS,Stroke x2,endometriosis,Diabetes type 2,neuropathic pain,nerve damage due to tailbone removel,nerve damage due to fractured back,deppresion,high blood pressure,severe nausea,atrophy,chronic pain,nerve damage due to botched bladder surgery,torn hip joint,hypoglycymic
 
Norco(double strength vicodin) 80 to 100 mg @ day
Ms Contin(morphine) 45 mg @ day,Lyrica 600mg @ day
 
 
 


Piercings
Regular Member


Date Joined Aug 2008
Total Posts : 326
   Posted 9/30/2008 1:04 PM (GMT -7)   
Karen, which side of Seattle are you on? And I didn't realize that they were doing that up there as far as the state restrictions on the docs. I'm down in Portland and it's a lot easier on them here.

Tyno3...to answer your question. In my state there's what they call pain management clinics. The scripts in my state are not restricted like they are in Karens. But most doctors here do not want to write narcotic prescriptions on a regular basis. Too much hassle from the DEA. So there has become PM clinics in almost every state.

In PM you will usually have one doctor that you work with there. There's a consent that they ask you to sign. These consent forms usually are an agreement of several things such as:

1. You will not fill any narcotic scrpits from any other doctors without clearance from the PM doc.
2. You will only have your prescriptions filled at one pharmacy and they ask you to state what location etc.
3. You consent to possibly have UA's or blood screens.
4. You may have to agree to bring in unused medication at visits.
5. That you realize that scripts will not be modified by phone, and will not be re-issued if lost or stolen
unless a police report is filed listing the medication as being one of the items stolen.

Those are the most common points of most pain contracts. #1 is to prevent you from going to multiple doctors and getting more than what you've been prescribed. #2 is to make sure that you're not filling scripts from other doctors. I know of PM docs that have called the pharmacy to check their patients records. #3 is a dual purpose item. It tells them that YOU are the one taking your medication and you're not just getting scripts filled and then selling them on the street. It also tells them that you're not taking any OTHER medication besides what they're prescribing you. #4 is to make sure that you're not selling them, and/or to make sure that you're not over using them. That you have the appropriate amount of pills left that you should for the time since your last visit. and #5 is pretty self explanatory after you're been over the reasons for 1-4.

Most of it is basic common sense items. And generally as long as you're not taking more than you should be, or selling them, or filling a bunch of other scripts, it's not that big of an issue. I don't like the way that some PM doctors and clinics are. Some of them treat you like you're a criminal till you're been with them long enough to prove that you're not. But sadly it's not surprising with the abuse rate that there is on some of the higher end meds.

Hopefully that gives you a decent idea of what PM clinics are and how they work.

tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 9/30/2008 4:43 PM (GMT -7)   
Thank you all for your information. Wow, how complicated it all is. I was living in Florida for a couple of years and filled out the contract wth my GP, similar to what Piercings described. It was just between the doctor and I though. He was quite helpfull and I had the first completely out of pain experience there. He prescribed Methadone and on about day three, as I was walking on the beach early one morning, I had this feeling come over me like "wow, so this is what it feels like to be pain free." I wonder if there are people out there, walking around who feel this way a lot of the time. Wouldn't it be great to be able to wake up, pain free, get up without hobbling around, not having to wait an hour or so for my medicine to start to work before I can walk around and tend to my daily duties. I went back to the doctor after 3 months and asked to go back to a less powerful medicine. If I wasn't able to continue to get that medicine, I would be a sorry girl if I moved, or lost access to the GP prescribing the meds. I try to work with the least addictive or habit forming medicine so if I run out or can't get my meds the withdrawl won't be so horrific. A cautionary approach in this climate of politicians practising medicine. 

Piercings
Regular Member


Date Joined Aug 2008
Total Posts : 326
   Posted 9/30/2008 6:28 PM (GMT -7)   
Then it sound like the GP was handling it like a common pain contract. Usually in PM you only work with one doctor. It's just that for insurance purposes and such the doctors tend to cluster together to practice in clinics. It makes it easier for them as they have a system of protecting themselves by almost always consulting a second pain specialist. Even if you never see this doc that they consult, your record information is shown to a second set of eyes to make sure that the prescribing doc isn't just prescribing for a patient that they have a soft spot for. It helps to protect them from the scrutiny of the DEA.

tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 10/1/2008 1:01 PM (GMT -7)   
It seems the DEA is overfocused on the good guys and neglecting to focus on the really bad guys, the ones running Drugs like Crack Cocaine and Methamphetamine. A doctor who has gone to school for 7 yeras ought to be able to determine whether somebody is really hurting or just pretending. I think the DEA is taking the low road, rather than the high road. I've heard horror stories of people in terrible pain doing drastic things because they were cut off from their prescribing doctor.  

donnaeil
Veteran Member


Date Joined Jun 2006
Total Posts : 1156
   Posted 10/1/2008 8:37 PM (GMT -7)   
Ok Karen,

You will understand what I am now experiencing. According to my physician, he will no longer prescribe my pain relievers because he is a family practitioner. He says that the state of WA will soon no longer let him.

In addition, he said there were studies, which I cannot find, that state that long term use of narcotics can cause a lowering of IQ by 20 points and a reduced cognition level.

I thought this was hilarious because I testes in the 90th percentile in cognition, on a bad day at that, and had a pretty good IQ.

So, I now have to get my meds from a pain specialist. I have been to two pain doctors who did absolutely nothing. One, I visited a few months ago and all he did was email fibro studies to me. I, in fact, new far more than he did.

So, now I have a referral for Swedish Hospital's pain clinic in Seattle. Fortunately I live there.

I will let you know what happens. Soon however, my meds will be reduced and then eliminated by my doctor. All I will have left are naproxen and lyrica. This is not enough.

I fear being bed ridden again and unable to swim. It is scary.

I think pain doctors in WA are a complete waste of time. First of all, most of them refuse to see fibromyalgia patients. They do not even believe in they disease. Talk about incompetence. I let my doctor know that he was sending me to a doctor who would not help period.

A couple of MDs attended a seminar on pain control a few weeks ago. When the GPs asked the pain doctor about their handling pain clients the pain specialists just told them to give out more narcotics.

I asked my doctor that if that is what they said to other doctors, what do you think they say to us?


Anyway, I will step off the stage and let others contribute.

Thanks for letting me vent folks.

Donnaeil

donnaeil
Veteran Member


Date Joined Jun 2006
Total Posts : 1156
   Posted 10/1/2008 8:38 PM (GMT -7)   
Oh Karen,

Sweedish hospital takes medicaid. Let's have lunch there one day. They have a wonderful cafeteria.

Donnaeil

d2parrotperson
Regular Member


Date Joined Aug 2008
Total Posts : 320
   Posted 10/2/2008 9:50 AM (GMT -7)   
I go to a University Pain CLinic. They will prescribe the big guns other drs are timid to prescribe. They will also try different needle therapies. I had to put my foot down to get the bigger narcotics. They would rather avoid them, but I told them, "I came here to get help and try to feel better, and I've gotten no help at all." That day they got me fentanyl, lidocaine patches, oxycodone for breakthrough, baclofen and the assorted drugs I've tried (Cymbalta, Lyrica, etc, etc). But, they did help me to at least be able to function.
150mg Azathioprine, Lomotil, Iron, Nexium 2/day, Fentanyl patch, Oxycodone, Baclofin
Crohn's, Fibromyalgia, Several bulging discs, Bone spurs, Osteoarthritis, Osteopenia, Reflux, Stenosis, Strictures, Dengenerating facet joints
2 resections
 
Stephanie
When I am weak, then am I strong


Blair
New Member


Date Joined Sep 2008
Total Posts : 3
   Posted 10/2/2008 11:23 AM (GMT -7)   
Wow, now I am really nervous. I see my GP who precribes my MS Contin. Yesterday I saw my Rheumotologist and he said it was time for me to start going to Pain Mgnt. I do probably need something for breakthrough pain but if there is a chance they would alter my MS Contin and want to discontinue it I would rather just stick with my GP and suffer it out with no additional meds. It just never ceases to amaze me the stigma of pain control in this country compared to others. I have only worked one week out of the last year and the Rheum suggested it was time to file for disabilty. Funny, how being ill with a chronic condition can make you feel embarrassed. I never speak of any of this with my friends. I am a nurse and you would be so shocked to know that the opinion of Fibro amoung most nurses is that it DOES not exist. I have had so many tell me that since there is no "blood" test etc they do not believe in it.Many nurses think people who "say" they have Fibro are just lazy and are drug seekers.Sheesh.....I feel for the most part my own profession has let me down.

Geez, I sound like such a downer today...I do want to thnak everyone who shares of themselves on here. You all make me smile, laugh and I have cried along with you. Thanks for all being there. What a terrific group of people you are!

tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 10/3/2008 2:18 AM (GMT -7)   
The stigma associated with Fibromyalgia, (hysterical, drug-seeking, lazy) is a very real and egregious phenomena. See, I'm just trying to show ya'll that reliance on pain-medication in order to function doesn't affect my IQ. Look at those forty dollar words there, eh? Not a laughing matter. I am not a biblical scholar, someone here might be, but it seems to me there is a passage (in Genesis, I believe) about the Lord putting plants and flowers on the earth that they may be "as food," to benefit mankind. By this, and I apologize for the inaccuracy of my quote, I believe the plants were such as Poppy'. So here we have this drug war waged between the Gov't and the producers and procurers of medicine. Over there we have this Multi-national Pharmaceutical Industry popping out all sorts of chemicals, at exhorbitant prices, policing themselves, essentially, and many of these two year    wonder drugs get yanked off the shelves by about year three when they discover little side effects, like stroke, or bleeding ulcers. You have the doctors stuck in the middle trying (most of them, to ease suffering because that is why they went to medical school in the first place.) Then we have the heavy hand of legislators coming down hard on them, and pulling their licenses if they are prescribing too much pain medication. Why? Money.  
I was referred to a (get this) psychiatrist, once. He had me wait about forty minutes in his waiting room. There was nobody else there. That should have been my first clue. I could hear him yakking away behind a closed door so since it was a one way yak, I figured he was on the phone, so, OK. I wait, and wait, still the one way yak. Finally, the door swings open and this middle aged guy invites me in. So in I go. Then the middle aged guy devil carefully places his cell phone in the middle of his desk, and mutters something about expecting a call. OK, so maybe he has a patient in crisis. So then he leans way back in his chair and throws his feet up on his desk, and says "so what's your problem?" So, I begin to tell him, single mom, 3 jobs, no babysitter, headaches, anxiety, can't sleep, Fibromyalgia, He stops me right there, takes his feet down off his desk, stares me right in the eye, and says "Convince me you have Fibromyalgia". I begin to sputter, not quite sure how to respond and thank goodness, his cell phone rang. He pointed toward the door and said," do you mind, this is a personal call ". I could hear him booking his T Time for a golf game that afternoon as I bolted from the building. So there you have it folks. They used to banish leppers to caves in the mountains where they would suffer till death miraculously saved them. This is not so different. There is little "evidence" to establish Fibromyalgia. So we must be making it up.
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