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I think my MD just 'washed his hands' of me------WTH?

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Posted 1/7/2008 12:30 PM (GMT -6)
I went to my Primary MD today--to review my on-going (8 months) pain in my upper right quadrant (ribs, shoulder, neck, mid-back, right arm going numb/purple) etc....

Well--he kept focusing on my "anxiety/depression" (even did a 'test' to see if I am Bi-polar)---and when we FINALLY talked about my recurring pain (never healed/fix itself WHATEVER) he pretty much told me one of three things:  1)  I can go and see a Rheumatologist (although my tests came back negative), 2)  Continue to see the Back/Sports Med MD (I have an appt. on 1/18) and see what he thinks---- 3)  gave me a script for Klonopin to use PRN---"just in case", AND (oh, yes...a #4)  come back and see me in THREE MONTHS!

UM---HELLO?!!!  I am still in pain here---aren't there ANY other tests we can do to see if there's anything else going on with me?    Those 4 things don't make my pain go away!  MY PAIN IS REAL---it's there---it limits me!  UM---HELLO!

Now, WTH do I do?  mad eyes mad

he said I may have "chronic Regional Pain Syndrome"........... redface   redface redface confused    WHAT IS THAT?

Laurel

Post Edited (hopeisreal) : 1/7/2008 11:34:09 AM (GMT-7)

Posted 1/7/2008 3:56 PM (GMT -6)
thanks Bonnie! What's the DO-in-training's name? LOL!! Hopefully, she will read this thread b/c it has "MD" in it--and she can give me some insight! I feel real doubtful that the Sports MEd MD will do much for me either---just a feeling I get b/c it seems like NO ONE can help!? WAH!
Posted 1/7/2008 6:06 PM (GMT -6)
Oh yeah---Sarita! I will "page" her to check out this thread! LOL! Thank you Bonnie for your encouragement----I did have an MRI back in August ofmy thoracic spine---it was normal----I am going to ask the Back Specialist if I can get an MRI of my neck though---something just isn't feeling right there.......
Laurel
Posted 1/8/2008 12:20 AM (GMT -6)
LOL, Laurel, I'm here, I did just see your thread about your MD. I'm sorry to hear about what happened, but it actually sounds like he is not quite finished scrubbing his hands just yet :) He is giving you several options and all of them are pretty decent - a rheumatologist or sports medicine doc might have some more ideas of what is going on. Sometimes it's frustrating for doctors when they can't seem to help their patients, and they want to give you the best chance of healing, so will consider other options. I know it does feel like he is frustrated with YOU (I've been through it too), but he is probably just frustrated that he isn't helping you that much.

Chronic pain especially is so, so difficult, and I empathize with you - I can't imagine being in pain like that constantly. No wonder you are anxious. So this is pain in your upper back? Numbness/tingling/anything like that, or just pain? Is it near your shoulder blade? Is it constant or intermittent? Does anything seem to make it any better or worse?

A little background about D.O.s - a D.O. is a doctor of osteopathic medicine, whereas an M.D. is a doctor of allopathic medicine. Really, these are two birds of the same feather - identical training in most ways - but the major difference is that all D.O.s are trained additionally in what is called "osteopathic manual medicine" (OMM). So, for instance, I am taking all the same classes as my friends in allopathic schools (anatomy, pharmacology, neuroscience, biochemistry, etc. ad nauseum), and will be able to specialize in any field I choose (rheumatology, sports medicine, oncology, pediatrics, whatever). But during our training we have additional classes in "osteopathic manual medicine," where we focus on treatments of the musculoskeletal system.

Some D.O.s are specialists in "neuromuscular medicine," or are OMM specialists. That means they do a residency after their medical training that specifically focuses on using OMM as treatment for illness and injury. They are board certified, can prescribe medications, make referrals, etc. so yes, they are "real" doctors! These people can be really wonderful for patients with chronic pain. ESPECIALLY those with types of pain like yours, in the cervical or thoracic spine.

Let me know if you have any other questions. Best of luck to you.
Posted 1/8/2008 12:22 AM (GMT -6)
P.S. One other tidbit - sometimes going the MRI route is actually not particularly helpful in arriving at a diagnosis. They've done tons of studies showing that giving patients an MRI rarely is useful in treating the injury and is super expensive for the patient most of the time. So if your doctor isn't super-aggressive about getting you one, that might be the reason why!
Posted 1/8/2008 3:17 AM (GMT -6)
Sarita, I am just wondering because I am hoping to go to med school in a couple years. But I have heard/read that in reality very few DOs actually use OMM in practice, do you know if this is true? I also heard that there is a growing movement to remove it or make it an even smaller part of the curricullum in DO schools due to the lack of evidence supporting it (studies), despite a sometimes favorable response from patients that a lot of people believe may be a placebo effect. Do you know anything about this?
Posted 1/8/2008 3:33 AM (GMT -6)
Hi Circa, best of luck with the pre-med process, it's the next best thing to being in med school! Sigh...it's a long haul but if you really want it you can do it.

I don't want to hijack the thread but essentially there are several "camps" in the D.O. world - those who believe OMM can heal the world of every ailment known to man, those who think OMM is useful in certain settings, and those who think it's all quackery. I'm in the middle group. For refractory back pain, OMM can be very helpful. It's also been proven useful in treating otitis media, asthma, and IBS. There are plenty of studies indicating such. For other illnesses, OMM's usefulness is limited. I wouldn't say OMM is a cure-all - just another tool in the tool box.

One of the most important things I am learning from my OMM training is how to feel comfortable touching patients. It's very hands-on. It really does necessitate a strong doctor-patient mutual trust, and that goes a long way in treating anyone.
Posted 1/8/2008 3:43 AM (GMT -6)
That seems to be what the to-do is really about, touching patients, especially for people who believe OMM is indicated in the psych setting, where a barrier btwn provider and patient is usually considered to be very important. I think cranial-sacral manipulation is the one I read about in relation to this. At least this is what I have gathered, correct me if I am wrong.

Anyway sorry for hijacking the thread. Just interested.

Post Edited (Circa1988) : 1/8/2008 2:47:24 AM (GMT-7)

Posted 1/8/2008 5:23 AM (GMT -6)
http://www.stoppain.org/pain_medicine/content/chronicpain/crps.asp


This sounds to me to be the closest thing possible. There is also RSD (some say its the same thing, other doctor's view it a bit differently. I have a friend who's had RSD for 22yrs,  but that would usually occur after a trauma to the spine and circulation would be affected. CRS isn't a shot in the dark when you realize the patient not only has pain but the area  involved becomes swollen and changed in color, resisting all attempted treatements, and lasting this long.  I agree that the sports med guy has probably seen this before, even if he can't treat you, his notes of what he feels your diagnosis is. Osteo doctor wouldn't hurt. The Rheumy he wants you to see is not just for RA, they cover a wide host of ailments, including things involving the kidneys, such as lupus etc. What I'm trying to say is that a Rheumatologist may not be the doctor you need to stay with, but he may be your ticket in finding the right direction to go in. .They know more about bones/muscleskeletal than most. I think Id try that route first. I wouldn't think Id be staying with him, but rather examined by him and explained what he thinks im looking at, for proper referral.

If you find that none of the offers work, I'd change general practs and be referred to a pain specialist, for they obviously see all types of chonic conditions, and would know what yours is. Depression/bipolar/anxiety can in no way swell or make skin purple, just doesn't happen. Mind is strong over matter, but not that strong .

Im so sorry your going through this. After much pain my family doc (young woman who looks very pristine) referred me to spinal rehab and from there we work on meds with injections.

Although she's right about an MRI being expensive. I think it's well worth it in your particular case. You say there's something just not right in your neck? It needs to be looked at so it can be treated or ruled out. It will always be a question of radicular pain unless the neck has been properly evaluated.

Hope you find your place of help soon!

Kiera

Posted 1/9/2008 8:21 AM (GMT -6)
"Chronic pain especially is so, so difficult, and I empathize with you - I can't imagine being in pain like that constantly. No wonder you are anxious. So this is pain in your upper back? Numbness/tingling/anything like that, or just pain? Is it near your shoulder blade? Is it constant or intermittent? Does anything seem to make it any better or worse? "

 

Sarita---sorry I haven't answered sooner---sick kids in the house! eyes

Anyway---This pain is in my mid-upper back---pretty much my right upper quadrant (ribs-front/back, mid back, neck/shoulder, pain around shoulder blade, serratus anterior, right arm, and even sometimes my right leg).........

I do get numbness in my right arm---it often goes numb, and feels "heavy" by the end of the day---the more 'repetitive' motion I do (vacuum, drive-hold steering wheel, hold computer mouse, hold my kids' hands) the more numb/freezing cold it gets (sometimes this happens with my right leg as well---sciatia?)  I also get bad headaches and dizzy/nausea-fun!

I usually wake up with dull pains all over the upper right quadrant/neck/shoulder---as the day goes on--it gets worse!  I try to put heat/ice on it--do my PT exercises and take Advil (right now---about 4/day)---the PT and Advil help a little bit.

I had one MRI of my thoracic spine---came back OK--they should have done my neck also, but didn't.  I will ask my Sport Med MD about this------

So, that's all!

anymore thoughts---I appreciate it!

Laurel

Posted 1/9/2008 12:34 PM (GMT -6)
Dear Hopeisreal,

Do you get any relief if you reach behind your head/neck with the hand opposite of your painful side....same movement with same side hand as souce of pain? I only ask because once I was finally diagnosed correctly my wonderful neurosugeon laughed when I described that as the only way to get a moment of relief from the pain in my neck, back, legs, chest and arms....he had me look out into his waiting room where several patients would eventually resort to the same movement. Turns out I had a pretty severe case of stenosis throughout my c-spine amongst other spine problems. Once he gave the spinal chord and nerve roots some breathing room it was as if he performed a miracle...wish I could say the same for subsequent surgeries. I just wanted to encourage you to keep asking your doctor the specific questions and seek other medical providers if they don't take your case seriously and treat it with a sense of urgency. I've been posting here for a couple days and although I'm not very good at it one thing I can share with certainty is my advice not to be a timid or passive patient. I went through 45 years of unspeakable misery and a pretty crappy quality of life because I didn't realize that my doctors may not be taking my problem seriously. After a week in the ICU being treated as a heart attack victim because my body was shutting down, a doctor making the rounds one night asked a rhetorical question..."what seems to be the problem"....I told him I couldn't say but I could show him what I'd been dealing with since the age of 4 or 5.....I struggled to my feet and moved my head to one side and tilted it back......I let out an awful gutteral involutary groan and fell to the floor limp. Once he composed himself and got me back on the table he said don't do that again.... He said he'd seen that before and he thought he might know what was causing it. After a few films from the view through my open mouth he confirmed his suspicions and started a battery of tests.....My spinal chord was being severly smashed by narrowing of the column and nerve root openings...I have this and other back problems from brain stem to tail bone but the closer to the brain the more urgent. Until being hit from behind in a car wreck i was actually doing very well based on the surgery. I share this not only to serve as a mental release for me but as a genuine suggestion to you. Don't suffer silently. Don't make the same 45 year mistake i did and accept doctors telling you there is nothing wrong with you just because they don't see blood gushing out of you. Many sources of extreem pain are never going to show up on a MRI, Ct Scan, etc.....Be assertive and find a doctor that will commit to helping you find the cause of your pain and get you the best treatment possible....I was the worst informed, ignorant, overtrusting patient in the world and i got help after almost 50 years of "it's all in your head"...dag gone right it was... my brain stem that is. Best of luck to you.

Posted 1/9/2008 4:07 PM (GMT -6)

See the rhuemotoligist they deal with chronic pain and inflamation all the time and even if you don't have RA they may be able to help.

Also keep a pain diary if you aren't already doing so rate your pain on a 1-10 scale once an hour and write down briefly what you did that hour It might help you and your doctor figure this out and it cant hurt.  Doctors like data.

Also if your doctor doesn't have a good atitude toward treating you get rid of him.

Posted 1/10/2008 3:54 AM (GMT -6)
Have they ever done an EMG on you? MRIs are good, but they can't pick up certain things, especially when the nerves are involved. An EMG could test you for something like thoracic outlet syndrome or any number of other neurological abnormalities. With the numbness, cold sensation, radiating pain, it seems like nerve entrapment or damage could be leading to your symptoms. Do you do any repetitive motion with your arms for work, for instance? Or have you been in an accident in the past?

I hope that sports MD doesn't just send you for more PT - sounds like you need some more work than that!
Posted 1/10/2008 7:00 AM (GMT -6)
i do repetitive motion stuff at home: vacuum, drive, housework---- and photography stuff on the computer (holding the mouse, etc..)----I have not been in an accident in the past----but, I was working out at a gym last spring---doing a lot of rowing, lat. pull-downs, military press, shoulder press, (and leg exercises too)---took a spinning class 3x/week. I think I injured myself there-------

I will ask about a cervical MRI and EMG when I go to the doctor---any other insight from ya'll would be good---I want to go into the Sport Med MD informed-----b/c it's pretty hard to get in and see him!

Laurel
Posted 1/15/2008 11:37 AM (GMT -6)
CRPS is a miserable hopeless pain which will increase and is incurable. Dr.s are mostly ignorant of pain in general and when it come to a choice of trating your pain and possibley losing there license, just guess who doesn't get treated. I know a doctor in the Chicago area who may be of help (if she has been scared off by the pain med gestapo(DEA},
MY email address is lbedwell69@verizon.net
Take it from a guy who's been dealing with chickensh-t "Doctors) for years, Pincushion1
God help us
Posted 1/15/2008 11:37 AM (GMT -6)
CRPS is a miserable hopeless pain which will increase and is incurable. Dr.s are mostly ignorant of pain in general and when it come to a choice of trating your pain and possibley losing there license, just guess who doesn't get treated. I know a doctor in the Chicago area who may be of help (if she has been scared off by the pain med gestapo(DEA},
MY email address is lbedwell69@verizon.net
Take it from a guy who's been dealing with chickensh-t "Doctors) for years, Pincushion1
God help us
Posted 1/15/2008 6:17 PM (GMT -6)
hi,  Just to let you know you aren't alone. My Dr. kept telling me that I was going to get better and now its been almost 3 years and every test known to mankind and still no answers. I have now paid privatley where I live to see the same surgeon that I was on a 36 month wait to get in and see. Funny how money talks.  My family dr has washed his hands of me.I have hit rock bottom and know the only way is up from here.  I have now gone to one of the best sports medicine hospitals in my area and am awaiting answers....if something shows up on these tests. All i can say is don't give up...we know our bodies and the pain we live with not the dr.  All the best to you

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