New Doc Advice/New Pain Clinic

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Regular Member

Date Joined Feb 2009
Total Posts : 141
   Posted 6/4/2009 3:35 PM (GMT -6)   
I asked to be and was referred to a pain clinic the last time I saw the doc. The pain clinic said I am required to see three doctors; an occupational therapist, a pain management doc and a psychologist. I see the occupational therapist on Tuesday the 9th.

I had posted something about advice for seeking a new doc a little while back but didn't get many replies. I am looking for advice about seeing if there is someone more qualified at the pain clinic that could treat my pain. I believe this doc (my current one) to be lacking if not outright dangerous.

Is there anything I should or should not do or say when at the pain clinic? Any advice on how I should approach a conversation about a new doc? Thanks for any help.

Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours

Regular Member

Date Joined May 2008
Total Posts : 177
   Posted 6/4/2009 4:10 PM (GMT -6)   
Just went over some "good advice" for new patients with my neurologist in my local clinic today (we're friends and I'm a regular at the clinic).

1) See a new doctor with a positive attitude. Don't be aggressive or defensive certainly not if you had bad experiences with other doctors (we all know about those ones).

2) Be honest and open. He/She can't help you if you keep thinsg back.

3) Anxiety often makes people forget what they wanted to say or ask. Write down, well in advance, everything you want to say and need to ask. COver each topic in detail and if necessary provide your doctor with a copy so he/she can follow your reasoning.

4) Write down a list of the meds you take and hand it over, this makes mistakes less likely.

5) If you need meds (not likely on your first appointment), make a list as well for your doctor.

6) Have a detailed medical history ready, if necessary of your relatices as well. Bring your latest test results and all those of times past that might be relevant.

7) Make sure you understand what kind of treatment your doctor proposes and make sure he/she explains the risks involved. Better to ask too many questions than miss a single crucial one.

8) Should your doctor recommend serious action be undertaken (surgery for example), and if time permits (which isn't always the case in let's say cancer patients), take the time to think things over and talk it through with your close ones.

That's it. Actually we got these points from an American medical journal we found lingering in one of the waiting rooms (we were looking for coffee) and thought it might be a got idea to translate them and hang up some copies in the hospital.
To stand and be still at the Birkenhead Drill is a mighty bullet to shew.

Regular Member

Date Joined Feb 2009
Total Posts : 141
   Posted 6/4/2009 4:24 PM (GMT -6)   
Thank you very much. This is quite helpful.

Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours

Veteran Member

Date Joined Mar 2009
Total Posts : 1158
   Posted 6/4/2009 5:50 PM (GMT -6)   
Morgoth covered it all.....
My only advice other than having your ducks in a row (medical records) is to be VERY HONEST.  Don't be one of those people (like my hubby) who try and down play your pain.  They can not help you with your pain if you don't tell them the real level its at.
Honesty will get you relief in the long run.
I wish you well

39 yr young female with,
Chronic Kidney Stones, PKD (Polycystic Kidney Disease), Chronic Kidney Failure, Severe Hypertension, Urological RSD
Also CHF (Congestive Heart Failure) and Sleep Apnea
Hopefully NO MORE........ I think I have it all

Veteran Member

Date Joined Mar 2008
Total Posts : 3089
   Posted 6/5/2009 10:46 PM (GMT -6)   
Hi Skrape,

I have one thing to add, although it kind of goes along with what Morgoth said about medical history: If you have already been on multiple medications for pain (whether they helped or not), it would be a good idea to make a list of them (and the doses & duration, if you remember) & your reaction to the drug (ie. did not help, made me to sleepy, helped a little, etc.). It's also helpful if you can write down a list of doctors/specialists that you have seen for your condition (and perhaps the contact info for doctors who you are still seeing regularly) and any other treatements that you have tried, whether they be alternative therapies, like acupuncture, or conventional therapies, such as PT, & the duration and result of those treatments. I'd physically give the doc a piece of paper containing these lists, that way they have everything in their records, in an easy-to-access place. It saves a lot of time that could be wasted by talking about trying options that you have already exhausted. I actually keep a list like this on my computer & update it every time I try something new. I've given this list to all my docs & they all find it very helpful.

Oh, and also, if you have been keeping a pain journal, I'd bring that - or at least a summary of your pain throughout the day & what, if anything aggravates it.

Best of luck,

Veteran Member

Date Joined Dec 2007
Total Posts : 1235
   Posted 6/5/2009 11:44 PM (GMT -6)   
Just like LL said  not to underestimate your pain, don't exaggerate it either. Don't claim that your pain levels are at a constant 10 or even a 10 more often than not, because the doctor is not going to believe you.  Be honest in what you can and can not do, what you hope to achieve with pain management ( not pain free- not going to happen if you have chronic pain).
Be willing to try what your PM recommends, even if you have already tried it before. He may have a different way of combining meds or suggestions that you haven't tried before. Be open to it. It might not have worked in the past, but as our pain levels fluctuate, you may find that a medication or therapy recommendation might work this time, at this point in your life. Don't discount PT or using ice or heat instead of pain meds at times or in addition to the pain meds.
Be open to suggestions of using electric stim or TENS units or other non invasive modalities in addition to the pain medications.
With the right combination of pain meds, and other treatments, you might be surprised at how some physical excercise , PT, TENs units, or other electric stim can be the right combination for you.
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.

Veteran Member

Date Joined Nov 2008
Total Posts : 1037
   Posted 6/6/2009 1:28 PM (GMT -6)   
Well, you are on the right track...Pain Dr.'s are the best at helping with CP...They understand and are more qualified as far as giving meds... I have never had to go to any other Dr.'s though...I guess I'm lucky...the thought of having to add 2 more doctors to my list seems like more then I could handle...I am already seeing a Dr. for Diabetes, Pain, therapist for my son and a Psychologist for him as well...Also having to see others at the pain clinic for procedures... Wow....too many for me.
Good luck.

 I hate Boats!!!!
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 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 5mg. 2X in the morning


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