First of all i know how intimidating this whole process can be; and i also want to say that first pain clinic you went to is completely wrong, and is very discriminating... i hav been in chronic pain since i was 16, so believe me, ive dealt with the age issue, and that everyone seems to think that especially if your a teenager you cant be anything but a druggie....
Anyway, i think you have found a really good pain clinic, it really sounds like it.... iknow all the urine tests and seeing this person and that person can be very tiring, but really, that happens with almost all pain clinics; and u have been through the worst of it! now that you have had your consulting appts and done urine tests, they know u r not a druggie, not looking to get high, have a legit reason, and are not doctor shopping... and all this is now documented, so u will be able to use this to ur advantage in the future if you ever run into any problems,which i pray you wont...
It also sounds like you found a very good doctor, and honestly the plan you and she discussed sounds exactly like what i started with and what a lot of cp people are on... and it is a good plan, it gives you a baseline control but also you have something for when the pain acts up throughout the day. Yes, it might be oxycontin for the extended, and i was on that for prob a year or so and also oxycodone normally works best with oxycontin for breakthrough pain, which i was also on...she probably will start with a lower dose for 2 reasons, 1- cuz no one wants to be on more pain meds than they have to, and 2- it is generally a good idea to start at a lower dose and gently taper up to a higher dose if needed. If your concerned that the starting dose wont be enough to contol your pain, just talk to her about it, and ask her what you do and where you guys go from there; most likely she'll have u call in a week or two to see if the meds are working or to what extent they are working. The most important thing is to be honest with ur doc, i know it sounds cheesy but really it will get you the best treatment possible and she will appreciate ur honesty!
As for the addiction and dependance thing, i would also just discuss that with ur pain doc, and i would tell her u are concerned about becomeing dependant on the pain meds; she will appreciate ur concern, my pain doc really did... and also no one can really tell you if or when u will or can become dependant on them, because everyone reacts differently to each med... but if you are on opioid pain meds for an extended period of time, most likely you will have some dependancey, but this should not scare you, because if you need or want to get off these meds, as long as you taper them, which your doc will help you do, you will be fine, and experiance very few withdrawl symptoms if any. As for addiction, i worry about that too, but honestly people who take pain meds because they have actual pain, are the people who are least likly to become addicts, and that includes yourself! also, im even more convinced that you wont have any addiction problems for a number of reasons : you have real pain, you are concerned about becoming addicted, and uve seen firsthand what addiction can do to a person thru ur brother (which im also sorry about) and because of all this you wont take a pill if your not in pain, and i dont kno what pain meds uve tried before, but if uve ever got lik a head rush or anything because of them- i cannot stand that, and thats considered the "high" and people in pain do not want to be on these meds, but it is what helps and often the only thing that does; addicts do not need the pills, do not have pain every day of their lives, and will not stop taking the pills no matter how bad things in their life gets. People in pain, which includes you are not like that; these meds will help control ur pain, which will help u get back to as normal a life as possible, and when you think about that, the benefits far outweigh the risks!
I think ive gone on long enough, sorry if its too long.... but i wanted to let you know that ur not alone and that u hav none of the risks for addiction! Im sorry uve had to go thru all this stuff, but honestly ur on the way to getting relief and ur thru the red tape so now things will be getting better, and u will be getting some real "treatment," some real management, and that other people do share ur feelings of intimidation and fear, but it is okay, and whenever u hav doubts or worries, u can always post here, everybody uderstands life with cp, and understands the hassels of cp, and everyone here is very compasionate and give some great advice! Hope this helps somewhat and again sorry that u have had such a hassel with all the hoops to jump through, but your on ur way, and ur almost there, and u are doing the exactly right thing by going to a pain clinic and a pain specialist! Hope u get some real relief soon and have much less pain!
"In God's hands, in God's time."
"The scourge of life, and death's extreme disgrace, the smoke of hell, that monster called Pain."