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Regular Member

Date Joined Jul 2011
Total Posts : 101
   Posted 7/31/2011 12:45 AM (GMT -6)   
I just wanted to stop in and introduce myself.  I've been a lurker for some time now and have gained quite a bit of good info from you all relating to CP.  I've been very hesitant to consider myself a *chronic pain patient* but I guess I might as well jump in, as I finally have my first appointment with a pain management doctor on the calendar...although it's a month away.  I have been suffering with low back pain for a number of years now and have not had a diagnosis.  My family doc has been prescribing Lortabs now for about 3 years and for the most part, they have been giving me some relief.  Recently, I have had a spike in my pain with horrible sciatic pain in my right leg, sending me back to the doctor's office.  She finally ordered an xray, which revealed ddd with some bone spurs.  She told me I *just have arthritis*.  Finally, as the pain continued to progress (especially sciatica), I asked for an MRI.  My results came back showing 3 bulging/protruding discs in the lumbar area.  I have neck pain as well, but she only ordered a lumbar MRI.  She then referred me to an orthopedic surgeon, but I requested pain management instead.  So here I am, I have my first appointment next month.  I'm nervous about it for some reason...not really sure what to expect.  They told me to bring all my meds in and I will most likely have a drug screen.  I'm wondering if the pain mgmnt doc will start writing my scripts instead of my GP?  As of now, I think I am sort of *maxed out* on what my GP is willing to RX.  I'm taking Lortab 10mg three x day and I will NOT ask her for an increase, although I'm not getting much relief.  I guess my nervousness revolves around what I have read many others have posted...that you don't want to look like an addict/ seeker.  That's always on my mind.  Well, I have lots of other things to talk about, including my awful insomnia, depression, etc. but this post is getting long.  I look forward to getting to know you all better and wish everyone a pleasant and low pain day tomorrow.  ((((Hugs))))

Forum Moderator

Date Joined Feb 2003
Total Posts : 15831
   Posted 7/31/2011 2:02 AM (GMT -6)   
Hi Mysti and welcome to Healing Well's chronic pain forum. I am sorry that you have to be here but very glad that you found us. Glad that you decided to jump in and post and tell us about yourself.

Try not to stress yourself out over the appt with the PM dr, sounds to me like that is where you really need to be for care. If you have been putting up with pain this long and it sounds like you are getting progressively worse you made a very wise decision in deciding to see a PM dr. You are right, you probably have maxed out with your PCP for pain medication. They are so reluctant these days to bother with seeing someone with CP, most will say they do not have the time it takes to handle a CP patient and now there are new guidelines in place for treatment of CP patients. Besides that, PM drs are trained to treated pain and they are more up-to-date on what is being offered out there in terms of new medications out on the market and things of that nature.

Most PM drs will mail a new patient a lengthy questionaire to fill out and bring with to the appt, at least where I live they do. So, you may receive one in the mail. Be sure that the PCP sends your records to this dr before your appt, or at least gives you a copy to take to the appt. It is important that a copy of the MRI report be included in these records too. Do you know what the plan is with your PCP about your medical records, if not make a call and let them know what you need done before this appt.

I would make a list of medications you have tried in the past including OTC meds and how they worked, along with what you are currently taking and how effective they are or are not. In your case you stated that you are not getting as much relief as you really need so be sure that is listed. When speaking with the dr about your current meds not working so well, be honest and tell him they are not covering your pain. Then ask the dr what he can do to help you get better pain relief than what you currently have. By handling it that way you are not asking him for pain medication, you are letting him know you need his help and you are letting him make the decision on what to try you on. You are simply asking for his help and you will not look like a drug seeker.

Also try to be descriptive when talking about your pain, whether it a burning, a deep throbbing type of pain
or a stabbing type of pain. Don't just say I have pain in my back or my neck, that really tells him nothing.

Be prepared to sign a Contract with his office, which pretty much states he can fire you as a patient if you are non-compliant, have dirty UA's, dr shop, get pain meds from more than one dr or dr shop. Also, they state that you will obtain your pain medications from one pharmacy only. Do not be offended by having to sign a Contract either, they all pretty much do this now and even ones that didn't before are now doing it because of the new guidelines in place for PM drs. My PM dr does not believe in the Contracts, she never had her patients sign them either. But after the first of the year with some of these new guidelines out she had to ask all of her patients to sign one.

If you will look in CP101 there is a pain journal in there and you may want to run a copy of it off and start keeping a record of how your pain is affecting you daily and what makes it spike moire. Take this with you to the appt and be sure they dr looks at it.

Your appt should consist of the dr doing an exam and asking questions about your health. He should decide then if he can help you or not and most likely will either continue you on your current meds or change things up completely or maybe even add something to it. He may recommend PT or some other things to try.

Anyway, I wanted to pop on and tell you welcome aboard. Take care and keep us posted on how you are coming along.
Moderator Chronic Pain Forum

Screaming Eagle
Forum Moderator

Date Joined Sep 2009
Total Posts : 5005
   Posted 7/31/2011 7:52 AM (GMT -6)   
wink         Good Morning Mysti!
            I'm very to see one of the "Lurkers" hop on board here!...and we warmly welcome you to the "Chronic Pain Forum"!!!
              As I read some of your post, I wondered why in to world you're Dr was scripting you pain med's for three years, and had not checked out what was causing your pain. And then you had to request an MRI? Generally, Dr will do test first,... to see what is causing the pain, before scripting out med's. They will also most likley suggest PT after it is known that you have a back problem.
If that doesn't work, then they will suggest a CT scan or an MRI to get a much better picture of what they are dealing with.
    If PT does not work, then they may suggest an injection, such as an epidural. Then if that does not help, they may send you to see a surgeon.
       I will tell you this much though...that surgery should be a last resort, and even then should be approached with caution.
        Have you tried an epidural yet or PT? It may be that the PM will actually suggest this first, as many of the PM clincs do these. There are two different types of PM dr's....one will do injections only, and the other may do both injections and script pain med's.
    I hope I did not misunderstand any of your introduction....but the bottom line is...we are so glad you found us. Please check in often, and ask any questions you wish. The members will be more than happy to visit with you
         Also may I also suggest that you check out the "Chronic Pain 101" located at the top of our home page...it is chalked full of information, and I think you will find several articles of interest for you.
         Take care...and enjoy!
          SE wink

Moderator Chronic Pain Forum

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Post Edited (Screaming Eagle) : 7/31/2011 7:55:56 AM (GMT-6)

Veteran Member

Date Joined Oct 2008
Total Posts : 2024
   Posted 7/31/2011 8:56 AM (GMT -6)   


  Hi Mysti, I am so happy you joined our forum here after lurking. My name is Suzane and I too suffer

from chronic pain. I have had constant severe headaches for over eleven years. And of course, like you

say the chronic pain comes with depression, insomnia, loss of identity and loss of job for some of us.

So I really feel for you. I see you have been generously welcomed by Straydog and SE, and they

have given you tons of info. I sure hope all goes well with your appt in Aug.

Please come back and let us know how that goes. Keep posting as that is how we all help each other out.

You will love the members here. Very warm, friendly, non-judgemental, supportive, etc.

Look forward to chatting with you again. May i ask where you live? I am in Ontario, Canada.

Take care,


Veteran Member

Date Joined Jul 2009
Total Posts : 2042
   Posted 7/31/2011 9:12 AM (GMT -6)   
Hi, and welcome to Healing Well.

Over all you have gotten some really good suggestions and advice, but I would like to add some things.

As far as your medication goes and wondering what the pain doc will do, it really depends on what kind of pain doc s/he is. Some only do procedures and do not write prescriptions at all and others "do it all" including writing scripts.

One thing you should be prepared for though is for the pain doc to act like this is a totally new condition on your part and that you have not been under a doctor's care at all for it. Other than the Lortabs I do not know what else you have tried to help with the pain, but even if you have had physical therapy, tried injection therapy and all that, not to mention several non-narcotic pain meds, this pain doc is going to want to try them all again. By all means let this PMD know if what you have tried and if it helped even a little bit or not, but at the end of the day do not be totally shocked if the PMD basically gives you 2 choices, try it again or find another doctor. While not all PMD's do this or take this kind of approach this is more than a common enough theme when seeing a new doctor for pain.

Finally, if you have tried physical therapy before with no or negative results and it comes up, talk about what kind of PT your doctor has in mind. There are many different kinds of PT that can and is used and it is possible that a different kind might help.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Regular Member

Date Joined Jul 2011
Total Posts : 101
   Posted 7/31/2011 12:09 PM (GMT -6)   
turn  Thank you all for the kind words of welcome.  I'm so glad to have found a way to express my true feelings and vent when I need to.  And I also am a pretty good and non-judgemental listener myself, so I'm here to offer my shoulder as well.  @ Screaming Eagle:  Yeah, I agree that my Dr. really should have ordered some diagnostics a long time ago to see where my back pain comes from...but I can't say why she hasn't done that.  I like her and I feel comfortable with her, but she certainly isn't aggressive with her treatment and I always feel like I have to ask for a particular test or exploring a problem further.  Not a good thing on her part at all and she always seems so super busy.  I don't think she is the type to just readily write out scripts for narcotics, as it did take some time before she rx'd me what I'm taking now.  We've tried other non-narcotic meds, such as Celebrex, Mobic, Ultram...none have helped, then she started off with a small amount of hydro.  I don't have a pain contract, but she has verbally told me to be sure and use one pharmacy, etc. and she never puts refills on my scripts so I have to call her each month.  She normally refills in a timely manner though and I have never tried to refill too soon.  Here's the thing that I guess worries me about seeing a PM....since I've never had UAs at my GP doc, I tend to *self-medicate* quite often.  I mean, although I am allowed 3 pills a day, on bad pain days I will double up and *play* with the dosages.  Yes, I know.  That is so wrong.  When I do that, I find myself having to do without for a few days and often (and more often than not) coming up short at the end of the 30 day supply.  I just tough it out and have never called her early to ask for more.  Never.  But this has become a habit and I realize that with the PM doc I must follow the script to a T because I will be tested and pill counts etc.  I hope I can do this.  Any tips or suggestions that any of you have to help me comply with this, I would love to hear from you. 
No, I haven't had PT or an epidural or anything else yet, but I am hoping that's what will happen.  I am willing to try anything.  This PM doc was highly recommended to me by my brother, as he has the same back problems and gets the injections.  So I know this doc does epidural injections, etc.  but I'm not sure about writing scripts.  My brother just sees him *as needed* and not monthly, so I don't think he is getting meds from him.  That's the thing though.  I doubt my primary doc will change anything...and yet I am afraid to stop taking the hydros.  I also fear she will not renew my scripts since she knows I'm going to PM.
@ Straydog:  Yes, the PM office said they would send me a packet of info to fill out so I am expecting that.  Also, they do already have my records from my primary doc, as well as my xray and mri reports.  Actually, they said they had to review all that before they could even accept me as a patient.
Hi Suzane...nice to meet you.  I am in Texas.  This heat isn't helping matters much either, as far as my pain goes.  I just stay inside in the a/c.  Thanks for your warm welcome and I look forward to talking with you more.
@Jim...good point about the doc will probably want to have me try things again.  I will keep that in mind and try to be patient.
Again, thanks to you all for welcoming me to the group.  Hope you have a calm and low-pain day. 

Veteran Member

Date Joined Mar 2011
Total Posts : 816
   Posted 7/31/2011 2:08 PM (GMT -6)   
Hell Mysti, and welcome to cp forum, I am nini53/Kathy, I will answer to either.lol
I have had some early success with epdurils, put make sure your pm doctor does not just do injections, that they also prescribe.  You can have a doctor the only prescribes, you cannot do with a doctor who only does injections.  Well thats just a personal feeling actually.  I am sorry, I should say I would not go to a pm doctor who only does injections,  while they work somewhat, I think in my case the meds go hand and hand with the injections.
Also, some injections are only allowed like every 3-6 months.  Just go and do what you feel is best for you.  I joined this forum in March 2011, and this has been one of the greatest things that has happened to me for a long time.
Take care and hope you are feeling well, and good luck with your pm doctor.
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

Forum Moderator

Date Joined Feb 2003
Total Posts : 15831
   Posted 7/31/2011 2:35 PM (GMT -6)   
Mysti the self medicating always leads to problems and it is something that you will have to to figure out how to deal with. As you know a PM dr will not put up with it, not sure if your PCP is aware of this, if so you would have probably been cut off a long time ago. Its a bad habit to get into. But, the flip side is this, if the PM dr can come up with a good plan for you and get the pain under better control then you should not need to feel that you need to self medicate.

Injections are something that can go either way, not help, make worse or help. There are many different type of injections too besides epidurals. Not everyone has a good response and my current PM dr not believe in these procedures at all, she says its just a way to pad the bill, she says its all about money. She is not the first one to tell me this either. I have had some of these procedures from other PM drs and they did not help. The only thing that ever help was having a RF ablation on my neck, it did nothing for my low back pain. Trigger points really have helped for severe muscle spasms. I got told the same thing on my neck recently when I re-injured it, a lot of spurring and stenosis, which is all new, the disc herniations are old problems. I had some arthritis show up previously on a scan but not as much as what it there now, guess I am just getting older, like my body.

I hope the appt goes well for you with the PM dr and you can get some of this pain under better control. That makes all the difference in the world. Take care.
Moderator Chronic Pain Forum

Veteran Member

Date Joined Jan 2010
Total Posts : 3557
   Posted 7/31/2011 3:04 PM (GMT -6)   
Hi Mysti....welcome to HW....others have given great advice...and I hope that you will have a successful appt. next month with the PM..

I absolutely adore my PM...Hopefully you will get lucky and this one will be able to help you find a good combination of things to help your pain..

A good PM Dr. will want to treat your pain with many modalities and find the best one's that will help.

I use daily/weekly/monthly exercise, yoga/stretching, Physical Therapy, acupuncture, injections of cortisone when needed, counseling when needed to help cope with living with CP, opiates when needed, a muscle relaxer when needed, a sleep med at night, I eat all Organic, don't smoke, take hot baths, massage, etc..

These are just some of the things I use...There are also antidepressants that help with pain...nerve pain medications...and other types of injections as mentioned by others..

So...the key about chronic pain is to not rely on one medicine to solve the issue...as well as it's not meant to take away all our pain...Unfortunately...most of us will never get to a 0 again...I live with a 5-7 depending on my activity...and that is using all the things I wrote above..

As mentioned...if they haven't sent you the new patient packet...if they have a website like my Dr. does...where you can print all that out to fill out beforehand...so check and see...

And Straydog mentioned about the 'how' you explain your pain...Dr.s like facts and figures...so it helps to tell them what you can/can't do...and what hurts worse...and what helps...

They will want to know that you want to be part of the team as well...and yes..that means taking the medicine exactly as prescribed...I know your in pain...we all are...but minus anything like a ruptured appendix or something like this....sometimes we will have more pain on days that others...that doesn't mean we can decide to take more medicine...that's when you pull out other tools in the toolbox...like a hot bath, massage, stretching, etc. to help...because even though it hurts...we aren't going to die of the pain...(not trying to be snarky..I promise...I just mean that this too shall pass)...

Now...if your pain is getting worse over many days...then it's best to call the Dr. and ask them what to do...sometimes they will allow taking some extra medication...but it's only allowed if they ok it...as you found...when you self medicate...you may have a few hours where the pain is less...but then on the days you run out...then your pain is skyrocted...as well as going through withdrawals...

Obviously surgery is the last resort...but sometimes...it is needed to help with the symptoms and pain...I had to have all 3 of mine or risk paralysis....it wasn't meant to cure the pain...but it took away the nerve pain...and relieved the pressure on the spinal cord...they were all done within a week of MRI...

You really need to be seeing a Board Certified Orthopedic Surgeon or Neurosurgeon to be looking at the MRI and seeing if you need another..
they aren't there to just do surgery..they can recommend many treatments to help and work with your PM DR...a GP does not specialize in the spine...

It sounds like you have many things to try like PM and injections...it's just about being open to use any and every modality to help your pain...and finding the right combination of things to use every day/week/month to help you live a good life...

Again...welcome to HW...it's a wonderful group of people here!
SB and "the pup who snores loudly" 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
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