Update on PM apt today

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Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 8/22/2011 3:52 PM (GMT -6)   
Hello All,
 
I just wanted to give you guys an update on the PM appt that I was dreading so much.  I went in (w/hubby) and saw the PM Dr....no UDS (that was a real surprise).  He looked over my file then acted perfectly fine...like he had never said anything about "not chasing the pain with meds" that the nurse had told me.
 
So I gave him the run-down of what had been going on and he did an exam (boy has it been a long time since he did anything like that).  He believes the horrible pain I am going through is not a result of all of the bulges everywhere, but a direct response to the problems with the L5-S1 that keep showing up as a bulging disc (despite the fusion).  He was very happy that I was going to see the Neurosurgeon next Monday and agreed to do some RFA's on Sept 20th.  He said he felt the muscles and joints were causing the pain and that treating the facet joints (w/RFA) would do a great deal toward giving me relief....(it really does very well for me).
 
I asked him to discontinue the Dilaudid because it just doesn't do any good and I don't want to take meds that don't help and he responded that he was very glad I had requested that and agreed completely.  I then asked for an increase in the Oxy IR, which he did do (without making me wait almost a month to fill it...like usual).  He said we would do the increase for now, but he wanted to see what the neuro said and hopefully get his "blessing" on what we are doing.  He did express, however, that he didn't think he would get it because he had worked with that surgeon before.  After the RFA at the end of September, he wants to reduce the Oxy.  I'm sincerely hoping he will not do that, but I didn't want to argue the point right now.  If he brings it up when I need the refill, then I will have to deal with it.  I soooooo hope that he doesn't because that and Ultracet are the only two pain meds I am on now and I will be in a real mess if he does. 
 
He did discuss the Ultracet too and said he believed the relief I get from the Ultracet is actually from the Tylonal it contains, rather than the Tramadol.  I'm not a believer in that part.  I've been on Ultracet for close to 10 years and I don't want to stop taking the only thing that helps my fibro!!
 
So that is the good and bad of it all for today.  I didn't get much "real" information about the MRI results, but I did get what I asked for in a way.   I just hope it was a good decision.  Either way, I have a ton of pain meds that I did not need at the time they were given so I have just put them in a great safe and will keep them for emergencies :)
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

momtofourangels
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Date Joined Apr 2010
Total Posts : 2261
   Posted 8/22/2011 9:33 PM (GMT -6)   
Hi RetiredMom I'm glad that your appointment went pretty well. It's over a month till the procedure. I bet you wish it was sooner since it helps you. Do you think the increase in the Oxycontin will help your pain? I sure hope so.

If you think the ultram in the ultracet is helping your pain, I wonder why your doctor didn't switch you to ultram instead. That would save your liver from all the Tylenol.

How are you doing? I hope you're having a low pain night. Love ya my friend

hugs
Loretta
Dx: osteoarthritis, bursitis in left hip, Osteoarthrits in right hip, compression fracture in thoracic spine due to falling on frozen ground March 2001 , ddd, spinal stenosis, bone spurs, osteoarthritis in spine, osteoarthritis in both knees
Meds: Fentanyl patch, oxycodone, otc: BenGay, Tylenol Arthritis on occasion

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 8/23/2011 4:23 AM (GMT -6)   
Thank you everyone for your concern and imput.

I must have had medicine head when I was typing....about the Ultram/Ultracet. It's the combination of the meds that helps me the most. I have already tried both separately. I've been on it so many years.

I honestly appreciate all of the concern about the tylonol, but I do have it monitored quite closely. I have the liver function tests done several times a year (mostly due to other conditions), but it takes care of the Ultracet too.

I'm just happy to get the RFA session(s) set up:)
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

tmjpain
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Date Joined Oct 2008
Total Posts : 2024
   Posted 8/23/2011 8:28 AM (GMT -6)   
Glad you are happy with your appt you just had RM. I sure hope you get some relief soon.
I hope you have a nice day today.

Suzane

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 8/23/2011 9:27 AM (GMT -6)   
 
    Hello retiredmom!
 
       Well, it sounds like you both have a short term plan, and I'm hoping the injection's will help. I suppose he will want to reduce you're med's to see if the injection is working or not, but he sounds just a little to eager to reduce your med's.
 
      The big picture is to get you some better quality of life...something we all could use, and it would be nice to do it without taking med's to get it done. I think I hate med's more than anyone....but I know that not true, as most all of us would love to be off of them.
 
   To me, it seems to be the lesser of the two evils, and I'm in no hurry for surgery again. shocked   That was rough for me!
 
       Take care, and we look forward to your updates, and hopefully they will be good reports.
 
   Take care,
   SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 8/23/2011 10:29 AM (GMT -6)   
Thanks guys!

I'm with you about the PM being a little too eager to reduce meds SE. I wanted to take it back to just two kinds (as long as I can) but I don't want to play with what is working. If we reduce too much, I'm going to end up in a pain cycle that will make me end up in the hospital. That is always a nightmare and I don't want to do that. I hope he will leave that option up to me when the time comes. I can only keep myself calm and not think of that possibiltiy.

My next step is the Neuro apt on Monday. I don't think he is going to want to do anything, but he may want to go in and "fix" that L5-S1. I KNOW how rough surgery was for you and it was equally HORRIBLE for me! I don't want surgery unless there is NO other option. I know people who say they have had 6-9 back surgeries and I can only think WHY? One was plenty for me. I know there was no other choice at the time and that it was an emergency, but quality of life is something I'm not willing to give up by adding surgeries that may leave me worse off than I alredy am. Pain Meds are a necessity that I am prepared to live with. I just don't want to have to fight for every refill. I don't abuse them or take anything extra and I am probably the most compliant patient they have ever had.


Take care and have a great day!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 8/23/2011 10:52 AM (GMT -6)   
 
      I think you hit the nail right on the head retired mom....and yes you need to stay focused on the positive for now.
 
         You take care, the best of luck!
 
 SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16295
   Posted 8/23/2011 7:48 PM (GMT -6)   
Hi RM, wow, I really do not know what to think of your PM dr. I have never seen one so eager to decrease a patients medication as your dr is. I mean yes, in the grand scheme of things you would want them reduced if the patient does not need the dosage, however, that has not been your situation at all. That is what is so perplexing.

My fear is you have the RF's done and get a little decrease in pain, is he going to use that little bit of a decrease against you and drop your meds back? That hardly sounds fair. I would be very careful on how I word things after having the RF's done if I were you. I can see the writing on the wall already.

Good luck with the appt with the surgeon. It is going to be interesting what he has to say about L5/S1 and I am betting surgery will be an option because you do have a lot of problems per the MRI. Lets see if he agrees with what has been read by the radiologist.

Keep us posted.
Moderator Chronic Pain Forum

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 8/24/2011 6:50 AM (GMT -6)   
Thanks Guys! This PM is all over the place with his med issues. Sometimes he's wanting me to add meds and play with the meds from my psych (anxiety/depression) and of course the psych says no way (he's great by the way) then he (PM) is saying we can go up on this as much as we need to...you need to have a life (in a good way) then he saying decrease, decrease, decrease. I wonder sometimes what is going on. I wouldn't mind changing to a new one and I did check, but they did say I needed a referral from HIM.....hugh? Ok, so that was strange. I guess there are so many out there wanting meds that they play that game. I would honestly like one a little closer with a more open mind.

I'm also interested in what the Neuro says. I find it interesting that the PM doesn't think the neuro will agree with the treatment he is proposing. I just wonder...but Monday isn't that far away and my hubby is going with me to hear everything (and perhaps chime in) if I need him.
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 8/24/2011 8:42 AM (GMT -6)   
 
     Mother!...I have never heard of such a thing as to you needing a referral from a PM! How in the world did you get the current one?....who refered him? It would be reasonable,... I would think to get one from your PCD maybe. Can you confirm that?...is this what your Ins company said? WOW!...I'm as stunned as you are on that! shocked
 
      I think you should maybe consider waiting, and see how things turn out, but think you are doing the right thing in getting all of your ducks lined up just in case. It's obvouis you are in pain, and more than you want to be, or should be for that matter! I have been there too!...and its a worry to say the least!
 
     Keep plugging away at it, until you get the answers and or treatment you deserve,... for at least a better quality of life. We all have our fingers crossed for you! wink  
 
      We appreciate your updates, so keep them comming OK? wink       
 
          Good luck to you dear!
 
    SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

Post Edited (Screaming Eagle) : 8/24/2011 10:47:50 AM (GMT-6)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16295
   Posted 8/24/2011 9:06 AM (GMT -6)   
RM, no I have never heard of the current PM dr being the one to make a referral to a new one, that is something that can be done by your PCP or even the neurosurgeon. I would not let that one just sit and be the determining factor on not changing PM drs either. Bottom line PM drs want a referral and it does not matter who makes it as long as it is a dr. Yes, they will want a copy of the current PM drs records.

I have always thought this guy was a little off the mark the way he has done you with medication. Like you say, he is every where with it and you are the one to pay the price for it.

Take care.
Moderator Chronic Pain Forum

Post Edited (straydog) : 8/24/2011 1:34:31 PM (GMT-6)


Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 8/24/2011 10:17 AM (GMT -6)   
You guys are the BEST! I'll keep you up to date when I have more data. Like I said, the Neuro is on Monday and the next PM apt is on 10-20, so who knows what will happen by then. I know I won't be calling them unless the is an absolute EMERGENCY. :)
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....
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