Discouraging appointment

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Heather Lynn
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Date Joined May 2011
Total Posts : 283
   Posted 10/24/2011 3:36 PM (GMT -6)   
I had an appointment with the physiatrist today. He is sort of a PM - does injections and can prescribe pain meds but prefers not to.

He did a thorough physical exam. Seemed very concerned I have groin pain and pain in my left lower abdomen and that it may be a hip problem. Seemed less concerned with my main complaint of worsening back pain. I showed him the lab work my PCP did and told him I thought it was time for imaging. He ordered labs and x-rays but says he expects them to come back normal. I am starting physical therapy on November 2nd, and he seems to hope that is going to "help".

I pushed him a bit more about the pain, and he asked me if I'd tried Neurontin, Lyrica, or Cymbalta. I told him I'm on Cymbalta 90mg and Neurontin made me put on 20 lbs in 2 months. At that point he didn't seem to have anything else to do for me. Mentioned we could re-inject my SI joint, but didn't ask me if I wanted to do it, just that it was a possibility but he didn't seem in favor of it. He told me to go to PT and he'd see me in 2 to 3 months.

It wasn't until I left that I realized he basically had said his plan is to do nothing. I'm just very discouraged. I've already done two months of physical therapy that failed to resolve my symptoms - that is when we decided to do the injection. I feel like maybe I should have pushed for another injection, but I'm not sure. I have breakthrough meds, but I'm worried no one will renew my prescription when I run out because my PCP is not managing my back pain and the physiatrist doesn't want to prescribe.

My wife wants me to get another opinion, but we are moving in two months so I feel like I'll just get new doctors there. But I am kind of out of luck, unless PT miraculously helps even though it hasn't yet.
Fibromyalgia, low back pain/SI joint dysfunction, anxiety, obstructive sleep apnea, endometriosis, asthma

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Date Joined Oct 2010
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   Posted 10/24/2011 3:54 PM (GMT -6)   

I'm sorry you had a discouraging appointment. Doctors are really hit or miss.

Regarding the PT, again, hit or miss. I've been to about a dozen. One is extremely good and I've stuck with him. I've seen another that is o.k., but the rest are useless. The one really good one used to be a professor of PT but has returned to primarily clinical work.

If you live near a university with a PT degree (or when you move), look into whether any also see patients.

One thing that the PT did was work on the alignment of my SI. If you haven't had a PT check the alignment yet, that is something to address.

I had a few SI injections back in 2005. The first was just in the doctor's office and it did nothing. The second was under a fluoroscope and it made a huge difference. In fact, it made more of a difference than any other procedure for pain I've ever had. My SI pain was due to the ligaments getting torn (from a car accident). But if you haven't had one done under a fluoroscope, then do try that.

Also, once you move, try to find a PM specialist. If you don't know anyone in that new area, there are various sites with doctor reviews (Ratemds.com for example).

Monty's Mom
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Date Joined Aug 2010
Total Posts : 664
   Posted 10/24/2011 5:48 PM (GMT -6)   

I am sorry that your doctor was not more encouraging, or had a ready answer for your pain. I have been through three PM docs, two that only do injections and my last, who does trigger point injections in office and prescribes meds. It took me 2 years to find him, and my PCP's office staff worked hard to find one for me that would prescribe for my particular issues. I hope you find a new one when you move, one that is able to provide you with what you need. Good ones are out there.

The doctor I have now was chilly at first, very vague, mentioning the injections and then acting like they weren't a ready option. From how you described your visit, I could picture the doc I see now! My 3rd visit, I just asked him why he mentions the injections but never asks what I want. His response was that he was giving me options for treatment, and I should tell him which ones I want to try when I want to try them. He was aware that most doctor's approach is to tell you what you need and that is it, just do as you are told. His approach is to give me options and let me choose. If yours is anything like mine, maybe he is waiting for you to say, give me injections! I want to try them.

I too have pain in the groin and hip area with endo and adhesions. My doc reminds me all the time to do stretches to improve the muscle, and we do trigger point injections into them and the SI joints. I don't know if this is an option, but I hope you get relief soon.


Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 10/24/2011 6:24 PM (GMT -6)   
Doesn't sound like that particular doctor did you a lot of good.

In my prostate cancer battle, I spent 5 months in regular physical therapy (which did nothing for me), and having been going for 6 months in a highly rated Oncology Rehab center in my area. I go twice a week, and so far, as far as my chronic pain goes, the sessions make things worse, takes me days to get over them. My oncologist is suggesting that perhaps its time to stop going to physical therapy altogether at this point. Haven't made a final decision yet, as I am afraid if I dont keep going, then things might progress worse for me.

Good luck in your situation.

Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

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Date Joined Mar 2011
Total Posts : 816
   Posted 10/24/2011 6:51 PM (GMT -6)   
Hi Heatherlynn, I think you should get another opinion, I dont know if you can wait until you move or not.  But the pm doc you are seeing now does not seem to have your best interest.  I dont like to hear of doctor who wont prescribe, that makes me nervous right away, there is no reason for not prescribing when you have documentation of your disabilities.
Have you had an mri, xray wont show much, but mri's will, thats probably what you need to get.  Well good luck to you and I hope you find a better pm doctor when you move, this one is not doing you much good, worring about getting your scripts filled is very stressfull and you should not have to go thru that.
Take care and good luck,
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

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Date Joined Jun 2009
Total Posts : 974
   Posted 10/25/2011 5:53 AM (GMT -6)   
I know you have alot of female issues but before my fusion surgery at L/4-5 I was having alot of pain in my groin area and down the front of my leg.  Most people talk about sciatica where pain goes down the back of the leg but with mine the femoral nerve was being pinched causing hip & groin pain.  After you get settled in your new place I'd be looking for a good PM doctor.  Looks like you could use an MRI of your lumbar spine but the xray may show if the disc space between the vertebra is narrowed which would probably mean a bulging or herniated disc.
Keep us updated on what the xray shows.

Heather Lynn
Regular Member

Date Joined May 2011
Total Posts : 283
   Posted 10/26/2011 9:53 AM (GMT -6)   
Thank you everyone for your support. Mindy, I do wonder if he's sort of like your doctor - mentions things and then waits for me to say "yes, let's do that!". That is sort of how I ended up getting the injections for hip bursitis.

Right now I am torn between getting a second opinion and going back to my PCP and seeing what she says. I really need better pain control - the pain is affecting my work, never mind my quality of life - and I'm most likely to get that from my PCP. The person I would seek a second opinion from is also a colleague of mine. I am hesitating because even though I know he's the best, I am very hesitant sharing medical information with someone I work with.

Heather Lynn
Regular Member

Date Joined May 2011
Total Posts : 283
   Posted 10/26/2011 3:27 PM (GMT -6)   
Well my body has made part of this decision for me. I'm at the urgent care section of my PCP's office with 8/10 pain that is making me dizzy and nauseous. So at the very least I'm having a conversation about pain control with a doctor in my PCP's practice this afternoon.
Fibromyalgia, low back pain/SI joint dysfunction, anxiety, obstructive sleep apnea, endometriosis, asthma

Veteran Member

Date Joined Apr 2010
Total Posts : 2265
   Posted 10/26/2011 7:08 PM (GMT -6)   
Hi Heather I'm so sorry that you're having such bad pain. How did it go at the urgent care? I hope they were able to help you to feel better. Take care.

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

Heather Lynn
Regular Member

Date Joined May 2011
Total Posts : 283
   Posted 10/26/2011 8:57 PM (GMT -6)   
Thanks Loretta. The doc prescribed me Vicoden and Lidoderm patches. The Vicoden has taken the edge off the pain, and I came home and have been resting in the recliner. I will try the Lidoderm tomorrow.

He also said I should consider having another SI joint injection, since that is what has helped the most. Going to discuss this all with the physical therapist next week, I really trust her opinion.
Fibromyalgia, low back pain/SI joint dysfunction, anxiety, obstructive sleep apnea, endometriosis, asthma

Regular Member

Date Joined Oct 2011
Total Posts : 24
   Posted 10/26/2011 8:59 PM (GMT -6)   
Hi Heather,

Working at a cancer center, I work with alot of other MDs from almost every background imaginable. A couple of them have became good friends over time, even though we started out as colleagues. While I too was hesitant to share my medical info with others, I have found they're input and advice invaluable. If your colleague is someone you can trust, then go for it....it'll likely be the most honest opinion you'll get!
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