Need an opinion regarding neck injections and PM question?

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Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 1/11/2012 12:52 PM (GMT -6)   
Hello All,
 
I'm back to ask a question of my HW friends.  I have an appointment on Tuesday for the first of a series of three facet injections in my neck.  Normally I would be very happy about this, but right now my lower back (my normal pain site) is in insane pain.  Meds are barely touching it and I've been going through some pretty major stressors for the last month (at home).  I have to go in for the procedure to get my med refill (they didn't give me a refill date and told me to ask when I came in for the procedure and they would give me my prescriptions).  
 
Anyway, I am in so much pain right now that I don't feel like moving at all.  I've definitely overdone it!!!  I called the office (which many of you know is a MISTAKE with my PM) because I received something from insurance saying the last procedure on my lower back (RFA - Nov) was denied.  I was concerned about them doing another procedure with that outstanding since they normally won't.  They said they had already gotten this one pre-approved (but the insurance said they had not).  So, if I call back, they are going to be in that "she's hunting meds" attitude that is so prevalent in the office and if I don't then I guess I'm not keeping them up to date on my procedure needs. 
 
Do I go ahead and get the neck injections and my scripts despite the horrible pain of these injections or call and cancel the procedure and ask for med refill dates?  I am so afraid of either option!!!
 
Opinions are very welcome!
 
Thanks guys!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, 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, Vision Issues & much more.....

straydog
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Date Joined Feb 2003
Total Posts : 16302
   Posted 1/11/2012 2:10 PM (GMT -6)   
Hi RM, wow what a mess. Perhaps by Tuesday your pain levels will have dropped down some and you will feel more like going ahead with the injections. Because of it being who it is, I am afraid if you call and cancel you may run the risk of having everything bad you mentioned happen to you. You know this outfit better than anyone and dangling your meds in front of you has been a real tactic of that dr.

I know you really do not want to hear this, but this is another reason to get away from there and find a decent dr. Yes it is a real pain in the rear to do this but even having to travel a little, a good dr is worth it, rather than go on this roller coaster ride you do. I could not live like that wondering if I can get my meds this month or not. But, its all in how much grief a person is willing to put up with. I have no tolerance for that, I deal with enough. I know the PA was great but she is not the one that really calls all the shots there.

I hope all of this works out without too much drama its just not good. Take care.
Moderator Chronic Pain Forum

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 1/11/2012 2:25 PM (GMT -6)   
Thank you do much for the reality check, Straydog. I was waiting in line to pick up my child and reached to call. I decided to check the board first and saw your response. You made up my mind NOT to call. I so wish I had better PM care, but I'm a chicken. I'm terrified of going through the new dr changes. I'm afraid it has to be the last result for lack of good PM dr's in the 60 mile driving range. Thank you!!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, 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, Vision Issues & much more.....

straydog
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Date Joined Feb 2003
Total Posts : 16302
   Posted 1/12/2012 1:33 AM (GMT -6)   
RM, I drive 60 miles round trip to see my gastroenterologist. I would drive 100 miles if I had to, thats how good he is. I have been his patient for 7 years. I live in a very large city with tons of gastros and have been the patient of 4 before before becoming his patient. The other drs wanted to treat my crohns disease old school way which is loading you up on Prednisone. If I could have tolerated it and not end up in congestive heart failure by day 3, things may have been different. But, that is what happens to me with oral or IV steroids. I have actually been admitted to the hospital thru ER because of bad flare when my gi was out of town and been given IV Prednisone and go into CHF after telling the drs I cannot tolerate it. I had ne dr tell me well I have had you on a low dose for three days and you should not had this happen, hello. Oh, he was scurrying around like a rat after that ordeal. The drs would not listen to what I had told them, so I have no trust in anyone but my current gi. He says he would never consider giving me a steroid and in 7 years he has never has. Even when hospitalized and very ill there are other meds that can be used to get a flare under control.

Let us know what happens. Take care.
Moderator Chronic Pain Forum

White Beard
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Date Joined Feb 2009
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   Posted 1/12/2012 11:18 PM (GMT -6)   
RM Straydog has given you some excellent advice! I know it is a hassle to change doctors, and especially PM Docs and driving a long ways is alway difficult. But it does sound like you need to do something, in the mean time I agree with going ahead and getting the injections. It will at least show your doctor you are willing to try what ever he prescribes to ease your pain and not just wanting pain meds. Some doctors are really funny about that. And it sounds like your doctor is definitely like that! You know I live about 35 miles one way from all my doctors, heck even when I go and do most of my shopping it is that 35 mile drive. Not good in snowy cold weather like we are having here today. You just do what you have to do, thats all. But if your not happy with your doctor, remember even with insurance, your one way or the other paying for that doctors service, the doctor works for you, you can hire and fire him. It is often easy to get intimidated by ones doctor, and they know that too! But you do have rights, it all depends if you want to use them. Only you can deside that and if it is right for you!

I do wish you well and hope things work out for you!

White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 1/13/2012 6:22 PM (GMT -6)   
I think you guys are the BEST! You always give wonderful and honest advice and I appreciate it very much.

I typed long (as usual) respons to Straydog a day or so ago and then lost the whole thing. Basically, I do already travel quite a distance to all my Dr's and am very willing to go as far as 60-70 miles for my endocrinologist, but the others are all about 20-25 miles and are within about a mile or two of each other.

I KNOW you guys are right and I am inimidated on this. That's for sure! I'm scared of burning a bridge and finding the devil I know was better than the devil I don't know. I'm sure you know what I mean. I also have such a difficult time driving in traffic and that would be the basic problem with going to the larger city (60-70 miles) with lots of heavy traffic. Like so many here, I can't move my body as well as I should to turn and the multiple lanes give me a scary driving situation. I have my husband (usually) for the procedures because I have to have a driver, but there are problems there too and they are too much to go in to here on the board. I'm sure you understand.

I guess it's just that I am so afraid of messing things up worse. I know what I "should" do, but I haven't made the leap there. As I mentioned, most of my Dr's (including PM, PCP, Gastro, Psych) are very close to each other and therefore communicate often. I can certainly get the new referral from the PCP, but she's not the greatest in deciding which Dr would be the best. There are so very few here!! Many don't prescribe, many don't do procedures, and many over or under prescribe as a known fact. All of that makes it worse!

I did not call and will have the procedure done. I'm a chicken and don't want to, but I will. I honestly wish they could do the lower back again NOW instead of the neck. I need it so badly.

Anyway, I appreciate the help you guys give and and how honestly concerned you are about my healthcare. It is so rare to find such honest and caring people and I am blessed to have found you! I would give the same advice to anyone else asking my same question, but I have a hard time following my own advice :)

Have a wonderful weekend!!! Wish me luck on Tuesday!!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, 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, Vision Issues & much more.....

straydog
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Date Joined Feb 2003
Total Posts : 16302
   Posted 1/13/2012 6:42 PM (GMT -6)   
RM I wish you the best come Tuesday. I still think you are selling yourself short on the dr situation taking into acct the things you have written about. If nothing else I would get on the internet and pull up my health insurance and see who is available on my plan and just make some phone calls. Ask the receptionist questions about medications, procedures, how long the dr has been in practice that sort of thing. You can learn alot by just making some calls, if the receptionist is nasty then big X goes by that name, lol. If you cannot find anyone on your plan that you think you may not want to consult with then you will know perhaps what you have is all you will get. But I would at least do a little checking around.

At least by doing this much if you end up leaving his practice later on down the road for whatever reason, you may have a name or two in the back of your mind that you could perhaps call in the future.

I guess I am just hard headed when it comes to drs, and no, I will not let one intimidate me. Believe me, I have left drs offices because of that very reason. I have met some great ones and then I have met some that I would not take one of my dogs to.

Take care and let us know how you do Tuesday.
Moderator Chronic Pain Forum

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 1/14/2012 5:09 AM (GMT -6)   
Thank you Straydog. I have done that before and have even called around to most of the offices I found, but that was quite a while ago (after the first office insanity) and I was not in a good place to be making appointments with a new Dr). Perhaps this would be a perfect time, since there is nothing immediately pressing and I can continue with the injections and meds from my current Dr while looking. I do hate to leave on a really horrible note, since that almost always causes nasty notations in your medical file and travels with you to the new Dr.

I will be doing the search today! Thanks for suggesting it!!

Have a great weekend!!!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, 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, Vision Issues & much more.....
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