Should I see a pain management doctor?

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mattolsen
Regular Member


Date Joined Jan 2012
Total Posts : 24
   Posted 3/30/2012 6:03 PM (GMT -6)   
So I'm 31 and have been going through one of the toughest times in my life so far. I've been suffering from body wide pain that's affected my schoolwork and my friendships. Luckily, I have my girlfriend who has been my saving grace so far.

Anyways, so I had been going through different doctors trying to find out what's wrong for way too long. Recently, I got fed up with my GP's lack of empathy for my situation and found a new one that's a family friend. Luckily he cared enough to take an interest in my concerns. I very quickly found out that I have some sort of autoimmune condition. I don't know what yet, as I haven't seen a rheumatologist yet. Although, my Rheumatoid factor was high, among other flags he found. Now if this was it I'd be fine but unfortunately it's not.

So, this new GP put me on prednisone and hydrocodone until I can finish my semester, as I'm a full time college student. All was well at first and for the first time in almost a year I felt like my old self again. about 2-3 weeks goes by and I'm having this horrible neck pain again. I can't sleep through more than a few hours at a time. I forgot to mention I also had cracked my tooth a month or so ago and couldn't afford to get to the dentist with all the other medical bills I have. My GP is outta town and the Prednisone is doing its job but the hydrocodone isn't so much anymore. I'd prefer a longer acting pain killer as I don't like the ups and downs of the short acting one but my GP said to keep on this for now. So my wisdom tooth is impacted and pushing against my back molar which cracked as a result. I saw the dentist today and he said "wow, that doesn't look good", and told me that he doesn't even know the right course of action and that I'll need to see an Endodontist to do the surgery to remove my wisdom teeth. He said that with the cracked tooth as bad as it is, and 4 wisdom teeth in, I'll have to plan with my Endo.

So my question is..... Since I'm more than halfway through the semester, and my professors are being accommodating, I want to try and make it through, otherwise my financial aid will get messed up. I have been thinking of seeing a pain management doctor until I have the time and the money to have the dental surgery. I don't want to keep asking my GP for pain meds but I can't even see straight some a lot of the time because of the pain, nor sleep through the night. When I felt good initially on the meds I was good but it slipped quickly. Do I see the pain doctor or not? Alternatives? Suggestions? I'm all ears but lean towards trying to control the pain and finish the semester. Thanks in advance for any suggestions.

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1235
   Posted 3/30/2012 6:32 PM (GMT -6)   
I don't see where a pain management doctor is equipped to assist you with dental pain . That should come from either an endodontist or your regular dentist.
As to whether or not long acting meds are for your condition or not..that can only be determined by seeing a rheumotologist and your primary care doctor.
I have a daughter in college as well so I do understand your concerns about financial aid, but a pain management doctor is not going to treat dental pain, since that is not within the scope of their practice.
See the rheumotologist to rule out what is causing your physical pain and they can make the referral to pain management for the autoimmune condition if you need one and see the endo to start coming up with a treatment plan to help get your oral pain under control.
That's the only way to handle both problems.
Good luck
Sandi
Motorcycle accident 1992, Back problems from 92 to 2005. August 2005- early 2006- Chiropractor care
March 2006- consult with surgeon -PLIF/TLIF L4-5, spondylolysthesis, canal and foraminal stenosis, multiple herniations
Post Op Cauda Equina Syndrome
Revision August 2007- salvage op
March 2011- 2nd onset of Cauda Equina Syndrome
Needs surgery to prevent paralysis

Blessedx8
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Date Joined Aug 2008
Total Posts : 3193
   Posted 3/30/2012 6:39 PM (GMT -6)   
Mattolsen,

Hey... good to hear from you. I think I responded to you the first time you posted. I'm sorry for all you are going through - I really am. I am glad that you've got a supportive girlfriend.

I understand your situation - in that you want to make it through this semester w/ school - which makes complete sense.... My first thought is to say "yes", definitely see a PM. While that's still my advice.... I just want to throw in the fact that sometimes it does take awhile to find a good pain management doctor.

So... I still think this is the direction you should head in (seeing a PM doc).... but, in the interim (to get the appointment, etc)... will the new GP possibly prescribe something stronger to buy you some time? Have you explained that you are in school and all you are trying to deal w/ along w/ the pain?

Even if the GP won't prescribe you a long-acting med - there are stronger, short-acting meds.

...Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 3/30/2012 6:41 PM (GMT -6)   
On my last post, I was referring to treating the neck pain... not the dental pain. As Sandi said, the endo is the one for that....

:) --Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5029
   Posted 3/30/2012 8:23 PM (GMT -6)   
Matt, don't you have some sort of insurance? Most colleges require it, either from family or the plan they offer. I'm sorry you are in so much pain and not getting treatment because of the cost.

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 3/30/2012 9:56 PM (GMT -6)   
I would see a rhuematologist. Let him/her prescribe pain medications. My rhuemy is well versed in pain management and quite willing to write scripts for her patients.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 3/31/2012 11:01 AM (GMT -6)   
Hi Matt,

As others have suggested, work with your GP and rhuemologist first. It may be too soon for a PM. Also, most PM's will require that you take a time-release opioid as part of your treatment. That can cost a lot. If you don't have prescription benefits, we're talking $200+ per month for many of them. Moreover, it may be a bad way to start a relationship with a PM if you go in there with undiagnosed rhuemtological issues and dental pain. That's not going to look good at all, especially given your age.

I generally wouldn't recommend credit card debt, but if you have no other options (parents, etc.), maybe take care of your dental needs on a credit card. Depending upon your credit rating, you might be able to find a 0% interest for the first year, or something fairly low. Google "credit card offers" and see what is out there.

Another option to consider is a dental school. I realize that is scary, but you might want to look into it. They can treat patients at far lower costs or even free of charge in some cases. Perhaps also coordinate between one and a professional, to try to balance costs.

Acute dental pain can be overwhelming, but it is fortunately one of the causes of pain that can be most successful resolved. Try to get that out of the way.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

mattolsen
Regular Member


Date Joined Jan 2012
Total Posts : 24
   Posted 3/31/2012 1:08 PM (GMT -6)   
First off, thanks so much to all of you who care enough to take time out of your day to give me advice.
So, I've got health insurance just not dental. And to answer the questions above...... yes my GP will likely prescribe anything he can to help me as he's a family friend and knows that I'm not a drug addict. Which I must mention, I'm sick of being treated like some sort of drug addict. It's sad to me to think that at least 3/5 doctors I've seen so far have been more concerned with the possibility of abusing these drugs than they are in my well being. I can see it in their eyes when I even mention that I need something for the pain. And being that I've already been prescribed 10mg/325 norco that I take 2 at a time it was funny to me that the dentist I just saw prescribed me 7.5/750 . I mean isn't it the tylenol that is the dangerous aspect of that drug?

Sorry to get off topic. So, in response to Sandi..... I'm under the assumption that a pain management doctor is trained to treat "pain" in general. Or am I misinformed? I brought up the idea of a pain management doctor because I've read that there is pressure on doctors when prescribing pain killers and being that my GP is a family friend, I don't want to think I could get him in any trouble for prescribing me painkillers for dental pain. I just figured that's the pain management doctors main purpose as a practice, to assist patients in legitimate pain. And I feel for you daughter, as I'm sure you do/did, but trust me when I tell you that you really don't understand. I don't mean that in a mean way. I'm just saying that you'd need to know more about me and my life to understand how hard it is to throw away an entire semester of struggle without looking into other options first. Not that it matters, but I'm a biology major chem minor and it's not like taking a communications class. It's a huge amount of work to just walk away from. If school wasn't so important to me I would simply just get the surgery done and move on. But I plan on seeing a rheum but the dental stuff has to go first, as it has the highest probability for complications. Plus, the prednisone that I'm on has made a big difference in how I feel in regards to those symptoms. And for all I know the high rheumatoid factor and other things that are indicating I may have an autoimmune disease may actually be reflecting complications from the dental stuff.

If I hadn't spent a ton of money already trying to find out what's going on to get no relief until now I'd be gung ho about going to every doctor I can. However, if I could explain the extent that my life has been affected by this you may understand why I'm just looking to feel like a normal person again, even just for a while. As it sucks to gradually work up to the pain I'm in today, have a temporary bit of relief to realize how bad it actually is just to have to suffer again is crap. I'm refusing to suffer anymore because it affects my girlfriend who I love more than anything in the world. It hurts more to think I've caused her any grief bc of my pain than anything else.

Thanks again, and gotta go bc I can't look at a screen any longer.

rjbeck
Regular Member


Date Joined Feb 2008
Total Posts : 257
   Posted 4/1/2012 2:52 AM (GMT -6)   
I am sorry that you are suffering. But what amazes me is how fast doctors are to prescribe prednisone the miracle drug.(HA) When I was in the medical field I Noticed that so many doctors put patients on prednisone for almost every type of ailment. And not telling the patient the horrors that this drug can cause.. Prednisone ruined my life.Just make sure the doctors you see don't keep putting you on prednisone since it works very well with an autoimmune disease because long term use of this drug will hurt you bad.. They need to find out what is wrong and not cover it up with a drug.Feel Better Randy
AVASCULAR-NECROSIS (AVN) in 6 joints. HIPS,KNEE'S and SHOULDERS-Replaced RT shoulder.Left hip 2011
Bilateral Empyema-Thoracotomy with Decordication.(Removed the Lining of left lung)Bilat Pneumothorax (2005-2008)
COPD.
Hiatal Hernia-needs repair-Severe GERD
MED'S-methadone 45mg's Bid---oxycodone 30mg's Bid--nucynta 100mg-Prn
Former Respiratory Therapist/Perfusionist

mattolsen
Regular Member


Date Joined Jan 2012
Total Posts : 24
   Posted 4/1/2012 3:21 PM (GMT -6)   
Thanks randy, actually my GP was apprehensive to doing so but prescribed it after the high rheumatoid factor on my bloodtest, previous medical information, and having horrible neck and body wide pain. Our current plan is to stay on 10mg's 2x's a day until I'm able to see a rheumatologist. Between school, dental stuff, and trying to play catch up in school, among other variables we agreed that a short term goal of just managing my symptoms was in order while I make progress both with the rheum and with the dental surgery. Again, thanks to all of you who take time out of your day to give advice. It's very much appreciated.
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