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Jen1978
New Member


Date Joined Apr 2012
Total Posts : 13
   Posted 4/27/2012 11:48 AM (GMT -6)   
Hello Everyone,

I am new to this part of the boards. I am also on the Fibromyalgia board. I was referred to Pain Management by my Primary Doctor and my first appointment is on Monday. My health issues started years ago, I was first Diagnosed with Cushing's Disease. Had to have a Pituitary Surgery and Bilateral Adrenalectomy to cure it, The Gallbladder removal. Those surgeries were done in 2005. Then 5 knee surgeries on left leg and 2 on right leg. I have 4 bulging/Protruding discs in lumbar spine and 4 bulging discs in cervical spine and was diagnosed with Degenerative Disc Disease.I have Arthritis in both legs and my back. I was diagnosed with Fibromyalgia almost a month ago. My spine Doctor suspects Complex Regional Pain Syndrome, he told me this on Wednesday. My primary doctor is prescribing my pain medication for now, she, my specialists and Pain Management are all in the same hospital. So...what should I expect to experience at my first appointment with PM? I am anxious and nervous. Any tips/suggestions are greatly appreciated.

Take Care,
Jen

Post Edited (Jen1978) : 4/27/2012 11:06:39 AM (GMT-6)


tmjpain
Veteran Member


Date Joined Oct 2008
Total Posts : 2024
   Posted 4/27/2012 12:12 PM (GMT -6)   
Hi Jen
Welcome to our cp forum. Glad you found us but sorry you are having so much pain. You certainly have a lot of issues going on. Must be difficult for you. What meds are you on right now. I am sure your pm doc will tell you what he can offer you for the issues you have going on. Meds, injections etc.
I wish you much luck for your appt and please come back and post on how it all went.

Take care
Suzane

Jen1978
New Member


Date Joined Apr 2012
Total Posts : 13
   Posted 4/27/2012 12:27 PM (GMT -6)   
Hello Suzane,

I am on Dilaudid 2mg 1-2 every 4-6 hours and Methocarbamol 500mg (muscle relaxer). This my second month on Dilaudid. I was on Hydrocodone 10/325 for 2 1/2 years, but it wasn't helping as much anymore. I've had 5 epidural injections in my back in the past and they never helped. I am starting Aqua Therapy soon and PT if I can handle it. I also was diagnosed with TMJ a few years ago, but thankfully it doesn't cause too much pain frquently,it locks on me every once in a while. Thank you for the welcome, Suzane!
P.S-Suzanne is my middle name. =)
Fibromyalgia
Cushing's Disease
Back problems
7 Knee Surgeries
Arthritis In knees and Back

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16796
   Posted 4/27/2012 1:55 PM (GMT -6)   
Hi Jen and welcome to the chronic pain forum. Many of us here are under the care of PM drs. It is getting more difficult finding a primary care physician that is willing to write scripts for narcotics for long term use. Most of them they do not want the DEA breathing down their necks or have to put up with all the red tape, so we end up with PM drs.

Usually not much happens on the first visit with the dr. The nurse may go over your history with you, alot of times they mail a packet out to fill out and bring in on the first appt. Sometimes the nurse goes over this with the patient. The dr should do a physical exam and then discuss what type of treatment plan he thinks would suit you the best. Its good to make a list of all medication you have been on in the past and which ones worked or did not work for you. Some drs will not give a new patient a script for pain meds until they have had a drug screen so do not be alarmed if this ha pens. If he is to take over writing your scripts then he needs to let your PCP know his policy on this so that you do not run out pf medication.

I do hope that your appt goes well and you like the dr that is half the battle I think. Please keep us posted on how you are doing. Take care....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 4/27/2012 3:19 PM (GMT -6)   
One question I would give some time thinking about before your appointment is:

What do you realistically expect from treatment?
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
Moderator Depression Forum.

Jen1978
New Member


Date Joined Apr 2012
Total Posts : 13
   Posted 4/27/2012 4:20 PM (GMT -6)   
Hello Susie & Jim,

I think my records and meds aren't a problem, because like I mentioned all my Doctors, Meds and records are in the same hospital. My Primary wants me to go to Pain Management because she said I will most likely have to be on meds long term. What I am hoping to come from going to PM, is that my pain level will be about a 4 or 5. I take Dilaudid that Primary gives me and I get 180 a month no more than 6 in 24 hours/day. It works for 2-3 hours, then I use heating pad/motrin til my next dose. I take 1 then if needed I'll take 1 more, then none for 4-6 hours depending how I feel. Primary mentioned that maybe Oxycodone or Oxycontin would probably be a better fit, so thats what I think she is hoping for me from PM? I am scared to try stronger meds? I have so many issues and different pain from different things. I am going to schedule an appointment with a Neurologist about the Complex Regional Pain Syndrome, to see if I have this. I have a contract with Primary saying I won't take meds from any other Doctor. That went into effect when she started the Dilaudid, which was fine with me. I do get my Prednisone and Flornef from my Endocrinologist, but he is in same hospital.
I will ask more questions as I think of them I am sure. I will update after I see PM Doctor. Thank You guys for info!

Take Care,
Jen

Post Edited (Jen1978) : 4/27/2012 3:27:30 PM (GMT-6)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16796
   Posted 4/27/2012 5:32 PM (GMT -6)   
Yes, you would do better on something long acting and then something for BT pain. As strong as Dilaudid is, it has a short life to it. Constantly chasing the pain and so many peaks and valleys. Hopefully the dr will see it this way too. Good luck....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 4/28/2012 8:35 AM (GMT -6)   
 
     Good morning Jen!
 
        I missed the welcome yesterday...as I hit the sack pretty quick after I got home! shakehead
 
   Anyways! Welcome! smilewinkgrin   I feel badly for you, as I see that you are suffering from multiple health issues...all pain realted as well! shakehead   Not fun eh! Well, you have found a wonderful forum for chronic pain support...and I hope you continue to share with us here. Stick around for a while...and you will make several friends for sure!
 
    Now the question of a first PM visit?....well!...I myself have only had one visit to a PM...which did not go well....but don't let that scare you..as I found out later there was a tiff going on between my Dr and the PM...and I caught in the brunt of it. Grrr! tongue
 
      Since your Dr and the Pm are in the same hospital....I doubt that things will be much different,....same type of a contract and so forth. The only difference may be that the PM will be much more adapt to scripting med's for you that could possibly give you better relief of the pain you are enduring.
 
  It' really would not surprise me to see them change your med's on the first visit...however don't count on it. I understand going into a new PM with some fear...but it will not serve any purpose other than getting you all worked up.
 
     Long term med's? It sure seems like a possibility for you! However I caution you to be careful...and really,... from the decription you gave in your reply above...it soulds like you will be. I think your expectations are right on! wink
 
     The only suggestion I have for you...is to discuss refill times with your PM...and ask what if the refill happens on a weekend or a holiday. I see so many patients get caught up on a weekend...or their PM is on vacation,...out of the office....holiday....and the patient goes into a horrible withdrawal because of this! Trust me!...this is no fun..as I have been there! So!...make sure you discuss this!
 
       Good luck to you!...and again we welcome you! Enjoy!
 
      SE wink     
Moderator Chronic Pain Forum

Weekly Quote!

"Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward."

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 4/28/2012 8:51 AM (GMT -6)   
Make a list of the medicines your on and the ones your allergic to, as it helps, the first
appointment will basically be going over your records and you'll probably have to do
a urine drug tests...but nothing to be very worried about...and you've already been given
very good advise from the others...Many many well wishes and keep us posted on how it goes...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 4/28/2012 8:57 AM (GMT -6)   

 

      ahh!...one more suggestion! tongue ... (it never stops with me tongue )

     BT med's!...if you do not need them...then don't take them!....and snarf those puppies back for emergencies!... I'm sure you know all of this anyways!....I just can't help it! smilewinkgrin Just trying to help!

  SE wink


Moderator Chronic Pain Forum

Weekly Quote!

"Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward."

Post Edited (Screaming Eagle) : 4/28/2012 8:19:51 AM (GMT-6)


Jen1978
New Member


Date Joined Apr 2012
Total Posts : 13
   Posted 4/28/2012 4:04 PM (GMT -6)   
Screaming Eagle & Chartreux,

Thank you guys for the information and suggestions!

I welcome as much advice as possible! Hope everyone has a great weekend. =)

Take Care,
Jen
Fibromyalgia
Cushing's Disease
Back problems
7 Knee Surgeries
Arthritis In knees and Back

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 4/28/2012 8:17 PM (GMT -6)   
Darn...I thought I'd posted to you Jen, and it's disappeared into the ether somewhere. So welcome :-)

I'm sorry that you've got so many pain issues to deal with, but I'm glad you've found us here.

I will leave the others here to advise on how PM doctors work, as I'm not from the US. But I've had Complex Regional Pain Syndrome for 13 years. If CRPS is even suspected, please don't hang around in getting it looked into. CRPS needs intensive therapy from a 'team' who knows what they are doing - and involves treatment from a lot of different angles. Antidepressant or epilepsy meds are usually used for the pain, nerve blocks, physiotherapy (if you can do aqua therapy, that's great!)

Laura
Moderator - Chronic Pain Forum

Full body CRPS with spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bursitis, CTS, osteoporosis, multiple compression fx, disc bulges.

Oxycodone ER/IR, Topamax, Mobic, Somac, Cipramil, Midodrine, Vit D & C, SCS, baclofen/bupivacaine pump

Jen1978
New Member


Date Joined Apr 2012
Total Posts : 13
   Posted 4/28/2012 10:10 PM (GMT -6)   
Hello Laura,

I called a neurologist at my hospital, and they are going to call me on Monday with an appointment. I am sorry you have CRPS, I have read anything I can find. I really hope I don't have this on top of everything else. I plan on doing Aqua Therapy next week. Thank You for welcoming me.

Take Care,
Jen
Fibromyalgia
Cushing's Disease
Back problems
7 Knee Surgeries
Arthritis In knees and Back
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