Another discussion came up earlier about pain managment doctors, and I thought I would give my take on this subject. If anyone else has information in this type of medical doctor, comments or questions please feel free to share with the group.
Last spring my GP decided it was time I went to go see a Pain managment doctor as my pain was so hard to control and I did not have a lot of options for treatment. I agreed to go after a lot of grumbling. Why the all the grumbling I was scared and had a false idea what a PM doctor was thanks to an awful ER experience, were I was accused of being an drug seeker and addict. My thoughts were mainly this type of doctor was for addicts (a new way of saying rehab or addiction specialist). These thoughts were so wrong and off base. So here are some points to know about PM.
1.) A pain managment doctors whole goal is to get you out of pain. Preferably without the use of opioids. So you can get back to life as normal.
2.) They will use a variety of treatments to accomplish this with you. This includes medications, surgery, injections, physical therapy, acupuncture, and the use of a therapist who specialize with chronic pain patients. Some of these might be at the PM doctors location or at another location.
3.) How are you able to see a pain managment doctor? Well, according to my PM and a few others you will need to be referred by another doctor, some may take what is considered a “walk in” but with these there are some cautions we’ll go over with later. There are two things why only by referral one being the PM doctor will want all your medical history on your condition, and the other is the problem with people who think these doctors are just suppliers for opioids, and it also may depend on local laws, or even the doctors own business insurance for their practice. So if you would like to see a pain managment doctor you should start by talking with the doctor/s you have now to refer you to one.
4.) Before the appointment you will need to have your medical history of your chronic pain sent off to the prospective PM doc. They will review this info before your appointment. With some PM doctors they will even base the medical records to allow you your first appointment or to be a pain patient at their clinic.
5.) With your first appointment they will go over your illness, about your pain, and may do a physical. You and the doctor during the appointment should begin a plan for your pain managment. It might not be an over night deal on getting the pain better, but it is a plan and a new start to get you better.
6.) Medications
Make sure to have a list of all medications you tried the reaction or result from that medication and what you are taking now. Include any supplements you are taking. I wish I had done that because during consults it is hard to remember what reaction I had to what or what result I had from what medication.
Depending on the medication, the PM doctor may or may not take over and be the prescribing doctor.
Also depending on the medication or the doctor you may need to sign a medication contract. These are usually stating you will not abuse your prescription, will not get more medications from other doctors (2 prescribing doctors for the same medication), or sell your medications, you will get refills depending on the outline of the contract, ECT.
7.) Opioids
If you are thinking a PM doctor hands these out like candy you have the wrong idea and have not been reading this too well.
Opioids are considered by a lot of doctors the last resort. If you have not tried every possible way to control your pain you may be ween off these until it is proven this class of meds works for you.
If you have tried everything possible to control the pain or make the pain go away and opioids work for you. This why it is important for these records to be sent prior to your appointment. Doctors do not like using these types of meds, but will when it is deemed appropriate.
8.) length of first appointment should at least be an hour to two hours long. Anything shorter and I would look for another PM doc. This gives time for you to get to know the doctor and vice verses.
9.) beside all the medical stuff to remember and bring you should also bring someone that has seen you in pain or takes care of you. It might come as surprise but they will ask your person that came with you questions too, like how the pain affects you and your ability to function. How medications affects you as well. It’s good for your treatment plan. Trust me on this one, you want someone with you.
10.) just like all other doctors it may take a few tries to find the right PM doctor for you. That’s okay. Don’t give up and keep looking till you find the right one for you.
11.) under fire
If your not aware of this already the pain community is under fire by the DEA and some other private groups. States such as Florida and Washington especially. PM doctors have been thrown in jail or prison due to the crazy witch hunt that was started by pill mills. So your pain managment doctor will follow all the rules to the t. It is important for them to do this to keep their license to practice and stay out of places like jail. You might like these rules you might not like some of the rule sometimes but to your doctor there important for him to keep his job, and you in the long term to keep your doctor.
12.) Things to look out for
Make sure your doctor has been in business for awhile. Places that pop up over night stay away.
Places that don’t accept insurance, stay away.
Places that seem super cheap and only take cash. Stay away
Places that accept a literal walk in appointment stay away
Places were the doctor only want to hand you a bunch (and I do mean a bunch) of pills stay away
If the clinc is in a strip mall be wary, and you may need to stay away.
Why all the stay always, these places are what most likely are to be pill mills. Where the doctor just prescribes huge amounts of opioids. Later down the road when you really need a PM doctor they may not accept you as patient if they find out you were going to a pill mill.
13.) pain control
Lastly sometimes pain managment can not take the pain all the way away from you. Then your case becomes one of pain level control. It is never a fun idea but I recommend that you think hard about what is the pain level that you can stand to be functional, and what pain level is no longer functional for you. Not saying you will ever be one of those cases but it is always a good idea to be prepared.
I know all of these were quick and to the point but I just wanted to shed a little light on this subject. If anyone else has further input or might have some questions please feel free to share. Hope you all have great day that is pain free:)