RD referring me to pain specialist?? | Arthritis Information

HI, I have a couple of questions. I talked to rd about vicoden just isn't doing the trickt and they said I need to see a pain specialist but I have to get the referrel from my PCP Doc. Who has been to one and what do they do? I don't understand why rd won't prescribe me something stronger than vicoden 750mg. I see my pcp tomorrow and will see what she says. My mom went years ago and she said all they did was put a heating pad on her and gave her a prescription for pain meds. If that's true, I have a heating pad at home. I also do stretching in the morning when I wake up and try to stay active. The pain hits me in the afternoon and the vicoden isn't doing anything anymore. I have been taking it for 3 years and must be immune. Any advice or comments?

thanks and God Bless

never been to one. Just wanted to say... cake takes all the pain away.went to one and I wont go anymore because he said all he would do is spinal shots for pain no oral meds cause I am overweight. He said I would all asleep and quit breathing. jerk he wasnt exactly nice 4 times there saw him 1 time out of all those but you might have a better experience. My pcp has been giving me hydrocodone for 2 years without a problem but thought the pain doc could do more oh well good luckI had a really bad experience with a pain specialist and would never do it again. Hope you have a better experience.I had one. I signed a contract with them that I wouldn't get pain meds from anyone else. Then I got my toe caught in the power cord of my laptop, hurt my left foot bad, was all swollen up, black and blue. Went to the Urgent Care, it was on a Sunday. He gave me hydrocodone. I forgot to call the pain management doc the next week. When I called and tried to get my normal meds renewed, at the time I was taking Lyrica and talacen. Could NOT get then to call me back. Got a letter a few later telling me that I was no longer his patient, I violated the contract. MY PCP now gives me my pain medication, I need soemthing different. I was supposed to see him this week but got the appointment all screwed up, I arrived for it the day after I was supposed to be there. My PCP has lymphoma so he wasnt even there, he was getting cheno that day. Sorry to ramble on, this is my venting place. Feel better soon!!I have a pain management doc and I love him. I am pretty anti pain med since it's just me and a 4yr old. He did a series of nerve blocks and prescribed PT. He also did cortisone shots in my sternum(for chest wall inflammation) which my reg. dr. didn't feel comfortable doing. He did presribe Lortab which I take sparingly-when things get really bad. Honestly, the nerve blocks have done far more than pain meds.

I think a pain dr. is like any other dr. You can get good ones and bad ones. This one came highly reccommended by my RD who I also like.

I've never been to one, but my MIL goes and she says that he has "cured" her. The types of treatment he gave her varied from oral meds to pain patches to shots. She had a good experience as far as I can tell. Maybe you will too? If not ask your pcp to be your back-up if the pain specialist doesn't work well for you. Best of luck.

Jodie

PCP's don't like writing scripts for pain meds because the feds are watching very closely and if they start prescribing too many they will get in trouble and their license may be in jeopardy. It's a joke. Any doctor should be able to prescribe anything that helps a patient without fear of interference from the feds. My RD has prescribed my pain meds, but I did try a pain specialist to see if there was anything else they can do. They admitted that I had pretty much tried everything else, and wanted to focus on a different problem and have me re-try some things, but they weren't really listening to me and I didn't go back. I recently went to a different pain doc for an epidural nerve block my orthopedist wanted. He was much more realistic, but the injections he gave me (epidural nerve blocks and joint injections for my low back problems) didn't help, so now we're done.

Like Rebecca said, there are good ones and bad ones. Give it a try and see what happens. If it doesn't work out, I would go back to your RD, say that you tried, and ask them to prescribe something different or stronger. My RD has prescribed me meds as strong as Dilaudid before, although currently I am taking Vicodin HP (high potency) 10 mg/660 mg (more hydrocodone but less acetominophen).

CinDee, I see a pain specialist and have for over 6 yrs. My first one I saw for 5 years. she was a neurologist, pain spec., and had a degree in psychiatry. I just loved her and we had a great relationship. She prescribed pain meds and anything else that would help me.

Then my med group decided that the only pain specialists they would refer to were anesthesiologists. I like him okay, but I only see the doc when I get a procedure. My reg. appts. are with PA's, which I don't especially like.But I have had nerve blocks, nerve root blocks, and radiofrequency burning of the nerves to basically keep the area from feeling any pain.Some worked and some didn't.

I am currently awaiting approval for a pain pump, to be implanted in my abdomen with a tube threaded into my spinal canal. It is to be filled with dilaudid in my case. That's what they're trying first. If not working well enough, they can change the med or dosage. The only problem I am having is that my hospital doesn't want to do these procedures anymore because they are not cost effective. I am calling my insurance co today to see what we can do. My pain meds can't be raised due to my sleep apnea. And I can't tolerate the CPAP, so the apnea goes untreated til someone comes up with an alternative treatment.

I do agree that there are good and bad in any specialty . If you don't like the first one, ask to see another.

edited to correct spelling and grammer.

Nini2008-07-25 10:58:50Thanks for all the replies. I saw my PCP today and what a visit. She wouldn't prescribe anything to help me with my pain because my rd gives me pain meds. She agrees I need to go to pain clinic> She also thinks I have fibromyalgia (sp?), need a hysterectemy (sp?) and lose weight. I left in tears. She says I need to call my ins. co for referral. That sounds crazy to me. Anyway, I look in phone book, there are 3 in my town. I can't have epidurals because of allergies to it while in labor with my daughter. That was 20 years ago, but they told me never to have one again. She told me I need to join a fit club and do water excercises. I just laughed and said "yep, that would be nice, if I had the money, your clinic has already turned me over to a collection agency." My blood pressure was 164/106, I think because of the stress and pain. She also wants me to do sleep apnea which I told her I didn't think would work because I am one of those people who can't sleep anywhere but my own bed and I would be awake all night unless they drug me. SO, I left, they're supposed to get back with me about everything. I called rd after I left and asked for a refill of vicoden until I can get to this pain clinic. They got right on it and I am feeling a little better this evening. My hubby got my recliner fixed so I am able to put up my feet again. I plan on calling my ins. co on Monday to find out if I need a referral and find out benefits for everything. Jeez, I feel like I got the run around and am bummed out about everything....I hope you guys all have a good weekend and thanks for your inputs.

take care

I am sorry, Cindee.

It just all seems like an up-hill battle trying to get fixed. It seems we go for one visit and then a referral to a new Dr, and do not forget the 2 week follow up visit with the first Dr, who in turn will want another 2 week follow up, because he is trying something new on ya, and that is only if the new med did not send you to the ER first.

I hope you get it all straightened out and your pain can be made less.

Much hugs to you.

joonie2008-07-26 16:52:48CinDee, I don't understand your pcp. Does she want you to call the ins. co. for referral to a pain specialist and/or an OB/GYN? That seems so strange to me. With my Medicare Advantage HMO, my PCP gets the authorizations for me. An exception would be for regular pelvic exams and pap smears, for which I need no referral.

I'm concerned about your blood pressure. Are you on blood pressure meds? 164/106 sounds pretty high to me. Do you usually have high blood pressure? Of course, you are right about stress and pain. That's the only time mine is the least bit high, when I have extra pain. Usually I am quite low.

I didn't think I would sleep for the apnea test either, but, surprisingly, I slept for about 4 hours, which is about all I sleep at home. Turns out I had severe obstructive sleep apnea, but cannot tolerate the CPAP, so I am untreated til someone comes up with another treatment. It may be surgery, in my case. But I am not able to get any change in my pain meds until a treatment is found, because they say they are already concerned about my lack of oxygen while sleeping. So, if it's possible, I hope you can do the apnea test. Maybe then, they will be more helpful in treating your pain.

I'm so glad your RD was helpful in getting your Vicodin RX for you. At least it's something. Through my pain specialist, I am taking Methadone, 2- 4 times a day, and Dilaudid for breakthru pain, up to 2- 4 times a day. I have been on narcotic pain meds for several years, and don't know how I would function without this pain control. As it is, I am still in my power chair most of the time, since I broke my pelvis.

One thing about my pain meds, though, is that I was being treated with them for a long time before I was diagnosed with RA. I do have many other chronic problems with my spine, including OA, DDD, advanced scoliosis, foraminal stenosis, and several others. I don't know if my RD would have treated me with these meds for RA or not. However, as things are, she has no problem with me taking them.

I hope some of my experiences have been of some help. Good luck, Sweetie. I am glad your RD, at least, seems compassionate.

Hugs, Nini

Thanks you all made me feel so much better.

Nini, I think pcp is calling for referral and getting me set up for a gyn visit. My blood pressure runs a little high but nothing like it was then. She retook it and it went down to 138/100 which is still high. I also had to push my mom in her wheelchair to dr appt. She sees same dr as me. So, I was out of breath and stressing. She also mentioned she thinks I have fibromyalgia (sp??) which might explain why none of the meds are working that great now. My next option is infusions for the ra and I don't know if I am ready for that or if I can even afford it. That is a major stress too, the money for all this. My clinic turned me over to collection. I was paying clinic a month faithfully but they still turned me over, the funny part is, I am still paying to collection agency. LOL

Thanks again, now I'm not so freaked out and I am actually starting to get used to the idea of it all. Also would be nice not to have Aunt Flo come and visit me every two weeks for 10 or 12 days.

Man! I wish I could have Aunt Flo not visit me anymore! I HATE that "monthly bill". Just irritates me to even think about it.
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