pain managers?

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pain managers?

Post  finnosian on Thu Feb 11, 2010 10:07 pm

I hear a lot of discussion of pain managers as an adjunct to a primary neurologist. I always thought that my neurologist did my pain management, so what exactly is the role of a pain manager?

I am at a loss as to what to do right now to control pain. Sometimes i go three or four days with a headache and i just want a little break.

Migraines have affected my life adversly to the point that i cannot maintain any real employment, and i am losing my mind half of the time.

I am really desperate to regain some life back, even small steps right now would really make a huge difference.

Any advice would be appreciated?

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Re: pain managers?

Post  HeelerLady on Fri Feb 12, 2010 6:46 am

Well you are in good company - we understand your pain. Pain managers...one thing you have to remember is that this board has the potential to be a world wide thing. It depends on where you are and your health system. I'm in the US, and my neurologist (who specializes in headaches) does take care of my pain management - but this could be solely due to the health plan I'm on. Other plans may incorporate someone who is responsible for pain management and that is their only job.

Controlling pain....well most of us use the meds we have and tough it out the best we can. Some days the M wins....I know what you mean though about wanting a break - I'd kill for 24 hours pain free and no symptoms. I am probably the wrong person to consult on working through it...although if I didn't have the job I do, I know I would be in your shoes. I have the ability to work from home which is a lifesaver. I don't have lots of insight but one thing that struck me after being here a while is how others used their meds. I realized that I wasn't using mine to keep me comfortable, I was using them as directed. It was a quality of life choice.

I hope this has been somewhat helpful and keep asking questions. Smile
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Re: pain managers?

Post  Paradox on Fri Feb 12, 2010 7:12 am

I have the same questions about it. I'm going to a pain clinic on Feb.22. My GP is sending me pain management for the chronic pain in my lower back. Between my back and my head I never have a day that's under a 5, and haven't had for months and months.

I take narcotics to bring the pain down to a 2/3 which is tolerable. But, I'm not comfortable with how many I'm taking and am hoping a one sustained release pain med. for chronic pain and hopefully something addition for breakthrough pain for really bad days.

I'd love to hear from any of you who use pain managers.

Charlotte
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Re: pain managers?

Post  meihee on Sat Feb 13, 2010 12:04 am

I go to a pain clinic as well as a neurologist since my neurologist does not prescribe any pain meds. he only deals with my migraines/preventatives/recommends pain meds etc. The dr. I see in the pain clinic does botox, cortisone injections, pain meds, etc. He's amazing!

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Post  Richard on Sat Feb 13, 2010 6:35 am

In the USA, doctors all get an MD, but many choose to get further education to become "Board Certified" in vwarious spelcialties.

The one we are most familiar with in our neurologist. To become a neurologist, a doctor is am MD then specializes in brain stuff to the point that a board of experts says "Yes, this guy knows his stuff - he is a Board Certified neurologist."

To keep Board Certification, a neurologist ought to keep up to day on what is happening in research and advanced knowledge of the brain.

Well, folks, just like Board Certification in Neurology, Psychiatry, OBGYN, Oncology, Surgery, etc ... there is Board Certification in Pain Management.

My migraine doctor is Board Certified in Neurology and in Pain Managemnt (PM) Pm is a recognized area of medicine in the same way as psychiatry or neurology or any other specialty.

So I happy if you are happy to have your neurologist or general practioner (usually a Board Certified Internist) handle your Pain Menagement. If it works, it works.

But I ask you, does your GP also serve as your OB-GYN? Does he do your surgery for you too? How about psychiatry? Does your neurologist also handle any oncology issues that arise? Just curious in a sarcastic manner to make a point.

When I say, add a Pain Manager to your healthcare team, I mean an MD who is Board Certified in the medical specialty of Pain Management.
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Re: pain managers?

Post  HeelerLady on Sat Feb 13, 2010 8:41 am

Good clarification Richard. I didn't realize there was a difference and will be checking over my neurologists credentials.
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pain managers

Post  finnosian on Sat Feb 13, 2010 12:43 pm

thanks for the responses. My neurologist is a neurologist only as far as i know. He used to provide me with pain medications, but has stopped doing that in order to try other methods.

This has left me in a really bad place, i feel like i have no resourse against the headaches and my life style has been affected because of it.

I'm not sure if it is appropropriate to seek out a pain management clinic or not. How does one know if they should? I dont want to upset my neurologist by doing that, but at this point i feel quite alone in what i need to do. Horrible things go on in my mind and i need this all to stop to be productive again.

I am in illinois and was wondering if any one knows any good pain management clinics in the north suburbs (really for reference at this point until i can discuss this further with my neurologist).

Thanks again.

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Re: pain managers?

Post  meihee on Sat Feb 13, 2010 1:28 pm

I was referred to my pain management specialist through my GP.

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Post  AuntieBubbs on Sat Feb 13, 2010 2:14 pm

Good explanation, thanks, Richard. I'll be checking that out about my nuero as well.
I know my GP is actually also my GYN but she's board certified. She's in practice with her hubby, and he does minor surgeries, like mole removal, and he's board certified to do that. They have different doctors in their practice board certified for different specialities, and then they all practice general medicine. But my nuero isn't in their practice, he's part of a clinic and there are several other specialists that practice there (like dermatologist, OB/GYN, oncologist, podiatrist, etc. etc.), it's a large clinic, almost like a little hospital. I never saw "pain manager" after anyone's name though. How do I find out without insulting the nuero?
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Post  HeelerLady on Sat Feb 13, 2010 4:40 pm

A lot of clinics have a website and you can look at a doctors bio - this is sometimes how I chose one, see if someone specializes in my condition.

I'll post the links for my neuro and another one who is certified as a neuro and pain management.

http://findadoctor.uwhealth.org/findadoctor/Provider.action?_sourcePage=%2Fresults.jsp&id=5905

http://findadoctor.uwhealth.org/findadoctor/Provider.action?_sourcePage=%2Fresults.jsp&id=5437

Hopefully this will show the distinction. Smile
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Re: pain managers?

Post  Richard on Sat Feb 13, 2010 5:01 pm

The net is great for locating a Board Certified Pain Manager. Look up the state's medical association and see if they have a search engine embedded to find a doctor ... many do have that function.

As to ticking off a neurologist by seeking a Board Certified Pain Manager, well, I would question the patient-doctor relationship, emphasis on "doctor" in that equation.)
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Post  moominamy on Sun Feb 14, 2010 10:56 am

I have seen a pain specialist on the NHS (in the UK), but he didn't really know all that much about chronic migraine or its treatment, despite him thinking otherwise!!! But it was very useful as a fresh pair of eyes on my symptoms and he referred me to his clinical psychologist who specialises in helping people cope with chronic pain. This has been helpful.

I still find that the only drs who truly get migraine are my headache specialists. But as long as you realise what your drs strong and weak points are and have good communication between them or can co-ordinate it well yourself, I think a different opinion can be worthwhile.

Amy

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Re: pain managers?

Post  Anna's Mom on Sun Feb 14, 2010 11:30 am

We have taken Anna to four different pain specialists. Never to get pain meds prescribed. Her GP and past neuros prescribed pain meds.

Doc #1--pain doctor at a large pain clinic. Saw him in 2002 and in 2008. His specialty was occipital nerve blocks and epidurals. He was easily frustrated when when his injections didn't work. Last time we saw him he stated Anna uses head pain to get out of working and to avoid having relationships with the opposite sex. When those words came out of his mouth, that was the end of him for us.

Doc #2--anesthesiologist at a university pain clinic (out of state). Wonderful, wonderful doctor! Loved her! She listened to the whole saga and immediately jumped to IV Ketamine and IV Lidocaine infusions for Anna. Successful treatments, if we could ever get them here at home (which we can't). She said to try Xanax for pain and vomiting. She did an epidural on Anna's herniated disc which was successful

Doc #3--pain doc at a small pain clinic. Hardly worth mentioning. Had nothing inspiring to say or offer. Said no to doing the infusions. That's why we went to him--to ask.

Doc #4 (Doc #1's boss)--How I wanted to tell him the stupid things said by Doc #1, but I let it go. He immediately offered to do an intrathecal pain pump on Anna. It is on the back burner for now.

For some pain doctors, they make FAR more money on doing injections and procedures, and thus they are often unwilling to prescribe simple opioids.

Cheryl
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Re: pain managers?

Post  Anna's Mom on Sun Feb 14, 2010 11:37 am

Finnosian:

I've tried to send you two private messages, but I don't think it is working correctly. My messages disappear.

Why don't you send me a message, and I'll respond.

Cheryl
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Post  LG on Sun Feb 14, 2010 12:14 pm

I would tell doc 4 about doc 1. Being that he was like that to your Anna solely on the fact that the injections weren't working and every person is different, who knows if he would do that to me or the next guy or gal to walk into the office. I wouldn't want him fired if it was the first complaint (everyone has bad days, it doesn't excuse his actions but I am a forgiving person) but the issue should indeed be addressed before it happens again.

Hope things work out for Anna for both of you! I love you


Last edited by lovegia on Sun Feb 14, 2010 12:14 pm; edited 1 time in total (Reason for editing : typo)
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