Need any help you can give me....not sure what to do.

I have been a member here for many years but haven't been here much in the last year.

I am really in a mess right now.

Have had the same MD for the last 15 years and he has done everything possible to control my pain.

He really has been a Godsend to me.

Well, two weeks ago I went in to pick up my pain med refill and was told that he was retiring in a week!

I couldn't believe it as he is not near retirement age.

It was just a complete shock to me.

So I was told that when I needed my next refill to come in and see one of the other docs.

Well the other two that are there are both really young with just a few years experience.

That isn't necessarily a bad thing but you never know whether they will be willing to give you the pain meds you need or not.

Well, I saw him today and sure enough he isn't willing to continue my pain meds because he doesn't give them on a daily basis only prn.

He gave me a referral to a Neuro (I've been to so many and they always want to start from square one which is frustrating to say the least!) and a referral to the pain management guy in town.

He wasn't going to give me enough meds to get me thru til my appt.

I had to absolutely insist. I mean they know it's not a good idea to quit any pain meds cold turkey.

Especially when you have been on them for a long period of time like I have.

My biggest question is what is the pain guy going to do?

Is he going to want to take me off my meds too?

Will he at least do a slow taper if that's the case?

Please anyone who has been to pain management, tell me how they work.

I am really worried and scared because I don't want to go back to where I was a few years ago.

Unable to really have a life at all.

Thanks for any help you can give.

Cindy

Hi Cindy
I have just joined and just been diagnosed with migraines after many years of headaches. I am an RN and have worked closely with pain specialists. They are mostly anaesthetists or anaesthesiologist (if you are american) who have a special interest in pain.. They are usually very kind and understanding , believe your pain and are mostly up with the latest research on new drugs techniques ect. So don't be scared. They may change your meds , intro new ones suggest new treatments. A lot of pain specialists do blocks with steroids and local anaesthetics often with good success. Hopefully the one you have been referred to you will click with its important to trust them. Try to keep an open mind. Fingers crossed for you. Alia68

When I travel I carry a letter from my doc outlining my medical conditions and what meds work and at what dosages. Is it possible that you can get a letter from your old doc that details your experiences and what he knows works for you. It would be helpful also if he would state that you do not abuse the pain meds and that you have always been a responsible patient. Just a thought!

I agree. Also get a full copy of your records from your old doctor.
They need to see all that you have tried before you got to this point
So they realize you are a legitamate case and not a med seeker.

You never know, this could be a blessing in disguise.

I agree about getting a letter from your doctor as well as your records. I see a pain specialist for my constant headache and am on daily narcotics. Its a tough road, but the only thing that has helped me.

Pain specialists really vary...you will have it vary from those who only do one thing (like injections), those with a certain specialty (like interventional pain medicine, which means injections and nerve stim implants and such), and those who use a variety of treatments, who may or may not use narcotics, and who may have differing opinions of a ceiling dose.

I too was getting my pain meds from my primary doctor but eventually hit a wall where he wouldn't increase the dose or change the meds. He didn't have a pain clinic recommendation so I was on my own. I went to three before finding that the fourth was a good fit.

The ones I went to first suggested tapering down/off my pain meds and trying other treatments, but when I asked what, they either wouldn't specify or listed things I've already tried (and I told them that). Thankfully I now have a great pain doc who is willing to keep me on the pain meds, as well as change them around, while also trying other treatments which were never offered to me.

I hope you find a good pain doc. Neuros would be way less likely to prescribe narcotics (I saw one of the few who recommendeds them, but he wouldn't prescribe). They may want to try you on some new treatments, but hopefully they would keep you on the pain meds until something else was working.

If you don't think you will be able to get another script next month from the new doctor, or get into the pain clinic by then, you may want to get instructions from one of your doctors to start tapering down. Its a scary prospect, I know. For me it was a blessing to finally get in with this good pain doc, but it was quite the journey.

I can say that there is a 99% chance you will have to sign a contract and submit to UAs when requested at the pain clinic, as that is the norm nowadays. Pain docs are usually much better equipped to manage pain, so if you find the right one, it should be a step up, not down.

Its just that question of who is in your area. You may want to hedge your bets and make multiple doctor appointments...just be sure you only get meds from one doctor at a time. Nothing wrong with interviewing more than one though. Ask them specifically what their course of treatment would be in the semi long term. That will give you a good read on what type of doctor they are.

Sometimes their website can be telling too, such as if they list they don't do narcotics, or only are talking about all their state of the art imaging equipment for injections. Some folks end up having to drive far. Good pain doctors are in short supply and often have long waiting lists. You are right that if you do need to do a taper, it should definitely be slow, and with doctor support, which may mean adjunct meds to lessen any symptoms (Clonidine is popular). Sorry you are dealing with this. Hang in there and best wishes.

Hi,

First of all- I agree with the others- get all of your records. Also, as the current doc was the partner of the previous doctor, why was he so reluctant to either continue or to refer you. I know that each doctor has their own way of doing things. I also know that partners cover for each other- has your primary doc ever been out of town and his partner had to cover the scripts and patients then? Are you on an extremely high dose of something. It could simply be that the new dr doesn't feel comfortable prescribing them- (thank the DEA). Sorry for the child of physicians rant/explanation.

As to pain management- it is worth trying. However, I would check and see about the doctors near you and make sure they will take you as a patient. (Some don't like to treat headache patients.) But it may be helpful. It may take awhile to find the right one, but you will find them.

as to the neuro- he may be helpful, he may not. If you have seen him before and feel there is no reason to go that route again- ok. But they may have some new ideas or at least have a good idea of the pain guys in town.

I hope this helps.

Hang in there.

Pain free days,
sailingm

Thanks so much to everyone who replied to my post.

Your suggestions and encouragement means the world to me.

Well...had my appointment with the Pain doc yesterday.

I was a little concerned because at this clinic your first visit is with one of their PA's and I wasn't sure how that would go.

Well it couldn't have gone better.

He was so understanding about my pain and the struggle I have been thru with it.

He told me that when he got the paperwork from the Doctor that referred me he was really surprised in a way that this doc wasn't willing to continue my treatment since I had been going to that same clinic for the last 15 years.

Then he told me that they have had alot of referrals from other patients also left high and dry since my former MD retired.

He made the comment that he isn't sure what these young doc's are being told in Medical school because it seems that they are so afraid to RX pain meds and he just doesn't get that when patients have documented chronic pain.

I did have to sign a pain contract and give a ua which I fully expected and had no problem with.

He refilled my meds and asked if I would like to try some injections.

I am checking to see what my insurance will cover and then will make the decision on that one.

He said if I decided not to that is fine, they will still provide meds for me.

I told him how the doctor at the clinic made me feel bad saying I was on alot of meds.

He laughed and said that he is wrong I am actually on the minimum dose of pain meds.

I told him about the shots I used to get from my doc when I got the really bad ones a couple of times a month.

He told me when the next one comes on just to call and we can discuss trying a different med for just those times since they don't really give pain shots.

It was such a relief to me because I have been so worried about going back to being in pain all the time.

Thanks again to you all for your wonderful support and I will keep you updated on how things go.

Hope everyone is having a pain free day.

Cindy

Cindy, so glad it worked out and you found a good doctor. What a relief that must be!

I'm so glad it went well for you!

Thank you everyone for all your posts of encouragement.

It is a load off my mind to be back on track again.

Hope you all are having a pain free evening.

Cindy