I have 7 herniated disks and DDD
What to expect from a pain management doctor first visit?
Question posted by pusherx6 on 3 Nov 2013
Last updated on 6 August 2015
This question has also been asked and answered here: What does a pain management doctor do?
4 Answers
1smartdumbgirl
4 Nov 2013
it can vary quite a bit. the number one thing is don't expect to walk out of there with precriptions(s) in hand on your first visit. that sounds really sh***y, I know. Especially when many people have waited weeks, even months, to get a referral and appointment. This is the number one reason that I've chosen a more expensive PPO option over HMO. its very liberating to be able to go where I want, & not be at the mercy of a GP.
Pain management offices do this "getting to know you" process, its usually a pain in the arse because its designed to frustrate and drive away tbkse that really don't need the meds. They'll give you another reason for it, but its BS. I've seen a few different ones & finally found a great one who doesnt demand that I go to Tai chi, support groups, PT... but rather lets me CHOOSE what interests and works for ME. A good PMD also knows that pain mgt is achieved typically with 2-3 meds, not one.
Watch for signs that tbhe care about YOU & not only how the FDA is going to look at them. Some are so focussed on that, it clouds their judgement when treating patients. its sad how the abusers bave ruined it for us all with real pain. but its a catch 22 because some of the people buying medication off the street ARE pain patients themselves. They have been underprescibed by scared doctors and suppliment their presciptions themselves. i actually fear what may happen in a few years if my issue ends up being lifelong. who knows what hoops we will have to jump through just to get our medication a few years from now :-( I wish you luck & hope you found one of the good ones.
kaismama
5 Nov 2013
The "war on drugs" has done nothing but give the drug cartels a whole new client base. I figure a few years from now, one of 2 things will happen, we won't be able to get anything stronger then tylenol legally, or the whole nightmare will go away. Keep an eye on the suicide rate and heroin use in this country.
lauramorrick
5 Nov 2013
I agree. I have never went into a new dr of any type, Ortho, Nuero, GP, PM or any and walked out with a narcotic script. I have always had to schedule a second appt for something., I.e., physical, labwork, injection, follow up after a drug test on 1st visit, etc., and find this infuriating when I bring in MRIs, 3 Opinions for 2 surgeries, bloodwork done w/i last 3 mos., all prior dr records and wait, as you said, sometimes 3 plus weeks to get in! One thing you said that really caught my attention is watching for dr who only gives script for 1 thing/1script, bcus that's all my PM dr does, besides inj on every visit. 1 script for pain med. If I don't have an inj scheduled when my pain med is due, I still have to schedule an appt, pay my co-pay, and the nurse hands me my script and asks if my injs are wkg & if I want to sch another inj.
I feel like I'm stuck there bcus I know if I find another PM dr, he will not give me script for 2 mos & I will be breaking my current PM Contract, when the new dr calls for info, which they always do in that waiting period, my PM dr won't write script either!! I can't believe it's this bad/this hard to get pain med & if there is something that helps before the pain gets out of control, like U said U get 3-4 meds, what R they so I can talk to my dr? My insurance isn't going to pay for inj forever!
1smartdumbgirl
5 Nov 2013
This is where I was very lucky. My particular doctor DID in fact prescribe medication on my first visit. But I had been to several PMD's before him who didn't. (And I came with my printed history and MRI films.)One of them actually demanded that I attend 3 appointments a week in order to keep being prescribed (PT, group therapy, & Tai Chi - ALL of them at the same facility and all requiring a $20 co-pay). There are days that I can't even walk through a grocery store, but I have to keep 3 appointments without fail every week or be punished? This is the kind of thing that shows how little some of these places truly know nothing of pain.
This is why if you have a choice, and can afford it, go with a PPO instead of an HMO. NO referrals needed! It's very empowering. Don't like a doc? Just make an appointment with another! Having to get referrals is a pain in the butt & when I had an HMO it was miserable and my options were SO limited. the GP always wanted to push me onto a colleague within the same medical group and presented it like my only option.
It took time but I finally found a good PMD. If anyone is in California in the Bay Area & would like his info, let me know.
lauramorrick
13 Nov 2013
Thanks for sharing! Like it's not hard enough for us in chronic pain to make 1 appt w/our PM dr a mo., i.e., getting dressed in something nicer than our sweats, trying to look atleast a little better than usual, the long drive (as it seems I've never had one closer than an hr one-way!). I always have to wait, they are constantly behind but ask that I show up early, blah, blah... and by the time I get home I'm exhausted! I can't imagine him telling me "no meds unless U R here 3 times a wk" (but I can, as mine is "no meds unless more injections"). You made me laugh/made my day cause I thought it was just my crazy bad luck with drs!! Unfortunately and not funny, I don't see it getting any easier in the future & am complating 3 surgeries that I really don't want to have :(
kaismama
4 Nov 2013
Lucy explained it. I just want to add, do not ever ask for a narcotic pain med. They then think we're drug seekers and are very reluctant to prescribe anything. Keep a pain diary and keep track of the pain level in the 1-10 format, where it is, what kind it is, aching, burning etc, and what you did for it. I'm going to see a new one since I moved. I was handed a folder full of papers to fill out, by my primary, and that gives a good idea of the first visit. Your history, what makes pain better what makes it worse. I also have the narcotic contract, so you can get a chance to read it well. You will also have random urine tests, some docs do them on the first visit some don't. If you are on several medications, take the info written out, name, dose and how often you take it. I prefer to be able to hand them my info and have the time to talk to him about my pain.
I keep a list of my meds in mednotes, at the top of the page, then when I am going to a new dr I just print it out. Also take a written list of anything you want to talk about or ask. I know I'm a babbling idiot when I get into the office. Here is something I have heard that I think isn't right, but this happens. They judge us by how we look, are we clean, are our clothes clean and well cared for? That kind of thing. I guess only drug abusers are scruffy.
tj_1159
4 Nov 2013
Thanks kaismama, you give us all good answers, and right to the point.
I will be going to a pain clinic next month, & yea I got all those paper to fill
out, some questions do make you think they view us as drug seekers. I'm going for nerve damage in my right foot. Thanks again everyone all answers have help me out alot this is a good website.
sara12345
5 Nov 2013
Yes, as always kaismama gives great advice. Thanks for all that you do on here.
truthbear
6 Aug 2015
Yes also there's an iPhone app called care zone and it lets you put photos of your med bottles in and it then prints out a list of all the info u need to give your pain dr! It has a place for photos too and notes! Then there's also an app called pain diary and that's awesome too
lucyb78
3 Nov 2013
Hi and welcome to DC. This is a great support group for those of us with chronic pain which I am sure you must have with 7 herniated discs. You certainly have me beat.
As far as pain management goes it can vary from doctor to doctor and state to state. They will want to know what you have tried so far. Many options available. When I started they referred me to physical therapy and I signed an agreement to not get pain meds from anywhere else. And agreed to random drug screening. Next I did steroid injections, nerve blocks, nerve function tests. Basically I have tried it all and am still on medication but my pain is finally manageable. I now go every 3 months in order to continue my prescriptions.
I hope you can find the right treatment to help manage your pain. Unfortunately there is no cure for spine conditions , just treatment. I have finally accepted that after 3 years. I hope it goes well and check back in and let us know how it went.
Bleuidcowgirl
4 Nov 2013
Hi Lucy, I'm glad they were able to help you. I guess I didn't have the best pm team compared to yours.
Bleuidcowgirl
3 Nov 2013
Don't expect much mainly take your history and set up a pain regimen. They will offer you tests later in to determine what level your pain is. I was with a pain management for a year and it was a waste of my time. They said no to surgery and my primary said yes so it was a long battle that I one. Be your own advocate. Know your pain and know what your body needs. Have you try a physitry (sp) a pain doctor?
Bleuidcowgirl
4 Nov 2013
**won***
lauramorrick
4 Nov 2013
I didn't know Phych are also PM drs. Are they a certain kind of specialist? I had asked my phych at one appt if she could write a script for my pain med as I didn't have appt with my PM dr & was going to run out B4 I would C him & was told no, she couldn't write scripts for PM. Where would U look to find this sort of specialist?0
Bleuidcowgirl
4 Nov 2013
A physical medicine/rehab doctor normally works with of in a neuro surgeons office. They don't really prescribe meds but more or a rehab pt doc.
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pain, doctor, pain management, management
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