[jenniegump]

Hello,
Hope everyone is maintaining in this heat. It has been awful here in Love Valley, NC. My question is, I have not been happy with the treatment I have been receiving at the current pain clinic I have been going to. Vocational Rehabilitation has been helping me with the financial aspects of my visits and medicines for my RSD in my right hand, with the exception of narcotics. I also see a psychiatrist who prescribes me cymbalta, elavil, and xanax for anxiety depression and nerve pain. The pain clinic prescribes me topomax and percocet but the doctor only prescribes me one 10mg percocet in the morning and one at night. I asked for something for breakthrough pain between the twelve hours and she refused. The fact is that I take my medicine very early in the morning and by 5pm or so I am hurting pretty badly, if not before that. Also, I have been on percocet for almost a year now and my system is somewhat immune to that level of medicine. I do also use a tens unit, which I truly love and it helps tremendously, but if I have to go out somewhere I can't exactly wear it out. So....... the doc, decided to prescribe this ointment for my hand for breakthrough pain it has a neuropathic formulation of 10% ketamine, 2% amitriptyline, 2% gabapentin, and 5% lidocaine. Has anyone ever used this type of ointment for RSD?
Also, When you go to your doctor's visit, you fill a paper out that asks you if you have another appt. with any other doctors and when the appt. is. I was honest and the appt. I have made with this new doctor is a month from now. They didn't mention it and went ahead and made me another appt. for me there anyway. I know I have to cancel with them because I don't want to go back there and Voc. Rehab will only pay for one or the other. But I was afraid to elaborate on it right then because I wasn't real sure about how pain clinics work because this is my first experience with all of this. But I was afraid that they wouldn't prescribe me my meds if I talked with them about why I am going to a new doctor. The doctor I see now just doesn't seem to accommodate my needs and also when Voc Rehab stops helping me financially I will not be able to afford to keep going there. I have a disability case in the works now but it is a long waiting game!
I guess my question is do pain clinics make a big deal out of it when you want to switch to another one? I know I'm in contract with them so how do I go about handling that. Do I call and cancel my appt. with them and explain the situation so I will be out of contract with them? And, has anyone ever tried this ointment? Any advice would help. Thankyou, Jenniegump

[reruho]

Jenny
You can change clinics without any stigma. I have done it. I had a falling out with my 1st PM doctor. I called my lawyer and asked him for a name of a new doctor. I called my Primary and requested another referral for a new doctor. I even told my Primary what doctor I wanted and where I wanted to go. I had a new referral in a 3-4 days. You probably will have to go through Voc Rehab to get approval for a new doctor.

My PM doctor doesn't ask any of those questions of me or even have me fill out any questionaires. If I ever go to another doctor I tell them about it and share any copies of labs/procedures with them. But, I also give them a written list of all my medications each visit and I do a pill count and have that information on that sheet. My first PM clinic had me sign a drug contract and my 2nd has never asked me to sign one. When I started taking Vicodin I asked about it and they said no we didn't need one. My present PM clinic has only had me sign a form acknowledging it can take up to 72 hours for a refill request. Each clinic is different.

Also, my 1st PM clinic did not ask me any questions about my leaving. I had been there just days before. I just walked in and signed the release form to send my records to my new clinic. At the new PM clinic, once they found out who my doctor was, there were no questions. They knew the old PM was a jerk. My doctor had worked with him before he started this clinic. These doctors know each other and how they treat their patients.

Go to the PM clinic and sign a release form to transfer your records to the new doctor and cancel your appointment. Be polite but be firm. If they ask if you want to reschedule, say NO. If they want to ask why, tell them YOU DON'T WANT TO DISCUSS IT. The staff know what their doctor is like, and if she is a jerk they know it. My old PM clinic sent my records over the same day but your clinic might not. Remember, these guys work for you. Your insurance company pays big bucks for them to provide you services.

I know several people that use pain ointments, I do not. Many find them useful. I use a Epsom Salt Gel for additional pain relief.

I hope this helps.
Reta
I hope this helps.

[reruho]

Jenny,
Did you change clinics and how is it going?
Reta

[jenniegump]

Hi Reta,
I did what Vocational Rehabilitation told me to do and rescheduled my appt. with Unifour pain clinic until after my appt. with the doctor I really wanted to see. Unfortunately, I ran out of pain meds and still had a week to go before my appt. with Dr. Watson. I tried to call both Unifour and Dr. Watson's office to see if they could get me in this past Mon. because by last Saturday afternoon I was hurting so bad, I contemplated literally cutting off my arm all the way up to the shoulder it hurt that bad! The pain cycle continued all through until Monday and I alternated between my tens unit and heating pad continuously with no pain relief. I could not sleep at all from Sat. am until Tues morning around 12 am. I couldn't take it any longer, my mind raced with crazy thoughts and my body ached more than I ever knew it could.
You see, since my accident last Aug. and being diagnosed with RSD - I have always been on some type of pain medicine, even if it wasn't a narcotic. I was at least taking tramadol, or ultram. This past weekend I wasn't taking anything because I knew that at my appt. on Friday I will have to take a drug test I didn't want to do anything to mess that up. I am putting all my faith in this doctor because, well for one, I don't have much other choice right now, I have been waiting two months for this appt. and for another I really don't connect with my doctor at Unifour and surely, Dr. Watson can't be any worse ( I hope, knock on wood), and I have heard wonderful things about this doctor from some very well respected people I know and trust in. So, I ended up having to call a friend and ask her to drive me to the E.R.
I was a bit nervous, because I didn't want them to think I was a pill head junkie coming in just to get high. Although, it was the same hospital I went to last year when I had my horrible accident so they had all that info on record. The e.r. doc I saw was very straight up with me and I appreciated that and I was the same with him.
He was familiar with RSD, which I was thankful I didn't have to sit and explain it all to him. So I asked him when they were going to find a cure for this and he said, "They're Not!". I said, "Great, Thanks!". He explained that there is just not enough understanding of the cause and without that how can they find a cure. I knew that though, I just wanted to see if I would get a different answer. He told me that he would write me a script for what I was prescribed before and have been taking, percocet but that Unifour would be done with me if he did that. I had to make a decision and I didn't plan to go back there anyway. His only concern was that it may look bad on me. I said to him that all I could do was be honest with Dr. Watson when I go to see him on Fri. and take my hospital papers with me and my script bottle with the amount of pills I have left to show him that I am taking them as prescribed. Dr. Watson is not a pain clinic Dr. though so I don't think it will be a big deal. He does specialize in RSD but he is a Sports Medicine doc. You don't even have to sign a contract with him.
I couldn't suffer like that anymore though, that was the worst. Plus, since the medicine was out of my system so long, it took that much longer to kick back in and I have been in extreme pain ever since, it's not as edgie but I can tell a huge difference from last week.
Bottom Line, if you have a good doc - stick with them and don't miss any appts. Stay on your med regime and if you don't have a good doc that doesn't care about you enough to care of u if you are suffering or not---------- FIRE THEM! Remember, they are working for us too you know. We should be the ones going into that first appt. interviewing them.
Also, I found out through my disability lawyer that SS is already reviewing my case and she doesn't think I am going to have to have a hearing! Which is great news. She said, they are going off of my medical records, so I will find out tomorrow probably whether I was approved or not, wish me luck everyone, I'll let you know.
Blessed Be.

[reruho]

Jennie,
I don't understand a few things.

1) Your old PM clinic did not prescribe enough medication to last from appointment to appointment, correct? Aren't you allowed to call for refills in between appointments? Won't going to the ER be considered breaking your pain medication contract? Do you think breaking the contract could work against you? What if you don't like this new doctor? You might be screwed.

2) Why do you think you needed to detox before the appointment with your new doctor? If you are prescribed these medications, they will expect to see them in your system and at certain levels. So if it comes up on the test no one should hold anything against you. Unless you want this doctor to see how much pain your are in unmedicated. Did this doctor ask to see you unmedicated?

I think it was wrong for you to go without medication and suffer so badly. The problem is if we complain we are looked down upon as druggies, instead of patients that have not been treated properly. We are caught between a rock and a hard spot.

I am happy things are going well with the application for disability. I hope it goes through and things will start looking up for you.

Reta