Tuesday, April 3, 2012

b/c clearly pain management doesn't require a decent bedside manner

I confess....I've felt like the potato in a game of medical Hot Potato.  I also know this is rambly and that I'm becoming a bit of a broken record since I really only "talk" about the back issues.  I do have a book to review and might post that later but I need to vent. 

I saw the pain management doc on Thursday.  I was actually told I'd only see the physician assistant but after the nurse clocked my pulse at 117bpm, she had me lie down and the doctor appeared.  The nurse had taken a detailed history but the doc didn't ask any questions.  He acted like I was interfering with his day by being there.  He was brusque and didn't make me feel listened to at all.

The plan he put forth is injections that would eventually block the nerves.  This is not a fast answer since they need two test rounds before the real treatment.  I had the first test round on Monday.  The nurse was kind but the doc was visibly annoyed when he was told I was nervous.  Clearly it is silly to be nervous before they put needles into your spine.  He'd been unsure if the trouble was at the L4/L5 and L5/S1 or more at the SI joint. He went with the former.  It was pretty painful...there were four injections of local anesthetic and then the medicine itself...but didn't take that long.  I got a bit of relief (moved from a 7-8 to a 4 on the "pain scale") for about 30 minutes.  I'm not sure if that qualifies as a positive result or not.  I have a follow-up office visit next week. 

I am absolutely looking for a long-term fix (and will avoid a long rant about how I thought the surgery WAS the fix), but I also need help in the short-term.  I've gone from walking 6 miles a day to being bed-ridden.  That's not okay and it's just been getting worse since late February.  At the first appointment, the doc said he wanted to try a new pain medicine.  I tried it and it did not agree with me at all...I fell twice and felt all the blood rush from my head and into my feet whenever I stood.  It also barely took the edge off.  When I got the shots yesterday, I told the nurse beforehand about the bad reaction.  After the procedure she told me that the doc said to discontinue the medicine but that he wasn't going to give anything to replace it.  MM was there since I needed someone to accompany me home.  He banged on the office door (the suite was an odd set-up and the entire office was behind a locked door) and told the nurse that, having seen what the past weeks have been like, it was not an acceptable answer.  The nurse talked to the doc said to see my GP.  It felt RIDICULOUS to go to my GP for pain help when I had just seen a specific pain management doctor.  I'd been in last week but the GP had me come in again today.  He did offer a new approach...the medicine takes a few days to build up but hopefully it will help and a few days is a LOT quicker than the weeks or months it may take before the shots really work.

The pain doc also referred me to their psychologist.  I do think my actual depression is well-controlled but I am obviously not a happy camper given the rapid decline in quality of life.  The way the doc framed it, however, was downright offensive.  He said it was to teach me to identify when pain impacts my mood so "You aren't mean to your boyfriend when the real issue is the pain."  SERIOUSLY?!?  I retreat when I hurt.  I don't talk nearly enough to be mean (MM agreed).  My rapid change in life DOES impact him, but the assumption that I'm mean to him was plain rude (and sexist).  I'm trying to reframe it better in my head.  The psychologist is focused on only pain patients and I probably wouldn't have been opposed to trying it if it had been presented as helping me cope with the stress of pain while we work on the medical angle.

I know that some doctors are great at medicine but lacking in bedside manner.  But I would think pain management specialists would be good with people in pain.  I'm trying to believe that the injection plan will lead to good results, but can't see myself ever recommending this clinic to anyone.  Maybe my sleep doc can give this guy some tutoring.

1 comment:

Annabelle said...

I had one pain management specialist like that. Not only was he useless, the waits for your appointment in his office were often upward of 2 hours, which for a practice consisting entirely of people in pain was really not acceptable. Thankfully I found another one who was much better after a while. I hope you do too.