Hi Kayla,

Pain Management is just what it says, a De. who specializes in helping you "manage" your chronic pain. They use different modalities of treatment, different therapies, they are not just pill pushers. They will look at your case individually and come up with a plan for what they think will work for you. One very important thing to remember here...the goal is not to cure or stop your pain, that rarely happens...the goal is to get your pain to a manageable level that allows you to live day to day with a quality of life that your comfortable with.

Unlike other Dr.'s seeing a Pain Management Dr. comes with very strict rules and most require that you sign a Pain Contract. The Contract states things like, if you are on pain medications you are only allowed to get your meds from that Pain Management Dr., nobody else, except in the case of a life or death emergent situation. So this includes the E.R.. If you have to have things like Dental Surgery, where you normally need additional pain meds, it would be your responsibility to let your PM Dr. know about this and get it cleared through him before the day of the procedure. The Contract also states that you must comply with random urine testing at your Dr.'s convenience as well as pill counts. It specifies rules about missing appointments, how you go about getting prescription refills. What the offices Policies are and what the grounds for dismissal from the office are. It explains things like, if you lose your meds, you don't get an automatic refill, you have to wait until your next one comes around, etc. Most PM Dr.'s require you to keep all narcotic meds in a lockbox or medication safe, so that mishaps don't occur. They also strongly advise against making it general knowledge that your taking strong narcotic meds....you'd be surprised how easy a so-called friend will still your meds.

At your fist visit your PM Dr. will do a pretty thorough exam and look over and tests, reports, films, MRI's etc. that you bring from your current Dr. I know that your pain is uterine varicose vein related and that's rather rare for someone your age who's never given birth, so not sure what else they'll do for your that your GYN isn't. Narcotics are not great for stomach pain because they're hard on the stomach and sometimes make the pain worse. But their may be other anti-spasmodics, muscle relaxants, anti-inflammatories...different things that they may be able to try to get your pain down. They may have other modalities of pain control to try for you. Don't be surprised if they ask why your not considering a surgical fix...PM's consider everything to stop the pain...they don't like to see people on narcotic meds for long periods of time if they can help it. Don't be surprised if they ask you for a urine test, some do to make sure your not on any illegal drugs or to make sure your taking the meds you say your on.

Some of them can be very direct and get right down to business and some are caring with a great bedside manner, unfortunately that part you don't get to clue in on until you meet them. Hopefully you'll get a great Dr. that has some ideas how to get this pain to a manageable level so you can get back to living your life. There are many good Dr.'s out there, but PM's can sometimes take a little while to "warmup" so to speak.

Just be yourself, be honest, ....your there because you need there help. Write down any questions you think you might have the night before, because in the moment of the appt. you usually forget. And try not to be overwhelmed by all the Rules and Procedure.....these things are there to protect you and the Dr. and rule out addicts and drug seekers, so they are necessary, but don't be intimidated....just be you and let this Dr. know that you've tried everything your GYN could think of and it's not gotten better...you need their help.

Good luck, take care and let us know how the appt. goes.

kat

Thank you so much katlyn! Now I feel better knowing what will happen. I would have so overwhelmed the day of to have all that info thrown at me. Now I can make my list of questions/concerns and have them ready. My BF is also going with me, so I will have him read this too so he doesn't freak out. That is how he is tho.

Its funny, but I understand all that you explained. I will be honest about the fact that I do NOT want narcotics if it can be at all avoided.

My bf is having a hard time with all this as well. With me not working its a lot of stress on him, plus he hates seeing me in pain. Even when I put up my wall that I'm fine he sees right through it. At this point he just hates the medical field lol. He can't understand why they won't help me. Tensions have been running high in my neck of the woods.

I'm now excited to see the PM. I was worried they would just give me meds and say 'well, here you go. Your on your own now.'

kat you are so knowledgeable thank you for the break down (((hugs)))

Hey Kayla,

I hope that you get some answers so things can calm down...I know it's hard on our loved ones, they don't like to see us in pain, they don't like that they can't control any of this and men often end up feeling like they've failed in some way because they can't fix us....Chronic Pain is hard on relationships. And stress and tension just makes the pain worse....the whole situation sucks. So anything that you can find to get you back to a life that works, is worth checking into. I would encourage your boyfriend to write down any of his own questions that he might have for your PM Dr.

Take care,

Kat

Erika,

Thank you for the hugs, I hope your feeling better after your hectic week with the oral surgeon.

Take care,

Kat

for each person PM can a be a bit different EMSA has been down this road with this type of pain for her its been a series of shots and nerve blocks and PT. she not online everyday so i wanted to share what someone in that type of pain may go through
also you may want to call ahead of time explain your kind of pain and how that office might tickle the issue as the largest PM clinic in the area will tell you over the phone they only do shots, for myself I lacked a DX and asked how can you do shots when you don't where or why I'm in pain they said MRI, PT, therapist,shots, nerve blocks and than they would move on to burning the nerves ..I left and never came back

just wanted to give you a heads up that there is a whole system in play and many don't want to take your case unless you fit into a mold of standard treatment and lets face it there is nothing standard about pain and given a young age its even less standard. I just worry you'll get your hope to high and there will be a crash landing happens to many

I wish you all the luck in the world this just things I've seen and IMHO also be so very careful with any medications as side effects are a real danger my GI track almost came to stop and I was in the hospital for almost a week, than i had right side pain that felt like I was being stabbed for 9 months till I stopped all meds to weed out the reason .

again just giving you the not so pretty side so your informed
best of luck and please keep us posted on how it goes for you
tori

Kayla,

Just so you don't think I'm giving you advice with no knowledge of stomach pain or dealings with a OB/ GYN,. In 2000 I had to have a Nissan Fundiplication to fix Severe GERD and a Hiatal Hernia and then in 2004 I had Severe Endometriosis that webbed my Uterus, Ovaries, Small Intestines and Bladder together. I ended up having a Complete Hysterectomy with 3 additional surgeries to remove part of my Small Intestines, 1/2 of my Bladder and then a Bladder Reconstruction. I had a regular catheter in for 3 months and then a SuperPubic Catheter in for 4 weeks. It took a while for my Bladder to learn how to work again, and I had 24" long stints in from my Ureter to my Kidneys during a great deal of this time.....Stints are very painful and cause a kind of cramping that rivals childbirth. I've also had surgeries to remove my Gall Bladder, Spleen, Appendix, 2 right Kidney Surgeries and 2 C-Sections. So I deal quite a bit with stomach pain from scar tissue buildup and "Floating Organs", I've lost so many internal organs that the ones that are left tend to move around a bit into places then shouldn't be...and it gets painful at times.

So I do Pain Management for Stomach Issues also, not just Joint Pain/Bone Pain. I've been in Pain Management in 3 different States and never been turned away by a PM Dr. because my case was too difficult or because they didn't know exactly what caused what. If you go in looking for help, in whatever form they offer and don't just go in and demand pain meds....they tend to be more willing to help you and try to find different therapies that will help you. The other thing to remember is your PM Dr.'s job is not to Diagnose you, he's there to treat your pain. I've always found that Dr.'s in University and Teaching Hospital type settings make some of the "best researchers of non-standard conditions","most interested in helping you find an answer" and "most willing to try different things to find out what works."

I'm not sure where your at, as your profile doesn't say. Hopefully you have some choice in the Dr.'s you get to see.

Take care,

Kat

How long have they been doing gastric bypass surgery now anyhow? Maybe 30yrs?. Im sure there are tons of complications, side effects and problems like tori suffered that are still yet to discovered.

Kat you did an excellent job describing what happens at a Pain Management Clinic, that's exactly the way it was for me and all of the various people I have talked with, said the same about their experiences in the US. Good job!