I am proud of you for tackling this sensibly. Giving a team of doctors the chance to treat you before having the surgery is a very wise idea, they may be able to slow the recurrance of flares, who knows, but giving them a chance is certainly worth it. Your primary care Doc (PCD)will be in charge of your pain, neither the derm or the IDS will want that responsibility.. my IDS prescribed medication for my HS and infections, however he preferred to leave the pain meds up to my PCD and would only prescribe pain medication when it was absolutely impossible for me to see my PCD. The first year I saw the IDS on a regular basis, and after that I only had to see him when something huge was going on...like I recently had systemic infection, but other than that my PCD treats me on the same schedule that they all worked out together as a team. It probably isn't the best method for some, but it works well for me especially since my PCD is 2 blocks from my house and the other 2 doctors are well over an hour away.
I consistently see people posting on here about being unable to get pain medications from the doctors, and this not only infuriates me but baffles me as well. Living with HS is bad enough physically on the outside and mentally on the inside, but having to deal with chronic severe pain is enough to wear anyone down and make them have horrible thoughts.. it did me at least, I was ready to cash in my chips, I couldn't take it anymore. Please talk to your doctor and tell him/her that you feel this way.. that the pain is just diving you crazy and you need something to take the edge off of it. Total pain relief is not ever going to happen, and make him/her understand that you are awae of this fact.. but that you just need some type of pain control that makes life worth living and makes the pain tolerable. There are SO many pain medications out there that will work wonders for you, omg you have no idea.. insist on this if nothing else it will help you live with your HS until you do have surgery (if you choose) and if you choose not to have surgery it will improve the quality of your life to the point that it improves your mental well being as well as your physical well being. Being in constant uncontrolled pain is enough alone to cause more and more flares, just from the stress of dealing with the pain, so this cycle will not get better unless you get some pain control. Absolutely insist in some pain medication and do not take no for an answer, no pain medication is NOT an option at this point!

oh, and there are pain medications available to you at a low cost, the doctor may even be able to provide you with some samples, mine did. I got enough free samples from the doctor that I did not need to purchase all the medication that he prescribed, which was a relief and left me some extra money to pay for my pain medication. Ask your doctor for a generic pain medication and that is lower priced as well. Compare prices too, I called 3 different pharmacies and asked them how much it would ocst to fill a prescription for my pain medication before I went in, then I went with the lowest, this might sound petty, but there was a 4 dollar difference in their prices for the SAME thing! I could use that 4 bucks for a gallon of gas or a gallon of milk, no since giving it to those greedy asses! LOL.

Thanks so much Rebecca for your advice.I can see you have dealt with this waaay longer than I have.Like you I don't understand why a dr. wouldn't prescribe pain meds.Guess you just have to kinda chalk it up to all those wonderful celebs with their multiple drs. and multiple "friends" to stand in for them to get pain meds,who then overdose on the cocktails of meds readily and happily supplied to them by drs. who love to give them what they want,and the friends who help them get meds,just for a "high" or WHATEVER the case may be. I have enough trouble with pain meds,what with the stomach upset and the phenegran I have to take with them to tolerate the side effects.Percocet isn't as harsh on my stomach,but Vicodin does a doozy on my stomach,especially if I don't literally sandwich the pills between two FULL meals..needless to say..that doesn't help the waistline one bit..lol...at this point it's not like my weight is the most pressing issue I have. I am however (so long as it is not forbidden) going to print out some of the info. people have given here,and how it affects people and such.I've also started taking pictures of the abcesses as the come up,what they look like after lancing/or draining on their own,and anything else I can possibly think of. I do,however,know that my former GP has made it a policy (and it now states it in their little brochure) to not prescribe pain meds, but to pass that little job onto whatever dr. she sends you to. I'm not sure exactly what happened to cause this change in her practice, so I am considering getting a new GP,but I do know this will be a nice new pain in the ass,since I would need to go through all the changes you go through when switching drs. Also I know it could possibly look bad to go from one GP that you have seen for a few years, to suddenly changing to a whole new dr. It is soooo irritating to see so many of us struggling to just get relief from drs. who are scared to write certain prescriptions thanks to the REAL drug/high seekers.(I have one in my family,and soo many times I have just wanted to snap their neck!)Thanks again Rebecca for your insight! It is soooo appreciated!

My 2 cents...
I do work in the medical field. Md's won't give pain meds becasue too many people are abusing them. They don't understand the pain of these lesions unless you express it to them. It's so important to have a good relationship with your doctor. I love my doctor and I actually refuse pain meds becasue I personally don't like them. Please look around until you find a doctor that is willing to work with you and understand you. I know it's difficult to find a doctor that understands HS, but I do believe they are out there. Don't give up and you have the right to be in control of your medical care. Don't make pain meds your #1 thing becasue they then think you are a drug seeker. It's just the way it is in this world of medical bliss we live in.

I agree for the most part what theocs has said, DO seek another doctor, and you DO have the right to be in control of your medical care.. pain relief included. I know it is a pain in the ass to switch doctors, but seriously even if you have been going to your current doctor for 50 years, if she is NOT helping you then she is part of the problem. Ditch her and find a doctor that you can make a team member in your fight against HS. While I love my doctor dearly, I credit him with saving my life after I hemmoraghed post c section and was nearly dead when it was discovered, I would drop him like a hot potato in a second if he ever once denied me pain medication that I desperately need to be able to maintain my sanity and make it through the day during a flare. I am not in any way shape or form an addict, however I do DEPEND on the pain medication to maintain a tolerable pain level and have a better quality of life during a flare. I am very very careful to monitor my use of pain medication and make sure that I never refill excessively or use more than I actually need to knock the edge off the pain. I personally view any doctor who refuses pain medication as a barbarian. Who in their right mind would allow someone with a baseball sized cyst to prefer death over the pain? This is the year 2010, not 1710 for Gods sake, we have the ability to put people on the moon, and the ability to control pain sensibly.. to give up that right as a doctor is just as smart as going to the gynecologist fot a tooth ache!! It is just asinine in my mind. I simply can not understand it. While I am sure pain control is right up there in the top 2 priorities for you right now, I can understand the need for not looking like an addict searching for a fix, but when you are in the worst pain imaginable I see no sense in hiding that fact from your doctor either! I agree you SHOULD copy info from this site, get testimonials for your doctor to read.. I almost killed myself over the pain (literally!).. and take photos of your HS sites, do everything your your power to get the help you need, there is NO ONE out there who will do this for you, you MUST be adamant in your search for a doctor that will HELP (not hinder) you. Pain should not be a major factor that you have to deal with constantly to the point of losing your mind, especially when there is medication out there that will take the edge off and improve your quality of living and make getting up every day seem at least possible! I hope you find the doctor who will help you as soon as possible!!