Aa
what kind of dr do i need?
i posted a fluroscope pic of my lower back...MRI shows collapsed L5-S1 with bone spurs and disk above, L4, shows a tear, complete fluid loss a.k.a. "black disk" and about 1/2 way degenerated.
i have had 3 epidural steriod infections and 1 facet joint injection...surgeon suggests rhizatomy to help postpone a surgical double fusion...at the monent i am pain managed, 4 norco day, 1 (50mg) lyrica nightly...i'm in the process of locating another surgeon b/c insurance switching...just got referred to pain management dr for rhizatomy discussions.
should i be looking for neurosurgeon or orthropedic surgeon when the time comes for futher surgical discussions?
what is yout take on the damage you see on the pic?
should i be on extended release me with breakthru med since the meds on now listed above is just barely helping?
thanks for your time
i have had 3 epidural steriod infections and 1 facet joint injection...surgeon suggests rhizatomy to help postpone a surgical double fusion...at the monent i am pain managed, 4 norco day, 1 (50mg) lyrica nightly...i'm in the process of locating another surgeon b/c insurance switching...just got referred to pain management dr for rhizatomy discussions.
should i be looking for neurosurgeon or orthropedic surgeon when the time comes for futher surgical discussions?
what is yout take on the damage you see on the pic?
should i be on extended release me with breakthru med since the meds on now listed above is just barely helping?
thanks for your time
Sorry about the typos/mistakes;my eyes and hands aren't what they used to be. Smile!
Well, I am recommending you:
First, write a brief background about your back issue
Secondly, write about your pain; what kind of pain, how long it is lasting, where the pain is and what you cannot do because of it, and the intensity(pain scale is usually used 1-10;10 is the worst)
Thirdly, write about the current medications you are on and how they are not helping. If you can have something prescribed for you that is extended release and something for breakthrough pain. Mention about the Dilaudid you had used in the past for pain after your c-section and that it was effective(for the breakthrough pain); not sure if that will be just as effective for your back though. I do not think the physician will think you are "med seeking." Now if you are coming back to him/her every two weeks for more and more prescriptions or telling him gimme that narcotic, that dose and I want to take it like this in the first visit maybe he/she might be suspicious.
Thirdly, keep it short and sweet; to the point. The one thing I think that really annoys physicians is the patient acting like they are the physiciann and sucking up their time with nonsence. The meeting should be a dialog, not a monolog from either side.
Lastly, again, WRITE IT DOWN AND READ FROM YOUR SCRIPT. It will keep the meeting on track and address all your needs without wasting time trying to remember everything and get it out in enough time. Keep it focused on your pain control issues.
You might have to ad lib a bit.
Keep us posted.
First, write a brief background about your back issue
Secondly, write about your pain; what kind of pain, how long it is lasting, where the pain is and what you cannot do because of it, and the intensity(pain scale is usually used 1-10;10 is the worst)
Thirdly, write about the current medications you are on and how they are not helping. If you can have something prescribed for you that is extended release and something for breakthrough pain. Mention about the Dilaudid you had used in the past for pain after your c-section and that it was effective(for the breakthrough pain); not sure if that will be just as effective for your back though. I do not think the physician will think you are "med seeking." Now if you are coming back to him/her every two weeks for more and more prescriptions or telling him gimme that narcotic, that dose and I want to take it like this in the first visit maybe he/she might be suspicious.
Thirdly, keep it short and sweet; to the point. The one thing I think that really annoys physicians is the patient acting like they are the physiciann and sucking up their time with nonsence. The meeting should be a dialog, not a monolog from either side.
Lastly, again, WRITE IT DOWN AND READ FROM YOUR SCRIPT. It will keep the meeting on track and address all your needs without wasting time trying to remember everything and get it out in enough time. Keep it focused on your pain control issues.
You might have to ad lib a bit.
Keep us posted.
thank you very, very much for taking the time...i have appt. tommorow with a pain specialsts referred by primary dr...primary dr says he is known for good sucess for rhizatomy's which a previous surgoen suggested. i'm currently gathering research on that procedure both medically and from patient reviews...i do not plan on jumping into anything and therefore is why i want info on pain meds for the in btw time.
which, if you don't mind, leads me to another question...i hope it's not a weird question...now days with the limited time insurance puts on appt times it's necessary to go in w/ all angles of questions and info.
what is the best way to address questions on pain..in other words...is it annoying for docs to hear patients coming in w/ an idea of what meds they want to try? i have a feeling the "drug seekers" may do that in some way or another and i don't want to say any trigger words that might throw docs off track and therefore possibly waste precious minutes of my appt time...sometimes it's hard to describe all the pain and what level's they might be...blah...blah..blah...hell, i don't know what pain-free is to have a base line to judge from...what i know is the past and current meds and procedures that have little to no effect...and like most people on patient forums do..they discuss what they find has worked for then etc..etc...which is the only reason why i would mention to dr's a specifc kind of med to try and so forth...i want to and hope to explain all of this to dr but time always runs out...i mean...if there was no time limit...i could be there all day long trying to explain symptoms and what has or hasn't worked...know what i mean????
after talking to similar people w/ similar injuries etc...it was suggested i might benefit better w/ ext. release med and breakthru med...rather than my current 4 norco ir med...they say oxycontin er and oxy ir for breakthru work for them and some suggest breakthru like didulad (sp)....which worked well for me after my c-cection....i do know i'm not comfortable w/ the fentaly patch..not b/c i've tried it..just b/c it's scary to me...
your thoughts???? so sorry this is long-winded...this is the very reason why i need to consolidate my ?'s prior to appt ...lol
which, if you don't mind, leads me to another question...i hope it's not a weird question...now days with the limited time insurance puts on appt times it's necessary to go in w/ all angles of questions and info.
what is the best way to address questions on pain..in other words...is it annoying for docs to hear patients coming in w/ an idea of what meds they want to try? i have a feeling the "drug seekers" may do that in some way or another and i don't want to say any trigger words that might throw docs off track and therefore possibly waste precious minutes of my appt time...sometimes it's hard to describe all the pain and what level's they might be...blah...blah..blah...hell, i don't know what pain-free is to have a base line to judge from...what i know is the past and current meds and procedures that have little to no effect...and like most people on patient forums do..they discuss what they find has worked for then etc..etc...which is the only reason why i would mention to dr's a specifc kind of med to try and so forth...i want to and hope to explain all of this to dr but time always runs out...i mean...if there was no time limit...i could be there all day long trying to explain symptoms and what has or hasn't worked...know what i mean????
after talking to similar people w/ similar injuries etc...it was suggested i might benefit better w/ ext. release med and breakthru med...rather than my current 4 norco ir med...they say oxycontin er and oxy ir for breakthru work for them and some suggest breakthru like didulad (sp)....which worked well for me after my c-cection....i do know i'm not comfortable w/ the fentaly patch..not b/c i've tried it..just b/c it's scary to me...
your thoughts???? so sorry this is long-winded...this is the very reason why i need to consolidate my ?'s prior to appt ...lol
I would recommend seeing a Neurosurgeon from what you have mentioned. The picture was kinda confusing.
Secondly, have you told pain management that the medications are not effective? He/she maybe able to adjust the dosages and/or add another one on for breakthrough pain. From the description of what is going on with your back I don't think you will be totally pain free.
Keep us posted about you outcome.
Best of luck.
Secondly, have you told pain management that the medications are not effective? He/she maybe able to adjust the dosages and/or add another one on for breakthrough pain. From the description of what is going on with your back I don't think you will be totally pain free.
Keep us posted about you outcome.
Best of luck.
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