Medical Prof.

[lotspain]

I cannot afford to see a pain clinic so I see a community health clinic who is not aware of the needs of chronic pain clients.  My Nurse Prac. does not feel comfortable perscribing level of medication needed to allow me to deal with my pain.  I was on 4 60 mg of MS Contin when I began seeing the clinic now she has me at 30 mg daily.  Along with anti inflamitory.  How do you manage when you medical clinic is not educated in the needs of chronic pain but you cannot afford and have no medical insurance to see the pain clinics you need.  WIth all the drug abuse out there no one wants to take the responsibility and treat those of us who need the medication honestly.  The pain is so bad I do not know what to do, I have had relieif in the past when I had insurance.  I am denied low income insurance due to my husband disability being $11.00 a month over the limit and there are no exceptions.  What do other do out there?  I have searched all the local low income fields and am in too much pain to work and if I did work would loose my option to apply again for disability.  I am really at a lost, I feel like I need a surgar daddy or mommy just to cover my medical needs.

[Weffette]

Thank you for the support.  The most frustrating part...doctors tend to minimize and discount health concerns. I have a 9mm granuloma in my lung that NOBODY wants to look into. Back in 2004, I had CT's and saw a pulmonary doc, but said I was fine. Exposure to asbestos fro birth til I was 11...killed both my parents. Raw dust from dads work clothes (he was a pipe insulator, mixing the powdered form with water so the pipes could be wrapped and sealed with the mixture).
Not one single doctor takes me seriously.  I have a 2 page list of my health history (illnesses and disorders)...they look at me like I am kookoo. I also have a list of my limitations in conjunction with my health history. At 1st they appreciate it, but never do they want to investigate. I am a puzzle and I need to be put together so everything I am feeling makes clear sense.
Sorry...I started a tangent LOL
Again thanks for validation!

[keaheRN]

I, too, am truly sorry for those of us who experience chronic pain. On top of getting through the day, we also have to deal w/ doctors, insurance companies, disability workers, financial limits AND advocate for ourselves just to get appropriate care, Not an easy task. I asked lotspain several questions to try to understand the situation better. To go from 240mg/day of MS Contin to 30mg/day is a huge decrease (hope it was a slow taper...). I believe that NPs, MDs & other professionals DO feel uncomfortable prescribing controlled meds; there are laws & guidelines they have to follow that deal w/ specific diagnoses & documentation of why opiates are needed. There are pain management MDs that are just as hesitant to prescribe. There are many ways to treat chronic pain; medication is one of many tools. Weffette, you made a great point about writing down questions to ask. I write everything down & keep a "pain/wellness" journal, too. It really helps when explaining symptoms, changes, what helps/what doesn't, etc. And the more you document, the easier it is to apply for disability. You can also ask for your medical records. Providers have to give them to you by law. Hang in there & be well. <3  

[Weffette]

Oh boy do I understand where you are at right now! I, too, saw an N.P., that treated me like I was an idiot and that all my illnesses were no different than 100's of her other patients.  She has refused tests, medications and was so demeaning to me...I left the clinic in search of another. I have a health plan that is so limited, that many medications for my chronic pain is extremely minimal. I have applied for SSDI also, 3rd time. Without the proper health care, we will continue to deteriorate. The most important thing you can do for yourself (sounds like Judge Pirro :)  ) is become educated in your illnesses and be your own advocate. No one knows your body better than you do! Make a list of questions for your NP and the next appt you make with them...request 1/2 an hour or longer appt.
Unfortunately, many health clinics are so over booked and back logged, we are just another $ sign. It is so frustrating to have our concerns dismissed and ignored. Grrrr...sorry for ranting...I am just so disappointed in the profession called "medicine" and the lack of the ethics they were sworn to uphold.
I wish you so much luck!  Remember...make them HEAR you!

[Tuckamore]

Hi Lotspain,

Welcome to the Pain Management Forum. I am glad that you found us and took the time to post.... but sorry to hear about your chronic pain and your situation.

Have you talked to your NP about alternative physicians or clinics? Sometimes they have the answer or can help you find one. Unfortunately most PMP will not see a patient that does not have insurance.

When you say that you've applied for disability I assume you are referring to SSDI. Unfortunately even if you are approved you'll have a six month wait for Medicare Benefits and it can be difficult to locate health professionals that will accept only Medicare reimbursements.  

I've been blessed that I have never been without private insurance until my disability Medicare (SSDI) became effective. Is your NP willing to prescribe a less potent opiate for break through pain? Meaning you would have the MS Contin and another opiate? How about medications that will work with the MS Contin that are not a opiate?

Have you discussed any of these possibilities with the NP? Additionally in most states a NP must work under the direction or supervision of a physician. Is the physician available to prescribe for you? I know that there are clinics that only NPs manage but somewhere there may be a consulting physician....it won't hurt to ask.

I wish I had better suggestions for you. I do hope you'll keep in touch and let us know how you are doing. My heart goes out to you.

Take Care,
~Tuck

[keaheRN]

What kind of pain do you have? How long have you had chronic pain? Were tests done? What treatments have you had in addition to medication? Did you request that your records from your previous health care provider be sent to the clinic? Are you receiving disability benefits?