Pain Management Community
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1187071 tn?1279373298

Question about pain drs.

First off I want to thank everyone for everything you have done for me. You guys and girls are great people and really care about people and that is what we all need right now. I keep going back to your posts and trying the stuff you have told me to try, but the ice and heat, I can't do that cause it makes my pain worse, my pain is worse in the winter time when I am outside and when I am infront of the ac.
I was wondering for all those that go to a pain dr what happen on your 1st or 2nd visit? I was told by MY pain dr that after I am cleared by the shrink which I have been and then i see him again the treatment will start and I will be under contract with him but until then to get my pain meds thru my PCP. Ok that being said alot of people on here don't get treatment on the first visit. This dr is a very caring dr and kept telling me how sorry he is for what I have been going thru and what I am still going thru and he will take care of me. Even tho he has said this I really don't want to get my hopes up. I WILL be asking for a nerve block to see if that helps me any (Sherry) cause I am willing to do anything to help this pain. Being off meds for such a long time has been very hard on me. And with me going in there not being on meds might be a good thing a fresh start. So I won't be going to any other drs til I see this dr like I have said before and I also wanted to clear up I didn't go to the ER for pain managment I went for fluids cause i was not eating.
I don't know if you guys will be proud or mad at me for what I have done but i wanted to tell you. As you all know I have been on so many meds for nerve pain like gabapentin 9 different meds and none of them did anything for my pain that is why I am thinking it is not nerve pain. Today my pain is in alot bigger area and I don't understand how this pain can move as much as it does. Anyway back to what I did. I started taking the gabapentin again it does NOTHING for my pain and it makes me very off balance, very confused very nervous but what it does do is make me very tired and very hungry when I was taking them in high doses I have falling asleep while eating. Anyway yesterday I had 2 300mg of them one of them in the afternoon when I was texting you Karen and the other one at night before bed. Well I ate alittle bit yesterday cause they make me hungry, I am not eating alot but I am eating which makes me feel better that I am getting food in me and I almost slept all night which I haven't done is so long, my son woke me up 2 times if that didn't happen I would of slept all night. I am going to keep it at low doses just so it will make me hungry and help me sleep. The bad thing is I am very off balance and I almost fell down the stairs last night, I am making sure I am taking my shoes upstairs at night so that don't happen. I was able to stop myself from falling with my shoes on.
So this post is to tell you guys I know I shouldn't be taking these meds cause the side effects are so bad but since I don't go back to work til next saturday I will take them so I can get alittle bit of food in my system and sleep better. Before when I was on these I was taking 8 300mgs a day and I will NOT get that high I will only take maybe 2 to 3 a day til i see my pain dr and I won't take them when I have to work cause I am a cashier and I can't get confused when I am working.
Thanks for everything you guys have said to me and all the advice I have gotten. I am always praying for everyone to get better and hoping you all over a great pain free day. You guys are the best.
23 Responses
547368 tn?1440545385
Here is one of the better Pain Scale I have found. It is a bit lengthy but I beleive it is also very understandable. I hope this helps. :)

Comparative Pain Scale
0 No pain. Feeling perfectly normal.

MINOR: Does not interfere with most activities. Able to adapt to pain psychologically and with medication or devices such as cushions.

1. Very Mild:  Very light barely noticeable pain, like a mosquito bite or a poison ivy itch. Most of the time you never think about the pain.

2. Discomforting: Minor pain, like lightly pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails. Note that people react differently to this self-test.

3. Tolerable:  Very noticeable pain, like an accidental cut, a blow to the nose causing a bloody nose, or a doctor giving you an injection. The pain is not so strong that you cannot get used to it. Eventually, most of the time you don't notice the pain. You have adapted to it.


MODERATE: Interferes with many activities. Requires lifestyle changes but patient remains independent. Unable to adapt to pain.

4. Distressing  Strong: deep pain, like an average toothache, the initial pain from a bee sting, or minor trauma to part of the body, such as stubbing your toe real hard. So strong you notice the pain all the time and cannot completely adapt. This pain level can be simulated by pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails, and squeezing real hard. Note how the simulated pain is initially piercing but becomes dull after that.

5. Very Distressing:  Strong, deep, piercing pain, such as a sprained ankle when you stand on it wrong, or mild back pain. Not only do you notice the pain all the time, you are now so preoccupied with managing it that you normal lifestyle is curtailed. Temporary personality disorders are frequent.

6. Intense  Strong: deep, piercing pain so strong it seems to partially dominate your senses, causing you to think somewhat unclearly. At this point you begin to have trouble holding a job or maintaining normal social relationships. Comparable to a bad non-migraine headache combined with several bee stings, or a bad back pain.


SEVERE: Unable to engage in normal activities. Patient is disabled and unable to function independently.

7. Very Intense:  Same as 6 except the pain completely dominates your senses, causing you to think unclearly about half the time. At this point you are effectively disabled and frequently cannot live alone. Comparable to an average migraine headache.

8. Utterly Horrible Pain: So intense you can no longer think clearly at all, and have often undergone severe personality change if the pain has been present for a long time. Suicide is frequently contemplated and sometimes tried. Comparable to childbirth or a real bad migraine headache.

9. Excruciating Unbearable:  Pain so intense you cannot tolerate it and demand pain killers or surgery, no matter what the side effects or risk. If this doesn't work, suicide is frequent since there is no more joy in life whatsoever. Comparable to throat cancer.

10. Unimaginable Unspeakable: Pain so intense you will go unconscious shortly. Most people have never experienced this level of pain. Those who have suffered a severe accident, such as a crushed hand, and lost consciousness as a result of the pain and not blood loss, have experienced level 10.

My Best to You,

144586 tn?1284669764
Read the November 2009 "Scientific American" issue on pain control.
Avatar universal
I haven't been on in a while, but I've been reading through some posts and I've seen that you've been going through this pain without meds for around a month!  I'm so sorry for you.  I completely understand your need to take *something*, anything for the pain. I think it's like torture to live with CP, it's like we'll tell you whatever you want to know or do anything you want just to make it stop.
I think on one hand, it's never a good idea to take meds without Dr. Auth., On the other hand, the doctors have miserably failed you and I understand why you need to take something to eat and sleep.
I really hope things get better for you soon!
1187071 tn?1279373298
My old nerve dr gave me the meds and I thought since they are mine it shouldnt be a problem to take them, they are not pain meds.
Also I wanted to add that I will be calling the mental health board tomorrow in my area about a pain shrink. Also I wanted add that I just weighed myself and when i went off my meds I was 160 and now I am down to 144 so I have lost 16 pounds since I have not been on pain meds. When I am on them I eat more, not alot but maybe 2 times a day dinner and snack. When I am off them I don't eat much at all. Maybe a few bites here and there. Being back on the gabapentin I am hoping I will eat more here and there. I know it won't hurt me to lose weight but I don't want to do it the unhealthy way. when I was getting stiched weekly my dentist and friend would always how much weight I was losing and how he was worried so he told me to start drinking ensure when I am in alot of pain so that is what I did. I might get some today and see if it helps. I got some a few weeks ago and it did help but the taste is so bad but I finished them. I drank them when my family ate dinner. Caregiver I will look that up thanks.
Avatar universal
Hi Jamie,

I'm SOOO Glad that you ARE going to try the Nerve Block. You've come a LONG way since you were first on here in what you are willing to do to take care or  your pain!!

Each PM Dr. is different. Just look at EVERYONE'S experiences here on MH!! Just like with my Dr. He had my records and knew EVERYTHING about me BEFORE I even walked in the door. He offered me ANY of the meds that I wanted as I had been TERRIBLY  - UNDER-TREATED - since I'd been getting pain meds and I DIDN'T even know it. BUT in my case too, I FIRMLY believe that my age (almost 64) played a HUGE part in what they were willing to give to me. When you are younger you are going to have to FIGHT to get what you need. They ALMOST NEVER start a younger person (such as yourself) on anything STRONG, they make you work your way up BECAUSE they worry about the possibility of you becoming immune to your meds TOO quickly and THEN where will you go? (IF you will have to be on them for your entire life. )

The one thing that you MUST remember is that you HAVE to try their treatments and NOT tell them know. They are Pain Management Doctors and NOT just MEDICATION Doctors. Their ENTIRE purpose is to MANAGE your pain without, HOPEFULLY too many pain pills. I KNOW that you AGREE that the Pain Pills are not the IDEAL choice and if WE, Chronic Pain Patients, had a choice we would ALL choose NOT to have to be on them. So it's a good choice that you have made as that will help you with this PM Dr. Just be OPEN to ANYTHING that he suggests that you try. You don't have to do ALL or them BUT you must be willing to do SOME of them and then he will know that you REALLY do want to TREAT your pain.

I hope that I made sense, as I'm taking care of my Granddaughter as I'm trying to post this to you.  :)

I would suggest that you STOP the Gabapentin BEFORE you go to your appointment as he very well MIGHT UA you and you DON'T want ANYTHING in your system that isn't supposed to be. I'm not familiar with Gabapentin and I DON'T even know IF it shows up in a UA. Just wanted to throw that out there IN CASE!!

I'm looking forward to hearing how your appointment goes as FINALLY it's ONLY NINE DAYS AWAY!!!

Good Luck.....Sherry

1322157 tn?1279660281

I also want to add that just because the neurontin (you took the generic form) does not help with the pain, it doesn't mean you don't suffer from nerve pain. I have nerve damage and nerve pain and have tried a number of 'nerve' specific meds that do not help - but it doesn't mean the pain I feel is not nerve related. It takes a lot of trial and error to find the combination that will work and nerve pain is some of the hardest pain to control.

I also agree with namnam (Sherry), please don't make the mistake of taking this and then being told you will need a UA at the first visit - you might be denied further medication if they think you asre self medicating.

If you decide to keep taking this medication, be upfront when you go in and explain to the new PM that you have been taking it with little results since it was the only prescribed medication you had on hand and your PCP had refused to help you  in the months leading up to this appointment. I have a feeling he will understand  - and considering it had been prescribed to you by your neurosurgeon- and considering he (the PM doctor) had assumed your PCP would help you before he had a chance to treat your pain - it will hopefully be a non issue...

Just be honest and up front if you decide to keep taking it.... or stop it 7 days before you go in to see him.

I am also anxiously waiting for your appointment and can not wait until the day you post a 'hurrah!' note on here, telling us you are feeling less or no pain!

I am glad you will take an injection if he offers it.

I may have missed your answer to the question that was asked before, but when was your last MRI or CT? AND, did you ever consult your sister in-law who is a nurse?

Again, forgive me if you did answer those questions.... I couldn't find the response.

Almost a week away.... IT'S ALMOST HERE!!!!! Hang in there!!!!
1187071 tn?1279373298
My sister inlaw is always working it is so hard to get ahold of her but I have been trying. And I don't think the  gabapentin shows up on UA, it isn't a pain pill. I could be wrong and if I am someone please tell me cause that is ALL I have in my system.
I know my age is against me. But I am not the one that caused this problem and I want it treated cause it can't be fixed. I also DON"T want strong meds. I want the less amount cause if my age. I will NOT take morphine and I have already told them that. Im going to tell the pain dr I am willing to do what ever it takes to get my life back, my kids need their mom back into thieir lives. Ball is over for both kids so we will be staying more at home. I will really miss watching them play. I know I suffered at the games but I was there and that is all that matters and they know how hard this has been on me and very happy I did it.
Forgive me but I forget who said it but someone on here said that my pain is controling my life and instead of me controling my life. that really hit me hard cause it is the truth. I don't want this pain to control my life I want to be able to control it. I will be talking to my pain dr about that also.
I have had my best friends husband kill his self, my dads best friend killed his self, my sons surgery, my mom being sick all in what 3 months? So it has been really had and stress makes my pain so much worse. So i am going to have to learn when I hear bad news on how to control it, cause it just seems like I have a black cloud over my head, like someone esle said on here that is the truth.
I was thinking yesterday and this is how I feel about all of this. I feel like I am a dog that got hit in the middle of the road and everyone looks at me and the drives off. I know that sounds really bad but the way my doctors have treated me that is how I feel. I am so hoping the pain dr will help me so I can quit feeling this way. Everything rides on this appt, I just don't want to get left in the road at the appt. And I was thinking about calling the dentist (thank you sherry) and I will not. I have to let all of this go, I have to move on like everyone on here has told me. I have learned alot about myself in this last 3 weeks and one thing I do know is I need treatment and I have to hang on til I find someone that is going to do that for me, if it is nerve blocks or whatever I will take it. You guys have teached me alot about myself and I thank you for that. The one thing I live for is my kids they are my life and I need to get back to being their mom and not a mom that is always in pain.
1187071 tn?1279373298
I have another question, when I first went to the pain dr I was think I around 158 and if he sees how much weight I have lost will he know how much pain I have been in and not being able to eat. I mean I have heard of people going to the dr saying they cant eat and they weigh the same or gain weight. So if I am smaller then what I was he should understand the pain i am in right? BELIEVE me I am not trying to lose weight cause I don't have money to go out and buy new clothes. I just have to put up with my pants falling down all the time lol
356518 tn?1322267242
All drugs will show up in urine/blood test. The question is what will this particular doctor test for. There are the UA test that test for opiates and illegal drugs and then the more extensive test that shows everything in your system. The last doctor I had always did the extensive test that showed everything it just depends on what the doctor orders.
Weight loss can signal alot of different medical problems. The fact that your not eating as much would explain the loss but be aware that the doctor may want to make sure this is why your losing the weight. He would send you to your PCP for this as he is pain management but it may happen if he is concerned.
As far as a sign that you have been in enormous pain and have not been able to eat it just depends on the doctor.
I hope your appointment goes well:)
1375159 tn?1311691944
You have been through a lot, Jamie. Yes, the nerve medication can show up on the urine test. If it were me, I would stop taking it. I would definitely be upfront with the doctor and tell him that you are taking it if you continue to do so.

You have such a complicated history and you have been to so many doctors (most of which have let you down), so I was thinking that maybe it would be good for you to write everything down and bring that with you to your PM appointment. Sometimes, I forget to tell my doctor things and that is why I write things down. Also, can you bring your husband with you to your appointment? I always think that it's better to have a second set of ears and someone who can tell the doctor what he has observed in me pain-wise.

You've gotten this far!

1187071 tn?1279373298
The thing is with this med, my nerve dr knows I have it. Before every appt they give you a paper to fill out that you write down all meds that you are on so I will be putting it on there If I am still taking it.
I think it is a good thing that I am not on any pain meds right now, so we can start fresh if he starts treatment.
1322157 tn?1279660281

You wrote that you had already been seen and cleared by a 'pain shrink' from this doctors office - You also wrote that you were going to call the mental health board tomorrow in your area about a "pain shrink".

Do you need another one? If you need one, can't you call the one who already cleared you for this doctor?

I am glad you will be writing it down on the forms if you continue to take the neurontin. Remember, the pain doctors don't just look for narcotics when they question you.. they want to know everything you take. I don't want you to think that because neurontin is not a narcotic  - it won't be important. I had to explain an antibiotic to my pain doctor, why I had it prescribed to me, when I took it, if I took the whole prescription, etc....

They have asked me about allergy meds - I even tell them about the motrin and sominex I take -

Life through a pain clinic can stink.... but we must follow their rules.

Jamie, we just want to be sure everything goes smoothly for you in a few days... You are so very close. we all are cheering for you.
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