Pain Specilist - what to expect

[alianne]

After a horrible flair that sent me to the ER overnight I have asked my urologist to refer me to a pain management specilist within her hospital. What should I expect from this appointment? I do have severe IC (I'm having a second interstim put in later this month) and am not on pain medication on a regular basis. I take muscle relaxers, vitamins (IC Blend), nortriptaline to help me sleep and I end up in the hospital occasionally with pain that is more than I can handle. I want so badly to handle this well, and not abuse any pain medication. any advise would be great!

ali

[curlycue]

:pray: :pray: :pray:

[malone]

I am a little confused about what you mean by I do not want to abuse pain medication? Have you abused pain meds in the past? I only ask because when medication is prescribed for chronic pain there is very little actual abuse--yes, you may become habituated (your body is used to it) but the stats which are somewhere on the boards, state there is very little actual addiction. Good Luck

[Briza]

Ali
Just recently I had my first visit. Up to this point my gyn was Rxing Tylenol 3, which I used sparingly for my pain. When my pain go to the point that my gyn I guess did not feel comfortable prescribing anything stronger, he referred me to a pain clinic in the same hospital complex. I was NERVOUS, as usual, but got such great info and support here before I went in for my appt I felt really prepared about what was going to be offered to me.
They wanted to see all my Rx bottles, what I'm taking now.
Filled out a bunch of forms marking where my pain occurs on the body, the type of pain, and scoring on a 1-5 scale.

We discussed long acting meds like oxy contin, ms contin, morhpine, with a breakthrough med like Vicoden, and he also brought up nerve blocks and stimulators. I told him I was a little hesitant to try the longer acting meds at this point, and that I wasn't considering nerve blocks or stimulators (apparently these are the money makers, but results/relief can vary)

It was a really easy appointment for me, I think, because I took my cysto/hydro and biopsy resports dxing IC, pics of my bladder during hydro, results from a lap to rule out endo, and CT scan results (not the actual scans, just the report) so there was no question where my pain was coming from and why, and I guess my gyn had filled him in on what he has rx'd me in the past for the pain.

We decided on just going to a stronger short acting med Lortab 7.5 (Vicoden) since I do have remissions, and sometimes my pain is not 24 hrs a day, and since Tylenol 3 had been gviing me good relief up until recently, just to try something a little stronger.

Nurse took blood pressure and weight, no urine test.
I put on a gown but the dr only pressed around a little here and there in my pelvic area (on top of, not under the gown). I don't know what he was looking for but I guess I made the appropriate ouch, not there, that's sensitive, that hurts sounds :rant:

Only thing I asked for specifically was a muscle relaxer, he gave me several choices, I just picked the one I had heard of and used before for a back injury. He asked how many mg I wanted, I said I didn't know, he said, well, then, I'll give you what I feel is appropriate. He told me he understood how a muscle relaxer could help control the pain along with the pain med :)

When you're taking pain meds for real pain, that is not abusing. Even the pain dr explained that to me, again, when he mentioned morphine, and my eyes got real big! If you've been diagnosed with severe IC, and you're going in for your 2nd interstim, I would say that would put you in a class of patients that need consisitent, managed pain control, so you DON'T end up in the ER. It's soooo much better to have more control of your pain, rather than end up in the ER and not knowing what the outcome will be.

I wasn't asked to sign a pain contract, as I have heard many have had to do. Probably because we decided on Lortab for now, and not a longer acting med.

Best wishes...many told me this would be the easiest, best appt I would ever have...and it was.
Let us know how it goes!

[LKL]

I understand what you are saying, and I am definitely not an advocate for depriving yourself from using medicine for whatever needs you have. I can, however, speak for myself. I think I have an 'addictive personality' and lots of people out there do...(not necessarily for medication.) That said, I have had no drug problems, but can feel it might be a weakness for me. Regardless, pain meds don't do anything for me (developed a tolerance when I was a sick kiddo) and am looking into alternative pain managment myself.

Good luck in whatever you decide to do. My advice, just evaluate your strengths and weaknesses...and you'll figure out what will work for you!

God's Blessings,

LKL