Pain Management Doctor/Anesthesiologist

[zombelina]

Hello everyone, I am seeing a new back doctor June 22nd. The last one I saw was an osteopathic doctor, and I feel that the "osteopathic manipulation" aka back cracking only made things worse. Every time I spoke up about it he told me it was helping me. I was struggling with anxiety and depression at the time and I was too afraid/out of it to stand up for myself. It was a work injury so I had to visit at frequent intervals. Luckily, I was released from his care because I had shown adequate improvement. I have not seen a doctor for my back in over a year. Because I didn't receive treatment for a year, my worker's compensation has been dropped and I am able to see any doctor I want.

So the new doctor I plan to see is a pain medicine doctor/anesthesiologist. She is in an orthopedic practice that was recommended to me by an acquaintance. I know these doctors are quite common, but I just don't understand how an anesthesiologist is an expert in back problems. Does anyone understand this? I called the practice back after making my appointment to see whether a different specialist would be better for me, and they told me that no, this doctor is right for my problem.

I think my needs are pretty simple. I want a doctor who can help me stay as active as possible for as long as possible, and can try to predict when/if I will need surgery. I'm 29. I also want someone who can give the steroid injections. I'm not looking for actual pain medicine because I feel that I take enough medicine! Also, pain isn't my biggest problem, it's problems with mobility due to spinal stenosis.

I know this is not an epilepsy-specific question, but I know many people with epilepsy struggle with other conditions and have visited or heard of other types of specialists.

Thank you!

 

[masterjen]

Pain management is one thing. If you're pain is not helped with over-the-counter pain pills or special prescription ones that don't interact with your epilepsy meds then a pain medicine specialist perhaps can help (I don't know much about these doctors). If you are looking to stay active then probably a physiotherapist is the way to go - ask your family doctor about this or ask for a referral to one.

 

[zombelina]

I was thinking that too. When I called the office a couple days ago, they said that this doctor would refer me to PT if I needed it. So I'm wondering if it is at least worth a visit to see what this dr. does and whether it fits my needs. There is a different type of doctor in the practice who focuses more on rehabilitation, and I keep thinking he might be a better choice. His reviews aren't as good though. Not sure what to do! Thank you for your help

 

[zombelina]

I decided to change my appointment to see the rehabilitation doctor instead of the pain management doctor. His page specifically says that he treats my problem, so I think that is a good sign. My appointment is June 15.

 

[Hobbes]

Pain medicine at our child's hospital is anesthesiology, psychology, PT, and others. Initial appt is with an anesthesiologist and a psychologist. The standard plan is to get a pain specializing PT evaluation soon after (because regular PT is not the same). This is not the approach that worked for my kid because (pain drugs don't work, it was super slow to get insurance approvals for non drug approaches that were viable and) there was still a surgical alternative (brain surgery is easier to get approved, wacky) that could help but the surgeon was not sure it would help (it made a huge difference) or that any improvement would last for long (got 2.5 good years the previous surgery, 1 horrible year so hoping it pasts or lasts longer). In the mean time we are requesting some psychiatric treatment/CBT to help because it is likely to come back and there are few options left to try. Pain management will use acupressure, acupuncture and assorted other treatments as appropriate - but they really love PT and exercise. I don't trust they have much experience with cause of my child's pain - essentially a csf leak they can't fix, exercise makes things much much worse.

 

[zombelina]

Thank you, Hobbes. I hope the CBT helps your child. I think a child life specialist could probably be helpful too.

 

[Hobbes]

Thanks! We have worked with child life for various issues but continuous pain for 8+ months was way way beyond what they can help with.

 

[valeriedl]

I had very bad back problems for years. I could talk to you for days about all the things I did and drs I went to for it but all of them said there was nothing medically wrong with my back .

I'm not sure if any of the drs I saw was a pain management dr but all the drs I went to would give me pain meds and muscle relaxers that did nothing. Pain meds in general don't do a thing for me anytime I have pain in my body or headaches. I did stretches, saw a dr to show me how, but it did nothing either.

I went to a chiropractor weekly for a few months. After an appt the pain would go away for a day or two then come back so I stopped going to him.

I had steroid injections that did nothing. I stopped getting them after a few months. While I was getting the injections I was having seizures like crazy. It was only after I stopped that I realized that steroids caused me to have seizures. This could be something that just happens with me because everyone's different in how they react to meds.

I found an orthopedic surgeon who told me that I had two severely herniated discs in my back, it had been going on for years for it to be as bad as it was and one of the other drs should have saw it, and should have surgery. He flat out told me that if I were to have a seizure during the surgery there was a chance I could end up paralyzed and in a wheel chair but at the rate I was going I think I was going to be in a wheel chair soon any way. I had the surgery and could move just fine with no pain in two days. I think all the other drs were afraid to do anything serious me because I had epilepsy.

I hope you find something that helps!

 

[zombelina]

Hi valerie - I'm so glad the surgery helped you, and I'm sorry it took so long for you to find answers. I'm sure it was a scary decision to decide whether or not to have the surgery.
The first time I had the steroid injections, I had an increase in seizures, even though both doctors involved told me it was impossible. The second time, I asked them to halve the dose of the numbing agent, and I had no increase in seizures. I'm not sure if it was just coincidence or not, but it seemed to help. Thank you for your input!

 

[Dutch mom]

This article might be interesting for you:

View attachment Ketogenic diets and pain.pdf

 

[marika853]

This is just what I need to know. A month ago I started having serious pain in my hip. I had hip replacement in 2012, so was concerned that something had gone wrong. Went to gp. Gave me a steroid shot that did nothing. He sent me to ortho dr. who said I had arthritis in the back. Put me on prednisone that caused me some serious deja vu episodes. Had an MRI last week and going to see him today for results.
Funny thing is that the first thing he wanted to give me is narcotics. I told him, "No thank you." And they wonder why we have so many people addicted to painkillers.
Hoping to solve this because like someone else said here. I just want to be able to live my life without constant pain.
Thanks,
M

 

[zombelina]

Thank you, Dutch mom! I will check out the article.
Marika, I'm so sorry you are in pain. Let us know how your appt goes today! Mine is tomorrow. They tried to give me narcotics too. I was in a lot of pain at the time, but I didn't think I was in THAT much pain. Scary!

 

[marika853]

Just got back from dr and he wants to do surgery. First, he wanted to give me an epidural steroid shot but I told him about the problem I had with the prednisone and that I would pass on steroids. Then he casually says, "Ok, let's do surgery." Just like that! Took me a little by surprise. He said I could take some ibuprofen for a while and do some pt but he thinks the surgery will fix it. It is called TLIF and is supposed to be minimally invasive but it is on the spine. Which is what scares me.
I will have to wait and see. Story of my life.
M

 

[zombelina]

Can you get a second opinion before you decide on surgery?

 

[marika853]

Yes. I will be getting a second opinion. I also went to pt yesterday and her take on it was totally different. She seems to think that we should work on it by doing some mobility and core exercises. I need to do that anyway because my insurance won't pay for surgery unless I've exhausted all other options.
I certainly will not do the surgery unless absolutely necessary.
M

 

[Nakamova]

I agree that a second opinion is a good idea, since you have the time to get one. Doctors don't make it easy when they provide conflicting info about the best course to take. And many have them have built-in biases (both conscious and unconscious). Good luck and keep us posted. I hope the PT helps.

 

[zombelina]

Very frustrated. I just got back from seeing my new orthopedic doctor. I was really hoping to have someone help me with the spinal stenosis/leg numbness and weakness problem. I showed him my MRI from 2014. First, he read the report that said "spinal stenosis, bulging disc, etc. etc."

Then, he looked at the actual images of the MRI and, surprise, surprise, told me he didn't see anything wrong with me (aside from a small bulging disc). He disagreed with the other abnormalities on the report.

Here is the rest of the conversation:

Me: "Ok. I'm glad the MRI looks good, but if you don't see any spinal stenosis, why do I have to sit down and take breaks on walks because my legs feel numb and weak?"

Dr.: "I don't see anything wrong. Maybe it's an endurance thing. Try to get moving."

Me: "But I go on walks every day, and I'm pretty active in my work day. And sometimes the numbness starts as soon as I start walking."

Dr: "I don't see anything wrong on this MRI, but if you want a new MRI even though your symptoms have not changed lately, we can do that."

Me: "Maybe, but won't it probably look the same as the one you are looking at now?"

Dr: "Ok, what do you want then? Tell me."

Me: "I want to know why this is happening to me if it's not from stenosis."

Dr: "The MRI looks good. I'll write you a prescription for another one. Maybe that will give you some confidence about it and we can see if there are any changes. But again, I don't see anything wrong on the images, and your circulation seems good. I disagree with the report."

Me (again): "So why am I experiencing numbness and weakness when I walk?"

Dr: "I don't see anything wrong."

I'm so tired of not being taken seriously.

 

[zombelina]

He also told me that, because he saw no serious problems, he wasn't going to give me injections because there are risks involved with injections and he didn't think it was worth it.

 

[valeriedl]

Very frustrated. I just got back from seeing my new orthopedic doctor. I was really hoping to have someone help me with the spinal stenosis/leg numbness and weakness problem. I showed him my MRI from 2014. First, he read the report that said "spinal stenosis, bulging disc, etc. etc."

Then, he looked at the actual images of the MRI and, surprise, surprise, told me he didn't see anything wrong with me (aside from a small bulging disc). He disagreed with the other abnormalities on the report.

Here is the rest of the conversation:

Me: "Ok. I'm glad the MRI looks good, but if you don't see any spinal stenosis, why do I have to sit down and take breaks on walks because my legs feel numb and weak?"

Dr.: "I don't see anything wrong. Maybe it's an endurance thing. Try to get moving."

Me: "But I go on walks every day, and I'm pretty active in my work day. And sometimes the numbness starts as soon as I start walking."

Dr: "I don't see anything wrong on this MRI, but if you want a new MRI even though your symptoms have not changed lately, we can do that."

Me: "Maybe, but won't it probably look the same as the one you are looking at now?"

Dr: "Ok, what do you want then? Tell me."

Me: "I want to know why this is happening to me if it's not from stenosis."

Dr: "The MRI looks good. I'll write you a prescription for another one. Maybe that will give you some confidence about it and we can see if there are any changes. But again, I don't see anything wrong on the images, and your circulation seems good. I disagree with the report."

Me (again): "So why am I experiencing numbness and weakness when I walk?"

Dr: "I don't see anything wrong."

I'm so tired of not being taken seriously.

That's the same exact conversation that I think I had with all the drs I went to except the last one!!!!!! I went on for YEARS being told that the MRIs showed nothing so there was nothing wrong! I'm so glad that I found the dr who actually saw that something was wrong just by taking an x-ray in his office. He said that my discs were so herniated that it should have showed up on an MRI years ago, things like that don't just happen over night.

Funny thing is that the first thing he wanted to give me is narcotics. I told him, "No thank you." And they wonder why we have so many people addicted to painkillers.

All the drs I went to for 10 years just gave me pain killers and muscle relaxers. They didn't do a thing for me so I hardly even took them. I know if I would have I'd be addicted to them!

 

[zombelina]

That's the same exact conversation that I think I had with all the drs I went to except the last one!!!!!! I went on for YEARS being told that the MRIs showed nothing so there was nothing wrong!

It's so terrible that you had to go through that. 10 years! Thank goodness you finally got the surgery you needed.
Unfortunately, that sort of thing probably happens all too frequently. It's scary that it seems like every doctor reads tests differently. I've been through the same thing with EEGs. Ugh.
I'm going to look for another orthopedic doctor (even though I hate doing that, I want to find someone who isn't going to "shoo" me out the door). I'm not going to waste my money and time to get another MRI right now unless a doctor gives me a better reason than the one I heard yesterday..."It will give you more confidence." Whatever that means. onder:
Thank you for sharing your experience with me - it helps a lot.