Pain "doctor" experience

I  posted this as a new blog post, and also on another topic message board, hoping to help someone else if they are in this situation.

So, I decided to take another crack at a different pain clinic, this one recommended by my primary, who is wonderful, so I don't hold it against him at all.  I was impressed right away, the staff was very friendly and caring, they had a whole wing of the hospital for their use for clinic appts and procedures, very professional looking, so I thought, surely they can help me with this pain until I get cured (of course I have to be diagnosed first).  I was admittedly very emotional about being there, mostly because in my mind I had avoided going to the pain doc because I felt like I was waving the white flag of surrender.  So, I was weepy, they provided the kleenex and reassurance, the doctor came in, he was very nice (and even after the whole episode, I can't say he wasn't nice- he's just nuts I guess) LOL   I of course gave him all my info, very informative, nothing to hide, all my doc info, all my prescription history given to him.  We talked about the issues of the pain, I told him that I don't take the pain meds during the day because I want to function, so I am willing to be in pain all day, but it would be nice to have relief at night so I can enjoy my time with my family and get a good night of sleep, maybe.  I am not on high doses of anything at all.  I also told him that having the pain meds at home, helps to keep me out of the ER when I have these "attacks" of pain/nausea after eating sometimes, although even though it is a liquid pain med, sometimes it is so bad I can't even get that to go down, and then off to the ER we go.   After all this discussion, he explained to me how I am too young to be having to take these narcotic pain meds, and we need to get me off of them (which I was like, yes, let's get me something that works as well, yeah), but no...here was his plan: wean me off the pain meds, and then told me I can just take an ibuprofen or any other nsaid (Alleve) pain reliever   I was still polite, reminded him about my complicated GI history, and that I  have an ulcer right now, that I was told by all of my docs to NEVER take Ibuprofen/Nsaid pain relievers because of the damage it will cause my GI tract/stomach, his response was, well better to have an ulcer than to be taking those narcotic pain meds!!!    If Ibuprofen worked for my pain, I wouldn't be seeing any doctors.  As a bonus to this lovely offering of "relief" that he was so graciously giving to me, HA!, I had to sign an opiate contract (anybody ever heard of/seen one of these before? I work in the ER and I never heard of it), which read more like an agreement to go into detox than an agreement to get help with pain relief, it basically outlined that while I was under their "care", and I use the term loosely, I was not allowed to seek pain treatment anywhere else, including the ER!  Here was the kicker, he told me, you can go to the ER for nausea and they can give you Phenergan/Zofran, but he said, and I quote, "If you are going to the ER for pain relief, don't bother because under the terms of the agreement, they can't give you anything, so if it is pain, stay home, crawl in bed and deal with it until it passes."    I was so vulnerable, and fried emotionally at this point, and thinking that I had no other options, I signed the stupid thing, weeping the whole time, they gave me a script for a reduced dose of the medicine I was taking, and I tried to explain to them that my tears were not the tears of an addict who was going to miss their drug, they were tears of shame and embarrassment, and wondering why am I being treated like a drug addict???  They tried to bru**** off as a formality, but in my mind I was thinking about my co-workers, people I work with, seeing this thing and wondering if I have a problem!   I left there miserable, started sobbing as soon as the valet brought the car around, and continued to sob all the way down the road, my aunt tried to console me, she couldn't even understand me because I was hysterical.   Well, there is a bright side to this, somewhat, when I got home I called that place, told them that I was coming back the next day, and they could have their prescription back, and I wanted my "contract" back so I could rip it up!  I followed through with that yesterday, and I felt so empowered to hand that script back to them and tell them how they made me feel, and watched as she ripped the original contract up.  The doctor had mentioned to me during the original visit that he only gives dying cancer patients narcotic pain meds, so when I went back I told the nurse that he should just open up a hospice unit and forget about treating the people who are truly suffering, but not dying- yet!  I can imagine that others of you have had this experience, and if you haven't had it, I hope you don't, but remember that you are in charge of your body, don't be bullied by someone just because they had more years of school than you, or more initials after their name than you.

Milady,
You might find this hard to believe but I found your post on a search on Google by looking up dumping syndrome. I can't say what made me read your post when I was only trying to look up facts on dumping syndrome because of a laps in memory.
I want to follow the rules of the forum. So I will go back and read more so that I can post more in length to this subject matter.
I first would like to state that my WLS was done back in 2003 or 02.. I will lookup the rules of this forum, but my surgery was done in Dallas Texas @ Baylor Hospital. I too have been through the same experience and  I will not down play your experience because I do not wish to cause you further stress, but I am an RN and did not want my colleagues to judge me by my need of pain medicines as well. I had a perforated ulcers and 3 small leaks around the pouch as well, and he stated my body had compensated over the 2 years, after he had performed emergency surgery and had run my bowl and saved my life by what he guessed to be by hours. I had MANY surgeries after that, exploratory laparoscopic surgeries,  appendectomy, Cholecystectomy , and the final surgery that resolved 3 hernia when my plastic surgeon and my WLS went into me together, one to explore with me open and the other to remove all that loose skin from my weight loss! I thanked Jesus and everyone involved (except my ex) *laughs*
Bottom line is that I was 1 out of 200 statistically that have had problems with WLS that was cause by many different reasons that pop up with the human body. My first pain clinic  experience was like yours, less than good, to put it lightly. My doc, I will give the name I have used to others when I talked highly of him, Dr. Joe Cool, I had my husband of latter draw a sketch of Snoopy and the look of Joe Cool, on that last surgery he did on me that as soon as I woke up I knew he had fixed me even after 8 hours after surgery. Something about having to go through so much for so long made me aware that everything was finally fixed. But the Doctors that make up the pain clinics have to work under the laws of State and Federal laws. They have to protect themselves from lawsuits, but most importantly insurance companies. If you have uncontrolled pain you need to have someone drive you to the closest emergency. Call his office or have nurse at the ER call them to inform them you are there. That is a part of that contract. Uncontrolled pain is your body's alarm saying something is wrong. Do not let what you think others think, stop you from listening to what body is telling you.
 I will have them post this, in hoping I am not breaking any rule and not let you be alone in this time of crisis. *clicks submit*

HI there! My name is Cynthia. I am RNY since 2003 and I would not trade it for the world. Even as many problems I have had after with gut related surgeries. I will not quote or name blame or anything else pointing the finger at anything or anyone. Facts are things happen and for a reason. Last I read it was over 50% of WLS patients have their Gallbladders removed to thickening , stones or Carcinoid...etc If you have an appendix.. and are finding out that you might need to have it removed, I would not worry about something you did not likely need in the first place.
Ok I will post on this pain clinic subject for now... I had the same trouble, because I get my tail end handed back to me after I do any exercise. Who doesn't? We are not allowed NSAIDS after surgically altering our digestive anatomy. Fact deal with it get over it RIGHT? I know of 2 drugs that I am allowed to have... I am not saying any doctor or Nurse practitioner should prescribe to any patient, but I am allowed Tramadol and or Celebrex. Yes, Celebrex has had some bad feedback, but it was told to me that people with heart problems or other circulatory concerns should avoid Celebrex. It is up to you and your Doctor to make that call as any other prescription medicine. Tramadol took care of my mild to moderate aches and pains and that those helped me to sleep better at night. My pain clinic visits were horrible until I found the right one for me. You can't run around changing pain clinics every week or you WILL be labeled as a high liability and most Doctors and NP's oh sorry not to mention the good folks called physicians Assistants, who saw me for the most part when I was getting checked in the follow up visits. It is YOUR job to be very read up and Informed when making new specialty decisions. I probably sound like some drug commercial to you that read this thread, but it is really the patients job to rule things out, because who is going to back you up?? humph All I can say is hind sight is 20/20. *grins** If you love your primary as much as I love mine, I would have chosen the one she or he referred me to. I would have never known I should go into it further than what I did. I believe I went through 4 different pain doctors when I lived in Texas before I got the right doctor for me. Also you have to know how you feel and portray that feeling with confidence and you can practice that talking to one of your family members or close friends and get them to play devils advocate. Lay out history, when you had your pain start.. date time and how it progressed over the year(s) and what makes it worse and what helps even if it sounds silly or YOU THINK it MAY sound silly. They did not pass Med school by sitting on their thumbs. Heck, I am a nurse and I have been in the field for a very long time. The whole thing has been a education to me and I am thankful for every bit I went through so that I can apply it to my teaching when talking to my clients or friends. Most friends run when I start talking but I will save that for another forum. *Grins* Please do not let anyone intimidate your thoughts / questions / feelings. I have gone on and on and on at this Med student about my gut problems and it was a STUDENT that caught on that some of my pain was not gut related and I had some of my pain related illness cut down by almost half. (I have back problems) I hope I have helped in some way. I am always here for anyone that has questions about what I have been through and there is no such thing as a dumb question. If you get anything out of my ramblings please take that last thing I said to the bank. I have to fix dinner for the hungry animals..         *points at self* Hope you guys have a good night! I am on Alaska time btw. I no longer live in Texas. I saw my first baby twin moose yesterday. In my BACKKYARD! They are smaller than some horses that I seen in my days. Not sure how many of you folks know this but it is a state law that gives the moose more rights than anyone's pet dogs. *meaning you can shoot your neighbor's dogs and say they were risking the life of wildlife!

Wow!!!  You are one amazing lady and I commend you!!  Is there a diagnosis for this pain you're having?

Thank you for posting.

I think I've had 12 surgeries in 4.5 years (starting with my RNY). I believe we have communicated before.  There is a doctor our there that will treat you for your pain!  If you decided to go for another pain management consult, let the office staff know that you'd like to meet with the doctor (actually HAVE a consult) to see if the two of you can work together and THEN if you and the doctor come to an agreement to treat, you'll sign the contract.  About the ER, I had heard what you were told about not being able to get narcotic medication at the ER even if you've had something happen not related to your treatment for pain such as a broken leg or a car accident (G-d forbid); however, I have found that is NOT true.  I have been to the ER several times (unfortunately) for abdominal pain WHILE in pain management and I tell them that I am in pain management with Dr. Good Relief and I've still been able to receive the big guns such as Dilaudid (which is the only thing that relieves episodes of pain).  Dr. Good Relief is notified but I always check in with him myself.  Pain is pain and it's a signal that something is wrong with your body OR it's phantom pain where the brain refuses the signals of pain and decides on the pain itself.  You should research that because it CAN be treated but you are NOT helping yourself by allowing the pain all day and "only" wanting to sleep at night.  The pain has to be controlled around the clock so that if this is acute pain that has become chronic, it can eventually be cured. 

The abdominal nervous system is very closely tied to the central nervous system and is called the Enteric Nervous System.  Look it up.  It's amazing.  It may help you understand some of what is going on.  Also, it would be helpful to research acute pain versus chronic pain and how one can turn into the other.

If you have any more specific questions for me, please feel free to PM me.  I hope that you are pain free soon! 

Vanessa,
We have spoken before, and I really appreciate everything you had to say, and I will look into it.  I am really gunshy about even meeting with another pain doctor.  I just feel like I coast from week to week somehow.  I am back at work, which has been great for me mentally, not sure how it will be physically.  I am afraid to eat at work because of the possible repercussions, yet I don't want to lose anymore weight.  I did request an appt at the Mayo Clinic, we will see if that works out.  I am that desperate at this point.  I often steal/borrow your quote about medicine being "practiced", I love it and it is so true.  I don't knock the great doctors I DO have, but there are some that make me wonder, geeez!  I hope you are doing well these days, keep me posted.  I think I sent you a friend request, I'll have to make sure you are on my list :)

I'm so sorry that you've had such a negative response with the pain management doctor!!! It reminds me of the male doctor who says having a baby doesn't hurt! How the heck would they know unless they've experienced it???

Have you found out why your having the pain yet?

Still a mystery, I have my theories, but I bought Dr. Oz's new book; YOU: The Smart Patient, and I wasn't really sure if I was going to learn anything from it, but here is the major thing that I did learn, that I know I have been guilty of, in his book he talks about getting 2nd/3rd opinions, and cautioned that you need to make sure that when you see the new doc, that other than being informative about your history, DO NOT start giving them ideas as to what YOU think is wrong, or what other docs have thought was wrong, it can influence what they come up with or distract them from their own thoughts.  We'll see, waiting for Mayo Clinic to comb through my giant record and call me, I will add you as a friend and keep you posted, thanks!

Your pain sounds to me like Gallstones...Do you still have your Gallbladder ???