Re: Digest Number 1201

[Guest guest]

Dear Jana,

Everybody will have a different opinion of the " how's " and " why's " etc.,

but I'll toss mine out there and hope that in some way it may be of some use

to you.

The point of seeking out a Pain Management team, for ME, was to find a

doctor or group of doctors that might be able to focus on two areas that my

regular primary care physician might not be able to focus: 1.) a definable

quest for the most appropriate and effective narcotic pain relief therapy for

my specific makeup and needs, and 2.) the use of whatever other means

therapeutically available to return me to the most optimal level of

productivity possible, as quickly as possible.

My PCP's concern for me is more general: overall maintenance;

head-to-toe, overseeing the care of all my body systems in a balanced sense.

He's kind of the " Team Captain " or " Manager " .

And my GI, for instance, is there to care for that part of my body that

contains my pancreas, thereby covering my CP and diabetes; my

Endocrinologist (more specifically) on my diabetes; my psychologist on my

miscellany brain scramble, etc... You get the idea. These folks are the

" batting, base, fielding, running and pitching " coaches (depending upon my

specific areas of need).

The pain management doc's are there to cover all of the bio-physiological

pain aspects of the above systems, emphasizing (ideally) an interdisciplinary

approach - the goals being a reduction of pain and suffering, allowing the

patient to become more productive, and returning the patient to being in

charge of their life once again.

The obvious focus is pain medication or narcotics. The less obvious, but

in some cases equally as important (at least if you really want to guarantee

a referral from your primary care doctor) are ideally a whole litany of

various other disciplines... although I was only able to find a remarkably

SHORT list on any one clinic's site on the 'net. Following are a few of my

own, combined with a hit-and-miss that I was able to piece together from

visiting about twenty different sites (literally!), to seek out such

treatments as:

biofeedback, breathing/imagery, music, meditation, the use of spinal cord

stimulators, intrathecal narcotic pumps, radio frequency lesioning, steroid

nerve blocks, various massage techniques, magnetization, acupuncture,

physical therapy, myofascial therapy, craniosacral, trigger point, sports

massage, aromatherapy and others.

I've only met my PM doc once thus far, and I was pleased that what I

found was largely what I expected, at least for a first visit: a no-nonsense

attack of the narcotic issue with immediate focus on the issue of

" appropriateness " of drug, dose, secondary or breakthrough medication, etc.,

with a follow-up planned for two weeks later and a list of various other

techniques that I might explore on further follow-ups. Bing-Bang-Boom.

I figure a couple-three other visits to adjust dosage as necessary, then

I'd like to start addressing such techniques as craniosacral and massage,

coupled with some techniques I already practice (aromatherapy, meditation,

breathing/imagery), and within a few weeks, have at hand a relatively

thorough, comprehensive collection of tools available to improve my overall

quality of living and level of productivity... At least that's the plan

anyway... And my hope is that since it's all via physician's referral, it

will be attained with the cooperation of my insurance company's assistance.

WooHoo! Provided I can keep up my premiums, anyway. Wish me luck, and I'll

do the same for you Jana!

I hope that will be of some use... And I hope that your PCP is

cooperative and helpful. In my mind, there's gotta' be a better approach

than just opiates and ERCP's. Some days I feel pretty hopeless, but one of

the things that DOES successfully give me hope and get me back on track

fairly quickly is the prospect of gaining back as much of my life's

productivity as possible and really, REALLY being a part of the " living " as

much as possible, as soon as possible. I'm only 37, and I'm too young to die

old and tired at this age. At 23, I know YOU know exactly what I'm talking

about. Get after your doctor right away.

Good luck and God bless,

Terry in KC

<< I am trying to get into the pain management program and would like to know

more about it. What should I discuss with my doctor and what kind of care do

I ask for. I am on vicoden and take 9 a day. I have chronic Panc. and also

ovarian cyst that have to be removed every other month. I am 23 and have had

now six boughts of CP.

Thanks for any help that i can get

Jana Franck >>