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Pain doctor appointment coming up
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<blockquote data-quote="Marguerite" data-source="post: 260739" data-attributes="member: 1991"><p>I can't speak for how it works in your area, but what works for us with our pain management specialist, is he oversews the pain medications in general. It's a bit like having a really good GP keeping all the connections active with all specialists, plus having someone on board who is authorised to prescribe the stronger medications.</p><p></p><p>We don't have exclusive agreements, but some medications are only permitted with the overseeing approval of a pain specialist. Some of my medications, some of husband's medications, can only be prescribed by a GP for a limited time, unless they get specialist authorisation. Our health care system in Australia monitors prescriptions as well as authorisations, it all joins the dots. Therefore for us, a pain specialist makes it all much better.</p><p></p><p>Before I saw a pain specialist, I was very limited on what medications i was able to get. I could only get one packet at a time, which would last me three days. I was seeing my GP twice a week at least, sometimes more. And my pain was NOT well-controlled. So I asked my GP to refer me for pain management. It was a bit confronting at first because I have to see my specialist at a hospice for terminal patients. But so very soon, I was able to have my medications reassessed and overhauled, so what I was put on was not only more effective, it was also healthier for me.</p><p></p><p>So after the involvement of the pain specialist - he writes to my GP, who is then on much stronger ground when it comes to writing my pain medications prescriptions. If the government asks sticky questions, she has letters she can point to, paperwork she has filled in with the pain specialist's signature on it, that says I am allowed to have these medications at this dosage. And I feel safer knowing I can get a month's pills at a time, and will not have to argue with anyone for it. So I'm less inclined to try to doctor-shop or stockpile.</p><p></p><p>There can often be a lot more restrictions on availability, when you move to stronger pain medications. There are sound reasons for this because people can and do abuse these. Not just patients, but some doctors abuse it. So if you do find restrictions, they could well be for these reasons. Hopefully there will be a trade-ff in terms of better overall pain management and supervision of your treatment where it involves medications related to pain. As far as other medications are concerned - if they have an impact on pain, but are prescribed by a different specialist, then your pain specialist needs to know about them as part of your overall package but is unlikely to interfere with them in our system, at least. For example, the rheumatologist hasput me on prednisone. This also has analgesic benefit. My pain specialist knew I was seeing the rheumatologist (he asked me to go see him) and is getting copes of all letters from him. The pain bloke also knew that prednisone worked and by now, will have a letter from the rheumatologist about this. They may even get their heads together to see if they can come up with some medication alternatives, to get me off the prednisone but still have a similar action on the inflammatory process this indicates (previously not identified). What these two specialists are cooking up, is at the fringe of my GP's capability. My GP is very good, but is a generalist, not a specialist (of course). In this, she defers to those with more expertise.</p><p></p><p>What you want with your medical care, is a concerted, cooperative effort coordinated by one member of the team (usually the GP). Some areas require a specialist to be more capable of thinking outside the square and also of being able to overlap into other specialties. Pain management is one such area.</p><p></p><p>I hope there is no blanket rule that a pain specialsit takes control of ALL medications. Or if there is, then I hope he will automatically re-prescribe medications not connected to pain management, previously prescribed by another specialist. That would also be common sense.</p><p></p><p>But where a pain specialist takes control of prescription of all pain medications - this is generally for very good reasons. Ours take control but do it perhaps in a different way. husband gets his pain medication prescriptions from our pain specialist, while my GP writes my scripts (with the specialist's authority). So even one specialist in our case does things differently for different circumstances.</p><p></p><p>Susie, when you are in pain and you've found medications that help, it is understandable to be anxious for fear of supply running out. If there is a system tat works well with a pain specialist, and if you are only taking the medications as directed, you should be MORE carefully managed and be LESS likely to find yourself running short.</p><p></p><p>I hate the fear of running short. I'm permitted to occasionally take extra and I tell my specialist when I do. But it does mean that over time, I sometimes find myself in danger of running out. I can generally do something about it before it gets that far, but I can relate to the anxiety.</p><p></p><p>What helps best, in terms of good relationship with your doctors (especially pain specialist, pharmacist and GP) is continuity and transparency. I do my utmost to stay with the same one and I keep my prescriptions with the same pharmacist. Where most patients take repeat prescriptions home, or drop in on anybody, I try to give all the work to one person. It also means he shows the same loyalty to me when I need more medications - I just make a phone call.</p><p></p><p>Hopefully someone with more specific local info will give you the answers you need, as to how the paperwork functions in your neck of the woods.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 260739, member: 1991"] I can't speak for how it works in your area, but what works for us with our pain management specialist, is he oversews the pain medications in general. It's a bit like having a really good GP keeping all the connections active with all specialists, plus having someone on board who is authorised to prescribe the stronger medications. We don't have exclusive agreements, but some medications are only permitted with the overseeing approval of a pain specialist. Some of my medications, some of husband's medications, can only be prescribed by a GP for a limited time, unless they get specialist authorisation. Our health care system in Australia monitors prescriptions as well as authorisations, it all joins the dots. Therefore for us, a pain specialist makes it all much better. Before I saw a pain specialist, I was very limited on what medications i was able to get. I could only get one packet at a time, which would last me three days. I was seeing my GP twice a week at least, sometimes more. And my pain was NOT well-controlled. So I asked my GP to refer me for pain management. It was a bit confronting at first because I have to see my specialist at a hospice for terminal patients. But so very soon, I was able to have my medications reassessed and overhauled, so what I was put on was not only more effective, it was also healthier for me. So after the involvement of the pain specialist - he writes to my GP, who is then on much stronger ground when it comes to writing my pain medications prescriptions. If the government asks sticky questions, she has letters she can point to, paperwork she has filled in with the pain specialist's signature on it, that says I am allowed to have these medications at this dosage. And I feel safer knowing I can get a month's pills at a time, and will not have to argue with anyone for it. So I'm less inclined to try to doctor-shop or stockpile. There can often be a lot more restrictions on availability, when you move to stronger pain medications. There are sound reasons for this because people can and do abuse these. Not just patients, but some doctors abuse it. So if you do find restrictions, they could well be for these reasons. Hopefully there will be a trade-ff in terms of better overall pain management and supervision of your treatment where it involves medications related to pain. As far as other medications are concerned - if they have an impact on pain, but are prescribed by a different specialist, then your pain specialist needs to know about them as part of your overall package but is unlikely to interfere with them in our system, at least. For example, the rheumatologist hasput me on prednisone. This also has analgesic benefit. My pain specialist knew I was seeing the rheumatologist (he asked me to go see him) and is getting copes of all letters from him. The pain bloke also knew that prednisone worked and by now, will have a letter from the rheumatologist about this. They may even get their heads together to see if they can come up with some medication alternatives, to get me off the prednisone but still have a similar action on the inflammatory process this indicates (previously not identified). What these two specialists are cooking up, is at the fringe of my GP's capability. My GP is very good, but is a generalist, not a specialist (of course). In this, she defers to those with more expertise. What you want with your medical care, is a concerted, cooperative effort coordinated by one member of the team (usually the GP). Some areas require a specialist to be more capable of thinking outside the square and also of being able to overlap into other specialties. Pain management is one such area. I hope there is no blanket rule that a pain specialsit takes control of ALL medications. Or if there is, then I hope he will automatically re-prescribe medications not connected to pain management, previously prescribed by another specialist. That would also be common sense. But where a pain specialist takes control of prescription of all pain medications - this is generally for very good reasons. Ours take control but do it perhaps in a different way. husband gets his pain medication prescriptions from our pain specialist, while my GP writes my scripts (with the specialist's authority). So even one specialist in our case does things differently for different circumstances. Susie, when you are in pain and you've found medications that help, it is understandable to be anxious for fear of supply running out. If there is a system tat works well with a pain specialist, and if you are only taking the medications as directed, you should be MORE carefully managed and be LESS likely to find yourself running short. I hate the fear of running short. I'm permitted to occasionally take extra and I tell my specialist when I do. But it does mean that over time, I sometimes find myself in danger of running out. I can generally do something about it before it gets that far, but I can relate to the anxiety. What helps best, in terms of good relationship with your doctors (especially pain specialist, pharmacist and GP) is continuity and transparency. I do my utmost to stay with the same one and I keep my prescriptions with the same pharmacist. Where most patients take repeat prescriptions home, or drop in on anybody, I try to give all the work to one person. It also means he shows the same loyalty to me when I need more medications - I just make a phone call. Hopefully someone with more specific local info will give you the answers you need, as to how the paperwork functions in your neck of the woods. Marg [/QUOTE]
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