What kind of doctor? Ortho, neuro, rhuemy?

[DammitJanet]

I have a pending appointment with a neuro clinic but its far far away.

My problem is I probably have a herniated disk or spinal stenosis which is causing lower back pain and really bad leg pain. I also have the debilitating knee and hip pain to add to this. I only got the herniated disk or stenosis diagnosis from an ER doctor back in late June I guess but it makes sense from the symptoms. Something has to give.

Im not real sure what anyone can really do for me though. I went to my GP today and they give me palliative care ~ pain medications and muscle relaxers. Today they put me on a pain contract which I find kind of odd considering I am not on really heavy duty pain medications but ok...no problem. I dont doctor shop and I use only one pharmacy. (Oh dear...just thought of something...sometimes my pharmacy is closed at night and I fill emergency scripts in the middle of the night at the all night walgreens...hmmm.)

Anyway...does anyone have a clue what type of doctor would treat a herniated disk or spinal stenosis? Or if I should even see one for it? Or should I just leave it alone and deal. I have just about quit going to the ortho about my knees because the only thing they can do is give me cortisone shots because I am too heavy for the replacement surgery. The shots dont last long and they tend to make me manic. They also can make matters worse in the long run. I probably should go back and get more in my knees, hips and lower back now but I just dont know. Egads...decisions decisions!

 

[flutterbee]

I *think* it's a neuro. Some offices have ortho and neuro together. At least, we have a few of those around here.

by the way - got your voicemail. Call me.

 

[susiestar]

I would check with a neuro and with an ortho. There are some spine clinics or spine docs that are either neuro or ortho who have gone ahead adn taken special training to deal with spine issues. Any of them are going to want an MRI.

As for the pain contract, it depends on how well you know the doctor. If it is your long time GP it may be OK with him for you to continue using walgreens for emergency scrips. If it is a doctor who doesn't know you, or is a stickler, they will insist you pick ONE pharmacy. so it would be either NO walgreens or ONLY walgreens. I almost didn't get that epidural shot that was required before my surgery because this contract. I didn't WANT this "pain doctor" to do anything but the shot. But his nurse had a total hissy fit. She wasn't going to let me see the doctor at all. doctor said it was no big deal as they were not treating the pain issues. So DON'T count on what the nurse says, but have the doctor make a note ON THE CONTRACT if it is OK to use 2 pharmacies.

This contract protects the doctor if the drug enforcement people come in and audit things. It is teh medical communities response to the DEA's targeting them and to the doctor shopping and narcotics addicts. It lets teh doctor know you are willing to follow the protocol so most likely are not a drug addict.

Sorry you have this.

 

[DammitJanet]

Well arent you two so much help...lol....with saying both neuro and orthos...lmao. I dont think we have a spine clinic locally but I can google for one. Gosh I wish we had a decent pain management clinic but we dont. The only one I know of is in the next largest city and that is like 45 minutes away from me and darned if I want to drive that far every month. I already go that far every 3 months for my psychiatrist. This is what I get for living in a small town.

I am really not all that worried about the pharmacy issue...isnt it only for getting a pain medication script filled? I would only get an emergency script filled after hours for something like an antibiotic if I had to go to the ER with an infection or something. That has happened to me before. And the pain contract cant cover my psychiatric medications. Whole nother ball game there...they know I see another doctor for those. The thing with my gp is this...I see a group. I adore the one doctor, cant stand one, and just met one today who happens to be the daughter of the one I adore. I hope I get along well with the daughter...I got a good feeling from her. The doctor I adore has always been in my corner.

 

[totoro]

husband has Ankylosing Spondolysis and Spondylothesis... He sees a Neuro when he needs to reconsider surgery. He goes to the Rhuemy for his Gout though which is part of his Arthritis and part of which makes his back worse... SO I would say bug em all!!! Call all of them and see what they say?
I am looking for a Rhuemy for him here to start the evaluation rolling again.
Sorry you are in so much pain.

 

[Lothlorien]

Ankylosing Spondolysis is an auto-immune disorder affecting the spine.

Janet, you can go to the neuro if you think that surgery is inherent. However, you will most likely be referred to Pain Management Specialist. If you've had EMG confirmation of neuropathy (make sure you have the EMG before they go and stick you) they will likely do a trial of a few epidural steroid injections. The next step would be nerve blocks or possible ablation. If those aren't helpful, the next step would be surgery with either a good orthopedic spinal surgeon or neurosurgeon who specializes in spinal surgery.

If you get as far as the injections, please let me know. There are a lot of unethical physicians that do these injections without EMG confirmation of neuropathy, which is the ONLY indication for epidural injections. I'll give you more info if that comes about.

 

[DammitJanet]

I had a MRI back in Dec and since I am so highly claustrophobic that is the last one they are getting done. Well unless they sedate me with versed and put me in. They wont do that so its a moot argument.

I havent had the EMG on my legs. I had something on my hands years ago which showed ulnar nerve impingement but that wont help now will it? That was cervical Im pretty sure.

I really dont want surgery. I cant think of anything good coming from operating on my back. Number one is my weight. Everything I read says if your weight is high then it just comes back. So for me that means a no go. Maybe this is all just a useless exercise. Just go get them to confirm and wait to get worse...sigh.

 

[bigdmomof3]

Hey Stranger! I don't know what type of doctor you would see but just wanted to say that I hope you find someone that will be able to give you some relief.

Miss you and think of you often!

Hugs
Dee

 

[susiestar]

Janet,

Be very careful with that medicine contract. MOST say that you will get ALL your medications from one doctor and get them filled at ONE pharmacy. There ARE docs here who will drop you from the clinic, report you to the DEA and make notes on your file if you let any other doctor write a prescription or you get even an emergency antibiotic filled at a different pharmacy. Make sure you write on your contract that you see X and Y type docs who prescribe medications for their specialty, and you will also ONLY fill non-pain controlling emergency prescriptions at pharmacy W because it is open when your pharmacy isn't.

I am not joking about this. It would seem common sense to let the psychiatrist write the psychiatric medications and the pain doctor do pain medications and the GP do antibiotics etc... but MANY docs are following these contracts to the letter. The doctor you don't like could use this to drop you from the practice. He could also turn you over to the DEA for not following the contract. I don't know how rabid he is about these, but you should always be careful to ask about any of these things and have the doctor sign any exceptions.

I wish there was a way to magically help you feel better.

Hugs.

 

[DammitJanet]

Susie...I got to thinking about that and also thought it was strange that I didnt get a copy of this contract. She just filled it out, shoved it under my nose, said sign here...and took it back. I didnt get a chance to even read the thing. I think I am going to run out there and get it and read it before I even fill these prescriptions. Maybe tomorrow...same doctor should be there that I saw. I at least want a copy.

 

[flutterbee]

Weren't you going to try to go to Duke? Did anything happen with that or am I confused?

 

[Stella Johnson]

Since surgery is probably a bad idea with- your weight, try one of those inversion tables. I see them for sale all the time on craigslist. My ex uses one all the time and loves it.
he had back surgery years ago and won't do it again.


honestly I don't know many ppl who are actually better off after surgery

Steph