What type of doctor do you have?

[kukui]

My sig. other didn't have a doctor when he had his aneurysm -- a walk-in clinic found the problem. Now he has chronic pain after that major surgery and we've been thrashing around with different doctors.

What type do you use? Do you have both a regular doctor and a pain specialist?

We're in the process of getting a referral to a pain clinic, so we should soon have a "pain doctor." His current doctor is an internist, but I believe we need a new one since we feel like he has let some things slip through the cracks. He is the one now prescribing the pain meds, so I'm thinking if we change to a GP, we have to be sure that all pain meds come from the specialist.

How do you all juggle the doctor/specialist combos? Who watches out for your general health, problems which may or may not be tied in with the main pain problem?

Thanks!

[BrokenBladder]

My GP handles my general health. I don't have a pain specialist, but I do have a urologist and a RA. My RA is the one who prescribes all of my pain meds and that has worked out well for me. There will be others to come along and answer also and they have different experiences.
Good luck with finding what works best for your significant other. You will find alot of good information on this board.

[Bobbi]

A friend of mine has a 10 cm that his doctors are monitoring; he recently had exploratory surgery but surgeons decided to "wait and see" (the space is narrow and surgery is not a necessity right at this point).

His primary is a neurologist but he also sees a primary care physician and neurosurgeon; he had previously had three high-level C-spine vertabrae snap and is an incomplete (ASIA scale) SCI patient. Basically: He's highly functional SCI (spinal cord injury) patient, which resulted from an ATV that his work ordered/mandated he use on-the-job; it was an on-the-job injury when the ATV flipped and caused the breaks, etc.

His first aneurysm was when he was approx. 30 and it was mis-diagnosed as epilepsy. Neither he nor his family knew until a CT and other tests were done a couple years ago that it was not epilepsy.

The way he determines whom is the primary is by whom is most abreast of his medical history and assertive in his care and treatment.

His health is far more complex than is my health; I'm classed as "moderately complex."

For the staple of my health care, I see a primary care physician. Her specialty is internal medicine. Every test ordered, every lab result... It is cross-referenced: My cardiologist, PM doc, rheumatologist, and cardiologist receive copies, too, of the films and reports.

[Kira]

I have:

-Internal Medicine (primary care doc)
-Metabolic/Genetics (near home)
-Metabolic/Neuro/Genetics (in another state)
-Neuromuscular
-Physical Medicine and Rehab/Pain Management
-Nephrologist
-Cardiologist
-Ophthalmologist
-Orthopedic Surgeon
-Psychiatrist
-ENT
-Allergy/Immunology

I also have:
-Physical Therapist
-Pool Physical Therapist
-Metabolic Nutritionist
-Genetic Counselor
-Therapist

Honestly, I am the one who coordinates it all and watches out for my general health. My metabolic doc (the in-state one) does a lot of the referring and coordination, too... but technically my internal medicine guy does the referrals.

I have a complicated, multi-organ system disease... so I really don't have much choice but to have a doc for everything that goes wrong.

The way that I found good ones was mostly trial-and-error (this is my third neuromuscular doc, and he is the first one I've had that is any good). Also, my metabolic/genetics doc is friends with my boss, who told me about him. I found my orthopedic surgeon by asking the ortho residents who they would let operate on their own shoulders... then went with the name I heard the most often.

I finally have a team of docs that I like and feel comfortable with... but it took a while to assemble.

They don't really ever talk to each other about stuff, except my neuromuscular guy and metabolic/genetics guy have talked about me a few times. I do have them send letters to one another for things that are a big deal (results from biopsy, cardiac MRI, etc)... and I get copies of everything for myself and show them to the various docs at appointments. I keep all of my records in a couples of manilla envelopes and photocopy as needed to give to my docs. I NEVER let them have the original copies, though, because they lose them :)

[champgoof]

I have a Rheumy, Oncolgist and a gp. I am very lucky my gp is amazing and she coordinates the other docs etc..

[Kathi49]

Mine are:

GP (coughs, colds, etc.)
Spinal Pain Management (Anesthesiologist) (DDD of spine)
Neurosurgeon (in the same group as the Spine PM; did both cervical fusions)
Neurologist (for Neuropathy)
ENT (anything having to do with ear, nose throat; not minor)
Rheumatologist (tested a couple of times for connective tissue disease(s)
Orthopedic Surgeon (osteoarthritis of knee)
Ob/Gyn (for the obvious :) and menopause)
Urogynecologist (cystocele and rectocle; pelvic floor PT)
Gastroenterologist (Gastritis, GERD, colonoscopy, upper endoscopy)

It IS tough to juggle. Most of the time I see my Spine Pain Management doctor first since the majority of my issues are with the spine and neuropathic pain. But, at times, I go for follow ups with my Neurologist. Alll of my doctors get copies of all reports as I have requested them to do. I know my GP gets ALL of them and he DOES read them all. I guess it just depends on what is going on at the time. But 9 times out of 10, my PM helps me to sort things out. And it is usually the PM and/or Neurologist that prescribe the meds. And I make certain they ALL know what meds I am taking, dosage and why. It is just that most docs are so specialized these days, you can't help but get referred to yet another one sometimes. :)

[Mark N]

My PCP prescribes all my meds but my OSS and internal doctor are the ones that initially recommend the prescriptions. I tried a pain med clinic but didn't benefit from it because they kept pusing chiro adustments and I wouldn't let them do that with two fused areas of my spine. As a result, I have settled on my PCP to deal with my pain issues. Be sure the PM group isn't just trying to push one [their's] treatment ie injections but instead are concerned with what will work best with your husband.

[Kathi49]

Mark,

I understand what you are saying. :) The first pain management clinic wanted to do nothing but injections! They never pushed chiro adjustments and I wouldn't have done them anyway as I simply do not believe in them. But that is me. I know there are people that swear by them. However, the new PM I have is not a "needle jockey". As a matter of fact, he will NOT do them unless everything else has been tried first. And when he does do them, I have to wait for several months before another one. I will say that in the past and with him, it took the pain away considerably. Also, he will only do a few before he states things like Rhizotomy, etc. In other words, he will not allow steroid injections to go on for years at a time. So, injections, if done properly, are not always a bad thing. They are not only therapeutic but diagnostic as well. And if he had not done them, I never would have figured out where the pain generator was. :) But you are right, the methods have to be in the best interest of the patient. Mine has sent me into PT as well but was adamant NO SPINAL MANIPULATIONS!

[hoops2u]

Greetings all you Wonderful Friends!!!!

I have a General Practitioner, she is an Osteopathic Physician. I prefer this type as opposed to MD only due to personal experience. It seems as though in the course of their education, they do ternd to spend more time on the whole person, not just the body. I feel like when I am with her, I am the only patirent she has. Most of my family also go to various DO's and express the same results. My GP oversees everything and she does prescribe all my meds. (there are plenty of good MD's out there, I'm sure)

I do see a pain management specialist every 6 months to a year as needed, usually only if I need a med change or if there is a change in my condition. He is further away and more difficult for me to get to, but a nice enough guy. He is also way overworked due to his office being in the hospital, he does anestheology as well as PM. He always looks stressed to the max and I always take him a little gift, his staff too. His accomadations are ugly and depressing and I think it is appalling that he doesn't get more appreciation at the hospital where he practices. I haven't been there for a year, am going next week, so maybe things have improved. If not, It may be time for me to write to the Administrator. hmmm. He's like poor old Rodney, he gerts no respect.:(

Any other specialists I see, my GP sends me to as needed. I sure like keeping it simple. Like me, many will agree I am sure, SIMPLE. I am my best material for humor and wit. I don't mind at all making fun at me. So laugh away.:o

Love to ya'll
hoops

[curiousforever]

Only my primary care doc at this point.

[curiousforever]

I have:

-Internal Medicine (primary care doc)
-Metabolic/Genetics (near home)
-Metabolic/Neuro/Genetics (in another state)
-Neuromuscular
-Physical Medicine and Rehab/Pain Management
-Nephrologist
-Cardiologist
-Ophthalmologist
-Orthopedic Surgeon
-Psychiatrist
-ENT
-Allergy/Immunology

I also have:
-Physical Therapist
-Pool Physical Therapist
-Metabolic Nutritionist
-Genetic Counselor
-Therapist

:)


Holy cow. And I had problems figuring out which office I was supposed to be at when I had 3 docs.

[Kira]

I guess it's just what happens when your whole body decides to crap out. :(

Probably going to add a GI doc and a surgeon or IR doc to the list soon, as I am throwing up again. The GI doc to figure out the throwing up; the surgeon or IR doc to put in a port. Blegh.

There are days when I feel really bitter and pouty about all that is happening with my body... and today is one of them. I am in a whiny, "It's not fair" kind of mood today.

[kukui]

Thanks everyone who answered about their doctors. Wow, some of you have a ton of coordination to do! Here we are, just struggling to get a second doctor... I don't know how you do it, we are told we're getting a referral, told it's been sent, we play phone tag with the one person at the new doc's office who will make appointments, a week later we find she didn't get the referral, 3 days after that the old doc says they're working on it. It takes weeks to get things coordinated enough just to get an appointment.

The person who liked DO's, that's who we started with. She was wonderful, but soon after we started with her she got married and moved out of state. After the mistrials with the new docs, we've talked about trying to find where she is and move there too! :)

Hope everyone's having an better-than-normal day.

[tenacious]

My sig. other didn't have a doctor when he had his aneurysm -- a walk-in clinic found the problem. Now he has chronic pain after that major surgery and we've been thrashing around with different doctors.

What type do you use? Do you have both a regular doctor and a pain specialist?

We're in the process of getting a referral to a pain clinic, so we should soon have a "pain doctor." His current doctor is an internist, but I believe we need a new one since we feel like he has let some things slip through the cracks. He is the one now prescribing the pain meds, so I'm thinking if we change to a GP, we have to be sure that all pain meds come from the specialist.

How do you all juggle the doctor/specialist combos? Who watches out for your general health, problems which may or may not be tied in with the main pain problem?

Thanks!

i didn't read the rest of your responses, but i am sure that you have been informed that your pcp, your family doc, is suppose to be coordinating all specialists. however, it is very important that you advocate for yourself at each and every doc apt. and make sure each doc knows what you are on, hnow long you have breen on the med, ectc. so, in other words, y0ou need to become as knowledgeable as possible and do a great deal of coordiating yourrself. i wiish i didn't have to tell you that, but it is true.

i have had chronic pain for over 31 years, and i very strongly suggest if you want pain relief from a doc who is on top of the meds used today, make sure he/she hasd a background in abestesiolog.

(please forgiive me if i hwve missed letters in wordw, or added some....i cannot see well):D