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      07-28-2011, 09:37 PM   #23
HaZe_X
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Originally Posted by Gregxi View Post
I am tryng to get a better understanding of what your post said
Have you been taking 10/325 since '05? and if so at what daily dosage?
most Doctors would have sent you to pain management years ago, I understand chronic pain and have been living with it for the last 2 years.

I was sent to pain management also after MRI'S and X-Rays indicated degenerative disc disease and cervical spondylosis, they then did blocks, steroid injections, rhizotomy to no avail. countless meds arthritis,nerve,and even anti depressants which I found to be the WORST thing ever, I never understood depression and my heart goes out to people that have to take that poison.The only relief I get is the vicodin that they finally started prescribing me after the third or fourth visit. Opiates are a very slippery slope as you are probably very aware and I have struggled with this as I have seen far too many people lose everything over pill addictions.

Pain doctors usually will not start writing you scripts until they know you are in need and not just Dr. shopping or trying to feed your addiction. You are guilty until proven innocent in most cases. The DEA is going over every script they write due to the huge nationwide abuse of opiates, so they are going to dot their i's and cross their t's before you get "accepted"

Get the MRI done and go back and talk to the doctor he is going to suggest various forms of treatment before he prescribes narcotics as this is usually a last resort.
hope things get better for you
In 2005 the 10mgs were for my torn rotator cuff, took them for pre and post op. Then again in 08, same thing happened. since 2009.5-2010 I been on 10mgs of oxycodone. maybe 2-3, 4-5 days out of the week. because of my torn rotator cuff. Now since recently with M.S and all, with the legs pains, cant walk, and constant pain I have to take 20-30mgs for any kind of relief, otherwise Im sitting in a chair all day in pain, and right now I cant even work, which makes things worse.

For the M.S Ive been through Steroids, nerve blocks, and such, steroids (5days IV) help with the pain for a little while, but I cant have that around the clock. MY Neuro has done all this.

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Originally Posted by sjg111 View Post
Honestly, just shop around for another doctor and get a second opinion. There's no reason why you should have to put up with one who doesn't suit your needs. Definitely find a neurologist who specializes in MS.
I have another Pain management dr looking at my records as we speak to see if he will accept me as a patient, plus he is a Neuro.

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Originally Posted by CollinsE90 View Post
Yea I was being completely serious and using nothing but Dr House as my reasoning

Come on guys, its common sense, why would the Ortho send him to a pain clinic to JUST get pain meds, when he can prescribe them himself

Think guys
Guess to you didn't understand my posts...Ortho Suggested Pain management for shoulder and for my MS Pains. Obviously the Ortho would not treat my M.S conditions.

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Originally Posted by JayKay335i View Post
Find an MS specialist. Look into antidepressants that are also used for neuralgia. Don't take oxy because you don't sound responsible and will be on it forever.
Your an idiot.

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Originally Posted by pman10 View Post
OP, sorry to hear about all the pain you are having with your MS. It really is a debilitating disease, so you need to find doctors that are flexible and willing to work with you.

Pain management is a tricky business. Newer docs tend to err on the side of caution, to avoid looking silly by prescribing to a druggie or malingering individual. That's clearly not the case with you. Older physicians are usually more understanding and flexible in their pain medication administration - although this is not a hard and fast rule.

Are you taking meds for your MS? What are you on? Interferon therapy? What sort of MS do you have? Is it progressive or of the remitting/relapsing variety?

Also, find an MS specialist, if you're not seeing one already. ideally someone who is more aware of pain management, so you can work on a combined approach. Neurology/pain mgmt is a relatively new subspecialty, but you should be able to find someone. Academic centers are a good place to start.

To the others who say he shouldn't be on stronger pain medication - only he can really evaluate that. Pain management is far from a perfected science, while pain itself can be absolutely, utterly debilitating; until you have experienced it, it is very, very hard to understand what the OP is going through. i am of the camp that everything should be done to reduce pain to at least a bearable level, risk of addiction be damned. I would rather have a patient with a chronic condition risk addiction and withdrawal than have them spend months or years of their life in agony.
Was taking Avonex, which is Intro-muscular injection every week, Now Im switching to Rebif, which is an injection every 3 days.

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Originally Posted by M3Bahn View Post
Sorry to hear, I agree many doctors suck and don't have a clue.


Have you had your Vit. D levels checked?


Low Serum Vitamin D Linked to Multiple Sclerosis

A new study shows that multiple sclerosis (MS) is linked to low levels of vitamin D in the blood, but it’s unclear whether vitamin D deficiency is a causal factor in the disease or whether vitamin D supplements would protect against it.

Alberto Ascherio, M.D., Dr.P.H., a professor of nutrition and epidemiology at the Harvard School of Public Health in Boston, examined the connection between vitamin D and MS by accessing medical records and blood samples from more than 7 million U.S. military personnel. He found that in some soldiers with MS, vitamin D levels in the blood – drawn as a routine matter several years before they were diagnosed – were lower than in soldiers without the disease. The study was supported by the National Institute of Neurological Disorders and Stroke (NINDS), and appeared in the December 20, 2006 issue of the Journal of the American Medical Association.*

http://www.ninds.nih.gov/news_and_ev...vitD_serum.htm
My VIT D is always low, my last blood test I was scripted 50,000 units of VIT D, 1 tab per week. Now I think I need to take 4,000 unit daily or weekly, cant remember off the top of my head.

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Originally Posted by FStop7 View Post
That sucks man, what type of MS do you have?
Relapse/Remitting.


Some of you guys here shouldn't be in this thread until you experience pain, or what M.S really is, its debilitating disease. I was blind in 1 eye an entire month, I had Optic-neuritis, due to an M.S episode (my very first one). Due to the quick thinking of my Ophthalmologist, who started me on IV steroids right away, which I slowly regained my eyesight back, about 90% of it, recommended me to a Neuro who sent me for a brain MRI, saw lesions on my brain which goes hand in hand which what I have.
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      07-28-2011, 09:48 PM   #24
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Originally Posted by HaZe_X View Post
Was taking Avonex, which is Intro-muscular injection every week, Now Im switching to Rebif, which is an injection every 3 days.
It's good that Rebif is back on the market, only one which actually has any effect on restoring myelin sheath.
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      07-28-2011, 09:51 PM   #25
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Some of you guys here shouldn't be in this thread until you experience pain, or what M.S really is, its debilitating disease. I was blind in 1 eye an entire month, I had Optic-neuritis, due to an M.S episode (my very first one). Due to the quick thinking of my Ophthalmologist, who started me on IV steroids right away, which I slowly regained my eyesight back, about 90% of it, recommended me to a Neuro who sent me for a brain MRI, saw lesions on my brain which goes hand in hand which what I have.
Don't make a thread unless you want opinions, we don't want to hear you rant if we can't offer what we think. You're being a grade A douche to people who are trying to help you and give advice.
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      07-28-2011, 09:52 PM   #26
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      07-28-2011, 10:04 PM   #27
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Don't make a thread unless you want opinions, we don't want to hear you rant if we can't offer what we think. You're being a grade A douche to people who are trying to help you and give advice.
That comment was meant for you and Jaykay.

#1 because I don't think you comprehended yet that the Pain management dr is mainly for the M.S. Of course the Ortho could keep giving me percocet for my rotator cuff if that was the only problem. It was my Ortho's idea for pain management, #1 for my M.S, #2 for my torn rotator cuff. I feel like were not on the same page here...

#2 for Jaykay calling me irresponsible with Percocet/oxycodone. Who is he to judge. Im well aware of the addiction rate and all that comes with the drug.
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      07-28-2011, 10:09 PM   #28
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That comment was meant for you and Jaykay.

#1 because I don't think you comprehended yet that the Pain management dr is mainly for the M.S. Of course the Ortho could keep giving me percocet for my rotator cuff if that was the only problem.

#2 for Jaykay calling me irresponsible with Percocet/oxycodone. Who is he to judge. Im well aware of the addiction rate and all that comes with the drug.
The pain management doctor doesn't give a fuck what is wrong with you, his job is to find a way to relieve the pain. MS, Cancer, Back problems whatever it is. MS doctor is going to focus on your disease. You're not comprehending that Pain doctors have a hundred people walk in and say "Doc, I'm hurting I need pain meds". They won't just hand you a script and let you go, they want to try to avoid narcotics if they can, which I have said 15 times in this thread and you aren't understanding. You are bitching because you feel the doctor screwed you, when he is just trying to stop you from taking pain meds the rest of your life if possible.

Pain is pain, doesn't matter to them why you are hurting, they just want to look into the pain and find a way to help you sans narcotics IF POSSIBLE. Give it time, call your ortho for one script if you have to in order to get you by while the pain doc has time to evaluate all avenues.
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      07-28-2011, 10:22 PM   #29
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The pain management doctor doesn't give a fuck what is wrong with you, his job is to find a way to relieve the pain. MS, Cancer, Back problems whatever it is. MS doctor is going to focus on your disease. You're not comprehending that Pain doctors have a hundred people walk in and say "Doc, I'm hurting I need pain meds". They won't just hand you a script and let you go, they want to try to avoid narcotics if they can, which I have said 15 times in this thread and you aren't understanding. You are bitching because you feel the doctor screwed you, when he is just trying to stop you from taking pain meds the rest of your life if possible.

Pain is pain, doesn't matter to them why you are hurting, they just want to look into the pain and find a way to help you sans narcotics IF POSSIBLE. Give it time, call your ortho for one script if you have to in order to get you by while the pain doc has time to evaluate all avenues.
I know Im not just going to walk in and get scripted. #1 I would prefer nerve blocks if they worked (Had them didnt help). What Im trying to say is the Pain DR I went to did nothing for me. He wrote me a MRI for my lower back, reason, No idea. Legs/joint pains=MS. MS Dr confirmed it with me. THis pain DR had no idea why I was there, I think I said that somewhere in this thread. Said he couldn't help me. So why he wrote and non-sense MRI is beyond me.
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      07-28-2011, 10:31 PM   #30
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Originally Posted by CollinsE90 View Post
The pain management doctor doesn't give a fuck what is wrong with you, his job is to find a way to relieve the pain. MS, Cancer, Back problems whatever it is. MS doctor is going to focus on your disease. You're not comprehending that Pain doctors have a hundred people walk in and say "Doc, I'm hurting I need pain meds". They won't just hand you a script and let you go, they want to try to avoid narcotics if they can, which I have said 15 times in this thread and you aren't understanding. You are bitching because you feel the doctor screwed you, when he is just trying to stop you from taking pain meds the rest of your life if possible.

Pain is pain, doesn't matter to them why you are hurting, they just want to look into the pain and find a way to help you sans narcotics IF POSSIBLE. Give it time, call your ortho for one script if you have to in order to get you by while the pain doc has time to evaluate all avenues.
I normally side with you and Jaykay, but I'll have to side with the OP on this one. It is hard to comment on pain care/pain management without experiencing it firsthand or at least witnessing it. M.S. can be unbelievably excruciating, making it all the more important for physicians to recognize M.S.-associated pain and treat it rapidly.

I'm not saying that the physician in this case was necessarily wrong, but due to the C.Y.A/ malpractice-averse nature of most doctors and departments today, they tend to err on the side of THEIR own caution, rather than dealing with the pain aggressively.

I don't like to throw around credentials, but in this case, I'll make an exception; I've seen many patients suffering first-hand due to physicians being overly averse to side effects or addiction risks, or simply being insensitive to pain. I can't really blame them, due to the number of abusers in the system. But at the same time, leaving patients in pain does not seem compassionate.

I'll say it again - my opinion is that physicians should always err on the side of the PATIENT; as a compassionate individual, it is your role to take care of the patient first, and to determine if they are malingering later. This is, of course, a hotly debated topic, and many physicians will disagree with me and side with you on this matter. I just wanted to share my side of the argument.

P.S. - Pain management docs absolutely DO care what you are diagnosed with. There is a reason why pain management is a superspecialty (of anesthesiology or neurology) that requires training and experience in multiple different fields. Their role is to treat your pain, taking into consideration your pathology, risk profile, and PMH. Example: you wouldn't give morphine to someone with renal failure, but morphine is preferred to oxycodone for cancer patients.

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      07-28-2011, 10:32 PM   #31
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I know Im not just going to walk in and get scripted. #1 I would prefer nerve blocks if they worked (Had them didnt help). What Im trying to say is the Pain DR I went to did nothing for me. He wrote me a MRI for my lower back, reason, No idea. Legs/joint pains=MS. MS Dr confirmed it with me. THis pain DR had no idea why I was there, I think I said that somewhere in this thread. Said he couldn't help me. So why he wrote and non-sense MRI is beyond me.
If that is the case, do what I said in my first post and get a second opinion. Do some research for good Pain doctors and go from there. If not, talk with your MS doctor and see if he can help with the pain, he does know you have pain as he is the most familiar with your situation.

Once again, I wish you the best I know pain is something that is very hard to deal with. That is very hard to cure without addiction etc...
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      07-28-2011, 10:43 PM   #32
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Have you heard of this place, it came up on a google search?



Welcome to International Multiple Sclerosis Management Practice

The International Multiple Sclerosis Management Practice (IMSMP) is a state-of-the-art treatment center for the care of people with multiple sclerosis. Under the leadership of Saud A. Sadiq, M.D., the most comprehensive multidisciplinary MS medical team in New York City is assembled to provide the best care for people who have MS. At the IMSMP, a team of expertly trained healthcare professionals provide an unparalleled level of care to our patients.

Located in Midtown Manhattan, the IMSMP cares for over 4,000 patients while treating each person with the familiarity and compassion that is rarely found in today's health care environment. The center cares for patients from across the globe, including 47 US states and over 33 countries worldwide.

http://www.imsmp.org/
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      07-28-2011, 10:50 PM   #33
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...
It sounds like you are being well taken care of (aside from this latest pain mgmt doc). I hope you find adequate care for your pain. Keep us posted, if you can, and take care of yourself.



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Have you heard of this place, it came up on a google search?



Welcome to International Multiple Sclerosis Management Practice

The International Multiple Sclerosis Management Practice (IMSMP) is a state-of-the-art treatment center for the care of people with multiple sclerosis. Under the leadership of Saud A. Sadiq, M.D., the most comprehensive multidisciplinary MS medical team in New York City is assembled to provide the best care for people who have MS. At the IMSMP, a team of expertly trained healthcare professionals provide an unparalleled level of care to our patients.

Located in Midtown Manhattan, the IMSMP cares for over 4,000 patients while treating each person with the familiarity and compassion that is rarely found in today's health care environment. The center cares for patients from across the globe, including 47 US states and over 33 countries worldwide.

http://www.imsmp.org/
It's best to stick to an academic center. He's in north NJ, so I'd recommend Columbia or Weill Cornell. Better likelihood of getting chosen for a clinical trial that might work.
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      07-28-2011, 10:57 PM   #34
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as a doctor, i usually make up my mind in 5 minutes regardless of the diagnosis if Im giving a script for narcotics.

i would guess most doctors are like me. Im not going to risk my practice for someone I dont believe.

If not usually you can find a doctor that will make a pain contract with you. follow you monthly etc.

fk
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      07-28-2011, 11:26 PM   #35
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It sounds like you are being well taken care of (aside from this latest pain mgmt doc). I hope you find adequate care for your pain. Keep us posted, if you can, and take care of yourself.





It's best to stick to an academic center. He's in north NJ, so I'd recommend Columbia or Weill Cornell. Better likelihood of getting chosen for a clinical trial that might work.
I don't agree with that though sometimes it's true like with brain cancer.


He does seem to have many top choices in that area.


Intrathecal methotrexate shows promising results on progressive Multiple Sclerosis patients

The Multiple Sclerosis Research Center of New York (MSRCNY), together with the International Multiple Sclerosis Management Practice (IMSMP), today announced that results from its Intrathecal Methotrexate Treatment in Multiple Sclerosis study have been published in this month's issue of Journal of Neurology.

This study reports on the feasibility of using intrathecal methotrexate (ITMTX) in treatment unresponsive multiple sclerosis (MS) patients with progressive forms of the disease.

A retrospective, open-label, chart review analysis was conducted following patients with MS for up to eight treatments. Patients were considered for ITMTX treatment if they were unresponsive to or intolerant of FDA approved treatments.

There was a one year follow-up after their eighth or last treatment.

Patients underwent neurological assessments and Expanded Disability Status Scale (EDSS) evaluations.

In 87 secondary progressive MS patients, EDSS scores were stable or improved in 89%, with significantly improved mean EDSS post-treatment compared to baseline. Of 34 primary progressive patients, EDSS scores were stable in 82%, with no significant progression in EDSS post-treatment compared to baseline.

ITMTX may have a beneficial role in progressive forms of MS and is well tolerated with no serious adverse events.

"We have opened an avenue of treatment for an otherwise untreatable form of MS," said Dr. Saud A. Sadiq, Director of the IMSMP/MSRCNY and the study's lead author. "This is exciting news because it's the first time a treatment has been shown to be effective in the late stages/progressive forms of MS."

About Methotrexate

Methotrexate (MTX), an antimetabolite, has been in clinical use since 1948 when it was found to produce temporary remission of acute childhood leukemia. Because of its indirect immunosuppressive effects, MTX is used in treating autoimmune conditions such as rheumatoid arthritis and psoriasis.

About the IMSMP & MSRCNY

The International Multiple Sclerosis Management Practice and the Multiple Sclerosis Research Center of New York is a leader in MS healthcare and research. As a center of excellence, it establishes an unparalleled level of care for individualized, compassionate attention to patients' needs and well-being. Patients receive in-depth assessments and management plans with on-site physical therapists, social workers and neuropsychologists for cognitive rehabilitation.
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They do trials as well.



Current Clinical Trials at the IMSMP



Clinical trials help doctors and scientists test the safety and effectiveness of new or investigational medications. Many of the medications used at the IMSMP were tested in clinical trials to demonstrate their effectiveness in treating MS. Clinical trials have both potential risks and benefits for people who participate in them. Ineffective medication and possible side effects are potential risks, while receiving treatment otherwise unavailable and helping others with MS by contributing to medical research are among the potential benefits.



Below are some of the current clinical trials being conducted at the IMSMP. Click on the name of the trial to be redirected to their homepage.

STRATIFY 2

This study examines the incidence of adverse events and JC virus antibody formation in patients treated with Tysabri.

Accelerated Cure Project

The IMSMP/MSRCNY is also involved in the Accelerated Cure Project. This project aims to find the cause and develop a cure for MS.

Vitamin D

The IMSMP is conducting a clinical trial of vitamin D and MS, in which we are investigating various dosing regiments of vitamin D and the effect on MS and MS biomarkers.

Rituximab Study

This study aims at looking at how patients respond to the medication Rituxan by analyzing clinical tests as well as spinal fluid. We hope to identify markers in the blood or spinal fluid that may predict medication response.

Skin Biopsy Study

This study will look to see if microscopic changes in the skin can help us differentiate atypical from typical cases of MS.

Acetyl-L-Carnitine Fatigue Study

This study hopes to determine if Acetyl-L-Carnitine, a natural supplement, is helpful at reducing fatigue and improving endurance.
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      07-28-2011, 11:32 PM   #36
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If that is the case, do what I said in my first post and get a second opinion. Do some research for good Pain doctors and go from there. If not, talk with your MS doctor and see if he can help with the pain, he does know you have pain as he is the most familiar with your situation.

Once again, I wish you the best I know pain is something that is very hard to deal with. That is very hard to cure without addiction etc...
I just picked one out of the blue from my insurance company, he is currently reviewing my records, seeing if he will accept me as a new patient or not.

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Have you heard of this place, it came up on a google search?



Welcome to International Multiple Sclerosis Management Practice

The International Multiple Sclerosis Management Practice (IMSMP) is a state-of-the-art treatment center for the care of people with multiple sclerosis. Under the leadership of Saud A. Sadiq, M.D., the most comprehensive multidisciplinary MS medical team in New York City is assembled to provide the best care for people who have MS. At the IMSMP, a team of expertly trained healthcare professionals provide an unparalleled level of care to our patients.

Located in Midtown Manhattan, the IMSMP cares for over 4,000 patients while treating each person with the familiarity and compassion that is rarely found in today's health care environment. The center cares for patients from across the globe, including 47 US states and over 33 countries worldwide.

http://www.imsmp.org/
Never heard of it. Read below

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It sounds like you are being well taken care of (aside from this latest pain mgmt doc). I hope you find adequate care for your pain. Keep us posted, if you can, and take care of yourself.





It's best to stick to an academic center. He's in north NJ, so I'd recommend Columbia or Weill Cornell. Better likelihood of getting chosen for a clinical trial that might work.
My current Nuero is O.K at best, reason I say that is because they are taking the pain Im having and it seems like they are throwing it by the waist side. Sure they prescribed Neurontin, which made me sick to my stomach, and did very little for the pain, I tried it for 5 days and couldn't deal with it. I go to a well known one, in Teaneck, Im actually looking to get a new neuro, possibly.

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as a doctor, i usually make up my mind in 5 minutes regardless of the diagnosis if Im giving a script for narcotics.

i would guess most doctors are like me. Im not going to risk my practice for someone I dont believe.

If not usually you can find a doctor that will make a pain contract with you. follow you monthly etc.

fk
SInce your a DR. why do you think this pain management DR did this to me? He did nothing for my leg pains, caused by M.S. If you read up you can read the whole story, the whole visit took no more than 5 minutes. He didn't suggest cortisone shots, nerve blocks, steroids, he suggested NOTHING. He had all my records on hand.
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      07-28-2011, 11:50 PM   #37
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My current Nuero is O.K at best, reason I say that is because they are taking the pain Im having and it seems like they are throwing it by the waist side. Sure they prescribed Neurontin, which made me sick to my stomach, and did very little for the pain, I tried it for 5 days and couldn't deal with it. I go to a well known one, in Teaneck, Im actually looking to get a new neuro, possibly.
If I were you I would get on a MS forum like http://www.thisisms.com/index.php and start looking for highly recommended doctors and treatments centers, I would leave no stone unturned.

GL!
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      07-29-2011, 12:31 AM   #38
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SInce your a DR. why do you think this pain management DR did this to me? He did nothing for my leg pains, caused by M.S. If you read up you can read the whole story, the whole visit took no more than 5 minutes. He didn't suggest cortisone shots, nerve blocks, steroids, he suggested NOTHING. He had all my records on hand.
Im guessing
1. he didnt believe you
or
2. is too busy for his own good
or
3. doesnt care for your business

the liability is high for any doctor that will write a large amount of narcotics each month. He probably just doesnt want your business.

I know this sounds "cruel" but what we do is more like a business unless you are attached to a university that is funding paychecks.
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      07-29-2011, 12:53 AM   #39
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If I were you I would get on a MS forum like http://www.thisisms.com/index.php and start looking for highly recommended doctors and treatments centers, I would leave no stone unturned.

GL!
Thanks, never realized they had forums for M.S and all that jazz.

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Originally Posted by firstkill View Post
Im guessing
1. he didnt believe you
or
2. is too busy for his own good
or
3. doesnt care for your business

the liability is high for any doctor that will write a large amount of narcotics each month. He probably just doesnt want your business.

I know this sounds "cruel" but what we do is more like a business unless you are attached to a university that is funding paychecks.
DOnt know why he wouldn't believe me, its documented, I admitted to taking percocet, that was prescribed by my ortho for my shoulder. I didn't hide anything. I didnt go in there looking for narcotics at all. I told him what I take a day. I never said can you give me more. Like I said he told me there is nothing he can do for me, he didnt know why I was there. He could of suggested some type of nerve block injection, I would have said yes. But nope.

TO busy, I doubt it, his office was empty.

I just dont know, dont get it, Im fed up, thats all.
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      07-29-2011, 11:49 AM   #40
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It may be that you sound like a drug seeker on top of your disease.

Anyway, being so close to NYC and some top M.S. doctors it would be stupid of you to not learn more about the disease, join forums, get on top of tracking down the best doctors in NYC and take this head on.

Bitching won't get you anywhere and when it comes to medicine knowledge really is power.
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      07-29-2011, 12:45 PM   #41
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It may be that you sound like a drug seeker on top of your disease.

Anyway, being so close to NYC and some top M.S. doctors it would be stupid of you to not learn more about the disease, join forums, get on top of tracking down the best doctors in NYC and take this head on.

Bitching won't get you anywhere and when it comes to medicine knowledge really is power.
Wow, that sounds familiar...
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      07-29-2011, 12:50 PM   #42
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Relapse/Remitting.
When was the last time you were in remission and how long do you typically stay in remission for?

I am in no way a doctor or a med student, just curious about MS in general.

If the pain docs are concerned about your becoming overly dependent on oxycodone then maybe they should prescribe something else rather than just tell you to go without. Have you ever been prescribed fentanyl (actiq, durogesic, etc)?
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      07-29-2011, 04:03 PM   #43
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Smoke weed.
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      07-29-2011, 04:18 PM   #44
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Wow, that sounds familiar...
Is it what you said?

Theres a lot a text up there.

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