I had a doctor friend tell me that when she was in medical school the loser students chose the field of pain. It was seen as a money-making arena, rarely successful for its patients. Ambitious doctors chose other fields, where they could actually be effective.
A friend was just dumped from her pain clinic for remaining steady on her treatment plan for many years. She has a neck injury, two children and runs her own full-time practice. She found a med that works for her, and has been taking it at a low dose without incident.
Dream patient, right? Evidently, no. She doesn’t need expensive, experimental procedures. She isn’t making her pain clinic any real money and they need to make space for patients who need their services (i.e. desperate and have some insurance cash to spend). She is now struggling to find a clinic that will take her. Her life will be turned inside-out if she cannot get the medication she needs.
Pain clinics are failing our community. I’m sure you have heard at least one story about the pill mills, and they certainly exist. But the demonizing story you are likely to hear is too simple and has made things impossible for those of us trying to get real treatment. Many general practitioners no longer prescribe pain medications, they don’t like the liability. So if you have a chronic pain disease, you are sent into the pain clinic system.
Let’s use my experience as an example: I have a condition called Sphincter of Oddi (SOD3). One of my digestive valves is misfiring — closing when it shouldn’t — causing my entire system to back up. It hurts like hell, all day, every day.
I see the top GI specialist in the country and he does not have a cure for me right now. My pain, and its cause, is very different from that of fibromyalgia, RA or a back injury — it is called binary pain. It is rare, but not unheard of. I have been with my pain clinic for almost 2 years now and I still have to explain what SOD is at every appointment.
Without knowing anything about my disease, my pain clinic had a list of recommended treatments for me at my very first appointment: take gabapentin, do physical therapy twice a week in their clinic, and undergo steroid block injections.
I have discovered that this is what they recommend to everyone who comes to them, no matter their diagnosis. I don’t pretend to know why, but I suspect those injections make them a pretty penny. I did each of these things, the injections three times. When the third round made my pain worse, the doctor commented that he hadn’t thought that treatment would work for me!
Along with the expensive treatments, I get a lecture each visit about the horrors of using opioid pain medications. They simply must get me off of the one medication that actually works; the one thing that has kept me out of my bed and enjoying my girls for the last 7 years.
I have told them again and again, that unless they can find something that actually works, I will continue with the medication. However, if the war on drugs is successful at limiting the use if these medications for patients in good standing, it won’t be an option for me much longer.
I rarely see my actual doctor (he is one of the top 25 pain docs in the country), the clinic uses nurse practitioners and assistants to run the day-to-day appointments. I have yet to have an appointment where the nurse has actually read my chart before meeting with me. Every time I have a procedure with my doctor, I have to tell him who I am, and describe my condition and past treatments, while lying face down on the surgical table. They must see thousands of patients a year within their 8 clinic system.
It is a money-making mill, and it is my only hope. Most pain clinics are much like this. If you switch, or doctor shop, too often they decide you are a med seeker and you can no longer get in anywhere. They have us by the balls and they know it, no customer service required.
This is all to say that something has got to change.
Contrary to the guilty-until-proven-guilty way we are treated by our pain doctors, we did not choose to have chronic pain disease and we deserve the same kind, thoughtful treatment given to those with other conditions, like diabetes or heart disease.
Every patient should get an individualized treatment plan based on their actual diagnosis. Doctors should spent time with their patients, actually getting to know them and their potential for drug abuse. The end game should be bringing comfort to people who desperately need it, not filling pockets with cash.
It is time to submit editorials, write to our representatives and advocate for ourselves, or continue to accept things as they are, in quiet desperation.
Malia Cole lives in Minneapolis, Minnesota with her family. She has a blog on motherhood and chronic pain called Labor Pain.
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The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represent the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.