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Revision TKR Knee replacement is not nice to me...

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All that I had on Thursday was the informational seminar. The Physiatrist and the Psychologist both came in and talked to us about what pain is, how it can be controlled without medications, and how important it is for someone with chronic pain to go through therapy and all of that. What bothered me about it was a list of things that was describing the "chronic pain patient" One of them said that the chronic pain patient often "uses pain" to avoid things they don't want to do and shows that by unnecessary limping, complaints, and other things. There were several other things that were written that I took offense to and that was not cool. If anything, the reason I want to get help with my pain and such is so I do not have to avoid things anymore.

The thing is that I am working on my pain management mentally by working on issues with a counselor and attending therapy. I don't need to spend more money going to a psychologist to hear the same things I am hearing now.

The other thing that they said was that it does take quite a bit of time to get in to actually have an evaluation. The receptionist told me that the earliest they are scheduling right now is mid-September, unless you get on the cancellation list and get in sooner. So if you are looking for something to help you out right away, this is not the place to go. This is why I am going to just go to Dr. Scott at Downeast Orthopedics. He is easy to get into.

I am seeing a chiropractor now, so hopefully he can help work out some of the kinks in my hips and lower back and hopefully that can help.
 
One of them said that the chronic pain patient often "uses pain" to avoid things they don't want to do and shows that by unnecessary limping, complaints, and other things. There were several other things that were written that I took offense to and that was not cool.
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[Bonesmart.org] Knee replacement is not nice to me...
 
I went to a 3 week outpatient program that had that same philosophy. They also thought that "pain patients" talk about their pain to get sympathy and do not want to get well. I took great offense to that as well. :hissyfit:
Stay away from there.
Thinking of you.
Greda
 
Yeah, right.
We FAKE limping to gain sympathy?
We use pain as an EXCUSE to avoid things we do not want to do?
I am guessing that these bozos do not themselves have chronic pain issues.
I agree with Greda: stay away.
Sandy
 
Those that fake issues make it tough for people that have real problems. But for any provider to actually mention it? Thats beyond the pale for me.
 
Well, some people do, Sandy. And others go to even greater extremes - never heard of Munchhausen's syndrome?
 
hhhhmmmm.....been there with one pain specialist already. I think I'm gonna cancel my appointment! Thanks for posting about your visit!
 
I wanted to add a couple of things about pain mgmt programs. I was in graduate school working on a degree in clinical psychology with an emphasis in integrated healthcare and pain mgmt. One thing that is important is to find out what approach is taken. From the one that Coachie went to and the one I did...they take a straight behavioral approach. With a behavioral approach, the goal is to change "pain behaviors" and the thought is that the patient will feel better because they will not be focused on pain. I also know that pain is so often untreated or undertreated and it can affect every area of your life. There are some good pain mgmt programs but the ones like i went to and Coachie make it hard to believe. Unfortunately I had to stop my dissertation and school because of pain issues. I keep hoping pain will become something that doctors recognize needs to be treated.
I get frustrated when I hear stories like Coachie's, because I know she is not being treated for her pain and I wish there was a magic wand to fix it.
Coachie hope you are having a better day.
Greda
 
Makes me nervous now that I am being sent to a pain management Doc.
I keep hoping that something will fix the E verytime a Doc looks at me and says this knee is 'perfect' I think that they must believe I am a wacko. Now I'm off work. For the summer. Sounds fishy to me, huh????
I'd rather be at work in no pain.
Sandy
 
I think that pain management works for people who are stuck in that cycle that they can't get out of. However, I don't think the pain management clinic is necessarily useful if there is a specific reason for why someone is in pain. I mean, if I am hurting because my knee replacement is loose or something like that, then there is a specific reason for my pain and a little behavior modification is not going to help that. I can understand if someone is having pain for no specific reason and working with the psyche can help with all of that, but when there is a reason for the pain, how do you ignore that? Does that make sense?

Today I had my cleaning at the dentist which meant a dose of Clindamycin- which means heartburn and nausea. Now a days, that is the worst part of going to the dentist for me!
 
I think you have identified your situation perfectly, Coachie. You need to find the reason for the pain and, until you do "management" is only going to mean tolerating it or taking serious pain medication.
 
Audrey- I wouldn't cancel your appointment. It will probably be different for you as you are actually seeing a Dr for a specific reason (RSD) and he will more than likely be able to help you.

What I was referring to was the generalized "pain management seekers" that they talked about in the seminar. I didn't feel I fit that nor would you with your problems, so you can be helped.

I would go if I were you. I really would.
 
Coachie,
I agree with you. I think sometimes when doctors don't know what to do about pain you are sent to pain mgmt. Behavior Mod would not work for you. There are other pain programs that do not take that approach, however I don't think you are at the point of doing anything like that until the problem with your knee is treated. Hopefully by then you won't need it.
Greda
 
Hi everyone! I've already been to a "pain doctor" after I had my first knee replacement. I was not happy then, as that doctor was ready to stick needles in my back and "wait and see what happened". I was told at that time that I was a "drug seeker" as well. All the while, I KNEW (just like you, Coachie) that SOMETHING was wrong. Based on what you and others have said about some pain management clinics, I agree....for those who have already been through the gauntlet with doctors to find out what is wrong, and hopefully have it corrected and those people are STILL in pain, then quite possibly the pain MANAGEMENT clinic would be a good idea. Going the "behavioral" route would help people "deal" with the chronic pain they have and find ways to psych themselves up to mentally lessen the pain.
For those who focus on their pain 24/7, I also agree. Learning to mentally help yourself through the pain would be a positive.
Luckily, I have learned these "tricks" several years ago when I had a shoulder surgery and it left me with limited movement. I HAD to work at the time, and I psyched myself out of the pain during the day just to get through. I would give myself time to cry, get mad, and acknowledge the pain only at certain times and then I would "turn the other cheek" and forget it.
If I can help myself with tools to deal with things, then I do. However, I can recognize when I need more help and will seek it if need be. Always remember....if that little voice inside your head says "this isn't right"....LISTEN! Hope you have a wonderful 4th!
 
have been actively seeking tools to deal with chronic pain with my Psych. Behavioral modification doesn't work when the pain becomes intrusive to thinking, which was happening to me on a daily basis.

So far, it hasn't fixed my pain, but the mandated rest has helped me DEFINE it with more clarity. AND discussing it with her helps as she doesn't judge me.

Unfortunately, the pain centers I have visited for ongoing back issues are all about the sticking you with needles thing.

I didn't improve after the treatment last year, so the doc automatically went to the percocet. I MEAN... HE SAID IT WAS TIME TO GET ME OFF "DRUGS". Like I was addicted. This was a PEER.

When I went for a 4th opinion to the "GURU" at MGH, I thought I'd ask him how he managed post op pain after surgery. It was an open-ended question, and we had already determined my knee was fine and I did not need any intervention, but needed to re-investigate the back.

OH BOY. His tone changed, and he scowled, as if to say "why do you want to know". He then told me tha tHe would give "ME" only enough pain meds to last 6 weeks, and then it is off ot the PCP. However, he didn't really see an"reason" why people would need pain meds.
Go figure. A revisionist. Glad I do not need a revision. Who decided that at 6 weeks the pain from a major surgery should BE GONE????
Anyone in my practice with persistant pain gets a full investigation and most of the time, I find nothing, and the pain goes away. BUT AT LEAST I BELIEVE THEM!!!!!

My PCP does have a handle on how to manage pain, and I get the meds I need, without an issue.
Thank goodness for him.
Sandy
 
So if you could create a "program" for those who suffer with pain...what would it look like??? What kind of doctors would you have on staff, what kind of other staff would you have.. Coachie...I do not want to derail your thread, so I am going to start a Chronic Pain Thread in the Social area.


My daughter suffers with fibromyalgia. And her experiences are similar to what you described ...she has found a single source of help...but MOSTLY not covered by insurance.
 
Good question, Barb. I'm sure we'll all have to think about that one.

Tonight is a high pain night for me. I did do a bit more in ways of moving around, but did not move anywhere near what would be considered a lot for anyone. It wasn't even a lot compared to what someone post-op would do- but it was more than just sitting with my leg up. It frustrates me that just that little bit of movement has caused me this much pain. That is what bothers me the most. I am told to not think about the pain, to work through it and focus on other things and find a way to do the activity. Sure. Sounds like a good plan at the time, but then a few hours later I am paying for that. Sigh. Some people just don't seem to understand what it is like to truly feel pain.


Went to the Physiatrist at my "new" orthopedic's office. I was not impressed at all as I thought he was short with me and I just didn't like him. His first comment was that he wanted me to up my Cymbalta dosage since he "knew" I was depressed (and that was without him even talking to me!) I will not be going back to him. I will be so glad when this knee issue is over.
 
The last doctor sounds like a jerk...how could he make that decision without seeing you...Too bad we can't give our pain to someone else for a few minutes so they could learn maybe just a little empathy.
Wish things would improve for you.
Greda
 
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