The Pain Managment Clinic was unruly. There were two small waiting rooms, one inside and one outside. They were packed with mostly elderly folks, some in wheelchairs. There were quite a few people filling out new patient packages, which I took as a sign of a high turnover.
Before I ever even saw the doctor, I had to take a piss test.
I had a bad feeling going into this because I had seen the Indian doctor (as in "India") before, sometime during 2008--and I never returned, which is a good indication that I didn't like the man. My mother, along with other people, as they've commented over the years, insist that I simply don't get along well with doctors. There may be some truth to that, but I always clamor that when they treat you like you're stupid, I tend to get upset.
So, a medical assistant takes a quick history of me, the general, typical questions, like where's your pain located, and do you have any other medical illnesses that they should know about (I only admitted to having "anxiety and depression," not wanting to get into my entire psychiatric history).
The doctor comes in, and immediately fusses around with my legs and then asks me to stand up, so he can poke around on my back (which hurt, by the way). He doesn't spend five minutes examining me. "You have some inflammation in your back, and a spasm. Alternate heat and cold. Take over the counter anti-inflammatories, you know, like Tylenol. I can help you by giving you an injection, and then see you in six months."
I know about injections. Veterinarians use them constantly in horses who perform because they quickly alleviate lameness, although the results only last for a few weeks, and ultimately, the corticosteriod injections cause arthritis by damaging the joint they're injected into. So, no, am I going to have an injection? I don't think so. Besides, he's assuming that my pain is caused from the herniated disc, and two doctors already have decided it wasn't likely. "Would you be willing to continue to prescribe Norco?"
"No, with your level of pain, you don't need Norco."
"How would you know what my level of pain is?" I say defensively. I can tell he wasn't prepared for this reaction.
"Because of the results from the MRI's, my examination and I'm a pain management doctor."
I'm immediately thinking every bad thought you can have about someone (short of wishing death or harm). I'm even considering a few racial slurs (when I told my mother this after I returned home, she thought it was funny that her "pacifist liberal" daughter was a racist). "You didn't even examine me for five minutes."
"You don't need the Norco, now, if your GP prescribes you it, that's one thing, but I am going to give him my recommendation."
In other words, fuck you, Jae. I'm sure he feels like he's doing some good, stopping me from becoming a potential drug addict. I mean, fast food kills more people every year than opioids, and my god, does the government do anything to restrict fatty, fried foods and sugary sodas? I can guarantee you that it costs society more to handle the consequences of obesity and an unhealthy diet than it does to put a few thousand people through rehab (if need be). But, alas, who cares about fat people?
So, if Mr. Pain Management Specialist (he doesn't deserve the title of "Dr.") sends my GP a little note, saying that the Norco was unnecessary, that pretty much kills me every getting another opiate, ever, in my whole fucking life.
When it comes to back pain, chronic pain, often you can't see it on an MRI or scan. We haven't developed the technology yet to look at someone and pinpoint exactly where the pain is coming from and why. Someday, probably, but today, and in the near future, pain is a subjective experience. You take two people with the same lumbar spine MRI, and they will have different pain levels (or even one person who has pain, while the other complains of none). Pain is individualized because our brains are unique from person to person (even recently read an article that says the active DNA in each neuron is different). There are, of course, obvious exceptions to this. People with broken bones or cancer. You can see their pain, all lit up like crazy (they now have the ability to see the pain center of the brain in f-MRI's, and the differences between individuals in that). So, how can a doctor look at you for five minutes and determine your level of pain? Well, they can't.
Mr. Pain Management Specialist claimed to have solved a mystery that has taken other doctors months, and they still haven't come up with any answers (doctors like The Neurologist). I mean, isn't that a little arrogant on his part?
The Neurologist's latest idea is that I have fibromyalgia. I know very little about the disorder, just what I've read doing a quick google search, and the stories I've read. But, neverthless, I have almost every symptom, which the exception of the cardinal sign which is joints that when you press on them, they're painful. Besides that, I have it covered. Women with fibromyalgia tend to have painful periods, suffer from sleep disorders, fatigue, anxiety and depression and diffuse pain, spread out all over. What doctors have come up with is that narcotics don't help much. Although, in some cases I read, there was use of opioids anyway. So, I'm going to see yet another doctor to determine if there's anything to this fibromyalgia diagnosis. It's scary, but it fits. Unfortunately for me, all the drugs doctors use to treat this disorder with--I'm already taking.
In the mean time, I'm kind of fucked. I looked up yet another pain management specialist in town, but bouncing from doctor to doctor in search of opioids is seen as a warning sign of abuse or possible addiction. It's called "doctor shopping," and people in the medical profession really frown on it.
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