Pain Doctor Visit and Other Current Events

Today was my pain doctor visit. I see him every other month. It's crazy... I've been going to him for over 7 years now. I joked with the receptionist today that I'm an OG (Original Girl). I don't love going. I don't love the expense, for sure but it definitely helps me to check in frequently and know that my pain is legitimate and normal (for me, with my diagnosis'). I generally see the PA, who I adore for all visits except for once or twice a year and then he consults with the doctor before I leave. I thought it might be helpful to start recapping these visits again so I can remember my progress (not sure that's the right word) and for those who may have similar situations to know what my experience has been for comparison.

My list of diagnosis' is in the sidebar. There's a lot of stuff wrong with my back, nerve damage, migraines, Fibromyalgia and something of an autoimmune nature that we have yet to specifically isolate. I'm on several medications to help with pain although I am hesitant to list them so as not to be at risk for drug seekers. I do have a narcotic agreement with the pain doctor that requires me to submit to a urine screening at each visit... so that's always the first step once the nurse calls you back. Sometimes they will want to do a pill check which involves me bringing in all of the meds I take for anything - including advil - to be reviewed and listed. This time they did not ask me to do a pill check. Some pain doctors will call you randomly at any time and ask you to come in within a certain amount of time for a pill count. This will usually happen if someone appears to be taking medicines inappropriately or perhaps if a medicine they are prescribed does not show up in their screening. That urine screening is so sensitive that mine got flagged once for ibuprofen use... which is something that is approved for me to take but it wasn't listed at that time. It is a bit intimidating to know that anything I consume could come into question but if the alternative is living with pain, so be it. Truly, if ever pain medication were to stop being available to me, I would start using marijuana, whether or not it was legal. It becomes a quality of life issue.

After the nurse reviews your medicines, she will check vitals. My blood pressure today was 156/96 the first time... she did a recheck but I don't remember what that one was. I am on three blood pressure meds and other than yesterday (which I spent with Cosy) I had been resting almost nonstop since last Thursday night. It's frustrating and concerning to me that it's remaining high... however... it's a very clear indication that I'm in pain and ... although I would love to not have to be concerned about high blood pressure, I appreciate the validation so... yeah, high five, high bp! Way to represent! My heart rate was also high but.. that's not uncommon as I also have tachycardia. The cardiologist has already determined that my heart beats fast but in a healthy pattern so... that's ok.

After vitals, the nurse will go over your intake forms - a little questionnaire that you get from the receptionist when you check in. Basically it asks you to rate your pain on a scale of 1-10, 10 being the worst pain you've ever felt in your life. I don't do well with this scale because I rated it really high in the beginning because it was, literally, the worst pain ever but... it's gotten worse so...? It asks specific questions about what hurts, has your pain changed, is it getting better or worse and so forth. These forms are extremely important when you apply for disability!!! Fortunately for me, I am naturally articulate and my medical records helped win my disability case. I make sure that I always fill those forms out as completely as I can and don't cut corners or downplay things. At the pain doctor it's ok to be a whiner. You pay him to listen to you whine. It helps him know how to treat your pain.

Once the nurse has reviewed everything, the PA - we call him Dr. Matt - comes in to chat. He is the one who will go over any new pain, worsening pain, problems, side effects from meds... basically anything going on with me pain wise. I have a good rapport with Matt and I trust him. Today he discussed my migraines and blood pressure and suggested that I see a neurologist. He has been referring me for a procedure where they squirt meds up your nose to help with migraines. I'm not necessarily opposed to it but... my co-pay isn't cheap and so I've been putting it off. I told him that I'm still not really set, budget wise, for that procedure but I will request a referral to a neurologist.

Although I see the pain doctor for pain... my migraines for some reason fall under treatment of my primary care doctor so I will need to request the neurology referral from him. As with anything else... I hate the process. I hate making an appointment, doing the whole new patient intake.. the cost involved... having to remember what all has been done over the course of time with each diagnosis. It's a lot and my memory is pretty poor lately. Anyways... once Matt and I have finished our chat, he will check to see which medications need refills and then he will go consult with the doctor to get those and see if he has any recommendations. Thing he brings out the prescriptions and walks me to the receptionist with my chart so that I can make my next appointment.

Honestly, most visits the entire process is less than twenty minutes from in the door to out the door. If I'm scheduling a procedure it takes a good bit longer as there is always a wait to see the lady who schedules those things. There's a bit more involved such as getting insurance approval and determining the co-pay (and she's a bit chatty). For each visit to the pain doctor Medicare is billed $800. The agreed rate is much cheaper but it's still a few hundred and it does occur to me that there is a financial incentive for the pain doctor to keep me dependent on his care. At the end of the day, he's in business for a financial gain. All that being said... he is the doctor who has been involved in my case the longest and I do trust him, as much as you can trust someone who makes money off of you. When I was waiting for my disability to be approved he gave me samples of a lot of my meds, saving me literally hundreds of dollars a month. He started very conservative with my care. His office worked very well with my disability attorney and all of that matters to me. Would it be wise to maybe see another doctor for a second opinion on things like... would surgery help, etc? Maybe. The doctor who performs surgery has a financial incentive to recommend surgery so... who do I trust? It's hard to know.

At any rate... doctor visit done and dusted, I headed south for my weekly date. My guy also had a doctor's appointment this morning so I dropped off prescriptions at the pharmacy near his house and then met him at his house to store my groceries (I always bring yogurt and powerade and something to eat for dinner when he's working) before heading back out to his doctor. His visit went better than mine, fortunately. I haven't asked if it's ok to share what his medical issue has been lately so I will just say that he has given me a big scare in the past month. I am definitely glad to see him on the mend. We went and picked up my prescriptions and then headed out for lunch.

We love going to a place called Rico's World Kitchen in Buford for lunch. You can click the link to check them out. They are pricey but they have lunch specials that are affordable and we have never had anything there that wasn't absolutely amazing! We ate outside today although it was a bit humid, it's quieter out on the patio. Marvin loves this place because he can get Cheerwine there... if you're not familiar, Cheerwine is a cola that tastes a bit like Dr. Pepper but better. It's native to North Carolina which is where he was born. I like it ok... but carbonated beverages don't sit well on my stomach so I usually just get tea. Today he had a chicken salad sandwich on a croissant and I had a cheeseburger. We both got the house made potato chips... they are really yummy... and we shared an appetizer of fried green tomatoes. We probably go to this place once a month or so together and he goes by himself every now and then as well.

Once we got settled in back at his house we started watching the Netflix series Altered Carbon. It's ... futuristic and science fiction-ish and... two episodes in, I'm invested in the plot but I don't love it. Then Marvin left for work ... and I had my usual Wednesday night soak in the bathtub and watched One Born Every Minute on my phone while I soaked in the tub. Tonight's bath bomb of choice was cherry blossom from Walmart. Not my favorite but at least there wasn't any glitter in this one. My back has been bothering me quite a bit today so the hot bath was nice. I carried Cosy up the stairs yesterday because she had a hurt toe - the tiniest little injury is a big deal when you're a three year old little girl and I'm a sucker for baby-ing her when she has a booboo. I even made a big deal of bandaging her toe. She calls bandages "bambages" which is freaking adorable! Anyways... I know better than to carry her ever, especially up stairs so, it's my own fault.

I guess the most prevalent current event today is this Roseanne Barr thing. From my point of view, it's not ok to call someone an ape. Name calling is never ok. I'm not ok with the name-calling of our President, even though he's not my favorite person and... he does a fair amount of name calling himself. Two wrongs don't make a right. Ambien will for real make you lose your filter but ambien doesn't make you racist. The real tragedy is the rest of the cast and crew who have lost their jobs and it makes me sad when anyone says or does something that will forever haunt them. This is a life changer for Roseanne. And that's all I have to say about that.

Anyways... that was my Wednesday. Marvin will be off work in about twenty minutes so I'll get this posted and get my laptop tucked away for the night so I can enjoy his company. I have another Throwback Thursday blog post ready for tomorrow... although y'all aren't seeming to love those so... I don't know if I'll keep posting them after this week. Let me know what you think! Love and hugs, y'all!

My Dental Health

If you've been around for long, you probably know that I've spent the last dozen or so years trying to get my dental health sorted out. I spent a lot of years without dental insurance / as a single mom struggling to make ends meet and unfortunately, there was never money to do what I needed to do with my teeth. About fifteen years ago I got an estimate that it would take $13,000 to completely fix my mouth and to be honest, that was pretty accurate.

Once I got my Social Security Disability lump sum payout, I got busy sorting out my mouth. Things didn't go well. I had a lot of complications... it ended up being more expensive and more painful than I could have ever imagined. I LIKED my dentist but there were some decisions he made that probably weren't the best for me... things that probably should have gone to an oral surgeon instead of being done by a regular dentist.  We had discussed my pain situation at length in advance and he was fully aware of what medications I was taking. He called and talked to my pain doctor and they sorted out what meds I could take for the dental procedures. I confirmed with my pain doctor that he had talked to the dentist and that the dentist had permission to prescribe additional pain meds as needed. This is very important since I am on a Narcotic Agreement with the pain doctor. I literally cannot take anything for pain without his permission.

Then in the middle of a very painful complication from an extraction, when my pharmacist called the dentist to verify the prescription he had written for me, he told her that he had "no idea" I was on the other pain meds. This was a complete lie. I was so frustrated... it's hard enough to keep from being labeled a pill seeker when you have chronic pain and then the dentist makes me look like a drug addict... so I stopped working on my mouth for awhile because I honestly just couldn't face the pain and worried that it wouldn't be treated appropriately. I was afraid to be in pain and not be able to have it treated appropriately - or be refused at the pharmacy. Then my mom got sick and I just flat out didn't have the time to spend recovering from the next dental procedures.

SOOOO... finally last October I got my wits about me and went to a different dentist to get things finished up. I had one more major procedure to go through before I could get fitted for partials and finally, after all those years, have a mouth full of teeth. My dentist recommended an oral surgeon because I had so many complications in the past. I did my pre-op visit, we were all ready to go and.... two days before my last procedure was schedule... the oral surgeon was in an accident and broke his femur. He was out of work from October through February! You really can't make this stuff up! I struggled for a while trying to decide if I should go with a different office but... I trusted this guy. I had already gone through all the preop (and more importantly, PAID for the pre-op) and by the time I realized it was going to be such a long wait, we were already close to Christmas and then our trip to New Orleans. The LAST thing I wanted to do was go to New Orleans while recovering from oral surgery!

At any rate, in March I was finally able to get an appointment and have the last bit of surgery done. The Oral Surgeon was UH-mazing! The procedure was so fast that it was over before I realized he had really gotten started. The pain was completely bearable, I had no infection, no complications... it could not have gone better. I probably had about 3-4 days where I was uncomfortable but I was well enough to go to Marvin's the very same day as the surgery.

I have about half the teeth I should have so it is not easy to chew... I'm living on yogurt and softer things but I can manage just about anything... it just takes longer. I went in two weeks ago and had a mold made for my partials... I went in this past Monday to have the next fitting and in two weeks they will have the whole thing completed. I CANNOT wait to go out for a big, thick, juicy steak! I will probably gain twenty pounds in the few months after my teeth are ready and I don't even care. I'm just so glad to be past this. Now... of course, I still have some teeth that need work and there is still some additional expense (and pain) ahead. Chewing with half a mouth puts additional stress on teeth so there will be more work ahead, it's inevitable... but I'm glad to be past the worst of it.


So be prepared for lots of selfies with big toothy grins! I'd love to hear about  your dental experiences, bad and good, especially with partials since that is a whole new world for me. I also wanted to sort of set aside the stigma involved in all of this. I wasn't able to take care of things when I should have and there's no shame in that. I did my best to get my boys raised- mostly on my own- and I prioritized their well-being over mine. I'm sure I'm not the first mama to do that. I also imagine I'm not the first person to be terrified of dental work. It has taken me a long time and I'm really glad to see the light at the end of the tunnel. Shop around, the second dentist was far less expensive than the first dentist I used in my town. He also made me feel more confident. Be honest with your dentist about your fears and past problems. That made a huge difference for me. And if you can't afford it all at once, just keep plugging away. That's what I had to do and I'm glad now that I did. I'm also grateful for the support from my mom and dad along the way - driving me to procedures, helping with expenses I couldn't afford, etc. And to my fella who helped me recover from this last procedure.

I hope you're enjoying my return to blogging! Thanks for your support, it makes me WANT to blog!