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Thread: Patients suffer as pain doctors quit

  1. #1

    Patients suffer as pain doctors quit

    Patients suffer as pain doctors quitÂÂ*
    Joanne Laucius
    The Ottawa Citizen
    Friday, January 31, 2003Dr. Ellen Thompson
    ÂÂ*
    You can hear Dr. Ellen Thompson's next patient before you see her. There's the hissing intake of breath, like someone who has just felt a stab of pain.

    Pain experts calculate pain on a scale of one to 10. For women, 10 is the pain of childbirth without an epidural. For men, it's the pain of a good swift kick to the testicles.

    Most people can function with a pain of five. You can ignore a pain of three. Martie Whitaker, standing gingerly in Dr. Thompson's Civic-area office, is somewhere around 9.5.

    Ms. Whitaker has suffered constant pain for five years after a back injury. Even when she sleeps, she dreams she has been stabbed or shot.

    Dr. Thompson is one of only a handful of pain specialists in Ottawa. And today is her last day in pain practice.

    Across the city, at the General campus of the Ottawa Hospital, Dr. Dennis Reid, head of the department of anesthesia, will be spending his last day at the pain clinic there.

    Both doctors warn of Ottawa's growing inability to manage the pain of people whose agony is fierce and never-ending.

    After Dr. Reid and Dr. Thompson bow out, there will be only a handful of pain specialists left in Ottawa; four at the Ottawa Hospital, two at the General campus and two at the Civic campus. Two anesthesiologists have recently started pain treatment at the Montfort Hospital.

    "The remaining physicians are already having trouble dealing with the patient load. When I stop doing pain management, I will be the fourth pain specialist to do so in the last two years," said Dr. Reid.

    The two remaining doctors at Dr. Reid's pain clinic will take his patients, but they have already said they won't pick up his more "challenging" patients. Most have been sent back to their family doctors.

    "The problems in Ottawa are insurmountable for the foreseeable future," said Dr. Reid. "We are light years behind Toronto and Halifax."

    Chronic pain practitioners have a high burnout rate. It is exhausting and frustrating treating patients who can't be cured. Patients who see no end to the torture of being in their own bodies sometimes succumb to suicide.

    There is a lack of recognition and support from other doctors, said Dr. Reid. And pain patients don't have the money or the political clout to turn pain into a major issue -- despite the fact that chronic pain costs society as much as heart disease, he said.

    "It became apparent that even if I ran this office seven days a week, 24 hours a day, I couldn't fill the need and I would kill myself," said Dr. Thompson, who will continue to work as an anesthesiologist. "I go into the operating room to relax. Compared to pain management, it is so much easier."

    In recent years, pain management has improved in labour and delivery, in post-operative pain, and for cancer patients. But not for those with chronic pain, said Dr. Thompson.

    Prescribing narcotics leaves many pain doctors uneasy.

    Dr. Thompson has turned one of her patients over to a doctor who has refused to prescribe narcotics. "If I discontinue prescribing, he'll go back to toxic amounts of Tylenol," she said.

    Dr. Reid and a group of other other physicians are waiting for word from the provincial government on a proposal to develop a holistic pain treatment centre in Ottawa like those in multidisciplinary clinics in Toronto and Halifax. The plan has been in the works for six or seven years, but Dr. Reid says he has run out of energy and enthusiasm.

    Ms. Whitaker can understand the frustration. "We're miserable and they can't fix us," she said.

    She considers herself one of the lucky ones. Her family physician has agreed to
    prescribe the medications recommended by Dr. Thompson. But she's still worried about flare-ups. Pain clinics are booked solid, and won't offer her an anesthetic on demand.

    http://www.canada.com/ottawa/news/st...0-D5BF83403E89

  2. #2
    Junior Member Indiana Joe's Avatar
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    It is sad that Drs who would not hesitate to prescribe NSAIDS that kill 18,000 people a year in the US from bleeding are intimidated by old beliefs about narcotic addiction.

    Of course this is due to the old beliefs of society and our countries "War on Drugs" and the elected members of our government who write laws that allow government agencies to look over the shoulder of Drs who prescribe narcotics when the need is real.

    Drs are human and it has to be so frustrating to have so many patients that will never be healed but it is those Drs who dedicate their lives to the easing of pain and many times they make less being compassonate than if they would have went into another area of medicine.

    I have no figures to back my suspicions that a lot of pain patients would have had a better life if they would have refused surgery in the first place, many people have what they believe is terrible pain but quickly find out that indeed things can get a lot worse after a Dr cuts them and there are no true statistics to prove this as so many surgeons do surgery and as long as screws & plates are tightly in place they consder the operation a success even after they have sent their hurting worse off patient down the road to fend for themselves in a sea of Drs who simply will not treat patients with narcotics.

    Pain Medicine with all of the advancements seems to be worse today for many patients than before the narcotics laws were passed at the turn of the centry when anyone could walk in and buy opium & morphine without a script.

    It is my opinion that except for a few people who have a routine abdominal surgery that it is the Drs who create pain by cutting and except for accidents & tumors of the spine more people are worse off if they would have avoided their Dr from the start.

    When visiting a spine surgeons web page we read claims that successful surgeries are in the 80-90% range and only Enron can cook numbers with more bias than many spine Drs do.

    Just my opinion.

    Joey



    Lumbar:

    S1-L5. Facet hypertrophy, spondylotic spurring with minimal disc desiccation.
    L4-5. Moderate canal stenosis secondary to facet/ligamentous hypertrophy.
    Spondylotic spurring and a diffuse disc bulge also a focal central subligamentous bulge.
    L3-4. Borderline mild stenosissecondary to Facet/Ligamentous hypertrophy.
    Spondylotic spurring & a minimal diffuse disc bulge.
    L2-3. Minimal spondylosis, facet hypertrophy.

    Impression:
    The most significant changes are at L4-5 where there is moderate canal stenosis with bilateral foraminal compromise secondary to degenerative change.
    In addition to degenerative spurring there is degenerative spurring, disc desiccation with a diffuse disc bulge.

    Cervical:

    C3-4. Disc desiccation and a slight loss of disc height.
    Degenerative endplate degenerative change as well as marrow change.
    Uncovertebral joint bony hypertrophy on the right with a focal bony protuberance narrowing the lateral recess and the right neural foramin.
    Some effacement of the right anterolateral aspect of the cervical cord at this level.
    Minimal bony spurring involving the left unconvertebral joint.
    C4-5. Desiccation & loss of disc height.
    Degenerative endplate & marrow change.
    A "hard disc" which approximates the cervical cord, however it does efface the cord; there is no central canal stenosis, no neural foramin stenosis.
    C5-6. Disc desiccation & loss of disc height.
    Degenerative endplate changes & bony spurring.
    Bilateral mild degenerative uncovertagral joint degenerative joint disease.
    A mild disc bulge forming a "hard disc" that approximates the anterior cervical cord.
    No significant effacement & the cord intensity is normal, no foraminal stenosis.
    C6-7. Changes of mild spondylosis.

    Impression:
    A large right unconvertebral joint bony spur at C3-4 with cord effacement & right neural foraminal stenosis.
    Multilevel cervical spondylosis.

  3. #3
    Junior Member Indiana Joe's Avatar
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    It is sad that Drs who would not hesitate to prescribe NSAIDS that kill 18,000 people a year in the US from bleeding are intimidated by old beliefs about narcotic addiction.

    Of course this is due to the old beliefs of society and our countries "War on Drugs" and the elected members of our government who write laws that allow government agencies to look over the shoulder of Drs who prescribe narcotics when the need is real.

    Drs are human and it has to be so frustrating to have so many patients that will never be healed but it is those Drs who dedicate their lives to the easing of pain and m

  4. #4
    Junior Member
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    columbus, ohio usa
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    in reguards to the surgery aspect. i had surgery on 9/29/2001. before i had the surgery i think i was better off. i was not taking narcotics. just muscle relaxers and physical therapy. i has a fusion in the l4-l5s1 and things have progressively gotten so bad i am pissing my self and such. surgery was the worse misteak i have ever done. they say there is nothing they can do but fill me with morphine and too many drugs to list. good luck to the 10% that i may work for.

  5. #5
    different pain scale than i am use?
    i start to medicate at 3 , i can ignore a 1 or 2
    yes , that tends to be a problem with the stigma of using painkillers. not all pain problems can be fixed with surgery, and as you have experienced can make life worse.

  6. #6

    Unhappy betrayed

    I was so grateful when I finally got to see a pain specialist here in ottawa. I thought all my worried were over and finally someone who understood what I was going through could back me up. Not the case. My pain specialist did not take into account all the side affects of medication I have to use or the side affects of my disease. She certainly said I couldn't go back to my own job but did not specifically say I couldn't do any job even though I tried with no success. I found her cold hearted and very uncompassionate to my disease. I don't rate pain like a man does and I've been through 22 hours of natural child birth so I know what pain is. Even so my specialist disregarded my appeal to her to understand that I can in no way manage any job. Maybe retirement is the best thing for her as she is so obviously out of touch with the reality of living in pain.
    Quote Originally Posted by antiquity View Post
    Patients suffer as pain doctors quitÂ*
    Joanne Laucius
    The Ottawa Citizen
    Friday, January 31, 2003Dr. Ellen Thompson
    Â*
    You can hear Dr. Ellen Thompson's next patient before you see her. There's the hissing intake of breath, like someone who has just felt a stab of pain.

    Pain experts calculate pain on a scale of one to 10. For women, 10 is the pain of childbirth without an epidural. For men, it's the pain of a good swift kick to the testicles.

    Most people can function with a pain of five. You can ignore a pain of three. Martie Whitaker, standing gingerly in Dr. Thompson's Civic-area office, is somewhere around 9.5.

    Ms. Whitaker has suffered constant pain for five years after a back injury. Even when she sleeps, she dreams she has been stabbed or shot.

    Dr. Thompson is one of only a handful of pain specialists in Ottawa. And today is her last day in pain practice.

    Across the city, at the General campus of the Ottawa Hospital, Dr. Dennis Reid, head of the department of anesthesia, will be spending his last day at the pain clinic there.

    Both doctors warn of Ottawa's growing inability to manage the pain of people whose agony is fierce and never-ending.

    After Dr. Reid and Dr. Thompson bow out, there will be only a handful of pain specialists left in Ottawa; four at the Ottawa Hospital, two at the General campus and two at the Civic campus. Two anesthesiologists have recently started pain treatment at the Montfort Hospital.

    "The remaining physicians are already having trouble dealing with the patient load. When I stop doing pain management, I will be the fourth pain specialist to do so in the last two years," said Dr. Reid.

    The two remaining doctors at Dr. Reid's pain clinic will take his patients, but they have already said they won't pick up his more "challenging" patients. Most have been sent back to their family doctors.

    "The problems in Ottawa are insurmountable for the foreseeable future," said Dr. Reid. "We are light years behind Toronto and Halifax."

    Chronic pain practitioners have a high burnout rate. It is exhausting and frustrating treating patients who can't be cured. Patients who see no end to the torture of being in their own bodies sometimes succumb to suicide.

    There is a lack of recognition and support from other doctors, said Dr. Reid. And pain patients don't have the money or the political clout to turn pain into a major issue -- despite the fact that chronic pain costs society as much as heart disease, he said.

    "It became apparent that even if I ran this office seven days a week, 24 hours a day, I couldn't fill the need and I would kill myself," said Dr. Thompson, who will continue to work as an anesthesiologist. "I go into the operating room to relax. Compared to pain management, it is so much easier."

    In recent years, pain management has improved in labour and delivery, in post-operative pain, and for cancer patients. But not for those with chronic pain, said Dr. Thompson.

    Prescribing narcotics leaves many pain doctors uneasy.

    Dr. Thompson has turned one of her patients over to a doctor who has refused to prescribe narcotics. "If I discontinue prescribing, he'll go back to toxic amounts of Tylenol," she said.

    Dr. Reid and a group of other other physicians are waiting for word from the provincial government on a proposal to develop a holistic pain treatment centre in Ottawa like those in multidisciplinary clinics in Toronto and Halifax. The plan has been in the works for six or seven years, but Dr. Reid says he has run out of energy and enthusiasm.

    Ms. Whitaker can understand the frustration. "We're miserable and they can't fix us," she said.

    She considers herself one of the lucky ones. Her family physician has agreed to
    prescribe the medications recommended by Dr. Thompson. But she's still worried about flare-ups. Pain clinics are booked solid, and won't offer her an anesthetic on demand.

    http://www.canada.com/ottawa/news/st...0-D5BF83403E89

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