Pain Sucks. Depression sucks. Depression caused by living in pain sucks. For most of us living with chronic pain, life has changed from when we were pain free. Chronic pain is a special disease. It is one that has no real cure. It has no cutesy mascot. Heck it isn't really a driving issue in medical circles. There are thousands of causes, from illnesses such as fibromyalgia to injuries suffered years ago to failed surgeries to correct physical issues. The drug companies aren't looking for new ways to combat pain without addictive drugs. Addictive drugs ensure a future demand even if it is illegal. There are very few true pain specialists here in the US. There are a heck of a lot of doctors who practice pain medicine but they are mostly trained in other disciplines and turn to pain management to make a buck.
There is big money in pain management. Insurance companies are willing to pay over and over for shots that never really help. They continue to pay for expensive treatments and very expensive drugs and the doctors laugh all they way to the bank. A single pain shot can bring in 4 or 5 hundred bucks for 15 minutes of work, a much better return than just a regular office visit which brings in 50 or 60 bucks. Sure they bill for a lot more but insurance companies knock that down to the "contracted rate" an insurance term that basically means what they are willing to pay for certain procedures. This is how insurance companies keep costs down. If you don't have insurance be prepared for sticker shock when the bill comes. That 10 to 15 minutes of that of time you spent with a doctor if you were lucky or a PA or CNP will cost you about 300 bucks. At least. Heck my PCP charges over 200 just for an office visit. Maybe if you are lucky you can haggle a bit and get that down.
In pain management clinics shots really are the money maker. For my shots my clinic submits 2 bills and an anesthesiologist submits a third. First bill is the facility fee. Then we have the actual bill for the procedure and then the third is as I said from a 3rd party anesthesiologist who most likely isn't "In Network" and can charge out the ass for a few minutes of time. The facility fee is usually about 4 or 5 hundred bucks. The procedure will run between two and 5 thousand and the anesthesiologist bills between six and seven hundred if not more. Funny thing about these is that with mine I have seen the 2nd shot costs about a hundred bucks less than the first and the 3rd costs about four hundred more than the first for the exact same shot. Now depending on the shot series these shots are at least a week apart. So how can the exact same shot cost more or less than the first ? Beats me but the insurance company pays and continues to pay. Don't worry if those shots didn't work, they can try more, they have an endless series of shots to try.
It is really a shame that most of the doctors who treat chronic pain have no real training in pain management. They have moved into the field just to make a buck. This is ridiculous. We have doctors trained to treat cancer. We have doctors trained to treat so many different things yet the field of pain management is small. Just a couple of decade or so ago doctors didn't treat chronic pain. As this field grows we really need the doctors to have better training. Doctors who have no back ground in the treatment of pain should not be allowed to specialize in the field. Heck in medical school they cover pain treatment in less than 10 hours. Is that really enough education on it to become a "Specialist" in the field ?
Follow on down past the orange snow doodle and see some more.
So what can we do as the patients ? We don't really have much clout. Pain clinics can boot us out at any time and leave us at the mercy of our pain. They will just label you a drug seeker and bam you are gone. Good luck getting into another pain clinic. Complain to loudly or too much and they can toss you out. Demand being treated like a human being and you can suddenly become an ex patient. So we put up with all of the BS that the clinics put us through. The really long waits to see the doctor or PA. The fact in my case that in 5 years with them I have NEVER EVER seen an actual doctor except when I got shots. I was never evaluated by the doctor who owns the place. He does have training in pain management but that training is completely useless to me because I have never seen him. Many patients there have never seen him as well. But if we demand to see him out we go. We are trouble makers.
We sign contracts when we start pain management. The basis of it is that we agree to follow the rules or be tossed out. We put up with their BS. We put up with being treated like addicts by some of the employees. Why ? Why would anyone put up with this ? We swallow our pride and put up with it because the alternative is to not be able to get the medications we need to get through the day. These medications allow us to have some aspect of our old lives back. Not all of it. Hell no just a small portion of it. Thanks to heavy doses of narcotics I can go to work. I can't go bowling any more. I can't spend my Saturday or Sunday on the golf course enjoying a round of golf. I can't spend much time gardening in what used to be my lovely garden in front of the house but now looks like a jungle. I can't spend any real time cooking my famous chili or much of anything because it hurts like hell to do any of that any more. I can't pick up my nieces or nephews. I can't walk very far. I can't make plans for a week from now or even tomorrow. I have no clue how much I will be hurting. I can't go shopping, because picking up a gallon of milk is impossible. I can't sit in my favorite chair and read a good book for any length of time. My world has become very narrow. great way to live life isn't it ? I am not alone. My story is similar to others all across the country. We put up with the BS and humiliation so that we can have a small portion of our lives back. Some get more relief than others.
What can we do ? In my own opinion we need a patients bill of rights for pain clinics. Just like we must sign contracts to be treated they need to sign a contract to treat us like humans. Not like cattle with dollar signs branded into our asses. I don't think I should have to give up any more just to get treatment. I am tired of being told I must get the next series of shots even though I know they won't help at all. Yeah that has happened. I have been told I have to get shots to continue to be seen at the clinic. When I explained to the PA that the last time I got the shots she was recommending I had extreme pain, she didn't let up. Finally I got her to consult with the doctor who gives the shots and he refused to do them. So she came back with another set of shots she was pushing. They don't want patients who don't get shots. They don't pay as well. I am tired of being a freaking pin cushion just so they can make money. It really is amazing. This goes on thousands of times every day all across the country. I can't afford to get another set of shots that won't work. Hell my bill with them is over $800.00 right now. I just paid them $600.00 a couple of months ago and now my FSA is gone. Without the FSA I would be sunk but I can't afford to stick any more in there out of my paychecks. Most of my deductible went to pain management. I can't afford to keep paying for shots that don't work yet they will keep forcing me to take them. Now they say they will not treat me until I can get my bill down. Yeah makes sense. Cut off all treatment until they get their money. I borrowed $100.00 so I can get my next refill at my appointment on the 3rd. To make sure I showed up they gave me a 5 day refill so I run out of pills on the day of my appointment. They know how to fight dirty. I don't have any choice in the matter. Without my medication I will end up in a nice little ball screaming in pain. That will lead to me missing work and then being fired which means no insurance because I won't have any cash to pay for it. I sure can't afford COBRA payments and starting a policy through the exchanges would be out of reach as well with no cash coming in. So I will do what I can to keep giving them money. Taking it from where ever I can.Most likely the food budget. This needs to change and change fast. We can't keep allowing them to hold us hostage with our medication.