To start I would like to report on something positive before I start my rant about my appointment.
So to begin I would like to say DD15 appointment with her rheumy was great. He is one of the loveliest specialists I have ever dealt with. He is quite happy with her improvement after having been on 20mg/week of methotrexate for about 6months. However as she still has some areas of pain and about an 1hr of morning stiffness he has increased her methotrexate to 25mg and hopes she will get close to full relief.

Now for my less than impressive pain clinic appointment.
This is likely going to be quite long so appologies in advance.
The specialist was so rude and arrogant I can't even begin to describe how......grrrr he made me feel. Can't even find the right word.

Due to the numbness I have reported in my left arm he tested me with a pin to see where it was numb. He was getting frustrated that I could barely even feel it that he keep repeating the test over and over again pushing harder and harder and then continued trying different spots. Finally he even poked my breast multiple times, which obviously I did feel it there. I understand making a comparison between areas where I could feel it and where I couldn't and he did that with my right(good) arm but really was there any need to stick me in the breast?????

He told me he was prescribing Gabapentin for the nerve problem in my arm. I questioned why he was prescribing it when I was waiting to have a nerve conduction study to be done in Feb next year. I also asked why because I understand that Gabapentin is prescribe when no physical cause for the pain and/or numbness can be found, but given that I have AS and that test have so far not ruled out a physical cause why would he prescribe this before those tests are completed.

His responce was to ask me if I had taken Gabapentin before as I obviously knew what it was used for. I said no I haven't had it before but I did know others who had been prescribed it. He quickly responded by asking me who I knew that was on it. Like it is any of his business and as if by me naming a specific person it would make any difference.
He told me to just take it anyway. What????
So I asked "What are the side effects" I was particullarly interested if it could affect my ability to drive. (an absolute necessity) His reply was well about 50% of people find it helps and most will get some side effects at some point. But he never actually stated any possible side effects. He then went on to tell me to, I quote "Just take it until either it helps you or you get side effects"
OMG what???????
At this point my DD15 was ready to hit him. I surprised myself and remained relatively balanced.

To the next med he wanted me to just swallow no questions asked. He said I should take panadol, yes that's right panadol. I explained that I had been on panadol and panadineforte for years and it did nothing to ease my pain. Unless it was just for a headache, then it works great but not for the AS. And that I really don't want to be taking something that doesn't help me in anyway.
Looks like I don't a a choice in this either. I was told to just take it alright! Um sorry but NO.

And that's not where it ended either. He then went on to tell me I should get these pain patches for my lower back from my GP. (I didn't think a GP was allowed to prescribe them) anyway I reminded him that at the beginning of my appointment he asked about my allergies and one of the ones listed is my allergy to sticking plasters and the like. I explained how previous pain doctors as well as my rheumy have thought it best I don't use these pain patches due to the blisters they cause me. But of course he knows better than those professionals and went on to tell me that again 50% of people have a reaction but then he could just give me a steroid cream to take care of that.
Did this man even read my chart or the notes from the previous pain specialists?

So after shoving drugs at me for no real logical reason and against the advise of previous doctors at this same clinic, he then did something that may actually be of some good and wrote me up for a full spinal MRI. So it seemed this appointment may be taking a turn for the better....then.
I very politely asked if he could mention on the MRI referral that I am extremely claustrophobic and would like to request a mild sedative please.
He said it's not that bad and I should just deal with it after all he is writing me up for a very expensive test.
Yes that's right the pompous little prick just told me to suck it up princess.

At this point I took the prescriptions I know I will never fill and walked out of his office and proceeded to the front desk where I politely told them that I never want to see that doctor again.

I am honestly not a difficult patient but I do not take too kindly to being told to fill my body with worthless medications especially when other, older more experienced specialist have said they are not right for me. My daughter will tell just how bad this doctor was and how patient and well behaved I was. She actually picked up our bags and was going to walk out half way through the appointment she was so mad.

I warned this may be long. Sorry but I forgot to mention that he also ran down my rheumatologist. He said I must go back to see him as there are so many medications he should have put me on. Um again did he even bother to read my chart?

I have been on every medication possible for the treatment of AS in Australia, right up to biologics. Yes it is true I have only tried 1 biologic (enbrel) and I had to stop that due to reaction that affected my heart. My rheumatologist is unable to apply for another biologic until I see my cardiologist and get the all clear from him and that takes time in the public system.
The pain doctor then mumbled something I couldn't understand and said he will ring my rheumy and demand he see me ASAP.
He said that until my rheumy does his job and get's my AS symptoms under control there is no point treating my pain.
What? Who the heck does this guy think he is. I might mention at this point that he looks to be just out of school and his obvious opinion of himself is that he knows more than anyone else.

This is not all of it but this is long enough.
Needless to say I was not impressed one little bit and to top it off the only thing I can do is email the hospital I can't even discuss this with anyone in person.

I repeat WORST app EVER!!!!

Oh boy - what a sorry mess. Though one can't help laughing at this poor guy, totally wet behind the ears, scrabbling about, out of his depth - almost drowning in incomprehension. Gotta laugh gal. Though a heck of a waste of time and sooooo darn frustrating. Read the patient's notes - but very few do. In any country (they sure don't in France!) In the past years have only met three consultants and two GPs who actually 'read' my notes (two rheumatologists, UK, one ophthalmologist, France and two doctors, GPs, UK). It's an abysmal scene.

TG for the MRI. The only positive result from a mess of pottage! (BTW, keep the scripts. Evidence of poor clinical treatment! Think your rehumy is going to have summat to say to the fella...)

Glad your daughter received compassionate and good treatment from her rheumy. That is a happy positive.

Hope the MRI goes well. Take care -

Thanks I hope so too. Something I have really wanted but also feared dreadfully.

I should laugh I know but it was so damm frustrating.
Fortunately I didn't waste too much time as I was able to move my app forward to today to be on the same day as my daughters to save another trip down next week. With driving, trains and buses the trip 1 way takes about 2hrs so that is a positive. I would have been even more ticked off if I had traveled all the way just for this app.

BTW - ask yr GP for a couple of 'relaxer' tabs for the MRI - possibly might have a sample or two in his cabinet? Youdon't want a whole script, just a couple of tablets. Perhaps phone and ask, then pick up from the receptionist? Don't know the protocols over there...

With luck, a strong following wind and a couple of decades down the line, that guy you saw at the pain clinic might turn out to have learnt summat...that is, if he can get over his all too evident Napoleonic complex <LOL>

Take care -

Think that's about all that I can say in polite company!!!!!

These are for you:

and this is for not decking the jerk:

Clearly this DOCTOR knows EVERYTHING because he is as close to Our Maker as any person who walks this earth can be (cue : heavenly angels...) and you accidentally forgot to remember that this breed of doctor has uttered the Hypocritical Oath when he graduated, and that You are but a lowly human being.

The gumption of somebody like you ASKING QUESTIONS and wanting to make an INFORMED CONSENT to take a pharmacological substance into your body - it's lucky the poor man didn't choke on his own spit!!! (am guessing that despite your extensive CPR training you would have walked s-l-o-w-l-y over to him if indeed he had! ) Questioning his clinical decision making (prescribing gaba) must have made him see stars!!!

Trish - as a taxpayer funding your MRI - please have a dose of sedative on me! When you consider what I'm already paying for your VERY EXPENSIVE TEST what's few cents more for a bit of Happy Juice?!?!? Stupid rude man - I'm betting HE has never spent 55+ minutes in that claustrophobic tunnel of doom!!! As if it's not bad enough that lying down flat on a hard surface KILLS my back, doing it when you are claustrophobic is REALLY DIFFICULT!

I have done this twice, and let me tell you it has taken all my powers of concentration and relaxation to not push the Panic Button - cos I know that if I bail, I will NOT go back in!

Please ring the radiology Dept and tell them that the doctor *forgot* to order some sedation after you had discussed it as you went on to other topics. They will no doubt be able to get an order from the attending radiology registrar on the day, but it is easier of they have advance warning.

SO glad to hear that at least T's rheumatology appointment went well and that the trip wasn't all for nought.

Perhaps you might like to calm yourself down by making one of those 'therapy dolls' that we use in the paediatric wards with the kids before they have a procedure. Might I suggest you dress yours in a little white coat, write a *certain name* on it, then try testing its sensation with some very sharp pins?!?!? Aaaah - doesn't that feel better???

Thank you Louise you pretty much summed it up. I love the idea of the "therapy doll" but will make sure either it has breasts so he call feel exactly what it feels like or I may just stick pins in an equally sensitive area. lol Yes now I do feel better.

If the MRI and the nerve conduction studies show no physical reason for the pain and numbness in my arm then yes I will definitely give the gaba a go but until then it is just an unnecessary risk.

Molly I love the "Napoleonic complex" You hit the nail on the head with that.
If I get nowhere with the radiologist clinic I will give my GP a call and see if he can help. Thanks for the tips.

Trish - Yea - you go gal. (Sending looong hat pins across for sensitive parts...they might even be a bit rusty!!)

Louise. <ROL>

I'm so sorry you had such an awful appointment, though glad you got an MRI order out of it - assuming that he has ordered the right area and the right kind of sequences of course. May not have thought to put in for STIR sequences, and if they don't do those and it is some inflammatory reaction that is causing compression it won't be seen. Might be worth asking your rheumie to check the order and add in the extra sequences at the same time if they are necessary. I second asking GP for relaxant pills - something as simple as a single dose of diazepam should do it (just get someone else to drive you there) and that doesn't take a fancy specialist to prescribe.

As for all the other rubbish stuff - yes, write a letter to the clinic. If you email, put it as an attachment as well as in the text of the email (so easier to print out). Detail as bullet points all the things you described above, and then summarise by saying that you don't feel you were treated usefully or appropriately. Ask for an apology, if nothing else. They do need feedback.

Proud of you for not smacking him up-side the head. See how much you've improved in this area??? Hugs, dear. What an absolute sucky doctor. I wish you could see my pain specialist. She treats the problem at hand without waiting for the rheumy to get something that works. Hope you can get some good info off that MRI (a very good thing) and a little benzo for calming you down. (or have a glass of wine and someone to drive you to appt!)

Sorry for this terrible appointment. Agree with Molly--keep those rxs for proof of the 'care' you got from this specialist. Never take a med you aren't comfortable with. And docs shouldn't force them on you, either.

I take gabapentin (1800mg/day) with little side effects. It had no effect on my nerve studies (per the neuro who did the tests). Took 3 months to taper up to this dose, so it's hard to say what I've probably gotten used to over time. It doesn't bother me near as much as the Cymbalta bothered me. Both were prescribed by pain doc and I refused the Cymbalta due to side-effects. She was fine with my refusal.

YOUR doc's presentation of gabapentin was wretched, though. Not the way to present a drug to a patient, for sure. (Not trying to lure you to gabapentin, just giving some information.)

Trish,

I couldn't even finish reading your post! Run for your life. The pin pricking was unthinkable esp. when you are going in for a nerve conduction test and I would report him for sticking you in the breast!!! I know you won't be seeing him again. I would report him to their office manager first. Horrible experience! So sorry you had to go through that. It is unthinkable that most of us have had horrible experiences with health care workers. That got my blood boiling! I would get the M.R.I. done though. If you have some Xanax or Valium that is what they give me because I am claustrophobic too. I think one an hour before the appt. and then another low dose one 15 minutes prior.

Thank you all.
I am starting to think I maybe jinxed myself by posting that link in my other thread about the rheumy with shocking patient care.
I did ask if they were all like this.
I guess the answer is no they are not but some are worse.

I will write the email today. I didn't want to do it yesterday when I was still so riled up about it all and at least by having written this thread I still have clear details.

Thanks again for the kind replies and support.

Hi Dear,

Hope you are feeling a bit better by now.

I've been to doctors that just treat everything with drugs, others that won't prescribe me anything when I clearly need something, and everything in between. I think each doctors philosophy is a bit different.

BUT, bedside manner is so important. I had a rheumy, Dr. C, who forced Aleve on me. When I told him naproxen gave me edema and gastritis, he just told me to take prilosec. When I told him I was, he told me to just take more. When I told him that wouldn't help the edema, he just told me, "well, if you don't do this, I can't help you." so i went home, took it for a few days, then called to say it gave me edema and gastritis (even with the double dose of prilosec). and so he prescribed two more nsaids. and when they didn't work, he told me there was nothing else he could do for me. (of course there was tons more he could do for me; more there was nothing else he would do for me). But he basically bullied me into the nsaids, made me fear prednisone, and was always condescending.

But the next rheumy, Dr. B, was able to gently convince me to try 3 more nsaids, in different drug classes, simply by his demeanor. The way Dr C treated me, I didn't trust him. Yet Dr. B was asking me to do basically the same thing, but the way he asked instead of told, the way he explained, I felt totally safe doing as he requested.

Its all in how one asks, I believe.

If I were you, I'd call the doctor's office who is supposed to give you the nerve conductance test and ask them if its ok to take the nerve drug, or if you should wait, or if you should take it, but then stop it a certain amount of time before you see them. That's what i would do.

I didn't take that, but a second generation variation of that, Lyrica. It didn't help my pain, and it gave me migraines. But i did try it, but was desperate for anything to relieve the pain.

So, ignoring how he treated you, getting past that, consider if it might help. if you don't think so, then that's your decision, but try not to let his treatment of you cloud your decision about the drug (as I think I often did).

As for the MRI, call them, explain your anxiety, ask them what you can do. Do they have an open MRI that you could use? Or do they recommend a sedative? For me, I take my muscle relaxant, more for the pain of laying in there, but it kinda knocks me out, which is a nice side effect at times.

Then what I do, which is really important is to close my eyes and keep them closed. I accidentally opened them once, started to freak out, took some deep breaths with my eyes closed and was able to calm myself down again. that was the first time when I didn't know I was claustrophobic. Now they always give me a wash cloth or small towel to put over my eyes. If I accidentally open my eyes, its ok, its a really good solution. And oddly, even though they give me earplugs or cotton to put in my ears, I like the white noise of the machine; it along with my muscle relaxant lull me to sleep.

I've had my share of such appointments, so I know how you feel. Sorry you had one too.

OMG that is just incomprehensible!!!! Definitely email, call and report, file a complaint with the health dept, wherever you can! Poking you in the breast completely unacceptable...what nerve the [*bleep*]!! Ugh I am so mad for you!!

Know nothing about the meds, but get MRI and do open or take something. Good luck!!!

Wow!! I hope I never run in to him or his twin.

I am so sorry you had this terrible experience. I had a similar one many years ago with a doctor.

I hope you get some "real" help soon.

Hugs.
Possi

PS As far the MRI, when I get one, I ask for a washcloth to put over my face and music to be played through headphones.
I can pretty well zone out. Don't hestitate to ask for a sedative.