Rheumatoid Arthritis and pain management specialists


painMy GP has referred me to a pain management specialist.  I have been to one previously.  It was through the public patient system at the hospital. I attended three times, each time I saw a different doctor.  Each doctor questioned why I was there, as I should be at the rheumatology clinic.  When I explained I had unmanaged pain secondary to my severe rheumatoid arthritis, all they suggested was opioids.  MS contin, oxycontin, endone, oxynorm, targin.  So my GP and I agreed that he was quite capable of prescribing those meds and the pain clinic was a waste of time.

As the years have gone on, and I have yet to find the magic cocktail that controls my rheumatoid arthritis, I have progressed to using ms contin and oxynorm daily. At levels that my GP is not altogether comfortable with. So he referred me to another pain management specialist.  He’s apparently the best, and he runs a private practice.

I have found the public system is generally pretty dismal.  Private doctors have served me better.  So I agreed to go see this specialist, and was quite hopeful.

Until I learned that before you see him, each patient must attend a two hour information session on how to manage your pain.  This might be great for newbies.  But I’ve been at this for a long time. I have tried many therapies.  I was very tempted to cancel the whole thing.  Mostly because sitting for two hours is extremely difficult for me. Being forced to sit still increases my pain.  I need to get up and move.  I didn’t have a lot of faith in any pain management specialist who would expect prospective patients to do this.  I also expected it to be a whole lot of same old, same old.

And it was.  I have just returned, and it was not an easy two hours, nor an easy drive home.  I had to get up and move around the room, as did four other people.  The signs of chronic pain are very obvious to someone who suffers chronic pain.

The other five people in the room suffered intermittent pain, and were not in pain, or not in much pain this day.  (We were all questioned about our conditions, and duration of symptoms, and our pain levels today). For them this was an appropriate introduction to the practice, and the therapies they offer.

For the rest of us, I’m not so sure.  We’ve all filled out questionnaires about our pain, and the degrees of it.  And received a booklet that recapped what was discussed in today’s session.  Each of us will receive a phone call after the Doctor has reviewed our questionnaire, with his recommendations for which therapy or therapies he believes would be helpful.  These include physiotherapy, exercise therapy, hydrotherapy, acupuncture, massage therapy, diet and nutrition, pain counselling, mindfulness and self-care (reducing stress, pacing, balance of movement and relaxation).  I have tried all of those, and even if I were interested, I can’t afford these therapies.

A fair bit of time was spent on the mechanism of chronic pain. How sometimes the injury or cause of the pain has healed, and yet the pain continues.    I tuned that out.  Not relevant to me.

However, they did also mention nerve ablation, TENs and central and peripheral nerve stimulators.  These I AM interested in.  Even more fascinating, was ketamine infusion.  Essentially putting you under a general anaesthetic.  Supposedly this can ‘reset’ the brain’s pain receptors.

I’m really interested in this, because I’ve been put under a general twice, and each time my pain levels were reduced significantly for up to a week.  I even asked the anaesthetist why this might be so, but she had no idea.  I googled, and could find no information.  So I gave it up as a coincidence and forgot about it.  Until today.

The only problem is I’m terrified of anaesthetic.  I hate being put under. I’m convinced I’m never going to wake up.  Ridiculous, irrational fear.  Even though each time, I have woken up feeling fabulous, I still don’t want to go under again.   But it looks like it’s a valid therapy.  But I’m sure, as a therapy, it must be prohibitively expensive. As most of these therapies are, when you are on a disability support pension.

I have to postpone my appointment with the pain management doc because I can’t afford it right now.  I would wind up about $100 out of pocket, and right now that’s just not doable.

But I can wait.  I’m sure my pain will still be here in a few months, and the doctor will still be available.  And I can try some of these therapies then.  If he deems them appropriate.  I have to keep trying. I will always keep trying.

Time will tell. It will be an interesting phone call.  I look forward to what he has to say, and what he believes is the best treatment plan for me will be.

Wait and see…


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  2. Arthritis can be a very hard thing to deal with… Mostly affecting the elderly which can affect mobility and very simple things like opening jam jars.. There are products that can help.. It seems to be affecting more and more young people these days too… Maybe someone should run a study on that and find out why more younger people are being affected by this.

    Great Article!



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