Drug Contracts

I have a question, and I'm unsure how to approach it. I guess my Pain Management Doctor (the only doctor I really see) has finally found a surgeon who is qualified, and willing, to do my Spinal Cord Stimulator Implant. I did my trial back in Feburary with great success, but because my Doc wants to use the paddles for my implant (they afford better control and coverage then the standard leads) and the process for this requires a Lamectomy, /and/ the fact that in the last year 3 seperate surgeons have ended up with their patients suffering some form of paralysis, most Doctor's are not willing to do this procedure anymore. Also because of where my CRPS affects me I will need to have the leads "sutured" into place in my neck, up by C2.

Now as we all know any time you do surgery on the back it's risky, and especially the neck because of the size of the area. I'm in a debate on whether or not to do the procedure simply because of this risk; I'm not sure I want to saddle my family, especially my 8 year old son, with the responsibility of having to take care of me for the rest of my days. But I have tried to put this outta my mind until I talk to the surgeon and talk about the odds, his successes with this procedure, how many he's done, etc. Yah, I'm a logical numbers kinda person.

So I got the paperwork from surgeon the other day; my appointment isn't until the 24th of March. In this packet of paperwork that I have to fill out (read that my mother will be filling out as that much writing will put my arm outta comission as my pain levels have already been holding at a steady 9 on a pain scale) one of the documents is a Drug Contract.

I have heard good and bad things about drug contracts. I understand it means I can't seek other doctor's for pain meds, not even the ER. It means all refills are handled by this surgeon's office, I have to have the pharmacy I use contact them no less then 5 days in advance. It means I must use the meds as dictated, "or else". Now I can understand, especially with as tight a rein as they've put on narcotics, why doctor's do this, but to date I've /never/ had ANY of my doctor's have this sort of contract. I'm not sure if it means he'll be taking over my pain meds from my Pain Management Doc or not. I've got such a good relationship with my PM doc, and I trust him implicitly. If this is the surgeon I think it is I've met him once before two years ago back before I had a diagnosis. He was way behind schedule, and when he finally got to me he gave me such a look of disdain and made me feel like I was wasting his time. "There's nothing wrong with your x-rays. I'm a bone specialist. Why are you here to see me?" It was said in such a tone, as if I were a small child bugging him and taking up his valuable time. Now I'm not sure it's the same guy, I won't know till I see him.

So my question is this: What do you think of Drug Contracts? Is tying my hands with a guy who's office is an hour away worth it if it's the only way I can possibly get my surgery done? My PM doc has been with me for a year and a half now ... I hope you can understand my reluctance to turn my care over to someone I only want to see for a surgical procedure. I'd like to hear your thoughts if you were in my shoes.

Thank you all for your time.

Thankfully I already had an appointment in place to see my PM doc on Monday; time for the monthly renewal, talk about anti-depressants, and now this paperwork. After reading the contract again with my Mom because of how it's worded I shouldn't have to much trouble retaining my PM doc as head of my pain meds.

I'm definately /not/ signing the contract, I've come to tha conclussion without a shadow of a doubt. If it's just for post-op meds, that's fine, he can handle that, otherwise he and my PM doc can coordinate things. If not signing the contract means no surgeon, then so be it. That is one of my questions for my own PM doc as this is the surgeon he referred, and I know he's worked hard to find someone that would take my case; I don't want to offend him over what some would consider a trivial piece of paper.

It does at least turn out that this is not the same guy I saw two years ago, so that's reassuring. Also, and I think I mentioned this, my friend with the SCS across the street knows one of the other surgeons in thie group of Head/Spine specialists. As far as I know this surgeon is strictly to handle the implanting of my unit. I think after that everything else my PM can handle given he did my trial for me. Also I'm hoping I'll have the same Rep from Boston Scientific that I had during my trial, as I really feel I made a connection with her, and felt comfortable with her. Her and her team (I saw one of her associates for a minor adjustement during my trial) are really nice people and very fast at getting things taken care of.

You have all raised some wonderful points, and I will be jotting alot of this down in my notebook I take with me to appointments; my portable memory device as I call it. That way I get everything covered and asked that needs to be.

Laura -- Some of those questions, about the lamenectomy are questions I'm reserving strictly for the surgeon; they will be the make it or break it questions that will lead me to decide whether or not I'll have it done. You and I have talked alot about this recently I know. It looks like currently my CRPS is trying to spread to my neck now. Having alot of neck issues, and I know especially my jaw and neck are starting to pop alot, much like my wrist and shoulder do. Who'd have ever thought we'd be so "musical" at our age. Keep me informed about what sort of progress your doctor there is making about doing the paddle leads without the lamectomy as I would hope it wouldn't be long till they got that sort of ability in the states. I wish they didn't have to go into my neck, but with my arm being the issue I don't have alot of options. I wore my TENS unit today and I gotta say, after having the SCS it's like the difference between a Rottweiler barking at you, and then a Chiuaua's bark. But for the first time last night I was in so much pain that I actually had to grab my feather pillow to prop my arm on; it was the only way I could get it comfortable enough so I could eventually get some sleep.