I had a consult with a pain doc last week, a D.O. in Lynnwood, WA. I wasn't sure exactly why I was going to him, but it turns out it was for a one-time consult only, to see if he had any other ideas about what was causing pain. As it turns out, the interesting thing was that he reviewed my MRI films and found that although a radiologist had ruled out Chiari I Malformation, it might still be a possibility. He said there was more fluid in my brain than is normal. He gave me a copy of his report before I left (he typed his notes in as we spoke). He suggested that rheumy have a neurosurgeon he works with in St. Louis review the films and give his opinion as docs and radiologists in this area (Seattle) don't give Chiari I much credence yet. He also mentioned that my growing up in San Jose, CA around orchards could have exposed me to the chemicals used in spraying then, although that wouldn't be possible to tell for sure, anymore. That was the good and interesting part. We didn't click at all. I have two docs who type notes during an exam, but they RELATE to me at the same time. He didn't. He seemed to be the "I only see you once so I don't need to know you" type. He made a few attempts at being a little personal, but without smiling, so that was weird. Mostly, it irked me first when he shook my hand TOO HARD (I haven't a doctor hurt my hand when squeezing it for a long time). But REALLY when his report said I couldn't use "clearly defined" scales to identify pain and functioning, so my psych should prescribe pain meds! My psych has never had anything to do with pain meds and I wouldn't trust her to, I'm sure she is not a specialist that way. The thing about the pain scales - I am the type who likes to make sure I am giving a very accurate answer. I thought I did fine when 4 was described as "nagging", but then I saw 1 was described as "annoying". What's the difference??? I asked him, but no answer. He didn't help me at all, just asked questions and listened for the answers. Also, for functioning, I could have said 90% for working fulltime, BUT I do 50% or less than I would have done around the house. I told him that, but apparently that wasn't good enough for him to suggest a number or even say what I said in his report. I keep kicking myself over the fact that I couldn't bring myself to tell him that I hurt! I don't always do that well with rheumy, but he seems to know. Because this is a pain doc who obviously sees patients in much more pain, I felt stupid about saying that I had pain! Even when he asked if I was scared because I was shaking and I just said no. I should have said yes, it hurt when you kept your stethoscope pressed between the sides of my collarbone! DUMB DUMB DUMB. Instead, he thinks I am a basket case and made me out that way with rheumy. Some days I just have a harder time communicating pain. Wouldn't you think a pain doc would be able to sense things? Rheumy seems to, but this doc didn't seem to have a clue. I don't think I did my part, but I don't think he did his part, either.