I Found an Awesome PM Doctor - Dr. Trescot

[Jim M2]

Dr. Andrea Trescot is at the Univ.of Washington Pain Center. She recently arrived from Jacksonville, FL. She impressed me the way Drs.W and Yeung impress me. Extremely knowledgeable and able to explain with excellent perspective and detail. I didn't get the usual canned lines and generalities that specialists throw out. She specifically addressed my situations throughout the examination.

On Tuesday (1/13) she and her resident spent an hour with me. She thoroughly looked at my reports/imaging while talking to me and examining me. She wholistically assessed what was going on and gave excellent rationale for how my situation evolved to where it is today. I've got all of these problems: Loss of curvature of spine, calcified ligments, degenerated facets, functional stenosis, enflamed SI. No one would ever talk about these with me before.

She put me on 100mg/day Ultram ER + up to 3x50mg tramadol if needed. She bumped Gabapentin to 4000mg/day because I told her I used a MEDCO generic that didn't seem nearly as effective as Neurontin. She agreed some generics aren't as effective, otherwise she would not have exceeded 3600mg/day.

To start sorting through the layers of possible pain generators she started with a caudil injection which I had this morning (1/16). Here 9 hours post-injection I notice there's something missing in the normal spectrum of pains and discomforts from the lower back, but it's nothing I can specifically describe. It was fascinating hearing her instruct the resident who actually made the injection.

I'm going back next week for an SI injection.

Too bad I'm moving in 2 weeks, I would like to stay under her care longer.

[Maria]

Jim,
I don't know where you are moving but it appears you've found a gem of a PM doc. Not that it's rare tho I've been thru a number of them because of multiple moves and have stuck with one that is in San Diego Co. vs. L.A. county so far because I like him that much. I will try to stay under his care as long as I am able.

I was also extremely pleased with the anesthesiologist in Long Beach that used to do my ESIs because he actually sat and talked with me prior to the injections and gave me more information than the Ortho I had been seeing for numerous years or the PM doc I had seen in that city (but prefered to have my ESIs done with this doc). Edit to add that this doctor and the one I see now give such dead on great ESIs (transforaminally).

I hope you will get significant relief and if able can follow up with this doctor or one in her league. Personally I'm not sure how easy they are to come by such as this...

[Jim M2]

Hi Maria,
I'm moving from Seattle area to the S. Bay Area (San Jose area). That's the good thing about living in large metropolitan areas, you have lot's of choices for doctors, and when you find one that's outstanding, you stick with them. This Dr. Trescot really knows her business and it's obvious she loves helping the patient (and the resident) and gets a great deal of satisfaction seeing the patient improve. She has a great attitude.

Maria, you said "I'm not sure how easy they are to come by such as this..." Based on my sampling of dozens of doctors over 7 years I'm convinced I may never run into another doctor like this.

She did recommend a S.Cal based doctor, Dr. Bjorn Eek, for prolotherapy. I think he visits the Bay area once a week to see patients. I'm officially retired from Boeing and receiving their Retiree Medical until the new employment starts, although I've heard prolotherapy isn't covered anyway.

[Maria]

Jim,
definately good to be in a big metro area re at least having a chance to find another excelllent doc (maybe not as excellent or just different and still excellent). Well, wishing you the best as you can already imagine

A friend of mine that lives in NoCal now but previously lived in SoCal had prolotherapy long ago for her spinal probs and she said she felt it kept the problems at bay for at least 7 years. She paid out of pocket for treatment.


Easy does it with the packing and moving now~ and hope you will like your new job!

[Kathy]

Just wondering... What is prolotherapy?

[Jim M2]

Kathy,
Good question. I've seen it discussed on the forums many times but never knew what it was. Dr. Trescot thinks I should try it. This is from Prolotherapy.com home page.

Prolotherapy is also known as nonsurgical ligament reconstruction, and is a treatment for chronic pain

What is prolotherapy?

First, it is important to understand what the word prolotherapy itself means. "Prolo" is short for proliferation, because the treatment causes the proliferation (growth, formation) of new ligament tissue in areas where it has become weak.

Ligaments are the structural "rubber bands" that hold bones to bones in joints. Ligaments can become weak or injured and may not heal back to their original strength or endurance. This is largely because the blood supply to ligaments is limited, and therefore healing is slow and not always complete. To further complicate this, ligaments also have many nerve endings and therefore the person will feel pain at the areas where the ligaments are damaged or loose.

Tendons are the name given to tissue which connects muscles to bones, and in the same manner tendons may also become injured, and cause pain.

Prolotherapy uses a dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. This causes a localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and stimulates the tissue to repair itself.

Historical review shows that a version of this technique was first used by Hippocrates on soldiers with dislocated, torn shoulder joints. He would stick a hot poker into the joint, and it would then miraculously heal normally. Of course, we don’t use hot pokers today, but the principle is similar—get the body to repair itself, an innate ability that the body has.

How long will it take to complete a course of treatments?

The response to treatment varies from individual to individual, and depends upon one's healing ability. Some people may only need a few treatments while others may need 10 or more. The average number of treatments is 4-6 for an area treated. The best thing to do is get an evaluation by a trained physician to see if you are an appropriate candidate. Once you begin treatment, your doctor can tell better how you are responding and give you an accurate estimate.

[Justin]

Jim,

It's a bummer you are moving. It sounds like the PM doc you found is great and a great teacher as well. Best of luck in your upcoming move and finding a new PM doc.

[Jim M2]

It's over one year since Post #1 of this thread. I saw Dr. Trescot again a couple of weeks ago at UW in Seattle.

- She bumped me from 100 to 200 mg Tramadol HCL ER
- Gabapentin stays at 4g/day
- up to two 50mg Tramadols/day
- one 20mg piroxicam/day if needed

These meds have improved my life to the point where I can do some normal things. Before I took these meds I couldn't stand going out in public. Noise from store music, car alarms, car stereos, barking dogs... were so oppressive I had to go home and rest. Now I can tolerate going out. The noise is annoying, not painful. Also the distraction of pain interrupting me is much less so that I can concentrate longer.

If you're in the PNW you really need to go see Dr. Trescot at the UW Center for Pain.

Because I'm moving to San Diego, she recommended I see Dr. Stan Helm in Laguana Hills. Dr. Helm is probably over an hour away, up in Orange Co. I hope one of you can recommend someone closer.

[Maria]

Is Kevin Toliver and he practices in the Medical buildings across from Scripps Mercy Hospital in the Hillcrest area of SD (uptown). He's mid 40 ish and cool. I've been going to him for 5 years now.

[Jim M2]

Maria,
Thank you very much!!

[Maria]

Jim,
I know there are many other good PMs in the SD area and hopefully others here or other forums can chime in on this. I liked Dr.Toliver right away because he's super down to earth and not "God" like and he actually sees his patients vs. using NP or PA even just for med refills. He's got great secretaries/schedulers and here's a good example of the right hand knowing what the left hand is doing re communication.

Oh yes and Dr.T is dead on with injections.