Johnnyr99
01-08-2004, 08:57 PM
Hello to all and thanks for taking the time to read. I will expain my situation and why I chose to post here. My concern now is pain management and why I posted here. If anyone would have a simliar condition or just been diagonsed with this, I would be very happy to help you through it.
My situation starts like this. I am male, 47, in very good health all my life, non smoker/drinker, exercise and am very active all the time. I am self-employed with numerous employees and our job is rather labor intense (hard work). Everyday I will show up on every job and do every job myself to show everyone that it is possible and not to be affraid of hard or dirty work, the boss does it so it is possible.
During the summer of 2003 I developed one of my headaches from the heat (the only thing that really bothers me) and went to my truck to take 2 aspirins. When I swallowed, it felt like one had got stuck in my throat. It did not, but that feeling never went away.
After 4 weeks of my wife watching me rub my throat and me telling her there is a lump in my throart, she made the doctors appointment. Nose, ear and throat specialist.
He put a scope up threw my nose and was able to look down my throat. He said there is nothing to cause this, but he already knows what it is. (Acid reflux) and was very nice and gave me free samples of the purple pills to cure the problem.
Just to be sure he said, lets do a barium swallow test at the hospital. I am sure everyone knows what this is, and it is standard procedure to have a chest x-ray before the test. This is where a mediastium mass appeared. These are kind words for tumor that was as large as a grapefruit.
Next was a CT scan to determine the exact location and organs affected. This tumor was growing from my thymus gland and was classed a thymoma.
At this time there was never any pain or discomfort at all.
A few days later a needle biopsy was done to see if any evidence of cancer was present. 3 days after this procedure my right lung colasped as the surgeon went in a bit too far with the needle. This is where I got an education in pain. I will compare the pain to a toothache, except now your tooth is in your chest and almost a foot long. Each breath doubles the pain as putting cold water on your tooth would have the same effect.
Due to the pain and condition being life threatening, I was hospitalized. Morphine was used 1st with no effect. Dialudid was used next and worked well. After 5 days in the hospital and my surgeon now visiting me to give me the results of the biopsy, he said "You're here, I'm here and the O.R. is here, so lets get this thing out of you, it doesn't belong there." I said fine except for one thing, I am so weak from no rest and no sleep that if you try and remove a hangnail from me you will kill me. I need to go home and rest for a few days and then go on with this.
The operation was done 3 days later and went rather well. No evidence of cancer and the pain I was ready for. It hurt YES, but anytime you have your breast bone sawed in half, expect some pain. That was on a Monday and was released 4 days later and actually went back to work on a Sat. 12 days later. That is how well things were going and how well I felt.
On the nesxt day, Sunday, pain was growing on my left side and got so bad I was taken to the hospital. It was determined that blood from the operation did not drain properly and had filled in the sac around my lung. This also collasped the lung and pluasee(sp) developed. I thought I knew what pain was until this. 3 months now and the pain is still there, not as great and decreasing all the time, but I need help controlling.
I was placed on percocet (roxicet to be exact) 5/325 and these do work when the pain gets out of control. I only take when the pain is too much after a long day at work. On average, during a bad time maybe use 8 pills in a week. Sometimes go 3 or 4 days no needing any.
Now that my perscription is low, we called the doctor for a refill. You will never get this doctor on the phone or his partners, just a nurse to return the call. In her mind, I guess, that I was using too many pills. He had given me 80 pills to last 2 months. It has been 2 months and I still have 14 left, 1st question.....is that alot and am I using too many?
Since the nurse is unsympthetic and the doctor may never know I called, I was considering purchasing online. 2nd question.....is that possible and does anyone know where I could go?
Since it takes 4 to 6 weeks to get to see my doctor and if online is not the answer, are there any suggestions? The nurse did write a script for darvocet and these work well to controll the pain when I am at work. I will and have not ever taken a percocet while at work. I only used the darvocet at work because I am guessing that the darvocet is half the strength of a percocet. And these pills do help with the pain, it's just when the pain gets out of controll and I need a little extra.
I have about a 2 week supply of percocet (14 pills) and just thinking ahead when I do run out. I just don't know what to do and ask anyone here for help.
Thanks again for your time and consideration.
John
My situation starts like this. I am male, 47, in very good health all my life, non smoker/drinker, exercise and am very active all the time. I am self-employed with numerous employees and our job is rather labor intense (hard work). Everyday I will show up on every job and do every job myself to show everyone that it is possible and not to be affraid of hard or dirty work, the boss does it so it is possible.
During the summer of 2003 I developed one of my headaches from the heat (the only thing that really bothers me) and went to my truck to take 2 aspirins. When I swallowed, it felt like one had got stuck in my throat. It did not, but that feeling never went away.
After 4 weeks of my wife watching me rub my throat and me telling her there is a lump in my throart, she made the doctors appointment. Nose, ear and throat specialist.
He put a scope up threw my nose and was able to look down my throat. He said there is nothing to cause this, but he already knows what it is. (Acid reflux) and was very nice and gave me free samples of the purple pills to cure the problem.
Just to be sure he said, lets do a barium swallow test at the hospital. I am sure everyone knows what this is, and it is standard procedure to have a chest x-ray before the test. This is where a mediastium mass appeared. These are kind words for tumor that was as large as a grapefruit.
Next was a CT scan to determine the exact location and organs affected. This tumor was growing from my thymus gland and was classed a thymoma.
At this time there was never any pain or discomfort at all.
A few days later a needle biopsy was done to see if any evidence of cancer was present. 3 days after this procedure my right lung colasped as the surgeon went in a bit too far with the needle. This is where I got an education in pain. I will compare the pain to a toothache, except now your tooth is in your chest and almost a foot long. Each breath doubles the pain as putting cold water on your tooth would have the same effect.
Due to the pain and condition being life threatening, I was hospitalized. Morphine was used 1st with no effect. Dialudid was used next and worked well. After 5 days in the hospital and my surgeon now visiting me to give me the results of the biopsy, he said "You're here, I'm here and the O.R. is here, so lets get this thing out of you, it doesn't belong there." I said fine except for one thing, I am so weak from no rest and no sleep that if you try and remove a hangnail from me you will kill me. I need to go home and rest for a few days and then go on with this.
The operation was done 3 days later and went rather well. No evidence of cancer and the pain I was ready for. It hurt YES, but anytime you have your breast bone sawed in half, expect some pain. That was on a Monday and was released 4 days later and actually went back to work on a Sat. 12 days later. That is how well things were going and how well I felt.
On the nesxt day, Sunday, pain was growing on my left side and got so bad I was taken to the hospital. It was determined that blood from the operation did not drain properly and had filled in the sac around my lung. This also collasped the lung and pluasee(sp) developed. I thought I knew what pain was until this. 3 months now and the pain is still there, not as great and decreasing all the time, but I need help controlling.
I was placed on percocet (roxicet to be exact) 5/325 and these do work when the pain gets out of control. I only take when the pain is too much after a long day at work. On average, during a bad time maybe use 8 pills in a week. Sometimes go 3 or 4 days no needing any.
Now that my perscription is low, we called the doctor for a refill. You will never get this doctor on the phone or his partners, just a nurse to return the call. In her mind, I guess, that I was using too many pills. He had given me 80 pills to last 2 months. It has been 2 months and I still have 14 left, 1st question.....is that alot and am I using too many?
Since the nurse is unsympthetic and the doctor may never know I called, I was considering purchasing online. 2nd question.....is that possible and does anyone know where I could go?
Since it takes 4 to 6 weeks to get to see my doctor and if online is not the answer, are there any suggestions? The nurse did write a script for darvocet and these work well to controll the pain when I am at work. I will and have not ever taken a percocet while at work. I only used the darvocet at work because I am guessing that the darvocet is half the strength of a percocet. And these pills do help with the pain, it's just when the pain gets out of controll and I need a little extra.
I have about a 2 week supply of percocet (14 pills) and just thinking ahead when I do run out. I just don't know what to do and ask anyone here for help.
Thanks again for your time and consideration.
John
Sponsor
twisten
01-08-2004, 11:31 PM
H Johnny. I can't help you much just wanted to welcome you to the "group". As for purchasing narc's online, I don't think that can be done here in Canada but I could be wrong. Hopefully someone on here who has purchased them online will be a long shortly. Did you make an appointment to see the doc or only speak with the nurse? If it was me I would call back and try explaining the darvocet just aren't cutting it and that the doc had given you enough to last for 2 months and the 2 months is now up. I take around 180 5mg of oxycodone in a month so no, I sure don't think you are getting too many. Good luck and let us know how you make out.
wirry1422
01-09-2004, 12:43 AM
Sorry for your long education in pain, you'll have your master's degree in that subject pretty soon. Seriously though, i would strongly advice you against purchasing medication online. It is just too risky, you could easily get ripped off. Also, insurance will not cover online scripts. You should just try to wait until you see the doctor, and make sure you get an adequate supply of the percocet. And i would mention the nurses attitude with you on the phone, as it is not her place to make treatment judgements, only to carry them out. Also Darvocet is about 1/4 as strong as percocet, but i'm glad it works well for you at work, so try to get a supply of that to for at work pain control. Take care.
Shoreline
01-09-2004, 01:53 PM
Hey Johnny, Sorry to hear about your troubles. You remind me of a friend I have. He's a contractor and his doc wants to replace his hip but he doesn't have insurance.
I agree the internet has to be a last resort, but because your use is so minimal it would probably suite your needs and you wouldn't have to doc shop to get multiple scripts to take 8-10 pills a day the way many folks do.
There is a legal avenue called Telemedicine. Ideally you fill out new patient info, your medical history, etc. A doc should call and have a telephone consult and then he can prescribe meds. Not percocet, because it's a class 2 but you can get the hydrocodone products. Now this is how Telemedice should work and remain legal. I've yet to meet anyone that used the internet that actually had the site cover all the bases that would prevent them from being shut down. When they get shut down your name is now part of their database. That's what scares me, if the site isn't totally legit and doesn't cover all the bases of Telemedecine. Which is hard to tell. If a doc didn't call you and the pills arived would you send them back just to remain 100% legal? I can't imagine anyone doing that.LOL
My friend with the hip thought it would be cheaper to try and he Filled out a history and 2 days later a bottle of 90 Vicodin ES arrived. The instructions were to take one tablet every 4-6 hours. At a pharmarcy this would either be a 23 day supply if taken every 6 hours or a 15 day supply if the pharmacist considered entering it as taking one every 4 hours, 6 a day. He waited a month, called for a refill and was told that was a 90 day supply and not to attempt to purchase any more narcotics over the internet or possibly face prosecution for doctor shopping. It seemed the site was trying to be legit but the day supply didn't make sense. When you take a script to the pharmacy every prescription is entered into the computer with a calculated days supply based on the way the script is written.
90 tablets may last you personally 60-90 days wich is very reasonable but the one script cost 250 bucks and his name is in a database of a company that did not follow all the rules but seemed to be trying to enforce some later. Perhaps they were presently being investigated. He has a friend that enjoys pain meds and had 3-4 companies send him bottles of hydro products each month. That guys presently in jail for selling them.
250 bucks will get you an apt with your GP or family doc. and pay for a script. Surgeons are notorious for being stingy with pain meds, after all they surgically fixed you.You shouldn't need meds. Acording to them.LOL
Pain management is an option. However there are lots of non opiate modalities. Masking a problem that may not be what you think could also be dangerous. I self Diagnosed and called 3 episodes of chest pain GURDS and relux and took the OTC meds for this. The fourth droped me to my knees and was a heart attack in my 30's.
Thoracic problems can cause chest wall pain like pluracy, that's why it's best to let the docs do their thing and really investigate why your still having pain, not that chest pain 3 months post op from having your chest cracked would be unusual. Your limited med use shouldn't concern even an opiate phoboc doc.
Asking for percocet specifically can raise a docs eyebrow, but seeking pain relief and leaving it to the doc and if he askes what works then it's fine to say percs but be willing to try whatever he suggests. Percocet is a class 11 med and has a much higher level of control and reporting when each script is filled, "a big part of the reasons docs are quick to get you off Class 11 meds."
Because your needs are so limited "a couple percs a day" you fall into a gray area of pain management. Your pain is real, but should improve unless it's something else like a problem with your thoracic spine. Even docs that prescribe opiates may want to try other non opiate modalities. You haven't really been labeled with chronic pain or described it as 24/7, debilitating and preventing you from enjoying quality of life. I'm not trying to minimize your pain at all. My daughter has Costro condritis, where the breast bone doesn't fuse and subluxes, I understand it's very painful. But because it's not constant and likely will respond to other modalities it's hard to say that you need agressive PM with opiates.
The Pain managenet docs that prescribe want to prescribe the long acting ones because when used properly you don't get the buzz that addicts seek from short acting meds. To reach the point of needing LA meds your pain has to be documented and using long acting meds which there is no way to avoid dependence from, needs to be justified. That's not even what you are hoping for so this falls into an area where a GP or family doc really can help if he's not afraid too.
It's rediculous that docs are afraid of being asked why are you prescribing X for Mr. Y. If it's justified , and you would think if they wrote the script they felt it was justified, you take the call of inquiry, open the patients chart and explain that you just had surgery 3 months ago, you went back to work quickly and have had some complications. But no doc wants a call from a pharmacist questioning his prescribing or from the DEA or Board of pharmacy questioning their prescribing even when it's completly justified. No scripts means no calls. Sad but true.
There are quacks out there that will prescribe anything for the price of an office visit but they are more likely going to do more harm than good. So because your pain is not 24/7 and debilitating and you haven't shown you don't respond to any other treatment or haven't jumped through the "any other treatment hoops," You basically need continued meds for post op pain. Like many surgeons, they cut patients off before all the post op pain has deminished if it is going to. It does make recovery and PT harder when you don't have pain relief.
I do think you went back a little early and likely have caused some of the flairs by overdoing it. Your the boss, It's time to let the labor do the labor. Protect yourself from causing any aditional pain and see if your GP or family doc will help you through the rest of your recovery. I understand your mentality and that's the way I managed, I didn't ask anyone to do anything I wasn't willing, but you reach a point where you have paid your dues and don't have to justify to the labor why it needs to be done.
The internet sites will always be there. Nobody can realy recommend one but perhaps with a little more understanding of how the pain management process works some of what I said will make sense. Asking for pain management now may get you self hypnosis, Biofeedback, acupuncture, chiropractic, antidepsants, counseling,nerve blocks and a whole lot more where this really sounds like your GP can take care of you and investigate any other posiible problem that might be causing the continued pain.
If you find this is as good as it will ever get, then pain management is there to look into. I know I can get long winded. It's a topic that can be contreversial but Telemedicine probably does have it's place.You are the type of patient that it may be ideal for but I still have my concerns about dealing with a legitiamte Telemedicine doctor and site.
So my best advice would be talk to your family doc, your needs are minimal, you can probably manage with a class 111 med "Vicodin, Lortab, Norco, etc"" which draws less attn than Percocet or other class 11 meds. If your GP isn't opiate phobic "afraid of prosecution and addcition in patients" he would be the guy to turn to for a couple more months worth of Vicodin or lortab untill you have healed a little more.JMO
Have they done an Xray to see if your sternum is fusing back together? I would want to know at this point and they would see the calcium buildup if it was.
Anyway, sorry so long. Welcome and I hope you do continue to heal and perhaps learn how to delegate a little more especially if you know your going to do something that will cause you more pain. I know it's a tough thing to do when your used to jumping in and getting it done. But I imagine you have paid your dues and it's time to let the younger guys carry the heavy stuff for now.
Take care, Shore
I agree the internet has to be a last resort, but because your use is so minimal it would probably suite your needs and you wouldn't have to doc shop to get multiple scripts to take 8-10 pills a day the way many folks do.
There is a legal avenue called Telemedicine. Ideally you fill out new patient info, your medical history, etc. A doc should call and have a telephone consult and then he can prescribe meds. Not percocet, because it's a class 2 but you can get the hydrocodone products. Now this is how Telemedice should work and remain legal. I've yet to meet anyone that used the internet that actually had the site cover all the bases that would prevent them from being shut down. When they get shut down your name is now part of their database. That's what scares me, if the site isn't totally legit and doesn't cover all the bases of Telemedecine. Which is hard to tell. If a doc didn't call you and the pills arived would you send them back just to remain 100% legal? I can't imagine anyone doing that.LOL
My friend with the hip thought it would be cheaper to try and he Filled out a history and 2 days later a bottle of 90 Vicodin ES arrived. The instructions were to take one tablet every 4-6 hours. At a pharmarcy this would either be a 23 day supply if taken every 6 hours or a 15 day supply if the pharmacist considered entering it as taking one every 4 hours, 6 a day. He waited a month, called for a refill and was told that was a 90 day supply and not to attempt to purchase any more narcotics over the internet or possibly face prosecution for doctor shopping. It seemed the site was trying to be legit but the day supply didn't make sense. When you take a script to the pharmacy every prescription is entered into the computer with a calculated days supply based on the way the script is written.
90 tablets may last you personally 60-90 days wich is very reasonable but the one script cost 250 bucks and his name is in a database of a company that did not follow all the rules but seemed to be trying to enforce some later. Perhaps they were presently being investigated. He has a friend that enjoys pain meds and had 3-4 companies send him bottles of hydro products each month. That guys presently in jail for selling them.
250 bucks will get you an apt with your GP or family doc. and pay for a script. Surgeons are notorious for being stingy with pain meds, after all they surgically fixed you.You shouldn't need meds. Acording to them.LOL
Pain management is an option. However there are lots of non opiate modalities. Masking a problem that may not be what you think could also be dangerous. I self Diagnosed and called 3 episodes of chest pain GURDS and relux and took the OTC meds for this. The fourth droped me to my knees and was a heart attack in my 30's.
Thoracic problems can cause chest wall pain like pluracy, that's why it's best to let the docs do their thing and really investigate why your still having pain, not that chest pain 3 months post op from having your chest cracked would be unusual. Your limited med use shouldn't concern even an opiate phoboc doc.
Asking for percocet specifically can raise a docs eyebrow, but seeking pain relief and leaving it to the doc and if he askes what works then it's fine to say percs but be willing to try whatever he suggests. Percocet is a class 11 med and has a much higher level of control and reporting when each script is filled, "a big part of the reasons docs are quick to get you off Class 11 meds."
Because your needs are so limited "a couple percs a day" you fall into a gray area of pain management. Your pain is real, but should improve unless it's something else like a problem with your thoracic spine. Even docs that prescribe opiates may want to try other non opiate modalities. You haven't really been labeled with chronic pain or described it as 24/7, debilitating and preventing you from enjoying quality of life. I'm not trying to minimize your pain at all. My daughter has Costro condritis, where the breast bone doesn't fuse and subluxes, I understand it's very painful. But because it's not constant and likely will respond to other modalities it's hard to say that you need agressive PM with opiates.
The Pain managenet docs that prescribe want to prescribe the long acting ones because when used properly you don't get the buzz that addicts seek from short acting meds. To reach the point of needing LA meds your pain has to be documented and using long acting meds which there is no way to avoid dependence from, needs to be justified. That's not even what you are hoping for so this falls into an area where a GP or family doc really can help if he's not afraid too.
It's rediculous that docs are afraid of being asked why are you prescribing X for Mr. Y. If it's justified , and you would think if they wrote the script they felt it was justified, you take the call of inquiry, open the patients chart and explain that you just had surgery 3 months ago, you went back to work quickly and have had some complications. But no doc wants a call from a pharmacist questioning his prescribing or from the DEA or Board of pharmacy questioning their prescribing even when it's completly justified. No scripts means no calls. Sad but true.
There are quacks out there that will prescribe anything for the price of an office visit but they are more likely going to do more harm than good. So because your pain is not 24/7 and debilitating and you haven't shown you don't respond to any other treatment or haven't jumped through the "any other treatment hoops," You basically need continued meds for post op pain. Like many surgeons, they cut patients off before all the post op pain has deminished if it is going to. It does make recovery and PT harder when you don't have pain relief.
I do think you went back a little early and likely have caused some of the flairs by overdoing it. Your the boss, It's time to let the labor do the labor. Protect yourself from causing any aditional pain and see if your GP or family doc will help you through the rest of your recovery. I understand your mentality and that's the way I managed, I didn't ask anyone to do anything I wasn't willing, but you reach a point where you have paid your dues and don't have to justify to the labor why it needs to be done.
The internet sites will always be there. Nobody can realy recommend one but perhaps with a little more understanding of how the pain management process works some of what I said will make sense. Asking for pain management now may get you self hypnosis, Biofeedback, acupuncture, chiropractic, antidepsants, counseling,nerve blocks and a whole lot more where this really sounds like your GP can take care of you and investigate any other posiible problem that might be causing the continued pain.
If you find this is as good as it will ever get, then pain management is there to look into. I know I can get long winded. It's a topic that can be contreversial but Telemedicine probably does have it's place.You are the type of patient that it may be ideal for but I still have my concerns about dealing with a legitiamte Telemedicine doctor and site.
So my best advice would be talk to your family doc, your needs are minimal, you can probably manage with a class 111 med "Vicodin, Lortab, Norco, etc"" which draws less attn than Percocet or other class 11 meds. If your GP isn't opiate phobic "afraid of prosecution and addcition in patients" he would be the guy to turn to for a couple more months worth of Vicodin or lortab untill you have healed a little more.JMO
Have they done an Xray to see if your sternum is fusing back together? I would want to know at this point and they would see the calcium buildup if it was.
Anyway, sorry so long. Welcome and I hope you do continue to heal and perhaps learn how to delegate a little more especially if you know your going to do something that will cause you more pain. I know it's a tough thing to do when your used to jumping in and getting it done. But I imagine you have paid your dues and it's time to let the younger guys carry the heavy stuff for now.
Take care, Shore