madhatter
08-13-2004, 09:51 AM
i don't even think he looked at one entry of my pain log! And thats not like him! i've been trying hard to work, i work pt. time pumping gas on the weekends,5 hrs a day.And i believe that he thinks that since i'm working a little,i'm not in that much pain! I told him [had it in log also] my pain level has been a 7-8 ,didn't even faze him,he said,we'll keep everything the same,wrote a perscription for some kind of gel,he said he hasn't had good results with it,but give it a try anyway[for back pain]then he gave me my perscription for oxycodone 5mg I.R to take two every 4 hrs,but no more than 8! So when i got home i noticed,and called him,i said,if i take two every 4 hrs,thats going to be at least 10! and if i do that,i don't want to call your office for a refill having you's wondering whats going on! He said,and i quote"don't worry i won't leave you hanging,just call when you run out"end of quote.Now i have smor's node and d.d.d and the nuero surgon said theres nothing he can do,but recomend pain management,and my p.c doc. took on the reposability of that.I'm under the impression he thinks its healing by itself!
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scotty12
08-13-2004, 12:08 PM
madhatter,
the quick visit wouldnt concern me.my doc has been backed up and spent as little as a few minutes speaking with me, but the qty of pills and possibly runnuing out before your next visit would concern me.
what happens when hes not in the day you call.i hate even being 1 pill short of running out until filling the next script.i know how hard it is to save a few pills but those days where maybe you slept a little later (yea sure ) after a few months even a days worth of meds is very reasuring.nobody wants to see their doc while going thru withdrawals and it doesnt look good for the patient either.
i see my dr every 28 days and get my rx filled on the 29th day.im in the same siruation where im taking 16 hrs or 4 doses of SA meds a day.what do i do the other 8 hrs.that is why its so difficult keeping extra meds on hand.so when you have a med change and wind up with any extra meds i lock them up for emergencies.it does suck being dependant on medication but it beats being in constant pain.
so your supposed to take 10 mg 5x per day (if you take it every 4 hrs) and he wrote the script for only 240/30 day supply.whens your next appt? if its 30 days you should stick it out this month and try and go 5 hrs between dose but call him on the calculated day as if you were taking 2 every 4 hrs.if he's true to his word then you know what to do next month.but if thats the case why not just write the script that way?
at 5 hr intervals you dont have to worry about running out before your next appt.
i dont understand why alot of pain drs do that.you can take your meds at 4 hr intervals but they only give you enough meds to last 28 days.
ive been having a rough time this month because i slipped on our deck and fractured a couple ribs.i also aggravated my back and because i cant really stretch daily as i usually do my lower back has these huge knots and my hamstrings just ache all the time.i didnt ask for any extra at my monthly visit.i was so tired,it was nine at night and it was one of the rare days i actually work a full day.my chest was killing me from the rib pain and my back was awful i didnt know what to grab first.i just wanted my script so i could go home and lay down.
i think it takes time to build a relationship with your pain dr.
i was having problems sleeping because i didnt have any way of managing the pain at night.every 4 hrs starting at 6am gives me relief until 10 at night,same problem as your having.so he rx'd ambien and its been working somewhat.knocks me out about 11 or 12 and im lucky if i sleep past 4am.im up to 20 mg and im building up a tolerance to that dose which i believe is the max rec dose.so i dont know what tricks hes got up his sleeve next to get me through the nights.
he will try something else before writing more than 120 pills a month.
i take 15mg oxycodone 4x a day.i usually can only go 4 hrs between doses to keep the pain levels down during the day.ive asked to step down to 10 mg 6x a day.still 60 mg a day but atleast id be able to manage the pain with a dose at 10pm and if the pain wakes me during the night.still only taking my meds every 4 hrs.doesnt want to write a script for 180 pills even though it would be the same amount of mgs per day/month.it would mean a little more pain but more even coverage.
the negative publicity of pain meds must influence the way pain dr's think.a patient whose taking 20 mg of roxi and doesnt have script coverage would take (4)5mg generic oxycodone=16-20 a day or 480-600 a month.people see that amt. in a news article and most likely think abuse but to a patient whose not opiate naive and been on meds a long time its really not alot.
maybe the news with the fda telling drs its ok to agressively treat pain will help us as patients.pain drs should understand how long a med last wheather its a SA med or LA med,and not have to worry about raising eyebrows at the pharmacy because a script seems like alot of meds for a patient,although the patient has been on meds for a long time.not every patient does ok with 2 percs 4x a day.
i think if your in a pain management program your pain should be managed by whatever it takes to restore quality of life.especially those for whom surgery is not an option with positive expectations.
hang in there and the dr doesnt come through with the 5x a day dosing as you discussed then maybe ask him about something to help you sleep.it seems to be helping for me.id rather take something for to knock me out at night instead of taking the extra pain meds and run short at the end of the month.you dont want to do that.
..........or,maybe we both should find a new dr........................scotty
the quick visit wouldnt concern me.my doc has been backed up and spent as little as a few minutes speaking with me, but the qty of pills and possibly runnuing out before your next visit would concern me.
what happens when hes not in the day you call.i hate even being 1 pill short of running out until filling the next script.i know how hard it is to save a few pills but those days where maybe you slept a little later (yea sure ) after a few months even a days worth of meds is very reasuring.nobody wants to see their doc while going thru withdrawals and it doesnt look good for the patient either.
i see my dr every 28 days and get my rx filled on the 29th day.im in the same siruation where im taking 16 hrs or 4 doses of SA meds a day.what do i do the other 8 hrs.that is why its so difficult keeping extra meds on hand.so when you have a med change and wind up with any extra meds i lock them up for emergencies.it does suck being dependant on medication but it beats being in constant pain.
so your supposed to take 10 mg 5x per day (if you take it every 4 hrs) and he wrote the script for only 240/30 day supply.whens your next appt? if its 30 days you should stick it out this month and try and go 5 hrs between dose but call him on the calculated day as if you were taking 2 every 4 hrs.if he's true to his word then you know what to do next month.but if thats the case why not just write the script that way?
at 5 hr intervals you dont have to worry about running out before your next appt.
i dont understand why alot of pain drs do that.you can take your meds at 4 hr intervals but they only give you enough meds to last 28 days.
ive been having a rough time this month because i slipped on our deck and fractured a couple ribs.i also aggravated my back and because i cant really stretch daily as i usually do my lower back has these huge knots and my hamstrings just ache all the time.i didnt ask for any extra at my monthly visit.i was so tired,it was nine at night and it was one of the rare days i actually work a full day.my chest was killing me from the rib pain and my back was awful i didnt know what to grab first.i just wanted my script so i could go home and lay down.
i think it takes time to build a relationship with your pain dr.
i was having problems sleeping because i didnt have any way of managing the pain at night.every 4 hrs starting at 6am gives me relief until 10 at night,same problem as your having.so he rx'd ambien and its been working somewhat.knocks me out about 11 or 12 and im lucky if i sleep past 4am.im up to 20 mg and im building up a tolerance to that dose which i believe is the max rec dose.so i dont know what tricks hes got up his sleeve next to get me through the nights.
he will try something else before writing more than 120 pills a month.
i take 15mg oxycodone 4x a day.i usually can only go 4 hrs between doses to keep the pain levels down during the day.ive asked to step down to 10 mg 6x a day.still 60 mg a day but atleast id be able to manage the pain with a dose at 10pm and if the pain wakes me during the night.still only taking my meds every 4 hrs.doesnt want to write a script for 180 pills even though it would be the same amount of mgs per day/month.it would mean a little more pain but more even coverage.
the negative publicity of pain meds must influence the way pain dr's think.a patient whose taking 20 mg of roxi and doesnt have script coverage would take (4)5mg generic oxycodone=16-20 a day or 480-600 a month.people see that amt. in a news article and most likely think abuse but to a patient whose not opiate naive and been on meds a long time its really not alot.
maybe the news with the fda telling drs its ok to agressively treat pain will help us as patients.pain drs should understand how long a med last wheather its a SA med or LA med,and not have to worry about raising eyebrows at the pharmacy because a script seems like alot of meds for a patient,although the patient has been on meds for a long time.not every patient does ok with 2 percs 4x a day.
i think if your in a pain management program your pain should be managed by whatever it takes to restore quality of life.especially those for whom surgery is not an option with positive expectations.
hang in there and the dr doesnt come through with the 5x a day dosing as you discussed then maybe ask him about something to help you sleep.it seems to be helping for me.id rather take something for to knock me out at night instead of taking the extra pain meds and run short at the end of the month.you dont want to do that.
..........or,maybe we both should find a new dr........................scotty
Kissa
08-13-2004, 01:14 PM
Sometimes doctors do rush you and it isn't necessarily because they thing you are doing better or want not but sometimes they may have spent a little extra time with a patient so they are running a bit short that day. It happens a lot. Many PM doc's double book because in many area's there are so many patients but not enough doctors to really spend a good 10 - 15m or so with the patient so this is when they start the double booking routine.
If I'm understandig what you wrote, your doctor wrote that you can take 2 oxy every 4 hours but not take more than 8 total in 24 hours or rather just take it 4 times in 1 24 hour period. Correct?
Well one of the things he might be taking into consideration is sleep time. As a general rule people sleep 8 hours a day so that leaves 16 hours in a 24 hour period in which you are awake, now if you take 2 pills every 4 hours that covers your 16 hours you should hypothetically be awake. Now unless you only sleep 4 hours a day or even 6 or wake up every 4 hours just to take medications then yes by the end of the month you will run short. Does that make sense? Being that he said "don't worry" then I wouldn't, I am sure he will hold true to his word.
My doctor is the complete opposite, he assumes no one ever sleeps and therefor prescribes SA meds every 4 hours for a total of meds taken 6 times in one day or 24 hour period. So if you took one pill a day he would prescribe 168 pills (meds are written for 28 days) or if you took to at a time then he writes 336, but I've never had a script written x2 so not positive. I've never run short on meds, if anything I have extra's that he tells me to save so I could take them every 3 hrs if needed.
Of course now I'm on LA meds so I don't get the above scripts formulation instead I get 3x28 for one month.
If I'm understandig what you wrote, your doctor wrote that you can take 2 oxy every 4 hours but not take more than 8 total in 24 hours or rather just take it 4 times in 1 24 hour period. Correct?
Well one of the things he might be taking into consideration is sleep time. As a general rule people sleep 8 hours a day so that leaves 16 hours in a 24 hour period in which you are awake, now if you take 2 pills every 4 hours that covers your 16 hours you should hypothetically be awake. Now unless you only sleep 4 hours a day or even 6 or wake up every 4 hours just to take medications then yes by the end of the month you will run short. Does that make sense? Being that he said "don't worry" then I wouldn't, I am sure he will hold true to his word.
My doctor is the complete opposite, he assumes no one ever sleeps and therefor prescribes SA meds every 4 hours for a total of meds taken 6 times in one day or 24 hour period. So if you took one pill a day he would prescribe 168 pills (meds are written for 28 days) or if you took to at a time then he writes 336, but I've never had a script written x2 so not positive. I've never run short on meds, if anything I have extra's that he tells me to save so I could take them every 3 hrs if needed.
Of course now I'm on LA meds so I don't get the above scripts formulation instead I get 3x28 for one month.
madhatter
08-13-2004, 02:36 PM
right,he has me taking two 5 mg ocycodone every 4 hrs[10 mg] i don't understand why he just don't give me 10 mg oxycodone,and take one every 4 hrs,wouldn't that make more sense?
chriztene
08-13-2004, 03:10 PM
madhatter,
It sounds as though your doctor is treating your pain and plans on doing so..I really wouldnt worry about it and if he said no problem if you have to phone in early that he would take care of it - I am sure he will..
PM dr's do not expect to get our levels under a 4-5 and usually will tell you this. I am grateful to even have a pm doctor who is willing to treat my pain at all. Especially, in the state I live in and the disease I have is not so common.
He was probably having a busy day and maybe next visit you can talk to him. Also, if you have been on a la medication for sometime, you can build a tolerance to the med. You might discuss these issues with him as well.
It sounds as though your doctor is treating your pain and plans on doing so..I really wouldnt worry about it and if he said no problem if you have to phone in early that he would take care of it - I am sure he will..
PM dr's do not expect to get our levels under a 4-5 and usually will tell you this. I am grateful to even have a pm doctor who is willing to treat my pain at all. Especially, in the state I live in and the disease I have is not so common.
He was probably having a busy day and maybe next visit you can talk to him. Also, if you have been on a la medication for sometime, you can build a tolerance to the med. You might discuss these issues with him as well.
Kissa
08-13-2004, 04:00 PM
Well another option for 2 5's is that there might be a chance that you need the meds but not that you need the whole 10 that the 5 would suffice and it's more convienant than you having to break them apart, specially if they crumble.
Try not to worry to much, not many doctors would assure you like yours did that if you run out they will take care of you! You are very lucky.
Try not to worry to much, not many doctors would assure you like yours did that if you run out they will take care of you! You are very lucky.
madhatter
08-13-2004, 06:29 PM
well,the thing was,when i went to get them filled[240] they only had a 100,and the pharmacist that was on could be an arse sometimes,he said"you won't need the others anyways for 12 days,it didn't dawn on me until i got home.The way i look at it,there was suppose to 240,they gave me 100,they owe me 140,if i wanted them the same damn day i should be able to,its not like its a refill! But i told the owner today,he said no problem,the next time you get a script,make sure the doc. puts no more than 10 instead of 8 a day.
Kissa
08-13-2004, 06:45 PM
Pharmacies only keep a certain quantity of any medication on hand at any time. They base it on supply and demand.
Your pharmacist is not being helpful. He can order the remainder of the amount and have them in within a few days. I've had this happen before and never had a problem with any pharmacy, even the little ones. If you are going to a chain then even better they can have them in the next day.
Call the pharmacy soon as you get a chance to see if the remainder are in. It isn't that you don't need them now, that's not the point, you paid for them, they are owed to you, wether it be today or 2 weeks from now.
If you are unsure about the 2 5's then ask the doctor next time you see him or if you run out when you call him again.
Your pharmacist is not being helpful. He can order the remainder of the amount and have them in within a few days. I've had this happen before and never had a problem with any pharmacy, even the little ones. If you are going to a chain then even better they can have them in the next day.
Call the pharmacy soon as you get a chance to see if the remainder are in. It isn't that you don't need them now, that's not the point, you paid for them, they are owed to you, wether it be today or 2 weeks from now.
If you are unsure about the 2 5's then ask the doctor next time you see him or if you run out when you call him again.
madhatter
08-13-2004, 06:58 PM
Like i mentioned in the origanal post,i called him etc.Its just that when i went to the pharm. he made it sound like he wasn't going to give me what they owed me until i needed them going by the directions perscribed.
scotty12
08-13-2004, 07:07 PM
most states have laws regarding classII sripts.you should pick up the balance within 7 days or technically the pharmacist is not supposed to fill the balance after a certain number of days.
Kissa
08-13-2004, 08:38 PM
Good point Scotty, I wasn't even aware of that. In that case I'd highly suggest Mad that you call the pharmacy and ask when they will be in so you can pick them up.
I know for regular meds they will often call me if I forget or will just put them back. Just had this happen with my migraine meds. Cost me like $150 to fill 18 pills, they only had 12. I forgot about them until I needed them again and found I only had a few left. I was able to get them but the pharmacy shoulda called me on those.
I know for regular meds they will often call me if I forget or will just put them back. Just had this happen with my migraine meds. Cost me like $150 to fill 18 pills, they only had 12. I forgot about them until I needed them again and found I only had a few left. I was able to get them but the pharmacy shoulda called me on those.
feelbad
08-14-2004, 09:49 AM
i am rather suprised that they would even let you half the Rx as whenever i have taken in my CII Rxes in and they are short,even just by a few days they told me that with the CII Rxes, they cannot leagally do the split up rxes and the whole rx has to be filled at once.They gave me the option of taking the Rx to one of there other pharmacies in their chain that has the right amount in, or they would fill as much as they had and call and let my doc know so the doc could adjust my next Rx and give me it three days sooner.I had them fill it even though it was three days short but told them they needed to make darn sure that they called the doc so he was aware of the shortage,and they said they would.i also brought the Rx papers that have all the Rxing info on them that showed that i was given a fill with the three days worth missing just incase.Never had to show them though as the pharmacy did call to let them know.i assumed that this was some type of fedreral law regarding the normal rxing of CII meds as that is what they told me at the pharmacy.I wonder if this differs from state to state?Hmmm.Marcia
scotty12
08-14-2004, 09:53 AM
if you are using a mom & pop pharmacy ,chances are they will work with you,no problem.they want the business as compared to a pharmacist working at a chain who gets paid wheather he fills 50 scripts or 200 scripts a day...scotty
Kissa
08-14-2004, 01:09 PM
Not really sure Marcia. I've never had to split the ms contin because the dosage so low, but when I was getting the vicodin filled I was shorted a few times and they just gave it to me later and once with my percocets after my neck surgery.
Could be a state to state thing or could be a pharmacy thing.
At least your pharmacy called your doctor for you which was to your benifit so he'd know if you had a problem and came up short on the meds.
One thing I do know, a bit related/unrealated, is I've had a great problem with CVS. When I first took my vicodin prescription in they tried to tell me the insurance co wouldn't pay for 28 days but that their rule was 14 on the narcotics, which could be true, so they split it and got double co pays from me when I returned 14 days later. Funny thing is, I switched pharms to a grocery store chain who had better hours and prices and they filled the whole 28 days at one time and said they had no issues filling it. Same with my migraine meds.. so I'm not sure who was right in that situation..
\
Could be a state to state thing or could be a pharmacy thing.
At least your pharmacy called your doctor for you which was to your benifit so he'd know if you had a problem and came up short on the meds.
One thing I do know, a bit related/unrealated, is I've had a great problem with CVS. When I first took my vicodin prescription in they tried to tell me the insurance co wouldn't pay for 28 days but that their rule was 14 on the narcotics, which could be true, so they split it and got double co pays from me when I returned 14 days later. Funny thing is, I switched pharms to a grocery store chain who had better hours and prices and they filled the whole 28 days at one time and said they had no issues filling it. Same with my migraine meds.. so I'm not sure who was right in that situation..
\
erfan
08-15-2004, 02:08 AM
I have been in the situation twice where the pharmacy was short on botth MS Contin and MSIR. They gave me a little "IOU" with the amount of pills owed to me.
Down here in Florida, the law is that the remainder of the prescription must be picked up by the patient within 72 hours or it is discarded. I have had no problem picking up the remainder in a timely manner.
But Mad Hatter, if your pharmacist is telling you to wait more than 72 hours, he might be putting the balance of your prescription in jeopardy. Better check the law in your state because if the law is 72 hours like here, he will not be able to give you the balance after 3 days.
Now today, I had a weird situation where my usual pharmacy could only fill my MSIR. I ended up back at Walgreen's to fill the MS Contin.
Alan
Down here in Florida, the law is that the remainder of the prescription must be picked up by the patient within 72 hours or it is discarded. I have had no problem picking up the remainder in a timely manner.
But Mad Hatter, if your pharmacist is telling you to wait more than 72 hours, he might be putting the balance of your prescription in jeopardy. Better check the law in your state because if the law is 72 hours like here, he will not be able to give you the balance after 3 days.
Now today, I had a weird situation where my usual pharmacy could only fill my MSIR. I ended up back at Walgreen's to fill the MS Contin.
Alan
madhatter
08-15-2004, 07:36 AM
it is a mom and pop,and i did ask them if i'll need to get a new perscription from my doc. they said no.
scotty12
08-15-2004, 10:36 AM
the pharmacist shoulnt have a problem giving you the balance of your script.i wouldnt wait more then a week.its your meds,they should have the balance within a day or 2 at most.there is no reason to wait as technically they arent supposed to be filled after a certain # days.
Kissa
08-15-2004, 03:15 PM
Sounds to me like you may want to seek out a new pharmacy.
I agree, you should try to pick them up asap and find out what your laws are, if any, regarding medications due
I agree, you should try to pick them up asap and find out what your laws are, if any, regarding medications due
wirry1422
08-15-2004, 09:01 PM
Actually the only immediate release oxycodone product in 10 mg dosage is the percocet 10/325 or 10/650. However i am sure your doctor does not want you to take such a large dosage of apap, which is what you would get with the percocet. The next highest dosages of pure oxycodone immediate release is the "roxicodone" 15 mg tablet. However since you don't take three of the 5 mg's at once, and since spliting the 15 mg roxi would only get you 7.5 mg, i suspect your doctor simply realizes that until you move to a higher dosage of oxycodone, you are stuck with the oxy ir 5 mg tabs or caps. There is, however Oxycontin sustained release 10 mg tabs, which you may want to consider talking with him about. You would then require between two or more likely three 10 mg tabs a day, one every eight hours. However, if you are uninsured, oxycontin can be expensive. Just something to think about though.
madhatter
08-16-2004, 10:51 AM
thanks for the input! Well i just got back from the pharm. and he knows i'm going away wed. so he said he'd give me a few more[30]wich will cover me until i get back.They didn't even send ther orders out! I could see the list posted right behind the cash regester,and it seems they wait until they get the sheet fulled,plus,i talked to the one i get along with great,and he said he's just trying to help his other customers on the same med.,he said he has three other peaple that he had to part. fill there script also.He did say,someone came in that same day for a script. of 300,and they only gave him 100,he said if he gave him the 300,i wouldn't of gotten what i did.If the other pharm. would of explained to me that there just trying to keep everyone happy,it would of been no big deal![This make any sense?]
Kissa
08-16-2004, 10:54 AM
Not really. I would honestly find a new pharmacy plain and simple. At least with some of the bigger ones if you are shorted they have the rest within a few short days and don't give you any excuses like you've been getting lately.
Have him give you the rest when you return and then don't even go back there anymore, even if it's the closest one to you. I'd take at least the pain meds elsewhere as much as it might be an inconvienance. It's just as much of an incovienance to be given the runaround like you have been.
Have him give you the rest when you return and then don't even go back there anymore, even if it's the closest one to you. I'd take at least the pain meds elsewhere as much as it might be an inconvienance. It's just as much of an incovienance to be given the runaround like you have been.
scotty12
08-16-2004, 11:32 AM
find a new pharmacy. even a decent mom and pop pharm. should get the remaindr within 72 hrs.........
scotty12
08-16-2004, 11:34 AM
hey wirry,
......try splitting a 15mg roxi.......ive tried 3 pill cutters and they wont split evenly,kinda just crumbles in the center
sometimes i can snap one in 1/2 by hand but ysually not..........scotty
......try splitting a 15mg roxi.......ive tried 3 pill cutters and they wont split evenly,kinda just crumbles in the center
sometimes i can snap one in 1/2 by hand but ysually not..........scotty
madhatter
08-16-2004, 01:33 PM
Thats what i'm going to do! Thanks
wirry1422
08-16-2004, 04:06 PM
Actually, i haven't had much of a problem splitting the roxi 15 mg tabs with a pill cutter. It's possible you got an older batch of roxi, or perhaps the roxi was stored in a humid environment and that is why it crumbles. The only suggestion i have is when you cut the roxi with the cutter, make sure you line up the scored line on the tablet with the blade of the cutter. Also, don't store the tabs in the washroom, where the humidity is higher.
Streetcar
08-20-2004, 07:02 PM
Regarding the pharmacy: One thing I didn't see anyone one mention was the the possiblity (however unlikely) is that pharmacist might be using your(and others) meds for himself and hoping to get the books straight before he gets caught. Wouldn't be the first pharmacist caught with his hand in the cookie jar.
Just a thought?
Just a thought?