kebba
11-02-2005, 05:07 PM
Hi,
My primary doctor has prescribed 50 percocet per week for approximately two months due to lower abdomen pain. I am seeing an endo specialist on Nov 15th and he has been prescribing the meds until I find out what is happening with the specialist.
This week I called a day early becasuse I was going to be going right by his office on my way to get my son. I told the nurse that as well. My doc ordered a toxicology urine test, and it came back negative. I had taken 2 percocets in the morning (around 7) and had the test at 3ish.
He will not prescribe me any more because of this. I have an appointment with him tomorrow...can anyone PLEASE help me in what to say to him. I am taking what is prescribed (and sometimes not even as much as prescribed). However, I am not abusing the meds nor am I doing anything illegal with them. I am taking them myself and every 4-6 hours as prescribed. My pain is horrible and I really need them.
Please help me....I would appreciate any feedback that would be helpful when I go see him tomorrow.
thanks everyone!
My primary doctor has prescribed 50 percocet per week for approximately two months due to lower abdomen pain. I am seeing an endo specialist on Nov 15th and he has been prescribing the meds until I find out what is happening with the specialist.
This week I called a day early becasuse I was going to be going right by his office on my way to get my son. I told the nurse that as well. My doc ordered a toxicology urine test, and it came back negative. I had taken 2 percocets in the morning (around 7) and had the test at 3ish.
He will not prescribe me any more because of this. I have an appointment with him tomorrow...can anyone PLEASE help me in what to say to him. I am taking what is prescribed (and sometimes not even as much as prescribed). However, I am not abusing the meds nor am I doing anything illegal with them. I am taking them myself and every 4-6 hours as prescribed. My pain is horrible and I really need them.
Please help me....I would appreciate any feedback that would be helpful when I go see him tomorrow.
thanks everyone!
Sponsor
tina76
11-02-2005, 05:20 PM
So he refused to prescribe meds because there was no trace of the meds in your urine? Does he think you are selling them or something?
kebba
11-02-2005, 05:22 PM
I think he is thinking that I took too many of them all at once...?????
I don't know, but whatever the case may be, I didn't do anything except what I was supposed to do.
I don't know, but whatever the case may be, I didn't do anything except what I was supposed to do.
tina76
11-02-2005, 05:39 PM
That is really weird... Does he normally make you take a urine test when getting the prescription refilled? It seems really unusual to me that he would requested that you do the urine test in the first place?!?
Well, the real problem for you is why did the urine test come back clean? You need to sit down with your doctor and speak to him face to face about this. Explain tht you DID take the meds that morning. Find out what would cause the test to oome up wrong etc... Good luck! I wish I had more advice to give you. This is a very strange situation!
Well, the real problem for you is why did the urine test come back clean? You need to sit down with your doctor and speak to him face to face about this. Explain tht you DID take the meds that morning. Find out what would cause the test to oome up wrong etc... Good luck! I wish I had more advice to give you. This is a very strange situation!
Director
11-02-2005, 05:43 PM
Hey Kebba: Your doc must have been suspicious because you asked for your meds early. Some doctors don't care if it's a week or a day, early is early. He was suspecious enough to order a Tox Test and it came back negative. Although it obviously was an error by the lab of some kind, it's telling your doctor that you are not taking the medication. Usually in that case or situation, the doc think right away thinks that you are selling the meds. I had that happen to me once with Oxycontin. Fortunately I had known the doctor for many years and he was my Mom and Dad's doctor before they passed away, so I told him no way was I selling and he believed me. I had just built up a tolerance and got ahead in my schedule.
I guess what I'm telling you, is you need to convince him of the terrible pain you are really are in and there's no way you could do that and not have any for yourself. Be up front and explain to him you just could not do that, and for that matter, you couldn't even afford to sell part of them. Hopefully he'll believe you and continue to write your scripts.
Good luck and please let us know the outcome.
I guess what I'm telling you, is you need to convince him of the terrible pain you are really are in and there's no way you could do that and not have any for yourself. Be up front and explain to him you just could not do that, and for that matter, you couldn't even afford to sell part of them. Hopefully he'll believe you and continue to write your scripts.
Good luck and please let us know the outcome.
Shoreline
11-02-2005, 08:37 PM
Hi Kebba, You are about the 5th person in the last 2 years to have this problem, this explains why. I have this saved as a doc to save time for everyone that's getting hammered by inacurate or the wrong test or they aren't taking enough to reach standard minimum requirements to call a test positive.
If you follow the links you can print the articles by the US armed services, The Candaian health ministry and the NIH that all explain the problems in Oxy testing. There are a few tests capable of detecting oxy that can be used but you still have to reach minimal levels.
Testing for oxycodone and other keto synthetic opiates is far more difficult than testing for your standard opiates "morphine, heroin, and codeine," for 2 reasons.
1. your dose may not reach the required 150-300 ng per ml of urine to create a positive test.
2. Most tests aren't capable of detecting oxycodone and the docs and labs aren't even aware of the problem, but the US army, the Canadian health ministry and the NIH have recognized the problem. As of the date of this original post only 3 comercially available tests could acurately detect oxy or they would have to run your urine through GC-MS "gas chromatographic-mass spectrometer," an extremely expensive testing method reserved for forensic testing.
Here is the link to the entire article to take to your doc and show him that false negatives are a common problem for detection of oxycodone use which falsely acuses patients of diversion.
http://www.iatdmct.org/oxycodone.html
This is probaly going to exceed 10,000 characters because I copied 3 different articles that pretty much all said the same thing. Your doc and the lab may not even be aware of the problems involved in proper Oxycodone testing.
Summary:
Most laboratories use commercially available immunoassays to screen for opiates in urine. They do not normally confirm presumptive positive screening tests. These immunoassays were designed to detect use of the opiates - heroin, codeine and morphine but not other opiates such as hydromorphone, hydrocodone and oxycodone, etc. Clinicians and other users of laboratory services are often unaware that opiate screening methods are unable to reliably detect oxycodone use/abuse. Because of the potent analgesic effects of oxycodone, this drug is often used in pain clinics.
In 2001, medical directors of pain management centers in Canada were concerned about oxycodone diversion, i.e. selling on the street, by some of their patients. Because of these concerns, urine drug screens were ordered in several smaller centers. Since the test results might be "negative" for oxycodone screening., individual patients could be wrongfully identified as diverting their prescription drugs to others. To resolve these concerns, urine specimens must be analyzed specifically for oxycodone by GC/MS or another robust methods in order to obtain an accurate indication of oxycodone use by these patients. Further, clinical and forensic laboratories may be unaware that one cannot adequately screen for oxycodone use by commercially available opiate immunoassays. In areas where oxycodone abuse is known or suspected, laboratories providing blood and/or urine drug screening services should alert their users about the limitations of their ability to screen for oxycodone. Thus, the emergence of oxycodone as a popular drug of abuse highlights the importance of on-going communication between the laboratory and the end users. The laboratory should update the users on the advantages and limitations of blood or urine drug testing.
Oxycodone can be extracted from biological fluids by either liquid/liquid extraction or more recently, solid phase extraction techniques. Solid phase extraction techniques utilize C18, C8, or copolymeric columns. For greater sensitivity and detection, enzymatic hydrolysis with beta-glucuronidase can be used to increase the recovery of oxycodone from biological fluids.
Methods used for the detection of 6-keto-opioids, such as oxycodone, include commercial immunoassays, thin-layer chromatography (TLC), liquid chromatography (LC), automated liquid chromatography (REMEDi), liquid chromatography-mass spectrometry (LC/MS), gas chromatography (GC), and gas chromatography-mass spectrometry (GC/MS). Despite the numerous techniques, only gas or liquid chromatography coupled with mass spectrometry is the acceptable confirmation technique for quantification of opiates - morphine and codeine ( Note - oxycodone is not currently included as one of the SAMHSA analytes ) in urine according to the Department of Health and Human Services (DHHS) guidelines for drug testing of federal employees (12).
In general, immunoassays are not well suited for the detection of 6-keto-opioids, such as oxycodone, due to the low antibody cross-reactivity of the commercial opiate kits. Cone et al. showed that each of the 6-keto-opioid compounds had concentration-dependent cross-reactivities in commercial opiate immunoassays, and each had the potential to produce positive urine screening results (13). Furthermore, Smith et al. compared several commercial immunoassays to GC-MS and demonstrated that oxycodone present in urine was detected by TDx® opiates (TDx; Abbott Laboratories) and the EMIT® d.a.u. opiate assay (EMIT; Syva) for 6-24 hrs. However, the quantitative responses from these assays expressed as ng/ml of morphine equivalents were substantially lower than GC/MS determinations (8). As a result, immunoassays are not well suited for monitoring the therapeutic use, compliance, or abuse of oxycodone. Therefore, it might be advisable to confirm any immunoassay screening tests with increased urine opiate concentrations by using a suitable chromatographic method.
Toxi-Lab ATM thin-layer chromatography (TLC) drug detection system can also be used for the detection of oxycodone in urine specimens. However, therapeutic dosages of oxycodone might be below the detection limit of this system at 1.0 mg/L in 5ml aliquots. However, Gobar et al. demonstrated that oxycodone in urine samples of pain management patients was detected by TLC and then confirmed by GC/MS with cutoff limits of 300 ng/ml for both assays (15). Furthermore, the sensitivity and specificity for both assays were 72.7 and 84.2%, respectively.
Oxycodone can also be detected and/or quantitated in biological fluids by gas chromatography with FID or NPD detection. Confirmation by GC/MS in the full scan mode shows principle peaks at m/z 315, 230, 70, 258, and 140. GC/MS utilizing selective ion monitoring (SIM) of principle ions will increase assay sensitivity so that detection limits of 10 ng/ml can be achieved. At these detection limits, therapeutic use, compliance, and oxycodone abuse can be monitored.
In GC/MS, the choice of derivatization agents is one of the most important factors in the accuracy and precision of the method. Many derivatizing agents can be used including acetic anhydride (16), bis-trimethylsilytrifluoroacetamide/trimethylsilyl (BSTFA/1% TMS) (17), heptafluorobutyric anhydride (HFBA) (17), pentafluoropropionic anhydride (PFPA) (17), and MBTFA (18). Problems encountered with some GC/MS methods include instability of derivatives, poor chromatography, unsuitable ions and abundances, incomplete derivatization, derivatization side reactions, inadequate recovery, loss during hydrolysis, extended run times, and interference or coelution of other opiates (19).
Recently, an improved GC/MS method for the simultaneous identification and quantification of opiates in urine was reported (20). In this method, methoxyamine was used after enzymatic hydrolysis to form methoxime derivatives of the keto-opiates, which were extracted using solid-phase columns and derivatized with propionic anhydride/pyridine. This method demonstrated acceptable precision, the lack of cross-interference from other opioids, short analysis time of about 6.5 min, and a small sample volume of 2.0 ml urine.
Finally, LC/MS has been used to determine the concentration of oxycodone in plasma (21). This method was selective and rapid with a analysis time of 2 min. A small sample volume of 1 ml plasma was alkalinized and extracted with 2% isoamyl alcohol in n-butyl chloride. After evaporation and reconstitution in 15% methanol-85% water containing 0.1% acetic acid, the sample was analyzed by LC/MS. The limit of quantification was 1 ng/mL., and the limit of detection, 33 pg/ml. In addition, this method was linear from 1 to 100 ng/mL. In comparison, an automated LC - REMEDi is capable of screening with a sensitivity of 150 ng/mL. However, the major problem is that oxycodone is eliminated quickly from the blood as a result of its short half-life.
Overall, the analysis and quantification of oxycodone is increasingly important as its use and abuse becomes more widespread. In addition, pharmacogenetic typing of individuals taking oxycodone may be recommended, because oxycodone is metabolized to oxymorphone by cytochrome (CYP) 450 2D6. This enzyme is polymorphic with a prevalence of three mutations *3, *4, and *5 in about 10% of the general population (22). In fact, 95% of individuals classified as poor drug metabolizers have one or more of these mutations. They are more likely to experience severe toxicity or therapeutic failure. Thus, pharmacogenomics, in the near future, might become an integral part of pain management to individualize oxycodone and other drug therapy with minimized adverse reactions.
References
1. Baselt, R.C., Disposition of Toxic Drugs and Chemicals in Man, Fifth Edition, Chemical Toxicology Institute, Foster City, CA, 2000, pp. 644-645.
--------------------------------------------------------------------------------
Last edited by Shoreline : 08-05-2005 at 01:41 PM.
If you follow the links you can print the articles by the US armed services, The Candaian health ministry and the NIH that all explain the problems in Oxy testing. There are a few tests capable of detecting oxy that can be used but you still have to reach minimal levels.
Testing for oxycodone and other keto synthetic opiates is far more difficult than testing for your standard opiates "morphine, heroin, and codeine," for 2 reasons.
1. your dose may not reach the required 150-300 ng per ml of urine to create a positive test.
2. Most tests aren't capable of detecting oxycodone and the docs and labs aren't even aware of the problem, but the US army, the Canadian health ministry and the NIH have recognized the problem. As of the date of this original post only 3 comercially available tests could acurately detect oxy or they would have to run your urine through GC-MS "gas chromatographic-mass spectrometer," an extremely expensive testing method reserved for forensic testing.
Here is the link to the entire article to take to your doc and show him that false negatives are a common problem for detection of oxycodone use which falsely acuses patients of diversion.
http://www.iatdmct.org/oxycodone.html
This is probaly going to exceed 10,000 characters because I copied 3 different articles that pretty much all said the same thing. Your doc and the lab may not even be aware of the problems involved in proper Oxycodone testing.
Summary:
Most laboratories use commercially available immunoassays to screen for opiates in urine. They do not normally confirm presumptive positive screening tests. These immunoassays were designed to detect use of the opiates - heroin, codeine and morphine but not other opiates such as hydromorphone, hydrocodone and oxycodone, etc. Clinicians and other users of laboratory services are often unaware that opiate screening methods are unable to reliably detect oxycodone use/abuse. Because of the potent analgesic effects of oxycodone, this drug is often used in pain clinics.
In 2001, medical directors of pain management centers in Canada were concerned about oxycodone diversion, i.e. selling on the street, by some of their patients. Because of these concerns, urine drug screens were ordered in several smaller centers. Since the test results might be "negative" for oxycodone screening., individual patients could be wrongfully identified as diverting their prescription drugs to others. To resolve these concerns, urine specimens must be analyzed specifically for oxycodone by GC/MS or another robust methods in order to obtain an accurate indication of oxycodone use by these patients. Further, clinical and forensic laboratories may be unaware that one cannot adequately screen for oxycodone use by commercially available opiate immunoassays. In areas where oxycodone abuse is known or suspected, laboratories providing blood and/or urine drug screening services should alert their users about the limitations of their ability to screen for oxycodone. Thus, the emergence of oxycodone as a popular drug of abuse highlights the importance of on-going communication between the laboratory and the end users. The laboratory should update the users on the advantages and limitations of blood or urine drug testing.
Oxycodone can be extracted from biological fluids by either liquid/liquid extraction or more recently, solid phase extraction techniques. Solid phase extraction techniques utilize C18, C8, or copolymeric columns. For greater sensitivity and detection, enzymatic hydrolysis with beta-glucuronidase can be used to increase the recovery of oxycodone from biological fluids.
Methods used for the detection of 6-keto-opioids, such as oxycodone, include commercial immunoassays, thin-layer chromatography (TLC), liquid chromatography (LC), automated liquid chromatography (REMEDi), liquid chromatography-mass spectrometry (LC/MS), gas chromatography (GC), and gas chromatography-mass spectrometry (GC/MS). Despite the numerous techniques, only gas or liquid chromatography coupled with mass spectrometry is the acceptable confirmation technique for quantification of opiates - morphine and codeine ( Note - oxycodone is not currently included as one of the SAMHSA analytes ) in urine according to the Department of Health and Human Services (DHHS) guidelines for drug testing of federal employees (12).
In general, immunoassays are not well suited for the detection of 6-keto-opioids, such as oxycodone, due to the low antibody cross-reactivity of the commercial opiate kits. Cone et al. showed that each of the 6-keto-opioid compounds had concentration-dependent cross-reactivities in commercial opiate immunoassays, and each had the potential to produce positive urine screening results (13). Furthermore, Smith et al. compared several commercial immunoassays to GC-MS and demonstrated that oxycodone present in urine was detected by TDx® opiates (TDx; Abbott Laboratories) and the EMIT® d.a.u. opiate assay (EMIT; Syva) for 6-24 hrs. However, the quantitative responses from these assays expressed as ng/ml of morphine equivalents were substantially lower than GC/MS determinations (8). As a result, immunoassays are not well suited for monitoring the therapeutic use, compliance, or abuse of oxycodone. Therefore, it might be advisable to confirm any immunoassay screening tests with increased urine opiate concentrations by using a suitable chromatographic method.
Toxi-Lab ATM thin-layer chromatography (TLC) drug detection system can also be used for the detection of oxycodone in urine specimens. However, therapeutic dosages of oxycodone might be below the detection limit of this system at 1.0 mg/L in 5ml aliquots. However, Gobar et al. demonstrated that oxycodone in urine samples of pain management patients was detected by TLC and then confirmed by GC/MS with cutoff limits of 300 ng/ml for both assays (15). Furthermore, the sensitivity and specificity for both assays were 72.7 and 84.2%, respectively.
Oxycodone can also be detected and/or quantitated in biological fluids by gas chromatography with FID or NPD detection. Confirmation by GC/MS in the full scan mode shows principle peaks at m/z 315, 230, 70, 258, and 140. GC/MS utilizing selective ion monitoring (SIM) of principle ions will increase assay sensitivity so that detection limits of 10 ng/ml can be achieved. At these detection limits, therapeutic use, compliance, and oxycodone abuse can be monitored.
In GC/MS, the choice of derivatization agents is one of the most important factors in the accuracy and precision of the method. Many derivatizing agents can be used including acetic anhydride (16), bis-trimethylsilytrifluoroacetamide/trimethylsilyl (BSTFA/1% TMS) (17), heptafluorobutyric anhydride (HFBA) (17), pentafluoropropionic anhydride (PFPA) (17), and MBTFA (18). Problems encountered with some GC/MS methods include instability of derivatives, poor chromatography, unsuitable ions and abundances, incomplete derivatization, derivatization side reactions, inadequate recovery, loss during hydrolysis, extended run times, and interference or coelution of other opiates (19).
Recently, an improved GC/MS method for the simultaneous identification and quantification of opiates in urine was reported (20). In this method, methoxyamine was used after enzymatic hydrolysis to form methoxime derivatives of the keto-opiates, which were extracted using solid-phase columns and derivatized with propionic anhydride/pyridine. This method demonstrated acceptable precision, the lack of cross-interference from other opioids, short analysis time of about 6.5 min, and a small sample volume of 2.0 ml urine.
Finally, LC/MS has been used to determine the concentration of oxycodone in plasma (21). This method was selective and rapid with a analysis time of 2 min. A small sample volume of 1 ml plasma was alkalinized and extracted with 2% isoamyl alcohol in n-butyl chloride. After evaporation and reconstitution in 15% methanol-85% water containing 0.1% acetic acid, the sample was analyzed by LC/MS. The limit of quantification was 1 ng/mL., and the limit of detection, 33 pg/ml. In addition, this method was linear from 1 to 100 ng/mL. In comparison, an automated LC - REMEDi is capable of screening with a sensitivity of 150 ng/mL. However, the major problem is that oxycodone is eliminated quickly from the blood as a result of its short half-life.
Overall, the analysis and quantification of oxycodone is increasingly important as its use and abuse becomes more widespread. In addition, pharmacogenetic typing of individuals taking oxycodone may be recommended, because oxycodone is metabolized to oxymorphone by cytochrome (CYP) 450 2D6. This enzyme is polymorphic with a prevalence of three mutations *3, *4, and *5 in about 10% of the general population (22). In fact, 95% of individuals classified as poor drug metabolizers have one or more of these mutations. They are more likely to experience severe toxicity or therapeutic failure. Thus, pharmacogenomics, in the near future, might become an integral part of pain management to individualize oxycodone and other drug therapy with minimized adverse reactions.
References
1. Baselt, R.C., Disposition of Toxic Drugs and Chemicals in Man, Fifth Edition, Chemical Toxicology Institute, Foster City, CA, 2000, pp. 644-645.
--------------------------------------------------------------------------------
Last edited by Shoreline : 08-05-2005 at 01:41 PM.
Shoreline
11-02-2005, 08:40 PM
Laboratory Methods
Laboratory detection of morphine and codeine is performed by immunoassay. Confirmation is by gas chromatography/mass spectrometry (GC/MS).
Cutoff and Detection Post Dose
The detection limit of the initial screen is 300 ng/ml, with a sensitivity of 20 ng/ml. This is sufficient to detect heroin use for approximately 24-48 hours post dose and codeine for somewhat longer. Positives are confirmed on GC/MS at a cutoff level of 300 ng/ml.
OXYCODONE
Classification: Opiate-narcotic analgesic
Background: The milky residue collected from the opium poppy plant (opium) is the natural material from which opiate compounds are extracted or synthesized. Oxycodone is a semi-synthetic opiates derived from opium. Oxycodone, like other opiates is characterized by its analgesic properties, and the tendency for users to form a physical dependency and develop tolerance with extended use. It is a commonly prescribed analgesic taken orally, frequently in combination with acetaminophen or aspirin. OxyContin, the time-release form of oxycodone, is supplied in 80 mg doses and is often called “hillbilly heroin”. When the pills are crushed, the contents can be snorted or dissolved in water and injected. Its use as a “Club Drug” is reported as on the increase.
Street Names: Oxy; OC; hillbilly heroin
Detection in Urine: 1-3 days
Physiological Effects: Analgesia (pain relief), respiratory depression, constipation. Long time use leads to dependence and tolerance so that a dramatic increase in dose is necessary for the same analgesic effect. Tolerance begins after the initial dose but is usually significant only after the second week of chronic use. A 35 fold increase in dose may be necessary for the same effect. Withdrawal symptoms may begin 6-8 hours after the last dose and reach a peak at 36–72 hours.
Toxicity: Respiratory depression/failure is the greatest risk associated with opiate abuse aside from the risk of infection associated with illicit intravenous drug use.
Psychological Effects: Sedation, euphoria, mental clouding
Cutoff Levels: ImmunoAssay screen test: 500 ng/mL
GCMS confirmation test:
300 ng/mL
Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Opiate testing for morphine and codeine is performed routinely in forensic urine drug-testing laboratories in an effort to identify illicit opiate abusers. In addition to heroin, the 6-keto-opioids, including hydromorphone, hydrocodone, oxymorphone, and oxycodone, have high abuse liability and are self-administered by opiate abusers, but only limited information is available on detection of these compounds by current immunoassay and gas chromatographic-mass spectrometric (GC-MS) methods. In this study, single doses of hydromorphone, hydrocodone, oxymorphone, and oxycodone were administered to human subjects, and urine samples were collected before and periodically after dosing. Opiate levels were determined in a quantitative mode with four commercial immunoassays, TDx opiates (TDx), Abuscreen radioimmunoassay (ABUS), Coat-A-Count morphine in urine (CAC), and EMIT d.a.u. opiate assay (EMIT), and by GC-MS. GC-MS assay results indicated that hydromorphone, hydrocodone, oxymorphone, and oxycodone administration resulted in rapid excretion of parent drug and O-demethylated metabolites in urine. Peak concentrations occurred within 8 h after drug administration and declined below 300 ng/mL within 24-48 h. Immunoassay testing indicated that hydromorphone, hydrocodone, and oxycodone, but not oxymorphone, were detectable in urine by TDx and EMIT (300-ng/mL cutoff) for 6-24 h. ABUS detected only hydrocodone, and CAC failed to detect any of the four 6-keto-opioid analgesics. Generally, immunoassays for opiates in urine displayed substantially lower sensitivities for 6-keto-opioids compared with GC-MS. Consequently, urine samples containing low to moderate concentrations of hydromorphone, hydrocodone, oxymorphone, and oxycodone will likely go undetected when tested by conventional immunoassays.
Take in these articles and Explain you are willing to switch to a drug thats easier to detect but it's a shame to give up a med that's effective just because we presently don't have an easy and inexpensive way to detect OxyCodone in Urine.
Here is the entire post by suzie where we discussed this last year some time, after she receved a false negative on an Oxy screen done by conventional UA's.
http://www.healthboards.com/boards/showthread.php?t=161204&highlight=Testing+oxycodone
Good luck
Take care, Dave ;)
Laboratory detection of morphine and codeine is performed by immunoassay. Confirmation is by gas chromatography/mass spectrometry (GC/MS).
Cutoff and Detection Post Dose
The detection limit of the initial screen is 300 ng/ml, with a sensitivity of 20 ng/ml. This is sufficient to detect heroin use for approximately 24-48 hours post dose and codeine for somewhat longer. Positives are confirmed on GC/MS at a cutoff level of 300 ng/ml.
OXYCODONE
Classification: Opiate-narcotic analgesic
Background: The milky residue collected from the opium poppy plant (opium) is the natural material from which opiate compounds are extracted or synthesized. Oxycodone is a semi-synthetic opiates derived from opium. Oxycodone, like other opiates is characterized by its analgesic properties, and the tendency for users to form a physical dependency and develop tolerance with extended use. It is a commonly prescribed analgesic taken orally, frequently in combination with acetaminophen or aspirin. OxyContin, the time-release form of oxycodone, is supplied in 80 mg doses and is often called “hillbilly heroin”. When the pills are crushed, the contents can be snorted or dissolved in water and injected. Its use as a “Club Drug” is reported as on the increase.
Street Names: Oxy; OC; hillbilly heroin
Detection in Urine: 1-3 days
Physiological Effects: Analgesia (pain relief), respiratory depression, constipation. Long time use leads to dependence and tolerance so that a dramatic increase in dose is necessary for the same analgesic effect. Tolerance begins after the initial dose but is usually significant only after the second week of chronic use. A 35 fold increase in dose may be necessary for the same effect. Withdrawal symptoms may begin 6-8 hours after the last dose and reach a peak at 36–72 hours.
Toxicity: Respiratory depression/failure is the greatest risk associated with opiate abuse aside from the risk of infection associated with illicit intravenous drug use.
Psychological Effects: Sedation, euphoria, mental clouding
Cutoff Levels: ImmunoAssay screen test: 500 ng/mL
GCMS confirmation test:
300 ng/mL
Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Opiate testing for morphine and codeine is performed routinely in forensic urine drug-testing laboratories in an effort to identify illicit opiate abusers. In addition to heroin, the 6-keto-opioids, including hydromorphone, hydrocodone, oxymorphone, and oxycodone, have high abuse liability and are self-administered by opiate abusers, but only limited information is available on detection of these compounds by current immunoassay and gas chromatographic-mass spectrometric (GC-MS) methods. In this study, single doses of hydromorphone, hydrocodone, oxymorphone, and oxycodone were administered to human subjects, and urine samples were collected before and periodically after dosing. Opiate levels were determined in a quantitative mode with four commercial immunoassays, TDx opiates (TDx), Abuscreen radioimmunoassay (ABUS), Coat-A-Count morphine in urine (CAC), and EMIT d.a.u. opiate assay (EMIT), and by GC-MS. GC-MS assay results indicated that hydromorphone, hydrocodone, oxymorphone, and oxycodone administration resulted in rapid excretion of parent drug and O-demethylated metabolites in urine. Peak concentrations occurred within 8 h after drug administration and declined below 300 ng/mL within 24-48 h. Immunoassay testing indicated that hydromorphone, hydrocodone, and oxycodone, but not oxymorphone, were detectable in urine by TDx and EMIT (300-ng/mL cutoff) for 6-24 h. ABUS detected only hydrocodone, and CAC failed to detect any of the four 6-keto-opioid analgesics. Generally, immunoassays for opiates in urine displayed substantially lower sensitivities for 6-keto-opioids compared with GC-MS. Consequently, urine samples containing low to moderate concentrations of hydromorphone, hydrocodone, oxymorphone, and oxycodone will likely go undetected when tested by conventional immunoassays.
Take in these articles and Explain you are willing to switch to a drug thats easier to detect but it's a shame to give up a med that's effective just because we presently don't have an easy and inexpensive way to detect OxyCodone in Urine.
Here is the entire post by suzie where we discussed this last year some time, after she receved a false negative on an Oxy screen done by conventional UA's.
http://www.healthboards.com/boards/showthread.php?t=161204&highlight=Testing+oxycodone
Good luck
Take care, Dave ;)
StMishl
11-02-2005, 08:53 PM
Shore,
I am printing and saving this - as I am positive that there WILL come a time in each of our lives that we will need this info to prove we are taking our meds as prescribed. It is scary that you know so much more than the labs, employers, doctors and evryone else! This goes in my "KEEP!" medical folder, Thank you!!!!
-Michelle
I am printing and saving this - as I am positive that there WILL come a time in each of our lives that we will need this info to prove we are taking our meds as prescribed. It is scary that you know so much more than the labs, employers, doctors and evryone else! This goes in my "KEEP!" medical folder, Thank you!!!!
-Michelle
Wren9
11-02-2005, 09:24 PM
As Shoreline posted in much greater detail,
oxycodone and hydrocodone (and other synthetic and semi-synthetics) do NOT show up on a standard NIDA 5-panel screen. They must each be tested for separately.
Kebba, please tell us what happened. I hope you were not punished.
Wren
oxycodone and hydrocodone (and other synthetic and semi-synthetics) do NOT show up on a standard NIDA 5-panel screen. They must each be tested for separately.
Kebba, please tell us what happened. I hope you were not punished.
Wren
Chaddyfriend
11-02-2005, 09:53 PM
i am curious, waht was the dosage? was it hcl or was it with tylenol? this may help ur docs motive.
kebba
11-03-2005, 10:47 AM
Thanks to everyone (Shoreline very very very much!).
The dosage is 5/325. Could sometone tell me how many of those I would need to have in my system in order to show up?
I called the doc's office and asked what type of test they took. I was a standard urine test, but he specified to look for oxycodone (since that is what he is prescribing).
It took a little over a day to come back from the lab.
Shoreline (Dave)...does this sound like the test that is often erroneous?
I am armed with all of the info you all gave me and am going to see my doc at 3:15 est. I am very nervous even though I have done absolutely nothing wrong. My boyfriend is coming with me as well and will let the doc know that he handed me the medicine and saw me take the dose on the day I had the test.
I don't know how much more "ammunition" I need...I am just so confused and upset to think that I am being doubted.
The dosage is 5/325. Could sometone tell me how many of those I would need to have in my system in order to show up?
I called the doc's office and asked what type of test they took. I was a standard urine test, but he specified to look for oxycodone (since that is what he is prescribing).
It took a little over a day to come back from the lab.
Shoreline (Dave)...does this sound like the test that is often erroneous?
I am armed with all of the info you all gave me and am going to see my doc at 3:15 est. I am very nervous even though I have done absolutely nothing wrong. My boyfriend is coming with me as well and will let the doc know that he handed me the medicine and saw me take the dose on the day I had the test.
I don't know how much more "ammunition" I need...I am just so confused and upset to think that I am being doubted.
tina76
11-03-2005, 11:03 AM
Good luck with your appointment! I will be here rooting for you. This whole thing is just so messed up! Hopefully your doctor will figure out there was a problem and aplogize to you!
shoulderpain
11-03-2005, 11:05 AM
kebba,
Two things--1) percocet contains tylenol, which is very liver toxic. Any problems with the liver can cause abdominal pain, and until they've determined what is causing the lower abdominal pain, your doc is putting you at great risk by giving you anything with tylenol. Even at therapeutic doses, tylenol can severely damage your liver if you have any underlying liver disease. Your primary care physician is an idiot--the percocet could be itself causing abdominal pain or making it worse. I'd make an appt ASAP with another doc, explain the situation, and ask for labs to be done on your liver enzymes.
The toxicity of tylenol is one of the reasons long-acting narcotic medicines were developed and used.
2) The drug screening lab might be civilly liable for a screwed up or wrong assay performed that directly has a negative impact on your health care. You can always call them up and remind them of this. Do you have friends, family members that can verify that you are taking your medications?
Frankly, I'd consult with another doc, preferably in pain management. This guy sounds like an idiot.
If you do a google search on "percocet"+"liver damage" and "percocet"+"pain management" you'll find a ton of info why percocet shouldn't be used in pain management.
Don't be passive on this-your doctor's ignorance could be putting your health at risk besides mis-managing your pain.
Best of luck!
Two things--1) percocet contains tylenol, which is very liver toxic. Any problems with the liver can cause abdominal pain, and until they've determined what is causing the lower abdominal pain, your doc is putting you at great risk by giving you anything with tylenol. Even at therapeutic doses, tylenol can severely damage your liver if you have any underlying liver disease. Your primary care physician is an idiot--the percocet could be itself causing abdominal pain or making it worse. I'd make an appt ASAP with another doc, explain the situation, and ask for labs to be done on your liver enzymes.
The toxicity of tylenol is one of the reasons long-acting narcotic medicines were developed and used.
2) The drug screening lab might be civilly liable for a screwed up or wrong assay performed that directly has a negative impact on your health care. You can always call them up and remind them of this. Do you have friends, family members that can verify that you are taking your medications?
Frankly, I'd consult with another doc, preferably in pain management. This guy sounds like an idiot.
If you do a google search on "percocet"+"liver damage" and "percocet"+"pain management" you'll find a ton of info why percocet shouldn't be used in pain management.
Don't be passive on this-your doctor's ignorance could be putting your health at risk besides mis-managing your pain.
Best of luck!
kebba
11-03-2005, 11:23 AM
Hi,
The doc did do enzyme tests before prescribibg the percocet.
He knows that the pain is from endometriosis.
I had a total hyst 2 years ago and started to suffer again from pain in my lower left abdomen. After much rresearch I found out that it is very common for the endo to have gone elsewhere before the hyst and still able to cause pain. That is why I am going back to the doc who did my hyst. He is also a specialist in endo.
BUT...the percocet works for the pain. Any suggestions on what else I can take?
(if he will even give it to me)
The doc did do enzyme tests before prescribibg the percocet.
He knows that the pain is from endometriosis.
I had a total hyst 2 years ago and started to suffer again from pain in my lower left abdomen. After much rresearch I found out that it is very common for the endo to have gone elsewhere before the hyst and still able to cause pain. That is why I am going back to the doc who did my hyst. He is also a specialist in endo.
BUT...the percocet works for the pain. Any suggestions on what else I can take?
(if he will even give it to me)
Director
11-03-2005, 01:05 PM
Kebba: You asked for a suggestion on what else you could take. If your doc wants to stay with short acting meds, ask about Oxycodone IR HCL. It's made by Roxanne and comes in 5,15, and 30 mgs. It's just the Oxy, with no Tylenol (apap), so you have no liver involvment. A lot of pharmacies don't stock the 15 and 30's, but they can get them for you, that's why I told you makes it. It would be just like taking Percosets only you wouldn't have any Tylenol to worry about.
Chaddyfriend
11-03-2005, 01:26 PM
AS far as u abusing or selling the 5/325, that is stupid. noone is going to abuse or even buy a low quality med like that, especailly with 325 of acet. in it. I could see him complaining about morphine or oxycontin, or even oxycodone hcl without the acet. I think ur dr. is a friggen idiot, and maybe even opiaphobe. New dr please....
Shoreline
11-03-2005, 01:47 PM
Hey Guys, There isn't an absolute number of mgs that will gaurentee confirmation of oxycodone. Each test has different testing perameters, some are as low as 150 ng per ml some are 300 ng per ml and some require finding 500ng per ml. There isn't a conversion chart for mgs of a specific drug and how many ngs per ml the dose equates too. There are too many variables.
Your doc or the lab can't tell you what they should have found, whether it's 350 ngs or 20 ngs from a single dose of 10 mgs of oxy taken hours prior to the test.
Just because your doc asked for oxy to be tested speciifcally, the lab is going to use the comercial test they happen to have on hand from whichever manufacturer does the best job marketing it or gives a tox lab the best deal. Your talking about trying to detect 5-10 mgs from the last dose you took several hours prior with tests that have proven to be ineffective. Your being found guilty based on inacurate and incapable testing methods that were never confirmed by GC-MS or LC-MS.
This is flat out wrong and I would want to know what specific test was used and what the range of sesn****vity is. If he can't answer you, he's acting on information he doesn't have and doesn't know.. Was it one that was listed as able to detect within a certain range or completely unable to detect keto synthetic opiates.
Just because he asked specifically for oxy to be tested for, it doesn't mean the lab is using a test capable of finding that small of a dose of oxy. Your talking 10 mgs distributed throughout your entire body, metabolized and deminishing by the hour. If you were taking 80 mgs of oxyC 3 times a day, I might wonder why it didn't show up if the right test was used. But does your doc even know what the right test is, does the lab know what the right test is and what the limitations of the test are.
They should be able to give you a name of a specific comercial test used and tell you the range it's capable of detecting. Otherwise he's treating you like a criminal based on info he can't provide.
Did they confirm their test with GC-MS, I kinda doubt your going to get a GC-MS run on a urine sample for less than a couple thousand bucks and not every tox lab has
GC-MS capability.
I could set up my own tox lab and simply purchase 3 comercially available tox screens from 3 different companies for a few bucks a piece and none of them may be able to detect oxy or a low to moderate dose of oxy unless I really did my research and was aware there was a problem detecting oxy. A comecrial tox lab is absolutely no different. They use a comercial test bought from a large manufacturer and rely on it's ability to detect a drug within certain ranges and then toss them in the bio waste bin.
Your pee wasn't sent to a CSI lab like we see on TV, where trace evidence is found by a briliant and handsome investigator using the most advanced techniqes known to science. They open a box, pull out a test, put a couple drops of pee on it and call it reliable.
A false negative isn't unusual. I have a friend that is tested weekly for cumadin levels and often told they find nothing in his system. If the level doesn't reach the minimal level of testing detection by the specific test used you have a very legit reaon why they were unable to detect a few mgs of oxycodone.
Most of these disposable tests are no more acurate than the rapid disposable strep tests that often produce false negatives at your pediatricians office. How many times has someone with a child tested negative for strep on a rapid test at the Peds office and gotten the call the rapid test was wrong after the sample was cultured. This has happend with my daugter at least 4 times I can remeber.
Docs have little training in toxicology and likely can't name 3 comercial tests available on the market, that's why he can't tell you what test was used or what method to confirm the findings and at what range the test is acurate. This info should be on the report he gets from the lab and hopefully you can compare it to what we already know are inacurate comercial tests or only able to detect higher levels of oxy in your system. Just think about how little 10 mgs of anything is compared to your body mass that's made up primarily of water.
I'm sorry I can't be more help, but without knowing which test was used and the lack of data concerning dose conversions to ngs per ml of urine within a given half life, I can't be more specific or certain, but neither can your doc or the lab he used.
I do know there are problems detecting oxy and that your dose is so low I doubt it would reach the minimum required for the most sen****ve comercial test available.
I do know your pee wasn't tested or confirmed by gas or liquid chromatography. Your insurance wouldn't pay for it, you wouldn't pay for it and the doc couldn't afford to eat the expense. I do know the didn't send your pee to Quantico or any other major forensics lab. :rolleyes: If you can tell me the name of the test I can do some digging to get you started on a nice law suite against the lab and tie your doc up in court for lots of precious hours.
Take care and let us know how it goes., Dave
Your doc or the lab can't tell you what they should have found, whether it's 350 ngs or 20 ngs from a single dose of 10 mgs of oxy taken hours prior to the test.
Just because your doc asked for oxy to be tested speciifcally, the lab is going to use the comercial test they happen to have on hand from whichever manufacturer does the best job marketing it or gives a tox lab the best deal. Your talking about trying to detect 5-10 mgs from the last dose you took several hours prior with tests that have proven to be ineffective. Your being found guilty based on inacurate and incapable testing methods that were never confirmed by GC-MS or LC-MS.
This is flat out wrong and I would want to know what specific test was used and what the range of sesn****vity is. If he can't answer you, he's acting on information he doesn't have and doesn't know.. Was it one that was listed as able to detect within a certain range or completely unable to detect keto synthetic opiates.
Just because he asked specifically for oxy to be tested for, it doesn't mean the lab is using a test capable of finding that small of a dose of oxy. Your talking 10 mgs distributed throughout your entire body, metabolized and deminishing by the hour. If you were taking 80 mgs of oxyC 3 times a day, I might wonder why it didn't show up if the right test was used. But does your doc even know what the right test is, does the lab know what the right test is and what the limitations of the test are.
They should be able to give you a name of a specific comercial test used and tell you the range it's capable of detecting. Otherwise he's treating you like a criminal based on info he can't provide.
Did they confirm their test with GC-MS, I kinda doubt your going to get a GC-MS run on a urine sample for less than a couple thousand bucks and not every tox lab has
GC-MS capability.
I could set up my own tox lab and simply purchase 3 comercially available tox screens from 3 different companies for a few bucks a piece and none of them may be able to detect oxy or a low to moderate dose of oxy unless I really did my research and was aware there was a problem detecting oxy. A comecrial tox lab is absolutely no different. They use a comercial test bought from a large manufacturer and rely on it's ability to detect a drug within certain ranges and then toss them in the bio waste bin.
Your pee wasn't sent to a CSI lab like we see on TV, where trace evidence is found by a briliant and handsome investigator using the most advanced techniqes known to science. They open a box, pull out a test, put a couple drops of pee on it and call it reliable.
A false negative isn't unusual. I have a friend that is tested weekly for cumadin levels and often told they find nothing in his system. If the level doesn't reach the minimal level of testing detection by the specific test used you have a very legit reaon why they were unable to detect a few mgs of oxycodone.
Most of these disposable tests are no more acurate than the rapid disposable strep tests that often produce false negatives at your pediatricians office. How many times has someone with a child tested negative for strep on a rapid test at the Peds office and gotten the call the rapid test was wrong after the sample was cultured. This has happend with my daugter at least 4 times I can remeber.
Docs have little training in toxicology and likely can't name 3 comercial tests available on the market, that's why he can't tell you what test was used or what method to confirm the findings and at what range the test is acurate. This info should be on the report he gets from the lab and hopefully you can compare it to what we already know are inacurate comercial tests or only able to detect higher levels of oxy in your system. Just think about how little 10 mgs of anything is compared to your body mass that's made up primarily of water.
I'm sorry I can't be more help, but without knowing which test was used and the lack of data concerning dose conversions to ngs per ml of urine within a given half life, I can't be more specific or certain, but neither can your doc or the lab he used.
I do know there are problems detecting oxy and that your dose is so low I doubt it would reach the minimum required for the most sen****ve comercial test available.
I do know your pee wasn't tested or confirmed by gas or liquid chromatography. Your insurance wouldn't pay for it, you wouldn't pay for it and the doc couldn't afford to eat the expense. I do know the didn't send your pee to Quantico or any other major forensics lab. :rolleyes: If you can tell me the name of the test I can do some digging to get you started on a nice law suite against the lab and tie your doc up in court for lots of precious hours.
Take care and let us know how it goes., Dave
Terri43
11-03-2005, 05:08 PM
I have wondered about the same thing with my meds and how they would test. I take percocet 10/650 5 times a day, Neurontin 1800mg a day, 2mg of of xanax and 300mg of wellbutrin. What a mess that test would look like. I also worry about my liver with all these meds. I have been on the percocet for 15 months now. Next week I see my doctor again and i'm going to ask her to change the percocet it's not working as well as it was before. My body must be getting use to it. anyway does anyone know if any of my other meds are bad on the liver let me know. Thanks
Terri
Terri
madhatter
11-03-2005, 05:23 PM
A while back i had to take a drug test for a job,and i was taking at the time,40 mg. of oxycotin 2x a day,and percocet 10 mg 5x a day,and don't ask me how,but i got a call from a doc. who did the test,saying they found minoot,traces of pot in my urine,so i said" is that all you found?" He said yes,why,i said" thats funny,first of all,i don't smoke pot,second,i'm taking oxycotin and percocet,why didn't that show up? He was dumb founded,asked me who my doc was,what pharmacy i used,well,a week later i get a call saying i got the job! I feel for you,these tests are not 100%
kebba
11-03-2005, 07:04 PM
Hi Everyone,
I just got back from my doctor's. I brought my boyfriend with me and when he entered the room he asked "what can I do for you?" I said that I had a negative test result and I had no idea how that could be. He sadi "Oh well, I will NOT prescribe you any narcotics." I showed him all of the info. that Shorline gave me, and he said that he didn't care. He said that the test is accurate, and that is that.
I was so upset...but thank God for my man. He spoke up and asked the doc "so, what are you going to do, make her suffer?" He re-enforced his stand that he won't prescribe any narcotics. Then my bofriend got mad and told him that he was being ridiculous and can't imagine why he waould let me suffer. He told him that he saw me take the med's and there was no reason for the test to come back as it did..and there must be a problem. The doc said, "well, when are you going to see the doc in Boswton?" I said on the 15th of November. He said "Well, I will give you enough pain meds until then, and no more. After you see him, you are on your own.
So, I got enough until then...I just hope the specialist is sensitive about my pain and can help me control it AND get rid of it once and for all!
So..in conclusion, I got what I needed, but I still feel like the doc is a jerk and I am thinking of switching my primary to someone who cares and doesn't scare the crap out of me.
THANK YOU so much for all of you help, wisdom, and well wishes. It is so nice to talk to others who know what pain is and have been treated like crap like me.
I just got back from my doctor's. I brought my boyfriend with me and when he entered the room he asked "what can I do for you?" I said that I had a negative test result and I had no idea how that could be. He sadi "Oh well, I will NOT prescribe you any narcotics." I showed him all of the info. that Shorline gave me, and he said that he didn't care. He said that the test is accurate, and that is that.
I was so upset...but thank God for my man. He spoke up and asked the doc "so, what are you going to do, make her suffer?" He re-enforced his stand that he won't prescribe any narcotics. Then my bofriend got mad and told him that he was being ridiculous and can't imagine why he waould let me suffer. He told him that he saw me take the med's and there was no reason for the test to come back as it did..and there must be a problem. The doc said, "well, when are you going to see the doc in Boswton?" I said on the 15th of November. He said "Well, I will give you enough pain meds until then, and no more. After you see him, you are on your own.
So, I got enough until then...I just hope the specialist is sensitive about my pain and can help me control it AND get rid of it once and for all!
So..in conclusion, I got what I needed, but I still feel like the doc is a jerk and I am thinking of switching my primary to someone who cares and doesn't scare the crap out of me.
THANK YOU so much for all of you help, wisdom, and well wishes. It is so nice to talk to others who know what pain is and have been treated like crap like me.
Chaddyfriend
11-03-2005, 09:32 PM
u absolutly 100% need to switch ur primary, but i got to tell u, if i was a doc and someone brought there boyfriend in, and he was begging for u to get meds, i might get even more suspicious. I dont know much about ur case or ur history, and i am not accusing you, i am just trying to let u know to be careful about how u do things, and think like a dr. sometimes. Im glad u got osme relief though. goodluck!
shoulderpain
11-04-2005, 01:33 AM
Kebba,
So sorry you have to deal with this. Absolutely find a new and better doc right away. Explain the whole situation to the new MD, show him/her that excellent laboratory documentation about drug testing that shoreline found for you, and see how the new doc reacts to it. A good doc is going to be understanding and not dismiss that information and your concerns.
Probably a younger MD would be better; the better medical schools address pain as a treatable illness. That MD sounds like an arrogant, dumb, dinosaur from the 1950's. If there is a medical school/university nearby try and get an MD affiliated with the school. Generally, an MD affiliated with a medschool is under closer scrutiny in quality of care they offer, and required to participate in continuing medical education. Also, complaints about the MD's conduct are taken very seriously.
Very different from some old fart in private practice for years who just figures he knows everything and can treat his patients however he wants. If I had to deal with that MD I'd be shooting off letters to whomever is his boss, owns the practice, the local AMA etc.
I'm not an attorney but both that MD and the lab sound very close to malpractice.
And so what if your b/f went to your appt with you? A good doc is going to be glad that you have psycho-social support, because that's important for your pain management and other medical problems. I have two guy pals that accompany me to the pharmacy-I'm a small woman and severely disabled. I'm safe from being mugged or accosted when they're with me.
Get a new and better doc ASAP, and I hope the specialist is good and everything goes well!!
p.s. Shoreline, since I've been reading this board, and all the intelligent, compassionate, and well-researched insight and advice you share with others....well, I'm sure somebody upstairs is keeping track of all the good you do. You and so many others in here are remarkable in putting aside your own heavy burdens and doing so much to help other folks. God bless you all
So sorry you have to deal with this. Absolutely find a new and better doc right away. Explain the whole situation to the new MD, show him/her that excellent laboratory documentation about drug testing that shoreline found for you, and see how the new doc reacts to it. A good doc is going to be understanding and not dismiss that information and your concerns.
Probably a younger MD would be better; the better medical schools address pain as a treatable illness. That MD sounds like an arrogant, dumb, dinosaur from the 1950's. If there is a medical school/university nearby try and get an MD affiliated with the school. Generally, an MD affiliated with a medschool is under closer scrutiny in quality of care they offer, and required to participate in continuing medical education. Also, complaints about the MD's conduct are taken very seriously.
Very different from some old fart in private practice for years who just figures he knows everything and can treat his patients however he wants. If I had to deal with that MD I'd be shooting off letters to whomever is his boss, owns the practice, the local AMA etc.
I'm not an attorney but both that MD and the lab sound very close to malpractice.
And so what if your b/f went to your appt with you? A good doc is going to be glad that you have psycho-social support, because that's important for your pain management and other medical problems. I have two guy pals that accompany me to the pharmacy-I'm a small woman and severely disabled. I'm safe from being mugged or accosted when they're with me.
Get a new and better doc ASAP, and I hope the specialist is good and everything goes well!!
p.s. Shoreline, since I've been reading this board, and all the intelligent, compassionate, and well-researched insight and advice you share with others....well, I'm sure somebody upstairs is keeping track of all the good you do. You and so many others in here are remarkable in putting aside your own heavy burdens and doing so much to help other folks. God bless you all
kebba
11-04-2005, 07:57 AM
Hi,
You are so right. He is an older guy and he is arrogant. I will be looking for a new doctor very soon...and since I live outside of Boston MA I have plenty of opportunities available to me!
Thank you all so much for your caring and informative information. This is a wonderful place to go when I am feeling down or have unmanageable problems (in addition to the pain). You are all in my shoes in some fashion, and I hope you all find some kind of relief and continue to support the ones in need!
xxx
You are so right. He is an older guy and he is arrogant. I will be looking for a new doctor very soon...and since I live outside of Boston MA I have plenty of opportunities available to me!
Thank you all so much for your caring and informative information. This is a wonderful place to go when I am feeling down or have unmanageable problems (in addition to the pain). You are all in my shoes in some fashion, and I hope you all find some kind of relief and continue to support the ones in need!
xxx