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Old 11-10-2008, 04:12 PM   #1
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Izzy Needs Your Help!

Hi to all of my pain buddies...
Well, we all knew this day would come, and it did. Today I got a call from my reg. doc saying he cannot prescribe long term narcotics for me.

It was already getting bad because I was having to drive hours to get my scripts once a month [6 hrs], and I thought he was trying to weed me out, but when i called the front desk they assured me that it has been policy for EVERYone for the last 5 monts to come in and get scripts and sign for them. And he has been sending mine for 3 months after that, so I knew it was going to be a pain for me this winter., and he said he thought it was best for my ortho to refer me to a PM doc this week.

Anyhoo...MY ortho doc who couldnt do surg for my scapula scar tissue said he would refer me to a pain doc. they both talked today, and my ortho agreed to refer me.
My concern is...I would like to know: is an anesth. pain doc the best? Ive been on narcotics for over 3 years, and Im terrified to get a PM doc that wont prescribe for me, and Im leaving for Greece for a month on friday.

My problem is that my reg doc has been stead fast on not upping my dose for so long which Ive so desperatly needed which made me come up short on my meds for refill and the pharmacy called him and told him they werent comfortable refilling so fast. Im really kind of angry because he has told me I could take more than directed if needed, and now that the pharmacist called and said that state board is coming this week, ect. now all of a sudden they wont fill my script and hes scared to write. Im just amazed at how a pharmacist can call a doc who Ive been with for years and override what he had said I could fill this morning. Plus, she called me and told me to get my script from my doc and have him write for commercial or go to another compound pharm, but yet she calls my doc and seems to "turn me in?" I dont get it at all... with me leaving so soon, Im in a real bind. He did however tell me that after my appt tomorrow he [my gp who has been writing my scripts] and my ortho would visit. I hope Im just not cut off...Weve had these plans for over a year.
Im so angry at the pharmacist. Why does she kiss my docs' butt, but yet tell me other ways to get my meds filled??

Like I said...I have an appt with my ortho tomorrow and Im sure there is no way i can get into a PM doc before I leave. Im so upset... I could really use some help from everyone if you have the time.
xoxoxoxoxoxo,
IZZY'SMOM

Last edited by IZZY'SMOM; 11-11-2008 at 05:29 PM.

 
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Old 11-10-2008, 05:37 PM   #2
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Re: Izzy Needs Your Help!

My son has a ball game and I have to jet...I hope I hear from some of you guys. I could really use the feedback and support. I just want to be able to talk to my ortho tomorrow and ask some questions about this doc he is going to refer me to, and all of you have the best advice. This will be my first PM doc.
xoxooxox,
IZZY'SMOM

 
Old 11-10-2008, 05:54 PM   #3
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Re: Izzy Needs Your Help!

I'm sure you will be fine. I've been going to one of these for several years and no problems other than personality clashes. My first one made sure I was never ever out of meds. It just shouldn't happen in his book. The newer one (my old one moved away...boohoo) first started out with a urine sample as is the norm from many to look for anything in your system not prescribed to you or even illegal. I thought it strange at first but didn't have anything to hide. I've only had to do that for a job or my OBGYN so it was strange to me ha ha. The first thing this doc did was to change my meds. He moved me from oxycodone to hydromorphone er and I was terrified. I didn't want to be on anything that strong and was really worried about addiction and that sort of thing. I did some research and put my mind at ease. Then when I started taking them two wonderful things happened. My brain was clear-no fog from the meds, and my pain went away completely. The pain free was short lived. Around 2 or 3 weeks I think but oh what heavenly weeks they were. I would have pain if I overdid it but to wake up and not hurt was something I hadn't had in a long time. Over time he added break through meds and they help but my pain is no longer controlled. He didn the injections initially as well.

My daughter is ill and I am trying to get diagnosed so we can get her well. Therefore, I have to put off going to another specialist at PM recommendation until I get her issues resolved.

My point to all of this is, when you leave there on the first visit, they will likely at the very least send you out with what you have been taking. They will not make you endure unnecessary pain. It might take some time to find the right balance for you, but they are there to help us. So with that said, be brave, look forward to your visit and remember, they work for you so if you don't like them, try a different one. You will have a relationship with them for a long time so it is important to feel comfortable with them and to be completely honest so they can in turn help you.

Good luck! I've been gone so long you probably don't even remember me....

Take care,
Lisa

 
Old 11-11-2008, 12:51 AM   #4
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Re: Izzy Needs Your Help!

Sorry, I didn't see this until late. Greece for a month...you are soooo lucky!
Enjoy. Do you have enough pain meds to last you? A little?

So, I'm a little confused. Who's not writing scripts anymore...your gp? You said your pm was writing your prescriptions but you need a new pm? I'm sorry that I don't get it. Could you explain to whoever wrote the prescription that you are leaving for a whole month and that you have been taking meds for for three years and to stop abruptly would be no fun to say the least.

The ortho says he can't do the scapular surgery? Is he passing you off to pm because there is nothing he can do for you? I'm sorry if this is the case. I seriously doubt you're going to get in to see a pm before Friday. I'm not sure about the anesthesiologist part...I guess they are well versed in pain medication but I'm not sure if they're better or worse than any other type of pm. You know the drill with a new pm...you might have to jump through all of the hoops again. I'm sorry to say.

As for the pharmacist deal-i-oo...I think you should reiterate to your doc what he said about dosages and such and explain the trip of a lifetime and how you would like to be a human on vacation and not spend it in bed or hanging over the toilet vomiting in pain. I pray the man has some sympathy/empathy left in him. If this is your gp...he used to be sooooo great and soooo nice to you and soooo caring. I'm sorry this has happened to you.

Sorry this is so long but I wanted to let you know that I'm praying for you and caring and hoping that things work out this week. You've had a 'rough row to hoe' (as my mom would say) of late. You deserve a great vacation with your family. Please let us know what happens this week and post a little note before you leave on friday. Love you~Mush
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undiagnosed lung and back pain after pneumonia in '03, tmj, migraines,(two failed surgeries for) Kienbock's disease

 
Old 11-11-2008, 12:57 AM   #5
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Re: Izzy Needs Your Help!

Quote:
Originally Posted by IZZY'SMOM View Post

He did however tell me that after my appt tomorrow he [my pm who has been writing my scripts] and my ortho would visit.
xoxoxoxoxoxo,
IZZY'SMOM
Just wanted to point out where you said your 'pm' is writing your scripts.
Confused...did you mean gp.

Try not to worry to much....but don't let them send you to Greece in pain.
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Old 11-11-2008, 09:43 AM   #6
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Re: Izzy Needs Your Help!

Izzy honey,

I'm so sorry this happened. I don't think it's fair the way your old doc has handled this, but I think maybe a switch to a PM doc will be a good thing in the long run. (In answer to your question about anesthesiologists...... they do make some of the better PM docs) It's just possible that a good PM doc would feel more comfortable with the occasional increases that we all need from time to time. I think your old (current) doc has just reached his comfort level with meds and if I remember correctly, I think you mentioned that he was in a relatively new practice and that the other docs there do not even prescribe opiates/opioids. He might be succumbing to pressure from the rest of the practice. (Still, not the best way to handle discharging you as a patient)

Has he at least said that he will speak to or write a letter to a new doc? Maybe if he does that, any new doc you see would have a certain comfort level with continuing your meds for now. At least so you can go to Greece without worry.

Not sure when your appointment is with the ortho, but please let us know what he says, OK? Please know that you are always in my thoughts and prayers, even though I haven't been on as much as I used to be. Take deep breaths and vent here as much as you need to. We'll be here for you, hon. I'll check back in later to see whats going on. Warm gentle hugs, CMP/MM

 
Old 11-11-2008, 01:33 PM   #7
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Re: Izzy Needs Your Help!

God love you Izzy - I had just about given up on the board - I have so much on my plate ugh - thou I love me some cmpgrl, sky, ex and a whole bunch more - something pulled me here today - I will be on my knees for you - the Lord is going to take care of you - remember he is in control of everything- you start holding back on your meds so you will have extra traveling - the new doc will take care of you but you know that traveling is always stressful- I ended up in the ICU at Lovelace Hosp in Albukwerque(teehee cannot spell) and they treated me like the Queen of Florida had arrived- I just know this is going to be okay for you so you hang in there - you and I have a connection and I know it is going to be okay - work with the guy and he will work with you
huggs Aver

 
Old 11-11-2008, 03:38 PM   #8
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Re: Izzy Needs Your Help!

Izzy,
I read your post couple of times, honey, in order to help you with your questions but got confused as well. I did not get it who suppose to write script, who wouldn't? I wish to be able to help you more, but can't at this point.

My PM DR is in NYC, about 1 1/2 hours away from my house. I have to see him every month but if I don't feel good at the time of my app I call them and they send me Rx by mail. One time I called later than needed for the re-fill and they at first faxed Rx to my Pharmacy for only 10 pills and than mailed it to me in hard copy.
I guess it up to State rules or something?

Best of luck to you and have a great time at Greece - I love it there, beautiful and so much history!

 
Old 11-11-2008, 04:58 PM   #9
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Re: Izzy Needs Your Help!

Hi Everyone!!!!
Im such a dork...I meant to say that my GP was the one who discontinued my scripts. He and my ortho visited, and my ortho told him that he thought I would benefit better by having a PM doc. My GP agreed because he isnt comfortable with prescribing the amount of meds I need to even keep me functioning. Sorry I wrote the post when i was so tired and couldnt hardly keep my eyes open.

Heres what happened today at my ortho appt...
I went in and he knew I was upset. We agreed that my GP really does care, and has cared, but isnt comfy being in the new practice dosing out what I need. He told me that hes had many pts. who werent being treated adequately by their docs and most ppl either suffer, and try to hang in there or take more of their meds to accomodate their needs, and I shouldnt feel crappy about myself at all. He said he wanted me to go on my trip and that he will take care of my pain needs until he can get me into a PM doc that works for the both of us. I was really relieved.
He said my old doc, my GP still wants to be in the loop, and hes hoping I can find a PM doc as well. I was with this guy for 3 yrs, never under contract, and IM really kind of bummed everything turned out this way. I told this to my ortho today, and he told me not to worry, he wouldnt leave me in the weeds.
So I guess the trip is on, I wont have any more news until thursday when we meet and hopefully he will have some PM docs to choose from.
I wanted to say thank you to everyone for your support and love. Moldova, Aver my girl, Camp, Sky,Mush, Frosty, and everyone who read my post. Sorry again for the confusion.
xoxoxoxo,
IZZY'SMOM

 
Old 11-11-2008, 05:10 PM   #10
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Re: Izzy Needs Your Help!

Quote:
Originally Posted by cmpgirl View Post
Izzy honey,

I'm so sorry this happened. I don't think it's fair the way your old doc has handled this, but I think maybe a switch to a PM doc will be a good thing in the long run. (In answer to your question about anesthesiologists...... they do make some of the better PM docs) It's just possible that a good PM doc would feel more comfortable with the occasional increases that we all need from time to time. I think your old (current) doc has just reached his comfort level with meds and if I remember correctly, I think you mentioned that he was in a relatively new practice and that the other docs there do not even prescribe opiates/opioids. He might be succumbing to pressure from the rest of the practice. (Still, not the best way to handle discharging you as a patient)

Has he at least said that he will speak to or write a letter to a new doc? Maybe if he does that, any new doc you see would have a certain comfort level with continuing your meds for now. At least so you can go to Greece without worry.

Not sure when your appointment is with the ortho, but please let us know what he says, OK? Please know that you are always in my thoughts and prayers, even though I haven't been on as much as I used to be. Take deep breaths and vent here as much as you need to. We'll be here for you, hon. I'll check back in later to see whats going on. Warm gentle hugs, CMP/MM
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Camp...You are right on with everything you said. And actually my ortho tonite told me he would write for me meds to get me thru my trip and that he wanted me to go, and thought it would do me good. So I guess Ill figure it out. when I told my ortho I was going to stay home because Id been thru WD before, he said "oh no, you need to go, and WD's are so rough. Just dont fill your script at the reg pharmacy youve been going to. Go somewhere else."

I told him that if my reg doc would have felt comfy prescribing me what I needed none of this would have happened. Im not a bad person, and if I had the meds I needed, I wouldnt ever be in this situation. He said he knew that, and that a PM doc will be able to help me like I need to be helped. I know that too. Being undermedicated is terrible. I can recall posts where Shore, or someone used to tell me I was horrible undermedicated.
My LA meds were 25mg. 3xdaily, and BT were 20 mgs 4Xdaily.
Ill be happy to have a PM who can have my LA meds more than my SA meds. I just couldnt get that thru to my old doc.

One thing that really stood out for me is this: My GP who had been prescribing for the last 3 yrs with no contract, said this to me once..."Its hard for us docs, because we can get sued if we DONT treat pain adequately, and we can get sued if we prescribe too much." That and the fact that he would also allow me to take more than needed when I would call and ask. I hadnt been calling him at all, or had any "emergencies" other than to ask to take more meds or have any other things pop up... I always called every three weeks to get me script because I had to mail it to the compound pharm, have them fill it, and send it back to me all within a M-F work week They are only open m-f for compounding. The pharmacis obviously has some issues with state board coming, and it may not even be me...I just dont get how he has okd every refill and then this. As hubby stated..."Honey, think about the tons of times you've had to drive back or send back scripts that he wrote wrong...hes getting old and forgetful, and Im kind of happy you are going to get a doc who knows what to do for you."

If he wanted to pass me off on someone he could have done it sooner, and I wish he would have. Oh well...Ill have to take my lumps. i DREAD, dread, looking for a PM doc. I hope its not as bad as some of the horror stories...
xoxoxox,
IZZY'SMOM

Last edited by IZZY'SMOM; 11-11-2008 at 05:36 PM.

 
Old 11-11-2008, 05:52 PM   #11
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Re: Izzy Needs Your Help!

Hey Izzy...Sorry I haven't replied sooner as I haven't been feeling too well lately. As always, I'm here for you if needed.

So, if I understand things correctly, your GP, or your Doc that moved away, is the one who discontinued your meds? This is the guy who you've had to travel multiple times to on a very long round trip? It sounds as if he's bound to many new policies at his new practice, and given some of the past issues, he's gotten cold feet. I would imagine that the call from the pharmacist didn't help....Maybe was the straw that broke the camel's back. A pharmacist can be a patient's biggest advocate, or biggest nightmare.

To answer your question in your original post of what type of Doc one would recommend, there are five types of pain Docs, IMO:

(1) A GP who also treats patients with pain.
(2) A GP who has attended seminars and has a unique interest in PM and has developed a speciality within his/her practice.
(3) A rehabilitation Doc; one who specializes in injuries, workers comp, and etc.
(4) Anesthesiologist who specializes in PM.
(5) Hospice

While all are qualified, the third type tends focus on rehabilitation...Injections, and other type of treatments. They tend to have a very unique perspective in treating pain....Much different than the others. Some of these Docs won't prescribe meds at all, or in very limited amts. However, some will use meds as necesary, but also are very heavy on the rehab part of things, or functionality.

Anesthesiologists tend to focus on meds, especially with those who have been diagnosed with "chronic" conditions that aren't expected to improve. They are comfortable prescribing stronger meds due to their very unique background. Conversely, the GPs tend to sometimes be the opposite for the obvious reasons. GPs who haven't adopted pain contracts, or put other monitoring programs in place, tend to be watched more closely by gov't oversight.

Hospice Docs focus on end of life situations and strive to keep patients comfortable and relaxed.

I use an anesthesiologist....I started with a GP who specialized in PM, but was eventually referred to my current Doc. Thus, this is the kind of PM Doc I would recommend. However, all are very qualified in treating pain and it often depends on one's condition as to what type of PM Doc would work best. It's also important to note that not all Docs can be forced into one of the five buckets. Some GPs for example, are very compassionate and will treat pain accordingly.

Hope this helps, and I hope you situation gets resolved. Your Ortho's comments are very encouraging. Please let me know if I can help with anything.

Take care,

Ex

 
Old 11-11-2008, 10:10 PM   #12
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Re: Izzy Needs Your Help!

Ex~
Im SOO glad you posted. Ill write tomorrow when I have more time. I miss all of you guys' posts and advice, so good or bad, please Id love your FB.
Gotta get to bed... I hope everyone has a pain free or minimal pain sleep night.
xoooxx,
IZZY'SMOM

 
Old 11-12-2008, 12:43 PM   #13
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Re: Izzy Needs Your Help!

Glad to hear that the ortho is supportive. Yes, you do need to go on your trip. I hope you have enough meds to cover your pain so you can enjoy the trip without missing anything.

Ex hit it right on the head. I never thought about there being different types of pm docs as all of the docs in my pain management group are anesthesiologists.(at least I think so)

With all you've been through with your gp I think the stability of a pm will change your life. Your doc may have been 'taking care of you' but the ups and downs were not good for your stress level. It may take awhile to get settled into a routine and you may have to try a few things before your medication is settled at a level that controls your pain well but it will be worth it in the long run. This is a good thing.

Anyway, have a great trip. Think of it as a new beginning. Relax and enjoy!!!! Keep us posted.~Mush
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Old 11-13-2008, 05:07 AM   #14
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Re: Izzy Needs Your Help!

Izzy, I posted but some how it did not go through. Just wanted to tell you I went through choosing a PM & came here to ask advice of course. I ask two of my doctors to give me a couple names & chose the one that came up as a recommendation more then once. I also asked people I knew that worked at hospitals.
I also let the doctors know that I really wanted someone with alittle compassion. At that time I was fed up with doctors that lacked just that. My surgeon gave me a script to get into PM & I ended up making the of trying an anesthesiologist. I ask my SIL to call a couple of the offices & ask if they dealt with myofacial damage, which at the time is what the dx was. I took into consideration how the staff answered questions & how myself & my SIL was spoke to on the phone. I was sick of dealing with receptionist & MA, nurses that were disrespectful.
We did run into a couple offices that were not real accomadating or kind of rude. So those were ruled out right away. With the PM I have now I have discovered his staff is really caring & I believe partly because he deals so well with both his staff & his patients.
Thus far everything has gone pretty well with my PM but I can remember how I worried about choosing the right one.
I am happy you got your meds & really I think a PM is the way to go. They specialize in chronic pain keep up what may work for what. Enjoy your vacation & take care. God bless, Sammy

 
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