It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Chronic Pain Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 11-28-2009, 04:52 PM   #1
Newbie
(female)
 
Join Date: Nov 2009
Location: South Carolina
Posts: 9
HurtsSoMuch HB User
UA Worries

hello ... i just have a question, if anyone can help ... i'm taking 5mg OxyIR's for my pain & i had a few really bad days this month ... took a few extra over a few days ... i know i should've called my PMD, but i didn't ... i have an appt in 5 days, but only have enough meds for 3 days ... my question is will my levels be passable if i spread the 3 days' worth out over the 5 days?? i'm scared to death that i'll be fired by my PMD & i really didn't mean any harm ... i'm definitely going to tell him that what he's prescribed isn't sufficient, but until then, i have to pass a UA!! any help would be appreciated.

 
Old 11-28-2009, 09:52 PM   #2
Senior Veteran
(female)
 
backhurtz's Avatar
 
Join Date: Oct 2008
Location: NY, USA
Posts: 534
backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
Re: UA Worries

I would suggest that you talk with your doctor and tell him that you took extra before you take the UA. And discuss with him that you feel undermedicated.
As far as whether or not, spreading them out will give you a sufficient blood level to pass the UA or not, I don't think that anyone here can answer that question since it depends on what test he uses and the reference ranges.
Back

 
Sponsors Lightbulb
   
Old 11-29-2009, 08:15 AM   #3
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: UA Worries

Welcome to Healthboards. I hope you find your time here beneficial. Many here have lots of diverse experiences, thus, can offer lots of support and guidance.

I'm sorry to hear about your problem. Please know, however, that you are not alone in this. Many, Many CPers have all been in the same boat. Some may disagree with me when I say this, but IMHO, most PM Docs give you a months supply of meds and it's up to you to make it last. Sure, there are directions, but in many cases, the directions are very vague. For example, on my BT meds, it's says "take as needed for pain." That's it. So, if I truly take "as needed" some months, I may come up short. However, I signed a contract saying "no early refills." So, to me that means that I can take it however I want to, if I run out, then I run out. It's that simple.

And unless you're going through something unusual, like a transition to a new med or something, it's really unacceptable to ever tell a Doc you've run out. It's much better to tell them that you may run out, or that you're just not getting good coverage and thus, have to watch the clock for the next dose.

There have been times when I've had a bad spell of pain, and then I know I just have to ration my meds somewhere else. It's a very uncomfortable feeling because when you're in pain, you know the meds will help....However, it comes with a price....Taking less at some other point.

If it were me, I'd spread my meds out however I thought was best for my situation. As long as you take some of your meds 12-24 hours before your UA, you should be fine. There is a very narrow window for UAs, much more so than most realize...Usually 24-36 hours. Anything outside of that window is questionable that it will show up. In fact, those on regular narcotic therapy tend to metabolize their meds faster than those who don't, thus, causing the narrow window.

It's practically impossible to determine one's therapeutic level via a UA. Sure, some very expensive tests attempt to, but they are very inaccurate and unless something is way out of bounds (like really high), the results are of little value. There are so many inter-related components that determine your current blood plasma level....Metabolism, foods consumed, other meds taken, the time of the test relative to the last dose time, and etc. The UAs are looking for the presence of the med you're prescribed and for the absence of non prescribed meds and illegals.

Irrespective of your situation, the most important part of any UA is to very accurately inform the nurse (or whoever is filling out the form & asking the questions) when you took your last dose. This is critical because they match the level found (or not found) back to when you took the dose. For example, if you were getting a UA at 10AM and you told them you took your last dose sometime very early that AM or right before bedtime, it should show up in your screen. The absence of the med would likely indicate the patient was not being truthful.

However, if your UA is at 10AM and you last took your IR dose sometime very early in the AM the day before, it may or may not show up. So, if it doesn't, then they can match your supplied information to the test result. A good Doc would then know that even though the med wasn't found, it's likely because it had been metabolized.

To give me a little better idea of your situation, how many per day are you allowed and what time is your appointment? I'd be happy to suggest a more specific solution, if you like.

I think all will be fine. Most of us have been through something like this and it takes good discipline sometimes. However, this is assuming you're on the right dose to start with. You may in fact need to talk to him about the meds not covering your pain. I would tell him that you have to count down to clock because the pain is so bad and you're just not getting good coverage.

Getting an increase is sometimes an illusive task for some....A lot depends on the Doc and how compassionate they are. Another good strategy is to ask the Doc if it's reasonable to be able to have a pain level of 4 or 5 so you can live somewhat a normal life...Or ask him what is a reasonable level....And tell him that you're not there and could he help.

Regards,

Ex

 
Old 11-29-2009, 10:30 AM   #4
Newbie
(female)
 
Join Date: Nov 2009
Location: South Carolina
Posts: 9
HurtsSoMuch HB User
Re: UA Worries

thanks so much, both of you ... Ex, my dosage is 5mg OxyIR x 6/day ... any ideas? mostly appreciated!! and YES it is a low dose ... a "starter" if you will ... maybe he'll be inclined to increase me just based on that fact.

 
Old 11-29-2009, 08:18 PM   #5
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: UA Worries

Quote:
Originally Posted by HurtsSoMuch View Post

thanks so much, both of you ... Ex, my dosage is 5mg OxyIR x 6/day ... any ideas? mostly appreciated!! and YES it is a low dose ... a "starter" if you will ... maybe he'll be inclined to increase me just based on that fact.
Six doses per day gives you some flexibility. I was worried that maybe you were only permitted a couple per day....That could have been an issue. Sounds like you should be able to take almost 4 per day for the last 5 days. Depending on what time your appointment is on the last day, I'd make sure I took at least one dose, preferably (2) 12-16 hrs before your appointment. If so, you'll be fine. Keep in mind that it takes a couple of hours for the med to move through your system, so don't take it too close to the appointment time.

Best of luck to you.

Regards,

Ex

 
Old 11-30-2009, 10:14 AM   #6
Senior Member
(female)
 
Join Date: Dec 2008
Location: NC/USA
Posts: 243
katlovesdogs HB User
Re: UA Worries

They ususally ask you when you last took a dose so they know what the levels should be as well.

 
Old 12-01-2009, 07:40 AM   #7
Newbie
(female)
 
Join Date: Nov 2009
Location: South Carolina
Posts: 9
HurtsSoMuch HB User
Re: UA Worries

thanks again ... i will do JUST THAT!! my appt is at 11am, so i'll take 2 caps before i go to bed (after midnight) to be sure i've got some in my system ... i'm very grateful for your input!! mwahhz!!

Last edited by HurtsSoMuch; 12-01-2009 at 12:06 PM.

 
Old 12-01-2009, 10:42 AM   #8
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: UA Worries

Please let me know how it goes. Best of luck...I'm sure all will be fine!

Regards,

Ex

 
Old 12-07-2009, 02:06 PM   #9
Newbie
(female)
 
Join Date: Nov 2009
Location: South Carolina
Posts: 9
HurtsSoMuch HB User
Re: UA Worries

well, my appt. with PMD was rescheduled (by them) .. doc's in depositions for a court case or something ... think that's what she said ... anyway, now my question is this .. lol .. when i went in last month & got acquainted with them, the nurse said that "we do random urine tests 4 x a year" ... ya think maybe that means they don't do a UA each visit? i didn't think to ask her at the time, but now i'm wondering, especially since my appt was changed .. anyone got any insight?? thanks!

 
Old 12-07-2009, 09:33 PM   #10
Member
(female)
 
Join Date: Sep 2009
Posts: 92
LuvMyPittie HB User
Re: UA Worries

... Hi...

Good for you it worked out for you, but In am curious as to why youre concerned about random UAs and when they are given ?

Just curious. The randoms dont bother me at all, and just , guess, wondering what a reason for worrying about a PM random UA would be.

Dont mean to be mean. Just wondering

Last edited by LuvMyPittie; 12-07-2009 at 09:36 PM.

 
Old 12-08-2009, 05:37 AM   #11
Newbie
(female)
 
Join Date: Nov 2009
Location: South Carolina
Posts: 9
HurtsSoMuch HB User
UA ~ wth?

either you misunderstand me, or i'm not speaking proper English ... i'm not "worried" about random UA's at all .. i was only asking if anyone had any insight on this ... "we do random urine tests 4 times a year" ... that part is clear & it's no problem ... my "wonderings" were whether or not that means they also do a UA at EACH visit ... i expected one, but now they've rescheduled me, so i won't test + for oxy's .. i'll be out by then & didn't see the need to ask for a refill for just a week's worth .. SO, i wasn't clear on the "UA each visit" issue when i talked to her & i had so much stuff spinning around my head at the time, that it's all kinda blurry ... heck, i didn't even take a copy of the contract i signed that i didn't read!! this is my first time in PM .. my PCP always Rx'd my meds for me, so this is all very new & scary for me ... as for my "worries" ... maybe normal people don't worry over the things that i do, but i have OCD & yes, i tend to worry alot more than the average person about "trivial" (their word) things ... anyway, i asked a simple question .. i didn't come here to be attacked .. ~peace~

 
Old 12-08-2009, 08:00 AM   #12
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: UA Worries

Quote:
Originally Posted by HurtsSoMuch View Post
.. when i went in last month & got acquainted with them, the nurse said that "we do random urine tests 4 x a year" ... ya think maybe that means they don't do a UA each visit? i didn't think to ask her at the time, but now i'm wondering, especially since my appt was changed .. anyone got any insight?? thanks!
If they re-scheduled you and you'll be "out", then you have a perfect reason for not having any med in your system. Sounds as if that whole issue has worked itself out. Will you go into WDs? If so, I'd call them. I'm sure they'd give you a short term script. Or, just give you a month's worth but still make you come in at your appointment. I'm sure they had to do this for others.

As far as your UAs, it appears as if they do them quarterly. It's probably up to 4 x a year. However, I will tell you that most offices rarely stick to their pre-determined schedule. If they say 1x, it could be 1x, 2x or even 3 x...Or 0 x. All sorts of reasons why....Everything from getting behind to they suspect others. Normally, the office has a protocol to test so many per day and it's random, unless of course, they suspect someone.

I would suspect that early on, you'll probably be tested more frequently than not, so they can establish a relationship and trust. It's also plausible that not nearly as much testing will go on and they just told you that. The moral of the story is that one has to be following the rules or they'll eventually get caught. Most UAs are actually set up that way. I made a comment to my Doc once that it would be better to have mandatory UAs or blood test every visit and catch those folks who shouldn't be there real quick and weed them out, and he replied that he'd rather do it randomly and sporadically because it catches them off guard this way.

Best of luck at your appt.

Regards,

Ex

 
Old 12-08-2009, 10:26 AM   #13
Senior Member
(female)
 
Join Date: Dec 2008
Location: NC/USA
Posts: 243
katlovesdogs HB User
Re: UA ~ wth?

I went a whole YEAR with out a UA.I always made sure I had meds on hand to be present because there have been times when I have taken an extra pill here or there so could have run short, and for nothing. Then I got a test.They said they had gotten "behind" that there were people who had never had one at all and others it had been months. So far it has been 4x a year or every three months. They call them "random" because you will never know which visit.I have had them 2 months apart then 4 months etc...
They always ask when was the last med taken so they will know what to expect in the report. So I agree with Ex, this could be in YOUR favor. They changed your appt, you ran out of meds so nothing in your UA.

 
Old 12-08-2009, 01:06 PM   #14
Newbie
(female)
 
Join Date: Nov 2009
Location: South Carolina
Posts: 9
HurtsSoMuch HB User
Re: UA Worries

thanks, both of you!! as for w/d .. no, i'm fine .. in fact, i took my last meds yesterday a.m. & i'm fine .. thank goodness ... i can't even imagine w/d's ... i have a drug-addicted son (on methadone now) & i've seen how bad opiate w/d's are .. maybe that's one BIG reason that i obsess so badly over all of this ... i have a fear of being dependent on them ... i guess it comes w/the territory, unfortunately ... i spoke to my nephew today ... he's also a patient at the same PMD i go to (has been for like 5 yrs) ... he said NO, they do NOT test each visit .. it IS random ... which is COOL w/me!! i was also concerned with the expense of it as much as anything, as i am self-pay ... anyway, between y'all & my nephew, my question has been resolved & i promise that i'll TRY to not worry so much (yeah, right!) .. lmao ... **bad girl .. take yer OCD meds!**

thank you, again!!

 
Old 12-08-2009, 04:26 PM   #15
Member
(female)
 
Join Date: Sep 2009
Posts: 92
LuvMyPittie HB User
Re: UA Worries

Proper English was heard. I meerly asked a question. Did say didnt mean to offend/ make mad.


Just when u read about people stressing about random UAs/ running out early...etc...makes ya a little punchy...Least wise me.

Been in PM 5ish years same DR, and Ive read how some people on here are getting dropped for carious reasons, how theres some that abuse, how the DRs are getting tougher to come by ..etc..because of miss use of PM.....if that made sense.

And the people that make it so hard on us ligit CPrs/PMrs..just irritates me..as it should you.

Didnt mean to offend. Just asked a question

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Worries--does anyone have the kind I do? I_M_Scared Obsessive Compulsive Disorder (OCD) 7 11-03-2010 05:12 PM
Anxiety and itching, health worries can anyone relate? Aryana70 Anxiety 12 10-15-2009 10:16 PM
Anxiety, worries, no family support Photography38 Anxiety 2 02-20-2009 06:51 PM
puberty worries Tyler62 Sexual Health - Teens 3 08-26-2007 10:24 AM
Pap Smear & Pill Worries! brandy_bean Women's Health 3 03-08-2007 09:54 AM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added








TOP THANKED CONTRIBUTORS



gmak (38), katlin09 (20), cspineguy (19), tortoisegirl (18), BB07 (17), Moldova (13), Shoreline (13), LadyBassPlayer (12), jonnstar (11), nochange (9)

Site Wide Totals

teteri66 (1164), MSJayhawk (997), Apollo123 (898), Titchou (833), janewhite1 (823), Gabriel (758), ladybud (745), sammy64 (666), midwest1 (665), BlueSkies14 (610)



All times are GMT -7. The time now is 04:26 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!