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Old 06-23-2012, 04:00 PM   #1
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What's The Real Story...

Hello All,

I'm very new to the boards and wish to introduce myself. I'm 55 years old and have Chrone's Disease and back problems and have had 9 knee surgeries. Could have had more surgeries on my knees and refused a fusion of S-1 to T-4,5. Anyway, I have problems with pain management. It has become this endless stream of Urine tests, parden the pun, and on top of everything else there are so many different answer's about what is picked up on a drug screen and all the other horror stories about being thrown out of a program.

I was bit by a black widow this month, major infection and necrosis. 3 different types of antibiotics and major over eating of allocated pain meds for this month. I was offered extra pain meds in the E.R but turned them down because I wanted to stay true to my pain doc. I am going to be up a creek very, very soon and I don't know what to do. I have other meds left over from another doctor but I just feel wierd about it all.

When did it get so complicated? The federal Government as far as I can tell only wants us to drink beer and other spirited libations, smoke cigs. and lump it.

Anyone had any trouble with Ameri#$%???

What's the real story anyway? It is painful but is it worth it?

PFirefly

"Whatever it is, I'm against it"!

 
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Old 06-23-2012, 06:39 PM   #2
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Re: What's The Real Story...

Welcome! I guess I don't understand your question here. Yes more recently getting these meds has got to be a hassle (and expensive with UAs), but unfortunately as there are folks who abuse these meds, they do what they can to try to cut down on that, so the rest of us have to put up with it. It depends on your contract...some would allow to get meds from the ER assuming its a small amount and you notify the pain clinic. But often what they would offer would be weaker than we get anyways, so it may be best to try to get in early with the pain clinic if you need a short term dose increase.

I would recommend you contact them immediately, as its better to notify them as early as possible, especially if you will be short meds. You are correct you don't want to be taking any left over meds. Sorry you have been struggling with this spider bite. It sucks, but I put up with the hassle as these meds have been the only thing to help me. To me its definitely worth it. I don't see myself having any other options right now. I guess at the same time I have a good doctor...I have heard of some getting UAs monthly, getting accused of abusing their meds as the doctor reads the test wrong, etc. I think a good doctor can go a long way. Best wishes.
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Old 06-24-2012, 08:02 AM   #3
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Re: What's The Real Story...

Thank-you Kate for the reply,

My question is a combination of things really. I have read that antibiotics have been known to give both false possitives and false negatives. Do antibiotics give false readings? That's question #1. My second point being that with GC UA screening, the company that I have to go through, Amerit**, I have read some very disturbing things about folks getting flagged for drugs that they claim they didn't take. Morphine when they have been on say.........oxycodone or hydrocodone. My second question would be: is there anyone that knows how these tests really work? And what shows up as what and so on and so forth.

I am on the lowest dosages possable by my request. With the problem I have I do not want to have to go into the hospital for an emergency bowel surgery and be complaining how I am not getting adequate pain relief. This has happened to me before. The nurses looking cross at me and being denied help because the Doctor didn't think it was "prudent".

I guess my third question would be aimed at myself. I'm wondering if all of this is worth it. But when the pain hits I do not know how I could go any other way. I'm trying to simplify my life and to be honest the pain meds always and all ways get in the way. I know that I can only answer the third question. I do not blame doctors for protecting themselves. Hard work and many years have gone into their education. I think some doctors are over testing though. I think it's greed in some cases.

Thank-you again for your kind response. Have a blessed weekend.

Truly,

PFirefly

 
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Old 06-24-2012, 08:29 AM   #4
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Re: What's The Real Story...

Obviously there can be human errors....and with the basic testing of urine "in house"....those have a much higher rate of wrong readings.

But the Gas Chromatography/Mass Spectometry tests are said to be 99% accurate themselves. Again....there can be errors with mis-labeling/handling the specimen before sending to the lab...But the test itself is the most sophisticated of it's kind and would not mistake antibiotics for anything or give a false reading based on them.

Worrying about something that 'may' happen is futile....If you are going to your Drs. regularly, build a good relationship with them...Take all your medication exactly as prescribed....as in...not taking any extra....or running out early....Then you really should have nothing about which to worry.

Only you and your Dr. can decide if you need more surgery.....Or if you feel the pain levels are bad enough to warrant opiate pain medication...

The other key with pain management is not relying soley on the opiate to lower your pain levels...

For me...I have spine issues...knee issues....ovarian cysts...another Morton's neuroma in my foot....and a brain tumor....

And I am also on the lowest possible dosages of medication...

But I also do daily exercise....45 minutes a day.
Yoga/stretching
Aqua therapy
Home physical therapy
Massage
Acupuncture
TENS unit
Counseling...(to help find healthy ways to manage pain)
Eat all Organic
Don't smoke (luckily I never have..)
Maintain a healthy weight for my height


I also use a muscle relaxer when needed...
And a sleep medicine when needed..

But for me....I still need the addition of an opiate to help lower my pain. Every modality is like a piece of a puzzle and one alone doesn't work.

I am thankful that I've been with the same PM Dr. for close to 7 years and he is absolutely wonderful. It's only been in the last year that our state is now requiring a yearly random urine test ...And he knows I don't have any insurance right now so he just tells me to not pay and it kicks back to him to write off. As well as he was apologetic to me for even having to take the test because he trusts me and knows that I have never had a single issue in all those years. He even gets frustrated because I don't take more medicine at times..He really hates to see people in pain.

But he knows that if this is a life long issue...I want to be on the least amount as possible for as long as possible..

Is your Dr. is doing this type of expensive test every month? Or are they doing just the "dip stick urine test" most months..

I would be finding another Dr. if they are trying to do the expensive one every single month.

 
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Old 06-24-2012, 02:16 PM   #5
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Re: What's The Real Story...

I agree that there is only so much you can do...choosing a good doctor goes a long way. There will always be that chance that something could go really wrong, but a good doctor will both know how to read the results and would be more willing to ask themselves why did this patient's test come back this way when there had been no other red flags. I also have that fear that if I was in the hospital they wouldn't treat my pain adequately due to my tolerance. I think in that case you would want to get your pain doctor involved. I would sure hope that most doctors would take into account your regular dose though. If its something planned, that gives you the opportunity to ask those questions ahead of time.

Sorry I don't specifically know about the antibiotics giving false readings, but I have heard there are a handful of meds and even foods or supplements which could do this. Yes a good doctor will know how the meds you take are supposed to metabolize on the test. Its more of the primary care doctor types you would worry about. I'd also hope that the only reason we do hear about these cases so often online is because folks who have a bad experience are likely to report it...we won't hear about all those times where everything works out ok. Choosing the right doctor goes a long way.

I agree they should be using the GCMS testing (not in office), but shouldn't have a need to do it all that frequently--often when you start as a patient and maybe yearly after that. Unfortunately its one of those costs of this, same as the monthly copays for office visits and meds. I sure don't like how much control these doctors have over our life due to these meds, but I don't see any other option for myself right now. I have heard of offices being able to get the cost written of or reduced, but then again, its just part of the cost of it all. Same with how if the doctor really wanted to, they could say they would only offer you one medication, and if that happened to be brand name and you couldn't afford it, oh well.

I think doctors that over test are more likely doing it in fear, not greed. I don't think they are making much of any money off these visits. I see how little my insurance reimburses them for my lengthy appointments. I'm not even sure if they get a cut of the lab testing. Mine was direct billed from the lab, not through them, but it could vary. My previous doctor frequently told me he didn't feel comfortable doing X or Y because of the DEA, yet surprisingly he didn't require contracts or UAs (I only had to do that once when I saw his associate).

Its sad that in this day and age they are trained to treat everyone like a drug seeker, but that is the best thing they have come up with..even these methods aren't anywhere near 100% at catching folks, as there are ways to get around it. You are correct that only you can answer the question of is it worth it. I can only say that for me, it is. You have a choice in what doctor you see. It an be quite difficult to find a new one though. I struggled with that for about a year as I didn't have anyone on my side who had a recommendation. Standard contracts allow you to see any doctor you wish to consult with, as long as you don't get pain meds from them. Best wishes.
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