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Iowa1976 10-04-2012 10:26 AM

I messed up and not sure what to do?
 
First of all I have severe Neuropathy that affects my feet, legs, hands, arms, hips, chest and now in my bladder. I also suffer from sometimes severe flank pain. Dr's say the kidneys are fine and that the Neuropathy more than likely is moving into that area. In 2011 I started seeing a Pain Management Dr. and he put me on 7.5/325 Hydrocodone 6x a day and 800mg Gabapentin 4x a day. In the time that I was seen at this clinic, my pills started coming up missing. I would run short almost every month. Sometimes my pill were just plain gone???? I was at an appointment and the Dr. came in didn't say hi just said who is ??????;;;;;;???????. and I replied he is my brother, why? Well he has been red flagged and it could pose a problem with you because your names are so close. Anyway about two months later someone stole a 300lb safe out of my house that contained my pills. Needless to say the Pain Management clinic dropped me. I went to my PCP and she said that she would take over my pain management. She handed me a contract and said it is identical to the one I had with the pain management clinic. So for the last 3-months she has been handeling it. I was injured on the job and sprained my rotator cuff. They gave me a little bit stronger pill. When I was with the PM clinic if I was to receive medication from another Dr. I was to call and let them know. So since it was the same contract, I called my PCP and let them know that I was injured and what they gave me. All was well. I currently am not under workers comp care anymore. So about 3-weeks ago I woke up with extreme pain in my groin. I mean like somebody took a baseball bat and hit me between the legs. I did not want to go to my PCP for one it's a she and it was a little embarrasing. So I went to an Urgent care clinic. They diagnosed me with Epididymitis. For you that don't know what that is, it is an infection basically in the testicular region and it is very painful. I told them I was already taking Hydro and it wasn't working. They gave me percocet and Cipro. I called my PCP and informed them of the diagnosis and medication. About 5-days later. The pain was too much and I was on the other side of town. So I went to another Urgent care facility. Which was the same clinic, but just on the West side. They seen in my file that I seen dr. so and so and what his diagnosis was. They gave me a shot of an antibiotic and I had a ultra sound done. She gave me a little bit stronger percocet, and once again I called the PCP and informed them. About a week later I was still having alot of discomfort. I went back to the original urgent care clinic and was given Levoquin and a stronger Hydrocodone. I called the PCP and informed them. Next thing I know I get a call from my PCP saying I have breached the contract because I received pills from another dr. I have been red flagged. Even though they said the contracts were the same. I did what I was supposed to, and now it's all against me. Anyway, they are no longer going to handle my pain management. I am pretty much SOL on this. I have been wanting to find different things to help with this Neuropathy. I heard a person can get the nerves "deadend"? I am addicted now to these pills, and I want off them, but am in pain all the time. I am thinking about going to a Methadone clinic to help get off the pills and hopefully at the same time will have pain relief. Is there anything else I can do? I really need help with this. When I am in pain, my glucose levels get hight and sometimes too high and I end up in the hospital. If your a diabetic and your blood gets high, it feels like my body is on fire and cramping and they give me IV pain medication. Anyway it is just a viscious circle. Any ideas of what I can do?

luvinmusiq 10-05-2012 12:00 AM

Re: I messed up and not sure what to do?
 
[QUOTE=Iowa1976;5067030]First of all I have severe Neuropathy that affects my feet, legs, hands, arms, hips, chest and now in my bladder. I also suffer from sometimes severe flank pain. Dr's say the kidneys are fine and that the Neuropathy more than likely is moving into that area. In 2011 I started seeing a Pain Management Dr. and he put me on 7.5/325 Hydrocodone 6x a day and 800mg Gabapentin 4x a day. In the time that I was seen at this clinic, my pills started coming up missing. I would run short almost every month. Sometimes my pill were just plain gone???? I was at an appointment and the Dr. came in didn't say hi just said who is ??????;;;;;;???????. and I replied he is my brother, why? Well he has been red flagged and it could pose a problem with you because your names are so close. Anyway about two months later someone stole a 300lb safe out of my house that contained my pills. Needless to say the Pain Management clinic dropped me. I went to my PCP and she said that she would take over my pain management. She handed me a contract and said it is identical to the one I had with the pain management clinic. So for the last 3-months she has been handeling it. I was injured on the job and sprained my rotator cuff. They gave me a little bit stronger pill. When I was with the PM clinic if I was to receive medication from another Dr. I was to call and let them know. So since it was the same contract, I called my PCP and let them know that I was injured and what they gave me. All was well. I currently am not under workers comp care anymore. So about 3-weeks ago I woke up with extreme pain in my groin. I mean like somebody took a baseball bat and hit me between the legs. I did not want to go to my PCP for one it's a she and it was a little embarrasing. So I went to an Urgent care clinic. They diagnosed me with Epididymitis. For you that don't know what that is, it is an infection basically in the testicular region and it is very painful. I told them I was already taking Hydro and it wasn't working. They gave me percocet and Cipro. I called my PCP and informed them of the diagnosis and medication. About 5-days later. The pain was too much and I was on the other side of town. So I went to another Urgent care facility. Which was the same clinic, but just on the West side. They seen in my file that I seen dr. so and so and what his diagnosis was. They gave me a shot of an antibiotic and I had a ultra sound done. She gave me a little bit stronger percocet, and once again I called the PCP and informed them. About a week later I was still having alot of discomfort. I went back to the original urgent care clinic and was given Levoquin and a stronger Hydrocodone. I called the PCP and informed them. Next thing I know I get a call from my PCP saying I have breached the contract because I received pills from another dr. I have been red flagged. Even though they said the contracts were the same. I did what I was supposed to, and now it's all against me. Anyway, they are no longer going to handle my pain management. I am pretty much SOL on this. I have been wanting to find different things to help with this Neuropathy. I heard a person can get the nerves "deadend"? I am addicted now to these pills, and I want off them, but am in pain all the time. I am thinking about going to a Methadone clinic to help get off the pills and hopefully at the same time will have pain relief. Is there anything else I can do? I really need help with this. When I am in pain, my glucose levels get hight and sometimes too high and I end up in the hospital. If your a diabetic and your blood gets high, it feels like my body is on fire and cramping and they give me IV pain medication. Anyway it is just a viscious circle. Any ideas of what I can do?[/QUOTE]

Hello and Welcome to the board :) After reading your post this is the best place for support and suggestions. As a matter of fact, I haven't been on here in awhile. I was hospitalized due to my disease and even after I came home I just relaxed. But I'm back!!!!! I feel so bad for your circumstances. Please don't take this the wrong way but, I am shocked that you didn't get kicked out earlier. And trust me...I know what you are going through if you are in constant pain all the time. But you went to the urgent care centers too many times and got medication. Too them they consider that dr shopping. When you started to realized that the meds wasn't doing anything you should have contacted the doctor who is prescribing the meds. With all the bad luck you had with missing meds, you had with the pain management doctor they start thinking you are abusing your meds. Doctors will be quick to drop you as a patient because of how crazy the DEA has become on this issue. If they start looking in the records and ask the doctor "why are you giving this patient so many early refills". They are really strict and no nonsense about the contract agreement. They need you to know what you can and cannot do. But most pain contracts are pretty close to the same and what mines say is you cannot get any pain meds from another doctor and if you are not getting any relief you need to call them. The hospital is usually the only place you can receive pain meds from. I know what you are saying...."I did what I was suppose to do" but It looks very suspect going from clinic to clinic.That's just it you have had multiple prescriptions from different doctors in less than a month. That is one of the biggest rules that most pain contracts say. How many was the pcp prescribing for you? and what was the regiment? Maybe all the pcp had to do is play around with different regimens until you find one that work. Now I was kind of confused on one part of our message and that is...you are getting meds from other urgent care clinics. Were they giving you scripts or it was something you would just get one dose at the clinic? Well if you were getting scripts then maybe you can still have a chance in seeing another physician as long as you haven't been red flagged. You said you are addicted to the meds....I am not saying you are. Did you know that you may not be addicted. Instead it's more dependent on the meds. But whatever happens I really wish you the best of luck. If you decide to find another physician to manage your pain PLEASE read the entire contract and ask plenty of questions if you are not too sure about what you can and can not do. Sorry I was just rambling but I was watching Investigation Discovery Channel and I would stop typing and then when I look back down to finish, I'd think of something else to type. lol. My heart is going out to you because I do believe that nobody can tell me how I feel in my body. You just want some quality of life...one way or another. Please keep me posted and let me know whats going on.

Ilovemycutedog 10-05-2012 07:38 AM

Re: I messed up and not sure what to do?
 
Hi there...

Sorry to hear of your situation but I have to agree with Luv...It's surprising they didn't dismiss you earlier from the Dr.s office because they things you mentioned were not actual ER issues to need immediate care.

To say that you needed to go to and Urgent Care because you were embarassed to go to your female PCP just doesn't make much sense. There are females at Urgent Cares as well. So that alone was going to look suspicious.

And then the other times not calling your Dr. and just making an appt. with them about the pain going around town to different Urgent Cares certainly is going to look fishy.

And this on top of all the medication that has been "lost" and "stolen" previously.....Do you have police records on all of those..especially the robbery of your safe? That is the only way a Dr. will accept that particular story is if you followed through and immediately called the police.

So..that being said. You may not have any choice in the matter here as now this is all on your medical records so there probably won't be many Drs. willing to prescribe anymore opiate pain medication.

A methadone clinic is for registered addicts where you have to go there every single morning, 7 days a week if I'm not mistaken, to pick up your dose of Methadone.

Now...it's really figuring out and being honest about some things here to help you figure out, with a DR. whether you are truly addicted or not to opiates.

Have you had trouble with any addiction previously? As in smoked anything or any other pills? **You don't have to answer here if you don't want to...just to answer yourself or with your Dr.

And when you were on all these opiate prescriptions from your Dr. and Urgent Care. Did you take them absolutely as prescribed and on schedule. As in did you ever take one or more than what was on the bottle?

The other issue about pain is that with Neuropathy....opiates really don't do much for that type of pain anyway....And if the Neurontin isn't doing much for you...there is Lyrica or Cymbalt to try.

As well as many other modalities to help with one's pain but I only see you mention medication. If someone only reaches for a pill to take the pain away....then that is where problems can begin.

There are choices if you find that you truly do have an addiction problem and need pain management. There are specific types of meds that those who have these issues can take that don't hit the same receptors in the brain. But it also needs to be paired with you being 100% honest with yourself and the Dr. and getting help with the emotional side of addiction if this is the case.

I do wish you luck and hope you keep us posted..

Iowa1976 10-05-2012 10:16 AM

Re: I messed up and not sure what to do?
 
[QUOTE=Ilovemycutedog;5067549]Hi there...

Sorry to hear of your situation but I have to agree with Luv...It's surprising they didn't dismiss you earlier from the Dr.s office because they things you mentioned were not actual ER issues to need immediate care.

To say that you needed to go to and Urgent Care because you were embarassed to go to your female PCP just doesn't make much sense. There are females at Urgent Cares as well. So that alone was going to look suspicious.

And then the other times not calling your Dr. and just making an appt. with them about the pain going around town to different Urgent Cares certainly is going to look fishy.

And this on top of all the medication that has been "lost" and "stolen" previously.....Do you have police records on all of those..especially the robbery of your safe? That is the only way a Dr. will accept that particular story is if you followed through and immediately called the police.

So..that being said. You may not have any choice in the matter here as now this is all on your medical records so there probably won't be many Drs. willing to prescribe anymore opiate pain medication.

A methadone clinic is for registered addicts where you have to go there every single morning, 7 days a week if I'm not mistaken, to pick up your dose of Methadone.

Now...it's really figuring out and being honest about some things here to help you figure out, with a DR. whether you are truly addicted or not to opiates.

Have you had trouble with any addiction previously? As in smoked anything or any other pills? **You don't have to answer here if you don't want to...just to answer yourself or with your Dr.

And when you were on all these opiate prescriptions from your Dr. and Urgent Care. Did you take them absolutely as prescribed and on schedule. As in did you ever take one or more than what was on the bottle?

The other issue about pain is that with Neuropathy....opiates really don't do much for that type of pain anyway....And if the Neurontin isn't doing much for you...there is Lyrica or Cymbalt to try.

As well as many other modalities to help with one's pain but I only see you mention medication. If someone only reaches for a pill to take the pain away....then that is where problems can begin.

There are choices if you find that you truly do have an addiction problem and need pain management. There are specific types of meds that those who have these issues can take that don't hit the same receptors in the brain. But it also needs to be paired with you being 100% honest with yourself and the Dr. and getting help with the emotional side of addiction if this is the case.

I do wish you luck and hope you keep us posted..[/QUOTE]
I infact did inform the my PCP of any and all meds that were given to me. I have never did any other drug in my life. I have not even tried pot. Yes, I did have a police report for the stolen safe, because not only my pills were in there, the titles to my vehicles and birth certificates were in there. I didn't report some missing pills. When I went to the urgent care it was also after the hours of my PCP office hours. I did request a Male Dr. And yes the pain medications I was taken did help. There are many people that say opiates will not help Neuropathy pain. WRONG, it does help! I have tried Lyrica, it is basically the same as Gabapentin. It works the same on me. My insurance company will only pay for so much Lyrica in a month, that's why I take gabapentin. As for Cymbalta, it makes me sick to my stomach.

Ilovemycutedog 10-05-2012 10:28 AM

Re: I messed up and not sure what to do?
 
I am just offering different thoughts/suggestions based on what you wrote.

You had written the word "addicted"..(I was only quoting you)....so I was asking questions if you have ever taken more than prescribed or done other things...

If not, then that word doesn't apply to you.

I sense that you are angry but I, and others who take time to read your message and reply are just trying to help based on what you wrote.

I'm letting you know what it is going to look like on your medical record and to other Drs.

The Drs, the state, and the DEA take opiate medication very seriously and every Dr. is under pressure to explain the actions of their patients.

Unfortunately you broke the contract and are now in this position and have to go from here.

I am trying to explain that most every Dr. is going to suggest a nerve pain medication over an opiate for nerve pain. If you tell a Dr. that the only med you want to take for your pain is an opiate....that is going to raise a red flag.

Again..I'm trying to tell you what it's like from their point of view.

All you can do now is try to find another Dr. and go forward. My main point is that no matter what the pain issue....there is so much more to chronic pain management than just an opiate or medication in general.

There is daily exercise, physical therapy, acupuncture, massage, ice, heat, injections, biofeedback, TENS unit, aqua therapy, counseling, etc.

I've been in PM for 11 years now with too many surgeries to count including 3 major cervical fusions, knee surgeries, foot surgeries, lap surgeries, a fun brain tumor. So...I empathize with pain...

I'm trying to help based on what information you provide us. I do wish you luck..

Iowa1976 10-05-2012 02:00 PM

Re: I messed up and not sure what to do?
 
Yes, I am a little angry not at anyone here or any of the Docs, just at myself. I did follow the contract. It said I had to inform them if I got meds elsewhere, and thats what I did? I would love to find things that would work. I was told there was a "deadening" of the nerves that can be done? I sit in a hot tube every night. I don't ask for pain meds. I was given them when I had this other condition and that is what got me into trouble. Any Neuropathy patients out there that have had good luck with other meds/therapy? My old PM doc said that Methadone was used for treating Neuropathy, but at that point I wasn't interested in it.

Ilovemycutedog 10-05-2012 02:34 PM

Re: I messed up and not sure what to do?
 
I'm truly not trying to be snarky but provide information.

The contract that I have is not that you contact the Dr. after you get any meds but beforehand. The only time this isn't possible is if someone is actually unconscious or in an accident being transported by an ambulance.

My Dr. would expect me to call him if I was having any extra pain or needed to seek out care with another Dr. for pain. Even if it's after hours or on a weekend...every Dr. has an after hours service where you can leave a message. It's asking them permission to get another prescription for an opiate or if they want to up the dosage of the one you are on now.

So...just trying to help for if you sign another one that you really understand what it's purpose is. As I wrote, the DRs. who prescribe opiates are under great pressure from the state and the DEA these days with having impeccable records and have to explain everything in great detail if a patient of theirs fills prescriptions for opiates from other Drs. That is why they had to dismiss you after it happened more than once. Many places do it immediately the first time around.

Anyway...as we said...all you can do is go forward...not trying to harp on it.

The other treatment for Neuropathy is as follows...

Other medications besides the ones I listed are Topamax, Carbatrol, Tegratol, or even Dilantin. I happened to use Cymbalta and it worked very well for me...What dosage did you start on?

With many meds...you need to take them at least a month (barring an actual emergency allergic reaction)....as sometimes fatigue or nausea can happen but it usually goes away after that time.

So..just in case you wanted to try that again..and even if there is nausea that stays...there are medications like Phenegran or others that can help with that. It all depends on severity and the pros of the nerve pain med outweighing the cons.

There is also a cream called Capsaicin. It is a naturally occurring substance found in hot peppers but many people with Neuropathy swear by it and it is Dr. recommeded.

There are also Lidocaine patches. These can be placed directly on the areas that give you the most pain.

There is something called a TENS unit (Transcutaneous Nerve Stimulation)...these are found inexpensivley online and you can by them used if needed. If that ends up working well...there is a permanent unit called a SCS unit that you can get surgically implanted. The Spinal Cord Stimulator has worked very well for many people who have nerve pain issues.

Tricyclic antidepressants have been known to help those with Neuropathy. Either amitriptyline or nortriptyline especially.

And then the other things I mentioned which are daily exercise. Not smoking, eating healthy meals, limit alcohol.

Acupuncture and massage is also helpful.

Treating Neuropathy or any chronic condition really takes using as many modalities as possible so that each one can take even the tiniest edge off to all add up to a decent amount enough to live a good life.

As I said earlier...believe me...I completely understand, as we all do on here, what it is like to live with chronic pain.

Keep us posted..

Shoreline 10-06-2012 08:17 AM

Re: I messed up and not sure what to do?
 
Hi Iowa, You asked about nerve deadening procedures and there are procedures that they can do, some are short term like nerve blocks and some last longer like Nerve ablation procedures, Their are two way to destroy the nerves, chemical or radio frequency ablation. More than likely a PM doc would start with blocks and see how you benefit before considering an ablation procedure. Back in the early 70's they would actually cut the nerves but learned quickly nerve tissue can grow back and the pain that returns can often be much worse, so they simply dont cut nerves anymore. Even the ablation procedures have to be repeated every 6 months to a year. Blocks generally offer a couple weeks to a couple months relief. Their are lots of other meds that Ilovemycutedog mentioned and meds would certainly be the first step before doing anything terrribly invasive and nerve blocks and ablation procedures aren't generally fun and can increase pain before they start working to decrease the discomfort.
Methadone does have properties that make it more effective on nerve pain than other meds, but their are also other meds that reproduce the effect meth has like Nemanda, it's alss a potent NMDA receptor blocking agent. If you get your meth through a meth clinic you will be red flagged once again as meth programs are state funded and patients/addicts tracked. A meth clinic is only for the treatment of addiction, patients aren't trusted with more than a weekend supply even when going for years and you have to earn that trust to get a weekend supply. Meth is also prescribed very differently to treat pain rather than the once a day withdrawal prevention method used at meth clinics. Their are PM docs that will prescribe methadone but your in a tough position having been dumped by your last 2 treating docs. If you add a history of addiction by seeking treatment through a meth clinic it will make it even tougher to get back into the PM world once labaled and treated for opiate addiction. If you dont like being dependent on the meds imagine having to plan ever day of your life around that trip to the meth clinic. I would suggest looking for another PM doc to try some of the alternatives mentioned by everyone. Your GP isn't trained to do any of the actual procedures and really isn't trained to treat chronic pain so you need a true PM doc, more than likely an anesthesiologist if you thinking about nerve blocks or ablation procedures.

Good luck, Dave


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