Hi All,
I promised I would let everyone know the outcome of my pm visit, after all the frustration of wondering where I stand and what my future holds.
First, I would like to say that my husband's presence at the appt. played a big part in the overall scenario. I hate to think that we all need to have an additional advocate to obtain proper pm care, but it certainly seemed to be the case with me, as much as I hate the thought. My husband's "testimonial" as to my having no quality of life seemed to make a big impact on the dr. Not only that but he impressed upon the dr. how my condition has affected my husband's life as well.
It's funny but when the dr. came into the room, he had a defensive attitude that was evident. But when he found out that I wasn't gonna curse him or scream at him, he let down that defensive guard. I just told him like it was and said I'm here for my pain to be managed and that hasn't been the case in the last year. We addressed the complications I had with the pump and he said they were very rare but do happen in a small percentage of the population. He told me it wasn't my fault which made me feel alot better. He still feels that the pump would be an excellent way to help alleviate alot of my pain.
I was able to explain that the oxy was the only thing that provided some relief without intolerable side effects and since going off of them for a while (trying other meds to no avail), they do seem to work better for now. I explained what my day-to-day existence was like and how the oxy worked and didn't work at certain times; thus, my request for an increase to cover those long periods of minimal relief. He did not appear to think at all that I was a drug seeker. It seemed he understood perfectly well what I was going thru. After all, I've been his patient for four years and he should know me well by now.
Ultimately what transpired was two options (options that I didn't have prior to this visit). #1. was to increase the oxy to three per day #2. was to try a different trial for the pump - a three-day hospital stay where they could increase the morphine at an accelerated pace while in a controlled environment and what would also give him and me an indication of whether the morphine will again present the big problem I had with urinary retention. I did ask if something else besides morphine could be put in the pump and he said yes, but we're talking about some heavy duty, very strong medicine. I don't wholeheartedly agree with that, though. If the morphine should again cause problems, I can't understand why using another med would be so critical seeing that my history is evidence of opiate tolerance. That disturbs me.
So he gave me a choice of increasing the oxy now or trying the new way of doing a pump trial. I asked him if he were me which way he would go and he said with the increased oxy. So that is what I agreed to. One of the biggest problems with another pump trial is whether insurance will pay for the implanted pump again. That will be a very difficult process of convincing them of the need for a second time and I have the belief that they may not approve it. If that turns out to be the case, then I will just have to stick with the oral meds, but feel this time, he will not have a problem with increases when needed since I would have exhausted all other options.
I do feel better about my relationship with this dr. At least I was allowed the opportunity to plead my case and he actually responded in kind. As far as the pump goes, when the time comes for that and if ins. approves it (long-shot), I will get a second opinion before proceeding just to satisfy my own mind.
I appreciate everyone's support on this. I don't think I could have convinced myself to be such a strong advocate of my own health without it. Fearing another brick wall was undermining my ability to act in my own best interest. This has taught me alot about standing up for what I know is right and true and I will continue to benefit from this experience. Thanks so much, Linda
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