my doc. rushed me out ! - Pain Management Message Board

madhatter · 08-13-2004, 06:51 AM

i don't even think he looked at one entry of my pain log! And thats not like him! i've been trying hard to work, i work pt. time pumping gas on the weekends,5 hrs a day.And i believe that he thinks that since i'm working a little,i'm not in that much pain! I told him [had it in log also] my pain level has been a 7-8 ,didn't even faze him,he said,we'll keep everything the same,wrote a perscription for some kind of gel,he said he hasn't had good results with it,but give it a try anyway[for back pain]then he gave me my perscription for oxycodone 5mg I.R to take two every 4 hrs,but no more than 8! So when i got home i noticed,and called him,i said,if i take two every 4 hrs,thats going to be at least 10! and if i do that,i don't want to call your office for a refill having you's wondering whats going on! He said,and i quote"don't worry i won't leave you hanging,just call when you run out"end of quote.Now i have smor's node and d.d.d and the nuero surgon said theres nothing he can do,but recomend pain management,and my p.c doc. took on the reposability of that.I'm under the impression he thinks its healing by itself!

scotty12 · 08-13-2004, 09:08 AM

madhatter,

the quick visit wouldnt concern me.my doc has been backed up and spent as little as a few minutes speaking with me, but the qty of pills and possibly runnuing out before your next visit would concern me.

what happens when hes not in the day you call.i hate even being 1 pill short of running out until filling the next script.i know how hard it is to save a few pills but those days where maybe you slept a little later (yea sure ) after a few months even a days worth of meds is very reasuring.nobody wants to see their doc while going thru withdrawals and it doesnt look good for the patient either.

i see my dr every 28 days and get my rx filled on the 29th day.im in the same siruation where im taking 16 hrs or 4 doses of SA meds a day.what do i do the other 8 hrs.that is why its so difficult keeping extra meds on hand.so when you have a med change and wind up with any extra meds i lock them up for emergencies.it does suck being dependant on medication but it beats being in constant pain.

so your supposed to take 10 mg 5x per day (if you take it every 4 hrs) and he wrote the script for only 240/30 day supply.whens your next appt? if its 30 days you should stick it out this month and try and go 5 hrs between dose but call him on the calculated day as if you were taking 2 every 4 hrs.if he's true to his word then you know what to do next month.but if thats the case why not just write the script that way?
at 5 hr intervals you dont have to worry about running out before your next appt.
i dont understand why alot of pain drs do that.you can take your meds at 4 hr intervals but they only give you enough meds to last 28 days.

ive been having a rough time this month because i slipped on our deck and fractured a couple ribs.i also aggravated my back and because i cant really stretch daily as i usually do my lower back has these huge knots and my hamstrings just ache all the time.i didnt ask for any extra at my monthly visit.i was so tired,it was nine at night and it was one of the rare days i actually work a full day.my chest was killing me from the rib pain and my back was awful i didnt know what to grab first.i just wanted my script so i could go home and lay down.

i think it takes time to build a relationship with your pain dr.
i was having problems sleeping because i didnt have any way of managing the pain at night.every 4 hrs starting at 6am gives me relief until 10 at night,same problem as your having.so he rx'd ambien and its been working somewhat.knocks me out about 11 or 12 and im lucky if i sleep past 4am.im up to 20 mg and im building up a tolerance to that dose which i believe is the max rec dose.so i dont know what tricks hes got up his sleeve next to get me through the nights.

he will try something else before writing more than 120 pills a month.
i take 15mg oxycodone 4x a day.i usually can only go 4 hrs between doses to keep the pain levels down during the day.ive asked to step down to 10 mg 6x a day.still 60 mg a day but atleast id be able to manage the pain with a dose at 10pm and if the pain wakes me during the night.still only taking my meds every 4 hrs.doesnt want to write a script for 180 pills even though it would be the same amount of mgs per day/month.it would mean a little more pain but more even coverage.

the negative publicity of pain meds must influence the way pain dr's think.a patient whose taking 20 mg of roxi and doesnt have script coverage would take (4)5mg generic oxycodone=16-20 a day or 480-600 a month.people see that amt. in a news article and most likely think abuse but to a patient whose not opiate naive and been on meds a long time its really not alot.

maybe the news with the fda telling drs its ok to agressively treat pain will help us as patients.pain drs should understand how long a med last wheather its a SA med or LA med,and not have to worry about raising eyebrows at the pharmacy because a script seems like alot of meds for a patient,although the patient has been on meds for a long time.not every patient does ok with 2 percs 4x a day.

i think if your in a pain management program your pain should be managed by whatever it takes to restore quality of life.especially those for whom surgery is not an option with positive expectations.

hang in there and the dr doesnt come through with the 5x a day dosing as you discussed then maybe ask him about something to help you sleep.it seems to be helping for me.id rather take something for to knock me out at night instead of taking the extra pain meds and run short at the end of the month.you dont want to do that.
..........or,maybe we both should find a new dr........................scotty

Kissa · 08-13-2004, 10:14 AM

Sometimes doctors do rush you and it isn't necessarily because they thing you are doing better or want not but sometimes they may have spent a little extra time with a patient so they are running a bit short that day. It happens a lot. Many PM doc's double book because in many area's there are so many patients but not enough doctors to really spend a good 10 - 15m or so with the patient so this is when they start the double booking routine.

If I'm understandig what you wrote, your doctor wrote that you can take 2 oxy every 4 hours but not take more than 8 total in 24 hours or rather just take it 4 times in 1 24 hour period. Correct?
Well one of the things he might be taking into consideration is sleep time. As a general rule people sleep 8 hours a day so that leaves 16 hours in a 24 hour period in which you are awake, now if you take 2 pills every 4 hours that covers your 16 hours you should hypothetically be awake. Now unless you only sleep 4 hours a day or even 6 or wake up every 4 hours just to take medications then yes by the end of the month you will run short. Does that make sense? Being that he said "don't worry" then I wouldn't, I am sure he will hold true to his word.

My doctor is the complete opposite, he assumes no one ever sleeps and therefor prescribes SA meds every 4 hours for a total of meds taken 6 times in one day or 24 hour period. So if you took one pill a day he would prescribe 168 pills (meds are written for 28 days) or if you took to at a time then he writes 336, but I've never had a script written x2 so not positive. I've never run short on meds, if anything I have extra's that he tells me to save so I could take them every 3 hrs if needed.

Of course now I'm on LA meds so I don't get the above scripts formulation instead I get 3x28 for one month.

madhatter · 08-13-2004, 11:36 AM

right,he has me taking two 5 mg ocycodone every 4 hrs[10 mg] i don't understand why he just don't give me 10 mg oxycodone,and take one every 4 hrs,wouldn't that make more sense?

chriztene · 08-13-2004, 12:10 PM

madhatter,

It sounds as though your doctor is treating your pain and plans on doing so..I really wouldnt worry about it and if he said no problem if you have to phone in early that he would take care of it - I am sure he will..

PM dr's do not expect to get our levels under a 4-5 and usually will tell you this. I am grateful to even have a pm doctor who is willing to treat my pain at all. Especially, in the state I live in and the disease I have is not so common.

He was probably having a busy day and maybe next visit you can talk to him. Also, if you have been on a la medication for sometime, you can build a tolerance to the med. You might discuss these issues with him as well.