Shoreline

Hi Casper, What you got was name brand Ultracet in the only strength it comes in. It contains 37.5 mgs of Tramadol and 325 mgs of TYlenol, made by Ortho Mcneil.

They do make a generic if price ever becomes a problem. It's simply Ultram with tylenol, Ultram has opiate properties and SSRI properties, It was touted as the wonder non addictive pain med when it came out. However since coming out they know it can cause physical dependence although it's not a true opiate. It just has opiate properties. They also found more than 400mg of tramadol per day can cause a siezure and you shouldn't discontinue it abruptly.

Personally if this is your first experience with PM, I wouldn't go ahead and decide to take more than prescribed. Docs call it self medicating. If you really want them to help, and expect them to provide pain meds at some point, blowing up and calling the person names that you want help from after a simple eval and demanding pain meds isn't actually a good start.

Don't get mad at me, but most PM clinics aren't going to through opiates to everyone that they evaluate. They are evaluating more than your condition, but your attitude and likelyhood of compliance with medications, what your expectations are from PM and whether they want to take you on as a patient. You m,ade it very clear you expected pain meds. If they don't believe n the use of opiates they aren't going to change their phylosophy just for one patient. They know there are docs out there that will treat with opiates, But if they believ you not a good candidate, you will never be steered in that direction. I think it's actually kind of weak of a doc to say we can't help you because I don't want the headaches and risks of opiates in my office and then send you to someone they know uses opiates to let them take the risks and responasability for prescribing long acting pain meds like MSContin, OxyContin, Duragesic or methadone.

That's how I got into the last clinic, was by referral from another doc who's first words to me were, we don't use pain meds to treat pain here. After doing the eval she decided I wouldn't benefit from what she had to offer because I had already done 9 epidural steroid injections in the previous 5 years and referred me to a doc that would prescribe in certain cases.

She was conservative but it was beter than nothing. Eventually she dropped my insurance and my SSD attorney recomended the clinic I go to now which was in network and in my backyear the 7 years I went through non opiate pain management. Obviously nobody wanted to steer me that way untill everything else had been tried and failed.

Doubling up and calling and asking for an early refill isn't how it's done. Expecting instant relief isn't how it's done either. Knowing your hot tempered isn't an excuse for not controlling it. Just a little advice that will get you farther finding relief.

Only you can decide if Ultracet is working for your pain, If it isn't, call the doc, But personally I would get the MRI done and then try to get your apt moved up to within 3-4 days of your MRI so they can get results soon and get to the answer and a treatment plan sooner. Otherwise your just asking for stronger meds before he has his DX and tests done, which isn't realistic.

As far as fnding what works for your pain, it's all trial and error. Most docs don't through a quick fix they know or expect, and you expect to work before they know what's wrong. If they did anyone could complain of pain and expect meds on the first visit. Yes the meds are available, but not everyone is a candidate for those meds. So you start a process of finding what works as far as treatment and modailities and finding what works as far as pain meds. Why prescribe Percocet if Ultracet works. It's a process of elimination.

Not all PM docs and clinics use opiate pain meds, there are alternatives and demanding a clinic, doc or nurse prescribe something for an eval, is a bit over the top. If your in enough pain to need a PM doc or clinic, you arrived in pain, you have been living with pain, you can go home in the same condition, and an eval isn't going to change your life that much. It's not like you can bring a law suite because the eval was uncomfortable. I would be rich and would have had my pain mnaged all those years if that was the cased. Throwing a fit just worsens your chances of impressing these docs that your serrious about finding relief and trying whatever it takes, not just what you ask for.

I'm sayng this so you don't shoot yourself in the foot expecting pain medicine evertime someone lifts your legs or has you bend or turn your body. It would be like asking for pain meds for having your teeth cleaned. It's not comfy, but doesn't require meds used to treat chronic pain.

What hurts? Sounds like back problems if they want an MRI or could be headaches, TMJ, whatever. But that really doesn't matter. When it comes to PM it's just easier to say we can't help an irrational patient if they throw a fit and demand meds just because they came to the clinic. As if there has to be a med reward for coming in and letting them examine you so they can try and help. I wouldn't bite the hand that's trying to help or you won't find relief. Or it won't apear relief is what your looking for. Just some advice from an old pro.

4 pain clinics 8 hours a day, 5 days a week from 2-4 weeks long, a work hardening program, 3 surguries, a dozen Pm docs and 7 years before I met one that used pain medicine to manage pain. Yes, I had pain meds post op, but the surgeon cuts you off on his time table.

Even if they don't have the answer that works for you,you can still take away a couple tricks to help in a clinch. Spine stabilzatioon, more knowledge of CP, the benefit of PT and excercise, nutritition and relaxation techniques like bio feedback, self hypnosis and guided imagry. If you refuse one of the steps that won't hurt you but may not be effective, you may not make it to the next step which may be the answer.

The last PM clinic I went to did use LA opiates on people they had tried evrything else and thiswas the last resort. There were obviously people there that complained of terrible pain constantly, but refused to even learn relaxation techniques or do the PT and they were denied real pain meds. They got more of the same I went through years ago, antidepressants and mood stabilizers and a referral to a shrink.

When it comes to asking someone to help you, you are on their time table. A PM doc isn't going to change phylospohies about prescribing because he has a demanding patient with a temper.

He'll just tell you to find another doc, that he doesn't think he can help. It sucks to wait a couple months for an apt and find they can't help you for whatever reason. Even if they think they can and are willing, It's still trial and error going up a ladder to find what works and your the one that has to do the trial and error part and report the effectiveness at your next apt. Some docs will go farther up the ladder than others and use long acting pain meds or short acting, and some use Darvecet and Ultram on all their patients.

As far as the glucose test, I don't think I would put off a test that's so important because it's unpleaseant.There are plenty of unpleaseant methods to manage pain, Epidural steroids, nerve blocks, triggerpoint injections, and I was never given additional meds from a procedure designed to relieve pain. The pain from the procedure deminishes and hopefully you get relief from the procedures.

Not knowing and treating a problem because your not up to it, may be why your not up to it. Waiting untill you pass out while driving and hurting yourself or someone else isn't the best way to have the problem evaluated either.

Good luck with both, Dave