Please help with situation - Pain Management Message Board

IngyW68 · 12-28-2005, 08:54 PM

Hi everyone,

I need some assistance on what you would do. Sorry a bit long

Here is explanation is that in 2001 I had anterior cervical disectomy with fusion on two levels with my own bone but no hardware. Had to wear a hard neck collar around for 3 months! Was pretty much low on the pain scale after the surgery for about a year but then started getting worse and worse and started getting pain in my right shoulder and scapula area as well.

Went back to primary care doctor to evaluate and she tried all sorts of medications (not at the same time) like Morphine, Duragesic patches, Oxycontin, Percocet, and Ultram. I got sick on everything except the Oxy, Perc. and Ultam but Ultram didn't do much. She knows me well and that I like to lead an active life and my hubby and I are trying to have a baby so I don't want to be on anything too strong so I can function during the day.

She sent me to a pain mgmt. doctor and for the last year, everytime I have gone in for an appt., even a 5 minute follow up, I have to fill out a sheet saying where my pain is and shade in the area on a drawn body. I have ALWAYS said neck, right shoulder/scapula pain. Well, the pm doc decided back early spring to put me on Cymbalta and Oxycodone 5/325 3-4 times a day which really doesn't do much for the pain, I still was living with 6/7 on the scale during good days. He didn't offer any other procedures. He finally ordered an MRI in July which showed my first surgery did not fuse at all on one level and said I need to see a neurosurgeon to repair this. I said, ok, but what about my shoulder pain. He said, let's wait and see if this helps. So, I go to see the surgeon and he says, yes, you need surgery and it probably will NOT help the shoulder pain since the non-fusion is at a certain level.

So, I couldn't schedule the surgery until Dec. because of Mission trips and a vacation that had already been planned way in advance and I really wanted to go. They gave me the ok and said that no extra damage could be done only pain level. During those months, I had problems with my pm doc saying that now I am a surgical candidate, he didn't want to treat me anymore. I said that I am trying to live my life and can't have surgery until Dec. so he reluctantly kept me on the same meds. I asked time after time about the shoulder/scapula pain that is getting worse and my shoulder actually looks dislocated and moves completely different than my left. Again, he said, let's wait...

Fast forward until November and I am in NC visiting my dad and call the pm office for a perscription refill and say that my husband will come on Monday to pick up since I am away and won't return until late Monday night. Told this to 2 people in the office, one even asked where in NC I was.

Monday comes around and my husband calls me from their office saying they don't have the perscription because the receptionist says that I came on Friday to pick it up. He said that is impossible since I am in NC. She swore that it was me and got the manager and they went back and forth and still believe that it was me or someone pretending to be me and accusing me of having someone else to pick it up. I said that no one else besides my husband would ever pick up and said don't they even have a signature for narcotics and they say no. So, they very reluctantly give me another perscription.

Now comes surgery on Dec. 12th and my surgeon on the next day at release from hospital says that he doesn't take Tylenol for a headache so I don't need any pain medicine to go home with!!! The hospital says this is ridiculous and says if he doesn't perscribe something than they will. He prescribes 20 Percocets 7.5/325 to take 1 every 4-8 hours which means I could under his orders take 6 in a 24 hour period if needed (if I am adding that correctly). So, I run out in 4 days and call him for more medicine saying that I am in excruciating pain in my shoulder/scapula and need help. His office refers me to my pm doc. They say that they called my surgeon and he said that his prescription was supposed to last for 10 days!!! I said, no it was this amount and lasted 4 days. They wouldn't budge and said I am done with their office and they don't treat post-op pain. I said it's not post op pain it's my shoulder. They say, no, you shouldn't be having any post-op pain. Back and forth.....

So, I go to my pcp this past Thursday because I can't sleep, eat, etc. I am in such horrible pain. He gives me 5/325 oxycodone 30 pills which will barely last me through Christmas and I'm sitting there crying and he says, you need to go back to your pm doctor.

So here I go across the hall to them and show them the prescription and say that to please make a copy for the doc to show that I have this and my last prescription from the surgeon only lasted 4 days. The nurse practicioner comes out and says where did I get that prescription! I said my pcp since you all wouldn't provide one. She says "you deliberately disobeyed the surgeons orders and took more than you should have" Again, now with an angry voice , I am saying, NO, it was 20 pills!!! She says that is impossible and I am lying!!!! She is saying this in the waiting room with others sitting there.... Then she says I deliberately broke my contract. I said, " no, you said that you were done seeing me which means our contract is over" A contract is not for life, it means that I can't get prescriptions at the same time as getting them from you" She says that it is impossible for me to be having any pain and that they know I am lying!!!

Now, I am a very strong Christian but wanted to punch her in the nose!!!! I am standing there saying, "I just want to be sure that I understand, are you calling me a liar about my pain, and that I took the medicine the wrong way" She says, yes, you are not allowed in our establishment again, leave!!!!!

Well, I called my pharmacy and asked for the prescription to be faxed to their office to PROVE that I took the medicien exactly as prescribed and even took a little less than I could have.

Sorry for the length, really needing to vent and get opinions...

I have to see my surgeon tomorrow for my follow up and hopefully get my hard neck brace off. But, I feel that I should demand that he call my pm doctor again to tell them that he was mistaken about the quantity and amount of pills he prescribed me and that I was perfectly on track. I also want a written apology (may not get one) for my records that they were wrong in accusing me of lying about this. I also feel that they are negligent about not treating my shoulder/scapula pain and putting it off for an entire year. I swear, if something is seriously wrong and I have more damage because of that I will be even more mad!!!

I have an appt. with an orthopedic to get x-rays and start finding out what is wrong with my shoulder. But the bad part is that no one is treating my pain and I've left a msg. with my pcp but I don't know if my pm doc called them about the wrong information and told them I lied and now they are thinking badly about me.....

AHHHHHHH, I have never been so mad in my entire life. After their negligence of not requiring signatures for narcotics and then covering up giving it to the wrong person, wrongly accusing me of lying, and not treating my shoulder pain when I have told them every visit for the last year. What do you think I should do??????? What do I do about this horrible pain I am in??? I've never been to the ER before and I'm afraid that i would go and wait for hours and leave with nothing..

THANK YOU SO MUCH for listening to this whole msg. and understand if it takes people awhile to respond since it's so long.... I really apologize but needed to give the whole story to know where I am coming from and to find out what you all think I should do.

It is so great to have a place where people really understand what it's like to be in so much pain and have to feel like a child when the doctors play God and can just make decisions on whether your life is good or bad, whether we are in pain or low pain, it's awful for them to have so much power....

Hugs to everyone (((((( ))))))

Again, i am sorry for the long post

Ingy

Amsterdam · 12-28-2005, 09:35 PM

That sounds like how I am usually treated. I basically have to fight with docs to get the meds I need and all I can do is offer the experience that I have learned over time.

The surgeon not giving you a refill on the oxy's is VERY typical , or it has been in my experience. They will usually give one script for oxy and follow it up with a couple scripts for vic before they cut you off.

If you are still having pain due to the surgery you have every right to call the surgeons office and demand that they give you something for pain. They should be managing your pain from the surgery. I was never under the care of a PM doc after a surgery so I'm not too sure how that works, but I'm sure others can tell you.

Your PM docs office treated you terribly. I wouldn't just go with what the nurses say I would want to hear it from the doc personally. I am sure the nurses get ****ed with having to deal with med refills even though its their job. Even though the nurse said not to come back I would still go back and see the doc to see what the plan is. You did nothing wrong and you have all your documentation I would just blow off what the nurse said and get back in there because you don't want them to say you were non-compliant when you were always in compliance. That would be very wrong and you should not let them victimize you.

Get an appt with your PM doc ASAP and see what your going to do for ongoing treatment as far as PM goes. Just because you had a surgery does not mean they can just push you away like that.

take care and hang in there.

IngyW68 · 01-01-2006, 12:22 AM

Quick update but still need more advice on what people think on how to handle this.

Went to surgeon, he said surgery looked good, took neck brace off. Yeah!! Asked if he would call my PM to help clear things up about the amount of pills he prescribed and he said "ABSOLUTELY NOT" and that he doesn't want me to say another word and it's not important at all! My husband and I sat there looking stunned because we said, it's important to us to clear my name. Well, he refused and we left.

I call my PCP (the one I saw the week before Christmas who was not my regular PCP) and right off the bat he starts sounding funny on the phone and when I start mentioning being in a lot of pain and what to do, he said that my PM called them and told them the whole story (their version) and that he believes them over me, period. Even when I said I have proof for each item about the missing script and the wrong amount, he also said he didn't care and it didn't matter. I kept saying " this is not about me getting any medicine now but clearing my name" !!!!

WHY won't anyone listen to me it is the most frustrating thing!!!!!!!!!!!

So, I have an appt. on Tuesday am with my PCP whom I've known for 6 years and I am bringing copies of all my meds since June, a document with all the things that have happened since I started seeing my PM, I am picking up my records from my PM that morning and I can only hope they haven't taken out or changed anything on it since I don't trust them at all.

So, any suggestions for how to approach my doc and the ortho on Wednesday about this and if I should go to the medical boards?????

I am in terrible pain, sitting here at 2:21am and needing some help from my friends here.

Happy New Year to everyone

Ingy

dango · 01-01-2006, 01:56 AM

Well, unfortunately there are several problems with this situation. 1) I'm awfully sorry but you've been "red-flagged" as a med-seeker by these Docs--and you can talk until you're blue and probably these guys are SO scared, guarding thei licenses, that not much will change. IN FACT, the more "demanding", angry, or generally emotional you ARE about the situation, the worse it goes.

I am 41 years-old and had to leave the practice of the Doc I'd had since I was 15 for very similar reasons. He'd been chronically undertreating me for years. Thus I would end up in the ER w/bilateral severe pneumonia (he said earlier in the day I had no more than a virus), or kidney failure (he found no trace of even a bladder infection), and finally stated he could not JUSTIFY sending me for an MRI for severe back pain (I have DDD, Spinal Stenosis, Facet Joint Arthritis throughout my spine, multiply ruptured/bulging discs, ETC). I picked up my OWN records and was surprised to find that when I was angry about the "no justification for diagnostic imaging" they had noted that I was "possibly psychotic" OR "maybe substance abusing" as my "voice was going up and down in volume" and I was "belligerent and demanding". KEEP IN KIND THAT I AM A PSYCHOTHERAPIST AND DIRECTOR OF A MENTAL HEALTH FACILITY--WHICH MY DOCTOR WELL KNEW. So, I sorted through my notes extremely carefully, tossed out any that made those type of remarks, and hand carried them to my new Doctor's. I did NOT sign a release of information for these two Doctors to "chat" and frankly the matter never came up. My new Doctor ordered a series of MRI's on the first visit!

2) The word "demanding" comes up several times in your posts. I have found that most Docs have a rather larger degree of pride than the average bear, and are not prone to respond well (actually no human being is) to being ordered around or having "demands" made of them. When you appraoch a person with how "helpful they've been" and "how much you truly appreciate it"--and "could they possibly help you straighten out this one little misunderstanding"--at least they might LISTEN instead of flipping a widget!

3) When Docs prescribe meds for every 4- 6 hours, or every 8 hours--whatever it is... They really expect you to be sleeping at night--not getting up to dose yourself. For instance, when you get antibiotics--the label probably reads: "Take for 10 days, every 6- 8 hours" Then you look and there's only 30 pills in the bottle. This is your "info" that you take the med 3x a day. Sometimes it says 3x daily on the label, sometimes not. I have MSContin ER 90 pills. I know very well that divides down to 3 pills a day for 30 days--even though the label reads: "Take every 8 Hours". If they wanted you to take it all night it would be 180 pills for a month, or 60 pills for a week.

So, even though you're hurting like mad, your doctors are thinking, 'Okay, we write prescriptions out like this all of the time and people are generally never confused about the dosing instructions. What is going on here?' And, even though they may like and really care about/want to help you--they're very paranoid about getting in trouble.

I'm really sorry for all of your trouble. It might be time to start fresh with a compassionate Doc without this cloud over your head!

Chaswick · 01-01-2006, 10:13 AM

Hi,

Dan I'm sorry but I don't understand what you are saying about dosage times at all. If the meds. are written to take 1 every 8 hours then having 30 pills will last you 10 days. 24 hours divided by 8 hours is 3. Taking a med. every 8 hours would be simple to do withouti getting up in the middle of the night. Take one at 8;a.m. one at 4pm and one at midnight. What am I missing here.

Totally agree with you about biting your lip when faced with some fool who is accusing you of something that you didn't do. Hard to do but necc..

Ingy, I'm sorry to read about the awful time you are having. It sounds like a tiny snowball starting down a mountain picking up more snow until by the bottom it is an avalanche. Getting 'labelled' like that, according to what I've read, is something that could follow you around forever. Having it on your file is going to make getting pain meds. is going to be much harder. With the problems Dr.'s are having with the DEA, I'd imagine that if a Dr., after reading that a patient has been accused of being an addict and dismissed from other practices would probably be really putting himself out there if he Rx to you.

You really don't sound to me like someone who is 'demanding' that people follow your instructions. But I do think that you were probably quite emotional when they were accusing you of lying (and who can blame you). So with all of the addicts out there trying to con them out of pain medication, the people you are dealing with are probably looking for any type of behaviour from you that could possibly be called 'seeking'. And if you look for something like that it is not hard to twist things a bit and use it to further the argument against you.

What to do???? That is going to be hard I think.

- there is the option of going to see a new pain mgmt. Dr. if there is another one close to where you live. If you do, I'd be 100 percent upfront with him about prior accusations and tell him you understand that he may want to start on non-narcotic meds. and that you will comply with whatever he decides. Of course tell him, in a normal, matter of fact way, that you disagree with all of the 'drug-seeking' talk. Dr.s, like the rest of us, can deal with the truth. They are people and know that sometimes bad things happen to good people. If you are not upfront totally and he finds out about it, you won't have a chance.

It will be like starting over again, and won't do much for your pain tomorrow, but might be the only way to go save for moving to another state or country!!

Hopefully someone else will have more ideas for you. Sorry for your problems.

Cheers//Chas