Well- Had my second appointment with the new pm doctor, and left there feeling very concerned about his practices, so when I got home I went back to my referring doctor and am being referred to a new one.
I will try and keep this short, but the main point here is that when I went in to the office, I felt like I was in some kind of legalized drug den. There were 15 people in the waiting area and were being called back of course one by one. A good 12 of the 15 waiting were really acting very strange, like they were "jonesing". After them being in his office for no more than 2 minutes, they walked out with umpteen prescriptions in their hands. I caught a glimps of one scrip., and it was for 120 methadone pills although I looked away immedaitely because I didn't want to invade this guys privacy. Well, he had a strange look on his face, and after he left, he came back in with another woman and went to the receptionist and announced, "He shorted my prescription!" The assistant talked with him and he left again, and came back in another time and still was rasing cane about only getting 120 pills.
I got called back, and the pm doctor doesn't take my blood pressure or anything and asks how I'm doing and I tell him about the problems with Avinza and give him the unused pills in the bottle. He puts them in his drawer. I also tell him that sinse taking the Cymbalta I've been getting pounding headaches and feel like my heart is about to beat out of my chest constantly and I feel like I'm on the verge of some sort of rage. I've been taking them for almost 3 weeks now. He says to keep taking the Cymbalta and then hands me a scrip for massive amounts of Methadone. I told him I'm not comfortable with taking it and need some information about how it will help me. He says, "It will make you stop hurting." I told him that isn't enough for me because it scares me to take it. He asks why, and I explain to him why and then he tells me to get the scrip filled and I will feel so much better. I asked him if he would write me a scrip for Lidoderm patches since I had run out from the ones my referring doc had given me. He said, "no- you don't need those, you need the methadone."
I left there and cried the entire hour and 20 minutes home. When I got home, I went straight to my referring doctor with the written prescription for Methadone. I explained to them what happened and told them about how the Cymbalta was making me feel and when they took my blood pressure, it was 150/95 and my pulse is 106. My normal blood pressure ranges from 95/79 to about 110/80 and my pulse is not normally that high unless I am having a bad pain day. My doctor was mortified about what had happened and told me to stop the Cymbalta immediately and that she is referring me to different pm dcotor and didn't realize this other guy operates this way.
She has now put me on Neurontin for the nerve pain, Lexapro to help with the nerve pain, Skelaxin for the back muscle spasms and a small amount of Vicodin for pain when I really need it until I can get an appt. with the new pm doctor.
Can I ask this- was I over reacting about the pm doctor thing? I just need to know.
Lezlee, By all means you did the right thing!! If at any time you are ever uncomfortable with your pm I feel you have every right to speak with your primary. Good job. For me, it's the other way around, my primary is the pusher while my pm is more careful with what he puts me on. I hope your new pm is more careful and understanding of your needs and I wish you the best!
In a way, I think you were--the fact that you had concerns about the medication is completely fine, but can I ask why you don't want to take Methadone? It's actually a very good pain medication (and helps nerve pain, which is something I think you have based upon your message), but people are afraid of it because it's used for heroin addicts.
I definitely think that your concerns about Cymbalta were valid, but I think you went in there with the idea that if he prescribed Methadone to replace the Avinza, you weren't going to take it because of the stigma. I think you should have been a little bit more open to the idea; however, it is definitely your decision, and at least your referring doctor was cool about it.
Last edited by bulletinboard25; 07-18-2006 at 11:01 AM.
Thank you both for your point of view. I kind of felt like this would bring mixed reviews because there are many people who benefit greatly from methadone. It just really concerned me because he didn't want to hear what I had to say. He let me say how I felt, but he didn't really listen and then just totally wrote it off to nothing and didn't explain it to me. All he said is that it would make my pain better. It also bothers me that he was not willing to prescribe something like Lidoderm patches as well. Most doctors I've encountered are more than willing to prescribe non narcotic medications.
The entire visit was extremely uncomfortable for me. I know many of us need pain management, but he was so quick to bring out the "big guns", and I am just terrified of methadone, and terrified of addiction. I've seen first hand what addiction can do. No, I wouldn't abuse any medications, but this stuff really scares me. I know he treats pain for a living and has his methods, but it was really creepy- the entire visit. Even more creepy than the first visit.
I think I would be more comfortable somewhere else. For those of you who get help from methadone, I am very happy that it works for you because nobody deserves to live with pain. I think that I was just expecting to start with the less potent stuff, along with other modalities and if they work, wonderful, if not, then we can start with the stronger treatment.
Then again, I may just be overly sensitive about it....??
Thank you both again for your input. I welcome all of it.
PS- Bulletin- I forgot to answer your question about the methadone. Yes, there is a stigma to it, but there is also a stigma to being in pain management. I'm not so concerned about the stigma because I know my situation and I also know that people will form their own opions regardless. If someone doesn't live with chronic pain, they just don't normally undertsand.
My fears about methadone are just from reading about it and the things I've read scared me a bit. I just feel like maybe it's overkill at this point too. (Hopefully it's overkill because I'd like to think that something not so potent will bring my pain down to an acceptable level) I always try to hold out that hope. I've accepted that I will live with pain forever, but forever seems a long time for me to be taking methadone. I know this sounds silly, but I just get a heartwrenching feeling even thinking about it. I also forgot to mention that I had no idea methadone would even come up for me.
I agree that your concerns should have been adressed better and if you wanted a script for lipoderm patches whats the big deal.I just stopped using them because i get more relief from my TENS unit.
by no means should pain management consist of just pain meds.
i am going to PT, i exersize and stretch every day,i have had epidurals,trigger points,i just lost 20 lbs,i use a TENS,plus the meds and im still in too much pain to have any quality of life.
Ive had it and although my doc would increase my meds if necesary im having surgery in a few months so ive been trying to hold out.
docs that just rx meds whenever you say your pain is worse may not be around in a year and by that time you could be on a dose that many docs dont want to rx.what do you do then.
Im trying to say that a good pain management practice uses many modalities to treat pain and if they increase meds or switch you to stronger meds its usually after many other means have been tried
they have it documented to show that they just dont rx meds alone.
if you feel uncomfortable with this doc then you did the right thing.
While some may say "if your in pain and he is offering meds to help then dont complain" you have legit concerns and he seems too busy to speak to you about them or worse doesnt know what to say regarding your questions.
After many months of research and hearing other peoples stories about how Methadone had helped them I thought I was completely objective about it until my PM doc suggested I try it. I never had a moments hesitation about trying Morphine or Oxycodone, but I was troubled about the stigma of Methadone. I agreed to try it anyway, and I'm glad I did. More than anything else, it allows me to sleep all night most nights. I hope things work out for you with your new PM.
Hi Ozzy, I agree with the way you handled this too, not because of the methedone, I have never been on it but I know it has helped many many people on these boards, But because it looks like a 'prescription mill', not a doctor that is interested in trying a wide range of options, opiates being only one of them, and certainly one of the last tried. his lack of taking your vitals and refusal to give you the numbing patches, was just stupid, even if you take and need the meth, anything that can help you need LESS of it should make a good doctor happy to prescribe it. ~Lainey
Hi Ozzy: I wanted to jump in and let you know about a couple of things in your original post. I think you said your PCP put you on the Lexapro. I take Lexapro, 20 mg and it's an Antidepressant. There are a lot of CP patients on it. Concerning the Methadone, you really shouldn't worry about it or any stigma with it. That may have been true years ago, but today, most people who are knowledable know it's a very good drug and used in pain management. You didn't say about the amount that the PM doc had written, but only he had written a script for "massive amounts". I don't know what you consider to be "massive amounts", but I pick up my monthly script at my doctor's office and it's for #540, 10 mg tabs. I take 180 mg a day, so 18X30 is the 540. I hope you will reconsider your feelings toward Methadone, as it's an excellent pain med, especially when nerve pain is what it's written for by the PM doc.
Thank you all so much for your replies. It really does help. And again, I welcome all input because this is still a learning process for me.
I really am not concerned about the stigma at all. As I said before, there is even a stigma to seeing a pm doctor because people don't understand. They seem to think it's all about supplying people with drugs and creating addicts. There is a definate difference between addiction and dependancy, this I am sure of.
I don't think I can put in to words just how creepy this place is though. There are no exam rooms, no equipment for taking blood pressure, weight, etc., and the people in the waiting area were truly, TRULY acting like they were "jonesing", I mean, I have seen what addiction is and 12 of the 15 people were acting like addicts. One of them almost couldn't even talk and keep her eyes open. I know that sometimes being on pain medication can cause side effects and what not, but what I saw in that waiting area was not normal at all. I just wish you guys could have seen it. It wasn't right at all.
I really do feel that methadone is over kill for me right now (hopefully). I would feel so much more comfortable trying other medications and modalities, and if they don't work, I am 100% willing to talk with the doctor about trying the other medications such as methadone.
Again, thank you so much. I hope to get even more feedback as well. For those of you who need methadone, please do not think I feel anything but happiness that it helps you. I'm not downing it, I'm just saying that for me personally, I feel I'm just not ready to take that step until other things are tried.
I think you absolutely did the right thing!!!! To me this was more about wanting some information from your "doctor" and being an informed patient than if you wanted to take methadone or not. Besides the fact that you had witnessed what I think is some very odd behavior by the other patients. I think you had good cause to be concerned by this doctor and am glad you got a referral to go to someone else. If this guy couldn't tell you anything more about methadone than "it will make you feel better" then I wouldn't take it either. Plus, he's only spending a couple of minutes with his patients? He's not even checking blood pressures? He's got patients in the waiting room that look like they're "joensing"
I would have gotten out of there as fast as I could and done exactly what you did. While this medication is highly effective for many, many people and may or may not be what you need, it's the rest of the issues that give me the willies.
You should be proud of yourself for taking your health and well being so seriously.
Hi Ozzy - I've been waiting all day to hear about your re-visit to the pain management center. But I was hoping the results would have been better than they turned out to be! First, I have to agree with you that the atmosphere, as you've described it, in the office sounds pretty questionable. It almost sounds more like the kind of place where heroin addicts go to get their daily dose of methadone, not a pain management clinic where patients are getting help for their pain issues. To me a pain management practice should look and operate like a doctor's office - with all the requisite examining rooms, blood pressure cuffs, cotton balls and old copies of the Ladies Home Journal. My clinic has a website as well with information about the doctors, the treatments available, the philosophy of the clinic, etc. I'm not saying that all PM practices must have websites, but they should have some way of informing their patients of their services and their staff, even if it's a pamphlet on the table. So Ozzy, I think you have made a good decision to look for another doc. As far as your opinion on the methadone, you have a right to your feelings of course. I have to admit that when my doctor said to me one day, "KathyMac - how would you like to try Methadone as a pain medication?" that I almost fainted on the spot. I did have visions of standing in line early in the morning with lots of other folks while I waited to drink some orange juice. I had no idea that methadone came in a pill or that it could be written for on a prescription pad and brought to a pharmacy just like a script for percocet or oxycodone, etc. But I had tried just about every drug under the sun and still had a tremendous amount of pain. My tolerance to other drugs was very high and I had no idea that there was another choice for me. Methadone changed the quality of my life Ozzy! I really do think of my life in terms of before methadone and after methadone. I know you'll keep an open mind. Hopefully your new doc will have some other options for you that sound a bit more palatable. Just one question: If the doc is giving you Vicodyn for the pain, why can't you just stick with that? I don't remember why you didn't want to stay with that drug, sorry but I know you've probably posted why, but I'm a bit slow!! KathyMac
Charlie- I love the emoticons you used! It really did put a smile on my face and took my mind off of the stress and worry about all this mess. Thank you! I needed that!
Kathy- The pm doctor did ask me if the vicodin worked and I told him it worked in conjuction with the Motrin and brought my pain down to a 4ish which to me, is the lowest my pain has been in 2 years, and when I have a pain level of 4, I consider it a good day. He told me to try the Avinza, and that is when the problems started. He did ask me again before writing the methadone what worked for me in the past and I told him. I also brought up the Lidoderm patches as well. I point blank asked for the Lidoderm, but did not point blank ask for the vicodin for fear he would think I was just looking for pills.
Yeah, I was hoping for a good 2nd visit, but I am really glad that when it went south, my primary care doctor was open to referring to another pm doctor. Made me feel a bit more like I wasn't being insane about it.
And, if the time comes that other forms of medication and treatments are not working, then absolutely I will be open to methadone if the new doctor suggests it.
You know, I still get the heeby jeebies just thinking about the situation in that waiting room. eeyewwww
Have a great evening. I need to go lay down because the neurontin is making me a bit sleepy, but the good thing is that even after only taking it las night and tonight, low dose, 300mgs. the burning down my right leg isn't so bad that I can't sleep! I didn't think it would work that fast, so I feel lucky about that. First time in 2 years that I don't feel so much like acid is running through my saphenous vein! Maybe just hot water or something which is an improvement that I will enjoy while it lasts!!
Hello Everybody! Lezlee I'm so sorry about your visit to the pm. As I've already said my first visit is 7/27 and I'm very nervous. I've been reading and asking questions about pm for almost a year and we share a lot of the same concerns. I understand why you did what you did. I don't believe it was the stigma associated with Methadone, it was not being to talk to the doc and he listen to you!!! I had a similar thing with the orthopedic surgeon happen. I've gone to every specialist I could think of hoping that somebody would really help me with the pain. I'm scared to death of pm because of the servious drugs involved. I told this ortho that I'm able to sleep but in the morning when I wake up I can't move and that my husband has to sit me up and that the pain is so bad I didn't know how much longer I could stand it. It was because of this pain that I've been sleeping on the couch for the better part of two years. Not good for my back, but I would not get nearly as stiff on the sofa because I would keep waking up and moving around. The ortho wrote me a prescription for Soma, didn't ask any questions about my history, and that was it. Something told me not to take it, so I held on to it until I saw my internal med doc, the one who really knows my history. He told me not to take it, that my system is too sensitive for someone just to write a script like that without monitoring me and that it's highly addictive. My doc gave me Neurontin for neuropathy symptoms/nerve pain. The neurontin helped me be able to turn over in bed and to even sit up by myself, but the pain was intolerable. I called my regular doc in tears, the pain was too much. I had to admit that I need pm. The best way I can describe the pain is to say that I was attached to the bed and as I was pulling myself away from the mattress, I could feel my soul falling from my body. The doc told my hubby that if I didn't control the pain, I wouldn't make it.
We share the same concerns. You want the doc to explain why he prescribed the Methadone. I hope your next pm will listen. Methadone is a very good med...9 times out of 10, that's will probably how they start my treatment. I understand your concerns, I too want to be able to have a few treatment options, not just someone shoving a script under my nose. Luckily, the clinic I'm going to is about five minutes down the street. I think I'll go in and have a look around. I want to see if they have a copy of Ladies Home Journal.
Here's wishing you the best, Rosa
Last edited by Rosieposie1; 07-18-2006 at 10:08 PM.
I really hope that you will find help with your pm doctor. It's awful to have to live in such pain. I too sleep on the sofa many times because of my pack pain. Our bed has a great mattress, but when my back is really acting up, sleeping on the sofa seems to help it along some.
I do feel this was just a bad experience with this particular office. I spoke with my husband's cousin, and it turns out that she actually is a patient of the pm doctor that I've just been referred to. She said he is wonderful and that he is really "up" on many forms of pain management. She has been with him for some time now and has never once felt uncomfortable with the surroundings.
I have also seen, as KathyMac explained, several pm specialists that do have web pages and I think I'm going to see if the new pm doctor has one as well. If not, then no problem. If my hubby's cousin says it's good, I trust that.
I have accepted the fact that pm is going to be a part of my life whether I want it or not and am ok with that. I don't care what other people think about it, but I am not announcing it to anyone and everyone I know because I do feel like this is something that's private, and sometimes I deal better without everyone knowing and asking how things are with my back and knee. Also, the one thing I've heard many times is that it's a good idea not to be telling people about your pain management and if you are taking medications.
While my primary has been treating me, I've not discussed any medications with many people I know and am discreet if I have to take medication when others are around. I'm not trying to hide it, I just prefer to avoid the questions about it I guess. I don't like telling people I'm in pain every time they ask how I'm doing. Mostly I have a set answer which is, "Oh, I'm coming along.", "I'm getting there." I think people would get tired of hearing how bad I really hurt every time they ask.
I am feeling much better about everything this morning. I just can't allow myself to dwell and stress over all this. Mu husband is being so supportive and told me that whatever we need to do we will do and he will be with me every step of the way. He has problems of his own that stem from falling off a 3 story house 2 years ago and will be having an MRI soon to see what's going on in his back. I'll be posting about him some other time as we see what's going on with that. He doesn't want to go to pain management. Again, that's another story for another day.
I appreciate everyone reading and responding to my post. You guys are a huge source of support for me and it touches my heart.
I probably would of ran screaming out of the doctors office just based on the scenario you gave. I am really wondering if those that appeared to be jones'ing weren't on high levels of methadone. This can happen to some individuals. Or perhaps he is merely a pusher and needs to be reported to the authories. There have been numerous doctors where I live that have been getting busted lately. Doctors have realized how much money they can make by simply just prescribing medication and have taken advantage of it and are catering to addicts sadly. This makes it even MORE difficult to find a trustworthy doctor.
I wouldn't be overly worried about the Methadone but you do deserve direct answers from your doctor. I was on it for a short while and it gave me great relief but the side effects were too bothersome that I could not continue with it. I did a lot of research because I too was scared but found that it really is effective in a vast majority of individuals.
Hopefully the new PM will work out much better and open new doors for you. We should always keep our minds open to non evasive non medicinal treatments. In fact a good PM will go this route. It's important to treat the body as a whole and not just mask the symptoms with medication!
Isthere- Sweetie, thank you so much for your kindness. I know you have a lot going on right now and it means so much that you are here to support me in this. You keep up the great work you are doing because you deserve good things!
Kissa- Good morning (actually it's afternoon here- time flies...) Yes, I agree about trying the non medicinal treatments as well, and really would like to try as many as possible. I know there are certain medications I need, however, I do not want to rely solely on medication if at all possible. I'm lokking in to something called the Alpha-Stim 100. It's kind of like a TENS unit, but about 50 times better. I was able to use one for a short time and found that it worked so much better than my TENS and even allowed me to get to sleep without having to use Lidoderm patches or any kind of medication. That is worth more than anything to me right now.
Another funny thing about the ex pm doctor is that he does not accept insurance. I found that out at my appt Tuesday. Why wouldn't he accept insurance? I started thinking that maybe it was the other way around, maybe the insurance companies do not accept him? Things that make you go hmmmm
I'm so sorry that you had such an upsetting experience!!
So many people have made good points here that I don't want to repeat them, but the thing that jumped out at me when I read your story was that this doc seemed unwilling to engage in a real informative discussion regarding the methadone and your concerns. Maybe I'm reading too much between the lines, but he seemed to have a 'just trust me, take them' attitude. I'm sorry, but I really believe that since you are the one would be putting the medication in YOUR body, and subsequently taking on the risks of side effects etc, you deserve to be as informed as you need to be in order to be comfortable.
It also seems to me that there are a lot of options out there (though I'm not sure how many you've tried), but unless you've tried all else, I wonder why the doc wasn't willing to offer you some other options, explain the pros and cons of each, and then collaboratively make the decision of what was best for your situation, INCLUDING your comfort level!
I so hope that this next doc works out for you. This whole business of pain management is stressful enough, so I hope you get the kind of care you deserve!
Lezlee (and you too Rosa):
I wanted to fill you in on my experience with Pain Management. It was the BEST thing that every happened to my health!!! I had seen many specialists and they either didn't take my condition seriously or didn't want to get involved period becaues of W. Comp.. When I first went to my PM doc I was scared to death that all he was going to do was drug me up and send me home. But what happened was he took my pain seriously, got to the root of what was causing it and tried many many things before going for the big drugs. A good PM doc is going to try other means to reduce pain than just meds.. Unfortunately with my back nothing could be done to fix it and I will live the rest of my (hopefully very long) life with an implanted morphine pump and taking oral narcotics. PM docs do not just pass out meds, they can help in many other ways. PT, injections, TENS units, Spinal Cord Stimulators, etc. I understand the fear you are both experiencing, but hopefully it will help to know that there are many good PM doctors out there, just be as gutsy as you are and no when something doesn't feel/look right.
Good luck to you both - keep me posted as to how things are going. I'll be keeping you in my thoughts and prayers!
Glad the little smiles brought a smile to your face
Thank you ladies! I can't tell you how much your support means to me. I really appreciate all input whether it's in agreement, or in disagreement. The best way to learn and accept is to listen to what others say. You never know when you can learn something new by listening to other's points of view.
Anyway, back on topic. I am looking forward to getting the appt. with the new pm doctor. I called my primary doctor, but had to leave a message, so I don't know if the referral went through yet. The new pm doctor's office said they have to get the referral and review my paperwork and will let me know if they feel they can help me. I'm hoping they call and say, "I think we can help you." Fingers, toes and eyeballs are crossed over here!
As always, I hope you guys are having a pain free day......