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Old 10-02-2007, 05:10 AM   #1
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jodom1979 HB User
I need some advice.

Hi everyone,

I dont know what to do with my situation here. I will try and breifly explain my story. Nov'06 I was Dx'd with RSD which some of you may not know is a chronic painful condition. I went to my primary beacause i was having a real bad burning sensation. she looked at it and sent me to a local PM. I went there and my DX was confirmed. I went through all the shots, scs trial, counseling ect for this disease. Non worked. Ohh yeah this is W/C by the way.


Well, my primary RX's all my narcotics.
I was getting
240 50mg tabs of ultram
60 percocet 7.5's
120 klonopins
Nuerontin 1800mgs a day
lidocaine patches
Baclophen
Cymbalta.. Enough right?

OK, well 6 months went on with this "Cocktail" and I really started having memmory issues, I was blacking out.. And I was scared something was going to trash my liver and or kidneys. So I spoke to my Primary and she said lets consolidate your pain meds and put me on a duragesic patch. let me tell you NIGHT and DAY difference.

Now I take

duragesic changed every 48hrs
lortab 10/325 X30
90 klonopin
clonidine for BP
topamax

This new combo worked I was puking the first couple of weeks and then bam im back to my old self. So, I go back to my PM for a follow up and she had a cow about this. Said duragesic is horribly addicting and gave me a sob story of a MD friend of hers who is addicted to methadone. She said i need to go back to the pills(ultram percocet) and not use the patch. I disagreed but remained respectful and calm. I really liked her up until this point. Now im afriad im going to be put back on my original "cocktail" and I dont want this.

My better half wrote a letter about how I had changed since the switching of meds and hand delivered this to my PM. well on the 10th of this month I go and usually just pick up my Rx's for my Duragesic. so far they both have been in consultation so they know what each other is doing... well I guess, what do I do here? Sorry for the long story..

Anyone got any ideas?

 
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Old 10-02-2007, 05:34 AM   #2
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Arthr Itis HB User
Re: I need some advice.

Your best bet is to talk to your primary. Maybe there is another cocktail. Maybe the pm is over reacting. No two people handle drugs the same way. Fred

 
Old 10-02-2007, 05:50 AM   #3
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badoldback HB User
Re: I need some advice.

If your PCP is handling your prescriptions, I wonder what your PM is for? A PM who is scared of anything stronger than Ultram is probably not going to be of much use to you.

 
Old 10-02-2007, 06:34 AM   #4
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whitfield HB User
Re: I need some advice.

I also wonder why you need a PM if your primary prescribes the narcotics--what size was the duragesic?--You say this is a W/C case, so cost may be an issue--The patches are expensive--At the very least, I would change PM doctors--although you may not be able to if it is a Workman's Comp issue (I assume that is what WC is?) To summarize, I don't see why they would change something that is working for you--Fear of addiction? Cost? Makes no sense to me as all narcotics can be addictive--Good luck and let us know what happens--Roger

 
Old 10-02-2007, 07:28 AM   #5
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jodom1979 HB User
Re: I need some advice.

Thanks for the responses


My PM does procedures. Blocks,SCS ect... She has never Rx'd anything narcotic for pain as she utilizes Primary doctor for that.. Wierd setup. But thats fine. We were going to try and get this new itrathecal drug called "Prialt" used in the pump. Well it was turned down by W/C on grounds I have to go through morphine and a couple other drugs before being allowed to use it. She Refuses to use a morphine pump on me being im 28. She said she is going to fight the descision but my lawyer basically told me fat chance as she has seen this happen before.

Yes im stuck with this PM. I have no further appointments with her unless I need soemthing addressed so my primary will deal with me. I guess I will make an appointment on the 10 and just be completely honest incase she doesnt flip through my file and see her comments on durgesic..

Im on the 25mcg size. Baby dose that works more than well for me.

 
Old 10-02-2007, 10:29 AM   #6
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zach016 HB User
Re: I need some advice.

Hi Jodom,

Looks like a no brainer to me. If your PM doesn't Rx meds. maybe she isn't as educated about them as she should be?? Im' confused about her story about her 'friend'. Was she addicted to Fent. or to Methadone? I also thought that you were not supposed to take Percocet if you were taking Ultram - but I'm no expert!!!!!

You are getting rid of a ton of pills by going on the patch. That alone - to me - would make the patches a better call.

I sounds like this PM can't help you anymore. Do you have to SEE her for the comp. claim again??

Zach

 
Old 10-02-2007, 11:41 AM   #7
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madhatter HB User
Re: I need some advice.

In my own opinion, most pain management clinics,doctors etc. just care about one thing $$$$$ Is your pm doc fairly young? Your doc. stated some of her coleagues are addicted to meth. The doc.s view seems to be if her own colegues can become addicted,than everyone who takes it will! And you finally find something that helps with your pain,but your pm doc. strongly disagrees!
And theres no money in it for your pm doc. just to write you prescriptions!
But with all the injections,nerve blocks,tests, those cost big bucks! So what if they haven't worked for you,as long as you get them $700 shots,$1000 tests,who cares![ meaning pm of course] A majority of the people I have talked to say these shots ,blockers etc. don't work,but yet,there pm doc. continue to give them to the patient,ask yourself,why is that!?!! They do help some people,but why continue to give them to the people they don't?

 
Old 10-02-2007, 02:05 PM   #8
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linda71 HB User
Re: I need some advice.

What is the reason for not taking percocet and ultram together?

 
Old 10-02-2007, 02:42 PM   #9
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jodom1979 HB User
Re: I need some advice.

Yeah, the whole thing is just plain nuts. Im just hoping my primary sees me through this. My pm is older she's in her early 60's if memmory serves me right. I dont plan on going back to her unless it is in regards to getting a pump with prialt installed. if not she can just die of a horrible STD and burn.

Funny thing is up until now she has been the greatest... I had nothing but good things to say about her and then as soon as I mentioned my med consolidation she freaked. She used methadone as a generic story that apparently in her opinion everyone will be addicted to opiates and regret it.

But Ultram is addictive... Percocet sure is... Klonopin sure is too. and she had NO problem with me being on them. Actually on the klonopin I wanted off and she argued that i need to stay on them. It will be real interesting how things turn out when I go to get my refills in 8 days. God Nerve pain sucks.

Yeah im stuck with her... being how my W/C case has gone. I guess i need to come right out with what she said when i see my primary and see how im dealt with.

 
Old 10-02-2007, 03:03 PM   #10
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brianpain33 HB Userbrianpain33 HB Userbrianpain33 HB User
Re: I need some advice.

I had to post my reply since I am a recovering addict and on pain meds. I just recently started on the patch. It is one of the few pain meds that does not give you that "high" because it is a constant steady dose of medication. You don't have that up and down effect of the pills such as percocet and vicodin. I have been on Ultram for 1 1/2 years and currently trying to get off of it. I asked my new doctor about ultram and he said it is a narcotic and that it is addictive and can be abused although I never have abused it. I have been getting pretty good relief from the patch as well and I have nerve pain. I am on it for the pain relief and not for any kind of high or to abuse it. Well hope that helps a little.

Brian

Last edited by brianpain33; 10-02-2007 at 03:04 PM.

 
Old 10-02-2007, 03:57 PM   #11
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linda71 HB User
Re: I need some advice.

Is everyone talking about the same kind of patch? Are there ones that aren't addictive if it is released a little at a time? I have constant pain in my neck and hands from arthritis. I also have it up and down my spine. I was addicted to lortabs and haven't been taking anything but ultram. I would be interested in this patch if anyone would tell me what it is all about. Thank you in advance!

 
Old 10-02-2007, 04:09 PM   #12
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brianpain33 HB Userbrianpain33 HB Userbrianpain33 HB User
Re: I need some advice.

The patch is a fentanyl patch (brand name duragesic). It can be addictive just like any of the narcotic medications can. The big difference is the fact that the patch is hard to abuse unless you stick on multiple patches. Even then it takes quite some time to feel this increased effect and will more than likely just make you incredibly sick. The other benefit with the patch is the pain medication is released at a constant rate therefore you do not get the big up and downs like you do with the pills. The biggest thing, especially for recovering addicts (like me), is that you do not get that big release which could possibly cause the high such as with the lortabs. I do need to still be extremely careful and make sure that I do not try to abuse the patch. I also realize that my doctor is taking a big risk by putting me on the patch. However, I have pretty much exhausted all non-narcotic medications, injections, surgeries and the patch is usually a last resort. Hope this helps.

Brian

 
Old 10-02-2007, 05:55 PM   #13
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madhatter HB User
Re: I need some advice.

WC is that meaning workers comp.? I'm on that also,for almost 5 yrs! My lawyer even told me this,if your not happy with your current doctor,you can get another doctor! They can't tell you,or choose for you,what doctor to go see!
1) Its against the law,because if that were the case,they would send you to one of there doctors who works for them,and we all know about comp. doctors!
You can go in there with your backbone in your hand,and they will say your ok!
If you have been on WC for a while,I'm sure they sent you to an I.M.E
[independent medical exam] and thats a doctor WC hires[comp doc.] to contradict everything your doc. says.

 
Old 10-02-2007, 07:28 PM   #14
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jodom1979 HB User
Re: I need some advice.

Hey Madhatter,

almost a year now on W/C been through 3 IME's all agreed with my DX RSD. W/C sucks. They were all nice and friendly until that three letter acronym was said... RSD... Then all heck broke loose. I just went and obtained a lawyer. Its a long story but I got angry with the first PM and fired him on the first visit... sitting there for 3 hours and only spent 15 mins with me. BS I waited a month on him. so I chose my current PM... so its my bed so I gotta lay in it.

I feel for you having to deal with them for 5 yrs! GOD! I also have one of those Nurse wench's that follow me to all my appointments... but I have her trained and house-broken.

 
Old 10-03-2007, 12:08 PM   #15
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madhatter HB User
Re: I need some advice.

Quote:
Originally Posted by brianpain33 View Post
I had to post my reply since I am a recovering addict and on pain meds. I just recently started on the patch. It is one of the few pain meds that does not give you that "high" because it is a constant steady dose of medication. You don't have that up and down effect of the pills such as percocet and vicodin. I have been on Ultram for 1 1/2 years and currently trying to get off of it. I asked my new doctor about ultram and he said it is a narcotic and that it is addictive and can be abused although I never have abused it. I have been getting pretty good relief from the patch as well and I have nerve pain. I am on it for the pain relief and not for any kind of high or to abuse it. Well hope that helps a little.

Brian
Ultram is not a controlled substance,and is labeled non-narcotic. If it were,it would have the orange sticker saying controlled substance. I'm not a doctor,but I'm willing to bet my life on this. And for your own referance,look it up yourself,but I disagree by facts! And if your on the fentyol patch,just to let you know,its the strongest narcotic on the market!

Last edited by madhatter; 10-03-2007 at 12:10 PM.

 
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