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Old 05-21-2008, 01:30 PM   #1
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Need support in asking doc for new meds~PLease!

Hi everyone...
A while back, Steve or someone wrote a really great paragraph on how to ask your doc for a new plan without sounding pushy and also thanking him for wonderful PM care.
Does anyone have any thoughts on how to talk to my doc? I put a call in to him today, and most likely he will catch me when i have kids in the car or cant talk. If so Ill call him back.
But I want to try the compound oxy instead of the patches this summer, but I dont want him to tell me the old.."well then maybe we need to stop your meds for awhile, ect."
I dont think he will say that at all, but Im always terrified it could happen.
Usually I have no problem asking him for what I want, maybe Im reading into too much of the posts lately, and being sfraid that my doc thinks Im pushy or one of those pts who think they know it all.
Any help would be greatly appreciated.
If anyone can find the paragraph Steve wrote, that would even be better!
It was about 3 weeks ago. Ive been looking, too.
xoxoxoxo,
IZZY'SMOM

I am currently on LA hydro 15 mg
SA hydro 10 mg for b/t
12 mg patch 2-3 days usually 2

Last edited by IZZY'SMOM; 05-21-2008 at 01:31 PM.

 
Old 05-21-2008, 02:00 PM   #2
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Re: Need support in asking doc for new meds~PLease!

"Hey doc,"

"I can't tell you how much I've appreciated the pain coverage you've given me this winter, and how much I appreciate how understanding you are when we talk.

Summer's coming and I'm already experiencing perspiration and small difficulties with keeping the patch on. Plus I hear heating up while on the patch can drain it too fast.

You know my preference for the compounding meds. Do you mind if I offer an idea? How about we discontinue the patch for the summer and use compounding for my main LA med? I find that the compounded hydrocodone isn't a one-for-one substitute for the patch, but maybe something else. Something that will have the strength of the fentanyl but compounded - I've done real well on the medicine called oxycodone before, could they compound that for me in a LA form like with the hydrocodone? I'm willing to do a brief trial and see how it goes. After you select the dose we could do trial and error with dosing until it covers my pain like the patch did. If it works, then maybe that could be my hot weather solution.

I'd really like to try this if you think it's an OK idea."

steve

 
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Old 05-21-2008, 02:07 PM   #3
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Re: Need support in asking doc for new meds~PLease!

Wow, I have always wondered the same thing. I never know how to address things with these doctors. I usually pile it all on and I know thats not a good thing to do.
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Old 05-21-2008, 03:31 PM   #4
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Re: Need support in asking doc for new meds~PLease!

Hi IZzy, all Dr's are diffeent, I have always been very open and direct with my Dr. and he with me. He has even gotten a bit fired up with me at times, but I think he respects me. Usually, he has an idea, I listen to it, then I add whatever I think, or any suggestions. Then we work it from there. Because I do not have insurance, he went out on a limb treating me with only xrays and no MRI for many years. I did finally pay for an MRI, and he seemed to realize his instinct was correct in treating me. I had/have 5 heniated disks, 2 nerve impingements ect. I have told him repeatedly (and meant it) that I appeciate his having the fortitude to prescribe meds for me. I thanked him for giving me the ability to stand for 5minutes in the shower ect. He does get a bit fired up when I tell him a med is not woking, and he isnt quick to increase doses, but he has been good to me. I would say use your gut, and try not to overthink it, people can FEEL when we are sincere, and when we are not. Good luck!

 
Old 05-21-2008, 04:12 PM   #5
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Re: Need support in asking doc for new meds~PLease!

Can I ask.... why a compound, rather than OxyContin?

 
Old 05-21-2008, 04:49 PM   #6
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Re: Need support in asking doc for new meds~PLease!

Steve,
Can we just pack you up and ship you around the country to come with everyone when they have to go to the doctor??? Please.

Izz, I know how you feel about all the posts here. I usually try not to read any difficult posts for a couple days before I'm going to talk to my doctor. Otherwise my blood pressure goes up and I get soooo nervous thinking about all the things that could go wrong.

I don't mean to demean or belittle or negate anyone's troubles. I know that doctors can be difficult. I have just been relatively lucky with my doctor. Knock on wood.

Izz, Just relax and follow Steve's advice. You and your doc have a great relationship and if you keep the focus on quality of life and not a specific med, you'll be ok. That bein said....Good luck!!!~Mush
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undiagnosed lung and back pain after pneumonia in '03, tmj, migraines,(two failed surgeries for) Kienbock's disease

Last edited by trowftd3; 05-21-2008 at 04:49 PM. Reason: spelling

 
Old 05-21-2008, 05:05 PM   #7
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Re: Need support in asking doc for new meds~PLease!

Got a call back....Im kind of worried. I am in worry mode lately. whenever my pain is high iM that way, and I hate it.
I verbatim read from Steve's paragraph...and also told him Id spoken to the compound pharmacist, since we are on really good terms, and told him the patch wasnt going to be an option for me this summer, I was fearing.
I could tell he was harried, he told me I could come for an appt, but we could do this over the phone. He asked for my CPharmacy number and said he would call tomorrow and then call me back.
I did call my pharmacist and told her to expect his call. Also she told me that there is gel phentanyl, and dissove under the tongue, and I asked about the oxycodone.
She stated that they could do that in a ibu/oxy mix, but its up to my doc. Im really not feeling the pain coverage with the phentanyl, and I dont like how it makes me feel if they up it.
Honestly, I told her too, that I feel it is a drug that is for a LOT higher pain scale than I have.
Im kind of bummed that I didnt get to talk to my doc at all about what I wanted to relay to him. He was on the other line when the nurse called back to connect me to him, and I know he is busy.
When i asked about d/c the patch and being BOTH on LA and SA hydro, he said there are other alternatives that can make it even MORE Long acting.
I didnt feel llike he even heard me say that Id tried the oxy IR, and that had been somewhat helpful.
I hate stuff like this...I hate always feeling that maybe I said something wrong, or that maybe he thinks Im asking for something specific. I was afraid to ask specificly for the oxy because I felt if I did he would think I was not trusting that he would take care of me. So now I guess Ill see what he and my pharmacist figure out tomorrow. Maybe it will be something altogether better, so Ill trust that they will help me out.
I just feel that the hydro isnt cutting it at all....and there has to be a middle ground between the hydro and the fentanyl.
I know at one point he told me the oxy is really hard to get off of, also the pharmacist told me that about the oxycontin, but if the phentanyl is stronger wouldnt that be worse? Im kind of freaked that the pharmacist mentioned during our conversation that she didnt know if the phentanyl was stronger than the oxy. yikes...
xoxoxox,
IZZY'SMOM

 
Old 05-21-2008, 05:20 PM   #8
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Re: Need support in asking doc for new meds~PLease!

Quote:
Originally Posted by IZZY'SMOM View Post
I know at one point he told me the oxy is really hard to get off of, also the pharmacist told me that about the oxycontin, but if the phentanyl is stronger wouldnt that be worse? Im kind of freaked that the pharmacist mentioned during our conversation that she didnt know if the phentanyl was stronger than the oxy. yikes...
xoxoxox,
IZZY'SMOM
I think everyone is different when it comes to 'coming off' of a drug. It also depends on the taper. I think they're all difficult in one way or another.
I'd be freaked out too if about pharmacist didn't know that fentanyl is stronger than oxycodone. Hang in there and let us know what happens tomorrow.~M
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Old 05-21-2008, 07:38 PM   #9
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Re: Need support in asking doc for new meds~PLease!

Izzy,

I think things are going to be just fine. It's clear that your doc is 'on the case' and wants you to be comfortable.

I do wish you'd had the opportunity to speak with him w/o his being harried. I might have taken him up on that appt too, but hindsight is 20-20 right?

You're going to be fine.

I do have a suggestion. When he calls back be ready with a few items. Write down your average daily pain score over the last few weeks. Also, be ready with a number you wish the score had been (for example-your score has averaged a 6-7 and you'd really wish to live at a 5). This is whether you like his plan or not. Be prepared to request that he 'hear you out' for a minute, that you have something really important to share-and that if he's really busy at the time could he call you back at a better time or when could you call him back. This is where you need to address him like you would your caddy when he needs to listen up. If he cannot guarantee that, then I'd be tempted to make an appt.

When you do get to share your heart tell him about your score and that it's real important to you that he understand how critical it is to you to reach your target score. You might even ask him if he agrees if 5 is reasonable for decent quality of life? What doc worth their salt wouldn't agree with that?

Here's where it all comes together. Regardless of whether you like his offer or not, ask him 'if this approach doesn't get me to a daily average of 5 can we make adjustments or try something else until we get there? He has to know this is the whole point of your contacting him, and that you didn't get to explain it today. Again, of he's as compassionate as he seems he should say 'of course.'

The reason this is critical is because now you have his OK to continue to call and work with him until you're satisfied. So long as you get this assurance you're OK. Now, if things don't work, you can raise ideas like oxy that may not have flownthe first time.

This all will require some assertiveness on your part. I think it's time for that if you don't like how things progress tomorro, or even if you do - even if tomorrow's offer sounds good, only time will tell, and you'll probably be started at a low dose, so you need that assurance he's prepared to work with you over the next few weeks.

I sure hope this helps because I feel like I failed you earlier. Plus, and most importantly, I hope for much better pain relief.

steve

 
Old 05-21-2008, 07:44 PM   #10
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Re: Need support in asking doc for new meds~PLease!

Izzy, I'm glad you are able to talk to your doc, I have mine's cell phone number as well, but only for an emergency. I decided a long time ago after a terrible mishap when I left a message at the front desk that then went to a nurse and then the doc, and by then it was out of context. I actually drove to the office to get it straightened out and the doc was totally mis-informed. I wish I could call my doc's cell about a med change, but I wait for my appointment. Like yours, mine is so busy, I think he's probably doing 50 other things and not listening to me fully.

I'll be curious to see what he comes up with, I'm sorry your patch doesn't stay on in summer, I live in Florida and mine stay on fine. It always amazes me how we are all so different. I hope he changes it for you.

Melissa

 
Old 05-21-2008, 07:49 PM   #11
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Re: Need support in asking doc for new meds~PLease!

Re: Need Advice About Changing Meds~

aussiejono wrote...

"Why the insistance on a compounded med?" You asked me already on another thread...

Steve is right when he replied...
"I think the compounding gives you more options than most folks and it seems to suit you fine for relief and financially."
~Steve

So Ill answer again, my response from another thread...
"As far as the "insistance" of compounded meds...they work better and thats what I choose. I can pay for 240 vicoprofen at 560.00 per month or I can get 10mg of hydro compounded 240 at 96.00 per month. you do the math~ Pluse the LA hydro...same thing. Thats one reason I use the compounded meds."

They work better for me, period...

I hope this clears it up for you. Youve asked me twice, sorry but I thought Id answered this before. Strictly preference. Have you ever used compound meds? I know you wrote your sister is a pharmacist? Maybe she can fill you in on why a lot of ppl are turning to them.

IZZY'MOM

Last edited by IZZY'SMOM; 05-21-2008 at 08:05 PM.

 
Old 05-21-2008, 07:57 PM   #12
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Re: Need support in asking doc for new meds~PLease!

Mush,

Sure, I'll travel for the cause. In reality, I think your brief encouragement to Izzy was more helpful than anything in the novel I wrote. And my ideas got her nowhere. Your thoughts on quality of life were perfect, and I used that in my second novel.

I sure hope we can get her the relief she needs.

I also wish we could help her be less anxious. Just from her posts it's clear she has superior comm skills all on her own. She's got the whole package. I hate it when friends are fearful. But this stuff is so very important in our lives that it tends to cause lots of anxiety. I used to spend sleepless nights going over speeches in my head, editing all the while. Then I'd turn on the light and write things down. Then reprocess it all over again. But when I'd get to my appts things would go just fine. So I guess it took me 52 years to finally trust myself to handle things when it got to be crunch time. But what works for me isn't always best for the next person.

So, sure, I'll take my show on the road. However, I think each of us has what it takes to effectively comm w/docs, It's the confidence that's lacking. That's hard to provide in a forum post. I wish it would always work like it did for Juliet today. Now I'm rambling. My legs hurt so bad tonight. I think I'll try to see if sleeping will distract me.

steve
steve

Last edited by forginon; 05-21-2008 at 08:17 PM.

 
Old 05-21-2008, 07:59 PM   #13
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Re: Need support in asking doc for new meds~PLease!

Thats amazing... how can the drug companies justify those prices?

I wasnt trying to be rude, just wondered if you were allergic to the run of the mill factory made meds, of didnt find thm effective, or some other reason.

cheers

J

 
Old 05-21-2008, 07:59 PM   #14
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Re: Need support in asking doc for new meds~PLease!

Steve and Melissa~
Thx for the great suggestions and support. Im really stressed right now, and just having you get to the point and help me tonight is axactly what I am needing.
I need to get to bed, and Ill get back on in the morning and re- read all of the great suggestions from everyone.
Thank you again~
xoxoxox,
IZZY'SMOM


p.s. Steve? why would you ever think that youve let me down? Stop that, or Ill have to give you a good smack down!~ You know I adore you, and you are always so positive and knowledgable. Thank you for always keeping me positive and helping me out. Anyone who is positive and helps me thru a stressful time is always a huge asset. I consider you one of the ones who always knows me best.

Sorry, but Im really hurting these lst couple of days, and Im not very patient.

Last edited by IZZY'SMOM; 05-21-2008 at 08:11 PM.

 
Old 05-21-2008, 08:54 PM   #15
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Re: Need support in asking doc for new meds~PLease!

Izzy,

No need to explain about patience. Pain does this to all of us, and we all understand.

I even got short with my wife this evening because of how badly my legs are hurting. Talk about feeling like a low life. Even though all I did was ask for some alone time because of pain, no raised voice, just impatient, that kind of behavior makes me feel awful. Totally unscceptable! I'll do something special for her this weekend to make up for it.

As a matter of fact I don't think my knees have ever hurt this much except post op. This is one of those times I wish I still had the Actiq lollipops for BT pain. I can hardly walk.

Back to you, Izzy. I hope you get some real good rest. Tomorrow's another day - and I definitely think it'll be a very good day for you.

steve

 
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