As most of you know I have started with a PM doctor.
He kept me on the percocet & allowed me up to four aday, which I was up to 3/12 to four anyway. I appreciate that he listened to me & allowed me that amount. I was honest with him & told him at times I have to take at least 1/3 to 1/2 more in the morings & am very careful to take the least amount that would work for me.
The instructions are 1 10-325 every 6hrs. Well not matter how hard I try I cant make it 6 hrs most of the time, & 1 is just not enough most days for mornings. I am one who follows the rules but I just cant wait that long in between doses.
I have stuck to the amount allowed, no more then four aday, In fact still trying my best to stay at 31/2, he did make it clear that 4 is all he would allow me. I have had to go back to work & that makes it alot tougher. I have no choice at this time. Anyone living where I live knows if you have a job you better hang on to it & count your blessings. So I am sure this PM is well aware of that. Like I said I am doing ok with the allowed amount per day, its just the dose & hrs between. I can up the valium abit but I really dont think that will make a difference. The weather has been awful & that is making it even worse for me. In the evenings I when I am home I just try to rest & ice or moist wrap. That thus far is saving me from needing to take that fourth dose, but if I continue to work & the weather is not going to cooperate I can see me needing it in the future.
So what is the best way to approach the PM with my problem? since I just started I dont want to rock the boat so to speak.
I will have to let him know I had to go back to work. I am going for the Transforaminal epidurals & praying that I get some relief but I am not getting my hopes up. I would really appreciate any suggestions. Thanks everyone.
Sammy
Sammy.....Maybe you've said it and I just missed it, but what is your prognosis? Is your pain "chronic" and something that is expected to be around for awhile / forever.......Or, are you expected to eventually recover somewhat? I think the answer to that usually yields the treatment plan.
If chronic for example, you should be put on some type of LA med with something for BT pain. What you're experiencing is perfectly normal....The Percs just aren't cutting it anymore. Although the initial punch of the med may be enough, the time in between isn't.
I think I would just be honest and say that the Percs are working, but just like you wrote here, that the pain gets very bad and waiting 6 hrs is tough. Just be sure to characterize it as your pain, and not your body wanting the Oxy....Big difference between the two.
However, if your prognosis is some type of recovery, then you don't want to go down the LA road and the absolute minimum required is prudent.
Sammy, I know this doc made it pretty clear that he doesn't intend to give you any more than what you are currently prescribed, but I feel that with CMP and your other shoulder issues, you really need some form of LA med. That is why I would suggest that you try to hold out till the other PM who is in the process of participating with your insurance, comes on board and make an appointment with him. It bothers me that the one you are seeing right now kind of blew off the myofascial diagnosis anyway. Especially when his office staff told you he had other patients with CMP and was familiar with it.
I know the waiting is painful in more ways than one, but if you can do it, I would just keep calling the other office to check up on the status of his application with your insurer. As soon as they tell you he is on board, I would make the earliest appointment that they can give you and go see him. Or if they allow it, I would ask if they can put you on some sort of waiting list, so that you will know as soon as it happens. If I remember, they seemed to be quite nice when you initially spoke with them, right? They may even have other potential patients who are waiting for him to participate as well.
I am sorry it has worked out this way for you right now. Especially since you have returned to work and need better, more lasting coverage than just a short acting med right now. Maybe if you explain that your situation has changed with going back to work, your present doc might reconsider an LA med. Have you told him you have had to return to work? I think it is at least worth a try. Even if he could give you a real MR instead of just the valium, that would make a difference, I believe. I know the valium does help, but it's not quite the same as a true MR.
Sorry I'm rambling. Hubby has some nasty stomach bug and I haven't slept too well the past few nights. I've been sleeping on the couch so as not to get whatever it is he has. Sad, but true. I am taking care of him, of course, but I've washed my hands raw and I've been following him around with disinfecting wipes! I can't even let myself think of getting this bug. It would probably put me in the hospital because I wouldn't be able to keep my meds in me. (I am shuddering just thinking about it)
Anyway, Hang in there hon. My heart goes out to you. I wish you didn't have to go through this. But please remember I am praying for you and sending positive thoughts your way. Hugs, CMP/MM
Sammy, it could be that when the doctor told you he would prescribe no more than the 4 percocets per day because he is testing you to see how bad the pain is. I know when they first put me on pain meds they gave me the lowest dose then moved it upwards as needed.
I would go at your next appt and tell him how you take the percocets you are at a 7, 2 hours later you are down to 4, then by hour 4 you are at a 6, hour 5 you are at 6, hour 6 you are at a 8. You might even consider showing him documentation to this effect that you take the meds, it works then it slowly starts building back up. Hopefully at this point, he will increase your meds or move you over to long lasting. All you can do is show him what is happening and let him decide what the next step is. If he says he will NOT adjust the meds, then you know you need to seek out another doctor who will help you.
I think that you need to be on a LA medication. I know that he said that he would put you on no more than 4 of the Percocet per day but that doesn't mean that he wouldn't put you on something else. You should really tell him just how much pain you are in. Tell him that your average pain level every day is "x out of 10". Tell him that the pain is making it extremely difficult to be able to work. See what he suggests then. Hopefully he will then put you on something long acting. Maybe he would put you on Oxycontin with Percocets as the breakthrough. I know many doctors are staying far away from prescribing Oxycontin but there are other LA meds like: Avinza, Kadian, Fentanyl, Methadone, and Opana.
Linear Mode
