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Old 01-12-2010, 10:17 PM   #1
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Have You Ever Ran Out of Meds?

Have you ever ran out of your meds before it is time to get new ones. If so, what did you do when you ran out?

I go to a Pain Management Clinic. They prescribed meds for thirty days. They prescribed me 30 hydrocodone for my club foot and tumor in my knee. My PCP prescribed me more than the PMC.

I ran out of the 30 hydrocodone seven days before my thirty day cycle. I was given a prescription for 90 hydrocodone but cannot have it filled until 1/20. Has anyone ever had a prescription filled early?

I feel very bad. My PMC made me feel pathetic for running out of 30 hydrocodone one week before my thirty day cycle. Also, I know that the PMC has a thirty day rule. I do believe that they should have given me something so I am not in agony. All I can do is lay in bed all day. My pain has ended all of social interactions and life.

Now I want to go back to the PMC and tell them that the 90 hydrocodone is not enough and that they need to write me a prescription for 150. If not, I will be running out again before the thirty days is up. I do not want to make these people upset.

I am not happy with my PMC because I went there to get treated with a strong pain med and then something for break thru pain. I was hoping with this treatment I could get out of bed and start regaining my life.

What do you think that I should do? If you have run out of your meds early what did you do? Thanks.

 
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Old 01-13-2010, 03:16 AM   #2
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Question Re: Have You Even Ran Out of Meds

I'm sorry, I'm confused. So, your PMC wrote you a prescription for 30 Hydrocodone. Then they wrote you another prescription for 90? Why didn't they just write the initial prescription for 120?? What are the directions on the bottle of 30 (how many pills are you allowed per day)? So, was the prescription for the 90 Hydrocodone your PMC gave you, your next month prescription? I'm just confused why they'd only give you 30 initially and then the next time they see you give you a prescription for 90, but not allow you to fill it until a certain date?? If they wrote you a prescription for 90 they are acknowledging that you need more medication than the 30, so I don't see why they are making you wait until next week to fill it. What was their reasoning?

I do know from experience with my Pain Clinic, my Doctor and her staff are very strict on early refills - under no condition can I call in regarding early refill. Of course I can call with med questions. But, early refills are a big no-no.

I wish I could help more, but I'm just confused a bit by the "two prescriptions" and why your PM Doctor didn't write it as one prescription for 120 in the first place (which sounds like would be close to the number of pills you need for a month). So if you can clarify this, maybe I will be able to offer a suggestion.

Communication while you are in pain management is very important. So, definitely be assertive and let your Doctor know your pain levels and the amount of time your pain is managed after you take your medication and this will help your Doctor figure how much medication you should be prescribed to keep your pain managed. With your issues it might be worth it for you and your Pain Management Doctor to look into a Long Acting medication (in addition to the Hydrocodone). This would allow you take less pills and would only require you to take the Hydrocodone for break-thru pain. Has your PM Doctor talked to you about Long Acting medications at all?

Please provide clarification to the questions I asked in the first paragraph and hopefully I will be able to provide some input.

I'm so sorry you're going through.

~ Fiona Jo
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Last edited by Fiona_Jo; 01-13-2010 at 03:17 AM.

 
Old 01-13-2010, 06:03 AM   #3
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Re: Have You Even Ran Out of Meds

I am sorry you are having so many problems. However, most doctors, and almost all pain management doctors will not permit ealy refills because you ran out. Some will permit picking up scripts early due to severe weather events, holidays, or vacation needs. In those instances, if you were due on say the 15th and picked up on the 12th, you will have to wait until the 15th the next month (assuming a 30 day month). My PCP prescribes my meds and allows me to do this (ie. the Christmas blizzard in the midwest), however if I ran out and called for more, I would be dismissed.

Since you are going to a pain management clinic and were given a prescription for narcotics I assume you signed a contract. You need to read thru that contract and abide by it to the letter. Generally just asking for a early refill because you ran out is considered grounds for dismissal. Yes, I know you are in pain. Yes, I know it's miserable. I don't mean to be harsh, but you need to try to work with them. Most doctors add to dosages slowly as they get to know you and better evaluate your condition and how you react to dosages over time. Start keeping a log of your pain levels, and how it affects your life. Be specific, as in "was unable to fix dinner", "could not give kids a bath", "had to stay home from work", along with the pain levels. I'd record it at least 3 or 4 times a day. Be realistic with the numbers, a log that has all 10's isn't going to be taken seriously. I read your other post and it looks to me that they upped the hydrocodone to 3 a day and added another stronger med (oxycodone), is that correct? If so you need to wait and try that for a minimum of two weeks before calling them again. Calling or going in and demanding more before you have even tried that combination and had a second scheduled appointment is likely to get you dismissed. Certainly taking more than prescribed and running out again will lead to being dismissed and will make it difficult to get treated in pain management in the future. Pain management doctors often test paitients and unless they have already been in pain management and referred because they moved or something are started at very low levels of medication at the beginning to protect themselves and their practice from drug seekers. I'd guess that this is what this doctor is doing. I would try to work with them for at least a couple of months. Again, I'm not trying to be harsh or not take your pain seriously, but it takes time to get to an appropriate dose in pain management. Better to be miserable for a short time and have long term treatment than be dismissed and not be able to get treatment in the future.

Tigg.

 
Old 01-13-2010, 06:42 AM   #4
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Re: Have You Ever Ran Out of Meds?

If i find myself taking more than I am presribed I know I will have to take LESS for a day or so just so I won't run out early. having something is better than nothing at all, especially since they may do a US. The last thing you need is a negative drug test

 
Old 01-13-2010, 12:20 PM   #5
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Re: Have You Ever Ran Out of Meds?

Fiona,

When I went to the Pain Management Clinic, I was prescribed 30 hydrocodone. The care givers at the Pain Management Clinic told me that it would take a while to find out which medication works for me. I told them that my PCP gave me more than 30 hydrocodone for a month. I was told to contact them if I ran out. Due to the fact I chose to go to Pain Management because I thought they could get me on a better treatment plan that my PCP; a treatment plan that would allow me to be able to get out of bed and into physical therapy. Now that I am in Pain Management I cannot get any other medication from any other sources. That is fine with me because I prefer to have my medication given to me from one source. I feel really horrible and like I am failure because I ran out of 30 hydrocodone in the thirty day cycle.

 
Old 01-13-2010, 04:25 PM   #6
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Re: Have You Ever Ran Out of Meds?

Dear Vick,
I'm still confused that you said that your next prescription is for 90 pills and you already know that those 90 won't be enough and you want to tell the PM doctors that you'lll need 120 pills next month. First of all how do you know this? Even more importantly I see RED FLAG. Jumping from 30 to 90 and then asking to go to 120 is not a good thing to do. Don't tell the doctors that you need more pills, keep a pain journal and present the data to the doctors.
Please keep in mind that there's more to pain management than pills or even physical therapy. A lot of pain management is what we, the paitents, do to help ourselves. I know that I meditate every day, I use ice, heat, a TENS machine, deep breathing, hot tea, vitamins and others. It's key to learn how you can control the pain. This will help to lessen the amount of medication you will need to take. It will also help on days when you think that that day's meds aren't going to cut it. As one of our fellow posters said, if you need an extra pill today, take one less tomorrow. You don't want to go for a week with nothing.
In the meantime hang in there until you can fill your meds. I don't know of any pharmacy that will let you fill it before the date on it. From what I know, the pharmacist can loose their license for filling meds before their date.
I know it sounds hokey, but think happy thoughts, surround yourself with things that make you happy and relaxed for the next few days. Take a hot bath, have a cup of tea, laugh with your husband or child, watch the snow, get a CD and learn to meditate, exercise the upper part of your body, eat ice cream for dinner and realize that this too shall pass.
Take care and keep us posted.
Peggy

 
Old 01-13-2010, 06:48 PM   #7
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Re: Have You Ever Ran Out of Meds?

I am also truly confused by your posts. Your PM doctor, that I am guessing is a recent addition to your care, gave you a prescription for 30 vicoden. You got another prescription for 90 more vicoden from somewhere but can't fill it until the 20th. And you are now planning on telling them that unless they give you 150 vicoden, you are going to run out again. How many times have you run out of vicoden?
To answer your question, No, I have never run out of pain medication. In fact, I tend to have some left over each month. As far as getting that prescription filled early, no, you will not find a pharmacist who is going to fill it a week early.
If you are new to pain management, I would strongly suggest that you read that contract ,if you signed one regarding pain medication, getting it from more than one source, prescription filling, and running out of meds early.
It takes time to get to establish a level of trust between you and the doctor who is treating your pain. Almost every pain management clinic now uses contracts, urine or blood testing to check for the levels of the medications they prescribe, and to check for other, unprescribed substances too.
Getting your pain treated is a multi step process, and it is not just limited to
pain medication, but includes ice, heat, TENS, physical therapy, sometimes counseling to help a patient deal with their pain, and it takes time, not days or weeks to get medications correct but many times months to get the right combination of medications . Pain management is not a sprint, it's a marathon.
You are seemingly at the starting gate, and you need to have a lot of patience. Making demands and telling the doctors the quantity you feel that you need is not going to work well for you. Running out of medication is not allowed. If your pain is not being managed, you need to be seen again by the doctor, or you need to call them and let them know.
You will need to have patience when they try you on different medications, giving them at least two weeks after a change is dose or medication to see how it is going to work before deciding that it is not working for you.
I wish you luck but wouldn't advise trying to fill that script . You are far better off to wait until the 20th and to stick to the dosing schedule you are given by the pain management doctor. If that script came from your primary, you need to either let the pain doctor know and see what they want you to do with it, or throw it out and not fill it. Do not adjust your doses on your own, no matter what. If it does not work for you , then you need to discuss it with the pmd, instead of taking more. That will get you dismissed and you will find out that you can't get in to see any pain management doctor.

 
Old 01-13-2010, 06:55 PM   #8
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Re: Have You Ever Ran Out of Meds?

hydrocodone is the weakest of the narcotic meds and will likely not get a bedridden person out of bed. I would go in and be direct with a request to take a longer-acting stronger medication and then a short-actinng for breakthrough pain. If they are out of sorts because you asked for a specific type of PM (not specific medications, just a medication profile), then in my opinion, you are not out much

. I would then go elsewhere. Just my two cents.

Last edited by Administrator; 02-13-2010 at 12:41 AM.

 
Old 01-13-2010, 07:22 PM   #9
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Re: Have You Ever Ran Out of Meds?

[QUOTE=backhurtz;4162593]
Dear Vick,
I have to wholeheartedly agree with a few of the points that Backhurtz made.
First, if you signed a pain management contract you need to back and read it now. It will lay out the office policy of who you can and cannot get meds from. All of them I've seen and heard of state that the patients can only get pain related medication from them, the pain management doctors. This prevents doctor shopping and cuts back on patients who are drug seeking. I know that you're not drug seeking, I'm just pointing out why they do this. The contract will also tell you about blood and urine tests. The doctors reserve the right to do "random" urine tests.
Second, pain management consists of using many different modalities. I addressed this in my previous answer to you. One that I forgot about is counseling to accept our new pain filled lives, or to address issues with our medical conditions. I have gone for several rounds of counseling to deal with my TMJ pain. My pain is the result of an assault many moons ago, and I've been through treatment for post traumatic stress disorder.
Third, as much as it may be frustrating, please allow the meds time to take effect. Some of the drugs we use can take two weeks to get a good solid blood plasma level in our systems. Once you get to having the severe pain that we have the short acting meds are not always the answer to our problems. The doctors usually use a combination of long acting and short acting meds.
Please keep us posted. Hang in there, it'll get better.
Peggy

 
Old 01-13-2010, 07:59 PM   #10
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Re: Have You Ever Ran Out of Meds?

Vicoden may be on the low end of the spectrum of pain medications, but it does in fact, work very well for a large number of people.

Back

Last edited by Administrator; 02-13-2010 at 12:41 AM.

 
Old 01-14-2010, 10:22 AM   #11
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Re: Have You Ever Ran Out of Meds?

It's important to do the math and know how much you can take a day without running out. It seems many people aren't aware of this concept.

 
Old 01-14-2010, 09:25 PM   #12
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Re: Have You Ever Ran Out of Meds?

the first thing I do when I get my meds is to take out my weekly pill count box. I put exactly how many I'm supposed to take each day in its proper day.
That way I know that the prescription was filled properly (it always is, the pharmacy does a double count) and I don't accidentally take too many pills in one day.
I, too, have never run out of my meds.

 
Old 01-15-2010, 12:55 AM   #13
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Re: Have You Ever Ran Out of Meds?

When I went to my Pain Management Clinic I was prescribed 30 Hydrocodone. I ran out of the 30 Hydrocodone before the thirty day Pain Management Cycle. The thirty day cycle is January 20. When I went back to the Pain Management Clinic for my followup, I told them that I ran out of the 30 Hydrocodone. I felt very judged. At my followup appointment, I was given a prescription of 90 Hydrocodone which can be filled on or after January 20. I feel as though I made a mistake in taking the the prescription for the 30 Hydrocodone the first time I went to Pain Management. Now I am afraid that the same thing will happen with the prescription of the 90 Hydrocodone. I do not want to be a problematic patient. Both of the hydrocodone prescriptions are from the same place and will total 60 days; two thirty day cycles. My next appointment is in mid February. Thank you everyone for all of your advice. It really does help and I greatly appreciate all of you.

 
Old 01-15-2010, 07:32 AM   #14
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Re: Have You Ever Ran Out of Meds?

What were the directions on the bottle of 30 day meds? Were you only supposed to take one per day? Did they inform you that the script should last 30 days? I think when you go back you need to get this clarified. If you don't understand the directions or dose you should be taking then just ask. I would think that they would appreciate that you are asking in advance this time.

 
Old 01-15-2010, 05:46 PM   #15
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Re: Have You Ever Ran Out of Meds?

The problem Vick, again is that you can only take what the doctor tells you to take each day. It doesn't matter at this point whether you are having more pain. If that happens, you have two choices- either call your doctor and ask them what you should do or suffer through it/try other means to ease some of the pain. You are not supposed to "adjust" your own dosage.
You signed a contract saying that you would follow the directions of the doctor. The medications are supposed to last 30 days- not 23 or 25, 30 days.
It has nothing to do with judging you, it has everything to do with the rules you agreed to when you went to pain management. ONE prescription of pain meds for 30 days, no matter what.
If the meds aren't working you, then by all means, at your next appointment, talk it over with your doctor and ask him what other things you can do to relieve the pain, instead of taking more meds than you are prescribed.
If you fail a urinalysis because you took more meds than you were supposed to, you won't have to worry about being in pain management any longer. They will throw you out of their practice and it will follow you to any other doctor you see.
That's the bottom line.

 
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