It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 08-18-2012, 10:22 PM   #1
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
I could really use some advice please?

Hello. I'm very confused on an issue I ran into at a pain clinic. I went there for my first visit last Tuesday. I had been in the emergency room twice, 2 months ago, and they gave me lortabs both times. I saved a few of them, because I knew I wouldn't be able to tolerate sitting at the doctor without anything for pain. I spend about 98% of my time in bed, because the pain is in my neck, and I can't sit up for very long. Anyway, at the pain clinic last tuesday, I told him I had to take the lortab just to be able to sit up long enough to get through the appointment. He said that if my urine test came out positive, they wouldn't give me anything for pain, and it's one strike, you're out pain clinic, and then they will never give me anything. He said this particular pain clinic has a rule that if the emergency room visit was more than a month before the appointment, then they wouldn't make an allowance for me having the lortabs in my system. He said it wasn't against the law, but it's just this particular pain clinics rule. This was my first visit there, so I had no way of knowing about this rule. It's sad that I laid here in so much pain, and fought the urge to ease it with the few pain pills that I was saving. I not only did it for nothing, but not taking them until my appointment actually hurt me in the long run. My feelings are hurt so badly. I just feel like they are insinuating I've done something bad, but I don't know what. I've cried off and on since I was at the pain clinic. Despair isn't a word I've ever used, but it describes what I'm feeling perfectly..... I'm so confused not only about that being a rule, but also the fact that I don't understand how they could expect me to follow one of their rules before I was actually a patient, and how they could expect me to follow one of their rules, when I had no way of knowing this was a rule. I've just struggled so hard with this pain, and I'm exhausted in every way possible. Physically, emotionally, and spiritually. I'm trying to not give up hope, and trying even harder to be patient, but it's just breaking me when I'm referred by one doctor to another, and have to wait so long for an appointment, just to have another obstacle put in my way as far as getting help for this pain that I can't stand any longer........

 
Sponsors Lightbulb
   
Old 08-18-2012, 11:03 PM   #2
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
Re: Confused (Thread name changed) I could really use some advice please?

Just wondering if anyone has gone through anything similar to this, and/or has any advice on how I can handle this without having to go through changing pain clinics. I just don't want to get into skipping around to find a doctor to help me.......

 
Old 08-19-2012, 11:07 AM   #3
Senior Veteran
(female)
 
Join Date: Mar 2012
Location: Washington
Posts: 801
tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
Re: Confused (Thread name changed) I could really use some advice please?

Sorry you are dealing with this. I haven't gone through this situation, but I can so much relate to your desperation and frustration. If you think this clinic is the best option you have right now, I would schedule another appointment as soon as they can get you in (one Vicodin should get out of your system quickly) and follow the rules. They are required to have rules like this. I know it seems like so many hoops to jump through, but you have to have hope that they can help you. It can be a long journey to relief.

Even when you get into a clinic, they will likely have you try various non-narcotic treatments first...injections, meds, etc, unless you have records showing you have tried a lot of this, and they agree with how they were tried. The best you can do is calmly communicate to them the amount of pain you are in, for how long, and how it is interfering with your life. Be very careful not to ask for pain meds or come off as drug seeking.

I would try to see it as a positive thing that they essentially told you not to start treatment with them there today as you wouldn't have passed the test. They could have not told you that, then kicked you out right away. From their eyes, someone could get a one-time script for a med but then obtain them illegally. I can see why they have to set some sort of time limit of what counts as a recent prescription...its the same as if you are on a medication but still have some old pills left. Although that old prescription was valid, it doesn't cover you for taking that extra old medication (in the eyes of a pain clinic).

Hang in there! I know how tough it is to have to wait so long for any hope at pain relief. It took me a few years to finally get onto a treatment that helped, and then I built tolerance and my doctor wouldn't change or increase the meds. I spend a couple years in that cycle asking to be referred out to a PM doc, but finally realized I needed to find one myself. So glad I did that now as I am back at that good point now (50% relief, which is about the best we can hope for). Best wishes.
__________________
Kate
constant headache since 2006

 
The Following User Says Thank You to tortoisegirl For This Useful Post:
gmak (10-11-2012)
Old 08-19-2012, 04:19 PM   #4
Senior Veteran
(female)
 
BB07's Avatar
 
Join Date: Feb 2010
Location: Lower Alabama
Posts: 979
BB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB User
Re: I could really use some advice please?

hi- i am sorry you are suffering. but i understand why that pm refused to give you any type of med if your urine showed positive AFTER 1 month from getting them from the er, i know you said you made two trips to ER-If you are REALLY suffering, it is not logical that you would be able to any meds from er, because 1) they dont give that many-and if you are in debilitating pain-you would used them by know-so, your PM thinking is-

1- if you were in so much pain there is no way you would have any of the few the er gave you after a month,

2) this PM may believe you are lying about saving this med so you could get through your visit.

i will bet a month of medication that your PM thought you had them in your system is because you are buying/receiving them illegally.

i am not saying you lied either-just been in PM long enough to know the most honest intentions can be turned on you and make you look suspicous
__________________
constant companion pain

Last edited by BB07; 08-19-2012 at 04:22 PM.

 
Old 08-19-2012, 09:24 PM   #5
Senior Veteran
(female)
 
backhurtz's Avatar
 
Join Date: Oct 2008
Location: NY, USA
Posts: 541
backhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB Userbackhurtz HB User
Re: I could really use some advice please?

Most PM offices these days do testing/urine gcms testing off all new patients. As far as why their particular practice does not allow a new patient to take meds over 30 days old, is most likely because if you are taking meds from an ER or another doctor, by the end of 30 days, you shouldn't have any of that particular med left over, and there is no way to verify that those meds are from that same prescription. In the case of the ER, once you completed the course of treatment for pain/resolved that condition that caused the visit to the ER, there is no reason for you to still be taking pain meds given by the ER. Taking meds given to you previously by an ER, in the eyes of the new clinic is considered self medicating.
If you had not gone to the ER two months ago, you would have had to find another way to make it through the appointment, without the lortab and BB is right, if you are telling them you are in so much pain that you are spending 98% of your time in bed, and are unable to sit up long enough to make it through an appointment without pain medication, there is no way they are going to believe that you saved some lortab, while waiting for an appointment with them some two months after being seen in the ER.
One thing that patients need to understand is they need to realistic about their actual pain levels, and not feeling a need to over estimate their pain to get what they want /hope will be strong pain meds. Anyone who is unable to get out of bed, due to pain so severe it requires them to be in bed 98% of the time would have been hospitalized long before now because pain at that level , would have put their body in danger of increasing risk of stroke or heart attack due to the constant stress on the body.
Then there is the additional problem of laying in bed that much does cause further worsening of any condition that you have going on. It weakens the muscles and ligaments in the neck, as well as exacerbating any other weaknesses in the body you may have. It is also going to limit your ability to stand up as you continue doing that.
I am a bit confused as to whether or not , you actually took the urine test or not and if you actually saw the doctor. If you did, you may be left with no choice but to find another doctor/PM clinic and you may need to assume that they will give you another urine test at the first visit and plan not to take anything but maybe some anti inflammatory type meds or tylenol before the appointment if you need them. Heat and ice may also help with the pain levels prior to the appointment.
Back

 
Old 08-20-2012, 11:12 PM   #6
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
Re: I could really use some advice please?

You're right about the strain on the body. Because of my having to stay laying down, when I get up for more than 15 minutes, my blood pressure goes dangerously high. I've had to go to the hospital from my doctors office due to it being 228 over 154, and they couldn't bring it down with meds. My muscles are very weak because of not using them much also. It's definitely taking a toll on me.

I've had 3 surgeries on my spine, which I wish I hadn't, because the pain actually got worse every time I had surgery. The pain doctor said looking at my mri, he sees a few problems that just one of which would cause me severe pain. I have a bone spur growing inside of my spine where the nerves run down through it, and the nerves are bunched up due to that. I've got a lot of scar tissue around the area from them going in through the front in 2 surgeries, and through the back on 1 surgery. I have 2 bone fusions, one from a bank bone, and one bone they cut out of my spine from about 2 or 3 vertabraes down, and also a wire was attached to the back in an 8 shape around screws that are in the C6-C7 vertabraes to hold the space still in between them. The nerves that run through the top and back of my head and down my neck are all damaged permenantly also. I'm not sure what caused it, but I also have a muscle in the left side of my spine right below my neck that sticks up about 1 1/2 inches, is rock hard, and pretty painful. I've just got a lot of damage back there.

When I say I can't sit up long enough to get through the appointment, my meaning is that when I do sit up that long, I spend 2 to 3 days in so much pain, that I can't focus on anything enough to be able to think straight, it hurts too bad to even talk or cry, and I'm throwing up about every 15 to 30 minutes. The pain is just beyond unbearable and impossible to describe how bad it really is.

I did see the doctor. He said he has no doubt that my pain is for real, and that it is severe after reading my mri. They had me pee in a cup, so I'm assuming that was a drug test, since they told me it was.

Last edited by Administrator; 08-24-2012 at 09:39 PM. Reason: Removed inappropriate comment.

 
Old 08-20-2012, 11:18 PM   #7
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
Re: I could really use some advice please?

Where I wrote in my reply "The pain doctor said looking at my mri, he sees a few problems that just one of which would cause me severe pain.", I accidently left out that he said that just one would cause me severe pain, but I had multiple problems that each one causes severe pain. He also said that after seeing my mri, and the type of injuries, he has absolutely no doubt that my complaints of pain are 100% legitimate.

Last edited by Administrator; 08-24-2012 at 09:40 PM.

 
Old 08-20-2012, 11:30 PM   #8
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
Re: I could really use some advice please?

Oh. I forgot to mention, in addition to the other damage in my neck at the C6-C7 level, the disc above that is bulging, and two discs below are herniated.

 
The following user gives a hug of support to StruggledOut:
Paininohio (08-21-2012)
Old 08-21-2012, 06:14 AM   #9
Senior Member
(female)
 
Join Date: Jun 2012
Location: Pennsylvania
Posts: 144
Prettyinpink81 HB UserPrettyinpink81 HB UserPrettyinpink81 HB User
Re: I could really use some advice please?

I am so sorry you need to wait to get relief, I can't imagine how frustrating it must be for you.

Last edited by Administrator; 08-24-2012 at 09:40 PM.

 
Old 08-21-2012, 06:45 AM   #10
Senior Member
(female)
 
Join Date: Jun 2012
Location: Ohio
Posts: 125
Paininohio HB UserPaininohio HB UserPaininohio HB UserPaininohio HB UserPaininohio HB UserPaininohio HB UserPaininohio HB User
Re: I could really use some advice please?

I too am sorry your going through this, did the results come back yet and any word if the doctor will treat you? I know my first PM appointment my doc asked if i wanted hm to do my scripts or my DO, and to let him know the next visit. I believe it was his way of politely letting me know that he doesn't prescribe medicine on the first visit.

Best of luck to you!

 
The Following User Says Thank You to Paininohio For This Useful Post:
gmak (10-11-2012)
Old 08-21-2012, 10:35 AM   #11
Junior Member
(female)
 
Join Date: Jul 2012
Location: Danville, CA, USA
Posts: 30
ttomtom HB User
Re: I could really use some advice please?

Well, I woke up in full blown withdrawal. I was afraid of this. I even woke myself up in the middle of the night gasping for air (but that could have been a bad dream - not sure hard to tell), I'm drenched with sweat, shaky, nauseated, etc. I have to leave for the doc in an hour, so hopefully he can help, this sucks. Grrr.

 
Old 08-21-2012, 05:17 PM   #12
Senior Veteran
(female)
 
Join Date: Mar 2009
Location: East Coast, VA, USA
Posts: 556
Ilovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB UserIlovemycutedog HB User
Re: I could really use some advice please?

Hi there...

Sorry to hear what you are going through...

May I ask how many Lortabs the ER gave you on the last visit? And how many did you take in the 48 hours before the urine test?

And I am a bit confused...did you go to the ER because of your blood pressure? Or because you were in pain.

Many other posters are just trying to share what it "looks" like from the PM Drs. view. For a person who has had previous surgeries...like many of us on here have...usually there isn't a reason to go the ER. That is for life and death emergencies. So if you were going based on pain that you know is caused by your previous surgeries...it unfortunately "looks" bad that you are just going to try and get narcotics.

Now, if you had any type of new symptoms where you needed to actually call 911 like you thought you were having a heart attack or appendicitis with high fever...than those are true emergencies.

So right off the bat, this PM is already looking at the fact you have gone to the ER. Again...I am NOT saying that you don't have great pain. I have had 3, two level fusions myself. The last one they went in from the front AND the back of my neck...And yes, they have used both donor bone and bone from my hip. As well as I have a brain tumor, and numerous other health conditions...

I definitely empathize with you....

And as mentioned, the ER usually only gives a few days worth of medication...so yes, it unfortunately looked bad that you took the medication the day before/day of the appt. to see them as that would be "self medicating" in their eyes.

At this point I guess your only choices are going to be that they decide it is ok you took the medication and go ahead and take you on as a patient, or you have to make another appt. with a new PM to start over.

I truly am sorry that you are going through all of this and hope that you can find a Dr. soon. It took me quite awhile and meeting a few PM's before I found the wonderful Dr. I have now. So don't give up! Obviously now that you understand more about the "rules"...(and yes...what a terrible way to learn)....I would strongly suggest that you don't make any more trips to the ER (unless there is a true life/death emergency) so that you can start over fresh with someone new...

Good luck!

 
Old 08-21-2012, 07:28 PM   #13
Senior Veteran
(female)
 
Join Date: Mar 2012
Location: Washington
Posts: 801
tortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB Usertortoisegirl HB User
Re: I could really use some advice please?

Since you had to take the test at that first doctor appointment, and from what they told you, it sounds like once they get the result they won't treat you. I'd start looking now for another PM doc to consult with and hope that nothing from this doctor gets to them. I hope you can get pain treatment soon. Can you get your primary doctor to admit you to the hospital?

That could be a way to shortcut treatment. If you present that bad off (especially if you have someone to go in with you and say for X months you have been in bed because otherwise X happens), they may be able to get you stabilized and set up with a treatment plan before being released. Worst case they just stabilize you and say to follow up with your doctor though. The waiting game is so tough. When you were in before for high blood pressure, did they just let you out as soon as they got it down? It is very bad for your health to be in bed all day due to pain, as the others have pointed out.

Even once you were to get pain treatment, it is going to take longer to come back from this the longer you are bed bound...building back up that strength and such. I too hope you didn't take anything we have said to mean that your pain isn't severe or you are lying, but only trying to explain what we think the doctor was thinking, as they are required to look for any signs of drug seeking/abuse behavior, which often severe pain can mimic.

There are even folks who develop pseudo addiction...their pain is so bad they display symptoms of addiction, but as soon as their pain is properly treated it goes away. I can't begin to understand how frustrated you were to save those meds for the appointment and wait so long only to get turned away before the next journey even started. Best wishes.
__________________
Kate
constant headache since 2006

 
Old 08-24-2012, 04:51 PM   #14
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
Smile Re: I could really use some advice please?

Quote:
Originally Posted by Paininohio View Post
I too am sorry your going through this, did the results come back yet and any word if the doctor will treat you? I know my first PM appointment my doc asked if i wanted hm to do my scripts or my DO, and to let him know the next visit. I believe it was his way of politely letting me know that he doesn't prescribe medicine on the first visit.

Best of luck to you!
No sweetie. I haven't gotten the results of the labs back yet. I'm just so physically and emotionally exhausted from fighting this pain. I try not to lose hope, but what I'm doing is just trying to get through each day, and waiting to get so sleepy, that even the pain can't keep me awake. I sleep 2 hours a night, and that's all I can do. I literally throw up every day from the pain, which when pain is in the neck, it hurts like nothing imaginable. I'll be honest, I attempted suicide about 10 years ago, because I couldn't imagine going my whole life suffering so much. The doctor did say that he wants to give me pain medication, because he can tell by my mri that I have some major problems, but he has to wait until my results come back. He also said there was nothing wrong with me saving some of my lortabs and taking them over a month after my e.r. visit. He just said it was their individual rule there that the patient not take anything past a month of their e.r. visit. I just wish I had known about the rule before the day I went. There were so many times I almost broke down and took that pill, but I just fought it, because I knew how it was going to feel sitting up in that waiting room, and knew I couldn't do it. I actually had my neurosurgeon tell me that my surgeons "butchered" me. I know I'll never be pain free. I don't expect that at all. If I can get it managable enough to just be able to move around, sit up, and do little things would make all the difference in the world. I'm not the type to whine. I never talk to anyone about how bad it is. On this message board is actually the first time I've shared my feelings with anyone. It just seems like if I complain, it just makes it worse. I have to live it. Why talk about it is how I feel.
The worst is feeling like I'm letting down those who mean the most to me. My dad is 82, and needs help because his poor body is worn out, and I can't help him. That breaks my heart. My fiance' is loyal and stays with me, although I know it's not easy for him to have to watch me lay around all the time. I can tell he gets frustrated with it, and am scared he's going to get sick of it and end up leaving.
I'm actually a very strong woman, and know everything will be ok, and I can make it until then, but I just get so sad sometimes, when I see people living a normal life, and I want just a little bit of that. I'll be fine though. I will never allow myself to give up hope.

 
Old 08-24-2012, 09:35 PM   #15
Newbie
(female)
 
Join Date: Aug 2012
Location: West Virginia
Posts: 8
StruggledOut HB User
Re: I could really use some advice please?

When the pain is so bad that you can't even hold a pain pill down due to throwing up every 15 minutes to a half an hour, and it actually hurts too bad to cry, it's BAD! I've had to cancel appointments with other doctors, and actually walk out of the office before seeing the doctor because I couldn't sit up any longer, and was in too much pain to go through it. Going through that makes me do everything possible to make them last until I could get help. I've gone through this for 20 years, so I know what the future holds if I don't try to plan ahead for what I'm going to need to get through what I have to do. I did what the e.r. doctor said as far as trying to make them last until I could get to the pain clinic, and then was penalized for doing what she said. That's the part that confused me. I felt proud that I was able to succeed in making them last, and then found out it was held against me.

All I can do is be honest, and I can't help if a doctor doesn't believe me. I do feel that the doctor believed me. They just have certain rules that they go by, no exceptions. I can understand why. There is a terrible problem with pain medication abuse. I don't want a buzz. I just want a partially normal life.

One thing I didn't mention was that I've fought this pain for so many years. Last November I was in a car accident that totalled my car. I was driving, and it threw my neck out completely, and pretty much finished it off. I can't even turn my head enough to drive now, so that was the last time I was even able to get behind the wheel. I was actually on my way to get married that day, and needless to say, it didn't happen. I still haven't been able to go get married, because the pain is too bad to even make it through that. It's pretty much ruined my life.......

Last edited by Administrator; 08-24-2012 at 09:53 PM.

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 08:01 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!