Thanks for giving us an update as I was just reading through your previous thread from back in August as you were waiting until November to get your insurance. And back then..you weren't able to get any type of med increase...
So I am glad that you have found a PM Dr. and they are helping you..
I say this next thing with care and support and I promise it's not meant to be snarky.....I just think that you worry a bit too much about what is "normal" or not based on others experience or thoughts as you asked this same thing back in August..
And the reason I say not to worry...is that you just need to work with your Dr. and see what works for you. Trying to compare your medication or treatment to what others do, or even what friends/family think about it should not be a concern at all. I just hate for you to have any unnecessary angst based on this type of worry.
We all have different pain issues and treatments according to what our pain generators are, how long we have been in PM, what other health issues we have, and our tolerance to meds and pain.
Again...my point is not trying to be mean at all so I hope it comes out the right way
..I just don't want you to worry so much.
I know that you were in a lot of pain a few months ago and were hoping to get a medication increase and now it's great that you are getting the MSContin added to your Percocets...It's too bad that you had reactions to the Methadone...but thankfully the MSContin is helping lower your pain levels.
I know I had mentioned previously that you are on such a low dosage of the Gabapentin at only 600mg....The therapeutic dosages for that particular medication is from 1600mg to 3600mg. So that is where you can speak with this PM about raising the dosages if needed to help more with the nerve pain as opiates do not really work well for that type of pain.
Also....chronic pain management is so much more than just the medication you take. Does this PM have you doing other things daily/weekly/monthly to help with your pain?
The more we can use other modalities, the less we have to rely on our meds and keep raising the dosages over time.
There is daily exercise (at least 30-45 min. a day), physical therapy (going a few times and then learning what to do at home), yoga/stretching, aqua therapy, injections, steroids, acupuncture, massage (regular and ultrasound), TENS unit, biofeedback, counseling, ice, heat, etc.
As well as hopefully you do not smoke as this is now proven to cause disc dehydration in the spine (let alone all the obvious health issues), and then eating well and maintaining a healthy weight.
Are you still on track to get insurance in November? That will be great so that you can start using some of the other modalities that insurance will cover like the PT, injections, etc.
And sorry that you had a bad experience at the Pharmacy....but they are under great scrutiny/pressure, along with the Drs. with any controlled substance. So if you were coming in there for the first time filling your opiate prescriptions...then they are going to double check everything....And especially if you are paying cash...they are that much more suspicious.
Obviously I am not condoning rude behavior...but just explaining that if they don't know you, they are more apt to be more demanding/thorough with their questions.
Just make sure that your Dr. knows that you had to use another Pharmacy as many PMs have their patients sign contracts that you only use one Pharmacy for your opiate prescriptions. As 42 states now have the Prescription Monitoring Program that tracks you by name to see when/where/what you are doing. So this is another thing that this CVS may have questioned by looking you up to see that you normally go to another Pharmacy.
I certainly don't think your Dr. will have any issue with this as the Costco was out of the meds...but just wanted you to follow through to let them know about this.
And just FYI but most Pharmacies only get shipments of their controlled substances once a week. So I would make sure that you speak to the head Pharmacist at your Costco and find out what day they usually come in. And then the best thing is to always call ahead to make sure they have what you need before you drive there.
I think it's very important to befriend your Pharmacist and get to know them personally as well as they can get to know you. This can really come in handy with these type of situations...
So...I think it's great that you have found a good PM Dr. and really hope that starting in Nov. you can get even better treatments and start using even more modalities to keep your pain at a decent level.
I live with about a 5-7 on the scale depending on the day. With my PM Dr...we try not to up the dosages of medications but end up rotating them every 3-4 years. This way it has kept my tolerance level down to any medications.
But that is just me and as I've said...you have to do what is right for you and what you and your PM think is best for your treatment. There isn't any type of "right or wrong"....it's just about living your best life with chronic pain...
Thanks again for your update