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Old 03-19-2013, 04:00 PM   #1
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Please need support and advice

I had an epidural a few days ago and went to my pm for a follow up. I never see the Dr only the nurse practitioner... She told me that they are taking me off my medication because I have been on it too long and because I at one point got a refill by my primary physician, which is not allowed. I tried to explain to her that I really need the medication it's the only thing that controls the pain and the reason why I got a refill from my primary care physician was because I could not get an appointment at the pain management office before my script was done. My drug tests they do are always perfect, I never had a problem.
I am literally in tears!!! I started a new job where I sit all day and can't be withdrawing and in pain. The nurse practitioner was trying to tell me that I won't have withdrawals which is bull!!! Then she tried telling me that just because my script is for 4x a day it's as needed and I shouldn't have been taking 4 every day. Well why do I want to be in pain... I take it so I have continued relief. I just don't know what to do my script was norco 10 4times a day, so 40 mg total. How will I function at work?? She cut me to 20 mg a day for a month and then done. Leaving me a mess. She then said that I should just go back to a surgeon which is not an option for me.
Thank you if you got this far.

 
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Old 03-19-2013, 04:24 PM   #2
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Re: Please need support and advice

That sucks......


Hopefully other members have a helpful answer?

However....why would you get another Norco refill from your primary,knowing that is a major no-no in the Pain World now?


Last edited by ferd144; 03-19-2013 at 04:27 PM.

 
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Old 03-19-2013, 05:14 PM   #3
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Re: Please need support and advice

It was a stupid mistake but because I go through my auto insurance I couldn't get an appointment for 10 days because it required preapproval and I waited to long to make my follow up. I went to see my GP and she gave me 10 days worth to carry me over. It was not done in an effort to dr shop it was so I had my medication until my next pm appointment. It just really sucks that as a patient in pain management you are treated so poorly. I think I may just go speak to my GP and see if she can help me get through this. I don't know if GPs can help weaning off narcotics but I don't want to go back to that pm doctor after being treated like that.

 
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Old 03-19-2013, 06:04 PM   #4
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Re: Please need support and advice

Quote:
Originally Posted by alex12 View Post
It was a stupid mistake but because I go through my auto insurance I couldn't get an appointment for 10 days because it required preapproval and I waited to long to make my follow up. I went to see my GP and she gave me 10 days worth to carry me over. It was not done in an effort to dr shop it was so I had my medication until my next pm appointment. It just really sucks that as a patient in pain management you are treated so poorly. I think I may just go speak to my GP and see if she can help me get through this. I don't know if GPs can help weaning off narcotics but I don't want to go back to that pm doctor after being treated like that.
What you did after reading your explanation sounds very reasonable to me. However, at my PM appointments, I make the next appointment before I leave. Both the doc and I know very well every 30 days I need refills, end of discussion. Sounds like if that aspect of things were coordinated better, this wouldn't be an issue. Although what you did sounds reasonable to me and I say this because it's not like you went ahead and got a month's worth, you got what you needed until your next appointment. No real deception going on IMO. I will also tell you that there are PM docs/offices that have a very narrow view of things and just don't allow for anything off the main track. Did you explain exactly what you did to the PM doc, that basically you were just trying to continue to receive 4 pills a day? Good Luck!

 
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Old 03-19-2013, 06:45 PM   #5
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Re: Please need support and advice

First thank you so much for the support. I did explain it to her and her reply was its 4x a day as needed that I really shouldn't have been taking 4 a day everyday. I was floored! I started crying because I was embarrassed and was feeling like I was doing something wrong. I responded by saying as needed is 4x a day so there are none left after my 30 days. I'm so upset... I'm not sure if I can switch drs... Even if I don't go through my auto can patients just switch pm doctors or can general practitioners help pain patients? I've only seen this one doctor for 2 years so I have no clue

 
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Old 03-19-2013, 08:33 PM   #6
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Re: Please need support and advice

hi alex12

May I ask-what did that np mean by you have been on them too long? What is the source of your pain? How long have you been in PM? Have they ever offered you a longer acting medicine if your pain is affecting your ability to function?

Did you ask this np if this was coming from the doctor or her?
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Old 03-20-2013, 04:37 AM   #7
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Re: Please need support and advice

I have been on pm for 2 years. I had a hit and run which destroyed my neck that I àlready had issues with. I have chord compression, stenosis and pretty much anything else that can go bad with a neck
The only long term meds offered to me were last year in the form of a Butran patch. I didn't want it because I could not find much info on it as it was new.
Another thing the nurse told me was that they don't like prescribing narcotics for a long time.... And 2 years is too long and my tolerance has grown fast to 40mg from 20. I thought that was bull it's been two years and I'm still on a regular dose.
She said the doctor approved her taking me off meds. She said the epidural should work for my pain and if not that I have to go back to a surgeon. I was having success w the meds.... I don't want cervical surgery as its not guaranteed to work. I am open to other meds but it was not offered.






QUOTE=BB07;5149509]hi alex12

May I ask-what did that np mean by you have been on them too long? What is the source of your pain? How long have you been in PM? Have they ever offered you a longer acting medicine if your pain is affecting your ability to function?

Did you ask this np if this was coming from the doctor or her?[/QUOTE]

 
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Old 03-20-2013, 10:49 AM   #8
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Re: Please need support and advice

Quote:
Originally Posted by alex12 View Post
It was a stupid mistake but because I go through my auto insurance I couldn't get an appointment for 10 days because it required preapproval and I waited to long to make my follow up. I went to see my GP and she gave me 10 days worth to carry me over. It was not done in an effort to dr shop it was so I had my medication until my next pm appointment. It just really sucks that as a patient in pain management you are treated so poorly. I think I may just go speak to my GP and see if she can help me get through this. I don't know if GPs can help weaning off narcotics but I don't want to go back to that pm doctor after being treated like that.
Alex,
The problem is two fold- the first being that your meds were prescribed as needed not as take one tab every 6 hours. As needed means that you take them only when you are experiencing pain above a certain level , not anytime you are having pain.
The second bigger problem is that when you ran out you violated the
terms of your contract by getting pain meds from another doctor. That is considered to be doctor shopping. It doesn't matter why you did it, it matters that you did

I suspect that your regular doctor already knows.
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Old 03-20-2013, 10:56 AM   #9
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Re: Please need support and advice

As needed for me is 4x a day otherwise I am in pain. I couldn't go 10 days without my medication or I would be a mess, I only got enough to carry me over until my appointment. I don't believe I did anything wrong. Why should I have to suffer? My GP knew the situation I told her I needed a refill of 10 days until my PM appointment I wasn't hiding anything. It's sad that patients have to be made to feel like criminals when we are just trying to lead normal lives.

 
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Old 03-20-2013, 11:12 AM   #10
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Re: Please need support and advice

alex12

It is unusual in PM to be kept on short acting meds like vicodin/Norco(I seem to remember you asking about problem with vicodin in Feb)-other than for use as a break-thru med. 40 mg of Hydrocodone of any name would do nothing for my CP alone and long term. My bt med is much stronger. I remember you asking about the Butrans patch-you were prescribed Butrans 10? If your PM specialists asks you to try anything he thinks you will benefit from you need to follow those instructions-it could have really helped you, it has helped a lot of people, I have never been prescribed it,but had my doctor wanted me to I would have, I was desperate for relief, now I am at a plan that works for me, by following what my PM specialists instructions no matter what, because I do trust this doctor.

If you didn't trust yours you should have found another to help you-and when you are in pain, where every 2nd is a struggle and you have no quality of life-This was my situation, I was willing to do/try whatever my doctor suggested or prescribed. This is the only way I finally got to what worked for me, and able to function with less pain-the pain is still there but it's much better now than when I first started PM-It took close to 2 years to find what helps me the most. It is a lot of trial and error!


So if you are struggling with pain/anxiety you don't have to, find a new doctor whom you can trust, be honest and you will get to a better place too. good luck
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Old 03-20-2013, 11:40 AM   #11
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Re: Please need support and advice

You're right, I really should have looked for a different Dr. When looking for a new pm doctor is it the same as any other dr? Do you basically start from scratch?
As far as Butran patch... I was so scared to try it because I read some bad side effects. I would have been willing to try something that had been around longer. I know they don't rx oxycodone (not Percocet the other one that is long lasting) so that wasn't an option. That's part of the reason why I took 4x a day because my pain is all day long... I really would benefit from a long lasting med.
I am going to look up some Doctors or ask my GP for a recommendation. Do you think that is the right route to go? Ty everyone for the help and support! To top it off the epidural is not sitting well w me and I am in worse pain today

 
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Old 03-20-2013, 11:45 AM   #12
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Re: Please need support and advice

Hi Alex, In my opinion, I would speak to your GP about covering you until you can get in with a new PM and see if he/she will also refer you to another PM. Then if they are willing then terminate your current PM, send them a certified letter stating that you are cancelling your contract (if you have one) as well as stating that you wish a copy of your records to be mailed to you. (you may have to pay a fee for this part). You are not stuck with one PM. Personally I think what they did is horrible, and I would work VERY hard to get in somewhere new right away, you will be better off. Take care and I wish you the best of luck, let us know how things go for you.

 
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Old 03-20-2013, 04:25 PM   #13
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Re: Please need support and advice

I have trouble believing all of that is necessary. If the PM doc effectively dismissed you from their care (i.e. wont' prescribe refills of needed meds anymore), your contract IS broken and neither party is expected to follow through. Basically their actions ended their contract with you (they may argue you broke it by your actions). No future PM is going to tell you that you're under another contract and they can't help you. You'd just sign one with the new PM and off you go. I really hate the CYA attitude this world has become. Think "common sense" folks.

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Old 03-20-2013, 08:15 PM   #14
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Re: Please need support and advice

Alex,
I understand that you don't feel that you did anything wrong by going to your GP for a prescription to tide you over, but in the contract you signed with pain management, you agreed not to get opiates ( or any med from another doctor that you were getting from your PM doctor), so you did violate the terms of the agreement and they are well within their rights to not continue to give you any more opiates.
If you needed to take the meds every 6 hours then you should have made that clear to them so that they could change the prescription instructions to take one every 6 hours instead of as needed.....this is where the second problem is coming from.
I wish you the best but I think that they have already alerted your primary and I don't think that he will continue to give them to you either at this point.
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Old 03-20-2013, 10:28 PM   #15
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Re: Please need support and advice

I think one of the issues is that you really haven't been in pain management that long. And many patients who are on small amounts of med, hydrocodone, darvacet(before it got pulled), tramadol, etc. don't necessarily look at it like those of us on both LA and SA medication and much stronger. Which is why your primary had no problem giving you a small amount of meds.

I have noticed this often with people in their early years of pain management. A lot of time until it happens to you, you don't think about it. When I look back at my first years in pain management, I made so many mistakes and I just was lucky because things were not regulated like they are today. I didn't do it on purpose it was just I wasn't with a pain management doc, had multiple issues and did what I thought was the right thing to do.

I would ask your primary if they would consider taking over your pain management. Just explain what happened and then if they don't want to take it over, see if they can give you a recommendation to another pain management doc.

Good luck and I am sorry you were treated that way.

 
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