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Dr. said an Opiate is an Opiate


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Old 11-17-2005, 01:08 PM   #1
catnap
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Dr. said an Opiate is an Opiate

Well just got back from my third visit to new pm doc. I told him I needed to do something different. Either change the methadone or change the breakthrough norco. The sweating, farting, food craving has got to go. Not to mention the most important thing -- pain is not being managed. He then began to talk down to me. He said, you know when you can drink a 6 pack of beer and get a buzz, then you need to drink a 12 pack of beer to get a buzz, then .... I think you know where this is going, I did. I interrupted him with I know about tolerance. He said, an opiate is an opiate. Do you know what morphine is? An opiate. Do you know what hydrocodone is? A synthetic opiate. Do you know what an opiate is? It comes from the poppy plant. He just kept going with the drama. I interrupted again with I understand all that, but then why did the duragesic work better for me? He said, its stronger. He said, I thought you were having trouble with the patient assistance program and didn't want to deal with them? I told him I had found out I only had to pay $68.00 for it. He then asked how, and I told him through a drug assistance card I had. He asked me what I wanted and I told him 100 mcq change every 48 hours. He said, WHEW!!! Do you know how strong that is? Boy I would be puking my guts out. I gave no reply. He asked me what was I going to do when that started not working? I said I guess I will go back to methadone. He pretty much caught me off guard with that question. But after thinking about how the whole visit had gone, when I need to go up, how is he going to be? He wrote the prescription out and gave me what I wanted. When he got up I asked was he going to give me any breakthrough med. So he dramatically said well.... do you NEED any breakthrough meds??????????

For the time being I am going to hang in there with him because I don't want to make a 6 hour round trip to Dallas, but I really could have done without all of the drama. I know he doesn't know me and I don't know him. But I have never taken more of my meds than I was supposed to, never lost them, the cat never knocked the bottle off the back of the toilet, never needed early scripts, etc. But, I will change if he doesn't stop with all of the talking to me like I am 6 years old and an idiot. I have been going to doctors longer than he has been practicing medicine and I might not be as stupid as he seems to think. Now that I have that off my chest, thank you! Haven't most of us been there before.

Last edited by catnap; 11-17-2005 at 01:23 PM.

 
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Old 11-17-2005, 01:24 PM   #2
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Re: Dr. said an Opiate is an Opiate

No, opiates are not all exactly alike, That's why people exerience differential withdrawal even at equianelgesic doses when swithcing opiates. Particularly meth and fentanyl. Meth binds to specific receptors that no other opiates do and Fentanyl also has some unique qualities that can make transitioning from one opiate to another a fairly rough experiennce. But what can you do, Re-educate a doc.

That's extremely over simplified. So does he only use one opiate in his practice, and if not, how come? Unfortnately I doubt a converstation where you have to reteach a PM doc won't go over very well. Meth and fentnayl are very different and morhine and meth or fentanyl are very different. Why does one cause more sedation than the other. Why is meth used for heroin addiction and not morphine. Obviously something is different.

However Sometimes It's not worth the fight and we have to pick and choose our battles and sometimes the outcomes are are easy to predict. As much as I know abut the difference between opiates and opioids and the receptors they bind too, I wouldn't get in a Pi##ing contest over who knows more. You need him to manage your pain, so pat him on the head, stroke his ego or scratch him behind his ear and say good doctor, you have made it oh so clear.
Good luck, Dave

Last edited by Shoreline; 11-17-2005 at 01:28 PM.

 
Old 11-17-2005, 01:32 PM   #3
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Re: Dr. said an Opiate is an Opiate

Doctors are weird about pain management. I realize that a totally general statement to make about ALL docs - so please forgive that. In my experience, docs don't like to treat pain. If it's "just" pain, they think you jacking them. If you say, "I can't walk due to pain" then they seem more open.

Not knowing your situation, are there other pain management practices you can do, like meditation, or phy. therapy?

I really wish docs wouldn't think we are stupid or trying to pull a fast one. It would be wonderful if they truly realized that we are best an evaluating and conveying our symptoms. Sheesh.

 
Old 11-17-2005, 01:33 PM   #4
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Re: Dr. said an Opiate is an Opiate

Thanks Dave, I needed that!!! This guy is very egotistical and I can't say I wasn't warned about him. It was so nice to drive a 14 mile round trip in to see someone, instead of the road trips I have made in the past 10 years.

 
Old 11-17-2005, 01:35 PM   #5
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Re: Dr. said an Opiate is an Opiate

LOL, i think you are right shore, scratch behind the ears,lol. I think i learned that with my last appt. with my first pm. I think if i wouldnt have acted like i knew waht was best for me, i might have gotten a better reaction. I guess maybe just be strokin their ego is a good idea.
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Old 11-17-2005, 01:38 PM   #6
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Re: Dr. said an Opiate is an Opiate

Yes Dave, he changed me back to the Duragesic and gave me what I wanted. You have a great sense of humor. Enjoyed that -- and thanks for the url on the info.

Carol

 
Old 11-17-2005, 09:30 PM   #7
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Re: Dr. said an Opiate is an Opiate

Hi Cat....did you see a PM doc in Dallas?? This is where my doc is located. May I ask what his name was? If you don't want to say his name, how about first and last initials? You had to change because he was closing his practice, right? I think I know who it is, because I had to change, as well. Anyway, just curious.

 
Old 11-18-2005, 06:30 AM   #8
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Re: Dr. said an Opiate is an Opiate

Hey Key,

My good doctor was in Dallas. Sure do miss him at this point. He never spoke to me like this new one does. He was a psychiatrist/pm, initials, AJK.

Did you see him too?

 
Old 11-18-2005, 07:37 AM   #9
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Re: Dr. said an Opiate is an Opiate

Yes, I did. Dr. Klymiuk, right?? He was WONDERFUL!! I now see Dr. Day at University of Texas Southwestern Medical Center. He is WONDERFUL, too. He's very young (not much older than me, I would say he's in his mid to late 30's). He's the Director of the Eugene McDermott Pain Management Center at UTSW. He NEVER talks "down" to you and jokes around like Dr. K. He kept me on the same meds and dosages (I've even had some increases in meds) as Dr. K.

I couldn't have asked for a better doc!! I do miss Dr. K, though, I was with him for almost 5 yrs. I've heard that a lot of docs aren't taking his patients due to the meds they were on. That's a shame!! I lucked out because I've been a patient at UTSW for 21 yrs. due to my kidney (which is what I'm in PM for). It generally takes 3-5 months to get in to PM at UTSW, unless you have a doc on staff there at UTSW that can get you in ASAP. Anyway, how's your new doc??

Last edited by friendly_one; 11-18-2005 at 07:40 AM.

 
Old 11-18-2005, 08:13 AM   #10
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Re: Dr. said an Opiate is an Opiate

Hi Kstone..

Small world - who would have thought I would have run into another patient of Dr. Ks on this board. I saw him for about 5 years too. Started out on Central Expwy.

My new doc is a a pompous a __. Don't know if I can keep going to see him. See my first post about him on this thread.

Kat told me she faxed my records over to a Dr. Hyeun (SP?) pronounced wen. They told me they never received them. Why didn't they say they didn't want me as a patient rather than to lie? Anyway, Dr. K told me he thought the doc was overwhelmed by the amount of patients calling him. Dr. K only gave out two doc's names for referral. Guess I need to call the pm doc I saw previously to Dr. K and get a referral.

Last edited by catnap; 11-18-2005 at 08:19 AM. Reason: additional text

 
Old 11-18-2005, 12:56 PM   #11
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Re: Dr. said an Opiate is an Opiate

Hi Cat...Call up Dr. Day's office (I'm sure you can figure out how to find his number, LOL) and tell them your situation. They are accepting new patients, you may or may not need a referral. If you do, I bet Dr. K or Kat would give you one. One more thing, Monica's mother, Noel, (do you remember her from Texas Pain Medicine?) is a nurse there for Dr. Day and she knows that Dr. K's practice is closing and could get you in quicker. It's worth a shot! I just can't say enough good things about Dr. Day!!! He's outstanding! Good Luck and let me know what you decide, ok??

Last edited by friendly_one; 11-18-2005 at 12:58 PM.

 
Old 11-18-2005, 10:14 PM   #12
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Re: Dr. said an Opiate is an Opiate

Hey Kstone, thanks for telling me about Dr. Day. I was treated badly by Noel. She was always nice to my face but hateful over the phone. My pharmacist had a tough time with her on several occasions. She is Monica's mother? Monica was a very nice person and I was always treated very good by her but she really didn't have any experience with working in a doctor's office. She dropped the ball on my patient assistance program re-application and getting my prescriptions in the mail to me. She never returned a phone call either. I had to drive to Dallas to pick them up several times because she didn't mail them to me. She lied to me about mailing one of them. I am trying to think if I ever said anything about her mother to her and I don't believe I did. Oh well, I have never said anything about anyone that I would not say to their face. Dr. K knew about how much she messed up and was very unhappy with her. He told me he thought about hiring someone else, after he fired her, but he just decided to close the practice. As I see from the threads on this board I am not the only one experiencing hateful people. But I do think I could put up with the hateful office help before the hateful doctor.

I used to see a doctor at the Aston Ambulatory Center, which is a part of SWMC. Before he moved he was in Parkland's medical center's old building. He did several ear surgeries on me, but he is probably retired by now. I haven't been in there since 1994.

 
Old 11-19-2005, 12:48 AM   #13
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Re: Dr. said an Opiate is an Opiate

Hi Cat...there are other nurses there at Dr. Day's office and they are very, very nice. Just call up there and see if you can be seen. Like I said, just explain your situation about Dr. K closing and see what happens. There are other docs there besides Dr. Day, but I don't know anything about them. Dr. Day is just plain OUTSTANDING!!! I hope you can see him. Keep me updated, ok?? Good Luck!!!

Last edited by friendly_one; 11-19-2005 at 12:49 AM.

 
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