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    Old 07-28-2007, 09:20 AM   #1
    eddieJ85
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    Problems with pain medication..

    Ok I have been having problems with pain medication and am not sure what to do next. A brief history I have had 3 back surgeries, the last of which was in april and my most serious(a spinal fusion). Since then I have been taking pain medication. At first I was on oxycodone because I was in serious pain. But after a few weeks I was put on Vicodin ES(7.5/750). I have been taking that since around late May. At first I saw a pain management doctor, but my family is going through financial troubles and we could not afford to visit a PM doctor as well as the physical therapy I needed, the therapy being more important. So since early June my surgeon has been prescribing me the Vicodin ES.

    Anyways I last saw my doctor(the one who performed the surgery) on July 16th. At this point I was quite paranoid. I had never had something as serious as a spinal fusion so I did not know what to expect. It had been over 2 months since my surgery and I would still feel pain and sore-ness, to the point where I was tkaing 5-6 pills a day. Well, he told me that at this stage, it was still perfectly normal to be in pain, and prescribed me 2 week supply of pain pills. However, over time my body was becoming more and more adjusted to this medicine. First I would only need to take 1 and a half pills at a time. I only take the medicine 3 times a day, so it seemed fine. Then I was up to needing 2 pills at a time, which still was only 6 pills a day. Now, since the refill, I noticed I needed 3 pills at a time, which added up to 9 a day.

    When this happened, I decided to say something to my doctor. You see, I am very wary of the tylenol content I was taking. I am very aware that it can cause liver damage. So last tuesday I called my doctor and left a msg with his nurse explaining the situation. I told them I would like to be put on Vicodin HP, a medicine I took after my 2nd surgery. HP was 10 mg of hydrocodone, which means 2 pills will have roughly the same amount as 3 of the ES, which once again would reduce my daily pill count to 6 instead of 9. HP also only has 660 mg of tylenol. This means that with only 6 HP a day, I could cut my intake of tylenol in half. My daily tylenol intake would also come in safely under the 4000 mg a day mark with the HP, as you are not supposed to go over 4000 a day. However, with ES, it is over 6000mg of tylenol a day. I thought all these points would convince my doctor to switch medicines for me, as he was always very nice and understanding about pain meds. I am ultimately trying to get myself off pain meds, and can't do so if I am taking increasing doses.

    Well, it didn't go as planned. My normal nurse was not there last week, so there was someone new to fill in. The new guy told me that I needed to make an appointment with pain management, and that he would not give me HP, but would refill the ES. I felt like they had not listened to a word I had said, and I also felt like things might have been different had more normal nurse been there, who has more understanding over my situation and probably would of explained my entire situation to the doctor. Still I refilled the ES.

    The problem is my insurance runs out on August 1st. We simply cannot afford to go see pain management. I just can't do it. Yet I have been on pain meds since October, so I cannot simply stop taking them because I know the side effects will be severe, and that also worries me. What should I do? Should I explain to my doctor the situation more in depth, since this week my old nurse will be there again? I am just at a loss of what to do. My doctor has said pain at this point is still expected and unless it dramatically increases, I dont need to see him till October, which my family expects by then we will once again have insurance. Until then the only thing I need to worry about is pain medication, which is still only 20-30 dollars without insurance. Appointments and stuff however are not cheap.

    I am just at a loss at what to do, I plan to call my doctor again on Monday and explain the situation, but any advice would also help. I feel lost and like I have nowhere to go. I know once again by Monday I will be out of pain medication so if he does not listen to me I do not know what I will do, and also know I cannot make it through the day without them. I do want to stretch out the intervals in which I take medicine so I can slowly reduce the amount I am taking, but again I can't do this on a medicine that is no longer effective and I cannot afford to go see additional doctors in order to get the meds. I am counting on this doctor and I hope my faith is not misplaced, he has never let me down before but now I am more scared than ever.

    Last edited by eddieJ85; 07-28-2007 at 09:30 AM.

     
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    Old 07-28-2007, 10:15 AM   #2
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    Re: Problems with pain medication..

    Eddie,

    Darn what a situation. I had something similar happen to me this week. I'll be 6 months post op tomorrow and on Monday I had an Epidural Steriod Injection with a different PM as mine is on vacation. I've never had problems with my PM prescribing me medication as I've been with him prior to the 2 hemi's and recent fusion...well...I told the substitute PM that I only had 2 Fentanyl patches left (25mcg) and while I was in for my ESI asked him if he could prescribe a refill. He said sure he'll give me 2...I assumed it was 2 boxes/10 patches as this is what I use in a month...well after stopping at the druggist to pick up my Rx he only gave me 2 patches! As a result, now I have to track down my regular PM Monday and hope he can get me a refill before I run out...and if I run out I'm in trouble...if I forget to change my patch on day 3 I can't get out of bed I'm in so much pain!

    I'm sure because this was a 'substitute' provider for you this is why they were less understanding. Your regular provider probably wouldn't hesitate if they know your circumstances.

    I've said it before and I'll say it again...It really stinks that the people that are using these medications for the purpose of trying to maintain activites of daily living and to reduce chronic pain are the ones who seem to have the hardest time getting them!

    Best of luck to you!
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    Last edited by HBMod07; 07-29-2007 at 06:36 PM. Reason: Disallowed Topic

     
    Old 07-28-2007, 10:34 AM   #3
    eddieJ85
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    Re: Problems with pain medication..

    Hmm, I don't know what you mean by going to substitute providers..well, unless you meant the nurse situation. My doctor has a specific nurse who has always handled my prescription refills and she has always been really understanding, but she wasn't in the office last week and I had to deal with a replace, whom was unfamiliar with me and I with him.

    I have been on pain medication in total, since October of 2006. Since then, I have always gotten it from my doctor/surgeon. A few months after the 2nd surgery I had, the one prior to the fusion, a discectomy which I had in october 2006, well a few months after that he also suggested i see a PM doctor but once again I could not afford it. So he continued to give me meds. After my spinal fusion surgery, I did begin to see my PM doctor but he would force me to only get refills by coming to see him and he would only give me a 14 day supply each time, which means I was going to see him every 2 weeks, which was waay too much. So as I said after a month of that, in early june, my family realized we simply could not continue at this rate. I told my doctor that and he said ok..but as I said now he has once again asked me to go see PM. I am just going to have to explain to him that I cannot afford to see additional doctors and that I am counting on him for medication.

    Last edited by eddieJ85; 07-28-2007 at 10:48 AM.

     
    Old 07-28-2007, 11:14 AM   #4
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    Re: Problems with pain medication..

    Oxycodone and Vicodin are not the same medication. The generic version of Vicodin and Lortab is hydrocodone/APAP(tylenol). Oxycodone is the main ingredient in percocet, with added tylenol. Oxycodone also come in an IR version with no APAP (tylenol), and a long-acting version (oxycontin) in various strengths.

     
    Old 07-28-2007, 11:18 AM   #5
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    Re: Problems with pain medication..

    Actually, I did have a thought about doing that(im assuming GP means family doctor). If I had to, we can at least afford seeing a GP every couple of months.

    There might be a small problem. I have only gone to this man twice. For most of my life I saw a different doctor, but he usually handled younger patients so eventually I switched. I have only see my new GP twice and that has been just a pre surgery visit. So I do not know if that will make any difference in how he handles my situation or if he will be willing to give me medication or will make me visit him several times before doing so. On monday I will explain I am in the process of trying to set something up with my GP.

    I don't know if he will write pain scripts, but it is worth a try to see him and at least explain the situation.

     
    Old 07-28-2007, 02:58 PM   #6
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    Re: Problems with pain medication..

    Eddie, my heart goes out to you. It is just terrible the things us spinneys have to do when we are in pain and need meds.

     
    Old 07-28-2007, 05:08 PM   #7
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    Re: Problems with pain medication..

    i am just really kind of suprised that your surgeon has continued to Rx you pain meds this far out post op.it is usually standard practice,unless there are some major problems with the actual surgery to send the patient back to their primary after six weeks of post op care.surgeons do not usually keep Rxing pain meds to post surgery patients.i know with all my surgerys(five) this was pretty much standard practice.i think going back to your primary and really explaining your situation to him would be your best bet since usually, just the way surgeons do things,he will not continue this forever ya know?by him mentioning PM to you,i think he is giving you hints to continue on with your primary or to seek out PM.this is just not the norm when it comes to having surgery.most surgeons will take patients off of narcotics by six weeks.if there is a continuing issue,it is usually followed up with the primary or whoever is going to take on your ongoing care.your surgeon is doing a huge thing for you and i do not think it will continue too much longer.you just really do need to set up plan B or find out just why you are having this much pain still after this long.things should be getting better as time goes by,if they are not,you really do need your situation evaluated for possible problems.i just think you need to be prepared eddie.i think your surgeon is just about at the end of his continuing to Rx narcotics for you,really.like i said,six weeks is the "normal' limit they will usually go with that.

    just where was your fusion at with regards to your spine?what does your pain feel like right now?has it gotten better or worse with time?any other symptoms besides just the continued pain?if this is your first actual spinal fusion,just what were the other two back surgeries for,or what was done?i do wish you luck with this eddie.please keep us posted on how things are going.Marcia
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    Last edited by feelbad; 07-29-2007 at 07:12 AM.

     
    Old 07-29-2007, 07:18 AM   #8
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    Re: Problems with pain medication..

    My fusion was in the L4-L5 area.

    here is a link to a post explaining my full situation if you'd like:

    [url]http://www.healthboards.com/boards/showthread.php?t=512707[/url]


    the only update I have to that is that my doctor(the surgeon) told me an mri wont show us anything and that it is normal for me to still be in pain at this juncture. I told him how I had trouble sleeping, and he just said to take pills before bed, which I was already doing. So my situation has basically come to a halt wait now. He basically told me to wait and see for a month and see if the pain disappears. As for the pain, I still have it. The leg pain has been less frequent, but the pain in my lower back has been more persistent. The lower back pain is, however, still in the general area of where my incisions are(I had 4 in total, but I have two big ones side by side). So it could still be side effects from the surgery.

    I do realize he is doing me a favor by giving me these meds, I'm just hoping he can give me at least one more refill because I most likely won't get in to see my GP for around a week, and I am terrified of what will happen if I completely stop them. I just hope he will understand the situation. After my first surgery back in 2004, I had only been on medication for 3 months when I suddenly stopped. At the time, I didn't know any better, I didn't know I should be weened off the meds. I had also not made any attempts to reduce the dosages I have been taking. So I went from 8 a day to nothing. Even then, I was incredibly sick for 2 weeks, it was one of the worst moments of my life. Seeing as I have now been on medicine for a much much longer time, I do not wish to go through something even worse at a time when I am already suffering.

    Instead of fussing about changing meds, I am just going to ask for more ES and speak with that issue with my GP.

    Last edited by eddieJ85; 07-29-2007 at 08:26 AM.

     
    Old 07-29-2007, 09:07 AM   #9
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    Re: Problems with pain medication..

    Hi Eddie,

    Wow what a complicated situation.

    The Ortho surgeon who did the last two surgies on my arm will not give any pain meds for more than a few weeks after surgery......they don't like to do it. Just like Feelbad said I am shocked that the surgeon is still giving them to you.

    When I went to PM in the begining I had to go there 1 time a week and then every other then 1 time a month. I did not pay because it was a work comp thing.

    I had my last surgery in March of this year and they had to take a nerve and move it some place else so that it would not be compressed anymore and I still have pain and loss of sensation and heightened sensation there. I know sounds confusing but they had to cut surgically through my arm down to the deepest layer of skin and muscel. When they do that the incision area can be very aggrivated for a long time.

    I would go back to your regular doctor and explain the entire situation to him and see what happens.
    Being in constant pain is very hard to deal with and I feel for your situation.
    Hang in there....CHrissy

     
    Old 07-29-2007, 12:36 PM   #10
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    Re: Problems with pain medication..

    Well, I was able to make an appointment with my GP for august 7th, which is next tuesday. I just hope my surgeon will give me one last refill until then.

     
    Old 07-29-2007, 06:08 PM   #11
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    Re: Problems with pain medication..

    Eddie,

    When You made the appointment with the GP did they ask what it was for??

    Maybe you can get on a call list incase someone cancels!

    I hope that the surgeon will help you this one last time untill this gets figured out. Good luck and keep us posted...Chrissy

     
    Old 07-30-2007, 07:22 AM   #12
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    Re: Problems with pain medication..

    No they did not ask me what the appointment was for, even though I did stress I needed to see him ASAP. They were still only able to squeeze me in next Wednesday.

    About an hour ago I put in the call to my nurse, I'm hoping she can get back to me ASAP with some good news.

    Last edited by eddieJ85; 07-30-2007 at 07:23 AM.

     
    Old 07-30-2007, 07:37 AM   #13
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    Re: Problems with pain medication..

    Good Morning Eddie,

    Hang in there. I hope the nurse will get back to you soon.

    I am here to listen and help as much as I can...Chrissy

     
    Old 07-30-2007, 08:22 AM   #14
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    Re: Problems with pain medication..

    Yeah no word yet, hopefully I'll hear something soon. At least, I hope it is, I'm already starting to feel some withdrawal symptoms..severe stomach cramps. Those on top of the pain I'm already dealing with and well..I'm not feeling very well so I hope she hurries.

    I did tell her to try to get back to me ASAP because I was already out of medication, I just don't want her to think I'm some drug seeker.

    Last edited by eddieJ85; 07-30-2007 at 08:23 AM.

     
    Old 07-31-2007, 12:03 AM   #15
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    Re: Problems with pain medication..

    Hi Eddie,

    I hope she calls soon, I have been where you are, and its miserable. You'd think the pain would be enough to deal with, but theres always this side to it too.

    Others have given you great advice, I just wanted to add my support and let you know that DH and I also lost our medical benefits a while back.

    As DH is bi-polar and I have chronic pain, our meds alone were over $3000 a month, there was just no way we could have paid.

    I found most of his meds and a few of my non narcotic ones on Walmarts $4 generic plan, including my baclofen and tramadol, and some of his really expensive ones I wrote to the drug companies and they gave him a 'drug scholorship', they mail a coupon to the pharmacy every month and we get those for free.

    Since he works and we arent on public assistance, I applied at the county clinic, and surprisingly, we qualified for $20 office visits, $10 prescriptions, and 90% off all tests and hospitalizations.

    Its worth a try to apply, just look in the front section of your phone book under county, and find county health, then call and ask for a financial screening appointment.

    Good luck, I'm keeping my fingers crossed for you!

    ~Fabby

     
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