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    Old 06-02-2009, 07:33 PM   #1
    monkey5
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    Pain Medications and PM doctors/please help with this

    Hi there, it's been a while since i have posted but need advice. I have over did my activities and to already at to this my PM doctor presribes my meds at two a day and he gives me a script for 50. To start if he writes they need to last four weeks then it would be sixty of these. I said something already last month and they just ignored. Meanwhile this last week i overdid things and been stuck and have taken a few more as needed to get through this.

    Now I have called and talked to the nurse and blah blah i need to limit my activitites , well listen lady i can't i have a huge family and have to give my kids and family 24 seven care, so i have to make do. Anyway when calling today she gave me the speal of them not beeing able to do anything because of this contract. As far as i knew with the contract it was to say you agree not to take anything else thats not prescribed to you and not to sell them or take anyones elses. because this is what i signed with my regular MD.

    Gee i guess i should have paid more attention to this because now they have referred me to a Neurosurgeon and had another MRI wich i go this week and the nurse stated she didnt think i would get pain meds from this dr. due to that i have a contract, SO i am lost here. She didn't recommend being able to come in earlier than next week ect.What will happen if i go to the ER for this? I actually cried this morning and i havent cried in forever! How do i get out of this contract, do i just quit going because i dont like this, i have been poked and proded and i am sick to my stomache with all this, not too mention when i first started seeing my new MD last year she stated they didn't like to give pain meds to someone that doesn't have a cause for pain well guess what this MRI stated that i have two bulging discs and one protrusion, now unless the radiologist doesnt have a licence to read these films then i feel these dr.s are wrong! Oh and they both want me to do PT again and again with already completing this without results in the last two years and i can't, one i refuse to do to it makes me worse and omg the pain i had/have and unless then want to come watch my younger child for free go for it, oh and by the way he has adhd/mood disnorder/anxiety ect. so have at it! Thanks for letting me vent and sorry so long and any help i can get i will take!
    P.s. The recent MRI i had i was in the worst of pain and in the past is was a day were i was in control with meds go figure!
    Love, Monkey
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    Old 06-02-2009, 10:02 PM   #2
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    Re: Pain Medications and PM doctors/please help with this

    Hey Monkey,

    Unfortunately if you sign a contract you usually cannot get medication elsewhere if you need it - they usually also say to take as prescribed. I do understand what you said about only getting 50 for the month when you need 60 in order to reach 2 per day - have you discussed this with the nurse? Perhaps the dr can prescribe the extra 10 to last you until your next appointment.

    You can certainly quit but then you won't have any pain medication - do you think you'd be ok without it? Are you still taking methadone? These are not meds that you want to quit taking cold turkey. Unfortuantely the dr is probably going to be upset that you took more than prescribed on bad days, it seems unfair but this is why they have the contracts which state that you must take them as prescribed. Does the script say 2 a day when required? or 2 per day? If it says 2 per day then you should be written for 60 each month and the dr shouldn't have a problem filling them. Did you tell the nurse that you'd taken more than you needed earlier in the month? I do understand but they tend to get upset about this because it violates the contract. It sounds like you and your dr need to have a good chat about what is and isn't allowed and just how many meds you will get each month and how often to take them.

    I hope you are ok.

     
    Old 06-03-2009, 01:30 PM   #3
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    Re: Pain Medications and PM doctors/please help with this

    monkey:
    You need to be very careful about following the contract that you signed with the Pm doctor. You already know how strict these doctors can be and what can happen to the people that don't follow the contracts. You have been on these boards long enough to see the dozens of people that have been discharged with no where to go after violating their contact. First off I would not admit to taking more than prescribed because that could get you discharged immediately.

    If you can take someone with you to your next appointment that would probably be more favorable. I would really tell the doctor that you pain has gotten worse and that you have injured yourself. Tell the doctor that your pain is a ? out of 10 on average (whatever level your pain is at). Please be realistic and think about what your level is at. Don't say your pain level is a 9 out of 10 if you are able to walk in the office so think about what your level is at before going to the doctor.

    What does your prescription say on the bottle? Does it say to take up to 2/day as needed? You need to really tell this doctor that your pain is really inhibiting you from doing your daily activities and that it needs to be better under control. Give specific examples. You do not want to get yourself kicked out of the office. I know that you have had alot of obstacles in the past with your former doctor.

    If your pain is really out of control and you have already tried adding something over the counter such as ibuprofen or Aleve, then you should go to the Urgent Care or Emergency department. It all depends on how much pain you are able to withstand. You can always go to Urgent Care or Emergency and explain to them that you injured yourself and your pain is out of control. Make sure you tell them what you are already taking. Good luck

    brian

     
    Old 06-03-2009, 02:49 PM   #4
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    Re: Pain Medications and PM doctors/please help with this

    Jema,
    have you discussed this with the nurse?
    Yes I did discuss this last month and they just brushed it off and said well these need to last four weeks, what she doesn't get this i don't know! I called today and got a week earlier appt, and maybe they can do an increase or something. I am not on Methadone because that wasn't effective enough at thier dosing. Another this is that when this happened last month when i called the nurse told me to increase from 1 pill twice a day as needed to 1 1/2
    each time so that didn't help running out ithier. I cannot take a chance on not getting anything because i am going on a trip soon for a few days so they really need to get this straight! I do see my pm doctor face to face the following week before i go luckily but this is all so frustuarting.
    Brian, thanks for the input as well. I feel i do have a good relationship with the office, and they have seen me with my pain under control and I told them i only took a few extra with the increase to pain, and they seemed okay with that but i know that could change and dont want it to effect my care. Even my Dr. last month told me i am getting to know you and i feel you are not drug seeking and you just want answers and relief so this is what made me feel comfortable about being honest with the nurse. Maybe it's a matter of the clinic and your past relationship with them, not sure. Anyway i am suffering now not having anything but what else can i do. I dont have anyone to go with me to the emergency department to drive so i am stuck with that unless something changes! And dont get me wrong, i am with many, i think the contract is a great thing as well as i have seen some of the ones that ruin it for others who really need pain meds so i totally understand where it works for the doctors but they shouldn't just leave thier patients hanging with pain from thier mistakes on prescriptions they write!
    Take care, monkey
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    Old 06-04-2009, 08:18 AM   #5
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    Re: Pain Medications and PM doctors/please help with this

    Monkey, you sound very aggrivated, I am sorry to hear how bad it is at your PM DR. I havn't seen you on the pain board in ages but have seen your post on other topics here at health boards. You have so much going on health wise that I do feel for you.

    I wanted to say that it sounds like your PM Dr has possibly ended your contract and is reffering you to a neurosurgeon now. Normally Neuro's do surgery so perhaps you are having a surgical consult. You are correct. neursurgeons don't prescribe pain meds for chronic pain patients. the only time they will do it, is if you have had surgery by them and this usually ends after 2 refills as they really aren't pain specialist and don't like to treat long term with narcotics as its not there specialty. so I am pretty sure you won't get any pain meds from this DR, and if you do I will be very surprised.

    Pain managment is a privalage, and being prescribed pain meds is very serious and you have to follow the rules. If you don't they will red flag you as a drug seeker and can easily terminate you from the practice and leave you with nothing.

    You should have a good attitude with the nurses, you never want to sound rude to them or say blah blah blah or take a negative stance with them, this isn't good at all Monkey. your very lucky they have been prescribing for you!

    If the 50 tabs are not enough to control your pain than you need to make an apt with the PM Dr and let them know its not covering your pain. Please be very careful about telling the staff your out of meds early or that you need a refill on something that was supposed to last 30 days. It even said that on your bottle so there is no excuse for missing the dosing instructions. This was your fault totally, not there fault so be nice!

    I just hope its not late for you, as there already wanting you to go to see another DR.. My concern is why would they say this to you, " we don't think he will prescribe pain meds". how did this come up, unless they have terminated you, because your contract clearly states that you can't get meds from more than one DR and they are not going to approve this, not for narcotics. So that seems really odd to me. Maybe you miss worded it and you are asking us if we think a neurosurgeon will give you pain meds? Is that the case or did the PM office really say that?

    Anyhow I know its hard at times when one is under medicated and you have used more meds than your supposed to, and now your going to be short, but you have to deal with it until you can be seen by the PM Dr to have things re evaluated with your pain and your meds. What type of pain meds do you take as I know you used to take Methadone. Let us know how it goes. Please respect the PM DR and be thankful for what you are getting and for the good care they give you. I would hate for you to loose your pain management and have to start over with a new DR. your PM DR has been very good to you and has done a great job with your back issues, so please stick with him if you can. And be careful with your meds. to not run out early and than call the office expecting an early refill. This normally doesn't happen..

    SS

     
    Old 06-04-2009, 11:33 AM   #6
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    Re: Pain Medications and PM doctors/please help with this

    Quote:
    Originally Posted by slipperyslope View Post
    Monkey, you sound very aggrivated, I am sorry to hear how bad it is at your PM DR. I havn't seen you on the pain board in ages but have seen your post on other topics here at health boards. You have so much going on health wise that I do feel for you.

    I wanted to say that it sounds like your PM Dr has possibly ended your contract and is reffering you to a neurosurgeon now. Normally Neuro's do surgery so perhaps you are having a surgical consult. You are correct. neursurgeons don't prescribe pain meds for chronic pain patients. the only time they will do it, is if you have had surgery by them and this usually ends after 2 refills as they really aren't pain specialist and don't like to treat long term with narcotics as its not there specialty. so I am pretty sure you won't get any pain meds from this DR, and if you do I will be very surprised.

    Pain managment is a privalage, and being prescribed pain meds is very serious and you have to follow the rules. If you don't they will red flag you as a drug seeker and can easily terminate you from the practice and leave you with nothing.

    You should have a good attitude with the nurses, you never want to sound rude to them or say blah blah blah or take a negative stance with them, this isn't good at all Monkey. your very lucky they have been prescribing for you!

    If the 50 tabs are not enough to control your pain than you need to make an apt with the PM Dr and let them know its not covering your pain. Please be very careful about telling the staff your out of meds early or that you need a refill on something that was supposed to last 30 days. It even said that on your bottle so there is no excuse for missing the dosing instructions. This was your fault totally, not there fault so be nice!

    I just hope its not late for you, as there already wanting you to go to see another DR.. My concern is why would they say this to you, " we don't think he will prescribe pain meds". how did this come up, unless they have terminated you, because your contract clearly states that you can't get meds from more than one DR and they are not going to approve this, not for narcotics. So that seems really odd to me. Maybe you miss worded it and you are asking us if we think a neurosurgeon will give you pain meds? Is that the case or did the PM office really say that?

    Anyhow I know its hard at times when one is under medicated and you have used more meds than your supposed to, and now your going to be short, but you have to deal with it until you can be seen by the PM Dr to have things re evaluated with your pain and your meds. What type of pain meds do you take as I know you used to take Methadone. Let us know how it goes. Please respect the PM DR and be thankful for what you are getting and for the good care they give you. I would hate for you to loose your pain management and have to start over with a new DR. your PM DR has been very good to you and has done a great job with your back issues, so please stick with him if you can. And be careful with your meds. to not run out early and than call the office expecting an early refill. This normally doesn't happen..

    SS
    SS, I totally understand you! I have been completely nice to the nurses you bet, no problem there i assure you that!
    The reason i was referred to the Neurosurgeon is a consult for a spinal stimulator yeah! Not really sure if i want that ithier! i will let you know after today what he says and i did make an appt. with the nurse yes! So i will catch upi with you later and let you know!
    Moneky
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    Old 06-04-2009, 02:16 PM   #7
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    Re: Pain Medications and PM doctors/please help with this

    oh good. I am glad you weren't nasty to the nurses. I guess you were venting on the board so I assumed you spoke in the same manner to the nurse as you sounded really aggrivated and angry, so I wanted to remind you to always be nice to the ones that are helping you.

    I can't tell you how many times I have seen people come on this board and tell us that they were terminated for being rude to the nurses. all the nurse has to do is tell the DR that this patient is being difficult or no taking there meds correctly and than you are gone, with no taper schedule or anything! I don't want that to happen to you. It happens all the time. Espeically if your a difficult whiney patient or if you question or give the nurses a hard time. They won't tolerate it. PM offices usually have signs up in the office stating this, at least mine does.

    as far as the SCS goes I think its great your exploring it. It helps many people with leg pain, more so than with back pain. there is a lady I know that has one and it has changed her life, for the better. she is so happy with the results it gives her. she is able to live again and was able to lower her pain med usage.

    If your pain is that bad in the leg area you might want to give it a try. I have really bad leg, back and sciatic pain but my pain is covered by meds. if it ever came to the meds not working for me I would try the SCS. It really is a great tool for some people. You must be pretty bad off to have them refer you for one so I hope it all works out for you. Its a serious surgery and its a big commitment to have this implant.

    so I take it that your still in okay with your PM DR? I just still wonder why they told you they didn't think this DR would give you meds. Do you think you meant to ask the board if we thought they would give you a RX? Because it doesn't sound right at all to me why they would tell you that, when the contract states you can't get meds from other DR'S. Are you hoping to get a script for some pain meds from him?

    you had also mentioned going to the ER room for your pain and for meds. This isn't a good idea. You will be seen as a drug seeker and than they will notify the PM DR. You will also have to tell them you ran out of your meds early and that is why your suffering. this also will not look good and they will probably not give you a thing narcotic wise. It would be a waste of time.

    Let us know what the surgeon says and if he thinks your a canidate for the SCS. Have you read up on it? it doesn't sound like your to interested in getting one, why is that?

    SS

    Last edited by slipperyslope; 06-04-2009 at 02:23 PM.

     
    Old 06-04-2009, 08:50 PM   #8
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    Re: Pain Medications and PM doctors/please help with this

    Hello Monkey....Good to see you posting again.


    Quote:
    Originally Posted by monkey5 View Post
    my PM doctor presribes my meds at two a day and he gives me a script for 50. To start if he writes they need to last four weeks then it would be sixty of these.
    By reading your entire post, you sound very frustrated and I can understand why. When one's pain isn't adequately controlled, a person can get very testy, and for good reason....Especially if it lingers on and never really goes away. So, for this, i am very sorry for you. Please try to hang in there as long as you can. I know it may be little consolation, but have you tried some OTC meds....Possibly in between your other doses? That works for me sometimes.

    Just a hunch, but the directions on your bottle probably refer to the max you can take, which is 2 per day. However, you are correct in that 2 per day equals 60. I think PM Docs expect some days to be worse than others and for patients not to need the max per day....So that may account for the difference between what your bottle says and how many he gives you. I've heard mine say that for example. But, as you say, they don't walk in our shoes, do they?


    Quote:
    i guess i should have paid more attention to this because now they have referred me to a Neurosurgeon and had another MRI wich i go this week and the nurse stated she didnt think i would get pain meds from this dr. due to that i have a contract, SO i am lost here.
    This appears to be some type of consultation, not a referral to take over as your new Doc. Thus, this is why the nurse told you what she did about not receiving any meds....Because you're still covered under your existing contract as a patient of this first Doc.


    Quote:
    She didn't recommend being able to come in earlier than next week ect.What will happen if i go to the ER for this?
    I would consult my contract that I signed. It should spell things out very clearly. In my contract, for example, it actually instructs me to go to the ER if I'm having a lot of pain after hours. But, it also requires me to let the office know as soon as it's feasibly possible. I am also to let the ER know that I'm in a PM program and etc......So everything is above board.

    I've never had to use an ER, however, so I can't tell you how my Doc reacted and etc. But again, I would consult your contract as it should contain all the "dos" and "don'ts."

    Quote:
    I actually cried this morning and i havent cried in forever! How do i get out of this contract, do i just quit going because i dont like this, i have been poked and proded and i am sick to my stomache with all this
    You get out of the contract by simply telling your current PM Doc (or sending a letter) that you are switching Docs and no longer need his services. The key with PM contracts is that you have one Doc for your PM meds. So, if you terminate one, then you are free to get another. You just can't go back and forth.

    But, I think it goes without saying that I wouldn't terminate the one until I was fully transitioned to another. You don't want to get caught in between Docs and have no PM coverage. At my PM clinic, they have a rule that if you leave, you can't return. I guess this is to prevent people from looking around for a better regimen and then if they don't find it, they return. So, I would look into your particular clinic's rules & etc. before leaving.

    I'm very sorry that you are having to go through all of this. Have you tried having a candid conversation with your existing Doc....Being very upfront, but in a professional way? When I've needed dose increases in the past, I've had to come right out and ask the Doc for help....He seemed to not respond to my descriptions of my pain or symptoms, even though he would ask how I was doing.

    On the other hand, he's also sometimes asked me if I could get by on less at times, and I've always replied with "no", to which he then says "ok." I think Docs only give out certain meds when they have to, or at least it's the way mine is. My Doc doesn't seem like the type to go around increasing people's meds, but when you ask him for help, he's been responsive. I know some may feel uncomfortable with that approach, but in my case, I was really hurting and I just had to ask...I couldn't take much more, and luckily for me, my Doc has been supportive.

    I hope some of this helps you Monkey. Again, it's good to see you posting again. Best of luck to you.

    Regards,

    Ex

    Last edited by Executor; 06-04-2009 at 08:55 PM.

     
    Old 06-04-2009, 09:32 PM   #9
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    Re: Pain Medications and PM doctors/please help with this

    (Sorry so long!
    SS, thanks for the reply again is very helpful! I want to make it clear that it was me that asked the nurse about the Neurosurgeon giving me meds only because i feel it is my right to ask questions as a patient as well as them a professional as i dont feel i quite or they made me aware to understand exactly how the whole process was going in what direction with it all ,i hope i make sense it's been a long stressful day! I am still very frustuarted and am going to still seek out more answers i am not going quietly! It doesnt make it easier when you dont have more support! The only reason like i said and i know we are not here to judge one another, about the meds is like i tried to explain is that okay the first month prescribing meds that once worked for me at a certain dosage wich if they referred back to thier own records wich was in a way my fault as well for not speaking up and with trial and error with other long acting meds, I will refresh just so i dont run in circles. When i left my dr.s(MD) being referred to the PM I was on 750mg 3xa day of Vicodin es and then starting the pm dr. The tried long acting such as morphine, methadone to see if i responded better wich i didn't so we discussed after injections and such that we would go back to the vicodin because we agreed that the short acting was of more benifiet.Well it wasn't until late in the month that i over did things and realized omg what have i let pass by and then figured it out. Meanwhile realizing that i didnt even get the right amount for what they prescribed in the first place so i was going to run out well then i called at that time and let them know and they just said they have to last 4 weeks regardless, okay i delt with it once again , heating pad, nights in agony and called once again and the nurse stating well all i can tell you now is increase to 1 in a 1/2 from being prescribed 1 tablet twice daily as needed. Again her words being these must last 4 weeks. Now mind you they would only in two months not schedule me with my pm dr. only the nurse. And that i would run short as well and i still have a hard time of knowing what i did to make the pain worse to begin with unless i do absolute nothing. Oh and they even had the nerve to tell me to limit my avtiviteis the last phone conversation but i have to say it made me smile! I say that only that me being married I dont qualify for any additional anything because my husband works such as some single ones get to help run the errands, do the shopping ect.! Had i known this was the way pm dr.s worked I would have just came right out and whinned and said oh wait well do you not remember that when i was on this from the start i was on 750mg, now to me that wouldsound like a drug seeker to me? Basically had i would sat and thought hmmm let me do some kaniving thing and sit back and go what if this what if that and omg ect. and make sure i got my tracks covered to make sure i dont run short because i is gotta have my fix ect. No, i did not do research and search the net that meds had to last four weeks no matter given any ifs and or buts.I am not meaning to vent this out on you but it makes me sick that there are ones in the world that do this and make us have to figure this out the hard way! I know when you get your scripts we read over them but it doesnt say on there"oh and if your in the worst of pain that you thought you were in that day that you cannot get back in to get your dose adjusted or changed" (the reason behind meds and the Neurosurgeon is i was asking the board because i am /was new to what was happening)That you would be told over the phone to just increase the dose and yeah i know better now and i do know who it was that said this as i did think it was a bit odd! Okay on to the
    SCS, after my visit with the Neurosurgeon today as i said i was going to get back with you on this and this is why, okay i am getting mixed signals all across the board Okay i was told earlier this year seeing a foot surgeon that my foot was going the way it was because of my back, then i was even told by a psychiatrist(SCS candidate) that sometimes it works like this for some with back troubles and not others, okay i know it's reality that some of these dr.s only tell you what you want to hear right, yes i am very open minded really. Okay my thinking about the SCS is that if theres nothing wrong with me then why would i take this risk with this thing called SCS?I mean really. I am really going to sound crazy with this one, but maybe i am? I feel that and i am sorry if i offend some here as well, but this is one thing i have read up on seriously, I feel if you need something this serious than one should have a legit reason to have one right, i feel it should be visible wether it involving something emotionally(MS related), trauma like(accident), or physically(birthdefect) visible(Showing on an MRItest or other! So if they are not showing me a legit reason for all this then i am not buying into and if it means me stopping pain meds cold turkey and seeing a shrink or being commited for the rest of my life i am not sure if the risks outweight the benifiet i may recieve in the end or over all. I am not really even sure what the appt. was for because the Neurosurgeon himself did not exam me at all! Said there was not anymore tests that could be done besides what i have already have and i swear on the ground i walk on daily that i have only had an MRI without contrast and an EMG over a year ago, mind you when i had my very first appt. with my pm dr. he stated there were other tests that could be done! Now knowing what i knew when i started with this that i do know now i would personally commit myself to an institution just for being going crazy with the like of these dr.s i have had to deal with! I mean are they trying ot make you think you are crazy? What gives? I have said it before and i will say it again that i would rather make a big 1000.00 a month than a whomping 654.00 a month to live on a not have crap in this world to enjoy with my family, I mean i worked almost my whole life and this alll i get Okay not my whole life i am not even fifty yet but you know what i mean! I dont do it for the joy of it!Okay i think i'm done if anyone can help me out here it can't hurt!
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    Old 06-04-2009, 09:57 PM   #10
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    Re: Pain Medications and PM doctors/please help with this

    Quote:
    Originally Posted by Executor View Post
    Hello Monkey....Good to see you posting again.


    Ex, thanks of course not sure if it is a god thing or a bad thing!

    By reading your entire post, you sound very frustrated and I can understand why. When one's pain isn't adequately controlled, a person can get very testy, and for good reason....Especially if it lingers on and never really goes away. So, for this, i am very sorry for you. Please try to hang in there as long as you can. I know it may be little consolation, but have you tried some OTC meds....Possibly in between your other doses? That works for me sometimes.

    Ex, I have, I have tried Naproxen wich made me sick, and motrin that has really screwed up my stomach as well Alieve made me sick also. And there have been a few other none effective, heating pad helps some and tried ice with no luck and even went as far as using a tens unit!


    Just a hunch, but the directions on your bottle probably refer to the max you can take, which is 2 per day. However, you are correct in that 2 per day equals 60. I think PM Docs expect some days to be worse than others and for patients not to need the max per day....So that may account for the difference between what your bottle says and how many he gives you. I've heard mine say that for example. But, as you say, they don't walk in our shoes, do they?

    Well, this goes without saying for many and i never thougt about until recently it states that you should always take your meds as prescribed also to prevent your pain from becomming more out of control to begin with and thats another issue that dr. eat thier own word by saying take as prescribed kinda a twosided no win situation right!


    This appears to be some type of consultation, not a referral to take over as your new Doc. Thus, this is why the nurse told you what she did about not receiving any meds....Because you're still covered under your existing contract as a patient of this first Doc.

    yes i think i have it straight now after speaking with you helpful folks and the nurse and understanding why she said what she said.




    I would consult my contract that I signed. It should spell things out very clearly. In my contract, for example, it actually instructs me to go to the ER if I'm having a lot of pain after hours. But, it also requires me to let the office know as soon as it's feasibly possible. I am also to let the ER know that I'm in a PM program and etc......So everything is above board.

    The bad thing about this is yes i have a short memory but i dont remember getting a copy of the contract and i know and you know that i probably did get a copy but having a big family i am suprised i dont have hemroids from copies coming out my rear with copies of this and that and to think where i would have put this because yet everyone tells me i am very organized maybe them people can tell me where i put it! But then again i never thought i would need to refer to it seeing as i in the beginning i felt very comfortable!

    I've never had to use an ER, however, so I can't tell you how my Doc reacted and etc. But again, I would consult your contract as it should contain all the "dos" and "don'ts."



    You get out of the contract by simply telling your current PM Doc (or sending a letter) that you are switching Docs and no longer need his services. The key with PM contracts is that you have one Doc for your PM meds. So, if you terminate one, then you are free to get another. You just can't go back and forth.

    I do understand this!

    But, I think it goes without saying that I wouldn't terminate the one until I was fully transitioned to another. You don't want to get caught in between Docs and have no PM coverage. At my PM clinic, they have a rule that if you leave, you can't return. I guess this is to prevent people from looking around for a better regimen and then if they don't find it, they return. So, I would look into your particular clinic's rules & etc. before leaving.

    I'm very sorry that you are having to go through all of this. Have you tried having a candid conversation with your existing Doc....Being very upfront, but in a professional way? When I've needed dose increases in the past, I've had to come right out and ask the Doc for help....He seemed to not respond to my descriptions of my pain or symptoms, even though he would ask how I
    was doing.

    I have an appt. with the nurse on Monday although not sure if this is going to help or not, but then an appt. with the pm dr. on the 15th and i feel comfortable with him but...and i am going to write down all my thoughts as well and try like heck to bring someone with me for support as I tend to feel very intimidated by others although i have gotten a little better! I had a very hard day as you see and i was not ready nor do i understand about my visit with the Neurosurgeon today, like in another posts states that i feel i am getting crossed signals!

    On the other hand, he's also sometimes asked me if I could get by on less at times, and I've always replied with "no", to which he then says "ok." I think Docs only give out certain meds when they have to, or at least it's the way mine is. My Doc doesn't seem like the type to go around increasing people's meds, but when you ask him for help, he's been responsive. I know some may feel uncomfortable with that approach, but in my case, I was really hurting and I just had to ask...I couldn't take much more, and luckily for me, my Doc has been supportive.

    I understand this and if one could get by then what in the heck are you doing there in the first place right!

    I hope some of this helps you Monkey. Again, it's good to see you posting again. Best of luck to you.

    Ex, thanks again so much and i hope all is well with you!((((hugs))))

    Regards,

    Ex
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    Old 06-05-2009, 01:13 PM   #11
    brianpain33
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    Re: Pain Medications and PM doctors/please help with this

    monkey,
    We know that you are not crazy and that you are very frustrated. I think that you should at least give the SCS a chance and do the trial. What they do is they place the leads in your back and have you wear a device that adjusts the intensity of the voltage. Keep in mind that it has to help at least 50 % of your pain or it is not worth having permanently implanted. I am also considering doing the trial but it is a MAJOR DECISION. There are alot of things to consider like: you can never have a MRI done with the SCS EVER. That is a big thing to consider right there. Plus, you have to get the batteries replaced every 3 - 5 years so it is the same surgery every 3 - 5 years. Of course there are lots of possbile benefits too. It could greatly help you reduce or give up taking pain meds. However, you are not on very high of a dose of pain meds. They usually only suggest the SCS if you are on a very high level of narcotic medications or the pain meds are not helping. Has your PM doctor ever tried you on the Fentanyl patch. Of course this is a huge increase from taking 2 Vicodin per day.

    I don't understand why the doctor does not want to increase your pain meds. It seems like there are way too many PM doctors that are not caring and compassionate towards their patients. I know that your pain is bad and that you are not making it up or exaggerating how much pain you are in. This is the place to bring your frustrations. Keep trying

    brian

     
    Old 06-08-2009, 06:40 AM   #12
    sammyo1
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    Re: Pain Medications and PM doctors/please help with this

    Monkey its good to hear from you but I wish it was not under such bad circumstances.
    Girl you are walking in the shoes I walked in for yrs. I can completely understand your frustration.
    Let me see if I understand here, you had the MRI & it did show some issues with your discs, correct?
    Sometimes a PM will send you to a neuro hoping they will order additional testing & to see if your a surgery is an option, more or less for a second opinion type deal.

    I will share with you what I have learned from my nightmare. I had the exact same as you in the beginning an MRI & an EMG. Which showed some bulging, herinations or what ever you want to call it & DDD. Yet it was not enough according to the doctors to cause all my pain. Yet I was in major pain & like you getting no where fast.
    There are indeed other tests that can be done. If your pain is that bad why have they not suggested an myogram or discogram? I wish I would have had one done all those yrs. ago. I have read over & over that these tests can pick up problems that MRIs miss. So yes there are other tests out there.

    Has you PM tried ESIs or nerve blocks?
    I for one will never fully trust an MRI again, as the last one I received showed only a fraction of what was found during surgery. This is another story I hear over & over. What appears on film is not what is found during surgery. Not so sure any test can show everything, but why do doctors say this when they know all methods of diagnostic testing have not been used?
    Yet they want you to go through the cost & trial of an SCS? That would be putting the cart before the horse I would think. If they think you need an SCS then that is recognizing you have a problem that is causing you all this pain so why are they not treating the pain in the mean time? I am sure they dont just recommend trying the SCS to everyone, I would hope anyway.

    I am due next month for an MRI on the lumbar as I am still still recovering for cervical fusion. My PM said if there are problems there, which there was according to my last MRI on the C & T that accidently picked up part of the lumbar, he will try injections first.
    Maybe I am wrong but I would think this would be tried before an SCS would be recommended. Feel free to correct me anyone if I'm wrong.

    I have heard success stories with the SCS & if I am not mistaken it can be removed if need be. I would try the SCS only if testing was done in advance to show there is a chance it would help.

    As far as your PM well as EX said a face to face it needed. It makes no sense to have the script say x2daily & have only 50 for the month & no sense to have no additional tests done if this problem persists & your pain levels are not controlled.

    I will tell you if indeed those discs are pressing on any nerves or your spinal cord your going to have a hard time controlling that pain. At least I did, no matter what they gave me. By the way the MRI before surgery did not show the severity of the problem or that my vertabrae was shot, like in gone, what was left was into the cord. I am telling you this because you know your body. I went through the whole line of bull that perhaps it was in my head & no other tests could be done & so on.....exactly like you. I wish I knew then what I know now. When your in that kind of pain you cant afford to give up & you may have to suggest other tests to see if your PM will budge. The way I look at it if you were only interested in meds then you would not be trying your darndest to get further testing to find exactly whats going on in there. Its your body & you want to know.

    Have you matched your symptoms up on a dermatone chart to see if these discs could be causing this pain?
    I really hope you get somewhere. I would come right out & tell your PM you are in to much pain what are my options here? I cant function like this & have to take care of my family.
    I read through the posts very quickly & hope I understood.
    good luck & keep us informed. Sammy

     
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