Discussions that mention cyclobenzaprine

Pain Management board

Hi everybody. I had posted recently that my pain management doctor was leaving the pain clinic that I go to and that I would be seeing his replacement today. I had been pretty stable on my meds (methadone 120 mgs. a day and 30 mgs. oxycodone, 4 per day) for about a year, but just recently started experiencing increased pain in my right hip, right femur and mid spine and the oxy wasn't really helping me like it has in the past. I made an appointment to talk to the new doc about my options for a different plan of action and perhaps a change in my break thru med.

Well...I met with the new doctor who turns out to be a Fellow in anesthesiology at the University. I experienced so much of what other posters have gone through when dealing with a new health care provider and it wasn't a very good experience! First of all, the new doc (who looked about 18 years old) came in and looked over my chart and I told him why I was there. He asked me about other medications that I had taken in the past (other than the oxy) that had helped my pain. I gave him the list...there wasn't really anything that I hadn't tried in the past. Then I mentioned to him that I had taken Actiq at one point in my treatment. Well, you would have thought that he suddenly saw a blinking, neon sign over my head that said: DRUG ABUSER....DRUG ABUSER...ADDICT...ADDICT!! His entire tone of voice and body language changed. He told me that doctors could only prescribe Fentanyl and Actiq for extreme cancer pain and that it wasn't used in pain management practices any more. I tried to remember what everyone here has said in the past about not losing your cool, not getting defensive, not over-reacting...but I was so shocked by his accusatory stance that I was numb! I referred him to my chart where it clearly showed that the doctor who had just left the practice had prescribed Actiq for me for almost 6 months a few years ago. He himmed and hawed and stuttered....then he said that my doctor had personally told him that my medication should not be changed!! I didn't believe him...I mean, he had never met me and he wouldn't have had any idea why I was coming to see him. He made it sound like he was clairvoyant or something and had foreseen my medication problem and specifically spoke to my regular doc about it before he left the practice!! What a crock!! But I know enough now to not waste my time, my blood pressure or my stress level on folks like him. I've known his kind in the past!

It wasn't a completely wasted trip. He ordered some new x-rays for my hip and femur to rule out another fracture or problem with my hip replacement and handed me a prescription for a compounded cream. I've never heard of it and I wondered if anyone else had ever been prescribed this combination before: "DMS 0.5%, Dextromethorphan 10%, Gabapentin 10%, Lidocaine 10%, Marcaine 2%, Amitriptyline 5%, Diclofenac 5%, Cyclobenzaprine 5% in Anydrous base/PLO base. What a cocktail, eh? All of this is to be compounded by the pharmacist and I'm to use 1 gram three times a day on my skin...over the parts of my body that hurt.

Then he told me that he couldn't think of anything other than the cream to help my increased pain. He said, "The problem is...I don't KNOW you and I don't KNOW the kind of person you are!!!" I wanted to hit him I was so mad! It's not MY problem that he doesn't know me!! If he is questioning my honesty about my increased pain complaints right from the get-go, then we are going to have a very big problem! All he needed to do was take a little time and look over my history to see that I've always been compliant, have never asked for early refills, have never called the clinic for help after hours or on weekends to ask for meds, etc. Then he told me to try the cream and come back to see him in a month. I asked him if he was going to be my doctor for the long-term and he said, "Well no, I'm only here until July and then I'll be moving on!"

I've decided not see him again. Instead, I will call and ask for an appointment with one of the "permanent" doctors. My health care is too important to me to have it passed to every new "fellow" that comes through the clinic. The head of the department is supposed to be excellent and I'll make an appointment with him, even if I have to wait months!

So I guess I'm not asking for any real advice here. I just wanted to vent and to add my voice to the regular chorus of folks who have to deal with these kinds of doctors every day. Oh, and I would like to know if anyone has an opinion (like Shoreline or anybody else) on the cream. Have you used it? Did it work for you? Thanks for letting me b_ _ ch! KathyMac