Hey Fairy, Hydroxy Pam is Visteril, It's used to treat itching and nausea and in higher doses anxiety but it's actually an anti hystamine. It's used in conjunction with demerol injections for nausea and to boost the the meds a little. On it's own it has no pain relieving properties.
As far as calling the week before, If someone had self medicated and ran out of meds,requesting a med change solves that problem, but docs know it is a way to solve that problem. If he gave you a month worth of Vicodin and you ran out early, saying it doesn't work and needing to be seen early would hopefully get the patient a new script for a different med . A new script for percocet over rides the old script and insurance and your pharmacist will run it trough. If they are going to change your meds to protect themself haveing you bring meds in to be destroyed isn't unreasonable. If they don't work or your allergic or can't tolerate side effects, then presumably you would have some left and wouldn't care if they flush useless meds. Some docs have you turn the old meds in when they make a med change. They just need a witness to sign off on destroyingthem, usually a nurse.
As far as calling your doc, of course he should be available, But I wouldn't expect him to try to manage my pain without seeing me. If you had been calling all month, you might have avoided getting your feelings hurt had you just askded if they still had you on the cancelation list and had anyone canceled.
I think It was the way you post came across, like he has done something really wrong by not being able to squeeze you in early? If he's making changes everytime he sees you, he is working on your pain, what's shocking about having to wait a couple days?
The way you described the meds no longer working, it sounds like you expected to wake up one day and they just stop working and you would somehow be in agony. That isn't how tolerance deleveops. The meds that were working usually start working a shorter period of time and the relief is a little less each day. It's not a wham, this dose is no longer effective.
You may have a flair that makes things seem like you took a tic tac instead of medecine, but the nature of pain and pain managment means it will get out of control, how you repond to it is up to you and what your doc has instructed you to do.
If your in the process of titrating a new med, it's OK to call and say this dose isn't working and the doc said to call if we need to make an adjustment, but I didn't get the impression that was the case. Going through all your old meds looking for something to take is dangerous. Those meds were not prescribed with your present meds. They may overlap with a new med your on now or my interact with something. SO stop loking for something other than OTC meds like IBU, apap, aleve, hot baths, whatever helps your pain.
Maybe you have very high expectations of what pain management is about and how they are suposed to respond, but when you live like this for years, or have been on the same meds for a while, they don't usually completely stop working in between monthly apts? You could be having a flair up or simply growing tolerant, but toleance isn't an emergency that needs imediate attn IMO, but that's just my opinion.
If you call your doc every time you have a flair, being a high maint patient doesn' t build the best relationship either. Some folks are just never satisfied and they aren't good candidates for certain types of PM. I would just try to avoid pushing the envelope and see how many weeks in a row you can call before your labeled high maint or never satisfied.
As far as fridays, that's just from my wifes experience in the pharmacy bizz, There is a huge influx of calls to the pharmacy to see if meds wewere called in before the weekend. Folks that abuse or sell meds usually want more for the weekends.
I guess I just didn' t get why someone would ask "can they do this?" and act like your doc patient relationship has been altered because he can't see you before whatever day next week. Of course they don't have to let you come in today to be seen or call in stronger pain meds. What exactly are you asking if it's OK for your doc to do that seems unreasonable?
As far as contracts, they don't gaurentee the patient much at all, They are consent forms that explain the rules and policies and consequences. It's actually a good thing to know up front that they don't replace lost meds. Sure it happens, but it's the oldest story in the book.
I did have meds stolen, I did get police reprorts but I didn't request replacement meds because I knew they wouldn't be given. So why even put myself in the position of them wondering if I'm just trying to get over, or this one time it really did happen. Anyone can claim their meds were stolen and have a report taken by the police.
Living without PM isn't an option so risking it for anything, particularly when the subject has been covered by the contract wasn't an option or risk I would take. I personally wouldn't call the friday before an apt on Wed and ask to be seen because my meds stopped working or be shocked by the response you got. A few bad days or one bad month isn't worth the risk of being labeled anything that's not true. Just keep apearences in mind.
Good luck, Dave