Discussions that mention vicodin

Pain Management board


I agree with the others, it isn't abnormal for the doctor to ask for you to bring in medication for a pill count, if you signed a contract it is probably already on there as well as that you are not to take any medications he is not aware of.

The reason he won't call anything in other than what others above said is that there are many medications that can not be called in that are used in pain managment. In some states the highest narcotic you can legally callin is Vicodin while in another it could be Percocet. Add to that he's protecting himself from individuals who abuse medications that have a tendancy to call on Fridays as mentioned before.

Unfortunately yes you have to wait it out a week but there's been times I've waited longer when medications have stopped working but the doctor can't see me due to a very busy schedule. We have to tough it out the best we can and know that hope and help is just around the corner. So try to keep positive thoughts, as hard as it may be, and you'll get through it one minute at a time.

good luck! Barbie
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
Hey Fairy, Comunication s a funny things. When my wife and I were first married, the floor boards under the furnace cought fire in a locked closet at the apt we lived in. I sprayed Halon under the door crack and the fire seemed to be out. I had told my wife to call the fire dept or 911. After I was done putting out the fire, although we couldn't know for sure, my wife was telling the fire dept that it wasn't really an emergency because it apeared the fire was out. I was in the background yelling yes it is an emergency,they needed to open this door and make sure it was out. So everyone sees things a little different.

Everyone has a differnt definition of an emergency and has different expectations as a patient. I don't think I was the only one that didn't feel this as one of those "I can't believe I was treated this way" situations. There is a thread going on right now filled those types of situations. Having surgery and being sent home with no pain meds or the bare minimum because you are a pain patient. Waitng 3 months to see a PM doc who evaluates you in 3 minutes and says we don't use opiates here and sends you on your way offering no other advice. Those are the unelievable circumstances to me and many other folks that have been involved in PM for years.

Our expectations are much different than the folks new to PM that were prescribed opiates by the first PM doc they ever met. I don't see agressive pain management with opiates as something every persn with pain is entitled too and I see that type of advice given all the time. The meds are available, so everyonbe should have equal access with no other info about a persons condition. To me that's absurd. OPaites are the last thing you try before you trade a free life for that of physical dependence without trying every other method first. But that's just my opinion and the system I came though to be where I am today.

We have folks that cover the entire spectrum. Everything from those that feel entitled to the most potent meds once reserved for cancer simply because their pain meets the criteria of chronic in that it has lasted more than 4 months, I see people suggesting trying meth to folks that are no longer getting relief from Vicodin "which is totally absurd". Some of us know that your not going to die from pain if you have to wait a week for an apt.

Your skin does get tougher the longer you have been at this and you will get to know your docs policies and the way they operate without feeling abondoned because they won't blindly call meds in like some docs may have in the past.

There is no such thing as an instant cure, entitled to pain meds or a docs duty to prescribe if we request. Most likely your call goes through a triage nurse that seperates the need to be seen urgently and those that can wait untill their apt. The calls they get daily determine whether you really do end up on the list for cancelled apts. You learn as you go, your skin gets tougher and you realize everyone has an opinion, but that's all it is.

It's 5 am so if there is some mis spelling Im sorry, too tired to edit right now.

Take care, Dave
Fairy,

I'm new to PM also. I've only been going for about 4 weeks now. And, like you I waited a long time before commiting to the pain meds stronger than vicodin, which by law is allowed to be called in. In Ohio, once the meds get stronger than that, it can't be called in or mailed to the patient and a patient has to pick up the script.

I don't remember you saying how long you have seen this doctor, but apparently, the doc expects to have "work" with you on reaching the proper dose and type of drug to use. Otherwise, he wouldn't have said to call.

I don't know what you were prescribed, but if you are going to see him in a week, why don't you call and ask his nurse if it would be alright to take your current med more frequently until you see him the following week. At least that is something he could approve over the phone.

I'm surprised you didnt have to sign a contract. That has been one of the most shocking aspects of going to a PM doctor. lol Actually, I feel like a criminal with all the pill counting and things they can do. There are a LOT of stringent rules when using narcotics and this whole thing is a huge learning process for me and I'm sure it will be for you.

I don't think we can expect PM docs to react the same way as docs who can just prescribe vicodin over the phone for us. The drugs prescribed by these doctors are high addictive and easily abused. They really need to cover their arses in these matters AND so do we !!

I write down every pain pill I take and at what time and I took that list and my bottle to my doctor. Actually, I think it made a good impression on her. I can thank this forum for educating me on how NOT to piss off your PM doc. My doctor actually hugged me the last time I saw her because I was so thankful to have some pain free days although the med about knocked me out (like you) when I first started taking it.

If you can do so Monday, maybe you can call and speak directly with your doctor's nurse to see if you can increase your dose a little before your next visit. I hope he will comply...

Keep us "posted"...

Barb