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Baffled, Confused, and Hurt! Insights Anyone?
I am a young female with two major pain issues. I have had chronic pain for four years, only been treated with narcotics for the past two years. I had a pmp who prescribed me low doses of narcotics for two years with no problems. We had excellent rapport, and trust built up. I never requested early refills, lost my meds, had them stolen, failed a drug test, or pill count, or refused a procedure. Recently he retired and referred me to another pmp. This clinic has a waiting list until October, however has a favor to him who is a very respected and knowledgeable physician, they gave me an appt. at the end of June. There is nothing I can do to get it closer.
My pcp agreed to write my narc. scripts until I got into the clinic. He only writes me a week at a time, and I have drug tests and pill counts which I have never failed in the past 3 mos. he has been doing this. My pcp has been treating me for 8 yrs., I see him at least once a week, sometimes more. We have excellent rapport, and trust built up. We have more a daughter/father relationship than a dr/patient. He knows me better than my husband, and I go to him with every problem I have medical or not. Last Wed. I lost my bottle of meds, which was only 6 pills seeing he only prescribes a week at a time. I take full responsibility for that, it was stupid of me to take them along with me on a road trip, which was 4 hrs. long. I couldn't get in to see him until Fri., by then I was in full-blown withdrawals, having been on this medication for two years. I did not expect him to replace my meds, and I didn't even ask him. I just asked for withdrawal meds until he could write next weeks script. He gave me these meds, and then told me he could no longer prescribe narcs. because withdrawals was addiction. He gave me numbers to narc. anonymous, referred me to a psychiatrist who specializes in addiction, and told me to call him every hour, that together we'd fight my addiction. I was shocked and hurt, I couldn't say anything but cry. I took the scripts and left.
I came home and have been researching addiction and physical dependence since then. There is a huge difference. My pcp has been calling numerous times, and he even dropped by my house. I haven't answered the phone, and acted like I wasn't home when he came. I'm hurt, how could he accuse me of such a thing. My othopedist has agreed to prescribe my meds after I told him the whole story of what happened. He agrees I do indeed have a physical dependence and not an addiction, and cannot be without meds. So scripts aren't the problem. I just don't know what to say to my pcp. I cannot believe he doesn't know the difference having been practicing medicine for 40 years. I'm very hurt, and his trust means the world to me. I have a follow-up appt. with him this Monday. I need advice on what to say to him without coming across as I'm questioning his medical competence for not knowing the difference. Any input at all is appreciated. Thanks!
My pcp agreed to write my narc. scripts until I got into the clinic. He only writes me a week at a time, and I have drug tests and pill counts which I have never failed in the past 3 mos. he has been doing this. My pcp has been treating me for 8 yrs., I see him at least once a week, sometimes more. We have excellent rapport, and trust built up. We have more a daughter/father relationship than a dr/patient. He knows me better than my husband, and I go to him with every problem I have medical or not. Last Wed. I lost my bottle of meds, which was only 6 pills seeing he only prescribes a week at a time. I take full responsibility for that, it was stupid of me to take them along with me on a road trip, which was 4 hrs. long. I couldn't get in to see him until Fri., by then I was in full-blown withdrawals, having been on this medication for two years. I did not expect him to replace my meds, and I didn't even ask him. I just asked for withdrawal meds until he could write next weeks script. He gave me these meds, and then told me he could no longer prescribe narcs. because withdrawals was addiction. He gave me numbers to narc. anonymous, referred me to a psychiatrist who specializes in addiction, and told me to call him every hour, that together we'd fight my addiction. I was shocked and hurt, I couldn't say anything but cry. I took the scripts and left.
I came home and have been researching addiction and physical dependence since then. There is a huge difference. My pcp has been calling numerous times, and he even dropped by my house. I haven't answered the phone, and acted like I wasn't home when he came. I'm hurt, how could he accuse me of such a thing. My othopedist has agreed to prescribe my meds after I told him the whole story of what happened. He agrees I do indeed have a physical dependence and not an addiction, and cannot be without meds. So scripts aren't the problem. I just don't know what to say to my pcp. I cannot believe he doesn't know the difference having been practicing medicine for 40 years. I'm very hurt, and his trust means the world to me. I have a follow-up appt. with him this Monday. I need advice on what to say to him without coming across as I'm questioning his medical competence for not knowing the difference. Any input at all is appreciated. Thanks!
Please let us know how your appointment goes on Friday.
I stopped taking my medications during both of my pregnancies and it was really tough!
At that point I had been taking them for around 7 years or so. My PM doctor was totally against it and wanted to get me in with a high risk OB but I was so stubborn and insisted it was the only way as I wanted my children to have a great start at birth and not have to be treated for withdrawal.
I do not regret my decision but it was really hard to deal with.
I admire you for wanting to make sure your doctor knew he could trust you but you need to take care of yourself first. You went through a horrible ordeal that was avoidable.
I hope your appointment goes well. Please keep us updated:)
I stopped taking my medications during both of my pregnancies and it was really tough!
At that point I had been taking them for around 7 years or so. My PM doctor was totally against it and wanted to get me in with a high risk OB but I was so stubborn and insisted it was the only way as I wanted my children to have a great start at birth and not have to be treated for withdrawal.
I do not regret my decision but it was really hard to deal with.
I admire you for wanting to make sure your doctor knew he could trust you but you need to take care of yourself first. You went through a horrible ordeal that was avoidable.
I hope your appointment goes well. Please keep us updated:)
Where to start, where to start?? First, let me say, Never ever go through this ordeal again. You absolutely subjected YOURSELF to agony, for no other reason than, you didn't want to make it seem, to your pcp, that you where an addict. Why would you do that. YOU knew the difference between the two, and it's clear, so did he. After treating you for so many years and becoming to you, "a father figure", I say, shame on him. He was aware of the time you had been on the Narc's and I'm sure understood that you needed them. The fact that he shares a building office address with a clinic has absolutely ZERO impact on the DEA. You are red flagged only for scripts that appear out of medical reasoning, or occur with such frequent occurance that observation and investigation is warrented. I highly doubt that he falls with in this paramus.
But, I also say to you, YOU ARE ONE BRAVE WOMEN! To undergo those four days must, most certainly been, hell on earth. I have been on Narc's for almost 20 years. I have gone through periods of physical dependence, that required dose reconfiguration. That reconfiguration didn't occur till my next appt. and so even though it was dependence, withdrawal conditions set right in. NO FUN !!! Torture to be exact. For what's it's worth, PLEASE don't ever do that to yourself again. There is a reason a doctor or doctors have prescribed these meds over the time period that they did. It's because you NEEDED them.! Don't ever allow a human frailty or association, imped your answer to pain. In 20 years, I have been blessed with Doctors who cared and understood, I wish the future now holds the same for you. Oh by the way, if there was a clinic in this doctors building, why didn't he pick up the phone, and asked for the professional courtesy of setting an appt. up for you, forthwith. Well, in any event, again I hope things, for you, work correctly and with medical superlatives, to boot!!!
But, I also say to you, YOU ARE ONE BRAVE WOMEN! To undergo those four days must, most certainly been, hell on earth. I have been on Narc's for almost 20 years. I have gone through periods of physical dependence, that required dose reconfiguration. That reconfiguration didn't occur till my next appt. and so even though it was dependence, withdrawal conditions set right in. NO FUN !!! Torture to be exact. For what's it's worth, PLEASE don't ever do that to yourself again. There is a reason a doctor or doctors have prescribed these meds over the time period that they did. It's because you NEEDED them.! Don't ever allow a human frailty or association, imped your answer to pain. In 20 years, I have been blessed with Doctors who cared and understood, I wish the future now holds the same for you. Oh by the way, if there was a clinic in this doctors building, why didn't he pick up the phone, and asked for the professional courtesy of setting an appt. up for you, forthwith. Well, in any event, again I hope things, for you, work correctly and with medical superlatives, to boot!!!
My dear what WONDERFUL news!! I'm so glad that this is ALL working out for you. I hope that you will be sure and give us an update after your appt. on Friday.
Thank you for taking the time to explain the Dr. relationship that I had gotten confused. :)
Good luck..Sherry
Thank you for taking the time to explain the Dr. relationship that I had gotten confused. :)
Good luck..Sherry
namnam46-I'm sorry I didn't make myself clear. My pain mgt. physician wrote me a 30 days script before he retired. Then because there was such a huge gap between his retirement and my pain clinic appt. I went to my primary care physician who continued to write my scripts. He is the one who will no longer write them. My pain mgt. dr. I have not seen in three months.
Update- When I saw my primary care, and he said he would no longer write them because of my addiction, I had a routine appt. with my orthopedist that afternoon. I was so upset I told him the whole story and he was very understanding, agreed to write my scripts until my pain clinic appt. He wrote me a 30 day script. However, I realized that it might look bad, like I was doctor shopping even though this ortho appt. was routine, and had been scheduled for a month. So I never got the script filled, I went through my withdrawals, which only last 4 days for me because my narc. dose is so low. I went through the agonizing rebound pain, and now I'm left with agonizing regular pain. My primary care drs trust means so much to me, I didn't want there to be any suspicion that I went from his office to another dr. just to get pills.
I saw my primary care dr. today. I told him about the routine visit with ortho, and about the script. I showed it to him, that I didn't even fill it, that I went through wds, and I was in agonizing pain. I told him that if I was an addict I wouldn't care about his trust, I would of RAN to the pharmacy and filled it, caring only about getting high. He said he was sorry. That he used to wrong word, he said he knew the difference between addiction and physical dependency. And addiction has become a catch-all phrase for any physical response to narcotics. He said he meant my body was addicted, as in physical dependency. He said that he only wanted me to talk to narcs. anny. and a substance abuse psychatrist, because part of withdrawals is depression even in non-addicts, and they have more expertise with that than he does.
He told me to go ahead and fill my script from ortho. He said if someone else writes them that's fine because he knows I need them. But he said personally he just can't write them anymore now that I've been seen for withdrawals. His practice is monitored very closely by the DEA because in the same building is an opiate addiction clinic. And while he knows the difference between physical dependency, and addiction, the DEA is clueless, and would frown upon it, and he couldn't risk his license. Since I saw him last Friday he has spent hours on the phone with specialists, and pain clinics, and got me into one this upcoming Friday. So all is well!
Update- When I saw my primary care, and he said he would no longer write them because of my addiction, I had a routine appt. with my orthopedist that afternoon. I was so upset I told him the whole story and he was very understanding, agreed to write my scripts until my pain clinic appt. He wrote me a 30 day script. However, I realized that it might look bad, like I was doctor shopping even though this ortho appt. was routine, and had been scheduled for a month. So I never got the script filled, I went through my withdrawals, which only last 4 days for me because my narc. dose is so low. I went through the agonizing rebound pain, and now I'm left with agonizing regular pain. My primary care drs trust means so much to me, I didn't want there to be any suspicion that I went from his office to another dr. just to get pills.
I saw my primary care dr. today. I told him about the routine visit with ortho, and about the script. I showed it to him, that I didn't even fill it, that I went through wds, and I was in agonizing pain. I told him that if I was an addict I wouldn't care about his trust, I would of RAN to the pharmacy and filled it, caring only about getting high. He said he was sorry. That he used to wrong word, he said he knew the difference between addiction and physical dependency. And addiction has become a catch-all phrase for any physical response to narcotics. He said he meant my body was addicted, as in physical dependency. He said that he only wanted me to talk to narcs. anny. and a substance abuse psychatrist, because part of withdrawals is depression even in non-addicts, and they have more expertise with that than he does.
He told me to go ahead and fill my script from ortho. He said if someone else writes them that's fine because he knows I need them. But he said personally he just can't write them anymore now that I've been seen for withdrawals. His practice is monitored very closely by the DEA because in the same building is an opiate addiction clinic. And while he knows the difference between physical dependency, and addiction, the DEA is clueless, and would frown upon it, and he couldn't risk his license. Since I saw him last Friday he has spent hours on the phone with specialists, and pain clinics, and got me into one this upcoming Friday. So all is well!
I also agree to never say withdrawl or addiction to a doctor. They will not treat you anymore. I am so sorry that your relationship with your long time dr is under the water so to speak. I am glad tho that you got another doctor that will give you meds for your pain that is a big help. I would just talk to your long time dr and tell him that you have been on the meds for so long that when you went off of them you only had withdrawls cause your body was use to being on them not that your addicted to them. I wish you best of luck and hope things work out with this dr and you guys can remain friends.
Jamie
Jamie
I meant add.
also.."Withdrawal" these 2 words are a HUGE no-no when talking to your Dr
also.."Withdrawal" these 2 words are a HUGE no-no when talking to your Dr
in my experience any time you even mention the word "addiction" to your dr it results in immidate discharge
So Sorry for youre situation
So Sorry for youre situation
I'm sorry, I forgot to say that he didn't do this with any malice at all. I just think that it is the old school of thought and it's all that he has ever known. There is also the chance he may think that there is no such thing as dependence. Again , that would be the OLD SCHOOL of thought. It would have NOTHING PERSONAL to do with you at all. It would just be him.
Just wanted to add that. Don't worry you will make the right decision....Sherry
Just wanted to add that. Don't worry you will make the right decision....Sherry
Hi, and welcome to the Pain Management Forum. We're very glad that you found us.
If I read your post correctly, you PCP is and older gentleman and has just retired. But because you can't get in to the new Dr. as yet he has agreed (even though he is retired) to continue writing the scripts for you until your appt. at the clinic.
This happens MANY times with the older Dr.'s as they just don't have the energy and time sometimes to keep abreast of all the changes that are going on in Medicine today. Since you have such a good raport with him I think if you went and saw him, 1st so he can see that nothing is wrong with you and 2nd to explain exactly what the difference is between an addiction and dependence. You might take with you some written material that you have gotten off of the web or maybe even from your Ortho. Just be the same sweet person that you always have been with him and talk to him as if he were your Dad since you have that type of rapor with him. I'm sure that he is quite concerned about you since you haven't been accepting any of his calls. You might also tell him how special a Dr. he has been to you (or tell him one more time if you already have) and let him know that you will always remember him as the finest Dr. that you have ever had.
I'm sure the correct words will come. Let us know how it goes and how your new clinc is...Sherry
If I read your post correctly, you PCP is and older gentleman and has just retired. But because you can't get in to the new Dr. as yet he has agreed (even though he is retired) to continue writing the scripts for you until your appt. at the clinic.
This happens MANY times with the older Dr.'s as they just don't have the energy and time sometimes to keep abreast of all the changes that are going on in Medicine today. Since you have such a good raport with him I think if you went and saw him, 1st so he can see that nothing is wrong with you and 2nd to explain exactly what the difference is between an addiction and dependence. You might take with you some written material that you have gotten off of the web or maybe even from your Ortho. Just be the same sweet person that you always have been with him and talk to him as if he were your Dad since you have that type of rapor with him. I'm sure that he is quite concerned about you since you haven't been accepting any of his calls. You might also tell him how special a Dr. he has been to you (or tell him one more time if you already have) and let him know that you will always remember him as the finest Dr. that you have ever had.
I'm sure the correct words will come. Let us know how it goes and how your new clinc is...Sherry
My goodness. You are in an awkward position. If you want to continue seeing this doctor for future health problems, you might consider coming clean with him. Discuss the difference with him between addiction and physical dependence. Not all doctors understand this and/or keep up with the newest findings on these issues. Apparently, this is one area in which he is deficient.
Or you could just keep on seeing him as if nothing ever happened. However this option in my opinion, leaves the "elephant in the room" so to speak.
You would know best how he would react to either scenario. But you are in a very awkward position with him. I wish you the best of luck. Hopefully a wiser soul than I will answer you.
Let us know how it goes.
Or you could just keep on seeing him as if nothing ever happened. However this option in my opinion, leaves the "elephant in the room" so to speak.
You would know best how he would react to either scenario. But you are in a very awkward position with him. I wish you the best of luck. Hopefully a wiser soul than I will answer you.
Let us know how it goes.
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