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1855076 tn?1337115303

Failed urine test - Physician explsnstion if possible

I have been in PM for 6 years after failed thumb joint replacement, total of 9 surgeries, countless procures & too many meds to count.  Last  year switched to my primary for the PM & was on total of 40 mg./ day.  Several months ago my BP reached stroke level &they  put me on second BP pill.  First one was Clonidine, more for nerve pain.  I hsve CRPS, fbro, arthritis in many joints & herniatet disc @ L5Sl.  My first PM clinic I was very overmedicated which is why I went to my primary after I tapered from Fentanyl, oxy, OxyContin, morphine, attivan, ambient, Cymbalts & more.  I was going pretty well with using l0mg oxy only when needed.  When my BP went so high they gave me second BP med, which did not help.  They thought the pain was the cause & my primary sent me to new PM physician.  He tried me on long- acting oxymorphone, which was not helpful.  Put me on oxyContin 20 mg twice/ day plus l0 mg oxycodone 4 x day for BT pain.

I also have urethral syndrome which makes it difficult for me to urinate, which is in my records & I mentioned it to the nurse. She told me to drink tons of water & some coffee, which I choked down.  

Next appointment I'm told I failed the test that nothing showed. It is impossible. He told me it looked like it was diluted, like someone put something in it.  This is impossible because of how they have the test set up. I was not allowed to bring my purse, jacket, or anything into the restroom.  Two women stood outside.  There was blue dye in the toilet & I wasn't able to flush.  The water in the sink was shut off & I was told to wash my hands @ the sink outside the toilet ares. There is no way this could be tampered with.  I also checked the cup to make sure the cup was properly labeled & it was.  Seems everything was in order.

So physician is not happy & neither am  I.  He told me it was not from drinking extra water & coffee ...that it looked  tampered with.  From where I sit, it could only be tampered with after I  gave it to the tech.  I asked for blood or hair test & he told me know.  I told him I was unhappy with this & he stated "I don't care."  Told him  in all the years I've been in PM 6-7, I've never failed any test.  Now he gives me my meds two weeks @ time,  which is sort of a pain since it means  multiple trips every few weeks to his office & to the pharmacy.

My primary was very empathetic & believes me ... we've been together l3 years.  I have another visit with the PM guy   Wed.  & I want to clear  things because I need my physician to believe in me & work with me.  If not, I can't stay with him.  Trouble is I'm  concerned he'll flag me.  I am extremely compliant with things & never take too much or too little. I prefer using the least amount possible & he knows this.  He talked me into the long- acting & now has taken one l0 mg BT away.   He thinks we should taper down, which was my plan, though I was planning it when it got warmer since  cold really sets off my pain.

I also take Clonopin on occasion & ambient several times/month for sleep. I take multi vitamin, magnesium, Valerian   Root, i-cool for hot flashes, & Midnight for Menopsuse ... I  have some bothersome menopause symptoms, night sweats, irritable, weight gain, dry mouth, eyes.

I'm wondering if anything could have effected this urine test. The fact he refused to retest with blood test bothers me.  I take my relationship with my physicians very seriously & I know how difficult it can be to find great PM physicians.  But without trust & mutual respect there isn't the right relationship.  Anyone have thoughts on how this test came back like this?

I've worked in the courthouse & we use urine tests because they're cheap.  If we get any type of false test, though, they either blood  test or hair test.  (Also, in Mass we have the big scandal  with the state drug lab with the chemist who tampered with countless drug evidence causing thousands of prisoners to go free on drug cases.  I'm not naive & I have respect for the medical community & legal community & most importantly myself.

I'm just looking to see how best to manage this.  I hope we can keep this relationship because he seems like he knows his stuff.  I just can't figure out how this could have happened.  The urine tests I took in the past were not nearly that secure.      
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1855076 tn?1337115303
Things went ok.  Mentioned the things you pointed out & told him he should speak to my primary if he has any doubts about my character since she knows how seriously I take my pain management & how careful I am with meds, etc.  So we'll see how things go over the next few visits.          
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Avatar universal
You don't deserve that kind of treatment with your history and everything you've been through!   He's not the only game in town...you're right...so you'll need to look around again.  

They may do another urine tomorrow...let me know.

Good luck Sweetie!
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1855076 tn?1337115303
Also I tske 20 mg OxyContin in the morning & evening & l0 mg oxycoone every six hours as needed.

I bet if I ask for the test, he'll say no.  
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1855076 tn?1337115303
Thanks, Vicki.  I haven't been eating much prior to the appointment because I have been getting migraines since I hit menopause.  They started last year & for me, once they peak, I vomit for a few days & eat sort of bland for the next few days.  My BP meds are Clonidine & Lisinopryl.

I immediately asked for another test & he said no.  If he doesn't have a better      attitude tomorrow I'll look for someone different.  Plenty of teaching hospitals    around here.

Now I have some things to talk to him about tomorrow.  Thank you, my friend .You're the best :)

XOX      .    
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Avatar universal
Okay, it's as I thought: Over hydration will cause urine to be more dilute. Also, if your diet has been low in protein for some reason, your creatinine clearance will change and THAT result would indicate that the urine is dilute, even though it isn't.

You drank coffee, a diuretic which would contribute to the problem. Do either of your b/p meds contain a diuretic?

Don't let this "go"... Ask for another urine test tomorrow and eat a protein bar before the appt.  You know exactly how to nicely insist that you haven't broken your contract so please do that, just for the record!  

Let me know...
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Avatar universal
This is unbelievable to me Mary. The PM doc obviously doesn't know YOU very well!  

I'm not sure why your urine would have tested neg for opiates...I need to look up a couple of things, though.    Do you know about how much you took in the 3 days prior to the test, including that day?

You'll be seeing this guy tomorrow, right?  Ask him to be more specific about the findings...tell him how much you had taken prior. Also, suggest to him that if he doesn't want to recheck the results that's fine but that's it's a hardship for you to be doing all the extra driving.  I'd like to know what he thinks you did? Why would you dilute your urine anyway??  LOL.  It's just funny to me; you of all people!!   Ask him if he thinks you're abusing your meds. Bring all your pills in for him to count...  It's sad that you need to prove yourself...I'm sorry my friend...

I'll check back with you...I need to look up a couple of things...

xoxo

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