I Need Immediate Information

[BBlueize]

I take 3 different pain medications, Vicodin; Tylenol IV and Percocet. I am used to taking a tox screen and find no problem with it. My last visit I took a urine test and a week later they had me come back in for a blood test. Come to find out they say the Percocet isn't showing up in my results. The urine test didn't surprise me because I hadn't taken any but I had taken a Percocet on Saturday morning and the blood test was Monday morning so I don't understand it. I have been taken these meds for years and the Percocet for the longest, The reason the urine test didn't surprise me was the directions on the bottle are "take 1 every 6 hours AS NEEDED". If a medicine is prescribed as needed how can a doctor deny me my pain medication because it doesn't show up in a test? I have an appointment with him tomorrow am because he is now denying all my pain medication due to the negative result on the Percocet even though the Vicodin and Tylenol IV showed up. Besides my argument that the prescription is written "as needed" is there anything else that could help my case? Please, I'm begging you for help it's 6:36pm and I'm seeing him at 9:45am.

[BBlueize]

It's been a couple days since I went on the patch and I'm not taking as few pills as I'd like. I am taking less though. I'm trying not to be discouraged because he outright told me this patch wouldn't be strong enough for me so I'm focusing more on the fact that, even though it's not a huge difference it is a difference, I've gone from 8 Tylenol IV & 3 Vicodin a day to 6 & 2. I'm not waking up in the middle of the night for the extra 2 Tylenol IV (which I love!!) and I'm not needing the mid-day Vicodin. I'd like to drop down 1 more Vicodin at least by the end of the month but so far I haven't been able to handle the pain.

[BBlueize]

That's what I did first thing this morning and unfortunately "my" pharmacist wasn't working today. I pretty much got a lecture from the one on on how they pick these generic brand patches because they stick the best. No help whatsoever in what to use when they don't (other than what's recommended in the packaging, which I figured out on my own). I called another pharmacy and they have a brand of their own "bandage" that is a porous transparent dressing and the pharmacist there said that that would work (I think it's their brand of the Tagaderm Transparent Dressing now that I went back and checked - $2.00 difference and then my daughter who works there gets another 30%  off - worth trying the store brand first I think). As soon as my Neurologist is back from vacation I'm going to bring up the fact they're not sticking and see if maybe I can get something sent or something but I'll be willing to bet if it's true it probably only works if you're taking name brand patches. Shame on us peons who can't afford the $40.00 co-pay for name brand.

[Tuckamore]

I'm going to sound like a broken record...sorry. Call your pharmacist. It is my understanding that some of the manufactures will actually provide you with a sticky clear "patch" to go over the Fentanyl Patch.

Some ppl find that a product called Tegaderm Transparent Dressing applied over that patch will help it adhere for those 72 hours. They are a bit pricey and that is why I suggest that you talk to your pharmacist. One member claimed that the actual manufacturer sent her these type of patches at no cost to help the Fentanyl Patch adhere correctly.  

~Tuck~

[BBlueize]

I've started the patch. I'm not sure about any differences yet because I still have the other meds but I haven't taken a Vicodin since I put the patch on so that's something (I did have to take the Tylenol IV). When I first put it on I had taken both meds earlier and the patch felt better then.

I'm hoping someone can help me. Eight hours into the patch and it was almost half way off  my arm (I put it there to keep my eye on it because I knew the problems with it sticking). I know about using tape and the Bioclusive etc dressings to help it stay on; right now I have clear first aid tape on it but I'm not holding out much hope for this to be a three day last. Are there any tricks to making it stick better until I can get the dressing? And, I know you're not supposed to cover it with a bandage but since this tape is clear can I use one piece (it's wider than the patch) and cover it instead of cutting it up and holding down the edges? I was thinking maybe the tape would work better if it was in one big piece.

Thank you for any help. I really want this to work. It would be so nice to just go somewhere and not have to make sure I had enough meds to last.

[BBlueize]

Thank you. I was worried about the summer because we don't have air conditioning and I don't forsee having any in the near or distant future.. I'll just have to be careful. I'm on great terms with my pharmacist so I'll take your suggestion and talk with him when I get the 'script filled.

[Tuckamore]

The literature I have read says heat in excess o 104 degrees can cause a faster release than desired of the medication.

From a trusted web site:
"Do not expose the patch on your skin to direct sources of heat, such as heating pads, electric blankets, heat lamps, saunas, hot tubs, or heated waterbeds. Avoid sunbathing, long hot baths, or other sources of heat to the body. Tell your doctor if you develop a fever. The heat may cause more medicine to be released into your skin"

So yes be cautious but normal every day activities should not effect the medication in the patch. The reservoir ones have had more recalls and problems than the layer patches.

Discuss your concerns with your pharmacist. They are the true experts in medications.

~Tuck~

[BBlueize]

I have a question for anyone who's familiar with Fentanyl patches now that heat was mentioned. I forgot all about reading about being careful with heat until I saw cleo1988's comment. Do you have to be careful of heat in general or heat directly on the patch?

[cleo1988]

Please be carefull with this patch. I used to be on them and it does help.But getting off of them is pure HELL.Very addictive A friend of mine son took one and went to sleep in a water bed and DIED.Please be sure and do not put any kind of heat on it as it will release too much of the med in your system at once.

[Tuckamore]

Yes we are paying attention. Thank you for the updates. I have been wondering how you were doing.

Every physician practices a bit different, so I don't know if there is a "normal" way. I'm guessing the Fentanyl patch will help with your pain and help even more with any withdrawals you may experience.

Fentanyl is stronger more potent than any of the medications you have on your list. It may actually do more for your pain than the others did. It is a slow release so you should have better round the clock coverage.

I hope you will keep posting and let us know how you are doing. I am so glad that your neurologist has stepped up to the plate to care for you and your pain isues.

Take Care,
~Tuck~

[BBlueize]

If anyone is still paying attention to this since it's so old...my doctor is sending me a 'script for the lowest dose of Fentanyl patch but told me he knows it won't be enough. He wants me to keep taking my regular meds while I'm on the patch but to try to cut down on one (I chose to try cutting down the Vicodin since the Percocet isn't an every day drug and Vicodin was the strongest I was taking for my back). Is he doing it this way, instead of giving me a patch that he thinks will be strong enough and stopping the other meds, because he's afraid my body will go into withdrawals since it's been years that I've been taking the Tylenol IV and Vicodin? I really should have asked him but I never think of these things until I'm done talking to him and this time he's gone on vacation so I can't go back to him right away. I'm supposed to call him in 2 weeks to let him know how I'm doing. Is this the ordinary way to switch over to the patch when you've been taking as much meds as I have been?

[Mollyrae]

I have used the Fentanyl Patch for a long time. It works well and that's great. The not so great part is that because it is so strong, other meds such as Oxycodone or Hydrocodone do not work anymore. The Fentanyl cancels out the other drugs.

Your tolorance will get so high that other pain medications will not compare. Fentanyl is 80x stronger than Morphine, so this gives you an Idea of what you're dealing with.

If you would like more information about the Patch, please send me a PM. I can fill you in on the way it's used and the dangers before you actually start using the patch.

Be well,
Mollyrae

[BBlueize]

Just as an update...
I spoke with my neurologist yesterday and it's definitely a Fentanyl patch he's going to put me on; I have to call him back next week to get more into that with him. He did give me another reason to despise my former doctor, though. My neurologist got the results of my last bloodwork taken because it involved a Tegretol level and liver functions and I guess my jackass doctor was so busy thinking I was doing something evil with my Percocet that he missed that my platelet count was too high and there was too much protein in my blood. I know that's not pain related information but since I think it showed just one more reason why Dr. Twit throwing a mental fit did me a favor I'd write it up. I'm going for more blood work and my neurologist has set me up with an appointment with a hematologist/oncologist (next month). My neurologist figured that was enough information to deal with right now so I have to call him next week about the patch.
The fun never ends :-)

[BBlueize]

Thank you.

I wish I had more than my husband and his office staff to witness what he did. I'm in my 40's (pushing 50...but that's a secret) and I've never had any professional (and I'm not just talking medical...I mean right down to the "lowliest" job) treat me the way this "man" did. Once, maybe you're having a bad day...twice, you're just a jackass.

Thank you too for the information. I'm still waiting to hear from my Neurologist so the more information I know about what I believe he's thinking of doing the less chance I'll have of wigging out from the fear of meds not working and my having to go through hell from the pain again.

[Tuckamore]

Wow, you have really been through it with an incompetent physician. I am so sorry that this happened to you.

And I think you hit the nail on the head, Dr. Shmuck really did do you a favor. Who would want to be treated by a physician that belittles you and doesn't trust you? I surely wouldn't.

His behavior, especially in the presence of others is unprofessional to say the least. It sounds like you have worked through a bad situation and found good solutions.  I do hope you don't let this go. Physicians should be held accountable for their actions, good and bad.

The Fentanyl Patch or Fentanyl is not Morphine. They are two very different medications. Fentanyl is a synthetic (man-made) narcotic whereas Morphine is naturally occurring compound and a non-synthetic. I imagine your neurologist will start you on a low dose and gauge it's effectiveness.

Thank you for keeping us updated. I hope you will continue to do so. I wish you the best of luck.

Peace,
Tuck

[BBlueize]

Thank you for the information. My husband won't let me drive unless it's an emergency anyway because of the meds I'm on now & sometimes I do get drowsy. I don't have a car [my poor baby has been down & out for a while :-( ] so I really don't do a whole heck of a lot anyway. Summer's different. I still don't drive but my grandmother has a cottage on an ocean bay so I do more but if I do get on this (and I'm not going to predetermine anything because I don't want to get upset again) maybe that'll give me time to get more used to it. To be honest, the way I can't sleep maybe a little drowsiness wouldn't be so bad (at least for a while). I do thank you though. Even if I do get put on that; and the doctor does tell me it could make me drowsy, it's still better (for me anyway) to hear from people who've been on something and/or know people who've been on it too. It'll probably be something else somehow anyway and now that I'm getting used to the patch idea I'll have to get used to the idea of something else.

[Red931]

If you do get switched to the Fentanyl Patch it may work much better for your pain issues but it tends to make you very drowsy so be careful until you get used to it. I could not tolerate it but that may be because I take 30mgs. Oxycontin a day for about the last 18 months.

Everyone is different, but everyone I know on the patch gets very drowsy.

[BBlueize]

That's what I get for forgetting to proofread. I meant...
MAYBE Dr. Flippout did me a favor.
MY Dr. Flippout just sounds wrong!

[BBlueize]

Oh...now I feel dumb for getting upset. Maybe that's why he asked me how my depression was going :-)
I hope that's what's he's working on doing because once I calmed down just the idea of something I kept on me for a couple days instead of swallowing pills every few hours started sounding good. One big advantage I thought of was the fact  that I have trouble sleeping. Maybe I won't keep waking up every time I have to turn over. Add in the information you just gave me and now I'm hoping that we go that way instead of all the different pain meds I've been taking so long. Hopefully it'll work if that's what ends up happening (had morphine after my first daughter's birth and I don't remember it working all that great (but that was back in '85 so who knows). My Dr. Flippout did me a favor.

[TrayCee]

fentanyl patch
its morphine and REALLY strong....
pain should be a thing of the past

Good Luck

[BBlueize]

Okay, I've seen my Neurologist and what's happened is he made sure I had enough pain medication right now while he works things out. He's worried about all the acetaminophen that I've been taking all these years so he wants to try me on something else. He said something about a patch; that it would last a couple days and I think it started with the "f" sound. I was so upset about the fact that things that have worked for years were going to be changed and I might have to start going through all that pain again that I don't remember everything he said about it. Maybe someone can tell me of a medicine that sounds like that?

He's going to consult with a pain specialist (right terminology?) from the hospital in his area and then get back to me within a week. I'm supposed to call him if I don't hear from him. He said if I took this patch I probably wouldn't need as much Percocet either but that I'd be keeping some for the really bad days.

[BBlueize]

Thank you. All my anger aside for this "doctor" putting me into this situation...I honestly think there's something that's wrong with him.

[sandee1818]

Here is the site that will give you information on how to file a complaint in your state....
http://www.massmedboard.org/consumer/complaint.shtm


This is the AMA website information...

http://www.massmedboard.org/consumer/complaint.shtm

[sandee1818]

You need to report the doctor to the AMA which is the American medical association.
They are the ones who would be giving out disciplinary actions toward the doctor and fines if that's the case.
I would not prolong doing this. Write down everything (all the details) now while it is fresh in your mind.
I will post the information on how to file a complaint shortly.
I hope all goes well with your doctor tomorrow:)

[BBlueize]

Sorry for delay in response. I've been dealing with Dr. Shmuck and hopefully my Dr. Knight in Shining Armor.

To answer your questions:

1.) I don't know if my former doctor belongs to the Medical Society Office. I do know there isn't an office here; I live in a small town by Massachusetts standards. I don't know if there's one anywhere else around here.

2.) This doctor absolutely will not talk to me on this issue. He refuses. The best I got was the office manager talked to me...talked to him...talked to me...talked to him...I felt like I was in Kindergarten. I know what his problem is by way of this ridiculous routine. He believes that since no Percocet showed up in either of my tox screens I'm asking for more than I need. Thus I'm a "liar" and he doesn't trust me (got news bucko I don't trust you either). I basically take 30 Percocet a month (as needed, not on a regular basis. I may go weeks without needing any and then in the space of a couple of days deplete my prescription...it *****. Don't ever get Spinal Menengitis). Anyway I had gone through about 15 when I went to see him which would have been right on schedule for my needs. I think his problem is, besides that he's a moron, when he took over writing my Percocet he could no longer fill it when I needed it (like my Neurologist did) so the best he could do was write 3 scripts for 3 different months each for 30 pills. Make sense? Then he changed and decided to write 1 script for 90 pills to last me 3 months. I'm guessing the jerk is thinking the 90 pills is for 1 month. Who knows what's rattling around in his verging on the edge of senility brain. That may sound hostile; mean and sarcastic but I honestly believe there is something wrong with him. His behavior has drastically changed over the year and I've been his patient for about 10 years maybe? Maybe more.

3.) He got around the discharge issue by saying he's perfectly happy to continue to be my doctor but I have to find another doctor to write my pain medication. Yeh...like I'm staying with him. After his behavior I wouldn't let my dog see him.

4.) I plan on reporting him to my insurance company and to another place. I forget what it's called but it's where you go to report doctors for who act wrong. Luckily I wasn't by myself when he yelled at me the way he did so it's not just my word.

I may have finally found help. My Neurologist may be taking over my pain medication. I believe he understood the problem and he said he'd have no problems doing it as long as he was the only doctor prescribing pain medication (no problem there) but I'm reserving my happy dance until after I talk to him tomorrow.