Pain

Ok bear with me a moment, Im miserable. I used to be in PM but then I moved to wisconsin recently, and my doctr here doesnt think I need PM. He lowered my dosage which I understand, but now Im miserable. I called his office nd they say theres nothing they can do. I have had a bone infection in my rt. knee and just a year ago they took out a hernia mesh that ended up being infected. Without going into to too much detail, I am starting to wonder if its worth it anymore. I cant do anything with my kids really and I tend to think they woul be better off without me. I cant just keep being in pain ALL the time. I asked my doc to help me get back to a normal life and with the lower dosage Im miserable.

[Jaybay]

How long have you been on the lower dose?  Depending on how long you were at the higher one, you'll have quite a while of increased and generalized pain at the lower dose.  It's an unfortunate part of detox and one reason why it's so difficult for CP patients to taper down.

If your doctor is dead set against increasing your dose and can offer nothing else to treat your pain, then it's time to get a second opinion.  It's one thing when a doctor has solid reasoning behind a decision like that and thoroughly discusses it with his patients, but to lay down the law without an explanation is a deal breaker for me.  An important part of a doctor's job is to educate patients, and too many of them neglect it.  

[selgea1]

well when I moved here I immediately scheduled an appointment, I brought all my scripts with me. I had taken 10/325's every 4 hrs for about a year an a half. (while in PM) then when I came here he said he could only allow me 4 a day. I did that for last 3 mnths, although I explained after about 4 hrs I start to hurt again. then it makes it twice as hard to get it to go away. I lived with it. Then just last week he changed it to 7.5/750 every 6 hrs they simply made me feel sick. I cant get any real relief now. I never get over the hump

[Tuckamore]

Hello Selga,

Welcome to the Pain Mangement Forum. And Welcome to Wisconsin! I am a life long resident of the state.

You're correct you, we do not have PMP. Our PCP prescribe and follow their chronic pain patients. In all honesty I am very satisfied with this procedure. I enjoy the personal closeness with my PCP. She knows me very well and keeps me as comfortable as possible.

I'm in a rural community where everyone knows everyone else...which as you know has it's good and bad factors. But I like the "family like" relationship that you are able to develop with most of the physicians.

It may just take some time to develop a "trust" with your PCP. If you do not feel that is forthcoming don't hesitate to look for another PCP. As long as you had your medical record I see no reason why most PCP in this state would not have honored your medication regimen. I am on higher doses than yo are being prescribed.

You apap does is high and it may set better with you if that was lowered. Have you discussed this possibility with your physician? I am so sorry that this is happening to you. How may I help?

I'll look forward to hearing from you. If you have specific questions please do not hesitate to ask me.

Peace,
!Tuck

[sandee1818]

Jaybay is right you need to get a second opinion. If this Doctor is unwilling to help you then it is time to find a new Doctor.
If you hired a plumber to fix your leaking sink and he only half fixed it then would you pay him and call him again for another problem, No! We hire our Doctor's and we pay them just like we hire anyone else to provide a service for us.
When the Doctor became unwilling to listen to you and listen that your pain wasn't being controlled it became clear he is not willing to help you.
Do not get frustrated and feel like giving up, I know that it is easy to do that but there are very good PM Doctor's out there willing to help you and get your pain under control.
You have been on the same dose for sometime and it may be time to find a new Doctor willing to offer you more options such as an extended release formula. The medication your taking has a very short relief time and over time the amount of relief your getting will decrease due to tolerance. It is probably time to try something different as this medicine is not working anymore.
Call your local hospitals or referral lines and find a new Doctor. You can also try google or ask your pharmacist or friends if they can recommend one for you.
Do not settle for the treatment your receiving you deserve more:)

[selgea1]

thanks I just dont want to be accused of "doctor shopping". A wierd thing happened the time before this he had prescribed me percocet. I dont think he did it on purpose either. Im wondering f he meant to change my meds this time. ILast time I went and told him that the percs worked fine, but I didnt like having to see him every 12 days(yep I get 12 days at a time) I do get a refill but still, with the percs I cant get refills. So I asked him to change it back or allow me more at a time. I just dont know this pain jut seems to control my life now and I hate it.

[Tuckamore]

I understand you concern regarding doctor shopping. The true meaning of the term is one who goes from doctor to doctor obtaining or attempting to obtain narcotic prescriptions. They will often return to these same doctors for refills. That's doctor shopping.

Looking for a physician that meets your needs and that you are comfortable with is  another thing all together.

What do you mean a "weird thing happened the time before"? Is that when he increased them to 7.5/750?

Of course you are not "getting over the hump."  I am so sorry that your pain is so uncontrolled. And when it isn't you never really catch up.

Your new state, Wisconsin is very different from most other states where PMP prescribe narcotics. It's my understanding that in other states PMP are there just to treat pain which often includes prescribing opiates. That does not exist in WI. Unfortunately it's difficult to go to a PCP and say "I'm not getting the correct dosage or the right narcotic to control my chronic pain so I want you to treat me."  You may very well get nothing. You may even get labeled. A sad but true fact.

PMP do not prescribe narcotic in our state. On occasion they make make recommendations to the PCP for medications but in the end it is up to the PCP to write the RX. It's not like many other states where you can just go to the next PMP. It's just a different ballgame here. Most PCP are very cautious about what they RX, if any thing. It's another sad fact.  

So I do encourage you to try to discuss your pain levels and how it is effecting your life with your PCP. It's a trust issues in most instances. And hopefully you are just in the process of building trust and a good doctor patient relationship. However as I said before if this just isn't working and you are not comfortable with this PCP than please find another. Some of our PCP are more open to prescribing than others...some will never prescribe for CP... and others are liberal. Unfortunately it's entirely up to the individual physician.

I certainly wish you the very best. Pain should never control our lives as it is for you. There are compassionate and caring physicians here. If yours is not one of them you do need to find one that has those qualities.  

If you have additional questions please feel free to ask. My heart goes out to you.

~Tuck

[runitskat]

I know how you feel. I'm in the process of getting a second opinion even though I'm in PM. Also I was on 10/325 Norco since January. But last month due to insurance I had to go down to 7.5 this month. My insurance will only cover a month script for 90 tabs, and I had about 5 weeks until my next appointment. The 7.5's make me horribly sick even though it's the same amount I was taking with the 10's (30mg per day with both)

Also when my PCP was treating me I was on 6-8 a day. The first thing my PM did was cut me to 3 a day. It sucked horribly but you have to build a trust with them. I'm doing everything she wants me to do so hopefully she will see that my pain is not being managed correctly. If I were you I would switch doctors. I had to about a year and a half ago when this all started. My old PCP said she was going to get me an MRI but never did. I got fed up with her for many reasons and switch to my current PCP who then sent me to PM when there was nothing else he could do for me. It's not doctor shopping if you're leaving one to go to another. It's doctor shopping if you're seeing both at the same time and they don't know about it and are both prescribing narcotics.

[JadedSweetheart]

Everyone who has posted here is absolutely right.  When I first saw your post I had to check your age because this is SO common with younger people, and 46 is young for CP.  (Heck, any age is young to be suffering daily)  Has the PCP expressed that it may be because of your age and activity level that he will not prescribe more?  
My husband works as an inspector for construction work being done on the railroad, sometimes very precision maneuvering of huge lumbering tools.  He came home surprised the other day that many of the guys on the job site are in PM or taking something for pain.  Sometimes based on what you have to do every day, they will not prescribe a "high" amount of pain relievers for fear of liability.  My husband died and was revived at the scene of an accident (consequently breaking many bones and having much cartiledge and nerves ripped apart) and has had PM doctors send him home with Naproxen (Aleve) because he had to operate equipment.  He has since learned to deal with his pain with OTC pain relievers (and a lot of coffee) because he's just so stubborn and doesn't want to be dependent on opiates.  That's obviously where he and I differ, and I say, why suffer?  
Point being that it may be that your doctor is making the decisions based on your lifestyle, rather than need for relief.
I am currently in the same undertreated boat as you are (partly because of pregnancy, I think) where my doctor lowered my dose considerably and gave me no reason, in fact he didn't even tell me the dose would be so much lower than what I was on before the price of it shot up.  Now mine is MIA and I have to seek out another PM (who also sees pregnant women, which is proving difficult.
I really hope you can find another doctor to get you the treatment you deserve.  It's not hopeless, you will be okay.  Don't give up!

[selgea1]

Tuck what I meant by a wierd thing happened is that my Doc had giving me percocet a stronger med, but if I stayed on them I would of had to go see my doc every 12 days because he only gives me enough for that long. Here he cant just call them in. When I went to see him he even said it was a mistake. but rather than put me back to 10/325 he lowered it to 7.5/750 (way too much tylenol) When I was on the norco 10/325 every 4 hrs I was fine, then this doc said I could only take 4 a day it really changed things. Runitskat I hate insurance companies who arbitrarily put limits on meds. What do they know? I did research on hydro and if you look it up you will find it clearly states its lasting dosage is between 3-5 hrs max. There are alot of variables like metabolism, etc. yet 4 a day is 120 a month so they are really hurting you by only allowing 90. Jaded Im only 42 :)  but yea I am way to young for this, I just wanna be able to do thngs with my kids, like today my wife took them to lego discovery land in Chicago, I couldnt go because of my pain. I use a cane now and it just kills me to walk around. I still worry about another doc here, thier are to place around, one is aurora heath and wheaton franciscan and the docs belong to one or the other. aurora docs woud mean I have to travel further. Wheatons docs are much closer but since Im already seeind a doc with wheaton I worry that getting a new doc with same group may look bad on me. I have to do something though Im miserable.

[sandee1818]

I am not sure why your Doctor would lower your hydrocodone and then turn around and give you oxycodone which is stronger and then again lower your hydrocodne and increase the Tylenol content. It does not make sense. It may be time to look for a new Doctor. I know some here are from Wisconsin and do not see PMP there but I just googled pain management clinics in Wisconsin and had over 700,00 results.
Call around to your local hospitals as they usually have referral lines and even ask your Pharmacist and friends if they can recommend a Doctor. I found a great Doctor once by asking my Pharmacist!
It would be best to see a PMP as they understand pain better and they are more aware of the new medicines and studies done on PM.
But if you can not find one in your area then try a PCP that does treat pain. there are of course specialist too such as an orthopedist or rheumatologist that may help with pain management. I know some states allow physiatrist to do pain management also. So don't give up there is help out there.
Do not take one persons word that there is no good pain management as there is a vast amount of Doctor's and they are all different and have different views on pain management.

[selgea1]

I appreciate that I have been looking all day, I have some options but I also found out that it doesnt matter where I go unless I want to drive awile, the same PM docs are at all the clinics around here. Its odd wheaton says they have a pain managment program but when you lick on their site it takes you to another which isnt related truely. Im just so tired of hurting

[namnam46]

HI Selgea,

I'm sorry that you are having so many problems finding a good PCP to get your meds from.  BEFORE you make an appointment PLEASE ask them  if they prescribe Pain Medications. It's my understanding from Tuck and Mollyrae that the PCP's are the ONLY ones in Wisconsin that prescribe Pain Medication (narcotics). I think Tuck even says that in her post above that it's different than ANY other state in the Union.  I just would hate to see you spend your money and time on a Doctor that can't prescribe you any pain medication.  :)  IF I have understood Tuck's and Mollyrae's posts since I've been on MH the PM's only do precedures. Strange, I know!!

I hope that you can get the help that you need. It's so unfair that you couldn't have just continued the program of meds that you were already on.  :)

I wish yo the very best and I hope that you will let us know what you find out.....Sherry

[sandee1818]

There are laterally hundreds of pain management clinics in the state of Wisconsin. Like any other state there will be those who have different approaches just as I said.
When you do call ask the nurse if the Doctor does prescribe medications along with the other treatments they offer. If you just ask if they prescribe medications then they may get the wrong idea that your just wanting medicine.
There is no harm in finding out after all if you do find one that helps you it will have been worth it.
There are alot of clinics here in Florida that do not prescribe medications but simply do procedures. This is true in all states and not just one. I know that in Alabama they have a majority of the pain management Doctors that do only prescribe treatments and procedures but there is also many that do prescribe medications too.
To say that the whole state of Wisconsin has only pain management clinics that do procedures is not logical.
I am not trying to say anyone here is right or wrong only that you should find out for yourself in the area that you live in:)

[selgea1]

appreciate all the support, the clinics do prescribe here, but alot of people I found out get thier meds from their pcp. I am just going to have to work on seeing someone else. The clinics do proceedures as well, but even in my old PM place they did alot of proceedures and most of them arent really needed. I got monthly cortizone injections and they didnt help at all. One of their own nurses told me they do that to pad thier pockets.

[sandee1818]

I only hope you do find the relief you need. It doesn't matter which Doctor you do see only that you do get your pain under control.
Please let us know how it is going and I hope you do find someone very soon:).

[JadedSweetheart]

Sorry about the age thing! lol.  You are definetly young at 42!  Sometimes doctors can't see past our age when it comes to pain management.  Many of our members have experienced that.  
I have had the doctors who only want to do injections as well.  Here in FL we have all kinds.  Some do only injections, some only prescribe darvocet and tylenol-3, some do everything, and some give waay too much medication to people who don't need it.  It's difficult sometimes to find the right doctor.
In most states a PCP will prescribe pain meds until a PM can be seen, but that all depends as well.
I really hope that you get the relief you need soon.  Please know that you're not alone in this battle with chronic pain.  We're all here for you and are wishing you well.  Please let us know how it goes.

[Tuckamore]

Sorry Selgea I am late, as I just now saw your comment to me explaining the "weird thing that happened". It doesn't make any sense the way your PCP is jumping around with the doses between hydro and oxy. If the hydrocodone 10/325 (Norco) is effective on your pain I don't understand why he won't stay with that narcotic. It should be less of a concern to him because of the schedule differance between the two. He can also put refills on the Hydro thus eliminating the need to see him every few weeks or even monthly.

I never want you to think that I am discouraging you from consulting a PMP. I have seen PMPs at the two largest PM Clinics in our state. According to them, my current an former PCP and all other PM patients from this state (that I know) a PMP will not prescribe narcotic. That doesn't mean that it is impossible for you to find on that will prescribe for you. If you are successful in locating on, please let me know. I am sure our other PM members and my personal associates would love to have that information.

Yes, you're correct. A handful of PMP are affiliated with multiple city PM Clinics. So a PMP in XX city may very well practice in YY and ZZ City. According to my PCP one of the primary reasons a PCP prescribe for and manage their patients PM medications is because we are such a rural state. I am almost 2 hours from the nearest PM Clinic and over three hours to the next closest PM Clinic. There are simply not enough PMP and PM Clinic to go around in our state.

It's also correct that if you are followed closely by a speciality physician such as a neurologist that they may chose to take the prescription role over your PCP. Our state is just different than most other states.

Jadedsweetheart is correct. Age can play a factor in pain management. When I was thirty no physician wanted to prescribe PM narcotics regardless for me regardless of the amount of pain that I experienced. It was like if your young you can deal with it...and you can't possibly be in all that much pain. Foolish concept.


Again please let me know if you are able to locate a PM Clinic that does prescribed for their patients. You deserve better pain control. You have a life to live and even controlled CP interferes with it way too often. I'll look forward to hearing about your search.

I wish you the very best of luck!
~Tuck

[Tuckamore]

Just sent you a PM with more specific information. I hope it helps.

~Tuck