Doctor will not increase pain meds

[coupondiva]

Hello,  I came across this forum and I am hoping somebody can answer my question and perhaps offer some advice.  I have been seeing my PCP for treatment of migraines, chronic myofascial pain, and fibromyalgia.  I have been prescribed hydrocodone 5/500 since October of 2010.  In May of 2012 he increased my dosage to 7.5/325 and I have been on the same dose since then.  The hydrocodone stopped being effective a few months ago.  Instead of increasing the dosage, he started prescribing NSAIDS to take along with the hydrocodone.  I do not feel any better when taking the NSAIDS and every time I bring it up, he just prescribes a different one to try.  I'm very frustrated and dont understand why he won't increase my dosage or prescribe something else that would be more effective.

Just a quick background so maybe you can understand my frustration and not think I am just trying to get meds.  I take Savella (and have tried Neurotin), Roboxin (have tried flex oral, soma, and baclofen), I also take trazadone and ambient for sleep.  I go to physical therapy every year (insurance only covers 12 visits a year), I do stretching, use ice and heat depending on the pain, and try to get a massage whenever I can afford it).  I also get monthly trigger point injectionss, and keep a pain journal.

I am on a contract, although I have never been asked for a pill count and only one urine test although I bring my medication to every visit.  I have also never asked for an early refill.  

The past few weeks have been extremely hard for me.  My pain levels have increased and the medication only brings them down a point or two.

I really don't know what to do anymore.  

[trixy71]

I think when asking for a referral, don't ask your doctor for a specific doctor, but do tell him the name of the doctor you don't want and the reason you don't want to see that particular one. I think that would be reasonable, in my opinion.

There are quite a few long acting meds that come in generic, morphine and methadone are the cheapest, if I'm not mistaken. However your insurance may cover a long acting med if its prescribed by a pain management doctor, you just have to call and ask. Also, there are discount cards you can get through different companies who still only have brand name meds, AND most of them have some sort of program for people who can't afford it. Good luck!

[coupondiva]

I have considered asking for a referral to a pain management specialist.  However, I live in a rural area and there are only three practices, one which I went to originally and had a very bad experience with injections.  Do you think it would be unreasonable to request a specific pain management doctor?  I really do not want to return to the one where i had the bad experience.  My PCP also told me my insurance wont cover long acting narcotics (medicaids), and the website where I can check to see what medications are covered do not list schedule 2 drugs.  Can you recommending some inexpensive (under $100) LA?  I would hate to be prescribed something then not be able to afford it.

[Mollyrae]

I think that trixy71 offered you a very good solution and that was to ask for an extended release medication.

It sounds like your Doctor may me somewhat hesitant in prescribing narcotics. I'm wondering if you have thought about asking him far a referral to see an actual Pain Management Doctor who can treat you accordingly, they know so much more on how to treat pain and can create an individual plan to suit you.

I hope this helps.
Mollyrae

[trixy71]

Hi there, because of the media hysteria with pain medications, more PCP's are starting to get away from prescribing higher doses of pain meds, even though your under a contract. One suggestion would be to talk to him to see if maybe he'd be willing to prescribe a long-acting pain medication, or perhaps give you a referral to a Pain management specialist. Good luck to you.