my wife and pain management

[PromisedLand]

It's a long story but I'll condense it.  My wife had lat flap surgery 3+ years ago for breast reconstruction after breast cancer.  She has been in intense pain ever since.  She's been on vicodin, perc, oxy and now morphine..she was recently (3 months ago referred to a pain clinic who put her on 3 (10's) percs a day.  ON her last visit they did a uriine test which was no problem for her as she had nothing to hide.  He also then moved her up to morphine 2x day which she doesn't like and wants off..talked to the doctor last week about it.  He said "we'll talk about it next appt)...Today she gets a certified letter from the pain mgmt doctor saying he was dropping her..her test came back with no indication of perocet usage and they found traces of dilaudid, which she has taken 1 time in her life, 2 years ago for a migrain (and hated it).  She is now trying to convince this guy of her integrity and point out there must be an error..Of course, no return phone calls and the people she's talked to do not want to believe her.  She is in intesnse pain..she's seen 3 separate plastic surgeons each of which said they couldn't help her..Yesterday we saw one who gave her some hope..he's done over 500 and found that 1% of his patients wind up in her situation, but he believes he can perform a procedure that MAY fix it, either improve it, relieving the pain or making no change.he can't guarantee..but she's gonna try it..

Anyway...and advise on how to deal with this dilaudid thing and the pain clinic..so far after 6 hours, no return calls..she has taken nothing but percocet (and the morphine) with the exception of a shot of demorol for a migrain 3 weeks ago which he new about, and vicodin prescribed by her dentist..which angered the pain guy but they cleared the air on that.

would appreciate any advise/suggestions


Jim

[greyworld]

I think your wife may have lied to you.  My question to you is do you have experience with opiate dependency?  If you haven't then you would believe her straight out.  I don't know your wife but I know the length some of us go to to make both the pain and withdrawals go away.

[kim715]

I don't have a lot of experience with urine tests comming back false,but it did happen to me once.I was going to a methadone clinic and we had to get a UA once a month.My second month there my test came back not showing any drug at all in it,not even the methadone.At this time I wasn't getting any take homes yet.I was going to the clinic everyday and drinking my dose at the window in front of the nurse so I do know it is possible for a UA to come back false.There are others here who know a lot more about it and will be able to give you some advice.Hang in there.............Peace......Kim

[1234betterlife]

she could have a test done independently. that would give her something in her hand that is current. she then could approach the primary physician with the entire case. hopefully a kind hearted referral could get her back in the loop. i am sorry she is suffering so after what she has been through.

[lisa650]

1234betterlife, that is wonderful advice, i never would of thought of it! Knowing me i would just cry and chalk it up as another of life's injustices

[Coolio Hernendez]

Wow...I have been seeing alot of this on this forum......One thing it could be (happened to my mom).Someone who lives at your house could be stealing your pills and replacing them with something else..

Also when your on pills for a long time you will do crazy things to get fix and even lie to yourself about it....

[scaredmom330]

I think the independent test is the answer at this point...I go to a pain clinic and they are crazy...they immediately think you are selling your meds..they can make a mistake and mix up the urine test very easily...go for the independent test...and then see what happens...in the mean time go to the ER, they might be able to help you.


Karen

[PromisedLand]

greyworld..my wife has not lied to me. That much I do know...regarding stealing pills..possible..my 19 year old daughter has been a suspect for a while, but we kicked her out nearly 3 weeks ago (she lives with her sister)

1234..she is seeing her primary (earliest appt on Monday) and will take an independent test..though all traces of perc will be gone by then and only the morphine...

I read something earlier that some opiates (percocet included) can breakdown over time and manifect themselves as another opiate (morphine, dilauded)..though I didn't read the entire article and what I did read was rather quickly.


Jim

[PromisedLand]

And yes, Greyworld, I have a great deal of experience, unfortunately, with opiate depdendency, but I'll defend my wife to the death on this one, to the point of contacting a neighbor who is an attorney specializing in polygraph tests.  My own depdency/addiction is considerably different than my wive's..when I ran out, I'd find a way to steal some..she girds herself up and fights the withdrawal.

jim

[1234betterlife]

i would call the labs myself. talk to the director of that division. they know the test THEY use better than anyone including the manifestation of opiate sensitivity.
drug testing is very subject to error by test and the human factor.
i would want proof positive in my hand.

[lisa650]

Call me naive,     but i like to give people the benefit of  doubt, is there any possible way they could have mixed up her test?

[PromisedLand]

well, that's what we think...the mixed up her test..we called the lab we THOUGHT did the test..unfortunately, that wasn't it..it was done in Nebraska (we're in New Hampshire..and we have told the doctor we want proof in our hand..of course, he hasn't called back, nor answered emails.  We spent hours on the phone this morning with labs and pharmacists trying to figure out what could have happened.  One lab said yes indeed the test could have been screwed up

(thank you, Lisa, and 1234).

Jim

[10356]

I do not know about the testing but I did want to lend my support and say I'm so sorry your wife has too go through this on top of everything else she has endured.. The injustice of having to prove that you are taking pain med after enduring cancer residual pain and all the mental that goes along with it really angers me.. I hope you get this straightened out right away.. You are a wonderful supportive husband I wish her well on her future surgery and that it is the answer to this debilitating pain and that she can close this chapter of her life and move on...  lesa

[ochooked]

One thing is for certain - If I were in your shoes I would be looking for a new PCP that you guys can trust --- this one chooses to not believe you and that spells trouble down the road - --  I would certainly find a doctor who would listen to your story and then treat your wife ------  A good pain management doctor is worth his weight in gold - --- We had a very similar experience and it was eventually resolved when the doctor took a personal interest in my wife and began to treat the pain -----  There comes a point when you can't cry over the spilled milk - only find someone who will listen to your story and offer to help - -- that person (doctor) is out there - it is just up to you to find him/her ---- get busy -   I wish you and your wife the very best - -- I know what it is like to not be believed - but the next step is up to you.  

[lisa650]

You are so right, i have heard about the drug breaking down and it showing up as something else.  Back in my methadone clinic days, sometimes codeine would show up as heroin, i mean this gets so complicated, they are all opiates, i guess they do specific tests for specific drugs?  It is just so unfair! Damn doctor could have at least agreed to retest her, and i mean have her come in and test  her urine again, because when i was  in the methadone clinic my test came back with heroin, and my hand to God, i had not used, i had however taken codeine (tooth issue) but had a prescription , anyway, a paid 25.00 dollars to have my  urine retested, but guess what they used the same urine they had used the first time so yeah, it came back dirty again, all i could was cry and noone believed me, that made even worst. Got my weekend  takehome dose taken away and everything, 9 months pregnant at the time and an hour drive  away, but i'll tell u what nothing hurt as bad as my own husband not believing, so yeah, stand by your wife!

[Mollyrae]

Hello. I am sorry for what your wife is giong thru. There have been a few members who have had this problem with their tests coming out "clean". It is a really scarry thing when you are dependant on pain meds to make your life alittle easier. My suggestion would be to find a new pain mgnt. specialist. Either Google " Pain Mgnt. Specialist" and enter your area or get the phone book out. Also her PCP might be able to help. Don't be affraid to go to the ER for help when the pain gets too be to much to handle.

Tell her to hang in there, keep fighting for what you know is right. Don't let the current Pain Dr. get her down. There is always someone else to help you.

Good luck with everything,......Mollyrae

[Tuckamore]

I am so sorry for what your wife is experiencing...so sorry. I read more and more about these false tests. I do not know what the answer is, wish I did. But after hearing about all these bad tests I have come to the conclusion that IF I ever am in a program where I am tested I will have a second test done on the day that the pain mgt clinic makes me take a urine test. I haven't yet decided where or how I will have the second test done but I will do it. This is my advice to all of you that are required to be drug tested. I know that doesn't help you (bear) now.

I agree that you should talk to your PCP and do it now. OR a physician that you know and trust. Trust is the key word. My PCP perscribes my pain medication. We have built a high level of trust and I believe that if I had a drug test and I "failed" it in any way she would beleive ME. She would question the lab and than have me retest ASAP.

There are other PMP out there though I am sure this will follow you where ever you go. That's why it is so important to try and get this cleared up ASAP. Be assertive and get this cleared up or it will haunt you.

I hope the new doc will be able to help your wife with her pain. At least it sounds as though there is some hope.

I wish you and your wife the very best. We are here when ever you need to chat or ask a question. I wish I had a better answer for you. But others will post with more information and suggestions. Please keep us posted and take care. Tuck

[greyworld]

Well, in cases like this they should have asked for a follow up test to see whether or not there was an error.  If one test was absolute then there is a problem with the method of testing.  Th fact that they wrote her off so quickly says to me they did run a second test or that should be seeing a new doctor right no anyhow.

[Tuckamore]

I have heard this fairly often on this forum. And they do refuse to see these patients again based on the results of ONE test. Best Regards, Tuck

[PromisedLand]

Yes, refusing to do a second test seems to be the norm.  I can say without a doubt that she has not been using dilaudid or anything else unless prescribed.  Even if she were to buy "off the street" a) she wouldn't know where to go b) she has 1 fake eye and sees 20/70 out of the other and driving is not an easy task for her particularly with all the rain we've had in New Enland, C) whould wouldn't be caught dead in the areas around here
where street drugs are sold.

We have an appt with her PCP, she's emailed and called the pain doctor..no response..I don't care if he never prescribes her another pill...I want her integrity cleared up as the later we got today will follow her to whomever she sees next.

Thanks to all for the kind words and suggestions...I will keep you posted.

God Bless all

Jim

[sandee1818]

Pain management Dr's WILL NOT preform a second urine test and will not even entertain the notion to do so. There has been a lot of controversy with this issue as so many Pt's are having this kind of problem and it is from the office staff or the lab making mistakes most of the time. There are also drugs over the counter and prescription drugs that will interfere with a test being 100% correct. With these things in mind one should not simply jump to the conclusion that a pt is abusing their meds or not taking them at all. We are all here for support and compassion and automatically jumping to conclusions that will hurt someone is not really productive. I have done research on this before as we have had several members here with this very problem and it is a very real situation that some face. I will post some facts on this issue later today.

[sandee1818]

Hi, I am so sorry you and your wife are going through this nightmare. I would suggest that you ask your PCP to give you a script for blood work and it will show the correct drugs that are in her system. Call the office and ask for the nurse and explain the situation and that time is critical here. This will prove without a doubt her meds are in her system. Also there is a hair test that will show all the drugs she has taken in the last 90 days, if you would like the info on how to get this test let me know. It is 75.00 and you get the results online or by phone. It is very reliable also. There are so many things that could have caused her test to be a false negative but there are ways to prove she was taking her meds. I would do this and then find a new PM. I wish you two all the luck and hope things work out. If you have any other questions or need anything at all please let me know. I have done research on this and it is a very real situation that many face and it is sad.

[PromisedLand]

Thank you, Sandee and others for your advice...we greatly appreciate it.  I wrote an email to the doctor in my wife's defense last nigh and she wrote him earlier yesterday as well as several phone calls.  No responses of course.  Golf day.

My wife is about to give up on this, but I'm not about to let it die.  She's been through enough in her life, ex husband abusing her daughters, losing an eye and vision problems in the other, an apparently "botched" reconstruction surgery that has left her in pain and depression for 3 years...I'm not letting her just give up on this one..this is her integrity at stake and relationships with future doctors.

Thank you all again

Jim

[Tuckamore]

Your wife is very lucky to have such a loving and strong advocate in you. You aer a blessing.  I think you are absolutely right to not let this die. And correct also that this is her integrity and will effect any future relationships with physicians. I can hear your concern and love in your writings. She may be so exhausted with just fighting the pain that she is unable to fight this unjust allegation. You are so right in fighting this fight for her now and be her strength.

If I understand you correctly your wife is currently experiencing "intense pain." I hope she still has pain medication but if she does not do not forget about ER. They usually will prescribe a small amount of pain medication plus give her something while she is there. Bless you and hang in there. Tuck

[firemedic330]

I have a question related to painh management doctors...I was under the impression they did things like nerve blocks for pain?  I had thoracotomy for carcinoid cancer 3 months ago & my surgeon does not want to give me any more pain meds - he wants me to go to a pain doctor instead ... I only take Norco on occasion when I can't sleep after a workout, otherwise I use Advil mostly.
Any one w/ more pain doc info?  Thanks