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too early for refill??
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too early for refill??

I have been lucky enough to have found a great doctor for my pain management. It my first visit about a week and a half ago I was rx percocet 7.5/325 4 times daily  and lyrica 75 twice daily. And after being on vicodin es for 6 months, I have built up a tolerance I'm afraid. Some days have been worse than others and I have had to take one to two more percocet  per day than rxd, I'm on a contract and afraid to call and let them know I'm running out( they ask for 5 days notice) not to mention i think a room mate has swiped a few here and there so im real short.I just dntont want to be red flagged right away as " one of types patients" nor suffer through till my next rx. What should I do??,,,
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Avatar_f_tn
Please,  cut back on your med.  your PM dr. WILL notice and if this becomes a habit with you, then the office will take issue with you about it !!!!  Just wanting to caution you about that.  Hold out until your next Dr. visit and then tell your Dr. but do not call for early refils.   I am speaking from my own experiences and perhaps it will be different with you and your Dr. but I doubt it.

You can cut back drasticaly if you HAVE to and that is better that being put on your Dr's  List.

Best wishes

Ella
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535089_tn?1400677119
Hi Chadwick:

Pain Management Doc's are no dummies to patients asking for early refills. If you're not careful, you will loose your Doctor and be red flagged as you suggested. By my calculations, you have gone through almost 120 pills in 1 1/2 weeks. That entirely too much. The Tylenol alone could destroy your liver.

Because it is early on in your relationship with your new Doc, you need to explain to him/her that because you have been on the Vic es for a long period of time, it is not working anymore. You should really be on a long acting medication rather than the short acting. You should discuss the possibility of changing medications right away rather than going through so many of them. In my opinion, that's abuse of your medication.

You also need to find a new roommate and fast. DO NOT put up with anyone taking away from your comfort by stealing. You are the one who will pay the ultimate price by loosing your Doctor. Your roommate will go on....you may not.

I urge you to rethink this whole process. What is happening here is wrong and will injure you in the long run both mentally and physically. I hope you can get on the right path and soon. Please take care and I wish you luck in the future.
Mollyrae

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Avatar_m_tn
Hi mollyrae,
Thanks for the advice. Your calculations would normally be right, but the pharmacy couldn't fill the whole script because they were short, and the rest gets DC'd as you know. only 100 were filled. Like i said this was my first time with th PM doc, so i dont want any problems, and my appointment isnt for another month, however i dont see the dr to get my rx, i just call the nurse 5 days ahead, im new to all of this but with my usual doctors, if i ran out i would just call- i do know that this is a different senerio. as for the room mate, he's been given notice. Thanks again!
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Avatar_f_tn
My pharmacy will not even do an early refill for my THYROID medication....

I don't see how yours allows it, I guess mine is a lot stricter.

It does sound like you may need to re-think this, and not about how your doctor will react, but how you may be becoming addicted to the medication.

Please do not allow yourself to go down this road.
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535089_tn?1400677119
Totie:

The member concerned has a legitimate reason for taking pain medication as most of us do in this forum. Chadwick is most certianly dependant on the medication and not addicted. I feel that you've been somewhat harsh.

I wanted to send out this friendly reminder that we aer not to judge others that we do not know and treat them with the respect in which we would want to be treated.

I'm sure your intentions were good. Please take care,
Molly

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Avatar_f_tn
Please make sure you keep your pain medications in a "secure" spot. That might mean buying a small safe to keep your med's in. Do whatever you have to do to keep them secure. I too had med's taken by a "friend". Well friends don't steal from friends. Now anytime we have company to our house I have to put my purse in a secure spot.  Pain medications are too much a temptation for some people. I'm not saying just anyone would take them..but there are people out there if knowing you are taking these med's would stoop to stealing them. Please take care Let us know how you are doing..Tresa
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Avatar_f_tn
Sorry if I sounded harsh, not my intentions at all.

I am sure he has a legit reason for the pain medication, other wise he would not have been prescribed it.

I am just concerned that he has increased it (built a tolerance), and I hope he stays
at a minimal amount.

Chadwick:

Talk to your doctor about giving something for just the break through pain on the days you need it.
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Avatar_m_tn
Thanks for all of your support! Like I said I'm a newbie to all of this and am glad I found this forum for people like myself! Have a great weekend everyone and I hope your day has been nothing more than a level 4...
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Avatar_n_tn
hello chadwick,
at our pain clinic,  we have  patients sign a medication agreement (which includes informing the MD  of any changes made by the patient related to the prescribed narcotic (such as taking extra pills due to pain flare ups) ).
it is common for persons with painful conditions to take an extra pill here in there b/c of severe pain.  in such cases,  what we ask of our patients is to inform us that they want to increase or they have increased their dose/frequency  because the current one was ineffective in controlling the pain.  so if you plan to do so or if you have already done so,  call the clinic immediately.  that way, the MD knows that you are honest and removes any doubt that may form later on when you ask for an early refill.
Pain doctors are trained to give their patients the benefit of doubt.  Compassionate ones realize that severe pain can be so debilitating that they understand patients would resort to taking extra pills and run out quicker than expected.  By communicating with your MD that at certain times,  her prescribed freq & dose was unable to take your pain down to a tolerable level,  then the MD can adjust your meds,  (titrate to an optimum level, prescribe an immediate release and/or extended release narcotic, etc..) according to your needs.  A one time meeting with  your  pain MD is not enough to find the right plan of pain mgt. for you.  it still is a trial and error to find the right dose, freq, and drug that will lessen your pain to a tolerable level in order to function.
If you feel that your doc is one of the compassionate ones that would not judge you immediately for completing your pain meds early,  I would just tell the truth-  the current dose was inadequate in controlling the pain.  If you tell the truth and they write you off immediately or label you as a "junkie,"  I would ask for a referral to another pain specialist.
I hope this helps!
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547368_tn?1332173665
Hi Chawick,

Welcome to the Pain Mangement Forum. I'm glad you found us also.

Several things jump out at me on your post. One is that the pharmacy didn't have enough to fill your prescription. Therefor you started short before you even began. Nest time ask your pharmacy either how long it will take them to fill it completely or if there is another local pharmacy that can fill it. I use Walgreens. When they are unable to fill a prescription they will give me the time it can be filled and even once they called all the local pharmacies to find one that could fill it and sent me there!! So there are alternatives to the pharmacy shortage.

The roommate that may be helping himself should be gently told that your count is off. Inform him/her that you must make a police report if your pill count is off in the future. Lock up your meds. even if it's only in a small metal box. Ultimately you are responsible for the narcotics. Please keep them safe.

On the occasions that I have had to take an extra pill I chose another day to skip one.  I do not risk losing my physicians trust. I have had to discuss with my physician that I needed more meds or stronger ones. If you are new I assume your PMP is going through a trial and error process to see what works best for you. Be honest and upfront with him.

Best of luck to you, please let us know how you are doing and take care.

Peace,
Tuck  
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356518_tn?1322267242
Your pharmacy should have given you the pills they were short when they came in. Now your correct that when you fill such drugs as oxycontin they will delete the ones they are short but this should not be the case with the percocet.
I have had those filled and had the pharmacist give me the ones they were short when they got them in. It may be time to find a new pharmacist.
I advise PM Pts to talk to their pharmacist and let them know that they are chronic pain Pts and that you will be filling narcotics every month and if they are uncomfortable with that then find another one. I find that having a good relationship with your pharmacist is crucial.
Buy yourself a safe. You can get one for around 30 dollars and it will give you peace of mind as well as keep your meds safe.
Mollyrae is correct that we do not judge those who come here for help, we try our best to help in any way we can. Thank you Mollyrae for reminding everyone:)
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547368_tn?1332173665
In my state they (the pharmacy) have 24 hours to fill the Percocet (oxycodone) prescription in it's entirety. If they cannot, to put it bluntly, all you get is what they got. And you can never fill or obtain the remaining tablets of that prescription. I beleive that is federal law. It has happened to me (several times) as I explained.

The only fault that the pharmacy has if that they didn't have enough of the medication in stock and could not receive new shipment in the allotted time dictated and tightly controlled and monitored by the government.  
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535089_tn?1400677119
Quite often my pharmacy does not have the entire amount of the patches needed. I basically get 10-12 and the rest I will pick up sometime before I run out, usually within a couple of weeks. Is this unusual?? I have never thought that you only had 24hrs.

I have used the same pharmacy for 3 years now and know them all by first name but am horrified at the new information I am learning. I was not aware that they could take a part of a script away. My Pharmacist has put my meds owed to me in a drawer and have it ready when I am able to retrieve it.

Take care,
Molly
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356518_tn?1322267242
Mollyrae,
This is a perfect example of why I say one needs to get to know their pharmacist and them you. They are suppossed to nix the rest not filled but since you have a good relationship with them they look out for you. With the patches they are like the Oxycontin and any not filled at that time gets nixed.
I am glad you have a good pharmacist:)
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535089_tn?1400677119
WOW...Good to know this. I had no idea.
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Avatar_m_tn
Thanks for your imput/ advice, I live in Chicago where there are no shortages of walgreens( almost every street corner to be exact) they said it was a rare dose, however I told them I will need it every month on that date and they will order it, I called another walgreens just to have a back up, when I called my pm doc his staff scolded me for taking other does but as someone pointed out, this was my first app. And my first time
On this med, so they gave me an appointment earlier than previous to discuss so hope all will be well... Thanks again to all...
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775302_tn?1253104105
I have had to deal with a pharmacy not having enough meds and telling me that they would not fill the whole prescription, I think they should have told me before they filled it partially so I could have had the opprotunity to take the prescription to another pharmacy, I have since chaned pharmacy's to one that Is much nicer and I know the people there now and on the occasions that they are short they have had no trouble getting me the meds at a later date. However like most of you have said, If you have a good realationship with your pharmasist and tell them that you will be filling your script once a month for however many you get, they will make sure they have what you need.
A pharmacy is a business when you get down to it and they want you as a customer, most of them even if you are a chronic pain sufferer.They want your co-pay or full amount $$$ in their pockets and not the pharmacy down the street. Thanks for listening
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547368_tn?1332173665
Chadwick, I am glad that you did the right thing and called your PMP. It seems like a good clinic and they appear willing to work with you. That is wonderful news.

Mollyrae and Sandee, According to three pharmacies they only have a certain amount of time to fill the scheduled narcotics such as oxycodone and fentanyl. I was in error, it is not 24 hours, it is 72 hours. Mollyrae and I live in the same state so I don't know if this makes the difference. (I thought it was a national law but there is a lot that I don't know). If they cannot fill it in that time period the remainder of the prescription is not filled or nixed as Sandee put it.

Babs, In my state you have a right to say I don't want a partial fill, return the prescription to me and I will have it filled elsewhere. Indeed I have done this. I do not know why that would not apply in your state. They cannot say, "This is all you get, too bad."  And the best way to do it, as said above, inform your pharmacy that you will need this medication filled in this amount every month at approximately this time. If they want your business they will see to it that they have that drug in the complete quantity available for you next time.

Peacve,
Tuck
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547368_tn?1332173665
I have also had the pharmacists call the prescribing physician for the remaining dose that they could not fill. meaning they only had 20 oycontin and the script was for 60. The gave me the 20 than called the physician and he wrote an RX for the additional 40 when the pharmacy got them in. However that meant another trip to the physicians office to pick up the new script.

Maybe your pharmacy is covering themselves by having someone affilated with the pharmacy pick up that prescription for you....if that is possible. Otherwise I have never heard of them holding it for weeks waiting for the re-stock. I would ask the one you trust most in the pharmacy about this. Sounds strange to me.

Sorry Chadwick, I know this is not actually related to your original question and we have gotten off on another subject.

Tuck  
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535089_tn?1400677119
Tuck:

My Doc is in the Building where my Pharmacy is located and they are all friends. They watch over me as Sandee has stated but your right. It is 72hrs. here in our state. Also, at previous Pharmacies, when the whole script was not available, the Pharmacist would give me the option of either filling it or taking it elsewhere. They have never jsut filled it and then told me that they were sorry about the shortage.

I didn't realize jsut how lucky I was. I will have to take them some cookies........
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775302_tn?1253104105
mmmmmm cookies!!!!! LOL So Chadwick what is the latest? what is going on with your script?
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678449_tn?1263558216
I hope this doesn't sound weird but it is comforting and also very sad what we all have to go through to not be in pain.  I had to talk to my doctor today about my prescription and I always get this sense of foreboding before hand. But I was lucky, I was open with my doc about break through pain and the fact that I have started a new exercise program combined with the HEAT and my script is not working the same. She was very kind we decided on a pain management specialist but she is going to follow me until the appointment.  I also didn't realize how lucky I am to have a great pharmacist.  Chadwick I hope to read that all went well with you and I will have to think about the cookies.....
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356518_tn?1322267242
Cookies are a good idea.
I always remember to bring my doctor and pharmacy goodies on holidays too.
I usually make homemade candy and I take some to them during the holidays.
it is always nice to be remembered and appreciated whether your a pharmacist or doctor or even the mail man:)
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Avatar_m_tn
Hello everyone, I hope all is well. I decided to take a different approach, the ladies that run the doctors office aren't very aproachable, even on the phone. So I just made an earlier appointment to see my pmp citing " medication problems".I just don't want them to look at me and jump to conclusions.my doctor is very understanding ( sofar ) and have no problem telling him about having to take less/ more at times but I want to keep the ladies of the office at arms length away because I know there will be a time when I will REALLY need them, then I'll cash in, as for the cookies, that's not my style. However, I run a dog daycare and am a groomer so one of them is a client- yet another reason I don't want to cast doubt, weather it's desereved, or in this case, not. I will just have to wait it out until then
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535089_tn?1400677119
Chadwick:

That is a very good idea. I think with you making an appt. to see the Doc. early and keeping it between the two of you is the best scenario yet. I feel that with you being up front with him will make him respect you all the more.

Honesty is always the best policy and I can see that what you are doing is the best way to approach your medication issue. As for the cookies, everyone loves a good treat at work.
Please take care,
Mollyrae
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775302_tn?1253104105
Okay Y'all I really really want cookies now!!!! Hey Chadwick I know this isn't re right place to ask this but have you ever seen/been on, Groomer Has it? Anyone else watch it? also PM me about helping me with my new Puppy, I got a chiuaua and I've got him able to walk on a lead and heel and he sits but I can't get him to stay or come!!!! I'ts driving me mad, I've only had him 3 weeks!!!! Love to all

XOXOXO
Babs
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Avatar_m_tn
Our basically useless overpriced government has turned areas of the practice of medicine into typical government destroyed effectiveness. We are going to have to fight back. We have to cut off their money and force them to get rid of the legions of government agents, officials and employees that hound and harrass the public in order to keep their jobs secure. Read the Declaration of Independence and it will shock you, especially the parts where they list off the things that the king was doing to the colonists that caused them to finally rebel and throw the Brittish out. You will be shocked at how this resembles exactly what is going on today except our own government is acting like the Brittish did in 1776. The time is getting close to solve the problem. Some of you will say that I am just some nut complaining. Read the Declaration and honestly evaluate what is going on today. Forget about me.
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Avatar_m_tn
I am disabled and both my doctor's office and pharmacist were giving me 3 refills per month (yes - all 3 per month) which was 120
Somas 350mg and 120 Xanax 1mg - so that equalled 360 of each per month!  I had surgery for 16 hours in a 24 hr period and awoke and the anesthesiologist had to make me a "concoction" to stabilize me to continue.  Shouldn't the doctor providing the scripts and/or the pharmacy be help responsible?
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Avatar_m_tn
In Illinois they do not have to fill it within a 24 hour period. I've had to wait as long as 3 days to get the remainder when the Pharmacy was short, so its definetley not a Federal law. You might want to call another pharmacy and ask about the regulations in your state.
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