Chronic Back Pain Relief

[france12]

I have been searching for some help.  I had a worker's comp injury in 1995, four subsequent back surgeries and a fusion, have acurrent protuding disk, have had shoulder repair, broke my foot and severely tore tissues from a fall 4 months ago, but that is healing.  I have been on time-released OxyContin since the last back surgery in 2004.  Working with my doctor, we reduced the use of OxyContin from the 240 mg daily (80 mg 3 x day) to a maximum of 120 (3 - 20mg upon rising, 2 - 20 mg afternoon, 1 - 20 mg at bedtime) daily with 1-2 (usually 2) of Oxycodone as needed for breakthrough pain.  He also prescribed Lidocaine patches to help manage the deep back and leg pain, which is particularly difficult if I sit, stand, or ride for a period of time.  I generally used these 1-3 times a week with a maximum allowed of 3 per day (if severe, running down buttock to thigh).  This made my back/leg pain tolerable, but it never goes away.  Other meds were Lexapro for anxiety-depression, which, according to my doctor helped handle the tension and leg pain.  I was doing pretty well on this medication routine.

I have never had a "high" and do not understand or know what that is.  But, if I do not take the OxyContin, I in such severe pain that I cannot stand upright.  I feel like my back is breaking in two.  Prior to the 4th surgery, my surgeon said I was undermedicating and should take more of the pain medications.  I explained to him I was not looking to be completely pain-free, but for functionality.  I have been afraid of addition ever since seeing the black and white films shown to my freshman high school class back in the 50's about heroin -- I just want to be functional.

Long story short, my doctor left to practice in another state and Worker's Comp assigned me to a pain management clinic for the past year and 8 months.  Several months into the pain clinic treatment, which was essentially the same as what I had with the other doctor, Comp began denying the Lidocaine and Lexapro (I was awarded lifetime medical).  The PAs disagreed with Comp's decision, but were not good advocates.  They began prescribing epilepsy drugs for the leg pain, but they caused funny things to happen in my brain and even black-out periods.  I stopped taking them.  Then they prescribed Cymbalta, which made me lythargic--I quit taking it.  The PAs then recommended I consider fentynol patch.  I agreed to research and come back at next monthly meeting to discuss.  When I arrived, a different PA (never seen before) informed me with no prelude that I was going to be put on Suboxone--no explanation, no warning, no reason for switching gears.  Simply handed me a "patient's guide" and said you will get no more medications except this.  Appointment did not go well.

So, the doctor who owns the practice (whom I had seen only once before on the day I started - 1-2-08 - comes in and tells me it is a done deal--he has decided, and if I don't like it, get another doctor.  I attempted to discuss how and why we were going to this treatment.  He said the reason was I have indicated increased pain over the past 3 months (I fell and tore tissue and broke my right foot.  The break was not identified for a month and then was in a soft cast for about 2-1/2 months after identification.) and he was not going to give me more opiods.  I tried to tell him I had not asked for increased, but, in fact, meds were decreased with no patches.  I asked him how Suboxone was indicated for my back pain and he responded that I would not need pain meds once on Suboxone.  The patient handbook says Suboxone is not indicated for pain treatment. I asked about the addictiveness of Suboxone and he said he would "taper" me off after 18 months or so and there would be no need for pain medications.  Like I said, I am afraid of addition and he is scaring me to death.  Now, he has received authorization from Worker's Comp to do "Suboxone Induction" without my approval.  

I appealed to Comp to NOT TAKE SUBOXONE, but can find very little information about it and why a doctor would want me to go this way.  I am not a recreational drug user, never have been, am not an alcoholic, and am never without pain.

Input is appreciated.



This discussion is related to oxycocntin vs ...........

[Tuckamore]

I've done a lot of searching regarding your right to medical records in CA. I also searched W.C. in your state. I cannot find anything that says you must retain an attorney to obtain your medical records.

HOW CAN I OBTAIN MY OWN MEDICAL RECORDS?

You have a right under California law to access complete information about your medical condition and the care provided to you.2
  
You have the right to provide a health care provider with a written statement up to 250 words regarding any information contained in your medical records that you believe to be incorrect or incomplete. This statement will become part of your medical record and must be included whenever your medical records are disclosed by your health care provider to a third party.
  
  
From Health Care Providers
Health care providers, such as doctors, HMOs, and hospitals, must permit you to inspect your medical records during business hours within five working days after receiving a written request from you. You are required to pay reasonable clerical costs associated with locating the records and making the records available for your inspection.3

Your health care provider must provide copies of the records for not more than $.25 per page, or $.50 per page for records copied from microfilm.4 Your health care provider does not have to give you copies of X-rays if they provide them to another health care provider upon your written request within 15 days after receipt of the request, specifying the name and address of the health care provider to whom the records are to be delivered.5

This web address will provide you with more information:    http://www.calpatientguide.org/iii.html

I think they may just be giving you the run around. By law you have a right to your medical records regardless if they are based on a Workers Compensation injury or not. Good luck to you.

[Tuckamore]

What kind of state law denies a patient access to their medical records? I am far from an attorney, or any kind of expert but those are your records, regardless of who paid for your care. Write to your congressman, your senator and anyone you can think of in authority. This is a ridiculous law, that in my opinion could have only been made to protect physicians and insurance companies. Few things surprise me anymore but this one certainly does.

In my state, Wisconsin, you have a right to each and every medical record rather it is through workers comp or not. And I had no idea that Medicare will not pay for a pre-existing condition after a period if time. The federal government will not allow private insurance companies to have an unlimited amount of time on a pre-existing condition but it's acceptable for Medicare? That does not sound feasible to me either.

And how will one pay for an attorney when they are on Medicare? None of this makes sense to me. I am so sorry that you are caught in this nightmare of ridiculously unfair laws to say nothing about invasion of privacy where all medical facilities and W.C. insurance and staff have access to your records but you.  

[france12]

You have made a very good point about being possibly blackballed.  I just found out today that there is a low probability that another Comp doctor will take me because of what has been written in my records--which I have not seen.  Now another issue to deal with on getting the records plus finding a doctor.  The one Comp referred me to has refused to take me so maybe I am blackballed.  Who knows what this guy wrote about me that he has refused to let me see.

[christany]

It is really happy to hear some people like Mellowscout have cured from back pain. Similarly my brother(insane biker) was suffering from severe lower back pain. Even though he stopped his biking he had the problem. Then he got some back pain treatment & now he feels good. If you can too try, thats why I replied as soon. Thanks

[OtisDaMan]

I don't know the details of your situation beyond what you have stated, but it would seem to me that an arrangement has been made to deny you the healthcare that you are entitled to. At the very least, a complete and frank statement as to the reasons for the decision should be provided to you. In your situation, if you need to go through legal channels to obtain the case notes, you should probably also try to find out if you have been "blackballed" by the pain guys. If you have then other doctors will be very wary of taking you on as a patient, as I understand it. Perhaps one of the other contributors here can provide more accurate advice concerning the way that blackballing seems to happen in USA.

All the best and don't lose heart,

Regards,

OtisDaMan

[Mellowscout]

Hello,

Wow, I just can't believe that you can't get your records.  I'm so sorry that you have to deal with two things at once.

So if medicare with not pay for any work-comp, is there any way to get off medicare and try to get insurance?  I'm just wondering, I have never had to deal with worker's comp so I'm sure it's not that simple.

Also you said, "Several months into the pain clinic treatment, which was essentially the same as what I had with the other doctor, Comp began denying the Lidocaine and Lexapro (I was awarded lifetime medical).  The PAs disagreed with Comp's decision, but were not good advocates."  So if you have to get an attorney to get your records, then your attorney should also make sure that you get the lifetime medical that you were awarded.  This happened to my dad and he fought and won lifetime medical for some prescriptions he was awarded that got cut off when his doctor retired.

Don't give up hope!

Mellowscout...best of luck.