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Has anyone had trouble with a saliva test being negative for fentanyl?

My PM doctor was prescribing 50 mcg fentanyl patches to be applied every three days. They were going to give me a urine screen, but I have interstitial cystitis and a neurogenic bladder.  I was unable to provide enough urine, so the nurse gave me water to drink.  I was on my way back to the bathroom, when someone other than the nurse stopped me to say I was having a saliva test.  I went back to the room and continued to drink water, because I have dry mouth from taking Lyrica and Lamotrigine.  The staff member returned and saw me drinking water, and she hurriedly told me to move my tongue from left to right before giving me the device to put in my mouth.  I was contacted over one month later and told the test was negative and that I was being discharged.  I understand that it only takes 4-5 days for these tests to come back, so I don't understand why it took them a whole month to contact me.  It is also suspicious that I went back to the office for a ganglion impar injection five days after the saliva test and no one said anything.  I had to call the office the following day, after I experienced severe pelvic burning.  I was very rudely told to go to the ER and that the doctor was on vacation.  During the PM appointment, I had told the nurse practitioner that the fentanyl patches did not relieve my pain.  Her solution was to say she would prescribe the same morphine equivalent medication of morphine sulphate, but she wrote a prescription for thirty morphine equivalents less than the fentanyl patches.  My pharmacist did not stock the medication and thought she meant to prescribe something for breakthrough pain.  When I told him this was not the case, he offered to call the facility.  The phone nurse kept telling me the morphine sulphate was for the same amount, until I told her the pharmacist had given me a conversion chart.  She then said my medication was going to be reduced "anyway".  I have a lot of spine problems from previous surgeries and the neurosurgeon at this office had said I did not need surgery.  He had sent me to his interventional pain doctor, who wanted to immediately put in a spinal cord stimulator.  He became angry when I told him that my previous PM doctor said this would not help, but he agreed to do a CT Myelogram.  The test showed clumping of the cauda equina nerve roots and other problems, but I was scheduled with a PM nurse practitioner, who said I needed surgery and that one of the other neurosurgeons might see me.  The nurse practitioner returned to his former job, and I was not allowed to see the neurosurgeon.  I am confident that the facility wanted rid of me because I have so many spine problems.  I have asked three pharmacists about saliva tests and they could not believe I was discharged with no follow up to talk to anyone.  They said it is extremely difficult to detect fentanyl in saliva and that these tests are not normally used for fentanyl patch users.  They said urine tests are much more reliable and that I should have been given a urine test in their opinion.  I also learned that I should have been told to wait at least ten minutes after eating or drinking, before taking the saliva test, because this can cause the results to be wrong.  The maker of the test, Quantisal, said I should have been retested, but the office manager kept saying the test was correct.  In the end it worked out for the best, because I was able to get a referral to a much nicer, compassionate PM doctor who spent three hours reviewing my records.  He thankfully increased my medication and said the previous PM doctor apparently did not know how to read imaging reports.  (I have been in so much pain that I am not able to eat, sleep, of focus on anything for months, but I was treated like a common drug seeker for asking for an increase in medication). The new doctor is sending me for EMG testing, because he is afraid I am getting foot drop and he is referring me to a neurosurgeon.  I would not recommend East Tennessee Brain and Spine to anyone.
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st. louis, MO
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