Avatar universal

How do I get my good name back?

I have been seen in the same PC for about 7 or 8 years. They have tried everything for my pain, finally put me on Opana (Oxymorphone). I have done urine tests in the past without a problem. The PA I was seeing sent me to get back surgery in late Dec. and the Surgeon sent me home with Tylenol #4 to take with the Opana for pain and I was to get a refill from my Primary Care Physician. When I saw my PA in Jan. we discussed me taking the Tylenol #4 and how I got it and he said ok. Its even written on my summary of visit that I was taking Tylenol #4. Then in March I went in and they asked for a urine test, I had no problems doing this as I only take what I am prescribed. When my test came back, they called me and told me over the phone that my test came back positive for Norco. I told them it was wrong be cause I don't take Norco. I can't because I'm allergic to it . She said "yes you did", and I said we don't even have any in the house. She then said that they prescribe it to my husband. They hadn't given him a prescription in 5 years.  So they said because of that and me receiving Tylenol #4 from 2 different providers, they are terminating our doctor patient relationship and I am no longer allowed to go there, period. I have since been referred to another clinic and being the honest person I am , I took a copy of the letter and gave to the new Doctor  and told him that it was wrong and gave him a list of my Meds.  He said that if the test said I took something, then I did! He then labeled me as High Risk due to Prior Medication Misuse and that I was discharged from prior PC due to Mismanagement of Medications. The only Meds I was taking were: Opana, Tylenol #4, levothyroxine, omeprazole, vitamin E, topiramate, Vagifem and  Ibuprofen with Mountain dew for my headaches.  The letter states that they found Hydrocodone. In the past , I have been given Percocet and vicodin and as soon as it hits my stomach it comes back up and I'm violently ill, so I have always listed it as an allergy. I believe that hydrocodone is the component that is in those 2 medicines and Norco. What made my test show positive for hydrocodone? How do I prove my innocence? Now because of this. the new doctor is only prescribing 2 Opana per day instead of the 3 that I had been taking, and the paperwork that comes with the meds says to take 1 every 4-6 hours. I used to take 1 in the morning and 1 at night and if I was up moving doing anything that would cause pain I would take one in the afternoon. If that is mismanaging meds then I guess I need a keeper because maybe they know more about MY PAIN!!! Any advise would help. Thanks!
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14517465 tn?1434959656
I strongly agree with philnoir find a Pain Management Doctor. They are so much more familiar with how pain meds work. Your typical primary doc usually has NO clue. I know it easier said then done to find a good Pain doc. It took me awhile to find the one I currently have. He has moved offices several times in the last 5 years the last move he made was an hour drive from me. But I make the drive because I trust him so much with my care. I also think talking to the pharm is a great idea. I hope they can help you. Thanks to the druggies and the pharmacies that were not doing the right job people like you and I who are lagit suffer. Please let us know if the pharmacist was able to help. I wish you the best.
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Avatar universal
Good for you philnoir!  Great advise!  I just wanted to say, if I were you, I would see a pain management specialist and not stop until I found a good one!  There are good ones and bad ones, as there are good and bad PC physicians.  Has anyone ever mentioned methadone?  It is an awesome pain management medication and you wouldn't be drugged feeling on it either.  Many docs don't use it anymore but it is by far the best out there and it is super cheap!  I am a hospice nurse and it's our go to med when it's time to bump up from hydrocodone.  I bet maybe you could talk to the pharmacist and see what doctors prescribe it in your area.  I would think any that did, would be a pretty good doctor.  Just my thoughts!  Good luck to you!
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7721494 tn?1431627964
I believe you.

Many doctors, and especially their PAs or NPs do not understand opioid metabolism. Your best source for helping you understand a medication's metabolism, metabolites, and what might show up in the urine is a PharmD -- maybe one of your local pharmacists.

Hydrocodone is a metabolite of codeine.

If you have taken codeine within 1-2 days before your UDT sample was taken, hydrocodone, and its metabolites, (including morphine) could appear in your urine.

This is a complex subject -- opioid metabolism is not easy to understand.

Consult with your pharmacist, explain the problem, and ask if he/she can explain why a recent codeine dose would show up as a false positive for hydrocodone in your urine.

Perhaps your pharmacist would be willing to write a letter to your doctor or PA explaining why this happens.

Also, learn about an app for doctors from Remitigate.com called UDTApp -- it helps docs understand false negatives and false positives in UDT results. You may find information on the Remitigate.com website that helps you understand false positive and false negative UDT results. And, you can demo the app online.

Yes, you can fight this. It is unethical for doctors to give and charge for tests for which they do not have the knowledge to properly interpret the results.

So, use the facts to set the record straight.

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st. louis, MO
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