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Avatar universal

I Need Immediate Information

I take 3 different pain medications, Vicodin; Tylenol IV and Percocet. I am used to taking a tox screen and find no problem with it. My last visit I took a urine test and a week later they had me come back in for a blood test. Come to find out they say the Percocet isn't showing up in my results. The urine test didn't surprise me because I hadn't taken any but I had taken a Percocet on Saturday morning and the blood test was Monday morning so I don't understand it. I have been taken these meds for years and the Percocet for the longest, The reason the urine test didn't surprise me was the directions on the bottle are "take 1 every 6 hours AS NEEDED". If a medicine is prescribed as needed how can a doctor deny me my pain medication because it doesn't show up in a test? I have an appointment with him tomorrow am because he is now denying all my pain medication due to the negative result on the Percocet even though the Vicodin and Tylenol IV showed up. Besides my argument that the prescription is written "as needed" is there anything else that could help my case? Please, I'm begging you for help it's 6:36pm and I'm seeing him at 9:45am.
33 Responses
535089 tn?1400673519
Hi, welcome to the Pain Forum.

Even though it's prescribed As Needed, If you're refilling your prescription every month, that tells the Doctor that your taking the meds every 6 hrs. If you had some left over, you would need to take it to him and show him that you really are taking as needed and you didn't need the entire script that month. This also tells the Doctor how to adjust your medication.

Is he a PM Doctor or your PCP? I ask because PM Doc's seem stricter than your PCP.

Your Doctor will have to treat you for a 30 day period if you signed a pain contract. That's the law. If you didn't sign one then he can let you go at anytime.

I'm sorry that this has happened to you. Taking your medication Sat, morning and testing on Monday...the Pecocet will most likely not show up in the urine.

I wish I could be of further help.

Well wishes,
198154 tn?1337787265
ahve you told the Dr you dont take the Oxycodone everyday?
Avatar universal
The Percocet was originally prescribed by my Neurologist for headaches that were left over from when I had Menengitis. The doctor's got together and decided one doctor should write all the pain meds. Since the Percocet is for something that doesn't occur on a regular schedule I don't take it every 6 hours. I could go days without taking it and then in a weekend wipe out a good chunk. The neurologist originally wrote it as I needed it and that was approximately 30 pills for 30 days but when my PCP took over he wrote it as 90 pills for a 3 month supply with those directions because I only see him every 3 months where the neurologist would mail the script to me when I needed it. Hence the "As Needed". It never has and never will be a medicine that I had/have to take every 6 hours.For years 30 pills has been lasting me approximately a month.

The doctor is my PCP. Our local Pain Management Clinic doesn't prescribe medicine...just shove needles in your back.

My docotor hasn't threatened to let me go, to just stop writing my pain meds. What good is he to me if I'm in constant pain though?

Does this make any difference in the fact he wrote the script the way he did and now I'm being punished for it? I even told the lab tech that I had taken it on Saturday.
Avatar universal
The doctor knew when he took over writing the script from my Neurologist that it wasn't an everyday medicine. He originally was writing 3 different scripts for a 30ct for 3 different months and then changed it to 90ct for a 3 month supply.
547368 tn?1440541785
Sorry BBlueize that I am late to this discussion. I am wondering how your appt went this morning.

I assume the 90 Percocet are lasting the 90 days and have now for some time. I think you have a good argument. I hope this was not at the end of your 90 days and that you took in your bottle to prove that you had Vicodin remaining.

I'll look forward to your update.

1180465 tn?1271970993
Sorry to say but sometimes diet and the frequency of medication taken can make it dissolve faster or slower making it hard to show up in a blood test. I have had the same problem with blood tests and percoset. They SHOULD have immediately ordered a second test that day to determine if it was a glitch. He is not prescribing it because they assume (since it didnt show up on your blood work) that you are selling the prescription on the blackmarket which is unfortunately all too common.
Finding the right pain mgt doctor is key to your treatment.
Keep looking!! I know its difficult... it took me five pain mgt docs and four more gyn docs to help with my pain. Pain mgt docs have to be strict but finding the right fit is VERY important.

Healthgrades.com has been the most helpful and valid website to look for doctors in your area and in the expertise you need. If your insurance requires a referral talk to your PCP.
Best wishes!
Hope you had luck with your
Avatar universal
Yes, 30 Percocet a month has been my dosage for years.

I've come to the determination that "my" doctor is the doctor from hell. I'll try to be brief. I don't know why he won't write my scripts any longer. He refused to discuss it. I tried to show him the almost full bottle of Percocet and he said "I don't want to see it". I then asked what happened. All he kept yelling was that I was a liar and he didn't trust me. He said I lied 2x that I took all my meds. When I tried to get to the bottom of that and explain that if he asked that, I misunderstood and assumed it was the Vicodin & Tylenol IV he meant (though I doubt he asked that; all I remember him asking is if I took my Tegretol that morning because if I had it would screw up my level). I couldn't even finish the sentence when he said if there was a misunderstanding it was my fault. I asked him if he'd sit down and discuss this. And he refused. He he was leaving. He opened the door and kept up calling me a liar and worse and everyone in the hall & even the waiting room heard him. I still would like to know how I lied to him 2x when my second test all I was told (and not by him) was to come in for a blood test and take my medicine as usual & I didn't have to fast. No one asked me if I had taken anything that day. I seriously think this doctor is going senile. Since he won't discuss it an office worker pulled me aside and told me to call the office manager. Seems like I'm not the only person who sees he's being unreasonable.
Avatar universal
I've looked for doctors in my insurance index and I'm coming up blank. My worst fear is that whatever doctor I find is going to make me go through all my tests all over again. I won't have needles stuck in my back again. As a matter of fact my Neurologist told me to never do it again. After all these years having to go back to square one isn't an option to me.

Thank you for the web site though. Maybe I can match someone up from there with my insurance company.

What really ticks me off is he wouldn't even listen to a word I said. I totally believe in the tox screening. Even the office manager was shocked when he wouldn't look at the bottle of Percocet. And I'm left assuming that's the problem because he won't tell me.
Avatar universal
Do you have a Medical Society office in your city? Does your doctor belong to this organization? If so, call them and report the issue. He owes you an explanation. There are guidelines that must be followed when you discharge a patient. I work for a pain management practice and I have researched this before. They have to explain to you in detail what you have done, they have to give you 30 days to find a new doctor, they have to give you a list of doctors you can try or a place like the "medical society" office that can give you some names of doctors and it MUST be in letter form with ALL this listed. They MUST mail it to you by certified mail. If this does not take place..........report them to the Civil Rights department for your area. (I think that is where you would report them) Make sure they follow protocol if they want to be *****.
Avatar universal
Sorry for delay in response. I've been dealing with Dr. Shmuck and hopefully my Dr. Knight in Shining Armor.

To answer your questions:

1.) I don't know if my former doctor belongs to the Medical Society Office. I do know there isn't an office here; I live in a small town by Massachusetts standards. I don't know if there's one anywhere else around here.

2.) This doctor absolutely will not talk to me on this issue. He refuses. The best I got was the office manager talked to me...talked to him...talked to me...talked to him...I felt like I was in Kindergarten. I know what his problem is by way of this ridiculous routine. He believes that since no Percocet showed up in either of my tox screens I'm asking for more than I need. Thus I'm a "liar" and he doesn't trust me (got news bucko I don't trust you either). I basically take 30 Percocet a month (as needed, not on a regular basis. I may go weeks without needing any and then in the space of a couple of days deplete my prescription...it *****. Don't ever get Spinal Menengitis). Anyway I had gone through about 15 when I went to see him which would have been right on schedule for my needs. I think his problem is, besides that he's a moron, when he took over writing my Percocet he could no longer fill it when I needed it (like my Neurologist did) so the best he could do was write 3 scripts for 3 different months each for 30 pills. Make sense? Then he changed and decided to write 1 script for 90 pills to last me 3 months. I'm guessing the jerk is thinking the 90 pills is for 1 month. Who knows what's rattling around in his verging on the edge of senility brain. That may sound hostile; mean and sarcastic but I honestly believe there is something wrong with him. His behavior has drastically changed over the year and I've been his patient for about 10 years maybe? Maybe more.

3.) He got around the discharge issue by saying he's perfectly happy to continue to be my doctor but I have to find another doctor to write my pain medication. Yeh...like I'm staying with him. After his behavior I wouldn't let my dog see him.

4.) I plan on reporting him to my insurance company and to another place. I forget what it's called but it's where you go to report doctors for who act wrong. Luckily I wasn't by myself when he yelled at me the way he did so it's not just my word.

I may have finally found help. My Neurologist may be taking over my pain medication. I believe he understood the problem and he said he'd have no problems doing it as long as he was the only doctor prescribing pain medication (no problem there) but I'm reserving my happy dance until after I talk to him tomorrow.
356518 tn?1322263642
You need to report the doctor to the AMA which is the American medical association.
They are the ones who would be giving out disciplinary actions toward the doctor and fines if that's the case.
I would not prolong doing this. Write down everything (all the details) now while it is fresh in your mind.
I will post the information on how to file a complaint shortly.
I hope all goes well with your doctor tomorrow:)
356518 tn?1322263642
Here is the site that will give you information on how to file a complaint in your state....

This is the AMA website information...

Avatar universal
Thank you. All my anger aside for this "doctor" putting me into this situation...I honestly think there's something that's wrong with him.
Avatar universal
Okay, I've seen my Neurologist and what's happened is he made sure I had enough pain medication right now while he works things out. He's worried about all the acetaminophen that I've been taking all these years so he wants to try me on something else. He said something about a patch; that it would last a couple days and I think it started with the "f" sound. I was so upset about the fact that things that have worked for years were going to be changed and I might have to start going through all that pain again that I don't remember everything he said about it. Maybe someone can tell me of a medicine that sounds like that?

He's going to consult with a pain specialist (right terminology?) from the hospital in his area and then get back to me within a week. I'm supposed to call him if I don't hear from him. He said if I took this patch I probably wouldn't need as much Percocet either but that I'd be keeping some for the really bad days.
198154 tn?1337787265
fentanyl patch
its morphine and REALLY strong....
pain should be a thing of the past

Good Luck
Avatar universal
Oh...now I feel dumb for getting upset. Maybe that's why he asked me how my depression was going :-)
I hope that's what's he's working on doing because once I calmed down just the idea of something I kept on me for a couple days instead of swallowing pills every few hours started sounding good. One big advantage I thought of was the fact  that I have trouble sleeping. Maybe I won't keep waking up every time I have to turn over. Add in the information you just gave me and now I'm hoping that we go that way instead of all the different pain meds I've been taking so long. Hopefully it'll work if that's what ends up happening (had morphine after my first daughter's birth and I don't remember it working all that great (but that was back in '85 so who knows). My Dr. Flippout did me a favor.
Avatar universal
That's what I get for forgetting to proofread. I meant...
MAYBE Dr. Flippout did me a favor.
MY Dr. Flippout just sounds wrong!
765775 tn?1366024691
If you do get switched to the Fentanyl Patch it may work much better for your pain issues but it tends to make you very drowsy so be careful until you get used to it. I could not tolerate it but that may be because I take 30mgs. Oxycontin a day for about the last 18 months.

Everyone is different, but everyone I know on the patch gets very drowsy.
Avatar universal
Thank you for the information. My husband won't let me drive unless it's an emergency anyway because of the meds I'm on now & sometimes I do get drowsy. I don't have a car [my poor baby has been down & out for a while :-( ] so I really don't do a whole heck of a lot anyway. Summer's different. I still don't drive but my grandmother has a cottage on an ocean bay so I do more but if I do get on this (and I'm not going to predetermine anything because I don't want to get upset again) maybe that'll give me time to get more used to it. To be honest, the way I can't sleep maybe a little drowsiness wouldn't be so bad (at least for a while). I do thank you though. Even if I do get put on that; and the doctor does tell me it could make me drowsy, it's still better (for me anyway) to hear from people who've been on something and/or know people who've been on it too. It'll probably be something else somehow anyway and now that I'm getting used to the patch idea I'll have to get used to the idea of something else.
547368 tn?1440541785
Wow, you have really been through it with an incompetent physician. I am so sorry that this happened to you.

And I think you hit the nail on the head, Dr. Shmuck really did do you a favor. Who would want to be treated by a physician that belittles you and doesn't trust you? I surely wouldn't.

His behavior, especially in the presence of others is unprofessional to say the least. It sounds like you have worked through a bad situation and found good solutions.  I do hope you don't let this go. Physicians should be held accountable for their actions, good and bad.

The Fentanyl Patch or Fentanyl is not Morphine. They are two very different medications. Fentanyl is a synthetic (man-made) narcotic whereas Morphine is naturally occurring compound and a non-synthetic. I imagine your neurologist will start you on a low dose and gauge it's effectiveness.

Thank you for keeping us updated. I hope you will continue to do so. I wish you the best of luck.

Avatar universal
Thank you.

I wish I had more than my husband and his office staff to witness what he did. I'm in my 40's (pushing 50...but that's a secret) and I've never had any professional (and I'm not just talking medical...I mean right down to the "lowliest" job) treat me the way this "man" did. Once, maybe you're having a bad day...twice, you're just a jackass.

Thank you too for the information. I'm still waiting to hear from my Neurologist so the more information I know about what I believe he's thinking of doing the less chance I'll have of wigging out from the fear of meds not working and my having to go through hell from the pain again.
Avatar universal
Just as an update...
I spoke with my neurologist yesterday and it's definitely a Fentanyl patch he's going to put me on; I have to call him back next week to get more into that with him. He did give me another reason to despise my former doctor, though. My neurologist got the results of my last bloodwork taken because it involved a Tegretol level and liver functions and I guess my jackass doctor was so busy thinking I was doing something evil with my Percocet that he missed that my platelet count was too high and there was too much protein in my blood. I know that's not pain related information but since I think it showed just one more reason why Dr. Twit throwing a mental fit did me a favor I'd write it up. I'm going for more blood work and my neurologist has set me up with an appointment with a hematologist/oncologist (next month). My neurologist figured that was enough information to deal with right now so I have to call him next week about the patch.
The fun never ends :-)
535089 tn?1400673519
I have used the Fentanyl Patch for a long time. It works well and that's great. The not so great part is that because it is so strong, other meds such as Oxycodone or Hydrocodone do not work anymore. The Fentanyl cancels out the other drugs.

Your tolorance will get so high that other pain medications will not compare. Fentanyl is 80x stronger than Morphine, so this gives you an Idea of what you're dealing with.

If you would like more information about the Patch, please send me a PM. I can fill you in on the way it's used and the dangers before you actually start using the patch.

Be well,
Avatar universal
If anyone is still paying attention to this since it's so old...my doctor is sending me a 'script for the lowest dose of Fentanyl patch but told me he knows it won't be enough. He wants me to keep taking my regular meds while I'm on the patch but to try to cut down on one (I chose to try cutting down the Vicodin since the Percocet isn't an every day drug and Vicodin was the strongest I was taking for my back). Is he doing it this way, instead of giving me a patch that he thinks will be strong enough and stopping the other meds, because he's afraid my body will go into withdrawals since it's been years that I've been taking the Tylenol IV and Vicodin? I really should have asked him but I never think of these things until I'm done talking to him and this time he's gone on vacation so I can't go back to him right away. I'm supposed to call him in 2 weeks to let him know how I'm doing. Is this the ordinary way to switch over to the patch when you've been taking as much meds as I have been?

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