i recently had my very first pill count...at my primary care doc...i wasnt allowed to be present during the count..they wanted EVERYTHING i take.. in the bottles,not just the norco...should i have been present?
From your posts, it almost sounds like if you *remain* with your current Pain Doctor, eventually your "number will come up," and it will be 'your turn' to get the Wrong Result.
I like your idea about approaching your doctor. Actually, approaching your doctor on the basis you mentioned: on a "preemptive basis!"
"Hey doc, all these other people at XYZWhatever pain clinic end up with False Urine Results, and eventually I'm going to be the one with the Bad Result."
-and -- if your State allows this:
"...so Doc, I would be willing to even take LESS opiate, just so I could stick with you, and be under your care because I trust you fully."
There. What do you think of that? (heh heh it's YOUR idea, really... I just re-phrased it, so you'll know that I understand what/where you're coming from).
this particular doctor has given out incorrect urine tests one girl went directly to her regular doctor and had one done within the hour and it proved correctly. Some have gotten lawyers i have heard..I just don't want him to black ball me..or anything I guess i will cancel my contract after talking to other doctors in the area and my med doctor after they say they can take me..pain management doctors ..and see if my regular doctor can prescribe something she is further away but understands stuff.
i tried to cut my meds in half this week to try and the pain was soooo intense and could not sleep at night for pain i am on 20 mg oxycodone 40 mg opana. i don't really want to be on anything and like you said f### all this urine test and pill counts that is so degrading. and you feel like a criminal and this doctor is controlling your life...I am sick of it.I might go to my regular doctor and talk...she knows me well
Please don't jump all over me for saying this, but there is one more option that may work if you are on a mild-enough prescription: Quit all opiates and be DONE with this s**t. Then, you NEVER have to deal with doctors, urine, pharmacists, dirty looks, etc., again.
Obviously, some chronic pain patients are on considerable dosages of methadone, morphine, hydromorphone, and high-dose contins, for chronic, unrelenting severe pain, and absolutely need medication to function. For those, the discovery of the poppy is a blessing -- and -- the pain relief is worth (several times over) the hoops that we have to jump through to sustain our protocol.
However, I've noticed it gets revealed that some folks are on *really small amounts* of hydrocodone a day "to take the edge off," their mild to moderate pain, yet they go through incredible hassle to maintain this status quo.
I get that hydrocodone is 'nice' (it does provide mild pain relief, and does provide the oft-demonized euphoria which also mitigates our pain perception)... but the truth is, many *many* peoples' lives would be bettered by simply quitting. (Many people in unbelievable pain have happy, active, and contented lives on a couple Advil a day.) This frees up resources -- not only will the doctors have more time to focus on those that are in severe, incapacitating pain, but the pain patient gets their life back! On many cases, our bodies *are* capable of producing enough endorphins to make it through the day (how many stories do we hear about, "the truck was on top of me, and I didn't feel a thing").
Again, in case we skipped over this post's intro, my intention is not to anger those who are on large, and necessary doses of pain medication -- no, rather, this post is just a comment to 'consider' for those who aren't really in that much pain... and maybe even for those that *are* in that much pain, but would have a healthier, free-er life without the PM rigamorole...
I have no doubt Philnoir can help you with this. But, in the end it will be your decision to make. Finding a pain specialist in the first place can be very challenging. I'm going through this myself right now. Finding a second specialist can be even harder. Maybe it depends on where you live and how many specialists are in your area. Do your research. In my opinion this is very important. I'm not sure if you should find another Dr before you fire your current one or not. If you do that and have problems finding another Dr you may find yourself without any medication for awhile. That would not be a good thing. Can I ask if you're working with your primary Dr too? If so, maybe you can talk to them about wanting to find another pain specialist and they may be able to help you with that.
should i fire him and go somewhere else? and when do i do this and how
That's a lot of things coming together into one big screw-up, but with controlled medications, doctors cannot accept stories like this.
I can imagine that you could straighten out being out of town with hotel receipts, travel receipts, or whatever. But being short on your monthly count is like saying "my dog ate my homework."
Excuses like this just don't work. I've seen patients in their 60s and 70s dismissed from a practice because of a false positive or negative urine screen. No questions asked, no weaning. They receive a "you're dismissed" letter from their doctor's office, maybe with a farewell of "don't let the door hit you in the behind on your way out."
These are difficult times in pain management. You really have no idea, do you? The heat is on prescribers and dispensaries, buth. The DEA can't stop illegal drug trafficking, so to save their empire (and budget), they're now prosecuting physicians at a rate unprecedented since the Harrison Act -- over 1000 prosecuted last year alone.
We who are prescribed chronic opioid therapy (COT) and practioners who write our Rx have enemies everywhere. Regulators, the press, parents of children who've died of opioid poisoning, and even doctors who are supposed to be compassionate are are against COT. Just visit the website of Physicians for Responsible Prescribing of Opioids (PROPS) and read their "educational material." Many of their board of directors publish multiple reports annually that often misrepresent the facts to bring others around to their views.
Chronic painers need to protect their docs who endorse COT and all practitioners who are compassionate in their treatment of chronic pain. This means keeping our urine clean, cooperating with treatment guidelines, and not showing up with excuses like this. Pain patients have to be beyond reproach and add disprove with our behavior the statistics of groups like PROPs who claim COT causes addiction.
No doubt, the pendulum will swing back toward a reasonable approach to treating the estimated 100,000,000 people in pain, and the 35,000,000 who live with chronic pain. But until then, we have to live with the propaganda against COT.
Do you know that we are the only patient population who has to take regular urine screens, who has to agree to one-sided controlled substance agreements before we will be treated, who have to submit to humiliating pill counts and demeaning treatment at the pharmacy.
Complete candor and honesty is essential whenever one is dealing with a physician prescribing controlled substances. Impeccable behavior is a must to protect your rights as a patient, your doctor's rights to treat, and the rights of every other chronic painer maintained with COT.
Someday all this will change, but excuses won't help. God forbid I would lose half of my medication some month, but if I did, I'd rather endure two weeks of the misery of opioid withdrawal than jeopardize my doctor and my access to vital pain medication. The stakes are too just high.
yeah i should not have told the truth about the pills dropping on the pier i reached for my phone and one bottle fell out, the other bottle of different pain med was in other pocked intact. I was out of state when the doctor office called me, and was several days before i got home to the rest of the pills in the 7 day planner. I put them in my pocket one on left and one on right and things happened..I didn't know that being truthful would hurt my results but the doctor never responded to my messages directly to him on what to do when out of state with pills at home too.
I am not seeking more pain medications for surgery, I can't afford the surgery now and don't want to be forced into any surgery that is going to be a financial burden on me, and forced my mom into looking after me, and she is 88 years old. The places they can send me to for rehab after the surgery to recover handle old people and are short staffed, and all that i have heard of in the area are not good. My doctors don't want me to go to any of these places and want for me to recover at home. The comments to my regular physician was not warranted by this doctor, nor my attire comments by him saying I need to dress more appropriately..I had on shorts t shirt, tennis shoes, socks it was 58 degrees outside, does he not know the meds taken raise my level of temperature..and for the lack of meds in my system, 3- 4 days without meds because of their appointment schedule is not my fault..
my pain is from bone on bone with the hip no socket, back is d disc disease and various disc protrusions and compressions. I also have Rheumatoid Arthritis, I did not ignore the pill count, I was out of state, I have never had trouble with any doctor since starting this pain management in 2008, a lot of patients are having various issues with this office
Allrighty then... I'm moving the hands on my alarm clock up an hour
You've got to get up pretty early in the morning to get the jump on old Phil....
darn-in... Phil beat me to it (I was typing as fast as I could LOL)
What's that old saying about beating a dead horse or something... or the other saying, can't get blood out of a turnip, or, my favorite... something about lipstick on a pig (but that one doesn't apply).
Anyway, if I were you, I'd get a copy of ALL my medical records, and simply find (heh heh "simply".... well, you know what I mean...), and simply find a fresh brand new Pain Doctor.
No matter what, no matter how much a-convincin' you do, there's always going to be the elephant in the room.
Just forget it. Wave the flag, find a new doc.
WHATEVER you do (and I personally HATE this situation), do NOT be forced into surgery.
That's the worst part of this whole d**n deal.... you're on Narcs, which DIRECTLY affect the mood/pleasure/deep-genetic-decision-making center in your brain... and I just know you're going to cave in and get surgery if you stick with this doc, just so you can get your meds.
No, I'm not picking on you... it's just a fact -- opiates trigger an ever-so-deep center of the brain, and unless you have the discipline of a deity, it is difficult NOT to 'give in' and have procedures done, just so you can get more meds.
That's what I'm afraid of. The "get surgery or else" thing that's going on.
Please, run the other way.
(of course, if surgery is medically necessary, then by all means get surgery.... but from reading your post, my deepest hunch says you really need to think this one through).
Find another doctor -- any doc who coerces a patient into surgery to treat pain is not qualified to practice pain medicine.
But you too need to get your act together -- the story about dropping pills on the dock isn't going to fly in any doctor's office.
It sounds as if you are continually running low on medication at the end of the month. I understand that you are under medicated, but taking more medication than directed is a bad idea and grounds for dismissal in any pain doctor's office.
The way to deal with ineffective medication is to keep a pain diary.
Now, what else are you doing to manage your pain? Pain management works best when multiple forms of therapy are used. Physical therapy and exercise are so very important. Counseling with a pain psychologist is essential to finding the best treatments and coping strategies. New coping strategies need to be found and developed. Alternative therapies should be attempted.
Your reluctance to try new treatment options is a signal to your doctor. You have to take an active role in your pain management.
Self-education is key. Learn everything you can about your various diseases. Also learn about how these diseases cause pain, and how that pain is best treated. Do you have neuropathic pain? Opioids are a poor medication choice for treating this kind of pain. GABA analogs are a much better choice. Discover and learn about treatment options and their outcomes and you can have an intelligent discussion with your doc instead of arguing about how much opioid pain meds you're taking or not taking.
I'll leave you with this thought -- Pain management is a game of inches -- For instance, if you live with regular level 6 pain, then opioid analgesia lower pain by only a point or two. Coping behaviors can lower pain another point. Exercise lowers pain yet another point. Collectively, that's a 4 point reduction in pain -- 66% Now we're talking about a very tolerable level 2 pain.
When you can work together with your doctor, with mutual respect, you can achieve regular pain relief with a minimum of opioid tolerance and pseudo-addictive behaviors.
Still, I think this doc is making a wrong decision, but your behavior may have played a role in his decision. It is best for your long term pain management if you own part of the problem right now and learn from it.