New PA experience

[Jaybay]

For the past 5+ years that I'm been in pain management and on opiate therapy, my pain doc has run a pretty laid back practice.  Patients were only required to have a "forced" visit for meds every 3 months or so.  I could pick up a Schedule II scrip at the office every month and call in the others through the pharmacy.  It was easy, and saved me quite a bit of money on copays.

Now, the rules for pain clinics have changed so the practice is typical of any pain clinic in the country.  We all go in once a month for paper scrips for ANY narcotic no matter what schedule it is.  My pain doc hired a physician assistant to help with all the follow-ups, and I saw him last Friday.  I really like the guy.  Typical of most of my experiences with PAs, he actually listened and asked questions about my medical history.  I told him I wanted to changed my fentanyl scrip from 50 mcg to 25 mcg, but he couldn't do it on that visit.  The doctor had already pre-written the scrips and he can't prescribe at that level.  

I showed the PA the cut half of the 50 mcg patch and explained how I tapered by trimming off bits of the patch every 3 days.  He just about cracked himself up laughing.  He said these office visits usually go the other way with patients wanting more and more and more drugs, and that I made his day asking for less.  And there he was unable to change the scrip!  So, we left it at 50 mcgs and I'll just continue to cut them.  It's just as well this scrip will last two months.  Now that our insurance is gone, it's a $220 a month prescription!  Even the hydrocodone is $76 a month.  Then there's the phenergan and celexa and $75 a month to see the doctor...  I'm losing my freakin' mind.

I've always liked my pain doc, and I'm happy to say she's found a great PA to help her out.  It's just unfortunate that the old, laid-back clinic style is no more.  Stupid regulators anyway...  If it ain't broke, they always have to break it so they can pretend to swoop in and fix it.  :-/

[peekawho]

Rock on, girl.  I'm glad you're doing well.  Hang in there.

[Jaybay]

You're so right about the mind game.  I'm appalled when I look back over the years of reaching for that pill bottle for every little hurt.  Shoot, ten years ago I didn't know what pain was compared to what I've got now. And now, is it really that bad?  It's amazing what the human body can put up with if given the chance.  

I was a bit surprised that my PA didn't give me a ration of shite about cutting the patch to taper.  It's not exactly a medically sanctioned method since you can't specifically measure the decreased dose.  But, as it turned out, he loved the idea and said he can't argue with success.  LOL!

Back to the mind games though, that's what I use to deal with the pain more than anything else now.  Lots of meditation and distraction work about as well, or better, than the meds.  Just takes patience and practice.

[londean]

Kudos on the taper. You go gurl! Its a ***** and a real mind GAME! Ive been tapering for two weeks now from a 2 year, 4 a day 50mcg Hydrocodone (dependency). Im a firm believer in less is best!

[JadedSweetheart]

It's always great to hear about a good experience with a new doc or PA and changes.  It seems like so many things are changing to make things difficult and it's nice to hear that your new changes aren't too difficult.  I'm sorry to hear about the costs, though!  There's no telling what will happen with the insurance industry and economy any time soon and it seems like we're all just one pencil-pusher's mistake away from sudden disaster.
You are one tough lady for the tapering you've been doing and your strength helps me when I'm having a hard time with my taper.  :)

[GettingOlder]

I'm guessing that with the new laws to help curb abuse of Rx'd substances might be a reason for that? Perhaps along with the doctor not wanting any liturgation claims files against. I'm with you though, if it ain't broke, don't fix it but some authorities have that "change is good" philosophy! Best wishes!