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Avatar universal

Pain Medication Problems...

I've had pain from my left lower abdomen to my left testicle for close too 2 years now and i take 4 norco 10/325 mg a day. which does not fully help my pain but i really do not want to be on any stronger meds (don't even want to be on the norcos). My doctors can't find out what the cause is but i am in pain 24/7, I've seen a urologist 5 times in under 2 years, and any test under the sun they can think of. My current doctor last month started to lower my dosage from 4 tablets a day to 3, which isn't that big of a deal. But this month she lowered it again to 2 tablets a day, which puts me in a great deal of pain and I have to submit a drug test before every refill. Now last year I was forced to drug test 13 times!!! all of which came up positive ONLY for the norco I'm prescribed. So i ask my doctor why she is doing this and she said that its time to get off of the medication. Which is fine by me but I want to know why I'm in constant pain and also something non-narcotic to manage that pain if cannot be fixed. I don't feel as though i deserve to be treated this way and i don't really know who or where to turn for this type of thing. I would appreciate some advice
39 Responses
1331804 tn?1336870958
Hi and welcome to the pain management community.

I am terribly sorry to hear that your doctor has abruptly decided to taper you off of the medication before understanding the cause of your pain.  Did you tell her how much your pain has increased due to the taper from 3 to 2 norcos?  If not, you need to tell her this.  Keep in mind that there is typically more pain than what is really there during the first few days of a step down in dosing of pain medications.  It can take a month and sometimes longer for the real pain to remain after the taper.  However, there is a chance that the real pain could be very close to the pain level that you have right now, which would not be good.  

If you are seeing a primary care physician (PCP) or group practicioner (GP) for management of your pain, I encourage you seek out a pain management physician (PMP).  PMPs have more leverage in certain states to prescribe pain medication long term than PCPs or GPs.  

You are on such a very low dose of pain medication...even at the dosing level of 4 norcos per day.  The drug testing your doctor is doing seems a little excessive given you have always testing positive for the drug that you are prescribed.

Please seek out a pain management physician and keep us posted on your progress towards a diagnosis.  I do hope that you get the pain relief you deserve while still undergoing testing to determine the root cause of your pain.  You shouldn't have to suffer considering how compliant you have been with your medications.  

Avatar universal
Its reddicoulos that the doc is doing that , I would suggest tramadol and or gabapentin, will at least take the edge off.
1331804 tn?1336870958
Hi Jake,

I should add that you could try an anti-inflammatory such as Aleve to see if that helps with your pain.  You could also ask your doctor about Neurontin or Lyrica, which are anti-convulsants that are very effective on nerve pain.  This type of medication is non-narcotic.  If one of them works, it could be that the misfiring of nerves is at the root of your pain.  Nerve pain is very hard to treat.  Radio frequency ablation (RFA) which involves creating a lesion on the nerve endings that are causing the pain.  The nerves then die within a week and if they kill the right nerves, pain relief can last from 12-24 months.  The nerves grow back and require more RFAs.

1331804 tn?1336870958
Gabapentin is the generic equivalent of Neurontin.  Lyrica has no generic equivalent.  I take Gabapentin to help with nerve pain.

Avatar universal
Thanks everyone for the replies, i have tried neurontin and gabapentnn and also tramadol and nothing has ever helped. I think that 4 tablets a day is a reasonable amount considering that I am in as much pain as I am. I just feel as though I'm a suspect to them and I don't know why I am being treated like one. I'm trying to get a hold of Pain Management as we speak, they should give me a call back Monday (hopefully). With Kaiser everything seems to take twice as long as it should. I've been tested for nerve pain and nothing stood out to them as well as many urologist visits to no result either. I'm just concerned that it may be something serious that either there missing or haven't considered. But again I don't know where to turn for this type of thing. When I try to tell my doctor anything about my medication or my symptoms she literally ignores me. But I am afraid to switch doctors because I changed about 30 days ago because my previous doctor did the same things, but I don't want it too seem as though I'm doctor shopping or something.
1331804 tn?1336870958
Oh no.  You have Kaiser.  I had Kaiser for almost 32 years (ever since birth).  My employer decided to "do away" with Kaiser this year and we were all forced to Anthem BCBS.  I was worried about how things would pan out but now i am so glad I was forced to switch.

My pain was so poorly treated at Kaiser.  They only offer morphine or methadone as extended release meds.  Everything has to be generic.  The only way brand name drugs are covered is through pre-authorization (which they rarely grant).

I never had an option to see a pain management doctor under Kaiser.  I was told that they don't exist and that the family doctors are the prescriber of all.  Gosh, my pain was so poorly controlled under Kaiser.  I have been dealing with chronic pain for 12 years and I now have meaningful relief under Anthem BCBS.

It is pretty hard (or impossible) to "doctor shop" under Kaiser as it is a closed network.  With Anthem BCBS, the network is completely open and not connected so it is easy to see another doctor behind another doctor's back.  With Kaiser, that is not so.  When I filed a compliant with Member Services, the representative told me to make appointments with other doctors and then once I find one that is for me, I can then officially make him/her my new PCP.  The prescriptions are all linked as well as the appointments you make, so your regular doctor can (and normally they do) monitor your activity through the Kaiser network.  

I highly recommend, that you consider commercial insurance next open enrollment period.  I believe you will have a better chance of getting a diagnosis as you can see a specialist within a teaching hospital and the doctors at teaching hospitals live up to higher standards than regular doctors.  They are more interested in solving mystery cases then regular docs that just want to work 9-5 to get a paycheck and go home.  

Under Anthem BCBS, I don't need a referral to see a specialist.  I can make a appointment with whatever doctor I want when I want.  Under Kaiser just to get an epidural injection, my PCP had to order the MRI, then refer me to neurosurgery and then neurosurgery had to refer me to the pain clinic...it was ridiculous!  Especially, since I got denied the referral to the pain clinic the first go round.  So much needless suffering due to their communistic practices.

I posted my gripes about Kaiser on another thread as well.  I am sorry but Kaiser offers sub optimal care to their patients.  You are really selling yourself short with Kaiser.

Lastly, norco is only just a tad bit stronger than Tramadol.  It is actually very weak in its strength.  But if 4 norcos provide you with great pain relief, there is no need to push for something stronger.  I could eat norco like candy and it still wouldn't touch my pain.

Best of luck to you.  I sure hope things pan out with Kaiser.  Just remember that commercial insurance does tend to offer better care to their members.

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