Aa
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
-Thanks.
-Thanks.
I did file a grievance the day I found out what she put into my file. I also requested the information that you are talking about as part of the complaint and resolution questions they ask you. My pain is not very well controlled nor has it ever been. But I really am very very hesitant to pursue a stronger medicine because of the fact that it may be long term. I was offered from a few doctor's stronger dose of medication (Morphine/ Oxycodone) and I refused those medications. I just cannot fathom why in the world she would even put that in my file for no clear reason. And especially due to the fact of how upfront and cooperative with every doctor I have seen. In all honesty I am so very frustrated I don't know what to even say to my doctor. The bottom line is I have an appointment on the 23rd and I am going to get this straightened out one way or another, and then I am changing doctor's. In my complaint I mentioned that she has lied to my face on multiple times, for instance I clearly asked her "Do I have to do a drug test for you to release my medication" and her response was absolutely not and I left her office went downstairs to the pharmacy and waited in a hour long line to get up there and the pharmacist's said I had to do a drug test to release the medication. There has been other things that I feel she has lied to me about but not anything I knew for certain, so that was the only part I included in the complaint. Once I explained how she lied to me the woman on the phone seemed to take it much more seriously.
Hi Jake,
I am very happy to hear that you filed a formal complaint and I am glad that you realized how inappropriate her actions have been towards you. I am thinking she sent you to see a psychologist more specifically to back up her belief that you are addicted to your medications and that is just sickening. Doctors like her shouldn't even be offering pain management as it is clear that she is not properly trained in the field of pain management.
I have received resolutions through all of the formal complaints that I filed through Kaiser when I was a member so I am confident that all of this will get straightened out.
If you don't mind me asking, why are you hesistant to agree to taking a stronger medication? I don't know your age but I am 31 years old and I have been taking opioids for chronic pain for about 6 years. I have been battling chronic pain for twice as long as I have been taking opioids to control the pain. There are many different techniques that can be deployed to ensure that you have adequate pain control for many years to come. Once the "optimal" dose is achieved, many patients can continue on the same long-acting dosage for 4, 5 and sometimes 10 years as short acting opioids can be added or increased first before increasing the long acting opioid.
Additionally, many doctors deploy opioid rotations where they will switch you from Morphine ER to Oxycontin. Due to incomplete cross tolerance, you can achieve adequate analgesia on an equivalent dose of Morphine through the administration of Oxycontin. There are no ceilings on pure opioid agonists. I have read posts across the web from chronic pain patients that are on 700 mg of morphine per day. That is over 3 times the amount I am on via the Fentanyl patch. Many times after (for example) switching to Oxycontin for 6 months to a year, you can go back to the Morphine at the same dose and have pain relief from the medication again.
Many medical studies have shown that long-acting opioids slow the develop of tolerance when compared to short acting opioids. I should mention also that the tylenol in Norco is not good for your liver. The pharmaceutical companies still don't know what is a true safe dose of tylenol as they have once again reduced the recommended limit of tylenol that can ingested in one day from 4,000 mg to 2,600 mg. My doctor prefers to keep the tylenol intake below 2,000 mg per day when it is being taken on a daily basis over the long term. So, the tylenol in Norco limits how much pain relief can be safely achieved. I believe Norco has 325 mg of tylenol in each tablets which equates to 12 pills per day as 12 pills equals 4,000 mg of tylenol which is the limit. Just recently, my doctor took me off of percocet and put me on oxycodone IR which doesn't have any tylenol in it. I am extremely happy about this change.
If you don't like the change to Morphine and oxycodone, you can always go back to the Norco and deal with a higher pain level if that is a better choice for you. However, it just seems like you have been in a lot of pain and it has been hindering your ability to carry out your everyday tasks. The Morphine/oxycodone combo could help you get back to life. I am assuming the Morphine would be Morphine in extended release form and then oxycodone for breakthrough pain. This is a great combo as I was on a very similar mix a year ago with the difference being that I was on percocet versus oxycodone.
The oxycodone would not be taken on a schedule. Instead it would be for bad spikes in pain or to take before starting an activity that causes you a lot of pain as taking a breakthrough pain med after the pain is really bad renders the medicine not as effective. You always want to be ahead of the pain. Having a long-acting med like the Morphine ER covering your baseline pain level will help keep your pain levels throughout the day at lower levels. The Morphine ER would be dosed at a level equivalent to your current Norco intake with potentially the equivalent of 2-4 extra Norco pills than you are currently taking right now. Morphine is not much stronger than the Norco. The big difference is it will eliminate the ups and downs experienced when taking short-acting opioids throughout the day such that your pain will be controlled on a more consistent basis instead of increasing every 3 hours after taking a Norco.
There is hope that they will find the cause of your pain and be able to fix it. In this case, you would follow the strict tapering instructions given by your physician to minimize withdrawal symptoms as you discontinue the medication. I think the goal right now is to get your pain to an acceptable level so that you can function and pursue additional treatments and/or therapies. I wouldn't worry too much about pain control over the long term as there are medicines out there that are much more potent that will ensure pain control down the road.
Also, rest assured that opioids do not damage internal organs. The side effects that they cause are manageable. Constipation can be treated with over the counter medicines. Low testosterone levels can be treated with hormone replacement therapy (this side effect does not always occur and it is very dependant on the dose and how long it has been taken).
Uncontrolled pain is more damaging to the body than taking opioids over the long term. That is why it is so important for you to get the pain under control and I believe the Morphine ER with oxycodone for breakthrough pain would accomplish this.
Please keep us posted. And feel free to ask any questions you may have as we are here to help!
femmy :)
I am very happy to hear that you filed a formal complaint and I am glad that you realized how inappropriate her actions have been towards you. I am thinking she sent you to see a psychologist more specifically to back up her belief that you are addicted to your medications and that is just sickening. Doctors like her shouldn't even be offering pain management as it is clear that she is not properly trained in the field of pain management.
I have received resolutions through all of the formal complaints that I filed through Kaiser when I was a member so I am confident that all of this will get straightened out.
If you don't mind me asking, why are you hesistant to agree to taking a stronger medication? I don't know your age but I am 31 years old and I have been taking opioids for chronic pain for about 6 years. I have been battling chronic pain for twice as long as I have been taking opioids to control the pain. There are many different techniques that can be deployed to ensure that you have adequate pain control for many years to come. Once the "optimal" dose is achieved, many patients can continue on the same long-acting dosage for 4, 5 and sometimes 10 years as short acting opioids can be added or increased first before increasing the long acting opioid.
Additionally, many doctors deploy opioid rotations where they will switch you from Morphine ER to Oxycontin. Due to incomplete cross tolerance, you can achieve adequate analgesia on an equivalent dose of Morphine through the administration of Oxycontin. There are no ceilings on pure opioid agonists. I have read posts across the web from chronic pain patients that are on 700 mg of morphine per day. That is over 3 times the amount I am on via the Fentanyl patch. Many times after (for example) switching to Oxycontin for 6 months to a year, you can go back to the Morphine at the same dose and have pain relief from the medication again.
Many medical studies have shown that long-acting opioids slow the develop of tolerance when compared to short acting opioids. I should mention also that the tylenol in Norco is not good for your liver. The pharmaceutical companies still don't know what is a true safe dose of tylenol as they have once again reduced the recommended limit of tylenol that can ingested in one day from 4,000 mg to 2,600 mg. My doctor prefers to keep the tylenol intake below 2,000 mg per day when it is being taken on a daily basis over the long term. So, the tylenol in Norco limits how much pain relief can be safely achieved. I believe Norco has 325 mg of tylenol in each tablets which equates to 12 pills per day as 12 pills equals 4,000 mg of tylenol which is the limit. Just recently, my doctor took me off of percocet and put me on oxycodone IR which doesn't have any tylenol in it. I am extremely happy about this change.
If you don't like the change to Morphine and oxycodone, you can always go back to the Norco and deal with a higher pain level if that is a better choice for you. However, it just seems like you have been in a lot of pain and it has been hindering your ability to carry out your everyday tasks. The Morphine/oxycodone combo could help you get back to life. I am assuming the Morphine would be Morphine in extended release form and then oxycodone for breakthrough pain. This is a great combo as I was on a very similar mix a year ago with the difference being that I was on percocet versus oxycodone.
The oxycodone would not be taken on a schedule. Instead it would be for bad spikes in pain or to take before starting an activity that causes you a lot of pain as taking a breakthrough pain med after the pain is really bad renders the medicine not as effective. You always want to be ahead of the pain. Having a long-acting med like the Morphine ER covering your baseline pain level will help keep your pain levels throughout the day at lower levels. The Morphine ER would be dosed at a level equivalent to your current Norco intake with potentially the equivalent of 2-4 extra Norco pills than you are currently taking right now. Morphine is not much stronger than the Norco. The big difference is it will eliminate the ups and downs experienced when taking short-acting opioids throughout the day such that your pain will be controlled on a more consistent basis instead of increasing every 3 hours after taking a Norco.
There is hope that they will find the cause of your pain and be able to fix it. In this case, you would follow the strict tapering instructions given by your physician to minimize withdrawal symptoms as you discontinue the medication. I think the goal right now is to get your pain to an acceptable level so that you can function and pursue additional treatments and/or therapies. I wouldn't worry too much about pain control over the long term as there are medicines out there that are much more potent that will ensure pain control down the road.
Also, rest assured that opioids do not damage internal organs. The side effects that they cause are manageable. Constipation can be treated with over the counter medicines. Low testosterone levels can be treated with hormone replacement therapy (this side effect does not always occur and it is very dependant on the dose and how long it has been taken).
Uncontrolled pain is more damaging to the body than taking opioids over the long term. That is why it is so important for you to get the pain under control and I believe the Morphine ER with oxycodone for breakthrough pain would accomplish this.
Please keep us posted. And feel free to ask any questions you may have as we are here to help!
femmy :)
Thanks for all the information, the way you put it about the morphine/oxycodone makes me feel much better about that and I think also that would improve my day to day function. As of right know I can't do the things I know I should be able to be doing. Also as you said about the day to day pain getting worse and calming back down, that to me is the hardest part because I have to just sit down and try to get it back to an acceptable level.
It's hard to manage and has been impossible with some situations. For instance when I have to lift over 150lbs. With my job I have to do that from now and again and I have the strength but it makes my flare up very bad. At this point i just want to be comfortable and try to find the solution. But it can be hard when the treatments hurt me and then the rest of the day I have to try to deal with that.
On Wednesday I have that appointment and I'm going to bring all of this up, I'm at the point where I'm done being nice and now am not take any crap from my doctor's. Mostly I want to find out what is causing it and what can be done to fix or alleviate the problem.
Thanks for all the help I'll write back after the appointment in a few days.
It's hard to manage and has been impossible with some situations. For instance when I have to lift over 150lbs. With my job I have to do that from now and again and I have the strength but it makes my flare up very bad. At this point i just want to be comfortable and try to find the solution. But it can be hard when the treatments hurt me and then the rest of the day I have to try to deal with that.
On Wednesday I have that appointment and I'm going to bring all of this up, I'm at the point where I'm done being nice and now am not take any crap from my doctor's. Mostly I want to find out what is causing it and what can be done to fix or alleviate the problem.
Thanks for all the help I'll write back after the appointment in a few days.
Hi Jake,
I am glad the info I provided has helped you. About 6 years ago, I was on only short acting opioids and life was so much harder for me. And before that life was even tougher as I was only taking Flexeril for pain. Every day that I made it through a full day at work was nothing short of a miracle. Every week I made it through was celebrated! I was heating my back with a heating pad that I had attached to my work chair for 8-9 hours each day such that I ended up with a permanent tan on my lower back. And the worst part was that every year that went by, my pain only got worse.
I was constanly lied to by doctors. One told me Tramadol was the strongest medication prescribable so I suffered many years on that medication thinking there was nothing else that could help me.
Finding support groups like this one online truly helped me gain the facts and knowledge I needed to fight for better pain management.
I hope your appointment went well on Wednesday and that you are enjoying a great start to the holiday weekend! When you have time, please post how you are doing.
femmy :)
I am glad the info I provided has helped you. About 6 years ago, I was on only short acting opioids and life was so much harder for me. And before that life was even tougher as I was only taking Flexeril for pain. Every day that I made it through a full day at work was nothing short of a miracle. Every week I made it through was celebrated! I was heating my back with a heating pad that I had attached to my work chair for 8-9 hours each day such that I ended up with a permanent tan on my lower back. And the worst part was that every year that went by, my pain only got worse.
I was constanly lied to by doctors. One told me Tramadol was the strongest medication prescribable so I suffered many years on that medication thinking there was nothing else that could help me.
Finding support groups like this one online truly helped me gain the facts and knowledge I needed to fight for better pain management.
I hope your appointment went well on Wednesday and that you are enjoying a great start to the holiday weekend! When you have time, please post how you are doing.
femmy :)
The appointment last Wednesday went ok I guess. Basically the doctor kept the vicodin dosage at 2 a day instead of lowering it to once daily.
After having to fight and fight with her. This Sunday that has just past (the 27th) was when my prescription was due to be refilled and I was told by doctor that a Urine Toxicology wasn't required, but when I went on Sunday the pharmacy said I had to and lab was closed. So on memorial day I went back and then the lab said the doctor hadn't put anything in so I could not do the test. I went around the hospital to the adult medicine and then the ER and also called the nurse desk to try to get a doctor to simply put it in the computer so I can go do the drug test and get my prescription and then leave but no one would do that for some reason. So now this morning I had to go to the pharmacy again and try to get them to tell my doctor to either put the paperwork in or take the hold off of the medication( at that point I just don't care & said I would take it to just save some time) And then they said it was off hold but the doctor had discontinued the medication so I couldn't pick it up. So After another two hour pharmacy visit it finally got put through and I am so furious at the moment. It's always something with Kaiser.
After having to fight and fight with her. This Sunday that has just past (the 27th) was when my prescription was due to be refilled and I was told by doctor that a Urine Toxicology wasn't required, but when I went on Sunday the pharmacy said I had to and lab was closed. So on memorial day I went back and then the lab said the doctor hadn't put anything in so I could not do the test. I went around the hospital to the adult medicine and then the ER and also called the nurse desk to try to get a doctor to simply put it in the computer so I can go do the drug test and get my prescription and then leave but no one would do that for some reason. So now this morning I had to go to the pharmacy again and try to get them to tell my doctor to either put the paperwork in or take the hold off of the medication( at that point I just don't care & said I would take it to just save some time) And then they said it was off hold but the doctor had discontinued the medication so I couldn't pick it up. So After another two hour pharmacy visit it finally got put through and I am so furious at the moment. It's always something with Kaiser.
Hi Jake,
You have got to be kidding me?!? I can't believe that they would put on such a dog and pony show over one vicodin prescription. If only you could see my doctor. When I tell him I still have pain for x duration at x times during the day and it is interferring with x activity he always offers to modify my dosages of the long acting and short acting medications. I haven't given in to the higher dosage of fentanyl that he wants me on because I am trying to determine if I can live with my current pain level as that is the goal. I know I won't be pain free so I try to stay on the lowest dosage where functionality is retained and additionally mobility for more energetic activities is possible through breakthrough medication.
Kaiser is making things so much harder than they should be! I have no issues picking up my patches and oxycodone at the pharmacy. The pharmacists are very kind and helpful. I live in Colorado and perhaps things are a little more liberal here due to medical marijuana but California also legalized medical marijuana so it is surprising to me that Kaiser is this strict out there. Things are on lockdown in Florida, Tennesse, and other southern states as well as Washington state right now due to a higher level of prescription drug abuse in those states. Getting good pain management out there is like finding a needle in a hay stack. Many pharmacies even stopped carrying opioids entirely! Pain patients are suffering immensely in these states.
What happened to the offer from the doctor to prescribe morphine extended release with oxycodone for breakthrough pain??? Two vicodin a day for the pain you are enduring is ridiculous especially after you told them they didn't help cover your pain throughout the day so that you can function and carry out everyday tasks.
I would definitely call member services and include this recent occurrence involving a refill of your vicodin prescription in the grievance file. You shouldn't have to jump through all these hoops just to fill a medication! People with hypertension may have a heart attack having to go through so much stress just to pick up their blood pressure medication. But see the difference is people picking up blood pressure medication don't have these issues because there aren't people out there abusing blood pressure medications to get high. We as chronic pain patients need to stop being treated this way. You weren't there trying to fill your script earlier than allowed. You were following all the rules and were still treated like a criminal...this should not happen!
I am so very sorry you are having to enduring this unfair treatment over and over again. This adds stress which can elevate the pain intensity and cause additional suffering. Patients no matter what is being treated...if the patients are truthful, respectful, responsible, and are following the rules, they should be treated with kindness and respect along with given medical support to help their condition(s). Doctors need to treat all conditions/diseases equally. Chronic pain is a disease that normally requires medical treatment.
Please keep us updated on this Kaiser madness that is going on. Continue to pursue better management and know that what Kaiser is dishing out, is not how things should be handled.
femmy
You have got to be kidding me?!? I can't believe that they would put on such a dog and pony show over one vicodin prescription. If only you could see my doctor. When I tell him I still have pain for x duration at x times during the day and it is interferring with x activity he always offers to modify my dosages of the long acting and short acting medications. I haven't given in to the higher dosage of fentanyl that he wants me on because I am trying to determine if I can live with my current pain level as that is the goal. I know I won't be pain free so I try to stay on the lowest dosage where functionality is retained and additionally mobility for more energetic activities is possible through breakthrough medication.
Kaiser is making things so much harder than they should be! I have no issues picking up my patches and oxycodone at the pharmacy. The pharmacists are very kind and helpful. I live in Colorado and perhaps things are a little more liberal here due to medical marijuana but California also legalized medical marijuana so it is surprising to me that Kaiser is this strict out there. Things are on lockdown in Florida, Tennesse, and other southern states as well as Washington state right now due to a higher level of prescription drug abuse in those states. Getting good pain management out there is like finding a needle in a hay stack. Many pharmacies even stopped carrying opioids entirely! Pain patients are suffering immensely in these states.
What happened to the offer from the doctor to prescribe morphine extended release with oxycodone for breakthrough pain??? Two vicodin a day for the pain you are enduring is ridiculous especially after you told them they didn't help cover your pain throughout the day so that you can function and carry out everyday tasks.
I would definitely call member services and include this recent occurrence involving a refill of your vicodin prescription in the grievance file. You shouldn't have to jump through all these hoops just to fill a medication! People with hypertension may have a heart attack having to go through so much stress just to pick up their blood pressure medication. But see the difference is people picking up blood pressure medication don't have these issues because there aren't people out there abusing blood pressure medications to get high. We as chronic pain patients need to stop being treated this way. You weren't there trying to fill your script earlier than allowed. You were following all the rules and were still treated like a criminal...this should not happen!
I am so very sorry you are having to enduring this unfair treatment over and over again. This adds stress which can elevate the pain intensity and cause additional suffering. Patients no matter what is being treated...if the patients are truthful, respectful, responsible, and are following the rules, they should be treated with kindness and respect along with given medical support to help their condition(s). Doctors need to treat all conditions/diseases equally. Chronic pain is a disease that normally requires medical treatment.
Please keep us updated on this Kaiser madness that is going on. Continue to pursue better management and know that what Kaiser is dishing out, is not how things should be handled.
femmy
Have an Answer?
You are reading content posted in the Pain Management Community
Find out how beta-blocker eye drops show promising results for acute migraine relief.
Could it be something you ate? Lack of sleep? Here are 11 migraine triggers to look out for.
Find out if PRP therapy right for you.
Tips for preventing one of the most common types of knee injury.
Here are 10 ways to stop headaches before they start.
Tips and moves to ease backaches
