What if your doctor refuses to talk to you?

[pattisun]

I have severe pain and have been taking a number of pain meds for almost ten years now. I also had gastric RNY bypass and this limits what pain meds I can take and I believe it affects how my meds are absorbed and metabolized.

My pain doctors (who just give me steroid shots) do not prescribe meds. They want my primary doctor to do that. I was increased to 50 mcg of Fentanyl with vicodin for breakthrough (my pain doctors suggestion). I went to my doctor every four weeks complaining the Fentanyl patches would not stay on and the side effects were not worth it. I wanted less Fentanyl and weaker vicodin (she had changed me to Norco--wanting me to only take 2 per day). This last visit 2 weeks ago I finally got back on a weaker Fentanyl patch and I am doing much better. I decreased my Norco from 4-5 day down to 3. When I went to refill my RX for Norco my doctor refused it. They will not answer my calls and I guess I no longer have a doctor.

I am fine not taking Vicodin--but I have pain so I did take ibuprofen. I am not supposed to take that because of my bypass surgery.

Anyone get kicked out of their medical group? I am not worried about Vicodin withdrawal I'm sure I can get through that---but what about Fentanyl withdrawal? How to I find a new doctor without looking like some crazed druggie? I think I should never take vicodin again. I've taken all the other types of pain meds (like Ultram and Neurontin, etc.) prior to Vicodin (I refused percoset, Oxy, and morphine-Kadian).

How/where do I find a doctor that will understand my needs and believe that I have no interest in getting "stoned" just would prefer to stay active and have my pain decreased.

[413deedee]

I believe you. My pain doctor when I had one. And why I don't is bs another story Prescribed me oxycontin along with Vicodin for breakthrough pain. My insurance would not cover the oxycontin so I gave back the script and asked if they could just give me more of the Vicodin. they refused. I was like why not. aren't the oxycontin more potent then the Vicodin like why do you have a problem giving me more Vicodin when you were willing to give me oxycontins. I still don't know the answer to this.

[philnoir]

Mad Man,

Great advice. Thanks.

[TheMadMan]

When you lose confidence in a doctor who cannot or will not give you answers, its time to move on to another caring doctor. Doctors can be callous when they see so many pain patients. A pill is the simple answer but getting to the route of the problems is where the answer lies. Understand you diagnosis and ask about other options. If the doctor cannot give any, that is another sign to move on.
I have been to many a doctor (hundreds) and not for pain medication. I do not want the pain medication. I want to know if there is any procedure out there can can help me with my medical problem, not a pill.
I had one doctor who recommended me for a spinal cord stimulator. I completed the psychological evaluation but upon returning to the doctor, she 'decided' I was not a candidate for an SCS because she did not want to be 'married' to any complications from this procedure. She was cold and callous about her answer and then told me that she did not think the SCS procedure would help me but she had no problems giving me morphine.
In my case morphine does not help because my nerves are affected and morphine does not work on the nerves, just the symptoms. Again, I went to another doctor.
When you cannot get your questions answered with confidence and a clear explanation of your medical problem, that should be a clue that the doctor has become complacent in their care of your case.  
I went to a sport medicine doctor who would give me shots but never tell me what the shots were. I read the consent form and found they were giving me steroid shots which I cannot have due to degenerative joint/disk disease and the steroid shots only exacerbate my bone deterioration. This doctor would never talk to me about what he was giving me. I then read my MediCare bill and found he was 'overcharging' for these shots. I reported him to Medicare.
Learn to speak up and do not fear a doctor. Any doctor worth his salt will explain you health issues, side effects and possible treatment options even if they cannot do these treatment options. Research your medical condition and KNOW what options are out there and what a doctor can and cannot do for you besides 'pad the bill'. Take control of what you know and find a doctor who is willing to understand and listen. They are out there but the education starts with you and what you know and what the doctor can do for you. IF THERE IS ANY DOUBT ABOUT YOUR CARE, MOVE ON TO ANOTHER DOCTOR. There are real doctors out there that will take the time to help you understand what is happening to your body. When you learn about what is happening about your body, you can talk to a doctor that is willing to listen so stay vigilant and educate yourself.
This is a hard road to go down but worth the investment when you and your doctor understand and are on the same page.

[cousinjill]

I don't know if anyone can answer this but I will try and explain as briefly as I can.  My neice is 38 years old married with 2 children.She was addicted to pain meds after an accident and has been struggling on and off of this for a while. She was charged at one time with a forged prescription but doctor didn't press charges.  Anyway she now has cancer and went to a doctor to get chemo pills and he told her she was red flagged and could not give them to her.  Her mom is devastated because they claim someone is filling prescriptions all over in her name and when she went to fill the
prescription that she had they denied it. She has told the pharmacy to ask for id , call the doctor to verify the prescription and if it isn't her to call the police and have them arrested.  Sometimes you don't know what to believe but the cancer is in her spine, thyroid and kidney.  When they called me to come and talk to them I felt sorry for her mom and dad (my brother) and said I would try to find out.  Instead of dismissing her why wouldn't the doctor offer some suggestions on how to he could get treatment for her?

[TheMadMan]

Please get a copy of your med notes and any related information. You can present this to the hospital director/chief of staff or someone in AUTHORITY. Get everything in writing!
This LACK OF CARE and fear on the doctors part is not called for but needs to be addressed and you are the part of the grease that gets this wheel turning. Do not tolerate this! I had a doctor tell me that the shots he was giving me was his 'Charity Work' and this was reported to the hospital director AND chief of staff. I am now working with the chief of staff to correct these problems and make the hospital aware of the attitude these doctors carry when dealing with patients. Take a stand, it is worth your time when you can trust someone! Get your medical notes, hospital history and procedure history and anything that relates to your care. You can then present this to another doctor to show the lack of care and what you need for medical treatment and what has NOT been done. There are still SOME doctors out there that actually care but that research is on you, so be diligent and research. I have been to hundreds of doctors and still seek treatment when their is a lack of care. I get copies, report them and then move on. Not to show I am a crank, but to show I am not looking for the drugs, but actually treatment for my condition. Keeping your self educated with help with the fear and it creates a learning process in what you discover.

[susan1028858]

Pain Management Centers are a joke, they want to get you in there and hooked on these highly addictive patches. I am having this issue now and I am in the HealthCare Profession. Sadly when you try to talk to them they will refuse to see you and say you are noncompliant. I am going to seek my options with an attorney, I had to loose all my teeth due to being on the patch, my teeth were infected and I never knew it because the patch killed the pain, what should have been a cavity turned into dentures. Doctors are scared to prescribe pain pills due to the country being so pain pill crazy, there are people that need pain meds, these patches are dangerous and these pain management centers are a joke, they push injections on you and if you dont want to take them they dont want to treat you. Its sad, but I  am going to contact the medical board about my doctor today. These patches help some, hurt many, many others. Dont go to pain management centers, they are in it just for the money.

[Jon2111]

I sent in my regualr refill to my Doctor on a Tuesday explaining we were going away (family) on Satudrday, I know for sure he was open. He ignored three faxes for the request. I have been on the medication for almost five years and go through this every month with him. The drug store said they could set up my meidcation so it would be ready every thirty days and the doctor refuses to take part.  We have since cancellled our vacation and on Monday I will be down his throat and put the fear of god in him.This will be my last appointment for cure with this idiot with an ego on a power trip.  What an arrrogant embarrassment to his profession.. Perhaps he should read the oath he took when he became a Doctor? I have chronic pain which makes his ignorance even more magnified. I am currently looking for a new Doctor,then reporting him and then suing him. I have the money so I am going make it a point to ensure his career is over the legal way. No one should ever have to endure the abuse I have been through..

[Weathergirl21]

Just FYI...this post is from 2008.....

So if you have specific thoughts or need help with your chronic pain...starting a new thread is best...

I don't know of any law that prevents a Dr. from dismissing someone from their practice....

When dealing with opiates...most Dr.s are now having their patients sign contracts that explicity state that if someone does not follow all the rules they will be dismissed...

But Dr.s can leave their practice...shut down....or decide that they no longer can treat you properly and dismiss you.

Proving actual 'neglect' from a Dr. is very difficult and usually doesn't happen...

When dealing with opiates....there is usually more to a story and a reason why a Dr. stops prescribing suddenly...

[Abbyinokc]

A doctor in Oklahoma CANNOT just fire you or stop seeing you.  Our laws state:  Generally speaking, a physician must continue to provide services as long as the case requires it.

Unlike a patient, who may lawfully terminate the physician-patient relationship at any time, a physician may withdraw before the need for his or her services is at an end only after giving the patient prior notice. That notice must afford the patient ample opportunity to secure another equally competent physician prior to the withdrawal.  

Check with each state's medical board for help with the LAWS about patient dumping!

[debbiedoeshair78]

Thursday morning, i was getting ready for work when pain hit my chest and neck, almost brought me to my knees. i have severe COPD but keep on working for fear that if i become docile, i will wilt away, not my style. i was whisked away to the county hospital by my fiance and was took directly to the back for an EKG. Hmmm, nothing there. so, next step is to talk to these drs to see if there was possibly another answer. about three months ago, i had been in the same hospital to get a cat scan with dye, surprisingly i remembered that my personal physician told me that in this pic, you could see the diverticulitis flair-up, so i told the dr from this group and sure enough it also showed a hiatal hernia (classic heart attack symptoms) in the meantime, my COPD is giving me a run for my money and i am having panic attacks, asthma attacks, dizzy, etc.....you name it..i was a mess.. i now weigh 100 lbs more than i did a year ago from all the Prednisone, despite all my efforts, it will not budge. so, i was in the hospital for 9 days, and had a cardiology group from Jacksonville who did extensive testing on me, but found nothing, so they signed off on me. great people. now i am left with a doctor who calls himself a lung specialist, only has no degree as to such. i asked him about my condition and all he told me was :be patient (as he walked away.)  now i'm scared. about a year ago, there was a spot discovered on my lung, but no one ever did anything about it, so i asked him if there was a way to tell what this was...again. be patient. WHAT? is this all you have to say. as far as the other dr goes, the one from the internist, i was on flagile i.v.s, along with Prilosec and Nexium, and who knows what all else. the amount of i.v. steroids that i was being given was so high that it could not be reduced to pill for in order to turn me loose to go home. so, on the 9th day, Dr. "Be Patient" came in and said, ready to go home? not another word, no further instructions other than that i have severe emphyzema
(Really, knew that), then it was the other dr.s turn to maybe make this right. well, he refused to talk to me at all, with no further prescriptions, no explaination as to what my prognosis was, no nothing. i left the hospital feeling totally empty inside, like someone had stolen 9 days of my life. i went straight to my drs office and she gave me enough steroids till i go in on monday 8a.m. what the heck, you recon? can they really just stop treating you, kick you out and refuse to talk to you? do i have grounds to sue these people? help, i need a serious answer, please!
    

[TrayCee]

In PM you MUST keep ALL appts.  Or risk being discharged

So sorry about the situation you find youself in.... This is my NIGHTMARE that this could happent to anyone at anytime for any/no reason
good luck!!

[ddllpn]

My cousin goes to a pain management doctor who has continuously increased her dosage of methadone until now she is getting 480 tabs per month, He has suggested epidurals as well as a visit with a neurologist (the apt has been made and is May 21st). It is believed she will need back surgery.
She has one epidural and did have some relief with it but on the date of the 2nd scheduled epidural she cancelled because she was sick and the same for the 3rd scheduled epidural. She has irritable bowel syndrome and I think she gets herself all worked up over getting the epidurals that she cant get off the toilet.
Anyway, she just got off the phone with her pain mgmt. doctors office who said they will no longer treat her because she cancelled 2 epidurals and they said this means she is abusing her pain meds.(?)
They have left her to go "cold turkey" and I am hoping someone out there can help us to find a way to have the doctor be understanding that he cant prescribe meds of that quantity and then stop it cold turkey. She made the neurologist appt as requested and did have the one epidural so she is trying..., Any suggestions? Thanks, Debbie

[Dshell]

You are so right. As soon as you get on area under control it seems to give another area of your life permission to fall apart.  I hope you can get your meds soon and appropriate your awesome attitude!  The hunt for quality care continues.

:)

[pattisun]

Hey Dshell I agree there are MANY uncaring (or just have GIANT egos) doctors out there!! You have to be your own health advocate which sites like this one tell you to do. I worry about the elderly and the severely disabled that don't have anybody to fight for them--they may get pushed around! I faced my primary doctor (internist) in January after I'd been off my pain meds (except patches) for over a month. I apologized to her in case she had thought I was trying to get extra pain pills---that I was aware that people get high and/or sell their meds and that with the current publicity on prescription meds that I may have put her in a position to get into trouble. At first she laughed and said that was not her thought but by the end of our visit she was appreciative of my attitude (I also told her I would see her every month until we get my pain pill/patch usage at a livable point for both of us). At this moment we are at a happy place but I know that can change.

She prescribed some NSAID cream/gel but I can't afford to get that and I just found out I have an ulcer starting probably from taking NSAIDS when my pain meds don't work (I had RNY gastic bypass) But even though I can't afford to pick up my paid meds this until next month at least I am at a good place with my doctor. Life is like that, you get one thing straight and the other things (like my income) fall apart! haha

In regards to Rheumatologists---I had ONE nice Rheumie that I've met. The other ones I've met have been very arrogant, telling me to get a hobby and take depression meds. My best care has been with my internist. But I am on my fifth internist because my other good doctors have left to go into executive (expensive) healthcare. Oh well....KEEPING QUALITY OF LIFE while in constant pain requires a positive attitude (not always possible for us) and a determination to FIND A GOOD DOCTOR that will listen to us (easier said than done).  Best wishes to all

[Dshell]

Doctor have been made so afraid of narcotics they sometimes forget their empathy button.  I lost my insurance and now go to the county clinic for my primary but thankfully have been able to keep my pain management clinic. However, I lost all of my sub-specialties. I live in a smallish Northern California town with 2 Rummys in the same practice who make you sign a waver that if you see one you cannot be seen by the other.  My Rummy and had a disagreement when he told my to get a positive attitude and a hobby and I would feel fine.  

However, my rheumatological issues have worsened and I had no choice but to try to seen said hated Rummy though the county program.  The Rummy denied the referral due to a $10.00 pending balance.  I paid the balance today but he still will not see me.  My GP is going to try to refer me to UC Davis, which is a good thing.  I just wanted to point out there are many uncaring doctors out there and it is our right to be heard and taken seriously.

[pattisun]

Did you ever try one of the over the counter drug tests that parents give their teenagers? See if you get a positive...Maybe something in your body chemistry or some other type of medication causes a false positive.  Have you tried a community hospital or tried going to a doctor in another city/'county?

I had a problem with my doctor about 9 years ago--my old doc left and new one refused to prescribe Klonopin (long-acting Xanax)--I had to go to a psychiatrist to get my Klonopin and he wrote a long explanation to my new doct as to why my current meds were effective and I should stay on them. That really made her mad. Then I got into an accident and was injured. Things got worse with this doctor, always accusing me of lying or exaggerating to get stoned?? (on SSRIs???)---anyway I changed medical groups/hospitals and started all over again. After about five years I went back to another doctor at my original medical group. They did not connect me with my old records and I lived happily ever after..... (BTW, when they Subpoenaed my old medical records for the lawsuit for my accident I think my old doct. kept my records at her house because they have long since linked all old records and the ones when I was visiting her are long gone).... hmmmmm

GOOD LUCK

[sandee1818]

Samson1,
I would get a new doctor right away. There are some major problems with the urine test and many people have been left with no recourse. I would be up front and honest with your new doctor and explain that you were so outraged at the test results that you requested another test be done. Since you did request the second test it will look much better in your records. These test are not infallible and doctors do realize this.
Look for a pain management doctor in your area and make an appointment. It may take a few appointments to build trust but do not give up and live in pain:)

[igarfy]

Get another doctor

[samson1]

i had been on oxycodone hcl 15 mg tabs for years. I had been on fentanal and other stronger pain meds tha I felt were to strong or the patch would not stay on. In june of 09 my doctor stated that my last urine test indicated that I had taken a drug called dalodin which  I denined taking never had taken and didn't need to take because the pain meds she was giving me were strong enough. She informed me the test had been ran twice and the results were the same and if it happened again she would have to cut my pain medication off. In augest of 09 I was in her office for a routine check up and requested a urine test because I knew for a fact I had done no other types of pain killers at anytime and wanted to show that I had nothing in my system but what was perscribed to me. She reluctantly gave me the test and I left her office on augest 24th 09 I recieved a letter from her stating my last urine test showed drugs in my system she had not perscribed and would do anything else for me but perscrib pain killers for me again. On the same day I was involved in a serious auto accident. I was bed ridden for months with no pain medication. To this day I suffer everyday with out any pain medication because I fear asking another doctor to help me because I fear she red flagged by records. I need the medication for my back knee arm  neck and joint pain. I can not be operated on to repair the areas because of my lung condition and doctors are afarid I will not come out from under the aantistesaa after the operations. I take other medications for my heart which prevents me from taking over the counter paain killers like asprin, ibprophin tyanol etc. With out my pain medication most days I can't get out of bed and my weight keeps climbing. At one time with my pain under control with the oxycodone I had lost 150 lbs could get up and be fairly active to spite my lung condition what can I do can anyone tell me ?

[NoMoMeth4me]

I am also a LAP GBP patient and it was two years for me in September 2009. I have often wondered how my Endocet's are absorbed now?

As for Fentanyl, it has worked wonders for me since I started it about six months ago.

I lost about three patches in the early days and even called Sandoz as I was told they supply free medical tape which isn't true by the way.

I got a tip from another member here so here goes. It works WONDERS for me now!!!

Get the 'weed wacker' out and do some yard work downstairs of you catch my drift here??

DON"T shave but trim closely your pubic area and apply each patch slight off midline of your body. Your underpants will actually help to keep the patch on and in place and that part of your body usually stays relatively straight all the time.

Don't give up on Fentanyl yet, give this a try and let me know how it works for you.
Trust me, I was ready to dump the patches and try something elase until I found out about this method I use Endocet 10/324ng 1 every 12 hours as needed.

All the best.

-Brian.

[bmdad]

You are right about your doctor just looking out for your best interest. It really just shows that she cares and doesn't want you to hurt yourself by taking too many pills. I know you weren't taking too many as at the time your patches we not sticking. Anytime someone tries to call in a refill early the doctor is going to question it just to be on the safe side.
When you go to your doctor maybe try and work out a different pain med protocol if what you are using is not working. Are there more than one brand of fentynal? I know with other medications they may be different from one pharmacy to another. I wonder if you tried a different brand of the 50 mcg patches if they would stick better? There are also many different type of time released pain meds out there. I know you said that morphine doesn't work and most pain meds are derived from morphine so your choices may be limited.
Just be upfront and voice your concerns about your pain relief. I would also bring up the fact again that the reason you ran out of the vicodin was because your patches were not sticking. Tell her you are sorry for not following the prescribed dose and now realize you should have called and talked to them about your dosing options first. The more honest you are with your doctor the more your she will trust you and in turn will help you find a med regimen that will suit your needs.
Be sure to write down all questions to ask and comments that you plan on making to her. Keep us informed and best of luck with all!
Hope you have a great early Thanksgiving with your family!
I'll be checking the mail for my plate of early Thanksgiving dinner!!!!!

Brian

[pattisun]

Thanks for your support. As far as my bypass surgery they cut me at the Duodenal? or something like that. I cannot absorb enough calcium, iron, B12, etc. I have to go the hospital and get iron infusions, sometimes blood, and my vitamins need to be liquid, quick absorb (Iike under the tongue) or else I don't absorb them. (bad surgery!!). So, I have no idea if this affects pain pill metabolism?

The bigger Fent. patches did not stay on longer than about 6=8 hours. I'd tape it all around the edges after that but it didn't stay flat on my skin and would eventually fall all. So I'd go 2 days in that situation and then put a new on one. So--I was taking 3-5 vicodin/day during the 8 weeks of those patches.  I went to my doctor twice and explained this but I don't thing she believed me. And, my Fent. patches have a big DO TO TAPE over patch warning. (I promise!!) I tried to get the pharmacy to order a clear dressing patch that I could put on but they couldn't find any to order. They use them at the infusion center to cover your ivs. BUT, when my doctor finally got me back to the tiny 12 & 25 patches 3 weeks ago I got continuous pain relief and only needed 3 vicodin per day. Because of my prior problems with the patches I did try to refill my vics too soon and she cut me off. I'm not blaming my doctor, for all she knows I was selling them or getting high (but, again, I don't get a high/good feeling from pain meds since my surgery, everything has changed). And she is looking out for my interest and her liability. I like your idea---I intend to tell the pain doctors that their "advice" on my medications has made for a bumpy relationship with my PCP!!

I am doing fine with no vicodin (like no withdrawal symptoms) but the pain level is at times REAL high and burns like crazy. I am going to try the hot bath. I have foam matress pad, heating pads, massage chair, aspirin cream, and lidoderm patches. They all help. I have taken a few advil but I am NOT supposed to take anything like that because of that surgery I had.

Living with constant pain is such a chore. Only a group like this would understand. It's nice to have people to talk to. Most of the time I stay positive and only my husband and sons understand what kind of pain I live with. None of my friends/family know or could they really understand....  

I'm cooking Turkey today (early Thanksgiving for my NYC family that flew in)!! Have a great day.

pattisun in Sunny San Diego  :-)  

[Tuckamore]

Thank you for explaining your situation. I am glad that you called the administrators. It was the right thing to do and at least now you have the reasons for the denial in the refill. I know that doesn't make the pain any easier to deal with but knowing what you are facing can help you cope and hopefully rectify the situation..

I lost over 3 feet of my small intestine, the important portion where nutrients and some medications are absorbed. Gastric by-pass is similar but should not effect the vicodin or morphine absorption.

I agree with Brian, call the nurse back and request a sooner appt, explaining your high levels of pain. Sometimes you can be placed on the cancellation list, meaning if someone cancels they call you to fill the appt time.

Dealing with two physicians for pain medication is a tricky situation. Do you have to see the PMP? Can you just stay with your PCP? If so I suggest that you do so. It sounds like since they became involved you have had more problems.

According to my physican and pharmacist it is ok to tape the fentanyl patch. I don't know who told you that it was not acceptable. Actually the manufacturer will send you a specific type of tape like material to apply over the patch if you request it.  

I am sorry that you have not resolved this issue as of yet. Brian is also correct that IB can help with some of the pain, provided it is not contraindicated. Please keep in touch. Let us know how you are doing.

[bmdad]

One more quick question....you said you got 60 vicodin at a time and were to take 1 every 6 hours. Are those 60 suppose to last you 15 days? Did you run out early and try to get a refill sooner than when it normally would have been called in? If so, this could be the reason the doctor didn't want you taking them as she may have thought you were abusing them or just concerned on the amount of pain meds you were on. It does sound like she wants to see you so you can find something that works that you both feel comfortable with.