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.

[TrayCee]

I stand corrected.

I just read the "patient abandonment law".

However...in the time it takes to find an attornney who is willing to take a malpractice claim, file the papers....you could be dead

[pattisun]

Hello all---(the lady who's doctor refuses to call me....

It is ME again. I'll recap. There is a pain management group at Univ. Cal. where I get shot full of steriods (yeah, they freak out over some Vicodin but I get shot up with steroids every 10 weeks). I have spinal stenosis and severe nerve impingement down my legs. Plus some other conditions that are painful.

My pain doctors (who don't prescribe because they are short-staffed) decided I should take Fentanyl patch vs. Vicodin. I was at 25 mcg + 12 mcg Fent. patch per day. Doctor raised my Vicodin (I think I had Lortab 750/500) to Norco (1000/500). About two month later the pain doctors decided since I was still taking 3-4 vicodin per day that I should have a stronger patch. They sent my primary doctor an electronic note saying I should increase patch to 50 mcg and not have more than 2 vicodin per day. (I should also note I had gastric bypass surgery and I believe it may affect how I metabolize any pain pills.) OKAY== I hated the 50 mcg patches. One brand would not stay on (my doctor said just tape all over it==not supposed to do that); the other brand was bigger and it stayed on but my upper back broke out in rashes. I visited my doctor each month (my own idea to see her, she only requires I see her every three months) and complained about this. After meeting with the pain doctors (october) specifically for pain medication I explained I wanted OFF the Fentanyl 50 mcg. Their answer was take Kadian three times a day (because of my bypass surgery) and stay on the Vicodin until I get my pain controlled. I saw my current doctor Oct 29 and told her I didn't want to take morphine, it makes me nauseated and I think its a nasty drug for my system (been in the hospital a lot and thats their drug shot of choice).  AND I asked her why is it okay for me to pop morphine three times a day but not Vicodin? She put me on my old Fentanyl 12 + 25 mcg patches. I started on that and have not had problems with the patches staying on and got continuous relief. Since I started the patches Oct. 29 my vicodin use went from 4-5 a day down to 3. She prescribes my Vicodin with 60 and 2 refills. On Monday when I requested a refill on the Norco she must have done the math and got really pissed that I was taking too much Vicodin. (RX says take one tablet every 6 hours) I don't think she believed me that I could not keep the 50 mcg patches on.

So after I posted this morning I called the administrators at UCSD. The lady said "no, your doctor is not mad at you"--I asked how does she know? I asked her to go into my chart and read the nasty notes about me. I did cry for a second while I was talking to her---i just feel like I am being punished and I also feel like a big time drug addict. She insisted everything was fine. I KNOW that they called down to my doctors office and let them know I called.

This afternoon I got a message from my nurse who said the doctor does not want me to take 4 Norco a day along with the Fentanyl patch and she'd like to talk to me. BUT no refills are being given. My appointment is not until December 2.

SO...I am just not taking Norco anymore and have been crying and in sometimes severe pain. I guess it may be withdrawal or maybe the patches don't have quite enough pain control. This *****....  THANKS for listening.

[bmdad]

If you are still having quite a bit of pain maybe you could try and get in to your doctor a bit sooner. I would call and let them know how much pain you are in. More than likely the secretary will have a nurse call you back. Just let them know that with the pain you are having December 3rd is just too far out. Ask what you should do in the meantime for pain relief. You could also ask the scheduling department or the secretary to make a note and if anyone else cancels their appointment to give you a call as you need to be seen asap. I also suffer with chronic back pain from scar tissue hitting my sciatic nerve from a previous surgery, spinal stenosis, and arthritis in my back so I know how difficult it can be to live with pain. I pray that you can get in there sooner and get your pain properly controlled. One thing that really does help is to take hot baths as hot as you can stand. It really helps relax the back and the rest of your body. Also ibuprofen does help a bit. Try heat or cold on the areas you are having pain as our bodies react differently to each. Best of luck and hang in there! Let us know how it goes.
Brian

[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.

[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.

[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  :-)