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.

[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.