What should I do?

[pmcmen1019]

I have been going to my primary physician for over 2 years and she has been prescribing methadone for my chronic back and nerve pain. The last time I was there she took a urine test. I had taken percocets that were prescribed by my other doctor before I started. seeing her. It showed up in my urine test and I got a letter saying that I was being discharged from the practice. This was the first time this has happened and I wasn'.t given a chance to explain. The letter also said they would inform my new doctor about why I was discharged. Can they do that? Any help would be appreciated. Thank You.

[mellie4]

I hope you hear from them today.  And good luck with the Neuronton.  Some people get tremendous help with it.  (And others get a lot of relief with Lyrica, if you haven't tried that.)

[pmcmen1019]

That is my problem also, the nerve pain. It's so severe in my left leg that I can't walk. The methadone takes it completely away. I don't have a problem with side effects and I was thinking about trying Neurontin if I can't get anyone to write the methadone. I also asked one of the nurses at work that I can trust to see if she knows anyone. I never got a call back after the first one yesterday so I am going to make one more attempt today

[mellie4]

Good luck with calling the first doctor.  Maybe he'll be willing to do the methadone if you explain to him how it helps your nerve pain.  I have nerve pain and have found that though the narcotics will help some of my pain, the nerve pain is tough to treat.  I'm using Neurontin and not sure how helpful it is, though I'm on a low dose and it will be adjusted up slowly.  I'm somewhat sensitive to a lot of medications and get a lot of side effects, so it's been a quest for me.  They did suggest methadone for me a while ago, but I was a bit afraid of it.  I don't like taking pills and have a love/hate relationship with pain meds.  I tend to try to take medication holidays and see where my pain is at and I think that would be impossible with the methadone.

Even if a letter won't do any good, at least it will be in your file.  And she should be called out on not having the decency to at least talk to you in person.  I could see if it was repeated breaches of things or if you didn't have a relationship and were new to the practice.  I would expect much more from my doctors.  I know they have a hard time and have to be extremely accountable, but personally I think their responsibility is to the patient.

Good luck with the search!

[pmcmen1019]

I agree that is ignorant of her not to talk to me or tell me to my face that she is dismissing me. Since she didn't return my phone call I doubt a letter will do any good. She wrote in the letter that the decision will not be reversed for any reason. I am going to go back to the doctor that originally prescribed the percocet. He was my doctor for many years and was also my doctor when I first got hurt in 2006. He told me then that he did not like to write for methadone and he had 2 patients that were on it. He knows where I work and what I do for a living. If I explain to him that I can't work without the medicine and that it works so well for me he might write it for me or steer me towards someone who will do it.

[mellie4]

Keep trying to find other doctors, and maybe write a letter to the doctor that dismissed you.  This could take you some time and as we all know, time flies.  I might make another couple of phone calls, as well.  Even if they say know, I think it's ignorant to not give you the courtesy of a phone call or an exit appointment after 2 years!

[pmcmen1019]

Hi Val,

I live near Philly. York is a 2 hour ride down the turnpike for me. I drive 45 minutes to the doctor I was at so I would consider it if I can't find anyone around here. Could you email me the information? ***@****. and thanks!

[Val_123]

If your close to York, PA there is Dr Bruce Klaskin (office in Hanover too) and I know of a Dr. Loucks across from West Manchester Mall in York.

[pmcmen1019]

Hi,

I called her this morning and she never called back so it doesn't look good. Yes they were old and they were from a doctor that I was seeing before her so since they were prescribed for me I didn't think it would be such a big deal. The methadone takes the nerve pain away so I can work and live a normal life, I have already been to pain management and my insurance might look at this as pre existing so I don't know if they would pay for it. Thanks for responding.

[Ghilly]

If she agrees to meet with you, I would just plead ignorance and tell her that since you already had the other pills in your possession, you did not think of it as obtaining medication from another source.  The sad thing is, if the percocets were from a doctor that you were seeing BEFORE you started going to this one, and you've been going to this one for two years already, chances are the percocets weren't even good by this time.  So you jeopardized your relationship with your doctor for pills that were nowhere near full strength by this time.  They would still show up in a urine test, but if they can from a doctor that you haven't seen in two years, there is no way they were still within their usable date.

Just SWEAR to her that you won't take so much as an ibuprofen without calling her office first to make sure it's OK, and you might even agree to submit to spur of the moment drug tests for a while to prove to her that you are good at your word.  

It's a shame it has to be this way for people with legitimate pain, but the street druggies have put us in this predicament so now we have to deal with it.  Good luck!  I hope everything works out for you!

Ghilly

[pmcmen1019]

Hi melle,

I did call the doctor to ask for a second chance. I had gone for a scheduled appointment and was greeted with a letter and 2 months worth of prescriptions. As for the narcotic contract yes I did sign one but I told her I would be more then willing to be retested on the urine. I just have to wait until she calls me back. As far as my job goes they don't know that I take methadone and I am not sure I want them to know because the place is full of gossiping people. Hope she calls me back'

[mellie4]

I think it's definitely worth a shot to try calling the doctor.  Did you ever sign a pain contract?  If you didn't, it may be a bit easier.  Explain how it happened, whether you didn't understand about getting other medications for a different reason for someone else.

I'm not suggesting you're an addict.  But there's little difference in the physical aspects of dependency versus addiction, which is why I suggested the Substance Abuse Forum.  There's great information there, even for pain patients.  I think anyone who has to take a narcotic for pain management needs to be aware of the issues with addiction; both in the possibility of it for ourselves (even if unlikely) and also because when people abuse their medications, it causes problems for legitimate pain patients to sometimes get proper pain management.

I have experienced the physical withdrawals of oxycodone due to some stomach issues on two separate occasions and also once when my prescription wasn't mailed out on time.  When it wasn't mailed out on time, I didn't realize at first I was physically dependent.  It came before things got too bad for me.  The other two times though were pretty bad for me.  I just don't want to see you caught off guard.  You're probably already aware of all of the pros and cons of methadone.

If that is what works for your pain and enables you to work and participate in life, then you need to really find someone who can write the script for you.  I would call your doctor's office and ask for an appointment so you can discuss what happened.  If they refuse, you could still write to the doctor and explain things and ask for another chance.  In the meantime, ask anyone who may be able to direct you to another physician.  Are there any healthcare professionals that can steer you in the right direction in your work as a CNA??

I hope you'll keep posting on what's happening with you, and I really hope you find a solution.

[pmcmen1019]

Hi Mellie,

Thanks for responding. I am in PA and any doctor here can write a prescription for methadone. She gave me 2 more prescriptions so I have a little time. I am a CNA and without my meds I can't walk because I have 3 pinched nerves in my left leg. If I go off the meds I will have to leave my job and go on SSD. I have never been a problem in the 2 years I have been there. It is hard to find someone who prescribes methadone. I was thinking about calling the doctor and asking for another chance since I am a caregiver myself and I have never caused a problem..

[mellie4]

You're in a tough spot and you need to work on things as soon as possible.  I'm not sure where you are but I know in MA only certain doctors will prescribe methadone.  Methadone is very hard to withdraw from.  Try talking to your doctor and see if they will taper you down.  Even with a taper it can be difficult.  I'm not sure what dose you're at but ideally, the taper should be very gradual.

I would suggest you also post on the Substance Abuse Forum.  There is a man on there (gnarly_1) who has a lot of experience with methadone and it's withdrawals.  He's helped a lot of people work through it.  There are some things that you can do to help with the withdrawals, but it will be hard.

You'll still have to figure out how to deal with your back pain.  You could have a really tough time finding a doctor after being discharged.  They can and often do discharge patients if the urine test shows something they're not supposed to be on or even if it shows nothing.

Generally with pain management programs the agreement is you will not get any other medication from any other doctor.  Did  you sign a pain management agreement with your doctor?

Unfortunately, you don't have a lot of time on your side.  Methadone has a long half-life so you won't feel withdrawals immediately but they will hit you.  Would the doctor who prescribed the percocet be able to help you wean off the methadone?

You could also try to see if there's a methadone clinic that will work with you.  A suboxone program may also help you.

I've never been on methadone for my pain, though it was suggested at one time.  After the research I did, I felt it wasn't for me.  It has helped others, though.

Whether you're addicted or just physically dependent, I don't know.  At this point, though, either way you will have to deal with the withdrawal of the methadone.  It is really important to stay hydrated.  Drink plenty of Gatoraide, apple juice, water, clear broths, etc.  Eat what you can tolerate.  I would really urge you to post over on the Substance Abuse forum regardless of whether you feel you're addicted or not.  There are people there who have been in the same boat and you'll find a lot of support and suggestions.

I hope you'll keep us posted on how this goes for you.  If the withdrawals get too severe, you can go to an ER.  They will probably not give you any narcotics due to the circumstances you're in, but they will give you IV fluids and possibly some other medications that may help.

Also, please keep trying to call doctors and see if there is someone that will treat you.

[rsdbadfoot]

   Hi yes i think they can that is the only way they have to make sure druggies dont go to different docs and take too many pain killers if u died from taking them both together they would probably feel responsible.  what do u think they should do if she gave you meth and your blood shows perc what do ya think she thinks.  I hope ya dont make the list where no one will give ya any pain meds cause they sure do it......i have heard of it and had a brother in law that couldnt get pain pills anywhere so be careful........see ya Alan