Dismissed (to PM) by neurologist - suspicious...

[hands4]

Hello everyone,

I'm new here, and I've spent a good amount of time reading many of the questions and thoughtful responses.  Here's my situation.  In February, I developed peripheral neuropathy.  It came on so suddenly (within a week I was pins & needles / numbness in all four extremities).  My neurologist, who'd successfully treated me for a month-long migraine last year, admitted me to the hospital and over the course of nearly a week I got what they referred to as the "million dollar workup" - yay me.  Besides the usual neurological tests, spine MRIs (to rule out MS), and bloodwork, they discharged me without a concrete diagnosis - "ideopathic" peripheral neuropathy (unknown cause).  Let's back up three months. My PCP had been prescribing me Norco - hydrocodone/apap 5/325, 2 per day, for DDD and 2 herniated discs.  Forward to the week of the neuropathy onset - and before the hospital admission - I sent an email to the neurologist over their portal, and my PCP, and told them that the pain and stiffness were so bad, I was taking a norco every four hours.  The neuro told me to go to the ER where I'd be admitted (and I was) where she could speed up diagnosis and they could better control my pain.  I never saw her there once.  I was treated by hospitalist doctors, and visited twice by another neuro in her group.  (Sorry this is so long at this point but I had to start from the beginning - you get it.)  I saw my neuro three days after I was discharged.  She said she'd discovered what was wrong with me (eureka!):  bloodwork revealed that my copper levels were low (normal range was 70, mine was 63).  (Very) low copper levels can lead to neuropathy.  My husband and I, quite vocally, questioned this diagnosis (not abusively, of course!). She told me to take a copper supplement from GNC (I did), prescribed Gabapentin, and Nucynta, 50 mg. every 6 hours as needed. Five days later I told her the nucynta was working very mildly, but I didn't want to give up on it.  She increased it to 100 mg. every 6 hours as needed.  That was the magic bullet.  This is very good medicine; few side effects and very effective.  I called for a refill when I'd run out.  That's when the sh*t hit the fan.  She told me that "as needed" didn't mean "as directed", and because I was taking that much (I took no more, no less) I should go to pain management and she would no longer treat me.  She also said I'd been going to "other doctors" for pain medicine (only my PCP - the norco that she knew about).  This all made my head spin.  My husband thinks she 1) doesn't like to prescribe narcotic pain medicine, 2) didn't appreciate us doubting her diagnosis (she has a major god complex), and 3) found a way to get rid of me.  She filled a script for one week's worth (same directions), and that was that.  I haven't spoken to my PCP yet.  I made an appointment with another neurologist, but that had been my plan - a second opinion.  How do I handle this going forward?  I feel like a victim (and I hate that).  (Thanks for reading, and sorry about all of the parentheses.)

[philnoir]

You'll never get both doctors to actually discuss this situation in the same room with you.

You will need to write a letter with copies to both doctors describing your understanding of the facts as they related to your contorlled substance agreement. Be factual as far as dates when specific Rx were written objective, and objective in your presentation of the facts.

Send a registered letter copy to each doctor along with a copy of the controlled subtance agreement and your notice of dismissal by the neurologist.

Since the neurologist seems to be most unreasonable and intransigent in his/her posture, then ask for an appointment with your PCP regarding this situation.

Anyone can make a mistake. Don't let this neurologist make a mistake that will make your future lie miserable.You have a right to pain treatment, regardless of his or her opinion.

[Wobby65]

Reading your story makes me very angry. The way some doctors treat patients is completely unacceptable. It has never occurred to me that a doctor would take issue with me taking medication as they prescribed it...my prescription contains the words "as needed", but I have never been scolded for taking it 3x/day as prescribed. If I were you, I would write a letter to the director of the practice the neurologist works at explaining your point of view, and ask that it be placed in your file. If your "dismissal" ever comes up with another doctor, hopefully your letter will help clarify things. I hope your PCP and the new neurologist can help you.