-pain management

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Obie
Regular Member


Date Joined Jul 2006
Total Posts : 83
   Posted 1/29/2008 5:20 PM (GMT -7)   
I finally got a referal to a PM doc and they didnt like me being on the 25 mcg patch and iv dilaudid in the hospital(or oral dilaudid at home) so they switched me to a 12 mcg patch and a 25mcg patch and 30 mg of oral morphine(liquid) every three h

hazelB
Regular Member


Date Joined Jan 2008
Total Posts : 114
   Posted 1/29/2008 6:47 PM (GMT -7)   
Obie- Do you feel that those doses are going to be succesful in relieving your pain? What form of dilaudud were you taking at home?
It should help that they perscribed the oral morphine every three hours instead of waiting the extra hour, because although it can be given again between 3 and 4 hours, pain docs usually dont perscribe the most libral amount of breakthrough pain meds and sometimes even write the perscription for ever 6 hours, I've even seen every 8 hours.
 Interstitial Cystitis and Endometriosis


Obie
Regular Member


Date Joined Jul 2006
Total Posts : 83
   Posted 1/29/2008 10:07 PM (GMT -7)   
I was only dilaudid when I was inpatient in July and it did nothing. When I was released the hospitalists came me vicodin and my family doc kept me on that when she refilled it but it didnt touch it. When they found out what was the real cause of my lower back and leg pain(osteomylitis and scarial joint infection) they admitted me for a week and I had to along with one nurse fight to get sent home on 2 mg of oral diulaudid. We upped it to 4 mgs a few days after I got out but the NP at my family docs office screwed the script up and she wrote it for 2mg and only like 2 days worth so by the time I got to my appt with my reg doc the next week I was in severe pain and she started the 25 mcg patch every three days and 4 mg dilaudid oral prn. We stopped the dilaudid in mid Nov but I still had some and the patches lasted me til about Christmas time. I had one patch left bc I was stretc hing thme out and trying to go without them bc my pcp wasnt comfortable I think writing them still. Whjen I went inpatient on 1/11 they asked what had helped with pain before amnd I told them at home the best combo had been the 25 mcg patch and 4 mg dilaudid oral...so they did the patch and IV dilaudid/ Then they switched me to a 12 mgc patch and a 25 mcg patch every 3 daysthe 30 mg(or 15 cc of morphine elxir of 10 mg/5cc) and actually in the hospital was getting every three hrs but I noticed the bottle says 4 times a day so not sure why they dropped it back). I was already on neurontin so they left me on that too as well as my flexaril. Thye had thought about cymbalta but bc of my allergies they didn't want to try something I have never had before. I see the PAat the pain clinic next wed. I think they hoped my pcp would be willing to write the scripts either bc of the drive for me or so they didnt have to deal with it but since my records sometimes take a week or so to get finished and then mailed to my pocp, i didnt want to take the chance of them running out since I only got 2 weeks to go home with. And I guess they will rewrite it when I see them, again. next week. I hope they will write it for a long period of time. It is an hr and 20 min drive down there so I cant do every 2 weeks. I know they cant call stuff in but can refills be written on the original script or can those meds not have refills writtenm on them. I know I had a refill on my percocet. Also do pain doctors increase the time between your appts or how often do people usually see tem?

hazelB
Regular Member


Date Joined Jan 2008
Total Posts : 114
   Posted 1/30/2008 3:48 AM (GMT -7)   
Obie- it sounds like youve been through alot before and after the New Year, I really hope the docs are willing to do all they can to keep your pain down. As for the scripts, they can write refills on percs and lortab and I have seen them call in those kinds of perscriptions(some docs say they cant, but my pm has, so maybe you need to be a certain kind of doc to do that, I dont know) But I know they cant write refills on fentynal, dilaudud, morphine or owycontin...and a bunch more. The law doesnt allow it because they are so addictive and dangerous and also because people who are able to trick some pm docs and sell there scripts. So only writting them for every month allows your doc to keep an eye on you for possible addiction and fraud. I also live a ways away from my doc and find it difficult to get in sometimes. As far as I know you can see you every month. If they would like you to go in every 2 weeks they might want to keep a close eye on your progress or lack there of because your a new patient. They are very causious with new patients and righfully so, they become liable when perscribing those types of meds and can loose there liscence if anything happens. Thats why they make you sign a contract saying you wont see anymore docs for pain meds, or use more than one pharmacy, give your meds to anyone else...etc...etc... As hard as it is to get there right now, it may be a benefit in the long run just to do what they want you to. I have always found that as hard as it is to go in when your hurting so badly,they can then see just what you deal with on a daily basis and that the meds really may not be working, its much harder to get that across in just words sometimes. Plus it makes them more causious when you have to cancel appointments and cant get in. Does you pm doc have beds in the back for other prosdures? when I'm having a bad day and have to go in to see them, I sometimes ask if I can lay down because I have a prob sitting in the seats(why do they make those seats so uncomfy anyway, dont they know there for the ill and pained...I hate them)
I know its hard to understand why they do the things they do. But its a wonder with all the DA's out there wanting to shut them down for treating non-maliganat pain that they do this at all. Thats why normal docs wont keep on perscribing.
Hang in there! I hope I've been able to help a little.
 Interstitial Cystitis and Endometriosis


Hound-Dog
Regular Member


Date Joined Oct 2005
Total Posts : 183
   Posted 2/2/2008 6:24 PM (GMT -7)   
In Canada, Federal law allows Dr.'s to prescribe  morphine,oxycodone-contins and the like for three months at a time, but it is up to the Dr.'s discretion.I have never had any problem getting three month prescriptions but I have talked to people that live in areas that have a high rate of illegal street distribution, that are only able to get one month at a time prescriptions.Bottom line-- it's up to your Doctor up here.I thought I remember reading about new laws in the U.S. that are to allow longer prescriptions. What's happening with that?

hazelB
Regular Member


Date Joined Jan 2008
Total Posts : 114
   Posted 2/3/2008 11:15 AM (GMT -7)   
I dont think that ever got anywhere. Even if they did pass that type of law in the US, I think it would rarely happen because the DA's are always looking to close down a pm doc. Even if the doc is following every rule, there faces light up at the probability of catching them do anything that skirts unethical practice. For pain docs even being unethical can cause troucle for them legally. Until I got to see it for myself from the other side of the law, I had no idea these kind of docs were that scruitinized. So if they did pass a law here to give them ability to write three month scripts for things like oxycontin and morphine, the docs would be less than smart to write them unless there was a way to guarentee that that person was not abusing or selling the meds. You wouldnt believe how many people in pain management are out there selling there pills. I'd wager there is at least one patient in each pain clinic abusing or selling there meds and one undercover trying to find out which one it is. They ruin it for all of us. Three month scripts for oxy would probably make it so much worse legally. It would be awsome to not go in every month. But for me I'd rather be put out than risk losing anymore docs who want to treat pain. But thats the US. I have no idea how pain clinics are looked at from a legal stand point in other countries.
 Interstitial Cystitis and Endometriosis
 


Hound-Dog
Regular Member


Date Joined Oct 2005
Total Posts : 183
   Posted 2/3/2008 5:32 PM (GMT -7)   
Dr.'s should be able to protect their butts AND see where their narcotics are going by having the computerized records of the amounts of narcotics in the patients bloodwork to justify their drug prescriptions to the authorities.Smart Dr.'s up here order frequent drug assays on patients they have suspicions with. My Dr. checked me out when I first became his patient after my old Dr. retired six years ago.At the time ,I was prescribed way more than anyone without narcotic tolerance could fake, so that answered the question to my Dr. as to where the drugs were going. I wonder why Dr.'s in the U.S. don't do that to cover their butts?

hazelB
Regular Member


Date Joined Jan 2008
Total Posts : 114
   Posted 2/3/2008 9:25 PM (GMT -7)   
Probably because they arent thinking that they could be the next to be investigated.
 Interstitial Cystitis and Endometriosis
 

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