Lots of extra medication

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Tony McGuire
Regular Member


Date Joined Feb 2009
Total Posts : 483
   Posted 3/1/2009 8:42 PM (GMT -7)   
One of my meds is Morphine.

The Dr is prescribing [up to] 6/day, in the event of breakthrough. I use a standard 3 with other meds, and maybe 2 a week on breakthrough. I get 180 as a one-month supply, so I have been left with 85-90 extra each month.

So, I have a WHOLE BUNCH of Morphine here, and will have even more at the end of this prescription cycle (over 200).

How do I break this with the Dr so that I don't get in any trouble? I've honestly not taken a single pill that I wasn't in need of. But I don't want the Dr to suddenly crack down hard and I wind up without meds that I wind up needing in 2 months.

Any ideas would be sincerely appreciated.
Wife: Liz
Dogs: Koshka & Chomp
Heart: Lisinopril
Brain Zaps: Gabitril
Kidney: Simvastatin
Diabetes: Metformin, Insulin
Pain: Avinza, Morphine IR, Methadone, Cymbalta, Lyrica


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 3/1/2009 9:18 PM (GMT -7)   
Tony,
My guess is you have a pain contract that says that if your relationship with your PM were to discontinue for any reason that you would need to return any unused pills. So, if you're determined to be honest with your doc (& I think that's a good policy), I would think the only option would be to take the "stockpile" from previous months and return it to your doc. Maybe he would say it's okay to keep a few extra doses, but I'd be quite surprised if any doc would be okay with keeping an extra 2 months or more of medication on hand "in case of emergency". If for some reason your doc was ever unable to keep prescribing for you, it really isn't a good plan to keep taking meds on your own unsupervised. If anything were to happen to you during that time while you were taking them on your own, you could be in a world of trouble -- medically, legally & going forward with ever getting prescribed pain meds again.

Is there a reason why you think you are in danger of having your doc "crack down" on you? If anything, I would think that being honest and returning unused pills would help. If you are using your medications as prescribed & are not violating your contract, I'm not really sure I understand what you're afraid of. Maybe you could explain that better so we could help you.

peace,
frances

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/1/2009 9:34 PM (GMT -7)   
Tony,
It does sound like you need to tell your doctor just what medication covers your pain. I mean we want to tell our doctors if what they're giving us isn't enough to cover our pain, so we should be willing to do the opposite. You might give yourself a little leeway if some of these are prescribed on an "as needed" basis, but I'd suggest talking honestly with your doctor at your next appointment. It's great you're not having as much BT pain, and so having yoru doctor reduce the prescription now - allowing for modifications in the future - should help keep a good relationship with him. Your doctor might tell you to keep the extras in the event of future BT pain, but let that be up to him. Just make sure you get a few extra in scripts in case you have BT, and that the doctor notes you may need more if your pain worsens.

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13479
   Posted 3/1/2009 9:42 PM (GMT -7)   
Hi Tony, my dr had me on a very low dose of medication for BT pain. It did absolutely nothing for me. I told him this. So when I went in for appts of course I was asked if I need BT meds and I simply said no. It did not cause a problem, in if anything he appreciated my honesty more. You should not have a problem with your dr over this. Simply tell him you have enough to cover any BT pain and you will let him know when you need a new script, end of story. I really don't see any reason to tell him the quantity you have on hand unless you are forced, just simply say you don't need them at this time....Susie


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 3/2/2009 12:55 AM (GMT -7)   
Tony,
Just tell him that you don't need another prescription for BT pain each time you go in for an appt. and by the time You Do use all of it, then you can tell him you need more. That way he'll know that you are honest. And the next time you Do need something he will be more apt to give it to you.

I wish I didn't need to take my BT meds. Man that would be nice.... But oh in a perfect world....

Me.
 
We are all in the same boat...unfortunatley it seems like it's sinking...
 
Rhonda
Post Lamenectomy Syndrome
Hemi Lamenectomy
Spinal Fusion
 
120 mg. Methadone daily
60 mg. Oxycodone daily
Lyrica as needed 

 


Tony McGuire
Regular Member


Date Joined Feb 2009
Total Posts : 483
   Posted 3/3/2009 7:41 AM (GMT -7)   
Sorry it took me so long to get back.

Thank you, one and all, for your honest advice.

Reading your responses, I pretty much got what I expected and hoped.

What am I afraid of? Since I didn't tell him right away, I'm afraid that he might see me having so many as ME being dishonest already. Really, though, I just wasn't sure whether I might truly need them.

I guess part of the reason I have them is that I've tried to not take them, even though I could have used more relief. I hum along at a pain level of 3-5 all day controlled, and since the Morphine doesn't do any better than that if I DO take extras (they put me to sleep, basically, and knowing that I wouldn't be able to drive), I've avoided them.

Next appointment I will take your (all) advice. I think I'll suggest we cut it down to 1 every 8 hours 'as needed'. That'll eat up whatever on-hand I have at about 3-5 pills a month. Unless he asks about how many, and again I'll be honest. As to what to do with 'extras', I've always taken them back to the pharmacy for destruction; not just pain meds but all meds, after seeing a news story about polluting the water supply downstream with medications by flushing them down the toilet.

Nice to know the quality of people here is what I had pretty much figured out. Thanks, everyone, for your advice.

(Edit: What is "BT pain"?)
Wife: Liz
Dogs: Koshka & Chomp
Heart: Lisinopril
Brain Zaps: Gabitril
Kidney: Simvastatin
Diabetes: Metformin, Insulin
Pain: Avinza, Morphine IR, Methadone, Cymbalta, Lyrica


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 3/3/2009 8:08 AM (GMT -7)   
If the morphine is not helping and just putting you to sleep then, your doctor needs to know this as well,
as maybe he/she could prescribe something else for you that might help.....
Doctors need to know whats working for you and what your on in case of emergency.......
Hope you get a low pain day..........
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc, Fibromyalgia, Gerd, Enlarged Pituitary Gland
******** "We could never learn to be brave and patient if there were only joy in the world" from Helen Keller *********

********>^..^<********>^..^<********>^..^<********


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 3/3/2009 8:13 AM (GMT -7)   
 
 
BT is breakthrough pain....
 
Me.

 
We are all in the same boat...unfortunatley it seems like it's sinking...
 
Rhonda
Post Lamenectomy Syndrome
Hemi Lamenectomy
Spinal Fusion
 
120 mg. Methadone daily
60 mg. Oxycodone daily
Lyrica as needed 

 


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/3/2009 1:25 PM (GMT -7)   
Tony,
I'm kind of with Char now that you're saying your pain really hasn't been covered. You've been kind of undermedicating yourself, right? That puts a different slant on it. Because your fear of ending up without enough medication is real. You're afraid of the driving issue? I can understand. I know for me that percocet doesn't make me groggy, and I generally have no problem driving while taking it. But I can't take a muscle relaxant and function. That about does me in. I've never tried morphine so I don't know. But maybe working with your doctor for a different daytime combination could help?

Just my two cents for now. I just would hate to see you go undermedicated unnecesarily. Enough of us struggle with that because of our doctors!!

PaLady

Tony McGuire
Regular Member


Date Joined Feb 2009
Total Posts : 483
   Posted 3/3/2009 9:07 PM (GMT -7)   
Again, thanks to one and all.

My PM doctor doesn't give me any reason to not trust him. And he has taken my word for everything, not testing me or anything, and changing my meds based on my answers to his questions coupled with my requests.

I certainly don't wish to break that trust.

As far as undermedicating, I guess I have been a little. But when I've used more of what I've been given leeway to take 'as needed', I've never gotten better results than with the lower dosage. So I've just gone back to the lower dosage. No sense throwing more garbage down the hatch if it isn't needed, I think.

And I think the Lyrica/Cymbalta mix has more effective pain relief; I'm just on a high dosage already, and the doctor is acting like he really doesn't want to up either of those dosages. Then, too, they are being managed by my PCP even though they are for pain relief.

Nice thing - the doctors aren't territorial; each of them will work on whichever parts of managing the pain or give up managing the pain or portion thereof to the other doctor.
Wife: Liz
Dogs: Koshka & Chomp
Brain Zaps: Gabitril
Kidney: Simvastatin
Diabetes: Metformin, Insulin
Pain: Morphine IR, Methadone, Cymbalta, Lyrica


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 3/3/2009 10:11 PM (GMT -7)   
I'm not sure how getting down to a level 3-5 is being under-medicated. That's where I'm at right now & I am ecstatic about it! 5 means different things to different people, but on my doc's pain scale it means the pain can be ignored for up to a half hour at a time if I'm doing something very engaging. Really, that's all pain meds should be used for. They are not to get rid of all the pain. That's not really a safe way to live life even if you were awake b/c you could injure yourself & not even know it b/c you're so heavily medicated.
That said, if a "5" for you means you can barely get around, then I would definitely suggest talking to your PM about changing or upping your meds b/c no one should have to live like that. ;)

As far as just continuing to take your meds while allowing your PM to believe you are not taking them, I would still insist that it is not a great plan. If your doc isn't prescribing for you, but you are continuing to take the meds, you really could face some difficulties. I recently went through my "medicine cabinet" & found an old prescription bottle that was more than half full. It was from more than 2 years ago. I returned it to my doc & explained that I hadn't been taking it & forgot I even had it until I was spring cleaning. He said it was good that I returned it & that he appreciated that. There weren't any negative consequences or anything -- he even offered to up my BT pain meds to give me a little more relief so I could progress faster with my PT (I can't afford the higher dose, but my point is that when you forge a good relationship with your doc, are consistently honest & don't go trying to sneak around behind his back trying to take care of things yourself b/c you don't feel you can trust him then you give your PM more reasons to trust you to behave responsibly and not do anything to get either yourself or him in trouble).

It's your choice in the end, but I really do feel that unless CP patients go above & beyond to show we are trustworthy that we will continue to face the same difficulties over & over again where we are treated like abusers or addicts. Hiding medication use from your doctor is something an addict would do. I'm *definitely not* saying you're an addict, just saying that appearances count & that anything you can do to eliminate even the appearance or slightest impression that you are maybe doing something wrong is likely only to help your doc to trust you more in the future. Be honest with him. If you just explain that you noticed that the extra doses were really starting to add up & tell him that you don't really need more than 3 doses a day at this time, I can't see how he could fault you for that. Maybe he'll let you keep them, maybe he'll have you use them for the next couple months or maybe he'll ask for them back, but you are trusting him with your life and he needs all the information you can give him to be able to help you and keep you safe.

Good luck with your decision!

Tony McGuire
Regular Member


Date Joined Feb 2009
Total Posts : 483
   Posted 3/4/2009 7:21 AM (GMT -7)   
Thank you, Frances.

Yes, as admitted above, I need to simply explain and get past it. My intent certainly wasn't to deceive, or to do anything in the way of 'self medicate' or anything. I just wasn't sure about how the dosages would go.

And even though the pill box said up to 6 a day, I took what felt to be right and waited to see if I did need more. Now that it doesn't, I'll explain and hope that is enough.

And again, thanks to all lending support.
Wife: Liz
Dogs: Koshka & Chomp
Brain Zaps: Gabitril
Kidneys: Simvastatin
Diabetes: Metformin, Insulin
Pain: Morphine IR, Methadone, Cymbalta, Lyrica

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