Advice for Switching to Another Dr.

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skrape
Regular Member


Date Joined Feb 2009
Total Posts : 141
   Posted 5/28/2009 4:51 PM (GMT -7)   
I haven't posted on this site for a little while now. For those of you that may not remember I will include a short (as short as I can make it!) summary below:

Oct. '07 - Injured my back by catching a falling car battery (ouch!). Visit to ER, MRI and X-Ray; no injury able to be determined.
Oct. '07 - Ended up back in the ER a second time for same back pain. Told to find a physician to treat me.
Oct. '07 - First saw my previous Dr. for back pain. Prescribed Oxycontin and Norco for BT.
Oct. '07 thru Nov. '08 - Back pain persisted over the entire period of time. Oxycontin was upped from 10 to 20 to 40mg.
Nov. '08 - Referred to pain clinic for treatment. Given shots on both sides of my spine (Cortisone? Not sure.) w/no effect. Second injection was into my spine (epidural injection) and really spun me out as far as level of pain went.
Nov. '08 - After epidural, saw my normal Dr. 4 times telling him I was in terrible amounts of pain and needed to take more medication than normal. He never said anything about me taking more medication (maybe he just wasn't listening to me, I am not sure). I was pretty naive back then...
Dec. '08 - Ran out of my medication early and was asked to "leave the practice" and given one month of Oxycontin and no breakthrough medication.
Jan. '09 - Went to the ER because I was out of medication and was not able to be seen by another Dr. yet (almost all of them were 2 to 3 months out before seeing new patients). I was given a list of Dr.s that were accepting new patients and that accepted my insurance.
Jan. '09 - Was able to find new Dr. He prescribed a Fentanyl patch and no breakthrough medication.
Jan. '09 thru Present - Fentanyl patch was upped from 50 to 75 to 100mcg.

I Found that generics (Fentanyl) leave me w/no pain control over the last 24 hours of the 72 hours the medication is supposed to be effective. Dr. prescribed DAW (name brand) patch and they worked a little better on the third day. These cost me over $800 a month and I simply could not afford it after a couple of months. I told the Dr. that I could not go with the name brand patch any longer and I asked him what we could do and he would change the subject. He spent over 20 minutes talking to me about my cholesterol levels but when he went to leave w/out telling me what I needed to do about the patches, he just turned and left the room. He is being evasive and outright running out the door when I ask him questions. I learned my lesson before and will not do anything that my Dr. has not put in writing, otherwise they either may not be paying attention to me or simply not even remember talking to me about it (I have to tell this guy my life story every time I see him because he cannot seem to remember anything about my condition, etc.). There are a lot of other problems w/this guy from his secretary not making appointments for referrals that they said they would to telling me to cut patches in half (can be lethal) to not returning calls, etc. and etc.

Due to all these problems, unbearable pain in my back that is unrelenting, a Dr. that won't even acknowledge I have asked questions, having no control of my pain and having quite bad WD almost half the time due to the patches ineffectiveness, etc. I need to find someone else that will actually help me. I have been feeling pretty hopeless lately. I have not been able to work anywhere near what I used to and all my bills are overdue. Elect. was almost cut off (they came out and gave me a 24 hour notice before I was able to get them to accept a partial payment), gas people need $800, my wife's car was repossessed last week and on and on.

I have been thinking more and more about ways to end this. I had to delete a lot of things I just wrote here but I will say this; I have woke up almost every morning thinking that if I only was alone... If I didn't have a daughter, son, wife and mother who would be crushed by me leaving... If it were not for these people, I wouldn't have bothered w/it this long. I know a lot of you on here have problems equal to or greater than my own and I don't want people to dwell on these thoughts. I do want to convey just how bad this has become for me. I am scared to death that I will end up loosing my resolve and will become weaker than I am. I do not want that and it scares me that I have become this way.

I do not want to tell my Dr. these things. I do not think he will understand or even care. On top of that I cannot stand his nurse/wife. When the topic came up that I could not afford the name brand patches this month, she repeatedly said (loud enough for everyone in the waiting room to hear) that "well, I guess you can either take the generic or try and tough it out but you'll probably end up in the hospital because of the withdrawal". I find this very unprofessional and I do not want to think of what she would do/say if I had to go in and tell them that I have been fighting thoughts of taking my life.

I believe I should find a new Dr. I don't want to give the impression that I am Dr. shopping (I have educated myself very well since my initial problems w/my first Dr.) and I would not hold back information from any other Dr. that I would see. I do find myself wondering what to do. How should I go about finding another Dr.? Should I tell my current Dr. that I want to find someone else? Wouldn't I need him to refer me to someone else? If I do ask him, will he cut off the only medication that I do have? I do not want to think of what I would do if something like that were to happen. I know I can continue on for yet a while if I am on my current medication while looking for someone else but if he gets angry and tells me to "leave this practice" because I want to go elsewhere, what would I do then? Can they lock me up for a period of time if I talk about how I am really feeling w/this whole situation? Man, I cannot believe how bad this has become. I have to do something, anything. I have been trying not to break down just typing this here... Thanks for the time and I apologize for the crazy long length of this post.


Skrape
Fentanyl Patch - 100mcgs x 72 hours
Baclofen - 10mg x 8 hours


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 5/28/2009 9:45 PM (GMT -7)   
Hi Skrape,

Is your current doctor a PM, or just your primary? Unfortunately, many, if not most, pain management clinics are referral only, so you would need to get a referral from your current doctor, if the one who is treating you currently is your primary (if not, then you could ask your pcp for a referral).

If it's your pcp who is prescribing to you now. I think that I'd have a polite conversation with him & explain that you would like to be placed under the care of a PM, as you feel that they may be able to better handle your case because they 1) have more options to offer (ie. injections, implants, etc) to better treat your pain and 2) are better apt to handle a long term pain problem because of their superior knowledge of pain & its treatment (worded in a nice way, as not to make your current doc feel like you think he is stupid). You could also mention that a PM would be able to set you up with other alternative treatments and services that may provide you pain relief (acupuncture, massage, PT, etc).

If it's your PM who is currently prescribing to you, then you could get a new referral for another PM from your pcp, and just send your PM a nice letter thanking him for his services & striving to help you live a pain free life, but that at present time, you have decided to switch your care to another provider for XXX reasons (such as you feel that you have exhausted all the available options that he has given you). If you want to keep the door open with this doc in the future, you could mention something about possibly needing his services again in the future & thank him again. I wrote something along those lines to my PM, when I switched (and the person who guided me through the process was a physician himself, so he knew how to write a polite "get me out of here" letter).

One other thing: Are you, or have you taken any anti-depressants? Depression is very common among CP patients. I am certainly one of those people who it affects, and as a result I have been on multiple medications. I really would urge you to talk to someone about this. If you don't feel that you can confide in your doctor, then why not look for a psychiatrist (who could prescribe), or at least see a psychologist/councillor in the mean time, while you are searching for a new doc, who could then take over that aspect of your case as well. There are also such things as pain psychologists (psychologists who specialize in CP). Some PM clinics even have these employed by or associated with them. You may want to keep this in mind when you search for a new doctor. And if you haven't explored this area already: some antidepressants (such as Cymbalta or amitriptylene) are even know to help alleviate nerve pain, and as such, are often prescribed by PM's.

I do wish you the best of luck in your search for a new doctor & during this time of transition. I know it is not an easy thing to do. It took a lot of gut and several months for me to "fire" my PM. But I am so much happier now that I did, because now I have a doctor who actually cares about me, listens to me, and works with me, for me. I hope you can find the same!

Skeye

uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 5/29/2009 8:56 AM (GMT -7)   

 

 

Skrape,

You have anawful lot of thoughts racing through your mind...and along with CP, that is a major storm brewing.  You sound like you need help, not only with money troubles, but with Depression as well.  Thoughts of suicide are scary, not only to your family but to you also.  "If only" "If only"  those words creep into all of our minds here...We have wishes of not being in pain, of making it easier on those around us...But taking your life will create more problems for the ones we leave behind.

Your Dr. is a JackASS!!  And I think you should definitley look for a more reputable one in your area.  He sounds like he is only worried about money and not YOU...  Some Dr.'s are like that and we should be able to weed them out.  But sometimes we have to go through several before we find one that we can put our trust and our lives in their hands...without worrying.

Sometimes you have to take that first step and tell that Dr. where to go....No, don't do that...but find another Dr. to go to, We deserve to be Pain free (almost at least).

Good luck,

Me.


 I hate Boats!!!!
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/15 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1000 mg. at night..Glipizide 5mg. 2X in the morning
                                                                    

 

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