Script Question

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LLPLUV
Veteran Member


Date Joined Mar 2009
Total Posts : 1158
   Posted 12/28/2009 9:20 AM (GMT -7)   
Ok I've seen a PM now for a year.  But I have not ran into this situation.
 
Over christmas I have been dealing with an absested tooth.  I finally made it into a dentist this morning.  I have been taking my pain meds every 4 hours, tooth pain suckssmhair
 
The dentist gave me a script for an antiobotic and more Codiene.  I know I will be short at the end of the month for the extra usage regarding the tooth.  Ihaven't filled the pain med.  I'm worried about that one.  When I fill out my paperwork every month it asks if you've had a prescription written by another doctor and for what reason.
 
Tomorrow I go in for another Pain treatment.  What should I ask the doctor?
 
I will be at work so I wont be back on till after 8 pm.  Any advice would be wonderful
 
Laurie
Kidney Diseases and Disorders
              Moderator
 
39 yr young female with,
Chronic Kidney Stones, PKD (Polycystic Kidney Disease), Chronic Kidney Failure, Severe Hypertension, Urological RSD

Also CHF (Congestive Heart Failure) and Sleep Apnea

Hopefully NO MORE........


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13478
   Posted 12/28/2009 9:29 AM (GMT -7)   
Laurie you need to talk to your PM dr and let him know how you have been taking meds every four hours and will be running short at the end of the month. Show him the script and get his permission to fill it because you don't want to be running out of pain meds. Best to just up front with him to avoid any problems in the future. Those guys know that things like this can crop up so he should go along with it, You have been a good PM patient so you won't have any trouble with him.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


flower123
Veteran Member


Date Joined Apr 2009
Total Posts : 856
   Posted 12/28/2009 9:47 AM (GMT -7)   
Yes, I agree with Straydog. I would actually bring your script with you to the doctor and ask if you can fill it. If not then I would ask if your PM could write you script for more pain medication.

I would definitely tell them that you've had to dose every four hours. Would a PM get upset that you have had to take your breakthrough more often because of the tooth? I mean because the pain is different from what the meds. were specifically prescribed for. Did that make sense? From what I read they can be very strict sometimes. I don't know the answer to that. Does anyone know? Just curious. I know that the rules of PM are so strict for a lot of patients.

Also, can you ask your PM to write it in the chart---I mean whatever happens--if your PM writes you an extra script or if your PM allows you to fill the other script. PM is so tricky sometimes and it's good to have all bases covered.

Ugh. I'm so sorry that you're in this pain. When I thought that mine was infected I did some research and the pain of an abscess is terrible. I remember when my wisdom teeth were infected before I got them taken out and boy--that was incredibly painful. That was years ago and I still remember how awful it was. And tooth pain really does keep you up at night, too.

I think that the antibiotics should help with the pain too. Am I correct in saying that?

Flower

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2284
   Posted 12/28/2009 9:49 AM (GMT -7)   
I agree with Susie. Definitely you need to let him know what's up. It would have been better to let him know about the extra doses at the get-go (even if just by a quick voice mail message to his office), but second best option is to let him know at your appointment. Being dishonest or hiding medication use is one of the flags for abuse. I am not at all saying I think you are abusing your meds, but if you don't let your PM know what's going on, it could LOOK like that might be the case. Sometimes appearances are as important as reality. Be straight with him & ask him if it's okay to fill the script your dentist wrote or if not if he could prescribe you something for the pain (I know my own PM prefers to write all pain scripts for his patients, regardless of whether they are for surgery or dental procedures or whatever -- he doesn't like his patients having scripts from multiple doctors).

take care. hope the pain from visiting the dentist gets better soon!
frances

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/28/2009 10:06 AM (GMT -7)   
LL,
Your taking your breakthrough meds for the tooth pain without calling your PM doctor first, might be a problem. With my PM practice, if something like that happens, you HAVE to call the PM office and ask them what he would like you to do to manage the acute pain. Many times, he will call in a script for that or have one written for me to pick up. I am NEVER to take my breakthrough meds for acute pain for another condition, no matter what it is , without his permission. I don't have a contract with my PM , never have, but know the rules for the practice.
What I would do though is call and tell them that you have an abcessed tooth and the dentist gave you a prescription for codeine or whatever it is and ask if you can fill it. Make sure that they document in your file. Usually, my PM writes any additional script for me, but has had my dentist do it if I have him call while I am there.
As to asking him for another script to carry you through until the end of the month, he may not do.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 12/28/2009 10:58 AM (GMT -7)   
I have to agree with Sandi,
call your PM Doctor, explain the situation and medicine you got from the dentist, or make an appointment and talk with him about your tooth pain...the PM Doctor is there to help you and they understand for different situations. but make sure to let your PM Doctor know...
Hope this info helps...
Lots of soft hugz and hope your feeling better soon (with the tooth)
((((((((((((((((((((((((((((((((((Laurie)))))))))))))))))))))))))))))))))))))))))))))))))))))))))))
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

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


Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 12/28/2009 1:28 PM (GMT -7)   
Seems to me this is all working out, in the beginning at least, pretty well. You have an appointment with you PM tomorrow so take your codiene script in with you and explain the situation and ask what you need to do. On the form you are suppose to fill out just be honest. List the codiene and put next it not taken or filled and why it was prescribed.

If this had happened and you did not have an appointment coming up very fast then you should call his office and leave a message requesting advice/instructions.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 12/28/2009 1:55 PM (GMT -7)   
Hi Laurie...

First, I'm sorry you are going through dental issues and extra pain - that stinks! Hope you feel better soon.

Also, I'm agreement w/ what everyone has said... For me, the biggest thing I've learned over the years w/ all my PM docs is just "disclosure" is what they are looking for... and just being upfront about everything.

For instance, I've been in/out of the hospital w/ vomiting issues (I know, fun stuff!)...not too long ago, I had a 9 day stay. Well, while in the hospital...they were giving me all of my meds... so when I got home, I had a serious stockpile of medication! This was not just a few extra doses...but, just on my morphine alone...55+ of extra pills. So, when I saw my PM doc afterwards, I let him know that I had these extra meds...so that he could adjust that month's scripts. He really thanked me for being up front about everything. In truth, he probably would have never asked me about the extra meds. However, I've always held to the belief that I want to do everything within my power to show him that I AM to be trusted...

Point being, I think if you bring in your script tomorrow when you see him... and just see what he wants you to do... that is the best thing...

Good luck, Laurie! I hope your dental pain goes away quickly. Let us know what happens tomorrow when you see your PM doc.
--Tina
Pain Issues: Cervical/Thoracic back pain; migraines; carpal tunnel syndrome; widespread joint/muscle pain, nerve pain in hands/arms/feet; I also have Dysautonomia/POTS; CFS/Fibromyalgia; Severe Hypertension; Hypothyroidism; Hypoadrenalism; Mixed (Obstructive/Central) Sleep Apnea - on Auto BiPap; Depression/Anxiety; etc etc

Meds: MS Contin; Dilaudid; Actiq; Soma ; Neurontin; Atenolol; Midodrine; Phenergan/Zofran/Reglan; Effexor; Synthroid; Prednisone; and on the list goes...

Future Plans: Intrathecal Pain Pump; already completed trial; awaiting my decision for implantation


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 12/30/2009 8:48 AM (GMT -7)   
Hi LL I do so hope your tooth pain goes away soon! I know what it is like to go through an abcesed tooth, its killer!! Anyway, I agree with everything that everyone says here. I as everyone knows have been seeing a Ortho on top of my Pain doctor and I had to sign a release of information so that my Pain Doc knows if doc has given me scripts for meds, which he hasn't as of yet. I'm on a pretty high dosage of medication already and I don't think I need to take any more medication.

But I digress.....I would be honest and upfront with your doctor so that you are not tagged as a "problem patient". That would be more of a headache then you need!

Hugssss

Scarred
What doesn't kill us only makes us fight back harder! :P
 
Two level fusion on S1- L4 in 2000. One level fusion on L3-L4 in 2003 and revision on L3-L4 6 months later.  This led to a diagnose of failed back syndrome, nerve pain and Chronic Pain. Two bi-lateral patellar realignments on both knees last one in 1988.  Overall...I'm in great health. 


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 12/30/2009 8:48 AM (GMT -7)   
Hi LL I do so hope your tooth pain goes away soon! I know what it is like to go through an abcesed tooth, its killer!! Anyway, I agree with everything that everyone says here. I as everyone knows have been seeing a Ortho on top of my Pain doctor and I had to sign a release of information so that my Pain Doc knows if doc has given me scripts for meds, which he hasn't as of yet. I'm on a pretty high dosage of medication already and I don't think I need to take any more medication.

But I digress.....I would be honest and upfront with your doctor so that you are not tagged as a "problem patient". That would be more of a headache then you need!

Hugssss

Scarred
What doesn't kill us only makes us fight back harder! :P
 
Two level fusion on S1- L4 in 2000. One level fusion on L3-L4 in 2003 and revision on L3-L4 6 months later.  This led to a diagnose of failed back syndrome, nerve pain and Chronic Pain. Two bi-lateral patellar realignments on both knees last one in 1988.  Overall...I'm in great health. 


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 12/30/2009 8:49 AM (GMT -7)   
Hi LL I do so hope your tooth pain goes away soon! I know what it is like to go through an abcesed tooth, its killer!! Anyway, I agree with everything that everyone says here. I as everyone knows have been seeing a Ortho on top of my Pain doctor and I had to sign a release of information so that my Pain Doc knows if doc has given me scripts for meds, which he hasn't as of yet. I'm on a pretty high dosage of medication already and I don't think I need to take any more medication.

But I digress.....I would be honest and upfront with your doctor so that you are not tagged as a "problem patient". That would be more of a headache then you need!

Hugssss

Scarred
What doesn't kill us only makes us fight back harder! :P
 
Two level fusion on S1- L4 in 2000. One level fusion on L3-L4 in 2003 and revision on L3-L4 6 months later.  This led to a diagnose of failed back syndrome, nerve pain and Chronic Pain. Two bi-lateral patellar realignments on both knees last one in 1988.  Overall...I'm in great health. 


uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 12/30/2009 1:50 PM (GMT -7)   
 
 
Laurie,
 
I went through the same thing about 7 months ago...I had a tooth pulled and the Dentist gave me a script for Lortab 10's... I had been taking more of my regular pain meds due to the pain in tooth and was worried about what the PM Doc would say.... I went ahead and filled it and took them....the PM Doc never said a word.  I would tell him/her about the tooth pain before I filled it...I was scared that when I went back they would get rid of me...it's not worth the stress, so just tell them and see what they say.
 
Me.

I have been a spectator for so long..Now it's time to participate.......
 
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/  30 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 10mg. 2X in the morning
Lantus 35 units at bedtime with Solostar Pen                                                                   

 

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