Help; Talking to Doctor

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tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 6/1/2009 6:02 AM (GMT -7)   
I already go to my appointments with my list in hand, and any empty med bottles, needing refils, but I don't know how to talk to doctor about needing stronger pain meds. I am on low dose Tylenol, Codeine compound, have been on it for about four years. Pain is under treated here in Canada. My doc has been very good about keeping me on a regimen of medicine that takes the edge off of the pain, but somedays, none of it works. It's like chewing M&M's. If seems pointless to subject my body to large doses of Tylenol, which by the way does nothing for me, when there may be other meds, that could be used. I did request a referral to a Rheumy, but here, the don't help much with Fibro. There is still the äll in your head, stigmatization of patients complaining of "pervasive pain disorder". That's what it is often called. I don't even think my doc is treating me with the mild pain med, I'm curently on, for Fibromyalgia, at all. When I speak of pain, he says "exactly where is this pain?" When I say, "all over, my legs, lower back, both arms, knees, well  just about everywhere, doc", his lip takes on this funny shape, kinda like when my big dog doesn't want to do something and I try to make her do it. I had discussed with him, and showed him the report of my soft tissue injuries from being struck down by a truck, in 2002, and I think that is what he gives me the pain meds, for. So, because, when living in USA, I was adequately treated for pain, then returned home, due to poor health, could not afford any meds in USA, I found the best they would do for me, is this low dose Codeine/Acetominophen compound. I am not complaining, I know some folks can't even get that, but short of coming right out and saying Ï need stronger pain meds, because I hurt allover", is there any other way to handle it. I know keeping a pain journal is a good tool, but the docs here don't read that stuff. When I gave him the literature on the accident, he read part of one page, handed it back to me, and wrote the precript I am now on. They average 6 minutes per visit. I see him, tomorrow.
Hypothyroidism, Fibromyalgia, Facet Joint Syndrome, High Blood Pressure, menopause, Migraines, Chest Pain, Anxiety and Depression/BiPolar II
Synthyroid .075mg., estradiol.5 mgs., Amyltriptilene, 100mgs, bedtime, Tylenol 3 PRN (six-eight, daily), Valium 7.5mgs. daily prn. Flexeril, prn (not so helpful), Zoloft,150mgs., Zomig approx. 12 per month, prn., Meds for High Blood Pressure, vary.


Mrs.T
Regular Member


Date Joined May 2009
Total Posts : 58
   Posted 6/1/2009 7:13 AM (GMT -7)   
That's awful! Can you possibly find another doctor? That would be my first choice for you in getting better care and meds. If you can't find a different doctor then I would just be as clear with yours as possible. I know we all face the problem of people looking at us like we're hypochondriacs or pill heads, but it's a risk worth taking if it works. If you are clear and right to the point about your pain, then you at least know that you did all you could to better your quality of life. If he says no to stronger meds, then maybe you should tell him that it's time you found another doctor who will listen to you. I find it funny how quickly doctors forget that they actually work for US. Something else you might consider doing is finding several articles about fibro and the pain involved and taking that to your doctor, maybe he's not quite as educated as he thinks. Good luck with this, I hope it all works out.
Mother to two wonderful boys and wife to the best husband ever.

~Fibro, Diabetes, PCOS~


** "Don't tell me to suck it up, do I look like a vacuum cleaner?"


tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 6/1/2009 7:47 AM (GMT -7)   
Thank-you Mrs. T. I will begin to ask around about docs who understand Fibromyalgia. I won't alienate this one, until I have another in hand, as believe it or not, this fellow was the best out of five I interviewed when I was doctor hunting after I returned to Canada. All the others said "Cymbalta", which doesn't help me at all as I cannot take the ephrinephrine (sends my blood pressure and anxiety through the roof). The idea of bringing literature (with the juicey parts highlighted) so's he can get the gist in his 30 second glance, is good. I see him tomorrow, and then he's going on vacation so maybe I'll luck out and he'll actually be inclined to read them, but I doubt it. One good thing about a not so good doctor, is he can be seen almost anytime, with almost no delay, and has lots of openings on his schedule.

Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 17097
   Posted 6/1/2009 9:48 AM (GMT -7)   
It's stories like this that make me glad I have the medical care in the US.  My doctor spends at least 20 minutes with me and never leaves until all of my questions are answered.  I just love him.  It's a shame that you couldn't get help with your prescriptions here.  I wish I could remember the site, but I found a site that got low cost prescriptions for my brother when he was unemployed.  If I think of it, I'll let you know. 
 
I did talk to him about stronger pain medication and he was open to it but he also knows I won't take it unless it's an emergency.  So, I do have my Vicodin in my medicine cabinet if I ever feel I can't stand it anymore. I was just upfront with him and explained the problems I was having and that what I take sometimes doesn't do the job.  I hope you can get the help you need.
 
Sherrine
 
 


Forum Moderator/ Fibromyalgia
***********************
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7

Post Edited (Sherrine) : 6/1/2009 11:16:52 AM (GMT-6)


MT Lady
Veteran Member


Date Joined Jul 2008
Total Posts : 955
   Posted 6/1/2009 10:45 AM (GMT -7)   
Hi Tyno,
I know exactly what you are going through and it is so frustrating. I had a wonderful doctor for over 20 years and she retired in January and I'm now seeing her associated and you'd think their thinking would be alike? No way. She was so open to new medications. All I'd have to do is come in and discuss it with her, tell her what I had researched and she would say "Okay, let's give it a try". I have now had three visits with this guy and he has turned me down at all three visits. I have been on the same pain medication for years and years and I just don't think it is working any longer, at least at the number of pills I take a day, which is what is prescribed for me. I don't want to go over that amount. I also don't want that prescriptin in addition to another one, I'd like to try something else, and he's turning me down. I also asked about Celexa instead of Prozac, turned me down on that one too, and something else which I can't remember now, oh yes, taking Adderall or Ritalin for fatigue...won't even touch that one. I never had this feeling before, but now when I walk out of his office, I feel as if he views me as a drug seeker. I know I have to look for another doctor and I'm dragging my feet, but in any case, I certainly can empathize with you.
If it were me, I'd go in there and be honest. Bring in a list of the medications you think might work and ask him if he's willing to prescribe any of them for you. If not, maybe he would recommend a pain clinic for you to see? I think that is my next choice too.
Good luck,
Miriam

Fibromyalgia, Osteoarthritis, scoliosis, back problems, hypothyroidism.


Hara
Veteran Member


Date Joined Mar 2009
Total Posts : 900
   Posted 6/1/2009 11:35 AM (GMT -7)   
Short of telling him out right you need stronger pain meds that's probably what is needed. If the doc. only stays in the room with you for 6 minutes. I would use all of the 6 minutes.
 
I have to nearly tackle my dr. when he comes in. Working at a medical office I know exactly how many minutes it is for a standard treatment and I use my whole time. Yes he does try to run away from me to. He doesn't like it when I tell him I'm hurting...hehehe
 
HARA

upbeat
Regular Member


Date Joined May 2009
Total Posts : 240
   Posted 6/1/2009 12:01 PM (GMT -7)   

Can you just say that there are days when this medicine is not enough to reduce my pain to a bearable or functional level. Tell him how it impacts you personally, can't walk your dog, can't clean up, can't do the grocery shopping - tell him how the pain disrupts your life. I think sometimes when we just say it hurts everywhere they are more likely to dismiss your complaint.

Hope your appt goes well - good luck!

 


Post Edited (upbeat) : 6/1/2009 1:24:05 PM (GMT-6)


Hara
Veteran Member


Date Joined Mar 2009
Total Posts : 900
   Posted 6/1/2009 2:22 PM (GMT -7)   
I still say to tell doc. outright. Then I would ask him how he would be able to function with alot of pain.
 
HARA

donnaeil
Veteran Member


Date Joined Jun 2006
Total Posts : 1156
   Posted 6/1/2009 4:11 PM (GMT -7)   
Well, I live in the US and my pain is under treated here, Docs are discontinuing opioids fro fibro patients due to the War on Drugs policy. I have seen 3 pain specialist and not one has helped. I live in Seattle where medical care is supposed to be excellent.

I do not want you to think it is only a Canadian issue, the pain relief problem exists world wide. I am a researcher so I am always checking scientific studies and journals to see which countries relive pain well. I am still looking.

Take care,

Donnaeil

Hara
Veteran Member


Date Joined Mar 2009
Total Posts : 900
   Posted 6/1/2009 4:48 PM (GMT -7)   

My dr. here in the USA finally gave me some Oxycodone for my chronic lower back pain. I've had back pain since I was 11. Just being a kid....hehehe

HARA


Stari
Regular Member


Date Joined Mar 2009
Total Posts : 235
   Posted 6/1/2009 5:39 PM (GMT -7)   
Ty,
Can you take a friend in with you to the doctor's appt...I mean to the examination room. Sometimes another person's input on the pain that you're feeling is of great help to the doctor. Ok this might sound crazy but have you thought about keeping track of your blood pressure? When a person is in pain his/her blood pressure will go up.

Good Luck

tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 6/2/2009 5:25 AM (GMT -7)   
I'm going to try this again. Thank-you, Stargeek, Hara, Sherrine, Stari, Stan and all; for your help with this. I believe as Donnaeil speaks of the politics of pain, she is right. I think perhaps, my doctor is in a tight spot, and given the War on Drugs, BS, excuse me, he is doing what he can in an impossible situation. He is the one down position in his group of Doctor associates, being the newest, and an older Doc there, I saw once, said to me, "You will get four tablets a day, no more (of an already weak compound), or you will get nothing, we can't have you driving and so on while on an intoxicating drug". Huh! Firstly, when I'm in bad shape, I have my son drive me in my truck. Secondly, I skip my dosage at noon, and endure a 120 mile trip, in pain, when my son is not able to drive me. He, of course, (this other Associate)  put me on a scale, said "you're too heavy, take the weight off, you won't have pain." I ran out of his office. next time I saw my doc I got a 40 minute lecture about the visit with the other doc. So, I guess the axe fell on him, too. I'll just do my best, but with all the stress, and pain and misery,  we live with, why does a visit to a doctor have to add to it all?
Hypothyroidism, Fibromyalgia, Facet Joint Syndrome, High Blood Pressure, menopause, Migraines, Chest Pain, Anxiety and Depression/BiPolar II
Synthyroid .075mg., estradiol.5 mgs., Amyltriptilene, 100mgs, bedtime, Tylenol 3 PRN (six-eight, daily), Valium 7.5mgs. daily prn. Flexeril, prn (not so helpful), Zoloft,150mgs., Zomig approx. 12 per month, prn., Meds for High Blood Pressure, vary.


Marlee2
Veteran Member


Date Joined Aug 2007
Total Posts : 6067
   Posted 6/2/2009 7:07 AM (GMT -7)   
Too bad they don't start a war on fibro too Donnaeil.  skull
 
I hope things goes okay today Tyno, maybe you should use the accident instead of fibro to get through to him. I am so blessed when it comes to doctors. I wanted to try provigil for energy so he let me try it and then adderal, even though he had to write a letter to my ins co for me to get it. Neither worked but he let me try them. Like Sherrine I have vicodin for backup but it will expire before I use it I'm sure. My rheumy is the same way as my GP and I wanted to try a little neurontin, he didn't have a problem with it, sadly I haven't tried it yet cause of my medphobia. They both work with me when I come up with a new idea that I read on here and I so wish all of you could find docs like that. They neither one work for a group that has to meet a quota either so time is never an issue.
 
luv and hugs
Marlee
Forum Moderator Fibromyalgia
 
Fibro,Sjogrens, Anxiety, Gastroparesis, IBS, Gastritis, Allergies, High Blood Pressure, Low Blood Sodium and Osteoarthritis
 
Amitriptyline, Celexa, Xanax, Synthroid, Zyrtec, Micardis, Spironalactone, Tylenol, Reglan, Lidoderm Patches and Tramadol
 
Co Q 10, Super B Complex, Extra B12, Multi vitamin


Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 17097
   Posted 6/2/2009 1:44 PM (GMT -7)   
Tyno, the rest are correct.  Getting pain killers is no easy task, no matter where you live.  My doctor told me he doesn't like to give out too much because, after a while, you need more to get the same pain-killing results because your body becomes accustomed to it.  Then, you can end up with a problem.  I don't want to go there at all if I can avoid it.  But I sure am glad I have the Vicodin in the medicine cabinet. 
 
My comment was about the doctors you are dealing with.  Six minutes for an appointment?  (You probably are waiting a long time for that six minute appointment.)  He should take the time to listen to you, read what you felt important enough to take to him, etc.  I was ticked off at that.  No one should be treated like that!  The way you described your doctor and the fact that you said most of the rheumies still think fibro is all in your head, doesn't sound like doctors I've run into in the US.  BUT, I know there are some like that out there and those are the ones to avoid. 
 
Sherrine 
Forum Moderator/ Fibromyalgia
***********************
Fibromyalgia, Crohn's Disease, Ostomy, Diabetes, Autoimmune Inner Ear Disease, Osteoporosis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
God does not give us a spirit of fear, but of power and of love and of a sound mind.    2 Timothy 1:7


tyno3
Veteran Member


Date Joined May 2008
Total Posts : 1081
   Posted 6/2/2009 6:27 PM (GMT -7)   
Well, I held my ground, but hit a wall with the doc. He had a look of pure disdain on his face, after I waited an hour to see him, I had six things on my list and some literature for him, about Fibro. After the second question, he looked at me and said "do you have anything else on that list?"Like I was a naughty child taking to many cookies from the jar. When I described tumbling backwards out of the bath, falling on the floor and hitting my head on the door, I said, I've had neck and sciatica pain since. He said ÿour sciatic  nerve is nowhere near your neck". Well, since our BR is tinty, I explained, I hit my back on the toilet on the way down. He just stared. Thenhe oblidgingly took my bloodpressure which was high, refused me the muscle relaxers I asked for, and refused any further help with the pain. There was smoke coming out of my ears as I left. At least, this time, I didn't leave in tears, but it kind of summed up the whole issue for me. I need a new doc. He seems to consider me a hypochondriac, junkie. So, I need to  contact the Fibro Group in this area and find a doc who is a believer. This gets so tiresome, dealing with his disdain and the pain and fatique and frustration of not being able to get things done. then to top it all off, I return home to a moping 22 year old, who is  complaining about being bored as I spend my last funds on dinner for us. He's off to see some girl, says he'll be back on the weekend to help me with a flea market, but hesitantly, as he says it makes no sense to sell belongings which cost more originally, than I'll ever get for them. Where do you think the money for your car, cell phone, gas, and food and internet, and free lodging comes from, son? So as most 22 years olds, I guess he thinks I have a money tree in the backyard. Thento top it all off, I  misplaced my cell phone, left it in a gas station washroom right after my most unpleasant doctor's visit. I didn't even bother to give the doc the info on Fibro, he's made up his mind, there's no educating him. I will have to find a doc who treats Fibro. I feel like I'm trying to patch together a quilt, from fabric well past it's expiry date. Anyhow, there's always tomorrow. Thank-you all.
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