Oh no, you are so right-you need to be seeing your dr for sure and insist that your appts be with him. If he ever questions you about seeing the other, tell him what happened. Thats BS, you have been a patient there far too long to have to put up with crap from some assistant in my opinion.
I would go ahead and get scheduled with him to get the Morphine out no sense in leaving something in there that is not working. I truly do not see how he thought adding Clonodine would help or even make a difference, all so wrong. I do hope he does right by you on this. There is a saying about pain pumps that is so true "your dr can either make your pump a success or a failure",. I have been on both sides of that coin and let me tell you, my new dr. is definetly making my pump a success.
The first year of my pump I truly thought I had made a mistake in having it put in. While titrating a pump the increases are usually done at 20%, well due to severe swelling of the legs and and feet my pm dr did not want to add to that problem by overloading me with pain meds and only did 10% increases which was nothing. I was in the very same pain I started with. After a year of that nonsense I finally told him a mistake had been made and all the crap he had told me on how much better my pain would be controlled was nothing but a lie and I had relied on him to tell me the truth about the pump. He was really surprised to hear that from me because I was not a complainer and I sure did not make waves and always went with the flow. But, I figured after all I went thru having the surgery, which was done as an out patient and that should never happen, I was tired of being Miss Nice Patient. I backed him in a corner and he knew I meant every word I said. As of right then I got a 20% increase and went back weekly instead of bi-weekly for increases until I got some relief. Don't get me wrong, I just loved this guy as a dr but I soon found out he wasn't worth a wooden nickel when it came to pain mgt and pumps and medications. He was just too green around the gills and he needed educating terribly. This is typical with many of the anesthesiologist turned PM drs. They just do not have the education and experience they need. They tell me generally speaking it takes almost 6 months to get you where you need to be with your pump. Naturally we are always started at the very lowest settings and most of the time the concentration level is the lowest as well.
After getting a new PM dr, my neighbor who is a nurse saw me outside one day. He commented that I sure did seem to be feeling alot better. I told what all had happened. He said well, I was really surprised that you were on such a low dose in your pump considering how long you had, had it. Like he said, someone could go to ER and get a shot of Dilaudid that was alot more than I was getting in my pump in 24 hrs. lol.
Its like my new PM dr tells me the pain will always come back and it will always be there. We will become tolerant to our settings over time. We will need increases and there is no set rule on when and how many it will take. She assures me on every visit that I am still considered a "low dose" and I have a very long way to go before ever maxing out on Dilaudid. She says even if Dilaudid maxed out or stopped working there are so many different drug combos that can used in the pumps safely. Knowing this is a great relief for me. She says she has one patient that has 7 medications in his pump and thats what it takes to keep this person mobile and able to have a life.
I do hope you get all this taken care of soon. Just hang in there and keep insisting that you see your actual dr.
Moderator Chronic Pain
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 & decreased circulation in both legs. 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 16 different daily medications. Intrathecal pain pump implanted June 05.