I'm so sorry you are having such a hard time. I have a few thoughts, though....
--Please don't think I'm being harsh - because I say this ONLY because I really do care -- but you have to be more assertive and advocate for yourself. It sucks that it is that way.... but you have to do it. Otherwise, you'll only have more and more experiences like what you are going through right now.
I think you have some transportation issues, is that correct? Is that why you get your scripts mailed? Some doctors will make certain compensations for unique circumstances; I've had that happen.... but the "usual" protocal is to visit your doctor 1x per month for your prescription(s). In fact, I'm on so many meds/high doses/etc. that I go in every 28 days. That way - I have 2 days to deal w/ potential pharmacy issues (not having enough in stock and so forth). It's still for just a 30 day supply but it gives me enough time to get it all situated.
--I know a lot about the pain pump, particularly the kind that Laura described (Medtronic). In 2008, I had the trial (which you have to do first to see if it even will work for you). I've told my story here before.... but, long story short, I've decided to wait on the pump until the meds just aren't working anymore. I'm almost 38 and the pump is sort of the "end of the line". Don't get me wrong - it's a wonderful thing and helps many, many people. But it's a definite last resort after trying all possible oral meds and so forth.
It seems you were getting some relief from the fentanyl? Is that correct? That would be an even more reason not to go the pain pump route.... if something works - that's great! You just need to get your refills on time.... and sometimes that means being aggressive. I'm a normally "shy" person....but take me to any medical office/doctor/hospital - and I have a totally different demeanor :) I've had to do this in order to survive. I've had some horrendous experiences.... been treated horrible.... etc. - until I learned that I had to stand up for myself and, at times, say - "this is not acceptable". Period.
I hope you don't take offense to what I've said. You sound like such a nice, sweet, kind, polite person.... and those are all wonderful qualities. But this is also your health you are talking about. The thing I always say is this - there is not ONE doctor....in our situation (chronic pain/illness, on meds, etc)....that would wait and not get his/her refill. And, ultimately, our doctors work for us; we hire them to take care of us. Letting you go off of Fentanyl "cold turkey" - in my opinion - is just not accetable care.
Hugs to you, my friend. I hope you understand what I'm saying :)
Many, many health and pain issues.
Many meds - including Atenolol, Effexor, MS Contin, Dilaudid, Actiq (oral Fentanyl), Soma, Vitamin D, Iron (for anemia), Synthroid...and on the list goes.
Personal: I'm a Christian wife and mother; I have six sons and identical twin daughters.