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Posted 6/11/2011 3:12 PM (GMT -7)
Ok..I don't want to keep going back and forth and not trying to make you do this...I am only going on what you said...and I know that you said that in April you went on the 25..then the 19th in May...that would leave you with 5 days worth of pills or 30 of them when you picked up your new prescription...

And yes..if you have days that you take less than 6...then that will also make it so you have 'extra' pills by the end of the month...

Straydog and i were just saying that from what you had written...your issue was not running out early...so there wouldn't be a need for the Dr. to up your amount per day..we were disagreeing with Razzle's post that you should tell your Dr. you need another Tramadol per day....that was all...

And yes...as I've stated in all my posts since you said you are going 'next' Saturday...you are going on day 31...there should be absolutely no problems...

I, and a few others were only confused from your very first post about 'this' Sat. not 'next'...so that was cleared up awhile ago...no worries:)
Posted 6/11/2011 3:47 PM (GMT -7)
I'm not trying to argue with you, so please don't take it that way. I just want it clear about what I mean by "early" and how I go about deciding when to get my tramadol refilled each month.

It's a a combination of how much tramadol I have left and when I'm going to be going into town for other reasons, like getting groceries, seeing my doctor, taking my dog to his vet, getting my car worked on, etc,.

When it comes to this month specifically, getting it on Saturday (when I will be going to town for other reasons) will leave me with five extra days of medication since I got it on the 19th of last month and the 25th of the month previous. That's the reason I started this thread.

I don't know if that's way too early and has the potential to cause problems between my doctor and I. He's a very good doc and I don't want any mistrust between us.

So in order to prevent any chance of that happening, I'm probably going to error on the side of safety and just wait until early in the week after next before getting my tramadol refilled. If I get it on the 23rd of this month, that should be a safe zone with no room for anyone to complain.

Post Edited (newname) : 6/11/2011 4:50:43 PM (GMT-6)

Posted 6/11/2011 3:54 PM (GMT -7)
....wanted to second what Straydog says,..... that being less than honest could lead to bigger problems down the road. It's one thing to cheat in the opposite direction on a good day, and save a few back that way, however, one thing to consider, is that, if you're PM or PCD has your blood checked to see if your taking what was scripted, and find a lessor amount...well then you might find yourself in a tight spot for treatment.

....so I agree fully that honesty is the best road to travel. Just be very careful if you are taking a risk....somewhere down the line you're going to loose. (to all members and visitors, in general) I think we all, have at one time or another taken risk in life....and many will tell you its not a wise road to head down. Myself Included!

I think Snowbunny has covered about every angle on this post, and her keyboard, must be in need of replacement by now!smilewinkgrin Good Job!

Take care,

SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

Post Edited (Screaming Eagle) : 6/11/2011 5:11:13 PM (GMT-6)

Posted 6/11/2011 4:14 PM (GMT -7)
LOL...I know...I'm sorry to Newname too...I wasn't trying to argue either...I promise:)...I am just a super throurough person when it comes to medication and I think we went back/forth in the beginning due to the misunderstanding...I think it's all cleared up!..

Newsome..I think I am also trying to help so much is because when or if, you ever get moved to a controlled narcotic...then you absolutely have no room for error...that is why we suggested from here on out to just write everything down so at any moment...you know exactly how many pills you have...

Lots of us have been at this for years unfortunately...


And maybe it's on your other posts...but I don't know what your diagnosis is and if you have had a recent MRI or injections....so I will read your other thread and see if it's there..

SE...at least I type really fast:)
SB and "the pup who snores loudly" 

ACDF C5-C7, (no hardware), with autograft bone Nov. 2001

(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 

ACDF with hardware, allograft bone Nov. 2005 

Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

 

 

Posted 6/11/2011 4:36 PM (GMT -7)
Well. I'm not going to lie to my doctor. Truth be known, there are days when I wish I could take more of the tramadol than has been prescribed because sometimes while working on my farm I have to put more into it physically than usual, which obviously will result in more pain during the evening.

But since I also take wellbutrin, which has an interaction with tramadol that can result in seizures if the dosages of both medications aren't strictly controlled, I'm not even going to ask.

What I might do is ask my doctor if it's okay to take an ibuprofen if the prescribed dosage of tramadol doesn't seem to be getting the job done on any certain day.

And for anyone who thinks I like taking multiple pills every day, I've got news for ya...

I'd much rather be a carefree teenager again or in my early to mid-twenties back when the only pain I experienced was the occasional headache from overdoing it the night before.
Posted 6/11/2011 4:52 PM (GMT -7)
No one is suggesting that you may be taking extra med's above and beyond what is scripted to you. Stray and I wrote what we did because of a suggestion here on this topic. I made it clear that I was talking to the members and visitors in general.

Just, reread the help here, and I think there is more than enough information to point you in an excellent direction.

Please do keep us informed as we all benefit from information like this. Good questions and answers today!

Good luck and again Welcome to the forum.

SE
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"
Posted 6/11/2011 5:03 PM (GMT -7)
I certainly wasn't suggesting or saying that at all either as you can read from my posts...

None of us who are medication 'like' taking it...just like none of us like being in pain...we all have different stories that have led us here to chronic pain...mine is from over 10 years and 3 cervical fusion surgeries...lovely metal in my neck to keep me from breaking...lol...as well as a pituitary brain tumor...

So believe me...we all get it and empathize...I know myself and others who posted are only trying to help you..
SB and "the pup who snores loudly" 

ACDF C5-C7, (no hardware), with autograft bone Nov. 2001

(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 

ACDF with hardware, allograft bone Nov. 2005 

Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

 

 

Posted 6/11/2011 5:17 PM (GMT -7)
It's all good.
I just want to be clear on how careful I really am when it comes to my prescriptions.
Along with having back pain, allergies, and OCD, I'm also a raging hypochondriac.
I've had cancer about a hundred times during my life (not in reality, but I convinced myself of it that many times).
There is just no way I'm messing around when it comes to the medications I take.
I don't even like to read the possible side effects of each med because I'll probably be too afraid to take the medication.
Of couse, I read them anyway because it's just the intelligent thing to do.
I know that abusing tramadol can result in seizures and something called serotonin syndrome, which can kill you dead.
I'm not ready to go just yet.
Too many things I don't want to miss.
My daughters graduation from High School and college.
Her wedding.
Threating her future fiance with a major butt kicking if he ever hurts her.
Seeing my grandchildren for the first time.
You know, those kind of things.
So don't worry about me getting whacked on any drug.
That just isn't going to happen because despite my pain, I love my family too much to do anything that will take my out of their lives before it's really my time to go.
Posted 6/12/2011 9:54 AM (GMT -7)
I'm confused. What kind of testing does a doctor do that determines if I am taking my prescribed meds correctly? All of my prescriptions state as needed.....
Posted 6/12/2011 10:37 AM (GMT -7)
Hi Harley..Not to take up more space on Newname's thread but I'll answer quickly and if you have more questions...Feel free to start your own thread with the Post New Topic button:)

A Dr. can ask for a random Urine Test which these days...they are extremely sensitive and can guage not just that you are taking a medicine, but how much you are taking....They also look and test for every single type of legal and non legal meds in your system..

As well as they can call and ask you to come in to do a pill count at anytime...

Dr.s care that people are taking their medicines correctly and as prescribed...not taking enough can signal perhaps that someone is selling their medication...Taking too much is obviously abusing the prescription...

Then they can dismiss you right then and there and then it is also on one's medical record.

Your own Dr. would know that if you take them 'as needed' you would then provide them with the bottle to show this as well as let them know how many you had taken in the last 24-48 hours (depending on the medicine) so the test would match up.

No one has suggested anyone here is doing this...so just for informational purposes only..

Posted 6/12/2011 11:38 AM (GMT -7)
I didn't know that doctors were allowed to call you in so that they can do a count of your pills or a urine test.

I'll ask my friend who is a lawyer, but is that even legal?

And what if they call me to come in on a certain day and I'm busy doing something?

Am I supposed to just drop everything and go running to the doctors office?

If you're on probation the police can show up at your house at any time to collect a urine sample, but it seems like a fourth amendment violation for a doctor to require that kind of test for his patients unless he or she is doing so prior to puttting someone on a new drug. Sometimes they have to test your liver to see if you can handle certain prescriptions, but doing a random drug test when someone isn't on probation or parole sounds legally shaky.

With all that said, when I had the trouble with walgreens that I mentioned earlier, I told my doctor that any time he wanted to test my blood to see how much tramadol I had in my system, all he'd need to do was ask. I even offered to let him test me that very day. All he did was give me a funny look.

In my 42 years on this planet, I've seen many doctors and not once have any of them requested a urine test or to count the pills in my prescription bottle. I've never even heard of such a thing.

I'm not saying they can't or that it isn't legal, but I'd like to know more about the legality of this.
Posted 6/12/2011 12:20 PM (GMT -7)
Newname...it's absolutely legal because controlled substances and narcotics are legislated and monitored both by the DEA and the State...

That is why an actual Dr.s license can be revoked if they are not adhering to the law of dispensing narcotics. Same with a Pharmacy as they have to do things by the book and follow the same laws. This is why there are so many 'pill mills' being shut down day after day in Florida and many other States..

Laws have been tightening up year by year....and the DEA is working with each State.

In VA...all Pain Management Dr.s have to have their patients sign a Pain Management Contract if they are taking any controlled substances or narcotics.....This contract lists all of the things I listed in the post above...as well as with dismissal from their office for any violations, they do NOT have to provide any narcotics to wean you off...Only for medicines that have lethal side effects of withdrawal...

That's why Tramadol is now becoming a controlled substance in each State..it just hasn't gone into effect where you are yet....It is in VA.

As well as I've been trying to warn those who are being managed by non Pain Management Dr.s for chronic pain...They are moving towards not allowing GP's, Rheumatologists, Surgeons etc. to provide LONG TERM (over a few months...like after a surgery or initial diagnosis) pain relief with narcotics..

The reason is that only Anesthesiologists or other Pain Mgmt. Dr.s have SPECIFIC years of training and medical knowledge of these types of medicines...that is why it is their practice...

So...even though I am friends with my PM...have been going there for 5 years...never had an issue...I had to have the standard yearly (they can do more if they choose on patients) urine test. It was my first time ever having this done...My Dr. is so kind to people who don't have insurance that he worked it out with the lab to 'write off' the cost which is over $400 and some are up to $1000...because HE is not requesting this...but the DEA and my State requires this. So he feels bad for those patients who can't afford it and pays for the test...

As well as monthly or every visit pill counts...again...if the Dr. does not follow these procedures to the tee....he can lose his license..

I also mentioned in another post about the State Prescription Monitoring system..This is where any Pharmacy or Dr. can ask them to pull up your name and it will show any other place you were dispensed medicine...this keeps the 'Dr. shoppers' at bay...They are hoping to move it to nationwide eventually...

So....in your State certain things may not be mandatory yet...you can look online if you choose.

But it's all legal..and even though it's more paperwork and monitoring by the Dr. on his end...My Dr. and his colleagues don't mind as it's helping to weed out those abusing the system so they can spend more time and effort on those of us with true chronic pain!..

I certainly don't mind it at all as it's not a big deal to me to bring my meds on a visit..Yes..they 'can' call anyone at any time to do this...but usually don't for those they trust..and only have them bring it to the actual scheduled appt.

For those of us who do everything by the book, like yourself...it's not a big deal..
SB and "the pup who snores loudly" 

ACDF C5-C7, (no hardware), with autograft bone Nov. 2001

(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 

ACDF with hardware, allograft bone Nov. 2005 

Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

 

 

Posted 6/12/2011 12:55 PM (GMT -7)
 

Hello Newname,

Perhaps I can be some help. I am a pharmacy tech and as you've heard already Tramadol is non narcotic so getting it filled early generally isn't a issue. The thing is your INSURANCE decides when you may and may not fill your medications. The only time pharmacist are brought into the mix is when we see a consistent pattern of schedule c-2 abuse ( ex: percocet, morphine, fentanyl so on) or any controlled medication for this matter. If you are consistent about getting it filled the same time every month and allowing us enough time to get it filled for you then you should not encounter any problems. If you get a large quantity of narcotics and then want them refilled before you should actually run out and are doing it consistently every month then that is a red flag that you are not taking the medication as specified by your dr and abusing it or selling it. At that time we will usually contact the dr and start asking questions. You though have nothing to worry about. Usually a 3-5 day grace period is more than adequate for insurance companies. As long as you have refills on your medications just call the pharmacy and have them process your prescription before you go into town. They will be able to tell you if it's too early to fill or not.  Hope this helps!!!

Posted 6/12/2011 1:15 PM (GMT -7)
Nsearch...thank you for your view of things on the Pharmacy end...Just realize that Tramadol is a controlled substance in some States now..I live in VA and it requires a Dr.s authorization.
SB and "the pup who snores loudly" 

ACDF C5-C7, (no hardware), with autograft bone Nov. 2001

(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 

ACDF with hardware, allograft bone Nov. 2005 

Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

 

 

Posted 6/12/2011 2:08 PM (GMT -7)
Thanks for both of your responses.

Snowbunny, I don't see a pain management doctor.

My regular physician gives me the tramadol and has never asked to count my pills or take a urine sample. And I don't see him doing so in the future.

If he ever called me and demanded that I come in for a urine test or for pill counting, I'd tell him to shove it unless he was willing to give me a few days notice.

I have a life and can't just quit everything I'm doing to go to my doctors office.

Now, if I was there for a regular appointment and they asked for a urine test, no problem.
And if when I made the appointment they asked me to bring my pills with me, that wouldn't be an issue either. As long as the nurse is willing to wash her hands first and take my pills out of the bottle to count them, after or before which she would have to determine how many there should be, I've got no problem with it.

I'm not in the least bit concerned about that ever happening, though.

With my doctor, it takes over a week to get in to see him.

And once there, you'll be waiting in the lobby a minimum of thirty minutes past your appointment time and then another ten minutes or so once you get called back to one of his offices.

That's how busy he is, so I can't imagine them having the time to call somebody in just to test their urine and pill count.

But as I said, I would not stop everything just to go running to my doctors office at his request to check my pee and pills. If he wanted to drop me as a patient because of that, so be it.

When it comes to the DEA going to war against prescription drug abuse, maybe they should first consider how miserably they've failed to combat the use of ILLEGAL drugs. If they actually get to the point of not allowing general practicioners to dispense pain medications to patients for more than a few months, then something is very wrong. Besides, there are a lot worse things happening in this country than somebody popping a few extra vicodin. In my opinion, if somebody wants to endanger their health by acting that ignorant, let them. As far as I know, there is no law against stupid.


@nsearch212, thanks for your input. My insurance has already told me they'd pay for the tramadol next Saturday. I really shouldn't have to worry, but getting it filled then will leave me with five extra days worth since I had it filled on the 25th of April and then on the 19th of May.
I don't know this pharmacist very well yet and so I'm kind of weary of how strict he is when it comes to refilling pain meds.

Post Edited (newname) : 6/12/2011 3:50:54 PM (GMT-6)

Posted 6/12/2011 3:27 PM (GMT -7)
My point was more about the States that have this in effect right now...as mine is one of them...so it is coming to other States in the next few years to move to PM's prescribing and contracts being mandatory...again...someone like a Surgeon or GP can do this for a few months...and then refer to a PM which most do anyway so that their patient can get the best care..a Surgeon has 'done his work' and is moving on..A GP is not trained specifically in pain management..

By December of 2012...if a non PM Dr. wants to treat chronic pain patients with narcotics..(long term) they will have to go through rigorous training and testing to do so. Some will choose to do so..others will not and just refer to PM..

Keep in mind..PM's do so much more than prescribe a narcotic...their job is to help us live the best possible life with using every modality to help our pain.

If it were as simple as just a 'few' people here and there taking some extra Vicoden..Unfortunately, the latest statistics are over 10 million people a year that use prescription drugs illegally...over 21% of youth 12 and over admitted to abusing prescription drugs...and over 425,000 reported emergency room visits last year due to narcotics abuse and overdose...

So...lots of us in chronic pain, like myself for over 10 years...has known that this has been coming down the line for things to get more strict...it's unfortunate but it's reality that those who have misused have made it more difficult for us who truly need care.

I really do give credit to those caring and wonderful Dr.s who are staying in their practice through all of this to keep helping cp'ers...

Ok..I have typed as much as I can on this thread...LOL...so time for me to move on as it's 2 pages...

Hope you have had a good weekend Newname and a good week ahead:) Be careful with that heavy lifiting!

Post Edited (Snowbunny21) : 6/12/2011 5:00:48 PM (GMT-6)

Posted 6/12/2011 5:08 PM (GMT -7)
Again, I think it's stupid to not allow a GP to give someone medication for chronic pain. A few months and then they'll have to send you to an expensive pain specialist?

For one thing, tramadol controls my back pain quite well.

In other words, it's under control and I have my general practicioner to thank for that.

Why should I have to suddenly go to a specialist to get the medication I need when I've already gotten it from my regular doctor?

I don't need an operation yet and might not if I'm lucky. Unless it gets to the point that the tramadol can no longer keep the pain down, there is no logical reason I should be forced to go to a pain specialist who likely won't do anything different than my current doctor unless the pain gets worse?

Posted 6/14/2011 5:54 AM (GMT -7)
I am not trying to be dishonest , but there has been times I needed a extra one. also if you get the 50 mg tablet then you can add one or 2 . But I did tell my dr . I need a little more help and she said fine . you can go up to 400mg per 24 hr period with Tramadol . No more . also you may need like a muscle relaxer with the Tramadol if its your back . and too straydog there are some days I only take one or 2 . yu just never know . Bottom line is if your hurting more tell your dr. R

its not a Pharmacy problem . best wishes to you

Posted 6/14/2011 7:06 AM (GMT -7)
In todays medical climate, I'm afraid to tell my doctor that there are days I need more than the three hundred mg of Tramadol that he's prescribed.
I'd be worried that he would think I was lying or trying to dope fiend him. He's already told me about clients he has (no names were mentioned) that he thinks were using him as their personal drug dealer. And he cut them off.
Apparently they were relatively young (like I am...though people in their teens or twenties might think being 42 makes me older than dirt), and kept coming to him every few weeks asking for pain medications.
Doctors are really being put under the microscope in terms of how they prescribe pain medications, so I don't want to push my luck with this guy.
Is it fair that someone who takes their pain medication according to the instructions on the label should have to be worried about telling their doctor that they need an inscrease in their dosage? No, but that's how it is.
Posted 6/15/2011 12:43 PM (GMT -7)
I am not worried about it , If I am in pain I tell them . as my disorder symptom is PAIN
Posted 6/15/2011 6:08 PM (GMT -7)
I haven't read through all of the replies but I can tell you what I know....I actually looked at the bottle of my subutex and it says "Most insurance companies will allow your next refill on or after..." and the date is about four days from the one month mark. Actually, most pharmacies prefer for people to call in refills a couple of days ahead of time. Also, since you are getting this refill exactly one month after the last one, there will be NO REASON for a red flag. Also, keep in mind that there were 31 days in May.

I understand your hesitance due to stigma attached to pain meds in general due to people who abuse the system (patients AND there are doctors out there that do it too believe it or not! I just watched a special on Dr. Oz the other day about "pill mills" becoming a rampant problem in America!). If you were getting your prescription, say five days early this month again, that "might" be a red flag. But you are getting it 31 days after your last fill of the prescription...that is what the pharmacist is going to look at. And if you have insurance, the insurance company goes by your last fill date (unless you have had an increase in your dosage and you have a new prescription with the new dosage and are getting it early for that reason). I think if you were to get it four to five days early EVERY month for several months then your insurance company may write a letter to the doctor, but one month and then the next month getting it 31 days later, I can't imagine why in the world anyone would call your doctor for that.

I hope my response doesn't seem insensitive. I just want to reassure you that you have nothing to worry about. You have done nothing wrong. :) Hope this helps!
Subutex-2mg daily(for pain only), (stopped Opana 6/8/2011) Aleve, Tylenol, Wellbutrin for chronic pain. Arthroscopic hip surgery 2007; Compressed nerves in low back due to bone spur causing low back and bilateral burning pain.
Wife and mother of two children. I HATE what pain medications have done to my life. I have went from a very outgoing person to a "blob of NOTHINGNESS!!
Posted 6/16/2011 9:28 AM (GMT -7)
wanttolovelifeagain, your answer didn't seem insensitive in any way. I'm probably just being paranoid, but so are some pharmacists. It's just the current situation with people abusing painkillers (and some doctors handing prescriptions for them out like they are Halloween candy) has caused both people on pain medications and those who dispense them to be extra careful, sometimes to an arguably absurd extent.
Posted 6/16/2011 2:01 PM (GMT -7)
Sorry to add to this long post, but I must vent. I just returned from my scheduled appointment with my rheumy. He informed me that he received a letter from CVS Caremark informing him that I was taking too much hydrocodone a month! I only took them as my doc prescribed! Two tablets every hours. I never abused them and I only called in a refill 30 days from the last day it was filled. Only once did I try to get it 2 days early, but that was because I was going out of town. I have RA, Crohnes Disease, and Fibromyalgia. I have had both hips replaced, colon resection, ankle and knee surgery....you would think that my surgeries alone would justify my need for pain relief! I can't believe this!! Thanks for listening!!!
Posted 6/16/2011 2:25 PM (GMT -7)
Harley...to get more responses...it would be good if you hit the button.."Post New Topic"....and that way...people won't add to this thread as I am one that has made it very long!...LOL...but you will get more help with your own thread..
SB and "the pup who snores loudly" 

ACDF C5-C7, (no hardware), with autograft bone Nov. 2001

(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 

ACDF with hardware, allograft bone Nov. 2005 

Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

 

 

Posted 6/18/2011 9:56 PM (GMT -7)
New Name,

In answer to an earlier question, Tramadol is a Narcotic (of the fully synthetic opioid type), but traditionally was listed as a "centrally acting anaglesic". For years, many doctors didn't consider it a narcotic as the SNRI effects were considered responsible for most of the pain relief and the sysbstance was previously uncontrolled. However, in recent years, its now listed (atleast by my pharmacies) as a narcotic since its opioid effects are more known and recognized. This is also due to its abuse, partially due to ease of reciept from doctors as abusers would take advantage of its uncontrolled status and despite being a very weak opioid (again most of its activity is SNRI anti depressant like activity) abusers would simply take larger doses to fill the gap. The biggest risk is siezures and well ER room visits from tramadol oversodes became more common, causing several states to make it a schedule IV substance, the same cateogory as valium.

Therefore even though its still uncontrolled in most states, like Soma (another federally uncontrolled pain medication for muscle spasms, schedule IV in some states), most pharmacies treat it like Soma, a substance with abuse potential due and with less restrictive status.

Ultimately, the FDA would do themselves a HUGE favor by simply placing both Soma and Tramadol into either schedule V or IV, schedule V ideally since both medications have a low risk of dependency when taking in normal proscribed doses. As a low end federally scheduled drug, it would be subject to less diversion and abuse while still being prescribed without issue by most PM doctors and even primary care docs.

Consider that Lyrica is a schedule V and Ambien is a schedule IV and doctors routinely prescribe both medications without issue in most patients.....except for side effects ofcourse.
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.
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