Fed up/Tired PCP refusing meds

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

leahlandrix
New Member


Date Joined Aug 2011
Total Posts : 9
   Posted 8/25/2011 3:53 AM (GMT -6)   
I am almost at my wits end with this issue.

I have been suffering from back pain for almost 3 years now.

Around the time it started, I had a back of the head trauma that resulted in me having double vision. I was told I had Increased Inter cranial Pressure and given a lumbar tap.

Not long after, I started to have really terrible/uncomfortable thoracic (upper region) back pain. Lots of sleepless nights, tons of miserable days. After MRI and Cat Scans that showed nothing they were looking for, My PCP treated me for about a year, trying first Diazepam, Flexeril, Tramadol and then finally Vicodin 5mg. After a while I was up to 7.5 and running through my prescriptions pretty quickly. I kept telling him that I needed 1 1/2 per dose to control my pain and he would only give me a warning through his nurses that I was using them too quickly. I repeatedly told him how I was using them, that I was not abusing them (giving/selling them away, taking for a high etc...) but he never spoke to me directly about any plans.

My "back spasms" (as they call them) did not stop and as of now, I am on my second Pain Management Dr (that I found myself). The first one just threw numerous muscle relaxers at me (which either didn't work and/or rendered me useless and sleepy) and eventually tried shot treatments that just didn't work.

My current Pain Management Dr is extremely hard to get a hold of, and out of my four visits thus far, I've seen him for a total of about 10 minutes. I am NOT comfortable with him. I went back to my PCP for help and he refuses to prescribe the only thing that helped, Vicodin. He even asked for the records from my current PM Dr (who does NOT believe in narcotics unless you have cancer) and I had them sent over, I guess as proof I wasn't receiving anything from him. After having him try "trigger point injections" and that only mildly relieving my pain for a week, he said he would not give me Vicodin anymore and he just phoned in a prescription for Tramadol, which really wasn't effective before and makes my ears ring.

I wish someone would have an effective treatment that would get rid of my pain and these huge knots/tender muscle tissue spots that every Dr has been able to feel in my back but not get rid of. But until I find that, it would be a godsend to get back on the medicine that took the majority of my pain away, Vicodin.

Aside from his frustration with my back, I do like my PCP, he's my family's doctor and I've seen him for years. But how do I talk to him about my pain needs and not seem like a druggie? Or since he's said he won't prescribe that, should I take that as a sign of his unwillingness to treat me for this condition and move on?

Any help is MUCH appreciated.

leahlandrix
New Member


Date Joined Aug 2011
Total Posts : 9
   Posted 8/25/2011 4:49 AM (GMT -6)   
See, this is what makes me upset. I told him repeatedly how much I was taking and what was needed to alleviate my pain. I was constantly in his office at this time and he even took a urine sample one time to make sure I wasn't taking large doses. Never did he mention that my dosage was an issue until it came time for a refill and it was relayed through his nurses.

Never once has he talked to me about substance abuse or any concerns, all of this information has been filtered through his nurses. Should I bring it up to him next time I see him? Or will I look like I'm drug-seeking and being pushy?

I feel in a way that I might have to be pushy bc I'm in serious pain that affects my daily life and I have NO one else to advocate for me.

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 8/25/2011 7:02 AM (GMT -6)   
Althought for the most part, I surprisingly agree with Requiem, I believe you may have burned your bridges with you PCP, and once that happens you have limited your resources.
 
I am not sure where you are, as in the country or city, but if you are in a city or near a city, I would consider finding another pm doctor, and probably a new PCP.  I say this because whatever records that are sent to new pm doctor are more than likely "red flagged", which means your records will include his reasons for thinking  you abusing your narcotic meds.
 
I see no other way out for you.  Sadly due to others who do abuse there narcotice meds, we all suffer the consequences.  So I would strongly advise you to begin again with getting both new PCP and PM doctors.  After that is done, you will have a clean start, and begin by asking your new PCP to recommend a PM doctor for you.  I am not sure how to find out if the new pm doc prescribes or not.  But if you have to begin again, so be it.  It beats walking around in pain constantly.
 
If you begin again, describe what is going on with your back, your pcp doc may ask for you to get mri's and ct scans, if they do, get them.  Alot could have changed by that time.
 
Good luck to you, and take care, please dont wait to long before taking action, this could only do more harm to you.  I know its a different pain to start over again with getting 2 new docs, but you may have no choice.
 
Hope you feel better soon,
 
Sorry, forgot to introduce myself, I am nini53/Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 8/25/2011 8:54 AM (GMT -6)   
I am curious about something.

Exactly how was the script written for the vicodin. This really will determine what your next course of action should be.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 8/25/2011 10:09 AM (GMT -6)   
Hi Leah and welcome to Healing Well's chronic pain forum. I am sorry that you have to be here but very glad that you found us.

I really hate seeing the mess things have gotten into with your medical care. But knowing how strict drs are when it comes to medication if you were taking more than what was written on your bottle, I see why the dr did what he did. In other words if the bottle said take 4 pills a day and you were taking 5 a day, that is grounds for a dr to cut off your medication and dismiss you from his care. Even though you did not hide from the dr that you were taking more the fact remains if you took more a day than how it was rx'd to you the problem remains the same.

If a person is given a medication that does not work, then the patient should make an appt & go back and see the dr and say I have been taking this and it is not taking care of my pain, is there anything else we can try to help get my pain level down. Also, we have other things we must add to help get the pain down besides medications, like heating pads and thing of that nature. When this has happened to me my drs have either increased my medication or even try me on something different.

I am sorry, please know we are not being judgmental here with you, we are just giving you our experiences that we have had after years of dealing CP and drs that take care of us. We have strict guide lines in place that we must abide by if we are going to get help from drs.

You may want to start fresh and find a new PCP and then ask to be referred to a PM dr. A PCP is not going to want to prescribe pain medications on a long term basis if at all. They don't have the time to deal with CP patients. A PM dr can be much more helpful since pain is his specialty. As far as vicodin being the medication that worked the best for you, I would not count of another dr rxing it to you. You may tell him that worked the best but that does not mean he will hand over a script of it.

Please take care and let us know how this turns out.
Moderator Chronic Pain Forum

leahlandrix
New Member


Date Joined Aug 2011
Total Posts : 9
   Posted 8/25/2011 2:19 PM (GMT -6)   
Thank you everyone.

Jim1969, to answer your question, I was prescribed for like 6 pills a day, every four hrs I believe. Usually when I would get a refill, it was past the day according to his written instructions but not according to his expectations, I guess. For example, he would write the script for 6 a day and then say he expected that to last me twice as long (like 3 a day). Also, he knew that during this time I was working 12 hr workdays, 6 days a week, 8hrs on Sundays on a job that was on my feet. My pain was exacerbated and my days were longer than most. I was (and still am, due to insomnia from my pain) sleeping an average of 5 hrs, if that. My insurance never had a problem refilling my medication and he never changed the directive on the bottle. I hope I explained that ok.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 8/25/2011 4:02 PM (GMT -6)   
Leah yes, you gave a great explanation on how the script was written. What I don't understand is why he wrote the script as he did if he had a problem with you taking one pill every 4 hours. Really does not make a lot of sense. I am sorry that you are in the situation that you, the only thing I can think of is you starting all over with a new PCP and then ask for a referral to a PM dr. By all means hold onto your bottles that say one pill every 4 hours, at least you would have those empty bottles to show how it was written legally.

Let us know what you decide.
Moderator Chronic Pain Forum

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 8/25/2011 5:49 PM (GMT -6)   
Just a little observation.

Most people who frequent these types of message boards are not going to understand medical abbreviations/shorthand. This is why instructions on pill bottle are not written that way.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

leahlandrix
New Member


Date Joined Aug 2011
Total Posts : 9
   Posted 8/25/2011 7:02 PM (GMT -6)   
You all have been very helpful. It appears the general consensus is I need to change doctors. Should I just start fresh, from page one? Including MRI's and everything (mine are about 1 yr 1/2 old)? Or is it best to be honest (which seems to have gotten me to this predicament) and tell them why I am switching? My concern with starting anew and getting a new dr is that right now I'm uninsured, so already expensive procedures and medications are going to really place a financial strain on me.

Also, since my PCP is not supposed to be treating my chronic pain anyway, is it better to just seek a new PM dr or will my records be "flagged", as someone mentioned?

Also, I don't keep empty medication bottles, is it possible to get a record of my scripts/refill dates from the pharmacies I used during this period?

Thanks for all the help guys, I'm really frustrated with this issue and have no one to rely on, so it means a lot to be able to come and get helpful, truthful advice.

leahlandrix
New Member


Date Joined Aug 2011
Total Posts : 9
   Posted 8/25/2011 7:03 PM (GMT -6)   
Oh also, requiem, you keep mentioning that he probably wont prescribe me any narcotics/opoids but he wrote me a script for tramadol. Tramadol is an opoid, isn't it? Or does it fall in another class than vicodin?

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 8/25/2011 7:46 PM (GMT -6)   
Leah, are you comfortable with your current PCP? If you are then perhaps changing drs is not necessary. Do you think he would be willing to help find you a new PM dr? It will be expensive and they will want payment up front since you have no insurance. Some PM drs will not see a patient unless they have insurance. Many times if a patient does not have insurance the dres will reduce their fees since the patient is having to pay cash out of pocket.

I am not sure if you are aware of this or not, but there are two different types of PM drs. One does procedures and injections only, no medication. The other of course does the same but will write a script for meds if he/she feels its warranted. Sort of sounds like you are in the no medication drs office.

Tramadol has recently been reclassified as a narcotic. Has anyone ever increased the Tramadol strength? I know a lot of drs really like to rx it to patients. Vicodin is so widely abused many drs will not rx it to their patients.

Yes, you can go to the pharmacy where you get your scripts filled and obtain a copy of the scripts you have had filled there. You could take a copy of this to your PCP so that he could see you were getting meds once a month and the printout should have the dosage on it too. Perhaps he would be willing to help you out with some type of pain medication until you could get in to see a different PM dr.

At this point I would not worry about repeating having an MRI done as these are very expensive. I would go with the films I have now unless something has really changed dramatically changed with you, or new and different symptoms are showing up with you. These are just ideas I have in mind.
Moderator Chronic Pain Forum

LordWood
Regular Member


Date Joined Aug 2011
Total Posts : 59
   Posted 8/25/2011 7:48 PM (GMT -6)   
I know I'm joining this conversation late but just wanted to add a few things. First Tramadol is a narcotic-like drug, what that means is its a opiate agonist which is a synthetic created drug to do like opiate drugs would do but just enough to help relieve pain. Basically just enough to help with the pain and not go overboard like opiates can. Less likelihood towards addiction problems as well.

Second you mentioned your having problems with your PCP prescribing for you, a lot of PCP's do not like to have to prescribe opiates and higher meds because of the way regulations are getting tighter on them. Most would rather like to pass you off on PM docs because they don't want to deal with it. You as another mentioned did hurt yourself by being honest to your doctor. When prescribed pain meds you never ever ever tell your doctor that your taking more then recommended because you are basically giving yourself the "Drug Seeker" label which then hurts your chances of getting anything. Especially if you try switching PCP's then because it simply looks like your trying to find a doctor that will give you drugs. This is the hard issue that doctors are dealing with in today's world because they have to try to separate and figure out who the drug seekers are from the true patients that are suffering and needing them.

Sadly to many doctors will just label all to often even the suffers drug seekers. What would have been help would have been to take what you were prescribed and then because of it not helping talk with your doctor about it. If he then continued to refuse to help you you could more on to another doctor but after telling him you used more then recommend you hurt your chances of getting him to help you and instead he simply begins to shut down in terms of wanting to help your further and would rather then the PM doctor help you. Which it seems you found a bad PM doctor is he does not believe in pain meds at other then for cancer patients. In my life so far in the medical field I've been on higher doses then most cancer patients ever get, so labeling it to the fact that only cancer patients need pain meds is severely unprofessional.

I just hope that you are able to get the attention of either a PCP or a PM doctor that you can tell your story to and that will actually realize your not a drug seeker and that all you need so help. All your asking for is a dosage of pain medication that will help you so that then you can function and won't have to take more. A drug seeker would constantly keep wanting more and more but it can clearly be seen this is not you. You are just pleading to be able to manage your pain until hopefully something can be found to fix your back problems. I wish you the best luck!! Trust me I know the medical field is screwed up and its understandable in some ways why because of all the druggies that have ruined it for those of use that really need the help.
I currently take: Cimzia 2-200mg injections, Zolpidem 5mg 1x daily, Vyvanse 70mg 1x daily, Dilaudid 8mg 4x daily
Health Issues: RSD, Crohns, Gastroparesis, Arthritis, Osteoporosis, Dysautonomia, & Remicade Induced Psoriasis.

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 8/26/2011 7:06 AM (GMT -6)   
I am confused, if your pcp doc gave you a prescription with instructions of taking up to 4xday or as needed, then what is the problem.  I have never heard of someone getting in trouble for taking there meds as prescribed.  If your pcp doc did not want you to take 4 a day he should have written it differently like for example 3xday or as needed.  Then if you were taking 4 a day you would be taking more than the pcp prescribed for you.
 
Also, as everyone else said, a pcp doctor is not going to prescribe long term pain patients the meds that are needed to let you have a quality of life.  But it is his responsibility to recommend that you go to a pm doctor, and then try to find one.   Again since you are uninsured, (which is an entire other subject that is a sore subject)  It may be wise for you to just find your own pm doctor and take your records with you.  Once you get your records from your pcp you have now, you can take a look at them and see if they reflect what your pcp believes to be abuse.  If you dont want to take your records, take just your mri's they tell the real story anyway.
 
Good luck and take care of yourself, as far as I am concerned you have done nothing wrong.
 
Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 8/26/2011 9:04 AM (GMT -6)   
My doctor prescribes Tramadol for me to use PRN. If I followed the label instructions but took it everyday instead of as needed it would last 10 days. My doctor informed me she expects it to last two months.
My doctor's office will not prescibe more than that-she would however contact my rhuemy or send me to a pain management doctor if I needed more than that.

Unfortunately the posters on this thread that pointed out that simply taking more than prescribed may have gotten you labled as a substance abuser are right. Even though the dose you took may not have been unreasonable once you start in on narcotics it's all about exactly following instructions.

I hope you have luck finding someone else to handle your pain management.

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 8/26/2011 9:13 AM (GMT -6)   
Leah, I do feel for you but I have to say that I agree with Requiem on this one, and I think that if you should have been talking to your PCP rather than continuing to take the medication at the higher dose.

It's much like my Endone. I get a supply of 50 tablets in one go and my box reads 'Take ONE to THREE tablets FOUR times a day when required'. It doesn't mean that I use my entire prescription in less than a week. Does that help to clarify a little? :-)

Laura

Mysti
Regular Member


Date Joined Jul 2011
Total Posts : 101
   Posted 8/26/2011 1:37 PM (GMT -6)   
Leah, I think it is totally understandable why you took the dosage you did, because you knew that would relieve your pain. However, I have to begrudgingly agree with the others here in that this is pretty much a "No No" when it comes to CONTROLLED substances. I can't tell you how many times I have been tempted to do the same thing, when my pain was intense. And to be quite honest, I have done it...but not on a regular basis....and BY NO MEANS am I condoning this behavior. I always had to make up for the extra I took, then had to suffer because I didn't have enough meds to take. It became a vicious cycle of constantly counting pills and "stretching" them out so I wouldn't be without at the end of the refill month.

This is the reason narcotics are controlled substances. We may feel like since we paid for the pills and they are OURS, we can take them as we see fit. But unfortunately, that's not how it goes. You simply MUST follow the doctor's instructions or face the consequences that you now are facing. I do, however, think that the doctor is somewhat to blame for this situation. He should have, in the very least, made it clear to you how he wanted your script to be taken. I agree that by writing "as needed", it becomes a bit ambiguous and can cause misunderstandings or abuse. My pain med isn't written that way. My hydrocodone script states "Take 3 times per day for 30 days". My doc told me to space them out as I felt I needed to each day, but only 3 per day. I think if she had written "3 times per day as needed for pain" (as most pain meds are written, I believe...just from my experience as a nurse) she would probably question my refilling at same time each month.

As far as where to go from here....I think if you really like and trust your PCP, then you should keep him. But I feel you definitely need to start from scratch with a new PM doc. I don't know how big your city is or how many PMs are in your area, but look around. And I think it is your right to not let the new doc see your old records if you don't want to...you do have to sign a release for him to get those records. But then again, the new PM also has the right to not take you as a new patient if you don't submit your records. But DO give him your xrays, MRIs etc.

As far as having no insurance, that is a big problem, unless you can prove you are indigent and on public assistance. If there is a local teaching hospital, you can discuss this with their business/financial office and they can determine if you can receive care at their facility without insurance and at a drastically reduced rate plan. Most have medical clinics in house with pretty much all specialties of medicine and you could get a doctor there. I would check into that.

I'm sorry for all your going through. I totally understand your predicament, but when it comes to controlled substances, we simply CANNOT be in control.
DDD, 3 bulging lumbar discs, bone spurs, facet joint arthrosis/sclerosis, osteoarthritis
New Topic Post Reply Printable Version
Forum Information
Currently it is Friday, September 21, 2018 9:59 PM (GMT -6)
There are a total of 3,005,613 posts in 329,243 threads.
View Active Threads


Who's Online
This forum has 161786 registered members. Please welcome our newest member, Wildcat44444.
286 Guest(s), 8 Registered Member(s) are currently online.  Details
Mind body spirit, clocknut, Fegyduck7, Wildcat44444, island time, sebreg, Healing98, Alxander