Living In My Own Dark Comedy

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BigLucy
Regular Member


Date Joined Mar 2007
Total Posts : 413
   Posted 10/27/2011 12:47 PM (GMT -6)   
Remember me? the one that goes to the chronic pain clinic that no longer believes in narcotics and was taken off of them this summer.  Well, Nothing, I mean, nothing has changed.  I go to the ER, I'm not joking, about every week and a half for fluids and pain relief; which, ironically, I've had no hassle getting IV narcotics each time (because the severity of my illness is all in the computer), but my PM MD is still holding out on giving me anything I can take at home.  And get this, every time I go to the ER the doctor asks me what is my treatment team is doing for me and I say, nothing mostly, no one calls me back and the ER MD says they will contact my doctors to inform them of my ER visit and encourage them to contact me.  It's been three weeks now since I've heard from GI and PM MD!  I email, I call, I've even filed a complaint with patient relations, which says they will look into it.  In the meantime, I'm living with really bad pain daily and that seems to be just fine with everyone as long as I'm not "addicted" to anything.  Aughhhhhhhhhhhhhhhhhhhhhhhh!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16804
   Posted 10/27/2011 1:44 PM (GMT -6)   
Lucy sorry to hear things are so awful for you. Can you change from the HMO you are on over to perhaps a PPO thru your employer? I know many times this can only be done at a certain time of the year. Is this dr the only one on your plan, the PM dr? One thing I learned about managed care years ago when it first was started was to never get on an HMO plan. We always had to pay a higher premium to be on the PPO, but it was always well worth it, they were not near as controlling as the HMO and the dr selection was much greater.

I hope you can get something done soon. Take care.
Moderator Chronic Pain Forum

BigLucy
Regular Member


Date Joined Mar 2007
Total Posts : 413
   Posted 10/27/2011 2:39 PM (GMT -6)   
Yeah, PPO to expensive b/c of copay; on a lot of meds and on average hospitalized twice a year at 20% copay--yikes.

One pill makes you larger
and one pill makes you small
and the ones that mother gives you don't do anything at all..

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 10/27/2011 4:54 PM (GMT -6)   
Maybe you can find a PM outside your plan. Most doctors offer a cash discount. My PM charges $110 under Blue Cross and I know he offers a reduced rate for cash patients. So, you might have to pay close $100 for an office visit, but if you only need to see the PM every three months or so for your refills, the total annual cost would be around $400. I assume you're probably paying a few hundred in co-pays with your HMO and ER visits are probably costing you money too. I am guessing, but $25 co-pays for office visits and $100 for ER visits? If so, then 4 office visits + 3 ER visits = $400.

Even if my numbers are wrong, it sounds like you need to step outside your HMO and just find a real PM. You might ask the ER doctors you've seen to give you a list of names. The ER Doc may also be willing to formally refer you? Alternately, have a look at ratemds.com. This and other sites can help you find a sutaible PM in your area.

You can keep your HMO for its drug benefits, etc. but if there is a real PM in your area whose office charges are reasonable, then you can get the help you need outside of your HMO. I assume that your HMO does not prohibit you from seeing doctors outside the HMO and hopefully they will cover prescriptions written by a non-HMO doctor (something you need to check).

When I had an HMO, I gave up and went to a few outside the plan, but I don't recall whether there was an issue with prescriptions.

It is not a fair solution, since you do have insurance, but it may be a practical solution both with regards to your unmet medical needs and maybe financially as well.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 10/27/2011 7:23 PM (GMT -6)   
Go ask Alice whens shes ten feet tall, go ask Alice, you think you know, when the white ones going backward and the left not at all, go ask Alice she thinks she knows, and your mind is moving slow, I dont know the rest but the last verse is feed your head, feed your head.
 
Love that song, Jefferson Airplace, Gracie Slick, we show our ages with these songs.
 
Now for your pm doctor problem, are you by any chance on medicare, the one great thing about medicare is you dont have to get prior approval to change doctors, you can see any specialist you want, you can get mri's anytime your doctor gives you a prescription for one, the only thing you cant do without prior approval is increase your meds, or change your meds, but even that is only one phone call away.  Your doctor calls your medicare approved pharmacy and away we go.  So if you do have medicare, get yourself another doctor, try to find out from someone else how the doctor is.  Check with the AMA.  Write letter to the AMA about the problems you are having with your doctor, who took an oath to "First do no harm".  They all need to remember that oath.
 
Good luck, take care
 
Kat
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

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 10/28/2011 3:25 AM (GMT -6)   
Oh Lucy, I'm sorry things are so bad for you still. Is a different doctor an issue? Next time you are forced to go to the ER, can they do anything about referring you to another pain management centre or GI?

Thinking of you.

Laura
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome, osteoporosis, osteopenia.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Midodrine, Somac, Cipramil. Have SCS, intrathecal pump with baclofen & bupivacaine and doing physio

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 10/28/2011 4:03 AM (GMT -6)   
I have to agree with Laura here! Surly the ER Dr's know something is terribly wrong, and that your not getting adequate care from your PM!

One would think that they would either report it, or at least refer you to another PM to take care of your need's. All I can advise is to get on the phone and keep looking.
Your insurance provider should have a list of PM's for you to check out. If your Primary Care Dr knows this is going on, than I believe I would drop him like a hot potato as well.
I have had trouble with a couple of PM's in the past, and I have always been able to go back to my PCD for care.

It seems to me that most PM's are referred by a Patients PCD, and in most cases it is required by the Insurance Company's….so the responsibility should fall back on your PCD, and he should be doing the referring for you.

I wish you luck for the tight spot your in, and hope something will give soon in your favor.

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"

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 10/28/2011 9:10 AM (GMT -6)   
Hello Lucy,
 
I've been keeping a check on you, although I haven't been posting much for a while.
 
I wanted to give you a word of encouragement and some well wishes.  I can't even imagine what you must be going through right now.  I know it is scary to get into a new Dr search.  I had to do that on a different kind of Dr lately and was so stressed at the first apt that my BP was "at stroke level" and my BP meds usually keep it low.  It's so hard to go in to any new Dr and tell them who we are (CP) and what meds we have taken (or are taking) because of the judgement.  In your case, however, you are going through too much for one person to deal with and it's wrong to continue suffering.
 
Have you considered a physiciatrist?  Ok, so that is a "crazy" question to some....but my psychatrist can prescribe and does prescribe for patients in chronic pain.  It's at least a start.
 
All my best to you!
TLIF L5-S1/failed, Pituatary disorder w/HGH deficiency, Fibro, Failed Bladder Surgery & Nissen, GERD, OCPD, GAD, MDD, CFS, TMJ, Migraines, Pre-glaucomic, HBP, Idiopatic Reactive Hypoglycemia w/Diabetic reaction to HGH, Bi-lateral CTS (surgery related trigger finger), Edema, Tarsal Tunnel Syndrome, Peripheral Neuropathy, Plantar Fascitis, Tibular Tendionitis, Adult Onset Flat Feet & much more.....

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 10/28/2011 11:01 AM (GMT -6)   
I agree with what the others said, next time you go to the ER have them recommend a doctor
in the area that might be willing and able to help...many many well wishes and prayers...
Keep us posted we do care and hope you can get better quality care soon...I'm in
search for another pm doctor, sure wish it was easy to find a good one....
Prayers and well wishes..
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

BigLucy
Regular Member


Date Joined Mar 2007
Total Posts : 413
   Posted 10/28/2011 12:59 PM (GMT -6)   

Thanks for all the suggestions, I've actually done everything I can do to advocate for myself in a HMO--not easy when you're weak and not feeling well.  I did talk to my latest GI yesterday and I heard some "fantastic sad " news; if I lose 10 more pounds, MD wants to put a feeding tube through my nose to bypass the stomach b/c stomach is not working properly; the BEST part is that I will have to go to work with this thing in my nose, taped--I already am sick of explaining things to my coworkers, can you imagine all the attention I will get with that? A friend suggessted I should just get a button made that says, "Feeding tube, don't ask" with an arrow pointed to my nose.

All this without pain relief.  It's so bizarre now that I can't stop laughing or won't because I'm afraid if I cry I wont be able to stop (crying that is).


One pill makes you larger
and one pill makes you small
and the ones that mother gives you don't do anything at all..

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 10/29/2011 1:56 PM (GMT -6)   
*gentle hugs* Lucy. I'm waiting on an appointment next week with my GI doctor so that w can work out how to manage a naso-jejunal tube for me without flaring my CRPS...my stomach doesn't work too well either. I had one for several months at one tim an they sure aren't fun, but at least I never had to try going to work with one. If you've got any questions about them, can probably answer them for you.

Laura
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome, osteoporosis, osteopenia.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Midodrine, Somac, Cipramil. Have SCS, intrathecal pump with baclofen & bupivacaine and doing physio
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