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Veteran Member

Date Joined Aug 2005
Total Posts : 617
   Posted 6/21/2012 12:26 PM (GMT -6)   
Hey Gang,
Just wanted to update you guys on my previous posts about my problems with being undermedicated for my current pain issues.  All of my specialists (Neurologist for migraines, Pain Management for bad back, orthopaedist for bad knees) require that my primary care physician (PCP) handle writing all my prescriptions for pain medication.  My PCP has kept me at the same level of medication for the past several years, which was #30-Lortab(5/500mg) every 7-10 days and #50-Tramadol(50mg) every 30 days.  In addition to the medication being insufficient, I also had the hassle of having to manually get new scripts every time, as my PCP would never include any refills.  Note: I don't take the opioid pain meds for my migraines(I take Seroquel) unless I have to get an injection, but that's a whole different issue.
I finally decided to schedule an appointment with my PCP specifically to discuss these issues.  I prepared for my appointment by writing out a three page document covering all my information so I would have the best chance of being successful.  I started out with the reason why my medication needed to be reviewed, I listed all of my locations of/conditions that cause my pain, then I followed up with all the things I do to mitigate my pain, in addition to my medication, like using a TENS unit, doing YOGA, hydro-therapy, meditation, etc.... Next, I listed all the reasons my current level of medication is no longer sufficient and what I have to go through every time I need a new prescription(it's a real ordeal).  Then I made a table showing my doctor exactly how I take my medications, which is different than prescribed, but factual and representative of why I need more medication than I am being given.  I finished up with a copy of a equivalency chart of opioid medications to show him that I had done my research on the topic.
This may sound like a lot of information, but it only took my doctor two or three minutes to read and it summarized everything I needed him to know without my having to remember it all.  He just asked me a couple of questions to clarify a point or two, then he agreed to bump me up to #2-10mg Oxycodone per day, with #30-5/500mg Lortab (as needed for breakthrough pain) every two weeks, and kept my Tramadol the same.  
I have a follow-up appointment with him in two weeks to verify that this change has resolved my undermedication problem.  After a day and a half, already I feel like a new person.  Yesterday, I was able to completely clean my kitchen, including mopping the floor and cleaning the glass in the sliding glass doors, did a sinkful of dishes, and cleaned the oven.  I can't tell you how long it's been since I've been able to do that much activity in one day.  I'm taking it a little easier today, but I am so thankful that when presented with the facts of my situation in a logical format, my doctor found my request to be perfectly reasonable.
Maybe this approach will help someone else.
Leigh Ann cool

•On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ, stomach problems
•Divorced, 46, spawn-free


Veteran Member

Date Joined Jan 2010
Total Posts : 3557
   Posted 6/21/2012 12:48 PM (GMT -6)   
That's wonderful to hear!....

I am curious though why you have to go in every two weeks. This is very unusual as most prescriptions are written for 30 days.

On the addition front....that is a nice jump in dosage to add 20mg of Oxycodone a day. Are they Oxycontins or Oxycodone immediate release?

If they are immediate release...I am just putting it out there that for a PCP to prescribe 3 different immediate release opiates (Tramadol is on the cusp), this may cause issues down the line if you ever switch Drs. or for the state or DEA looking at this PCP's prescription practices. The reason is that immediate release medication is not recommended long term (more than a few months) as the main source of pain relief. As Breakthough...yes....

So I am wondering why they aren't referring you to a Pain Management Dr. at this point...

I just caution that you don't try to do too much, too soon even though I feel like a new person with getting some better pain relief. So just go slow...but I am doing a happy dance for you! LOL

Anyway....not trying to be a downer at all...I am very proud of you for approaching your Dr. in a very matter of fact way and giving them all the reasons for upping your dosage.

I just want to help you make sure you don't have any issues down the line because of this PCP.
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

Regular Member

Date Joined Jun 2012
Total Posts : 28
   Posted 6/21/2012 1:25 PM (GMT -6)   
We should all keep a journal when we have multiple issues. Times when pain is the worst. if it helps etc. My dr. complimented me on my "chart" as she called it. It makes their job a whole lot easier. Good for you writing it all down. Its sad that so many people have abused "drugs". That those of us who depend on them for chronic pain have such a hard time getting them. Have a good day.
today is yesterdays tomorrow.

Veteran Member

Date Joined Aug 2005
Total Posts : 617
   Posted 6/21/2012 1:46 PM (GMT -6)   
Hey Snowbunny,
Thanks for the feedback.  I have to go back in two weeks just as a follow-up to see how I am adapting to the new medication regime, not every two weeks.  I can't take extended-release medications, due to the fact that I've had a gastric bypass.  The coating on extending release medications doesn't have the opportunity to desolve in the shorter time that the medication would be in my digestive system.  I learned this several years ago, when I was prescribed Wellbutrin ER and was receiving no benefit from it.  Upon close inspection, I noticed it was passing through my system completely undigested.  I don't even get the full benefit of regular medications, due to my shorter digestive tract. 
I actually see doctors at two different Pain Management centers because of their specialties, one for orthopaedic issues and the other for neurological issues, both of which want my PCP to handle writing my pain medication scripts.  Both PM Centers are located in teaching hospitals, so for good continuity of care, they prefer to stick to doing procedures and leave the decisions regarding pain meds to my regular doctor.  I have a long history with this PCP, as I've been seeing him for the better part of 35 years, since I was about 12 years old!
And yes, I'm taking it much easier today, even though I feel much better.  I'm sticking to folding a huge backload of laundry!
Leigh Ann cool
•On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ, stomach problems
•Divorced, 46, spawn-free


Screaming Eagle
Veteran Member

Date Joined Sep 2009
Total Posts : 5005
   Posted 6/21/2012 2:19 PM (GMT -6)   


      Hello CRANKY! Love the name! tongue

          It's a good day, when a member gets a script that helps reduce their suffering!

      Congrat's, and I enjoyed reading the explanation to Snowbunnys question. I wondered the same thing, and it's a reminder that we are all different with different situations.

    Enjoy your much needed relief! Were happy for you! I'm still working on mine...not there yet, but moving forward.

      SE wink

Moderator Chronic Pain Forum

Weekly Quote!

"Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward."

Veteran Member

Date Joined May 2012
Total Posts : 619
   Posted 6/21/2012 2:36 PM (GMT -6)   
Something must be in the air because a very similar thing just happened to me a couple weeks ago. I have been under medicated for years. My doctor wouldn't even give me flexeril. I was on 5/325 Vicodin 3x/day and gabapentin 200mg 3x/day and THAT WAS IT. The Gabapentin had just been started a month ago. My life was pretty miserable.

Suddenly, on June 12th there was a complete turnaround. She put me on Morphine ER 10 mg 2x/day, Gabapentin 600mg 3x/day with the Vicodin for BP. And she even tossed in Flexeril 10mg 3x/day. The difference was amazing. I got all excited and cleaned the house lol.

So congratulations to you! I know how much relief you feel right now and how wonderful it is :)
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