Posted 6/6/2013 4:21 AM (GMT -6)
Hi there, my name is Amanda, I am a chronic pain sufferer. I had a head injury in 2008 resulting in a concussion, although it was not a TBI, I did have a concussion which later caused PTCS (Post Traumatic Concussive Syndrome). I have been on pain meds ever since, and recently have come across a dilemma and would love some input and found this forum.
I am currently taking #15 Roxicodone 3x/day and #10 Oxycontin 2x/day. I used to take 3 Oxycontin's a day but 3 months ago was switched to 2 during a pregnancy, and never asked to return to the 3 after the pregnancy due to breastfeeding.
After my pregnancy resulted in the birth of my son, my PM doctor terminated my contract with them after 34 months of seeing them, and before that a different PM doctor. His reason for terminating me was that he felt as if I had reached maximum meds for my age and have been stable on that dosage for over a year (except the reduction I guess?). He told me that his facility has an agreement with my IPA that once stable, they have to send me back to my PCP to get the refills of the medication, and if any alterations need to be made, they then can send me back to be re-evaluated and stabilized.
I did protest in the beginning of the conversation, as my IPA never mentioned that in the referral letter and for 4 years I have been followed by a pain management facility (2 different ones). I went ahead and scheduled an appointment with my PCP and took my letter in tow from the PM doctor describing what meds I was on, when I was due next and why and how long I am expected to be on it.
I went to see the PCP (Never saw him before, been followed exclusively by the PM doctor, didn't have a physical in over 3 years) and unfortunately it didn't go as planned. I was treated like a drug addict from the time I walked in the door. He wouldn't accept the letter I handed him, he went ahead and contacted the PM office himself, while making me wait to get the letter from them directly. Then he had his nurse look up all of my filled prescriptions at each pharmacy I've gone to in the past and confirm with them when I'm due. So he came back in the office with the letter I had already given him in hand, as well as the pharmacy records from 2 pharmacies in the past year I used.
That's when things got sticky. He wrote the prescription for 30 days out. At both PM clinics it was always every 4 weeks (28 days), so A) it doesn't ever land on a weekend B) The pharmacy runs out C) In an emergency to keep me from going to the ER when having a hard day or D) The doctor calls in sick or I am unable to get to the doctors. The basically leaves me with 2 extra days or 6 Roxicodone's and 5 Oxycodone's extra. I have depended on those extra Roxicodone's for a long time, and those have saved me MANY times, for many different reasons. First off, Walgreens and CVS never have the meds, and when I bring in the script has to order it, so I use a hospital pharmacy, the only one in the area who actually has it, and they are not open on weekends, so if day 30 lands on a Sat/Sun I'm screwed. Also just last month, on my way to PM my car broke down and I had to delay the appointment an extra day (also would have been screwed!).
Also, lets be honest here, there have been quite a few times, where I had a horrific day/night and needed that extra pill (and my PM doctors were both OK and aware of all the possible scenarios including an extra pill and actually do the every 28 days for all patients). Also I'm nursing, so if I miss a day, it's not just me who could go through withdrawals.
Anyway, said he would only write for 30 days, wont give extra pills. I finally got him to call my PM doctor and he couldn't get ahold of him. He rewrote the script for 28 days and said he will wait for the doctors call back and let me know. He called me back a few days ago and told me that he will no longer be doing it for 28 days, only 30 days. That the PM doctor did say that is how he does things, but that he doesn't feel comfortable with it. My IPA said that he would write the script for my PM doctor and just bring the letter, yet he wants to change it now to the 30 days after 4 years of it being 28. I am really worried and anxious about being without pills as I depend on them to get up every day, and now to care for my newborn.
He said he would have the patient liason give me a call, so I can let her know of my dissatisfaction with his decision, after I told him I would have to find another doctor. The liason hasn't called me, so I am planning on calling her tomorrow, however, I wanted to make sure that this is something I should do? That it isn't something I should just accept and move on?
I'm sorry this was so long and winded, but I am not sure how to proceed. As far as contacting the Patient Liason goes, what I hope to achieve is, finding another doctor within the IPA who will be comfortable following the same 28 day refill for all of the above mentioned reasons, plus I can get it the same day of my appointment, which is just a matter of convenience but a plus!
The weekend scenario will be coming up at not this appointment but the next, where I will be short pills for 2 days because he wont even post date the script so I can have a pharmacy order it, he's too paranoid they'll miss the post date, or I'll alter it. He even has a stamp that says call to verify everything you see before filling (how is that possible on a weekend??).
Thanks all for reading it thus far! Any opinion (for or against my stance) is much appreciated!