Hello everyone, I am new here. I read quite a bit of the posts and I really appreciate all the info here. I am having some issues and I hope someone can give me advice?
Edit: Please read my responses before commenting so I don't have to repeat myself.
I have been seeing the same pain management doctor for about
6-7 years. I was referred to him from my family doc, who couldn't prescribe me pain medicine any more for my back due to my tolerance going up and the dosage going up as well. I initially injured my back while hiking up and down a steep hill here in Montana, pulling my two young kids in a wagon behind me. I went to many different doctors, physical therapists, chiropractors, etc. but nothing helped for long and they said the only thing they saw was degenerative discs (which they called normal with aging, ha!), arthritis, and a hemangioma on my spine.
My pain doc tested me with different things, I got MRIs, X-rays and injections. The injections helped, but the longest they helped was a week. The thing is, he injected in a spot different from where my pain is centered, I tried telling him but I don't think he listened to me.
It seems he gave up on trying to figure out what is causing my pain and instead has just been giving me the meds as a bandaid for at least a few months, possibly a year. I didn't know he gave up until my last regular appt when I asked him if his new stem cell business he might be switching to could help me, "we don't even know what's causing your pain". I was appalled! I didn't know he gave up on treating me!
Well, he also told me previously he was upset with the government interfering with his business and he already switched his board certification to something else. That's quite concerning for me, but I kept going to him, not wanting to rock the boat and hoping he would change his mind..
But over the years I have grown very tolerant to the meds I am on (Zohydro ER and hydrocodone for breakthrough pain) and he didn't want to increase my meds even though I was having a LOT of breakthrough pain over the past few months. So, I asked him if I could try different things to try to reduce my tolerance and/or my need for the meds. He gave me permission to try medical marijuana, which is legal in my state (Montana) and CBD pills and oil, which is legal everywhere. I tried them both to no avail. The CBD seemed to boost the meds a tiny bit, but the price for them to do so little is prohibitive for me. The medical marijuana seemed to help with my pain, but I was affected mentally and I do not want to be high. I need to keep my wits about
me and be able to drive WITH my pain relief working. That's obviously impossible if I'm "stoned".
So my last option was to switch meds. Every time we tried to switch meds, it didn't work for me. I cannot take NSAIDs, they cause my stomach to bleed and give me ulcers. Oxy types do not work at all for me, and the other stuff he had me try (Opana, Morphine) didn't seem to work, either. The last options are methadone (no thanks!), fentanyl (no thanks again!) and hydromorphone ER. So he put me on the hydromorphone ER (a week trial), but either he did the math wrong or he just likes to give 50 PERCENT less what his patients were taking, because I was still in pain. Before he gave me the script
, I asked him to be sure to give me some meds for breakthrough pain (since I remembered what happened the other times and they didn't work, I was miserable), he said, "I'll give you a couple." his exact words. He gave me 14 pills of hydrocodone, but he reduced the mg dosage. I was taking 10/325 and these were 7.5/325. I read the bottle, it said to take two and I thought he just made a mistake. I did the math, 7.5 x 7 = 52.5 mg, which is about
what I was taking before (I was taking 5-6 generic Norco each dose for breakthrough pain).
I waited till the evening and the pain was bad, so I took what I thought was one dose, 7 of those and went to bed about
two hours later. They didn't help a whole lot, but a little. The next morning I was hurting when I got up and waited a bit but took what I thought was the next dose and called my doctor's office to explain what was happening. The nurse was pissed at me, she was always pissed at something and even told me last appt that I was one of the patients she "hated to see come in" because my insurance gave her a hard time. I actually changed our insurance because of her! I can't believe she'd tell me to my face she "hated to see" me, but I didn't want to rock the boat so I didn't say anything to anyone...
Anyway, I explained to her that I took my rescue medication and I was still in pain. Long story short, the doctor seriously wanted me to take only TWO per dose, 15 mg ... when I was taking 50mg each dose just a few days prior. I misunderstood him, so he was pissed at me, thinking I was "abusing" the medicine!! He said, "that would be a dismissable thing". I have been seeing him for 6 years and never did anything wrong, I'm completely honest, I kept him informed on everything I have been doing.
He made me take a pee test, I guess he wanted to be sure I actually took the meds myself and didn't sell them or something. It's hard to believe he'd have such distrust, even after all this time, especially since I never lie. I guess I understand, docs must get lied to pretty often in that business, but it still hurts my feelings...
Well, he came in saying there was oxycodone in my pee! I tried oxycodone years ago through his office and it didn't work for me, I do not take anything other than what he prescribed, the medical marijuana and the CBD. He made me cry, it shocked the heck out of me, being accused of something I didn't do and being treated like a criminal! I am 100% sure the lab will verify there is no oxycodone in my pee, there couldn't be! But until that comes back, he must be thinking I'm a liar, which really, really hurts.
He had mentioned a "medication holiday" before to me, and I looked it up after the last visit when we switched the meds over. I was saying I'd be willing to try it in the summer when I have a little less pain (the weather and cold seems to make it worse) and more time to schedule a week or two of detoxing. He FORCED ME on the holiday, against my wishes, walked out without me being able to say anything. The meds were still working for me, I was just getting too much breakthrough pain. He very easily could have increased me breakthrough meds a little for two months till I could try the holiday. I am sure he did it as a "punishment" to me, though I truly did nothing wrong. I misunderstood what he said and I did NOT EVER take anything other than what he knows about
(besides some vitamins).
I am sooo upset at this doc for #1: Giving up on finding the cause of my pain and just bandaging it. #2: Not listening to me and forgetting things we discussed in previous visits and #3: Punishing me without any proof. He's switching professions anyway, it seems, so I need to just quit and see another doctor. The nurses mentioned the other pain management clinic to me when I was leaving when I asked about
withdrawals and possibly using something (Suboxone, I think?) to keep it not so bad during the holiday. So I called them and they said to get the records or a referral from my current PM doc to them to start the ball rolling. My PM doc is not there on Fridays, so I left a message with their answering service to please either refer me or just transfer my records over to the new one, whichever they prefer.
Did I do the right thing? What do you guys recommend? Am I REALLY taking too much of this medicine? I have always had issues with anesthesia, it wears off before the dentist is done in my mouth pretty often and what's supposed to last 12 hours (the Zohydro ER) only lasts 6, the hydrocodone only lasts 2 or 3 hours at best. I have mentioned it to the doc before, he said I might be a fast metabolizer and I asked him to test me. He never did.
I was on 3 50mg Zohydro ER a day and 5-6 hydrocodone 10/325 a day for breakthrough pain. Before, I was on 2 Zohydro ER a day and 8 hydrocodone 10/325 a day for breakthrough pain when my old insurance stopped approving the 3 a day. I am a large lady, btw.. Weight definitely matters when it comes to meds. IMO doctors should be dosing by weight and tolerance, not just a flat rule set by some bureaucrats or politicians...
Thanks for any help, I'm so scared and still in pain, not to mention hurt. :'(
Post Edited (Pashta) : 3/10/2019 8:07:11 PM (GMT-6)