Pain clinic nightmare today

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New Member

Date Joined Sep 2008
Total Posts : 5
   Posted 9/18/2008 9:12 AM (GMT -6)   
OK I posted the other day how my PCP wanted me to go to a pain clinic.   SO I had an appt. this morning at 8:30am.  This Dr. had my records from the last year along with my visit to my PCP on Monday.  He asked me what I wanted to get out of this appt.  I told him that I wanted to get a stronger milligram of hydrocodone AND a pain med to take STRICTLY when I am in a flare which is 1 or 2 times a month.  He said "we need to talk"....I thought here we go.  He went on and on about how addicting narcotics are I said I already know this BUT when you are in CHRONIC pain that is what works.  He said you have to treat the CAUSE of the pain....well the cause of the pain is from the fibro and lupus - helloooo CHRONIC PAIN.....He said he can give me an injection in my hip and neck but I have to go back to the ortho doctor and have the cyst in my knee filled with bone marrow from my hip.  I also have to go to a neurologist and get nerve conduction testing done on my hands because of the FIBRO I have on top of LUPUS. I am more than willing to do all this BUT I don't have health insurance until November 1st.  OK now when I went to my PCP on Monday he gave me one last script for hydro 5/325 for 80 pills with 2 refills.  NOW this pain Dr. has these records SO my question is this....the pain Dr. wrote me a script for NORCO 5/325 with 60 pills and no refills.  This Dr. I don't think realized I already have a script for hydro, so needless to say why would I fill this script when it's the same thing.....I am not a dr. shopper by any means I was looking for a different type of medication.  I can't fill this script until my other one runs out and I think you can only hold on to narcotic scripts for 30 days - right or wrong?  I don't know what to do - any suggestions.....these freakin' doctors are whacked.  I already take plaquenil, cymbalta, tramadol, prozac.....this doesn't help my pain so I was basically just looking for something for major flare ups from this lupus and fibro pain not something to take everyday.  I can say that thanks to all the people that doctor shop and are drug seekers it really really ruins it for people who have chronic pain, I feel like a complete loser right about now, I don't know what to do.  Can anybody give me a suggestion???? 

Veteran Member

Date Joined Jan 2005
Total Posts : 8616
   Posted 9/18/2008 10:40 AM (GMT -6)   
Hi mom,

I may have misunderstood your post . . . but it sounds like you do have the pain meds (for now).

I have to agree with the pain mgmt doc . . . the doctor should first find the source of the pain and treat that. . . he has given a couple referals to do some workups.

The fact that you don't have insurance shouldn't encourage a doctor to continue filling a narcotics script when they haven't completely investigated the cause of the pain.

I risk starting a fude here . . . and that certainly is not my intention. But we really try to be honest with each other here.

I hope you are able to contact the referral docs and make your appointments for the week of Nov 1. Some of these specialists have a waiting list . . . so you'll want to make your appointments today.

I hope some of the others have some good suggestions as well.


In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

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Regular Member

Date Joined Mar 2008
Total Posts : 89
   Posted 9/18/2008 3:26 PM (GMT -6)   

So you are basically saying that you now have two RXs and you're trying to figure out whether to fill them both since you may be without pain pills after what this new doc said. Right?

If you had insurance, they would not pay for the double RX but since you don't and are still paying out of pocket..then I would fill it just to have them BUT continue to try and figure out the cause of the pain. The only downside to this, is that you will be out the $$$ if they do figure out the cause and you end up not needing them. I think figuring out the cause would outweigh the money loss though. Don't you?



Diagnosed with Lupus in January 2008.
Currently taking Hydroxychloroquine (Plaquinel), Lisinopril and Hydrochlorothiazide.

Veteran Member

Date Joined Feb 2003
Total Posts : 5514
   Posted 9/18/2008 5:22 PM (GMT -6)   
I have to agree with Rosie here too.  I know first hand how horrible the pain can be from fibro and lupus.  I live with it every day, and I have found ways to cope with the debilitating pain in my feet, neck and back.  Narcotics are not an option I am willing to try.  The pain doctor is looking out for your best interest by telling you how addictive narcotics are.  He's not the bad guy here.  It sounds, by what you've written, that you have plenty of medication to get you through to November 1st when your insurance kicks in. You said you only need the medication one or two times a month during flares. 80 pills with 2 refills and 60 pills sounds like a lot of medication to me.  Maybe I'm misunderstanding this???
Anyway, I have to be honest here too, and like Rosie, I'm not trying to start a feud, but sometimes we need to be real clear with each other if something is not sounding right, or puts one of us in a bad situation. Please be careful.  I really hope this pain clinic can help you to find new - drug free ways - of dealing with the pain.  I understand 100% how bad it can get.  Believe me.  I'm doing this with NO pain medication. Not even extra strength Tylenol.  Nothing.  If I can do it, anyone can.  You asked for suggestions on what to do.... I suggest trying to do this with the help of the pain doctor, his resources, and without the drugs.
I wish you well,
I can do anything through Jesus Christ who strengthens me. I have learned in whatever state I am in,to be content. Phillipians 4:11-13

34 years old. Diagnosed with lupus in 2000. Fibromyalgia, anti-phospholipid syndrome(APS)(stroke),Sjogren's, Raynaud's, seizure disorder-(miraclulously disappeared!), Libman Sach's Endocarditis, vasculitis, sacroiliitis, arthritis (neck) . Prednisone, Imuran, Coumadin, Clobazam, Amitriptyline, didrocal, Cozaar, Tramacet, calcium, Cykolokapron, multi-vitamin, vitamin D, Magnesium, vitamin B6, Acidophilus

Regular Member

Date Joined Jun 2008
Total Posts : 363
   Posted 9/19/2008 8:11 AM (GMT -6)   
Hi Y'all, I'm one of those that has no option except narcotics. Every single anti-inflammatory, ibuprofen, naproxen, aspirin,ultram, mobic, arthrotec, everything makes my hives flare in an uncontrollable way. Huge itchy, painful welts all over my body. So right now I'm taking darvocet four times a day and now it's starting not to work as well. I'm becoming too adjusted to it. I hate to ask my pcp for something stronger because I don't want to turn into a zombie, but I have 2 small boys, 6 and 14 months. If I try to just deal with the pain in my hands and feet, I find it hard to walk or even pick up the baby. If anyone has any suggestions that are non-narcotic or even mild narcotic that works for Lupus and Fibo, please let me know. I've looked up every arthiritis medicine and all of them have uticaria warnings. Pred makes me feel great, but we all know what happens with long term daily pred use. I'd love to be able to exercise, but my hands and feet can't take anything more strenuous then light housework and childcare. I'm really beyond caring about addiction, I know eventually I'll have to taper off these drugs, but who knows, maybe by then we'll have a cure, better tx options or something. In the mean time , I take each day one at a time, take my pain pills, thank God for beautiful children and do the best I can. Sigh. I really wanted to be a "Super-mom" and I struggle with what I'm not able to do for my children. But I do know that children raised around a chronic illness tend to be more compassionate and caring. Perhaps this illness will end up helping my children to be stronger and more caring adults. So sorry, I didn't mean to get so far off topic, suffering from a bit of brain fog today. I'm really trying to find any positives in this situation. Thanks for the vent and God Bless.


Diagnostic Limbo: Seeing Rheumy since November 07, Taking plaquenil, Cymbalta, Flexeril,Claritin, Zantac,Ambien, vitamin D, Darvocet.



Veteran Member

Date Joined Jul 2005
Total Posts : 5403
   Posted 9/19/2008 9:20 AM (GMT -6)   
momtothree, I'm sorry about your bad experience and about the problem of the prescriptions and what to do. I am like Jennifer and when I am in severe pain, the only thing that works well for me is narcotic pain meds. I can't take NSAIDS like ibuprofen, Aleve, etc because of allergic reactions and kidney issues. Right now I take tramadol regularly to keep the everyday pain manageable and I have hyrdrocodone for days when the pain is really bad. I don't take the hydrocodone everyday, but I'd hate to not have it around. So far my rheumy doesn't mind prescribing for me because I don't use it everyday, but there is always that little fear in the back of my mind that one day he won't prescribe it.

It's hard to know what type of pain management doc to go to. I think there are ones who will work with people on finding the source of the pain and also be willing to prescribe narcotic pain meds if needed, but others are really reluctant to prescribe narcotic pain meds. People on the chronic pain forum might have some good ideas for you as to how to find a pain management doc who would be a good fit for you.

I think it's perfectly fine to hear everyone's opinions about this topic - we can all learn from each other.
Diagnosis:  UCTD (lupus) 2006; Raynauds 2006; Sjogren's 2006; lupus symptoms began 2003; UC 2008; CFS 1991; Mono 1985
Meds:  Plaquenil 400mg; Prednisone 5-10mg; Tramadol 100mg 3-4x daily; Doxepin 25-50mg; Prevacid; Evoxac; Steriod Cream and Mouth Rinse for tongue and mouth ulcers; Hydrocodone 5/500 prn for severe pain; Artificial tears



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Veteran Member

Date Joined Mar 2006
Total Posts : 2608
   Posted 9/19/2008 10:24 AM (GMT -6)   
Momtothree and puccini, a wonderful pain reliever for both lupus and fibro is accupuncture. I thought it was mumbo jumbo till the day I had a migraine and had spend the day in bed, under the covers, taking narcotics, throwing up, and not getting a lick of relief from anything I took or did. Finally, at 4:30 in the afternoon my DH came home, told me to get dressed because he was taking me to his friend the alternative medicine doctor who was going to relieve the migraine with accupuncture. I whispered to him to leave me alone. I finally got dressed and went with him because he wouldn't leave me alone. I had to walk into the doctor's office with my eyes closed. 15 miinutes after the doctor put the needles in my body the migraine was gone. I ate a hamburger on the way home.

It's not as easy as popping a pill, but neither is it addictive and you don't have to rely on a doctor to get a script for it. It works on fibro as well as lupus.

I also alternate heat and ice on my worst joints. When the joints in my hands were at their worst and I thought I'd go crazy I picked up a pair of knitting needles and taught myself how to knit, just as a way to distract my hands from the pain. Sometimes I can't knit, but it is very soothing and distracting.

Hippi's idea to look in on the chronic pain forum is a terrific one and I wonder why I've never thought to do that! Chronic pain is something we all deal with.

Momtothree, I understand your frustration and I sympathize with you more than you know. I changed rheumy's once because my then rheumy refused to give me anything at all (even tramadol) for pain. She was such a purist at treating the cause that when I would complain about pain (which was every time I saw her, she increased my prednisone till I was taking 60 mg a day. I recently read an article about the overuse of pain meds and saw this from the doctors' point of view. It was pretty scary. In Oklahoma death by overdose of oxycodone has surpassed overdose by any other drug, including heroine, meth, or cocaine. That's what doctors are afraid of.

Hang in there. We are all on the same side and we understand. I wish there was a quick and easy answer. You did the right thing by coming in here and ranting. That's the beauty of this forum.

I hope you find some way to get a little relief.


Lupus, osteoarthritis, fibro, renauds, restless leg, hiatal hernia, double vision, migraines, costocondritis.
cellcept, neurontin, prednisone, plaquenil, synthroid, triamterene, tramadol, actonel, tri-est, imitrex, cymbalta, tricor, acifex, multivitamin, calcium w vit D, fish oil, aspirin

Regular Member

Date Joined Oct 2005
Total Posts : 315
   Posted 9/19/2008 12:13 PM (GMT -6)   


Yes, narcotic meds are only good for 30 days. But, when you went to the PM, didn't you have to sign a pain management contract with them? Most of them require that. It states that you will not get any narcotic medications from any other doctor, blah, blah and a whole bunch of other stuff. So if you signed somethign like that, then you probably should not fill the other script. Mt rheum had prescribed me Lyrica in Feb for nerve pains, which I kept taking every month (he even gave me 3 month supplies). But when I went to PM & told him all my meds, he decided to take over the prescribing of Lyrica...and told me I cannot get any muscle relaxers or pain meds from my Rheum or any other doctor anymore. And of course they wanted my docs name, phone, etc. And my PM does not prescribe anything for more than one month supply at a time. I have to call in every month before I run out of my meds and request that they call in new scripts for me for everything. So far they have, but it's a pain. And the signs in their office are very condescending. But 2 of the docs I see there are pretty understanding about my pain, thank GOD! THough the strongest they prescribe me for pain is Ultram. worst pains are nerve and spasms, which no narcotic has ever helped before, so it doesnt really matter to me. They do not help my arthritis pains either. It's getting very difficult these days at PM, due to what you said. I don't want to get tolerant of meds either, but so far the Lyrica, Soma, and Ultram all together are helping my pain alot. The only thing that helps my pains tremendously are steroids, which I cannot take all the time.

I noticed that you take Cymbalta. I don't know if you are aware or not, but be extremely careful if/when you ever stop taking this med. It is widely reported that people who stop suddenly after taking it for some time have some terrible withdrawals. It's an anti-depressant (though it 's also used for other things off label)...many Phyciatrists may be aware of the withdrawal possibility, but I am not sure if other specialists are that aware. I know several people in pain management who were prescribed Cymbalta, then suddenly stopped either themselves or their PM stopped it..and has serious withdrawals. So just be very careful with that medication. Also, have you ever tried Lyrica for your Fibromyalgia? I only ask because it was recently FDA approved for Fibro. and seems to help some people.

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