Thanks for responses here. Loring ... my response to you is at the end of my post, sorry.
One thing here in play is that the FDA (and DEA) are cracking down on doctors prescribing pain medications to such an extent that even the 3rd doctor I saw yesterday said that he was too afraid to prescribe a narcotic for fear of losing his license. On October 6th, the FDA will have reclassified Norco, so now the boom is being lowered onto all chronic pain sufferers. I tend to be more assertive and confrontational with doctors when I believe my human rights are being violated. So, I detected with this 3rd doctor yesterday that he had read probably a scathing report about me from the 1st doctor I'd seen, to which he kept repeating to me to have an open mind about going to the HMO's pain management program. I seethed inside thinking, "I AM open minded, but not a danged IDIOT!" It was the 2nd doctor I'd seen who had told me how the HMO's pain management program works and that I would definitely be prescribed the Oxycontin (dosage unknown). So, what is happening here is that all the HMO doctors are with paranoia, terror and fear and transferring that onto their chronic pain suffering patients and passing the buck over to the Pain Management Department (PMD)... and thus far I have found NO abstract or anything online regarding any By-Lines, etc., pertaining to this "program." It's like I'm in **** Germany and the doctor in charge of this program is a Gestapo adhering to an invisible and strict program guideline that patients apparently are not privy to see!! I heard about a memo that doctors got last month, but not factual content. Basically, the memo orders the docs to send all their narcotic patients to this PMD ... that's the gist of the memo. Last week I did talk to an attorney and he said that I would have to go through arbitration since I can't sue the HMO. Well, I'm ready now to hire that attorney to do arbitration just to obtain this so-called PROGRAM. Heck, maybe people can sue the FDA? Dunno, but first have to find out in black & white the actual guidelines or abstract of this HMO program. So, on Oct 1st, I'll visit with this Pain Management doctor and listen to his litany and I'm sure he will suggest for me to attend some pain management class. Well, I looked online already and nothing at all is listed, not even a support group. The classes they offer is for Chronic Headaches. Please realize that I've been depressed for years and attended their class for depression. It made me even more depressed ... it was idiotic and a waste of my time (and gas).
Just because I'm 61 years old doesn't mean I'm resistant to change. It just means I'm more savvy in life's experiences. I simply refuse to be complacent about this matter and be toddled along like a sheep, which is what they want me to do. Yesterday, I called my psychiatrist and left a message that I was upping my Valium to 10mg's for 3x/day for ONLY two days ... to help clear my head a bit about this and to calm me down as well. Well, the message didn't get relayed properly about the TWO days bit, so whilst I was seeing doctor number 3, a message was left on my message machine saying ... yea, I think you can guess what it was like. I took a Valium last week after my horrid experience with Dr. #1 ... I don't abuse this stuff at all. After listening to my answering machine my frustration was further compounded after paying a 3rd doctor to say to me repeatedly to have an open mind.
So, after taking my second planned dose of the Valium yesterday, it cleared my head and I began formulating a plan. I said, they don't care, so I don't care. Hell, with my cancer I have enough to contemplate psychologically. So, I decided to release my compartmentalized mental controls over my pain COMPLETELY out the window. I decided to be PAIN FREE until I see the Pain Management doctor, which gee, I'll run out of the Norco before the FDA's mandate date of October 6th! And, I sent doctor 3, an email that my personal pain management is now out the window starting then and I plan to be pain free by taking more Norco than prescribed. Yes, it's abandonment of all I've learned and maintained in 30 years of personal pain management, but I simply do NOT care!! I, also, informed Dr. 3 that Dr. 2 had told me already about the Pain Management's program and I will be forced to take Oxycontin since that is THE PROGRAM set up. I indicated to Dr. 3 that after paying the $95 co-pay of the Oxycontin, I will then drive & park my car outside the emergency room (with a spew bucket) and take the one pill as prescribed and wait. You see, I'm highly allergic to codeine and whilst Oxycontin doesn't contain codeine, it is in the same classification category. I've been through this "same class" bit of meds and can attest that I've had same or worse side affects each time. Hey, it's part of experience! I've been thru it, but doctors are too busy to read about such past side affect issues, so I will wait outside the ER for what I feel will be inevitable.
It would seem reasonable to assume that the PMD might be reasonable in this and prescribe Roxicodone / Percocet instead, but after listening to Dr. 2 last week, it sounds like a very inflexible place. So, in the interim, I'm upping my Norco to 10/day to be pain free for less than a week, and then hand it off to this PMD doc and see how it plays out. I've been going thru my head to anticipate various responses/reactions.
Anyone got any ideas on this?
Well, after you have read my "shock" plan, in reality I've been tapering down my Norco and down to 1 per day (usually take 3/day), & will be 1/2 tomorrow for three days, etc. Then, drug free until Oct. 1st and take 2 Norco's since I suspect someone will order labs on me either during the PMD visit or when I have a bad reaction to the Oxycontin, so will want some trace of Norco in my system. Naturally, my plan will have to be altered depending on the dosage of Oxycontin that is prescribed since I don't want to be overdosed.
You may ask, why go through this elaborate plan? Well, to be able to get the medication I truly believe is right for me. Also, with the heightened paranoia within this HMO, I know things are only going to get WORSE, not better. So, I'll ask for more meds/day than really needed and stockpile them in my fridge. This way, when I am having a really bad sciatica attack, I won't have to wait two to three days (yea, slow process with the HMO docs) to get more meds (not to mention their demand I make an office visit since they can't prescribe more without such ... ever had to literally crawl from your car into your doc's office with debilitating pain? I care not to endure that again!!) ... I'll have them on hand. Basically, I want and need my own personal pain management control. I am unwilling to take an unaffordable medication like Oxycontin that does not allow a person to break it up to taper according to different pain levels during my life. Oh, by the way, the co-pay for me for Roxicodone is $13 versus the $95 for Oxycontin. It's not the cost that is my targeted problem ... it is the fact that I can't control it for my own pain management. I could risk fatality by cutting up an Oxycontin and take a piece (sitting in lot near the ER) and claim ignorance about it lol, but I'm not prepared to take that risk.
I'm faced here with working and striving for my own pain management system and avoid as much bureauocracy of the HMO as I possible can. Trust me, it is truly awful and know it will become increasingly worse.
Right now, my pain is manageable with just the one Norco ... I feel the pain just beneath the surface. But, I am determined to be Norco free and flush my system of it for a spell. I've done this before frequently enough with no major disturbing side affects ... nausea can be a problem, but I got Zofran for that. Oh, just a side thing here ... again I'm just a woman to be treated with contempt by a doctor ... Dr. 3 was most adamant about me taking some other generic formula of the Fosamax. I quelled my tongue on this since I will do the AMA bit ... against medical advice ... and refuse to take this medication. In the handout it even states that it is NOT recommended to be prescribed to cancer patients. DUH!! HMO docs are JUST too busy managing 15 minute patient visits to know everything about drugs they prescribe. If this doc hadn't been so busy telling me to have an open mind, I would have shown him in the handout (yup, I had brought it with me to my visit with him).
I hope folks here don't think I'm over-thinking this. It's just that through my experiences with this HMO, I've had to learn self-preservation and to defend myself. It's very frustrating and do my best to avoid interaction with them as much as possible. In the meantime, I'll be looking at Dr. 4 on the list to make yet another appointment.
Oh, one thing here is I'm dealing here, too, with what did Dr. 1 write in my medical file about me? On my first visit with Dr. 1, I had asked just in passing about Marijuana since someone told me that they were able to quit smoking when they got some MJ. It was a mere mention to find out if I could maybe get an Rx. Also, I've already been thru the cancer/caregiver bit with my deceased hubby whom died of chemo related infection from his cancer ... and I'd actually grown a plant for him that managed to get 12 inches high before the plant died on me. Anyway, when I saw Dr. 2, at the last of our session, she said that she runs VERY complete labs, INCLUDING marijuana and that if she found it in my blood she would never prescribe for me again! So, I ask, what the HE** did Dr. 1 write in my medical chart? It was evident again as well an attitude with Dr. 3 yesterday for him to treat me as some ugly monster, not just about marijuana, but just in general offishness. It's like I now have been blackballed!! So, this has added more to my frustration. I had a traumatic experience with Dr. 1 ... hence my call to my shrink since it was so traumatic I've been reliving it ever since over and over again... and was the motivator for me to do the two days of Valium. So, I guess my side of the story needs to be told to clear the air a bit and when I see Dr. 4, I will hand him the typed story and insist that he read it and put it into my medical file. I plan to send a letter to Membership services as well about my experience. Perhaps if there are enough doctors I see and are influenced by this medical report, then maybe an attorney can subpoena my medical record to see what he wrote!!
Sorry, venting a little bit there.
Loring, one thing about physiotherapy is it would have to be very defined and specific. No chiropractor for me since I've had the bone fusion done on my neck. Years ago I was able to go to physical therapy and it was GREAT. They put machines on my back, etc. But, that was a different HMO where I lived. Well, I was sent to physical therapy here with this HMO and all that was done was to take my vitals, check my reflexes and gave me a mimeographed paper with hand-drawn characters doing various exercises for me to do ... like I was in a position to do such at the time, right? It was an insult. The main thrust here for me to have gone at all was to attempt to get a referral for accupuncture. I haven't yet tried that for pain relief and have been seriously considering it if it won't hurt my pocketbook too much. Have you (or anyone?) looked into and tried accupuncture for pain relief?
Loring, I'm really sorry to hear that you have so many different pain regions as well. Yea, a doc diagnosed me with Fibromyalgia years ago as well and one thing that helped immensely was Guaipax (not to take if you have a heart condition and do not take with an antibiotic, especially Erthromyacin). The thing here is that the Firbro was kind of a flim-flam dx by the doc since I didn't really fit into any particular category for a Dx. I'm not saying that this is 100% of the time, but Fribro is oftentimes a precursor to cancer. Seven years later I was Dx'd with cancer. Research I've done on two drugs (of many) ... one is Soma and another is Ibuprophen. Taken as an as needed basis, I've read, it is okay. But, taken every day long term, there is indication they can be carcinogens. I stopped taking Soma soon after that ... think that was like around 1985. Oh, I thought about getting some again with Dr. 4 and asked about that since the Flexeril I use for severe muscle spasms seem to last only about four days in effectiveness (and can be a bad liver damager) ... and I was very surprised to learn that he couldn't prescribe Soma, either. I guess it is on the FDA's addiction list as well these days!!
Again to Loring (and others) ... for my neck pain and migraines that stem from it, I found that Indomethecine (Indocin) worked very well in reducing inflammation of neck & shoulders, but not so much on the "headache." I am now unable to really take this anymore since it reduces the platelet count in the body and is bad news with cancer. Ibuprophen never worked for me against my "neck" pain, but helps with my sciatica accompanied with the Norco. I don't have Osteoarthritis, but I can really feel for you in this area since my siblings and mother suffer a lot with it. I was more of the "lucky" one who only inherited a lazy eye in the family. Scoliosis runs in my family and my son has it really bad, but it skipped targeting me ... I just carry the gene. I believe that part of my degeneration and cancer is related to the radioactive dye that was put in my spinal chord 30 years ago before technology was improved ... hence I avoid frequent X-Rays of my neck and torso because of this since the X-Rays will activate the radioactive dye. Also, if my pain were on a constant level, then I would be more than happy for an implanted pain pump ... well, maybe not if it is made of plastic. One bad thing about plastic is that despite the sterile conditions that medical plastic materials are manufactured, there is no real way to sterilize plastic. One reason my hubby died was due to having a plastic tubed PIC implanted and he got the fatal infection (sepsis) from it. This is more common than people are aware. Years ago, they used glass shringes and could be sterilized. Last year a friend of mine, his wife went in for ordinary labs and ended up with fatal sepsis from that lab's plastic shringe. Sorry, don't mean to scare you.
I do agree that people should learn about ways to control their pain as well as learn how to manage it enough to be tolerable even with pain meds. I recommend it more so for younger people to try to figure out their specific pain levels and strive to work their mind to detect at what level of pain they're in and how much pain med to take. Even at age 61 I'm very scared of reaching the last limit of pain medication relief. It's much harder in my opinion for younger people to be faced with such pain and be on narcotics with a long future ahead of them. I guess I dread a day when a doctor says to me, "There's nothing more we can do for you for the pain." I learned over the years to mentally compartmentalize pain, anxiety, psychology, euphoria, tolerance, etc. The hard part is learning how to maintain that compartmentalization over hours, days, weeks and years. It's more automatic for me now, but at first I really struggled with it. At times this comparting goes out the window and only pain meds will help. I really feel for people having more intense pain than me. In some respects, I'm a lightweight in the pain department, but man-o-man, when pain hits ... wheweee!! Am I alone in getting crabby when in pain?
Oh .. to BnotAfraid. I've been thru the pharmacy route several times and each time I've figured I've not asked the right questions, so will be calling once again with another list of questions and maybe I'll be better prepared for my visit with the Pain Management Department on Oct. 1st.
Sorry for being a long poster.