Help Please!!!! I screwed up with the pain mgmt doctor

[Greg]

Hello all. I am still relatively new to the forum but have learned so much already. I want to thank all of you in advance for information you have put out there and help I'm sure I will receive in the future...ok, now to the point!

I have only been with my pain management doctor for a month now and am new to the "pain contract." So we havent got to the point of being prescribed a medicine that helps my pain. I was told 2 weeks into a month long script that I would get switched from vidon 10-325 to percocet 10-325 once I got back from my trip for work. I travel all the time for work which isnt that good since sitting down is a huge trigger for pain. While on my trip I made the poor decision (no dr at office on Fridays to call) to double my dosage since I was getting a new script in a week. I know I shouldnt have but it is soooo hard to put on a smile for clients when Im throbbing in pain. Long story short when I went to my next appt the dr was going to switch my meds but wanted the vicodins back. I explained my story and he sympathized with me. Unfortunately, I violated my contract and was told there is NOTHING he can do for prescribing pain meds....HOW DID I GET MYSELF IN THIS SITUATION/

I went to go meet the surgeon today (4 hrs one way) and was told there are no trials out there I would qualify for and my insurance wont cover 2 disc ADR. Now I have no meds, no surgery coming, a whole lot of pain and no idea what I can do next.

Will my contract violation keep me from going to another pain management doctor?

I have Anthem BC/BS out of Virginia. Has anyone with this ins been approved for ADR?

Are there any suggestions for a non-narcotic pain management device that would work for my situation?

I am so frustrated and stressed right now but I know one place I can count on is the caring people who make up this forum. Thank you to any and all with any advice. I have a herniated disc L5/S1 abutting the S1 nerves with an annual tear.....kinda the same thing on L4/L5. I have tried every conservative approach and am left with pain meds or surgery and both of those just got shot down

[Katie]

Dear Lord, Greg. I don't understand how a doctor can do that. I have never come across these contracts that several people on here have mentioned. My PM doctor just monitors my needs and gives me what is appropriate for my pain, without question. She is awesome, and I know she has countless patients who give her great grief, threatened her physically even, but she's never offered to cut me off. She knows the good from the bad.

That seems down right unethical, to cut you off completely. I wish I had some help to offer, but all I have is sympathy right now.

I feel just awful for you and I hope someone here has some better advice.

[Katie]

I know this is minimal and temporary, but have you tried a TENS machine, or acupuncture? Even ice may help a bit, at least better than nothing....sorry.

[Greg]

I know this is minimal and temporary, but have you tried a TENS machine, or acupuncture? Even ice may help a bit, at least better than nothing....sorry.

I have not tried acupuncture but think I will be seriously investigating tomorrow. What is a TENS machine? It might be something that could benefit me. I was fortunate to schedule an appt tomorrow with the original Dr who started all my treatment. Maybe this TENS machine is something she can help with?

My PM doctor told me that ethically and moraly I did nothing wrong. But due to the fact that narcotics are so highly controlled, they have rigorous guidelines to follow which include NO EXCEPTIONS...I hated to hear that part. Drove home (30 minutes) in complete silence b/c I was so shocked and didnt know what to think. Thank you for your help

[Cindylou]

First, just to respond to Katie's comments about the contracts here in the states: this is very much the norm here Katie. I'm sure it has to do with litigation fears as much as attempting to weed out the drug addicts. Every drug is counted, especially when you "should have some left" in the middle of treatment, or in Greg's case, when he was going to be switching medications. Greg, I know this doesn't help you in your current dilemma, but I believe it would have made a huge difference if you had even called your pain management clinic and told them that this is what you were needing to do, due to your pain levels. It's all about the communication. And even then, you could find yourself in my shoes where I am dutifully following the rules but just not getting the relief from my current doses. Greg, I am sorry that you are finding yourself in this very unfortunate situation. Now, I don't know if that will keep you from getting accepted at other pain clinics. Perhaps Justin can comment on that or anyone else who knows. I hope you get the help you need. Just remember if you get that second chance....you gotta work the program.

[KBear]

Greg,
I have signed these forms with the last 2 pain management clinics that I went to. They are basically trying to weed out people who abuse the medication, 'doctor shop' (ie. getting meds from more than one doctor at a time), and covering their butts. The one's I have signed do not say anything about bringing the medication back to them, I have had 4 different doctors over 4 years of treatment and have never once been asked to do this. However, this varies clinic to clinic and may be a state law in some areas (not sure). I also have to submit to random drug tests and can only use one pharmacy (that I have to write in the contract and I must sign a new contract to change pharmacies). You can switch pain clinics and the contract is no longer good, as far as I know, it is only between that clinic and you. I have had instances where the doctor wrote my script for 4 a day, I called and said that wasn't working and they verbally said 6 a day. Then, come time for refill, I was told by the pharmacy that it is too soon, according to the DEA, even though I had refills. I was able to call my doctors office, and they were able to have that overode and I got the script.

With all that said, unfortunately, pain being under-treated is the norm, not the rarity. Out of almost 4 years of pain, for only about 6 months has my pain been controlled well. It seems with all the laws, fear of the DEA, abusers and such; doctors are more scared of legalities than they have concern for patients.

A TENS unit is a machine that delivers electrical 'shocks' to your muscles. It doesn't hurt, it feels like the muscles are being used or stretched. It does offer some relief. You may have had this done at physical therapy, at a dr's office or at a chiropractor's. Your doctor can write you a prescription for one and you can order it off the internet (you must have a script for it though). They are inexspensive, mine was like $50. It's definitely a good tool to have around for pain.

I'm sorry you are in this situation and it sucks that it has to be like this.... you would never hear a doctor tell a diabetic, "sorry, you used too much insulin, sorry your blood sugar levels were high, you only get x amount a month, go home and deal with it" Only in the pain world does this happen. Hopefully, your doctor tomorrow can help you.

Kathy

BTW- to the forum, it's a great place for all kinds of help, support and information.

[Katie]

I am very lucky to have found the PM doctor that I did. My family doctor is very difficult to deal with, and if I had to depend on her for relief, I'd be in the same boat as you, so I understand that part. My PM just has a lot more compassion, I think.

Some provinces require triplicate prescription forms, with one copy going into the government regulatory offices to make sure you aren't double dipping, but not here. I think my doctor said she is 'audited' and has to account for regular appointments, and not just renewing over the phone, etc.

I am so sorry that you are stuck in that position, all of you. Yes, there are a number of people who abuse the system, but to make it so difficult for everyone is just as criminal as those who abuse it.

For whatever reason, the morphine does not help relieve the very intense pain when it flares up in my neck, just in my lower back. (I have five bad discs, two in the cervical, three in the lumbar). The TENS machine and ice are the only things that help relieve the neck pain. The TENS is a little box with leads coming off it, like an EKG. There are different levels of 'power', and different cycles you can use, and it feels like very intense vibrations or shocks, as Kathy said. Not painful really, but if you set it too high, it almost feels like it is burning, just a weird sensation. I think it breaks the pain cycle in the nerves, but that is a guess.

Up here they are more like $500...guess I should shop across the border!

I really hope that you can plead ignorance to the rules of the pill police, and hope for mercy With a little luck, your other doctor will not be such a stickler for the rules and can help you. While I understand their reasons for being so careful to stay in bounds, I'm sure that every doctor is a bit different in how strictly they follow the rules.

Good luck...and try the ice, acupuncture and TENS routine. It does provide some help. It took me a year and a half to find my PM doctor and got any relief other than that routine and tylenol. There are angels out there, honest!

[Gilbert P]

Hi Greg

And I am so sorry about your situation Pain just sucks>Could you try another pain clinic and explain what happened (if they ask).

If the pain gets to the point could you try the E.R. this is just a suggestion.

When I blew up my disc on the weekend the E.R. gave me all the meds I needed just to last until I could see a Doc.

I wish you all the best

Gil

[Terry Newton]

First off your physician sounds totally inflexible which is a bunch of crap. I hate hearing about this kind of shoddy care. I am completely understanding of pain management contracts as I am in the field of treating addiction. That being said, physicians have tended to under treat pain and get hyper-vigilant about it. This guy sounds like he has no flexibility at all. You need to find another pain management doctor that is not so rigid. You were in pain so you took more of the cure. There should have been a treatment of the pain and an IR medication for break through pain. Go find another doctor. The physicians are supposed to be cautious about addiction but some tend to see it where it does not exist. There is another thing that occurs as well and that is physical dependence. Most people will become physically dependent upon the medication after long-term use. This does not constitute addiction that results in craving and compulsive use. Let me know what the outcome is with searching for another doctor. If you cannot find one that will treat you please get a hold of me and I will talk about an alternative called Suboxone with you.

Good luck and don't beat yourself up. You only worked on treating your pain.

[Katie]

I was reluctant to speak strongly about something I have little experience with...your medical system. But I'm very glad that Terry has given you some great advice, in a no nonsense sort of way You're a good guy to have on our side Terry!