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    When your doctor won't prescribe narcotics: Tips for getting the pain relief you need
    jrae922 posted:
    Great article, really puts things in perspective.
    Was this Helpful?
    13 of 15 found this helpful
    red_flagged replied to HDienst's response:
    I think you mean, 'not ALL doctor's are your enemies". I agree with just about everything you said. I have been suffering from chronic pain from a permanent injury to my back, nerve damage, muscle spasms, etc. Recently I have been having pain all over my body & I have been told it sounds like fibro. This may sound strange to you, but it's better that it could be fibro because I do not want to take narcotics. However, my doctor wouldn't prescribe me ANYTHING. I asked for lyrica, cymbalta, something. He said, "I'm not giving you anything. You are a liar & a drug addict. I will not give you anything." (BTW, I never asked for narcotics, I specifically said I did not want them). I asked him (in tears at this point), "what should I do?" He said, "you can do whatever you want! But I won't do anything for you. However, I will accept you into my practice. Come back in 2 weeks." I have been suffering with severe pain for 2 weeks straight, non-stop. Anytime I asked him "what do you mean?" when he was explaining something, he would reply, "exactly what I said." And that was that. I brought my MRI scans in & all of the medical reports I had. I signed a release so they could get whatever they needed that I didn't have. I gave him detailed info about my diagnoses (endometriosis, sinusitis, hypoglycemia, permenent severe injury at L5-S1 & brought all the records of that one cause it's all I had). I have had 2 back surgeries & countless procedures. I told him the one that worked for a year, the spinal epidural (with the UV light, I think?) I also told him that I made the choice, against all of my doctors suggestions, to go completely off of narcotic pain meds 2 years ago. And I have. I went onto Methadone Maintenance for the withdrawals & took nothing but IBU. For the occasional flare ups AFTER the epidural injections (Series of 3) wore off (1 year later) I was willing to take narcotics pain meds & benzos for never more than a week at a time, and only 2 or 3 times since. The pain I am experiencing now is different. I have pain all over my body all day long every single day.

    For a person like myself, who probably was "one of those cases" (addicted), but worked very hard against all the recommendations of my doctors to get off of those addictive meds ad succeeded, to hear a doctor, who is supposed to help you, speak in that manner to you is a huge blow. He was not only rude, he was degrading & disrespectful. He took everything I have become & worked so hard for & made it irrelevant. He dehumanized me. The people in the waiting room that heard this looked at me with such pity. One woman said, "Oh, honey, I'm so sorry" with sincere sympathy. Then she grabbed my arm on the way out the door & said, "It's gonna be okay." That is all I ever expected from the doctor. Compassion. These injuries, diseases & pain have destroyed the woman I used to be. They have destroyed my quality of life & I am looking for is help. I changed my diet, no glucose, wheat nothing artificial, etc. I tried the holistic approach, which only worked while the epi injections were still effective, unfortunately. It was my choice to go off the methadone, they said I shouldn't because I will feel the pain. I thought I could handle it. I do not want to be on ANY drug the rest of my life. I went down, probably too fast & here I am. 20mg's a day is not enough, 30mg's a day was enough to keep the pain at bay & give me a decent life & mobility. 25mgs was okay, but I had many flare ups. I don't know if it was the methadone decrease that caused this or if it was when I fell the same day. A minor slip, never thought anything of it, just rested after. Then, it started, & it still hasn't stopped, 15 days later. All I wanted was some answers, or at least the attempt to find some. He said, "no". I asked for a referral to a physical therapist or a neurologist, or ANYONE that could help. He said, "No. I will give you NOTHING. You are a liar. You are not in pain." What is he if not my enemy?
    red_flagged replied to red_flagged's response:
    I want to add that this doctor did absolutely NO kind of exam or any test. Nor did he order any. And I asked for it all. No matter what I asked for, I got shut down. And I never once asked for opiates or narcotic drugs. I live in Maui & I am on state disability & state healthcare. They will pay a doctor a "bonus" for the less treatment he provides. It states as follows in the benefits handbook...

    '...Your A-o-a Care (I left letters out in case I can't use their name) PCP can get an extra payment from A-o-a Care at the end of the year if medical costs are controlled. This is called a Physician Incentive Plan. The extra payment your doctor may receive is not given to motivate or reward the doctor for reducing, limiting or providing less care than you need."

    It also says to let them know if I feel my PCP is not giving me the care I need or if he is not referring you to the doctors I need to see. So, I WILL be reporting him.

    I know his practice is failing, & that the state health care doesn't pay them even what it costs them to see a patient under state health care. But, does that give him the right to take it out on me? To take me into his practice, to do "NOTHING" to help my problems just so he can get a bonus???
    dollbug replied to red_flagged's response:
    Hello and welcome.....MiMi in NC....I would get another do not need to be treated like this. The doctor does not even sound like a doctor. I would also report him.

    Try to find you a doctor who knows and understand FM....I would say that this doctor DOES NOT HAVE A CLUE.

    I do hope you will check out the info under *tips* and *resources* I am sure you will find some good *tools* that will help you cope does take a trial and error process which does take time and effort.

    I do know that I have done a lot of research myself and since FM is considered to be a chronic illness....pain pills is not a good thing to manage it. I do not understand why this doctor would not offer you anything at all.

    I would tell him to take a hike. I do hope that you will find yourself a good doctor.

    Be sure and ask the doctor to check your Vitamin D level when you get one.

    Take care and good luck.


    My personal exchanges are Vitamin D and Pain and Wrath of the Dragon....if you care to visit..
    wgille replied to Getoverit's response:
    I hate taking narcotics every day. I literally can take narcotics and have a productive and fulfilling life or not take narcotics and spend my life in excruciating pain every day. I have end state osteoarthritis in one knee and it has been at the stage where it needs to be replaced for a dozen years. Every time I have had any type of surgical procedure in the last 23 years I have developed severe staph infections. I get MRSA from scratches most people take for granted. I have seen numerous specialists in infectious disease and orthopedics and no one will attempt a knee replacement. I have other issues as well, including type 1 diabetes, systemic lupus and other orthopedic problems. I find myself getting into awful cycles where pain keeps me from sleeping. Lack of sleep causes the lupus to go haywire. My kidneys stop working properly and my lower legs swell to the point my skin breaks down. Four years ago I was in a terrible state. I was sent from one specialist to another. Each gave me what sounded like a dire prognosis. I was told I was in renal failure, congestive heart failure, and just about any other kind of failure one can think of. Each specialist did a battery of tests, decided I wasn't their problem and sent me on to someone else. I would have to wrap my legs in cloth diapers in order to keep the fluid from draining everywhere. I would go through over 4 dozen of these a day.
    Without skin on either leg from the knee to the ankle I was in tremendous pain and even a toddler could tell I was very ill. In desperation I returned to my family practice doctor who sent me straight to the ER. I was admitted and spent many weeks in the hospital. My swelling went down and I grew new skin but the MRSA never went away. Four years later I am still in treatment. No doctor in his right mind will consider surgery under these circumstances. When my pain is adequately managed I attend college, taking graduate level classes and always make the chancellor's list with a 4.0 GPA. I contribute to my University by serving in student government, am an active church volunteer, do other community volunteer work, run a household, care for my husband and two children and I enjoy my life. If I get into a pain cycle and can't sleep the swelling comes right back. I would love a treatment for my issues, do everything my doctors ask me to do and now all of a sudden my family practice doctor has told me he can no longer treat chronic pain. I was one of only a few patients he treated for pain but the DEA has all of the physicians in my state scared. Pain Management Clinics are switching to interventional only practices. My orthopedic surgeon who has treated me for 35 years was recently warned that they are not to prescribe controlled medications for patients for a period of longer than three months. I have only received prescriptions from one doctor for years. This month I had to get my prescription from my ortho instead of my family doctor. Both doctors are working hard to find a pain management physician who will prescribe for me but so far neither has had much luck. I would love to find a way to function day to day without these narcotics. I never feel 'high' from them but I do feel energized because I am not bogged down by the crushing bone on bone pain I used to experience 24/7. When I experience a high level of pain these days instead of taking an extra dose of narcotic I am able to take an injection of Toradol. This would be my medication of choice if it were approved for daily use and the pill form were effective. Under our current system state and local drug agencies have realized they can't win the war on drugs so they go after the people they can easily target. Better for a million people in severe chronic pain to suffer than one addict trick a physician into giving him medication. I am now see pain patients turned into criminals because they have turned to street drugs to have some quality of life.
    BetteK replied to wgille's response:
    Have you written to your state representatves about this horrible legal position you and your caring doctors have been placed in? If you want change in laws, you have to go to the lawmakers.

    You are right that fewer and fewer doctors are comfortable prescribing opiates. They cannot afford to lose their licenses. And this is what happens to doctors who prescribe "too many" painkillers. Of course, there are specialties like pain management where hurting people congregate. There ought to be some leeway for doctors to use their own professional judgement and prescribe for those who should recieve meds.

    You know, the description of your appointment and non-examination sounds like one of those quacks who used to write trade meds for percs--until they got caught. In the back of my head, it almost seems as if Doctor X was afraid you were a sham patient and part of an investigation of him. He certainly doesn't sound like he gives the type of care you need. You need someone who will make sure that you both know all the causes of your pain, will try to ellieviate those he can, and will medicate you for those he cannot treat or cure.
    Doctor X was the last person you need in charge of your well-being. (Quack, quack, quack!)

    sfoamac replied to mymyrt's response:
    This is not correct at all Joan, there certainly are legal limits on prescribing narcotics. There are both prescribing guidelines (i.e., you cannot prescribe over a certain amount of Vicodin or Norco due to the Tylenol in it causing kidney damage) that put the provider at increased liability as well as legality issues. The DEA closely monitors all federally controlled prescribing and easily recognizes abuse patterns and will audit a prescriber's records if abnormal prescribing occurs. This means that if a prescriber is writing pain medications in excess of the max approved dosing he or she may be audited and potentially lose their license to practice medicine or have their DEA license pulled (meaning they can no longer prescribe narcotics for any reason.)

    I'm a prescriber and I've dealt with a great amount of pain management. The bottom line is that pain management is by far the worst part of our jobs. While essential for some patients, abuse is so widespread now that we spend 300% more time on a single pain management patient compared to any other type of patient. Many patients take Percocet or something similar for back pain but then demand another pain med. when they stub their toe. Then, when we try to explain that pain is pain and the Percocet will work for pain anywhere, we get irate patients screaming down the halls and throwing things.

    After reading your comment Joan, I would say you have a smart doctor who understands the law and the liability associated with your pain medication. The problem is most likely related to your desire to interpret the situation as you wish rather than listen to what he is saying in an effort to protect you and his license.

    Some exciting news though, Vicodin is soon to be reclassified to a Class 2 narcotic, meaning it will be controlled just as closely as OxyContin!
    sfoamac replied to Wolfsong452's response:
    It sounds like your doctor was actually trying to help keep you off of medications that without a doubt will become habit forming. You should thank him or her.
    lieder responded:
    I went to the maps pain clinic in Maple Grove what a joke. They basically told me straight out that they would tapper me off of my pain meds immediately even if anything they were trying wasn't working. My old pain med doctor took a position at hospital so he cannot take his patience with him. Does anyone know of a doctor in the state of Minnesota where I can get my pain meds filled? I need a pain med doctor that will manage my pain meds for me.
    Lisa_MarieLL replied to HDienst's response:
    Dear Dr. I for one thank you for your reply. I live in SW Fl. I was under the care of a PCP from 1997 until last April 2012, when I went to my families Dr. Since 1997 I have been precscribed percocet 10 mg 4 to 6 times a day (that's just the pain meds) I also take harmone meds, Ambien, and Valium 1 10 MG a day for panic attacks-IF NEEDED. I have Acute pain, cronic pain, due to Fibro, Radial Nerve damage (rt. arm total
    paralysis for 9 months) left shoulder has spurs and I have recieved shots for that and that worked fine. I have Herniated Dics C3-4&5 aslo buldging T3 and 4 and sequstration.I am constantly haveing numbness in all extremities, I also have severe arth. DX i 2000. Since 1997 I have not had my meds up's at all. I have bit the bullet A LOT, but I undertsnad also the meds hurt the liver, so I work SO hard at being careful and taking only when I can't take the pain, Dr. said do not chase the pain. But I suffer stil a lot, but at least I can get out of bed and live somewhat a normal life, until now. I have done all the above you stated, all of it. I took my prescriptions last week to be filled, picked them up, the Pharm. told me we do not have all the pain meds, but gave you 60. We will call the Doc. That was last fri. Monday Docs RN calls me and fires me. No she will not fill the balance of my meds. PERIOD. I feel like I am going to die, I am a nervious reck and lost. This was wrong, Dr's also take an oath. I did nothing wrong, the Pharm was not allowed to talk to the Dr either, his RN said NO, NO, NO-WE WILL NOT FILL THE BALANCE DUE, goodbye. I have NO idea what to do or where to turn, scared to DEATH and lost!
    Lisa_MarieLL replied to HDienst's response:
    Dr. Please let me add, after winning a workmens comp case, I put myself into Health South Rehab for the Fybo INPATIENT Clinic-44 days and nights. They could not get my pain down past 9. They also through an MRI discovered I have an extra Vertebra and I can not sit or lie without cushions or pillows, I forget to tell you I also WAS precscribed soma twice a day for the most painful spasms you could imagin. I swear in my family. I did nothing wrong, and this coame out of nowhere. Your a Dr. What does someone like me do, I know full well that I could have a heart attach, and more. This is not care, nor right. I am paralized with FEAR.
    Lisa_MarieLL replied to jamesndebmoore's response:
    Oh so needed to read this.
    Lisa_MarieLL replied to mybdy's response:
    Thank you for your post. What you wrote saddens me. I don't think anyone really cares. If your head's not handing off of your shoulder's you must be fine. I don't know what's wrong with you, but I'm praying you'll be ok and get a Dr who CARES. Hug that baby lots, I understand you. Lisa
    Lisa_MarieLL replied to dakotaspirit1957's response:
    Thank you! Your wrote what I feel and have for so long... THANK YOU! Lisa
    leeskies33 replied to mymyrt's response:
    Hi everyone thanks to our wonderful I have to mispell it to be able to write it on here since were becoming more and more like red china, thanks to our wonderful guuvourmt pain docs can no longer prescribe oxys or hydros sched 2 or 3 narcotics! its regulated now and in tx they are only doing injections so if you get hurt you are in so much trouble you wont know what to do! I have a herniated disk and I have med records and mri and scoliosis and fibromialgia and cant get nada nothing zilch! Thank obamywammy!!
    leeskies33 replied to jmorr's response:
    Yes my fellow americanas! The big black brother is into socialism, don't blame me I didnt vote for him!!! When all else fails my friends go to a methadone clinic!

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