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    Pain Doctor has Refused to Provide Breakthrough Pain Medication.
    NavalVeteran posted:
    I have has a Medtronic's implanted morphine pump implanted in me for the past 12+ years. During this time, I have always been provided with breakthrough pain medication. During those 12 years, I have never had a problem with my breakthrough pain medication (i.e. never ran out ahead of time, never have lost my medication, and was even called into his office once, and told to bring in all my pain medication, so it could be counted - they were all present and accounted for). Yet about six months ago, my doctor wanted to change my medication in my pump from Morphine to Dilaudid. I did not want him to do this, as I have tried Dilaudid before, and could not stand the stuff. Yet he did it despite by objections. Then a few weeks later, at the fault of the VA, for providing me with the wrong medication to control my diabetes, I went into a diabetic coma, and was in full renal failure. I spent a week in the I.C.U. and another week in a regular room, I was finally released; and I cannot tell you how much I hate being in a hospital. I had lost all my desire to eat, as I had no appetite what so ever, and sleeping was next to impossible. So do to these desperate situation, I took thee puffs off some hippy hay, hoping to get an appetite. When I had to go in and have my pump re-filled, I told the doctor's nurse what I did, as I could not stand the Dilaudid. The nurse informed my doctor about what I did, and I was subjected to another drug test by my doctor. This makes it about the 7th time I had to be tested. Yet when the tests came back, it was negative for opioids. Yet because of what I told the nurse, my doctor refused to provide me with breakthrough pain medication. Instead, he wanted me to call his office, if I had breakthrough pain, and then he would increase the flow rate of my morphine pump. I have to draw the line somewhere, as I do not want my pump turned up so high, that I feel like I am out in left field all the time. I have stage four (end stage) cirrhosis of the live, as a result of contracting hepatitis-C, while I was in the navy, back in the mid 1970's. I even questioned my doctor about Medtronic's Self-Administered Pain Management, which would allow me to give myself up to four bolus amounts of morphine, for breakthrough pain. This would be much better than having my pump turned up all the time; yet he said it was not capable of it. I talked to Medtronic's, and they confirmed to me that my pump was indeed able to be equipped with being able to give myself an extra boost of morphine, when I am really feeling the pain, and then I questioned him about it again, except this time, a rep. from Medtronic's was in his office, so he could not deny that my pump could not be set up for this. The veterans' administration pays for me to be fee based out to a pain management doctor, as they do not have the ability to re-fill my morphine pump. My question is, do you think the doctor proper to take away my breakthrough pain medication, just because I admitted to his nurse about what I did, regarding taking thee puffs off some hippy hay? I know what I should have done, and that was just keeping my mouth shut. But I was trying to be honest about a situation. At least he removed the Dilaudid from my pump, and re-filled it with morphine. While I was on the morphine, I never had any problems, and with my breakthrough pain medication, I never complained. Now my liver doctor wants to put me on the transplant list, yet to date, I do not want to be put on the list, knowing that there are children, who also need a liver, should get one before I do. As a new liver does not take away the hepatitis-C, it just goes to work on the new liver.

    Mr. Lee Bolin
    redgundogs responded:
    I am so sorry about what you were put through. Your pm doc does not seem to be putting the pain management at the forefront of his mind. That is too bad. I applaud your attitude toward transplant. You seem like a very rational person.

    Does the VA have another option for you? I see a neurologist for pain management, and have a very positive relationship. I take the maximum doses of dilaudid, as well as Norco 10/325, a 50 mcg fentanyl patch and have a spinal chord stimulator. My doctor does not treat me like I am a criminal, and would certainly take away any pain control medication. It sounds like your doctor does not trust you in the first place. That level of monitoring multiplied by many years and the dishonesty regarding the abilities of your pump sounds to me like medical harassment. Does the VA have any other doctor you can use? Or a patient advocate that can help you out?

    Finally, thank you for your service to our country. I will keep you in my prayers, and an eye on this discussion.

    Lisa Positeri
    Anon_2912 responded:
    Did you sign & read a contract with him?

    Some doctors stick to the contract to a "T" regardless of the circumstances.

    If you did sign the contract then you don't have a leg to stand on.

    Even though you admitted verbally too them your use of smoking, they had every right.

    I know not what you want to hear.
    NavalVeteran replied to Anon_2912's response:
    Yes, I did sign a contract; I don't think there are many pain management doctors' left that don't require you to sign a contract. But what I think has him stuck, was when he had my drug tested that same day, and it came back negative. Those drug tests are not worth a darn in my opinion, as when I was in the hospital for my diabetic coma, they drug tested me then, and it came back negative for Dexedrine and Xanax; both of these drugs I take on a daily basis, and that is the second time that I have been in the hospital, and it came back negative for those two drugs. I got a call from the VA pain management nurse today about the self-administered pain management system, which is available for my pump that allows me to give myself up to four extra bolus amounts of morphine a day, for breakthrough pain, so things might be looking up on that aspect. I would like to have my pump turned down a little, so I don't have to find a ride to his office so often. This doctor is pretty ignorant when it comes to using a pump. My last doctor had my pump set up so it would give me less in the evening, when I was not active, and then it would increase starting in the morning, but that takes some calculations, which my current doctor is unable to do. He only spends about three minutes with me at each visit; the nurse is the one who re-fills my pump. My previous pain doctor was much different, as he would spend at least 1/2 an hour with me, inject my hands with cortisone, when they would cramp up on me. Two completely different doctors, what a shame that the hospital closed down the pain clinic they had; and my old pain doctor just went back to being an anesthesiologist. I still talk to him from time to time, and the only advice he could tell me was I need to find a new doctor, as mine does not know what he is doing. Too bad that is easier said, and then done; as trying to find a new doctor is like trying to find a needle in a haystack. Medtronic's needs to update their list of doctors, which deal with Medtronic's Implanted Pumps, as their list is way out of date. Thank you for your reply.
    NavalVeteran replied to redgundogs's response:
    Thank you for your reply, unfortunately, the VA is not very bright when it comes to that, and I do my best to keep away from the VA doctors. It was like pulling teeth to get them to pay for my private pain management. My private insurance used to pay got it, yet at the end of the visit, if you tried to make a co-payment, they would not take it, because they said I had a procedure done, so there is no co-payment due. But then you would get a bill from the hospital, saying that you owe them for the co-payment. I like to refer to this as "paying the rent, co-payment", and would refuse to pay it. What is also strange, is if you had to pay out of your pocket, the price it incredible; but then the insurance company had a cheaper price to pay. Then when the VA started to pay the bill, the price got even cheaper, and no copayment, triple standards? Thank you for thanking me for serving.

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