Need Help. Is this normal? Seeing doctor every month for refill?
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An_246720 posted:
Hi, I suffered from a sever fall that has ruined my shoulder and I am doing everything to avoid surgery for it in the hopes it will heal on its own which it is, slowly.

I picked a doctor in Chicagoland down near the city and needless to say, the place is a dump. I am from the northern suburbs but thought this place would be easier for me to get too but the staff is rude and the place is dirty. Needless to say,

I was prescribed 150 norco's when I was out of state for sever pain, I cut back to 100 a month now and can function well.

My problem is this, I am tired of having to go see this doctor every month for a refill. Is this Illinois law or is this doctor just trying to make money? In addition, I am told I will have to take a urine sample next week? The point of this is what? When I was out of state I had no such test done to me and I am from the north shore, Lake Forest/ Wilmette/ Winettka and I do not like this idea.

Is this how things work in Illinois? I must see a doctor every 30 days, have a urine sample in order to get refilled on prescirption medication for pain or is this doctor a fake? I would rather pay more money to see a much better and highly qualified doctor then someone like this but I am looking for suggestions. Out of state I would get refills, 3-4 before having to come back into the office. This once a month is not only expensive but time consuming and anoying.

Any thoughts? Is this normal?
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_swank_ responded:
It's normal for pain management. At least where I live. Although a doctor can write at least 2 refills for Norco but Schedule 2 meds like Percocet/oxycodone are only allowed for 30 days at a time. The rules seem to change often. For a while my doctor couldn't post date Schedule 2 meds so I had to go in every month or switch to Norco. Then the rules changed again and now he can post date the scripts.

The reason for the urine test is to make sure you're actually taking the meds you are prescribed. some people like to sell them. They also want to make sure you're not taking any other controlled substances.

If you don't like it, find another doctor or get your shoulder fixed.
 
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Confused252 replied to _swank_'s response:
Thank you, I appreciate your feedback. If I disclosed the medicne that another doctor prescribed for me for anxiety, it should not be a problem and if the medicine is in my system everything should be ok. If I am wrong about this please correct me.

Thanks again.
 
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KatMit524 responded:
If your seeing a Pain Management Dr. this is completely normal and you need to get used to it. I see my Dr. every month and get my scripts, I'm on higher meds than you and all Schedule II's, but I've been in Pain Management for 26 years and have had 30 surgeries.

Have you signed a contract? You should have and it should have explained all of this to you. You PM Dr. can have you drop a UA (urine test) anytime he wants, with no warning. They do this to check for drug abusers, to make sure people are taking their meds as prescribed, etc. If you drop a bad UA, it can get you dismissed for your Dr.'s practice immediately, with no notice, just like that!

Your Dr. can also call you in for pill counts with no warning at any time, make you bring in your bottles, and they count your pills to make sure you are taking only what's prescribed.

Pain Management is a pretty serious deal, and there are many rules and regulations to be followed...they don't mess around when it comes to being on narcotics 24/7, longterm. The main reason being, they know that you are going to become dependent on the narcotics, it can't be avoided, so all precautions have to be taken to make sure you don't slip over into addiction and abuse....it happens to the best of them, easier than they ever thought it could. Due diligence is very important in Pain Management.

If you signed a Contract, you are not allowed to get any kind of pain meds from any other source, including the Emergency Room, unless it is a "life saving emergent situation", or you will be dismissed from your Dr. The only place you can get pain meds is from the current PM Dr. you are seeing. And you have to be very careful with herbals and supplements they can have pharmokinetic and metabolism effects with the narcotics your on causing your UA's to read incorrectly, showing substances that you're not actually taking...which can get you in trouble and even dismissed for your PM Dr. Once you have a questionable UA, it gets very difficult to prove your innocence and maintain your good standing with other Dr.'s, that bad UA will be in your record and follow you forward.

Now as for the condition of your Dr.s office and the staff being rude, whether you want to tolerate that or not is up to you. You can always go and find a new Dr.. That's not always the easiest thing to do, and it's not something you want to do frequently, because you will get flagged as a "Dr. shopper". And don't just assume that a new Dr. will pick up where this one is, they don't always do that. Each PM Dr. has their own way of treatment and prescribing. Some won't prescribed narcotics until you've tried other modalities of treatment. Some make you start at the beginning with the "baby narcotics" and work your way up....you don't really know what their treatment style is until you get in that first appointment.

So, if all this "fun" doesn't sound like something you can handle or have the time and money to invest in....you might want to rethink that decision to not have surgery until you absolutely can't stand it.

Pain Management is not like any other Dr. visit/treatment you've done before, it's tedious, challenging and a lot of work.

Okay well that's the basic gist of it. If you have any more specific Q's, give a yell. Take care.
 
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KatMit524 replied to KatMit524's response:
I didn't see your other small post. YES, most definitely tell him any and all medications that you are taking, EVERYTHING including over the counter meds and herbals, supplements and vitamins. As I said in my earlier "book" lol.....when these drugs mix and metabolize in your system then can show up as different chemicals, which can cause patients big problems.

Take care,

kat
 
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Confused252 replied to KatMit524's response:
Thank you very much for your help. It has been most beneficial. I have been just anoyed with havng to go to this doctor every month and in addition, a unrine but I have nothing to fear as everything I have been prescribed is only from a pschologist and this doctor.
 
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annette030 replied to Confused252's response:
Why would you not have told the doctor giving you RXs for pain meds, ALL of the meds you are currently taking? That is your job.

Take care, Annette
 
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annette030 replied to KatMit524's response:
Every state has its own laws, and every practice has its own rules for opioid RXs. The federal government under the DEA has its own minimum requirements or laws for opioid prescriptions. The laws written by the federal and state government are not negotiable. The group practice rules may be, depending on the doctor. I think it is important to know the difference starting out. Do some research on your state laws where you live.

I live in Oregon and see my doctor once every three months, she gives me three properly dated RXs of each schedule II med, with her own handwritten instructions not to fill them prior to a particular date. That way I fill them once a month. I have signed a contract with her, every office may have their own caveats, so read whatever you have signed and keep a copy for yourself. Just always know that if you break those rules in your contract the doctor can dismiss you immediately. If you sign it, it is probably binding.

Take care, Annette
 
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annette030 replied to Confused252's response:
You do have something to fear if the drug for anxiety that you take has not been disclosed to the doctor writing the RX for pain meds. Take care of this right away.

By the way, the interaction of benzodiazepines (one kind of drug for anxiety) and opioids is up to who you read lately. Some doctors do not believe in mixing these two drug families at all, some don't mind. If you are taking one of the benzos, you might be asked to choose between the benzo and the opioid. Do your reading and go to the appt. prepared.

Take care, Annette
 
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KatMit524 replied to annette030's response:
Generally someone new to Pain Management is not going to be allowed to go 3 months in between visits. Yes once you've gotten established and built up that all important "trust" with your Dr. they lessen the hold a bit. But in this climate with the DEA breathing down every PM docs neck and Rules and Regs changing constantly many PM docs are stopping giving out multiple predated scripts. I post on 4 different Support Boards and in the last couple of months there have been alot of people who's dr.'s are no longer giving them 3 months worth of scripts. The other thing that some people get confused over is that Federal rules override State rules when it comes down to it, it can get confusing. And actual "Laws" override a practices "rules" every time. So when doing the research, you need to make sure your learning the proper things. All Schedule II meds and higher require a written script "walked" into the pharmacy for each fill in every State, no call ins, no partial fills, and no refills.

Kat
 
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Anon_2912 responded:
Why not get the surgery? What type of surgery would it be? Surgery would avoid you having to be in pain management. Yes you would get pain med for post op surgery, but you would not be a slave to pain management.

For me I hate taking pills (kinda gag)....anyway...
 
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TDXSP08 replied to Anon_2912's response:
My Pain Doctor see's me in person every 3 Months and as mentioned previously i get my med's from a special Pharmacy that all they do is Pain Medication and it arrives via UPS on the same Day every month unless that day is on a weekend and then it comes on that friday, and since it is located in secure location somewhere in the City where my Doctor is, Her Secretary brings all the scripts to the public pharmacy of the secret Pain Pharmacy obviously they keep the location hidden and secure because they service the pain med's for thousands upon thousands of customers and so they have a very large stock of you name it Schedule II they got it, and therefore would be a real big target of drug thieves they will kill and maim for the small quantities a CVS or Walgreen's has, so what they would do to get this place would be crazy. but regardless my Doc sends scripts for my meds 2 times and then we visit and repeat, I would see her more if i lived closer i love my Pain Doc she is a great woman and i could learn a lot from her.
i have no small step for man, but i have 6 tires for mankind,Watch your Toes!
 
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bren_bren responded:
For your type of injury, look into prolotherapy before surgery. You have the best prolo therapist right down the road from you. At least go in for a consult. He has many videos on YouTube out there that explain what it is. It will speed your healing process. Let me know if you have any questions.

BTW, how old is your injury?
 
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Confused252 replied to bren_bren's response:
Hey,

Thank you, I did not know about that.

It originally occured in November of 2010. Then the second injury happend in September of 2012.

Everyones answers here helped me. I now know how serious it is to get scripts and how doctors need to know what medicines you are on etc. to cover themselves and make sure your not a addict/selling it and so forth.

I'll take up that consult idea, I appreciate that.
 
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Confused252 replied to TDXSP08's response:
Hey,

I'm finding it anoying, I would get 150 norco's in Kansas, visist every few months, thats it. Here in Illinois I got chewed out hard for coming in a week early (I thought my appointment was then) even so, if it was not, why would it be a big deal? I would not have got them anyways yet to be litterally bitched at for it?

Anyways, Are you in the Chicagoland area that you could recemend a doc? I have my appointment tomorrow and wet from 150 to 100 in one month, could not handle the pain and got a fill for 30 from my primary doc. I had no idea that its not agood idea so I called my doc and explained to his secretary but over a 30% decrease in medication In a month I had too many withdrawl effects.

In addition, for some walgreens tech to call my doctor notifying him I had asked if I "could get this script filled" when it said "not fill til xxx" date, only pissed my doctor off more.

If I get chewed out tomorow I'm going back up on the northshore where people know not to speak to others like that. I'm 23, two concussions in 18 months, plus much else, I forgot a few things.

I'd appreciate if you could provide me any info or recemend a doc. "Advanced Pain Care" is where I went, it was a dump, filthy, and the only reason I am going back is because one of the top rated docs is busy until end of August so I am on a call if cancel apt.

Thanks if you read this.