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Don't know what to do
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An_254712 posted:
A couple years ago, I severely hurt my back at work lifting a patient up off the ground (I am a registered nurse) and I herniated 3 discs in my lumbar spine and one in my sacral area. I went 6 months in excruciating pain before I was referred to a pain management doctor. He tried non narcotics at first, as well as physical therapy, pool exercises, and multiple cortisone injections. Finally, he put me on methadone (which I was very reluctant to take), but in order to be able to make it to work everyday, and have some sort of quality of life, I started taking it. I have been on it for about a year and a half. I was taking 25mg (which is a very low dose) a day. Recently, my doctor told me he was moving his practice and that he would still see me at his other location. Well about a week before his office closed, he decided he wasn't going to be taking insurance and was only going to be private pay, which I cannot afford. He wrote me a prescription for a months worth and told me l was on my own. He was supposed to transfer all of my medical records to a new pain management doctor. Well, he never did, I am almost out of my methadone and I'm I'm excruciating pain and having severe withdrawals. I have terrible anxiety and panic and haven't slept in days. I started to wean myself down. I went from 25mg a day to 10mg a day to conserve my medications, and I am miserable. I cannot find a doctor around here that does pain management, and I'm really terrified of completely running out of this medication. I am a nurse and I don't know what to do. I asked my previous doctor If he would wean me before he left, and he told me no because I need it. He is right, I need something, but it's going to be months before I will be able to find another pain management doctor. Please help me someone I don't know what to do. I have never had an addiction problem or failed a drug test, but the physical dependence on this drug is killing me.
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blessedladyptl responded:
Don't ask the dr for Methadone. When you go for your first visit, sign the papers giving the new dr permission to get your medical records from your previous dr. The new dr may or may not continue you on the Methadone. When a patient asks for a specific medication, drs are being told that can be a indicator of drug seeking behavior.
 
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Anon_27116 responded:
Dear An_254712:
You are in a real mess! That is very true from what you wrote. However, I think that you must find a new pain management dr. in order to prevent going through a very scary and painful de-tox from the methadone. I do not think that doing that is even a safe
thing.

Since you are a nurse, you already know this. You work around many drs. so why not ask who is a really good pain mgt. dr. and say that it is for a friend of yours if you do not want
to say that it is you that needs help. That is what I would do. Ask some of the other nurses that you work with and make up the story if you have to. If they do not know that you need a new dr. then that should not be a problem. Nevertheless, you do
need a pain management dr. to help you., I take methadone and take 60 mgs. per day. That is not all that I take though from my pain mgt. dr. I am prescribed 2 different muscle relaxants and then I have a neurologist that takes care of my headaches and migraines. It never hurts to go to another specialist when you have serious physical problems going on. You should not be embarrassed or so scared. Just find a pain dr. that is not the one you have been seeing. If you can't drive as far to see the new dr., ask a friend to take you. Also, I do not drive much unless it is very close to my home. I have found through many churches they have volunteers that will help you get to a dr. appointment. Over the past 10 years I have had the help of these wonderful volunteers help me. When my husband can help me he does too.

Don't give up. You have got to find a new dr. That is your job for now. Please understand that I am not trying to be a Know it All at all. I have been in your shoes too. I have had a similar
experience happen to me. My pain dr. passed away unexpectedly many years ago and I was not even able to get hold of my medical records from his office. He did not have another dr. in his practice. It took me some months to find a new pain mgt. dr. and it was not easy since I did not have my medical records from the dr. that had died.

I finally found a pain mgt. dr. and took all of my operative reports and x-rays to him and he took me on as a patient but he never would help me with my headaches and neck pain.
I finally started going to a neurologist and he prescribed me the proper meds for my headaches and migraines. Then one day I had an appointment with my pain dr. and they said "why are you here" "didn't you get our message"? I said no. They told me that the dr. had referred me to another pain dr. and I was
supposed to know this. I told them that no one had called me and that I was not leaving until I saw the dr. He saw me and gave me only 1 month of medicine and also told me that he had sent all of my medical records to another pain mgt. dr. without my knowledge. That in itself is not right. I called that new pain mgt. dr. and have been seeing her from that time to the present time. I do not think that the pain dr. I had did this properly though.

There are a lot of pain mgt. drs. that do not want to prescribe pain meds and prefer to do treatments instead. That was the
direction that my other pain dr. was going.

Back to your methadone now. You must find a new pain mgt. dr. or you probably will end up in the hospital detoxing. If you have to do that well, then at least they can observe you and see how you are. Maybe that is best, I do not know. To take only 25 mgs. of methadone a day is not a huge amount, but enough to make you sick I would imagine. Detoxing at home is
no pick nick either and it is not safe.

Please find another dr.
Let us know what happens.,
Anonymous
 
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cweinbl responded:
I have my family practice physician prescribe all of my medication, including pain medication. Many of us have a long and trusting relationship with our internist or family doctor. That, at least in my case, far superseded the trust level of any of my pain management physicians. In fact, my doctor allows me to try different combinations of medications as he knows that I conduct extensive research (maybe more than he does, at least with pain drugs). This trusting relationship has made an enormous difference in treating my chronic severe pain. It also reduces the chance of potentially dangerous drug interactions.


Sadly, many internists and family practice physicians today are more motivated by fear gong on a DEA list than they are about reducing their patients' chronic pain. They shovel off these cases to pain management physicians who have never heard of or seen these people before, resulting in the patient having to start earning trust with a new physician from scratch. I urge you to consider asking your family doctor about this. You have nothing to lose by trying. If it works, you'll not be at the mercy of a recalcitrant PM physician again.
cweinbl
csw2@bex.net


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