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Jeffster
Stranger
Reged: 10/06/02
Posts: 21
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I hope I'm posting in the right Forum U guys--This is a complaint on this last months visit to my Pain Doc.
I have Back Pain--He Did Prolotherapy on me (24 Injections in or very near the Spine (Trigger Point Injections). At this point in my treatment (Over a year now), I am willing to try anything--This was the first time he did this procedure on me and I screamed and cried (Tears) the entire time. Aftyer the Procedure he wrote me a Script for 30 60mg Avinza and 90 15mg Roxicodone for Breakthru Pain. For the last year I have been on nothing buy Hydro (10/325) around 7 to 8 a day. Hydro has worked fine for me. I believe he wrote me the new stuff because of my reaction during the procedure--He saw the Pain I was In.
Anyway, 2 Days later after Throwing Up twice and having a Headache I thought I was going to die from Literally, I called him to complain about the new meds and to ask for my trustworthy Hydro. He denied me and we basically fought on the phone. He told me to continue to take the Avinza (Morphine)--I told him I would not because it is really me up Bad and that he made a mistake prescribing this out of the blue. he told me to continue my walking program (What ever the hell that means) and he would see me in 1 month. I told him No, that I wanted the Hydros Now and that he had no right to take me off of something that had been proven to be effective for me. He said he would not change the script--see you in a month.
Is there anything I can do to him is my question. I'm really pissed Off. I would like to report him to a board or something. 1st of all, Because of the "Witch Doctor" procedure--Prolotherapy, which is nothing more than injections of Sugar Water at a price of $300 to my insurance company--This Procedure created about 5 times my normal Pain for about a week. 2nd--He changes my meds on me with no warning. 3rd--He has no concerns when I tell him 2 days later he screwed Up and I am having Adverse reactions to the medication he prescribed to me.
Sorry for the Ramble--Its late and I am Joining sentences.
I would like to go into the office on my next appointment and have some ammunition to the effect of--If you ever do something close to this again, I will report you to a medical Board, my insurance comapny, the BBB(Ha, Ha)............I know I'm dreaming here but I want to tell him that the Avinza/Morphine does not mix with me at all and the Roxicodone is less edffective than my Hydros--Believe it or not it took 5 15mg oxy's to equal 3 10/325 Hydros. I just want my 8/day hydros back and forget about a 24hour pill with some breakthru meds or if he wants to experiment on me, Give me some Hydros--at least 4/day, and what ever else he wants to try.
I just need advice to tell him that I am in charge of my pain, especially when his experiments with meds that make me take 2 days off of work because I am so messed up from the meds not the pain. Thanks for listening and sorry for the rambling, incomplete sentences, mispellings, etc...
Love you Guys
Jeff
I'm Adding a little more guys sorry--I understand where he is coming from--Moving me to a 24 hour steady release pill (Avinza) and Breakthru pills (Oxycodone)--But shouldnt he give me mostly Hydros' and a sample of these other meds--He even gave me a script for some heavy duty nausea meds because he says that some people get real sick off of morphine. And yet he wont budge when i let him know almost right away that he was wrong--at least for my body.. I told him I'm violently throwing up--He said keep taking them, it will pass--I said "your crazy"--After trying to get my hydros for about 10 minutes I said on my next appointment I need to go back on my hydors and he said "we can talk about it"--Talk about it Jeez..I am a legit Pain Patient with Records to prove and he's going to treat me like this--I dont like this guy but I'm sort of stuck as he's the only Pain guy around here--I think he thinks that when I asked for the Hydro, that I was asking for additional Meds--But I told him I would bring everything I already had from the pharmacy and turn them in to him if he wanted.
Thanks Again People--Love this Forum!!!
Jeffster
Edited by Jeffster (10/11/03 03:18 AM)
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mightymouse
Stranger
Reged: 09/08/03
Posts: 20
Loc: Secret star above Earth
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Hello Jeffster.
I really don't know if I'm going to be on any help to you.
However, I just wanted to point out that there are probably a few reasons for the change in your prescribed medications.
First of all, I would think that most of the chronic pain sufferers here will read your post and wish that they had your PM doc. He gave you something stronger and seems like also enough of it, alas...if it's not effective for you then they're worthless.
If he's been giving you the 10/325 hydros for the past year, then he may be thinking of your liver and wanting to give it a little break. It sounds like he is actively aware of your pain and isn't shy about prescribing potent painkillers (that's a plus for many members here who can't get anything stronger than the hydros). However, I do agree with you, if the hydros worked better and you've repeated it to him, then...he should by all means acknowledge your request. Besides, it is your body, your health, and your pain (who knows better but yourself).
I really don't understand why he wouldn't take back the meds. It's not like you are asking for more, merely an exchange for what's effectively proven for your pain.
Like I said, Jeffster, he's done more than the usual PM does in trying to provide relief for your pains. I'm sure someone here will have some sound advice for you. I'm sorry to hear that the Avinza/Roxicodone hasn't helped much and made things only worse. I do know that the combination can be extremely potent and make some nauseated until they get used to the strength of the meds. In your case, it seems like nada/zilch/less effect on the pain. Everyone is different and varies in what works for them. Thus, the doctor should abide by your responses and act accordingly.
I do hope you get the help you need before the next month.
If he's not listening to you, even though he willingly prescribes the potent pain medications, then it might be time for a new doctor. A good doctor is hard to find......
attentive + active = proper treatment/better health/good doctor.
I'm sorry for the early morning rambling...I don't think I've helped you any but I do truly hope someone will and I believe that someone can. Good luck!
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"Pain is inevitable...suffering is optional."
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Greycie
Old Hand
Reged: 07/08/03
Posts: 462
Loc: Pacific NorthWest
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I agree with mightymouse. If it were me, I'd be furious and it'd be time to march into the office, get my medical records and find a new doctor. I've been switched from hydro. to percocet but with less medication, so I requested to go back and my doctor was okay with that. Here's the deal, though- I had to wait 28 days because I signed a narcotics contract. Anyway, the reason I'd go see a new doc is that you're getting physically ill off of the morphine and from why one of my doctors told me, that's a sign of an allergy. Rather than addressing that, he's just given you anti-nausea pills? Did you tell your doc. that the morphine made you vomit? I'd do some research because it could be that there is something very wrong (legally) with keeping you on a med that you're having that sort of reaction to- but only if you told him, I'd assume- if he didn't at least check it out. I dunno. I'd think that, though. And to keep you on meds that don't work? Not good. I dunno, I'm no doctor and I'm no lawyer- but that'd be what my common sense tells me  Good luck.
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"I may not agree with what you say, but I will defend to the death your right to say it." - Voltaire
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JOJOM
Banned for off topic discussions, confronting mods in public, and being unpolite to members and mods
Reged: 08/16/03
Posts: 358
Loc: Yankee
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Jeffster,
I agree with you all, its a reaction and there is a little piece of paper you get with the rx that says if you experinece any side effects to contact your Dr. , well you did and he says just see me in a month? I would be as upset as you are if my Dr. told me to just deal with vomiting and feeling sick for a month, he must be out of his mind. You need to file a complaint with the medical board about him, he is too lazy to write you another rx so he says suck it up? I cannot stand Dr.'s who think they are always right when you tell them otherwise, he isnt even listening to you.
You should march in there and get your records and see a lawyer, at least it will make you feel better to speak to someone who knows the law and will advise you of your rights and options as a patient.
Good Luck to you!
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Nothing makes a woman more beautiful than the belief she is beautiful.
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Jeffster
Stranger
Reged: 10/06/02
Posts: 21
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Thanks for the Replies Everyone--This is the way I feel About it--If he wants to Experiment with different Meds on Me (Again--I'm Fine with Hydro forever) then I would like to tell him to keep me on what he has had me on for 3 months which is 6/day 10/325--I have been on these for over a year with different Docs and have only been with this Doc for 3 Months--Each time with this Doc, I have let him know that I need 8/day because I am use to the medication and 6/day for hasnt been enough for the last 6 months. The last time I went in he told me he would not increase the 6/day but would give me Clonidine (Which is suppose to give the Hydro a little more potency--but it didnt). Now this last time I went in he gave me all of this new stuff based on my reaction to this new treatment, Prolotherapy.
Basically this is what I would like to tell him--Keep me on 6/day--I would like 8/day, and give me samples or samll Scripts of what he would like to try. I know this is asking alot considering they are narcotics but its only asking alot because of his frame of mind--meaning he probably thinks that every patient is a Drug Seeker or something and this influences his decisions. Again--I dont want to "Upgrade" in Potentcy--I am happy with Hydro--which I think is a very good sign that I'm in it for the Pain not the Recreational Use. I have always heard about Oxy's and Morphine--but honestly I just want what works--And 8 hydros a day would be 325x8=2600mg of tylenol. Which is a little high but not horrible--And I really think its the partnership of the tylenol with the hydro that is most effective on my pain--For instance I could tell him to try mr on Percoset or Percodan instead of Oxy because of the APAP. But yes I did let him know I was throwing Up and had Severe Headaches 2 days after my script was written and he basically said to suck it up and continue with my walking program (He has never told me about a walknig program, I walk enough during a day at work, and like walking will help a Herniated Disk L4-5)
I really want to walk in, tell him I am losing trust in him, listen to me as the patient more as pertaining to my treatment, and he has one more chance to gain my trust
What do u think--too cheesy??
Jeff
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quincy
Board Addict
Reged: 11/07/02
Posts: 333
Loc: pacific northwest
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I had the same thing happen with my PM. My PCP had me on Norco and methadone 15mgs four times a day. When I went to him, he cut the Norco and left the methadone. Well of course I was in pain again, and I had to wait a month before he would see me, he wouldn't even discuss my pain over the phone. He just kept on increasing my methadone. Then I developed a kidney stone. Instead of going to the ER, where I know they wouldn't have done a thing for me since I go to PM, I went to him. Of course he sent me right to the ER. They did nothing of course, since I had a PM and used methadone. They just gave me some more which raised my dose by 25%. Nothing for breakthru. Now methadone is not good for acute pain like a kidney stone. Plus I was taking way too much methadone for me, I was slurring my words, falling asleep sitting up- people were asking me if I was drunk!! I called him after about a week of that. My pain was still bad, and I was doped out of my mind. What is the big deal about prescribing some Norco or Percoset?
What he did next made me wonder if he had gotten his medical degree from some foreign country. He took me completely off methadone and put me on Oxycontin--but only 20mgs twice a day. Now I could take 20 mgs of straight oxycodone about four times a day. I told him that that dose was way to small, I mean going from 100mgs a day of meth to 40 mgs a day of oxy? It made no sense. When I started to go into withdrawls, I called my PCP. I told her what happened and she agreed with me. She told me to cancel my appointment with him and put me back on my original regimen. Now I am back to where I am at least stablized. Of course I have to find a new PM, but thank God I have a good PCP>
I suggest you go to your PCP and tell him/her that your PM is not listening to you or taking your needs seriously. Ask if you can change docs, or see if your PCP can intervene for you. It does sound like you have a doctor that is not stingy about giving out meds, so I would really think about it before leaving him. I just would tell him point blank how you feel and tell him that you know your body, and its limits and what meds work best for you. I know how they like for you to "Try" some drug for a month and then won't see you early if it dosen't work. I hope you can get this straightend out.
Good Luck,
Sarah 
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prettyday
Threadhead
Reged: 02/09/03
Posts: 924
Loc: Coastal Sage Scrub
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I really feel for you. The back and forth with your time and life as different dosages are thrown at you will make anyone crazy.
I have been posting on this. Try acupuncture.
It is time to force your body to manufacture some of its own natural opiates (endorphins) and to distract the pain.
Exercise is great for this, but lots of us are depressed and have trouble sticking to a regimen. So go for the acupuncture, where a professional will identify those areas of pain, and treat them. The needles are tiny and disposable. You get new, packaged needles every time. You will feel a little pressure and discomfort as the area is stimulated. You will feel very thirsty afterwards. Good.
Drink, drink, drink, that water!
If you have already tried this, try another one.
Good Luck! 
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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Jeffster
Stranger
Reged: 10/06/02
Posts: 21
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Thanks for the Reply Sarah--Your Awesome--Very Close to what I'm going thru but it sounds like you have more experience--I'll probably post here and there about this and would love to here from you about the subject--Even though I havent contacted my PCP about this yet, I think I will let him know when I see him on thursday that I have talked with friends, family, and my PCP and they are very concerned with his actions (Hopefully this will keep him on his toes) I mean this guy does not know my first name, didnt really go over the Medical Record History that I brought in, etc...And his waiting room is always Packed with alot of young people--I think he knows whats going on and doesnt know how to treat a Legit Pain Person, He's just raking in the money and gets them in and out as quick as possible--The fact he would prescribe any drug be it an Antibiotic, Stomach Pill, Narcotic, etc... And not react to a Patient calling in 2 days later with Severe Adverse Reactions from the Medication he Prescribed--And basically doing nothing--That's got to be illegal or something. Not only did he not tell me to stop taking the medication and issue me the Hydro that works, he told me that it would pass and to keep taking it. I did a little research and it looks like I'm most likely allergic to morphine--Besides the Headaches and the Vomiting, I had a rash all over my face.
I'll let you know about thursday--I'm going to be an a semi jerk to him about what he did to me and see if it pays off--He'll remember my name after thursday...I'm letting him know he's got one more chance and that if he wants to experiment with new drugs, then he needs to be there for me if they dont work--Or give me my regular hydros and the new stuff and I'll let him know if it works on the next visit. I'm scared to be aggressive like this for fear of losing him, but People including Doctors need to be told when they have screwed up--I've probably got enough on him to report him to someone--Not sure who--But if he fights back on thursday--That will be my next question to you guys on how I can report him.
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voyager
Old Hand
Reged: 04/17/03
Posts: 415
Loc: United States Virgin Islands
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What ever you do DON'T LISTEN TO JOJOMON. That type of mentality is what has our health care system screwed up. What I would do is make an appoinment to go and see him and to discuss what it is that you have been experiencing as far as pain goes.
I think he got you off the hydros to help your body. (8) a day is an awful lot for your liver to metabolize for 1 year.
Good luck.
Voyager
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 882
Loc: usa
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I'm so sorry to hear your having so much trouble....I know it frustrating....With regard to the trigger point injections..their controversial...I know when I popped my first disc, I had HORRIBLE muscle spasms that even valium couldn't touch...and a doc tried a trigger point inj. & it's the only thing that actually worked...but they do hurt ALOT and if they didn't improve things for you..I think you can safely put that issue to rest.
With respect to the long acting Morphine, I can tell you that as a nurse, the nausea is a common reaction for a novice...and will pass within the first 2-5 days of continued use....and the doc may be concerned about your tylenol intake w/ the hydro's.....if you need 8 per day...it really is time to consider switching to a long acting pain med....I'm not saying he shouldn't listen to you...but he also has a point...and he's not just trying to make you suffer....but he has experience at this & knows that the nausea experienced by a new morphine user is transient...and it really is...I'd back of the roxi's or cut them in 1/4's...and take them only when absolutely necessary....try to continue to take the moprphine with the anit nausea agents for at least a week....eat SMALL, frequent snacks...i.e. every 2 hours or so...limit motion as much as possible for the first week of therapy...and you might find you'll expeience a new level of pain control with less meds that's less toxic to your liver...and nausea is NOT an indication of an allergy to morphine at all..and it is ALWAYS a transient reaction...you just need to develop a little tolerance to the drug....perhaps he could switch you to another long actng med like Oxycontin starting w/10mg every 12 hrs & increase to relief..but you'll likely experience some nausea with with that initially as well...I've been on it for 2 years now & trust me, the nausea goes away!
Or, if you feel you absolutely cannot do this, you need to call his office & schedule a consult asap to discuss it...
but the therapy he's prescribed is completely in line with the standard of care in pain management today....JMHO
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Folksong
Member
Reged: 07/11/03
Posts: 128
Loc: Texas
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Jeffster,
Am I correct in assuming that you were taking 8 hydro a day for year, and the dr. abruptly discontinued this and started you on the morphine and roxicodone?? I am not a dr. but it seems to me that if someone is going to change pain regimens, it should be done gradually. I do agree that nausea is a common side effect of morphine. Perhaps if you took it easy for a week to let your body adjust to the change, it would help?? You were used to the hydro and were able to do your "normal routine", if that makes sense. I would think, even tho the morphine is much stronger, that you would still experience some w/d's from the hydro.(?) Like the headaches?? Heck, it might even have something to do with the sudden absence of the tylenol.?
I am in no way saying that the way your doctor treated you was right. I have experienced so many condescending, patronizing doctors I could scream. It is so exasperating when they treat you like a 5 year old and won't listen when you try to explain that you have been in pain for years and know your own body...They have all the answers. I had this problem with my rheumatologist at first. It has taken awhile but she has finally started to listen to me, and treat me like I have an IQ above 70.LOL
Sooo, my advice is to talk to this guy. Just say, "hey, I need to speak with you, and I need you to listen..." then lay it all down. Ask him "why??(the change and then the refusal to resume the hydro)"--you have a right to know, it's your body. And basically, HE is YOUR employee. If you cannot reason with the man, dump him. But do try because, as others have pointed out, there aren't many docs out there who would even consider prescribing those types of medications, unless they knew for a fact that you were going to die tomorrow. Just my little opinion and advice.
Hope you find a solution soon and you have friends here if you need to vent or whatever.
Folksong
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