karkians
Stranger
Reged: 11/23/03
Posts: 6
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I'm living in Jackson, Mississippi, the lawsuit capital of the U.S., and I have a dilemma regarding my meds. I've been diagnosed with Trigeminal Neuralgia, an excruciating condition, and have been on methadone for the pain for a couple of years. Unfortunately, the doc I was seeing for my meds has quit practicing because of skyrocketing malpractice insurance premiums, and I have found no one around here(this is the south, doctors here don't even know that methadone is used for pain management- several have told me that it is only used for detox) who will prescribe it. I've tried Duragesic and a host of other medicines, Oxycontin, Hydrocodone, but besides being ineffective for my pain, I can't function on them. Methadone, for me anyway, doesn't cause the same sedation as the others. I am also on Neurontin, which helps some but doesn't cover the most acute symptoms. Anyway, the holidays are coming up and I only have a few tablets to get me through the next few days so I need to do something. I have an appointment for a pain doc the second week of January(the earliest appt possible, as he returns from vacation the day before) and I am optimistic about some of his methods(nerve blocks, etc) but quite frankly, without the analgesia methadone produces I believe I would go crazy or become suicidal within a couple of days. I've been to see a few family doctors, as they are more accessible timewise but haven't found anyone who seems to care about my plight. I've thought about calling ahead next time and talking to the doctor or the nurse at the clinic I plan to visit and find out if they would work with me temporarily; I don't want to waste my time taking off work for a fruitless chat with an intractable M.D.. So my question is, what do y'all think? Any experience with this? I know I can't get methadone online, already explored that option. Any help would be appreciated; I don't know if calling first is a bad idea or not, but I have no other way of "screening" the practitioners, and it is kind of humiliating asking a doctor for a specific medicine which has saved your life and job and having him treat you like a junkie. Thanks.
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voyager
Old Hand
Reged: 04/17/03
Posts: 413
Loc: United States Virgin Islands
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If it were me, I would get ALL of the medical records from my previous
treating
MD when you go to your next MD appointment (inclucing all tests, scans, MRI's ETC.
Show them the records that you have been on Methadone and that you are NOT a junkie. A pain manangement specialist is definitely your best bet but in the meantime go ask the docs that you have seen if they don't want to work with you can they refer you to someone that is willing. I know that in cases of LEGITIMATE medical needs, most MD's are more than willing to assist pts in pain.
additionally, if you just explain to them that your previous doc quit practicing (retired) then hopefully someone will understand.
Good luck and keep us informed.
voyager
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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I'm so sorry to hear you have Trigeminal Neuralgia, that is a nasty, nasty disease.
Whatever you do, don't let that methadone run out! I don't know how much you take, but you can't cold-turkey it and maintain any semblance of sanity, as you seem to already know.
If worst comes to worst, I'd go to the ER and discuss this with them. Bring your records. Any ER doc with an ounce of humanity will give you a script for the med that works for you until you can find another doctor. Maybe he can even refer you to someone who will treat it long-term.
Are the doctors you've seen that wouldn't script methadone pain management doctors? I can't believe they aren't aware of methadone's use in pain relief...that's just ridiculous. If they are family docs, chances are they have no experience with it, though they should still know. I really think the ER is your best bet.
As far as calling ahead of time, it's not a bad idea with your condition. I hope you have records, I'm assuming you do. Explain the situation on the phone (maybe ask to speak to the doctor, not the nurse), that you've been prescribed it in the past and can bring your records plus an old prescription bottle. Tell him you are looking for a new doctor, and ask if he will take on patients like yourself.
Btw- have you been to neurologists? I bet you will have better luck than family doctors.
Good luck.
-yawkaw
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pickles
Journeyman
Reged: 11/09/03
Posts: 54
Loc: Indiana
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Hello Sir,
I was trying to find you a clinic nearby and stumbled upon this: http://www.bitchandgripe.com/Mississippi.htm
It's total b.s.,i had no idea the regulations on Methadone and it's clinics.We have them everywhere here,and i live in corn-fed Indiana.You might,for temporary relief,have to make a road-trip,take your bottle into a clinic.I do KNOW they will help you.Especially for relief purposes,since,of course,your not one of there usual needle junkies.In the meantime,i will do all the research i can to find you a compassionate physician in your area.
Take care buddy!!!
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shane369
Member
Reged: 03/07/02
Posts: 155
Loc: USA
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Quote:
You might,for temporary relief,have to make a road-trip
I too live in Jackson, MS(I hate it here). I believe that you are correct, Pickles, a road trip to Louisiana is definately in order in this situation. I recently had a friend who died from a methadone overdose. IMO it is a drug that should be strongly regulated, but I also believe that every state should have a methadone clinic. Just my 2cents worth. And trust me I know what you mean about lawsuit capital of the world, my wife works for mr. one call(if you are from MS you know who I mean)
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"Actually I'm a mouse in the early stages of an elaborate scheme to take over the world"
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PAIDFO
Member
Reged: 02/01/03
Posts: 149
Loc: southeast
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I would ask my Dr (the one retiring)to give a name of a new Dr.When my Dr moved to another state,he referred me to a new one.Just a thought.Good Luck..
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"The difference between Ordinary and Extraordinary is the Little Extra"
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zoe11
Journeyman
Reged: 11/04/03
Posts: 87
Loc: Other side of the moon
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OMG -- I'm so sorry try this web site www.partnersagainstpain.com hopefully you will find someone there that could help. I agree a road trip would be a good idea with records in hand. I take methadone too for my pain from a pain specialist. It is a life saver for me. If none of this works, take your records to a methadone clinic. Perhaps they will help you. I've heard withdrawals from methadone can be fatal. Be careful out there.
zoe
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Horace
Journeyman
Reged: 11/22/03
Posts: 79
Loc: Earth
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I can't believe that the retiring doc doesn't refer you to one of his colleagues. It would seem the responsible and professional thing to do. As he has a patient on methadone, is he simply comfortable with retiring, and leaving you out in the cold, as it were?
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singlesu
Member
Reged: 06/07/03
Posts: 143
Loc: kentucky
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For what it's worth, my dad's pain management doctor is retiring at the early age of 54 for the same reason. He's tired of fighting the high costs of insurance and the tighter restrictiions on prescribing pain medication.
And to answer the others above, my dad's doc has not given him any referrals either, even though he has asked.
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"I know I'm crazy cause I've got papers to prove it"
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Firefairy
Member
Reged: 11/26/03
Posts: 147
Loc: Mississippi
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Your doctor has not referred you to a doctor who can help you most likely because he has no idea who can. If you live in Mississippi you know that anyone Rx'ing pain medications today is only a step away from having the DEA strip them of that right. Over half the doctors in my county are not allowed to Rx any hydro products, much less anything stronger. With doctors afraid to discuss pain management amoung themselves it is hard for them to know who will prescribe what.
I think the best idea of short-term damage control would be the emergency room solution. Try University or St. Dominic's. Both those have Rhuematologist's and other specialists on staff that are used to dealing with pain Family Practice MD's usually ignore.
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2muchpain
Enthusiast
Reged: 10/07/03
Posts: 274
Loc: USA
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What???
Over half the doctors in your county are not allowed to prescribe hydro? What on earth are they doing over there? That is 2scary! Who is regulating them on Class III pain med?
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flea
Enthusiast
Reged: 05/17/02
Posts: 276
Loc: Recently moved to Mid-West, bu...
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Karkians - -
I sent you a PM. I had read your post in a different forum. I did not catch that your dr. was retiring, thus the reason that he will no longer prescribe methadone for you.
Just a few thoughts on this matter, other than what I already sent you in my PM. For one, I wanted to respond to the whole "road trip" idea. Well a road trip across state lines into a more sympathetic area does seem like a great plan, except it is Christmas/New Year time and that may make things harder for you. Especially if you do not know where you are supposed to go once you get across the state line. There are little details that you will need before envoking on such a trip. You know, all of the "where's when's and who's" ought to be answered before you go, or else you may lose precious time. However, if you are in the middle of experiencing withdrawl symptoms, and your only hope is that some doctor across state lines is going to be your answer to a new methadone prescription, then I have to say that makes me a little worried for you.
I have to agree with the other person who posted that you should consider the ER for something like this. I do not think they can turn you away if you are in fact going through withdrawl. Especially with all of your medical records on hand. You must get thoses ASAP as I think that bringing them with you in an emergency situation can only help your case. Really. I mean an ER is usually the WORST place to try to get narcotics, but in your situation i do think it will be your best chance at getting something to stop withdrawl and to give you enough time to figure out when where and who you need to see to get a regular prescription of the methadone.
Pain clinics may be able to help you, but as you mentioned, why waste your time if you do not even know if they will prescribe it. And trust me, my pain doctor in the state of wisconsin would not prescribe it at all. Not only that, but he contacted my family doctor to try to persuade her to stop prescribing me meds all together.
So for me the pain management clinic was nothing but a waste of time and a really negative experience. If i did not have my family doctor then I would have been in the same situation as you are in right now. Because the pain clinics do seem to have the strictist policies on narcotic prescriptions, I think i would be a little bit cautious when calling them before your actual appt. I mean if you are just calling to feel them out then that is probably OK as I mentioned, why waste your time? But if you are hoping to get a prescription for methadone before your appt just based on a phone call then you may want to rethink that.
If I were you i would contact the office of your doctor that just retired. You need to explain your situation to the nurse there and tell her it is an emergency and without guidance you will most definately go into withdrawl and are highly fearful of a situation like that. Heck, who knows, you may even be completely out of them right now. I sure hope that is not the case. You poor thing!!!Anyway......as I was saying, this doctor needs to be held responsible for his patients, whether or not he has retired. Actually, BECAUSE he has retired, he should be even MORE responsible for your care as there ought to be some guidelines on this kind of thing. I can not imagine that this kind of abandonment is condoned by your state.
If you explain this to his old office and to the nurse that is now there, hopefully this will be the push they need to be responsible and follow through with your care, and to make sure you do not go into withdrawl because this ONE doctor is no longer practicing.
If anything maybe his nurse can call ahead to a pain clinic and explain your specific situation. That may expedite some of the red tape. Otherwise, if you do end up having to go to the ER, then at least the office staff at the retired doctors office will be well aware of your current situation, in case the ER feels as though they need to contact your doctor to follow up on your medical records.
Either way, I sure hope you find the help you need. Your story is just AWFUL and I am so disgusted that a doctor would allow something like this to happen to you. I sure hope you are able to act on this before you completely run out as you will have a difficult time remaining patient once you start to go into withdrawl.
I also told you in my PM to you that you should try to get some Clonidine just in case you do experience any withdrawls. It's a blood pressure medicine that regulates your body temperature. It is a godsend if you start to go through any sweating and or feeling really hot or really cold. That for me was the worst part of the withdrawl so if you can get some Clonidine right away, then you will hopefully protect yourself against the whole "sweat, and hot--cold--hot--cold sensation" that is quite common with narcotic withdrawl.
I believe it is rather cheap and is found online.
Anyway, good luck and I will keep my fingers crossed for you. Please keep us updated on your situation!!
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Flea
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2muchpain
Enthusiast
Reged: 10/07/03
Posts: 274
Loc: USA
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Very constructive post, flea. I also agree that pain clinics are a huge waste of time and money.
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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As much as I hate to advocate it, you CAN always get on a methadone maintenance program. Contrary to what people believe, there really are no real rules for getting on it. They don't care WHY you are there and you ARE technically opiate-dependent. It is expensive at $12 a day and they do not take insurance. That $12 pays for your single dose (no matter if it is only 5mgs or 130mgs) and there is a fee something like $100 for the initial intake. If you don't have insurance, some states will pay for it (but only through approved programs) on a Rule 25 basis (income eligible, but in MN you can earn something like $35,000 a year and still qualify)... The disadvantages, until you have 2 years on the maintenance program, you will have to come almost every day for your dose. You don't get any substantial "take home" doses until you have hit the 2 years mark without opiate-positive UA's. Then it is between once a week and once a month pick ups.
Like I said, it IS an option and is easy to get on the program (especially here in MN.)
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Never underestimate the predictability of stupidity.
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SBELL
Newbie
Reged: 11/04/03
Posts: 35
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Hi, sorry too hear of your problem. I understand darvocet is a direvitive of methadone . hope you feel better soon. Sbell
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Firefairy
Member
Reged: 11/26/03
Posts: 147
Loc: Mississippi
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Nearest Methadone clinic seems to be in Livingston AL. They will only do the daily thing because it is a maintance program, not a pain control one. Hope this helps.
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