HealingWell
Search Close Search
☰

How to ask Doctor for more meds..

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/5/2008 12:25 PM (GMT 0)
I have finally found a PCP that will prescribe me 30 Norcos a month for pain relief from lower back pain.  My pain levels are around 6 on most days and I use the Norco only at night to get some sleep. My daytime pain is horrible and all my activities are controlled by the level pain I'm in. I want to ask my Doctor for more meds but I'm afraid that he may feel uncomfortable about this request and cease prescribing the meds I'm getting.

I have degenerative disk disease/degenerative arthritis, I'm 52yrs and have been through steroid injections, physical therapy and chiroprator care. I have current MRIs that show my condition. My current PCP is an Osteopath.  I have no history of drug or alcohol abuse.

Can anyone give me advise on how to talk with the Doctor without it becoming a problem? This board has been very helpful with me and thanks to the advise of one of the members I have found a Doctor that has given me hope.

Thanks!

Posted 3/5/2008 7:34 PM (GMT 0)
Hi, I agree with the pp . I would tell your dr. that you don't have anything to help you with your daytime pain and was wondering if he/she could precribe you something. I hope you have a lpd.
Posted 3/5/2008 7:43 PM (GMT 0)
I agree with the above responses. I'd just add to tell your doctor specifics about your daytime pain, and how it affects or limits your daily activities - everything from working (if you still are able to) to getting dressed, etc. Then your doctor will see how it limits you. And don't be shy at all about how bad the pain is. I think many of us try to appear too strong - especially at first, and we don't really say how bad the pain is. This way your doctor can also document it, and even though he/she may start you out on a low dose, if that doesn't cover your pain you have some basis for telling your doc that you still can't work, get dressed, etc. without significant problems. Good luck!
Posted 3/6/2008 7:36 AM (GMT 0)
There are a couple of ways to go about this that are very reasonable. First, is to request that he recommend a good Pain Management Doc to address the pain related problems, including sleep disturbances, that you are having. While going in that direction, you can even mention that you've been told that a sleep study can actually determine if your trouble sleepingis caused by pain in the same way that it would show sleep apnea or other sleep releated problems. (more on this in a bit)

ZNExt, you can tell him that the Norcos, being a short acting narcotic, are not allowing you a full night of sleep, which I'd bet is also true. Norco wears off between 3 & 6 hours after it kicks in. Most people whith CP are treated with long acting narcotics which last a minimum of 12 hours, allowinf us a full night sleep and a full day of living, as opposed to having to stopping every 4 or so hours to take more pills and wait for them to kick in. Truth be told, I would not consider continuing to see a Doc who would disagree with any of these FACTS and refuse to treat me as my conditions requires.

You might also want to discuss other medications which might bring you some relief. In addition to my narcotics, I have also been taking Neurontin and Cymbalta, both of which have given me some level of relief from the nerve pain I've suffered.

Back to the sleep study. I could have had a V* and then maybe I would have realized that my increased pain and inability to sleep was froma tolerance to my current pain meds. Next week I hope to adress this with my Pain Doc and if we can't get me adjusted to a change of meds or dosage, I'll be seeing my Pulmonologist for a sleeep study to "prove" that my pain is real. He suggested that I consider this a few years ago, but I was doing OK at that point. Now, it may well be a useful tool to obtain appropriate treatment.

I hope that all goes well with your Doc and that you find the relief you need and DESERVE.
Posted 3/6/2008 10:11 AM (GMT 0)
It seems everyone has given you some excellant advice.

I will add a few of my own but I didnt see how long you have been seeing this Doc but from your post it looks to be a fairly new relationship and if that is so then he should be asking you how the meds are working out for you and if he isnt then you need to just be honest and say I want to address the issues of how this med is working out for me.

Be as honest as possible in your telling of it and like earlier said make sure he knows how this pain is effecting you on a daily basis,I have had to change alot of things I do and the way I do them related to pain. Example is I no longer wear shoes I have to bend over to tie, I dond wear shirts I have trouble pulling over my head and off at night and stay way way away from lots of buttons int eh back or zippers I cant reach without causing pain.

I had to install hand holds on the tub and take more showers versus baths which can be theraputic as well as relaxing since I cannot get in and out of the tub alone anymore without causing myself a great deal of pain and risk of falling.

Keep a pain journal and when you wake at night from the pain go to it and write a note saying what woke you. The same for the daytime hours,jot down that you had to stop washing dishes and lie down or didnt get to them at all since standing at the sink is excruciating for you. You dont have to write books like I do here. LOl just little notations in it telling it like it is. Docs like numbers and using the pain chart is a good way for him or her to see the levels of your pain at what given moment in time,what were you doing or not doing? Did you do something that brought it on or not? What brought relief if any and for how long and how much?

I use a spiral notebook and at teh margional lines I use those dreaded awful pain chart numbers( I think the are way off and useless) but most Docs and Nurses like them. Then I write what caused it if anything and what I did to better it or stop it.

Take it with you and if nothing more it will open the floor for discussion.

Alot of Docs feel they have to start low and move up the ladder and they cant or wont move without input from you.

If all that fails to get you relief keep looking for the right Doc for you as this one isnt if your not getting relief in anyway. As someone said there are certainly other meds to add to the mix without it being narcotics and sometimes it is a matter of finding the right mix to work.

Good luck to you and hope you find more relief.

If they see you are not just in pain at times but a constant state of being they may move on to a long acting med as Norco is not that and is better left to acute pain or a rescue med.

Posted 3/7/2008 2:14 AM (GMT 0)
Thank You every body for the wonderful responses! Yes it's true I've just started with this D.O. (Osteopath) in December 2007. Since that time he has been the only Doctor that has consistantly given me a script for Norco. The Norco does wear off during the night and my morning pain is really bad. I also have been diagnosed with Hashimoto's disease and just recently started levothyroxine. My hypothyroidal condition along with the chronic pain has been the worst experience of my life and I felt that my life was hitting bottom. Levothyroxine has really helped out but I'm finding that moving around more is aggravating my lower back and neck. I'm going to keep a pain journal to keep track of when and how bad the pain is doing different activities. This might help me be more exact with the Doctor when I talk to him next time. The night time pain is really bad and I also take Ambien or dramamine to get to sleep or to get back to sleep.

This D.O. has a machine in his office that blocks pain (?). I don't know what it's called but he thought it might help me. He also said that they do adjustments to the back and I wouldn't have to go to the chiroprator that I was seeing that is not on my insurance plan. At least I have hope that my life is going to get better.

Thanks!

D. Ross

btw- kara, what is a lpd?

Posted 3/7/2008 7:11 AM (GMT 0)
The pain journal does help quite a bit. I found that I would be telling my doctor that my level probably averaged 4-5 for the month, but after keeping the journal and actually doing the math figured out it was really averaging 6-7, and we changed meds.

lpd = low pain day.
Posted 3/7/2008 8:13 AM (GMT 0)
Mochiah, the journal kept be from looking like a bumbling idiot! With the brain fog I have some days whether it be from the pain or the meds or just me getting old eyes I could not for the life of me remember what I wanted to tell him of course until I was out of the office and back to the car!

I know for a fact as well alot of Docs take your bumbling and thinking for pondering his question re:pain as maybe half truths or they look at you like your maybe exaggerating the numbers a bit?

With the journal in hand I could actuall go in there and look like I meant business.

My Attorney's also submitted it the ALJ at my hearing and he looked it for quite awhile.

D.R, I got the impression this was a new relationship with you and I assumed this is where your reluctance was in asking for more meds, rule number one with Docs if at all possible you have to let them think the med increase is THEIR idea! So at times you just have to use certain tactics to get what they want you to have. Hehe!

As for the thing that blocks pain,it would be nice wouldnt it? He most likely is referring to a TENS unit and alot of spineys have them but alot dont find they do much either except cost money out of pocket for alot of folks.

As for the adjustments? Be extremely careful here and I mean extremely. Make sure whatever adjustments they are doing and that who is doing them are aware of your diagnosis and even then I would be reluctant. Adjusting pines that already have degenerative damage can and quite often does cause disks to bulge,nerves to be infringed upon by collapsing disks and if you dont have sciatica? Then you darn sure dont want it!

Not that C.O.s cant be of some help some of the time,they are not medical Docs therefore their knowledge of diseases and conditions are not as extensive as a PHD. They know their bones but pathology and physiology just are not being learning tools in those schools they go to.

I dont know what kind of bed you have but this might also be something you can look into help with your sleeping at night better. I know when I got my memory foam bed it made a 50 percent difference in my sleeping comfortably. Before that I usually slept sitting in the recliner and have not done so since buying the mattress. They have come down considerably since I got mine and are not so outrageous. I would not let mine go for nothing. Some folks tend to do better with a good firm ortho p's bed but I cant even get out of my daughters in the morning if I sleep in hers!

Each to his own and we all have to find those things that work for us.

I certainly am glad that you finally found a Doc that to some extent was willing to work with you and hope that you continue to build a good relationship with him.

Posted 3/12/2008 6:43 AM (GMT 0)
Hashimoto's too! Ouchie! By the time I got Dx, I was just about in thyroid failure and having the most awful muscle pain on top of the joint and connective tissue inflammation. Looking back now, it amazes me that I was still able to work through that period. The good news is that once you get settled on the correct dose of synthroid (levothyroxine) some of that pain may decrease. It took close to a year of monitoring my levels and adjusting my dose up in small increments, but eventually, we got that part straight and my life got better. Well, at least most of the muscle pain and lethargia went away. I hope it works that way for you too. Meanwhile, be as honest as you can with your Doc. Describe exactly how your pain affects your daily life and let him make the adjustments to your treatment plan.
Posted 3/13/2008 2:25 AM (GMT 0)
Just a note regarding the Hashimotos...I too have Hypothyroidism and even when my tests came back in the normal range I told my Doctor that I was still tired and he increased my thyroid dose a little bit more. I was retested and I was still in the normal range just a little bit higher. So, if you're still feeling tired you might ask for a small increase. It might really help. It did with me.
✚ New Topic ✚ Reply