Blood testing vs urine testing

Okay all, I know this is probably a stupid question, however I would like to know something.  My doctor tells me that they do 4 urine tests a year for all their patients.  However.....I have already seen my 3rd one this year!  Just seems like everytime I go in they are handing me a stupid cup and that in itself is irritating!  I feel like I am being picked because long, LONG ago I did have a drug addiction, but that was in 1982!!!  It's now come back to bite me I guess.

Furthermore, I have had two blood tests this year for "levels" as the doctor says and I kinda wonder if they are not overdoing it with my poor little psyche!  I've gotten to the point where when I go in I ask if they need a urine sample from the very beginning cause if they don't catch me when I first walk in I always go to the bathroom before I go back to see my doctor.  Each time they have said yep!  I think I have only been in twice this year where a urine sample has not been asked of me.

It's frustrating because I know that with urine samples they only tell "what" the person is taking not how much is in their system.  Am I wrong in this thought?

I just hate this....I want to try the stim but it seems that WC is really being a pain in the you know what!  They are now stalling!!!  GRRRRRRRRRRRRRRR!!!!!!

Anyway.....I'm done with my whining now hehehe.

Hugs

Scarred

 

   ....and just between you and I, I find it very rediclious that they are STILL testing you. Seems like a waste of time at this point. You ve been with them for so long, you would think they knew you better by now.

Its maxed bag for sure. But, I would not go to the bathroom first because if they want a sample then you are going to have to sit there and drink water so you can go again. My prior PM dr had big signs in the bathroom-do not go until you have checked in, lol. Place could get pretty packed people sitting around drinking water so they can do their duty.

I know you feel like they are picking on you, but they really are not. Try not to let it get to you gal, thats small potatoes compared to some of the crap we have put up with.

Frances,
I'd pick the island, too!

Funny how my comment to Scarred about going to the bathroom in advance was said from such a subjective place, as I'm one who can piddle at the drop of a hat!

PaLady

Thanks everyone! Your stories have made me feel a lot better! Yesterday was another one of "those" appts. But it would seem that I was not the only one having to take a cup so to speak. I think that it is just embarressing to have to do this, but I can understand totally. They just want to make sure that I am taking my medications. And I am. I've never gone over my totals and I would never be tempted by this cause I know the consequences of abusing my medications.

Had a talk with the nurse and she told me that they still have not heard from WC about the stimulator, but that when they do it will go pretty fast once I am approved. Uggg the wait is killing me!!!!! My tens unit is being abused, I use it every day and it seems to help a bit to bring the pain down. Brought my meds with me, as I do every appt and they had my refill on my Kadian for me that I had called in a few days before. So the nurse counted out the remainder of my old meds and set me to refill next week. Seems I never have any extra of those bad boys! But that's fine by me.

I agree that all those who are abusing should be sent of to some island! Maybe give them only bread and water to eat as well LOL!!!!!

Hugssss

Scarred

Hi All,

This post made me really laugh.  I was the only female parole officer in my office for a LONG time (several years ago now) and had to watch the UA's EVERY time there was a female in for a test.....you only THINK it's bad for the men....ahahahahah.....be the woman!!!  None the less, I don't mind giving my little test to the Dr.  I've given tests for 20 years for work to make sure I wasn't using and now at the PM to make sure I am.....It's kind of ironic, isn't it?  It seems that I was always given a test immediately after I was released from a hosptial stay.  I never tested positive for anything questionable though.  I have given hundreds of these things myself and thank God that part of my career is long ended.  Yuck!!!  And I have seen every imaginable way for people to try to fake these things.  I understand why they test! 

Honestly though, my PM actually sends the tests out to test exact amounts of meds, types of meds, and something about how they metabolize in your system.  It's actually kind of complicated because my last one showed that I wasn't taking my xanax cr as directed.  I ALWAYS take my xanax and NEVER miss it.  I even took a copy of the results to the psych who gives me the xanax and told him what was going on and that we may want to watch how I metabolize this drug.  He had no question about me taking my meds.  That's one of the things that I kind of freak on.  My meds are taken exactly as they are prescribed (unless I have been given permission to take them as needed). 

 

WB-
Which is worse, to be suspected of being a drug addict or to be suspected of being a drug dealer? I understand that it happens. One of my dimwitted downstairs neighbors got kicked from their pain clinic for selling their oxy. No worries, though, the spouse still was able to sell theirs & the idiot who was kicked from the clinic quickly found someone else to write the same script.

So I stand by my statement that the only ones really hurt by these tests are the legit patients who can barely afford their doctor's bills. And just try negotiating with the testing companies for a workout plan. I never ever mind proving that I'm using my meds as directed, but it is a hassle & the rates that they charge are crazy expensive (400-600/test b/c they're out of network & I don't have the option of choosing a testing company that is in network)!

Flower-
I don't leave until my name is written on the bottle. But as for not listing all your meds, I've dealt with that before (even though I'm required to bring a type-written list of all meds from all doctors and dosages to each & every appointment and I give a copy to the UA people). It sends a report to my PM saying "Frances showed positive for Dilaudid in such-and-such-amount even though she's not prescribed it." My PM quickly sorted it out -- I just hadn't needed a refill of it for a few months because I was doing better. It's a PRN med & I only need one every couple weeks. He was totally fine with it & wrote on the report that I use as directed.

Fortunately, the insurance company only gets a copy of my dx, not the results of the UA. But Heaven help us if they ever figure out a way to get their hot little hands on the UA reports (they're trying to figure out ways to do that now -- some are already succeeding). You know they will use it as yet another excuse to deny payment. :(

You know I don't think, after reading all your posts my friends, that the UA process is that clear. It is so sad that they cannot get the information correct. I'm in fear of testing positive for things that I did not take and it upsets me to know that you all have had the same problems. I happened to look at my paper once and it said somewhere on the top the words "Fentanyl". I wondered if they might be testing for this, but it was strange that they would even think that I was taking it.

Anyway, never got to peak at the paper again so I don't know.

Hugss

Scarred

HK-
Do you have to pay for yours? After I start my new job in another month, I will have to pay $260 out of pocket for every test. That's the reason why I'm so irate. Plus, I am worried that my insurance company will get their hands on them.

I don't think most people realize how much of their medical record is viewed by people. When I was (mis)diagnosed with MDD, it went on my medical record. My insurer started denying my pain meds saying they would worsen the depression (ironically enough, it was the anti-depressants that were actually worsening my "depression" because I had a thyroid disorder & they were slowing down my thyroid). So I had to cover my pain meds out of pocket for 8 months while waiting to sort all that out. I didn't have the money, so I put it on credit cards -- which I can't pay b/c my pain meds were $1500/month. I even had to fight to get them to cover my Lyrica, but they did cover that -- just not the narcs.

Then, part of the fine print in my employment contract says that they get access to all my health records including mental health, substance abuse & HIV status (yes, I knew what I was signing, but I had already been with the company for over a year & it was a condition of employment). It made it's way down the food chain to my boss' boss & then to my direct supervisor. It made my work life a living hell. My boss would make cute little comments about to me. Everyone hated being supervisors in my department so the deal was that they each only had to serve a one year term. So over time, 4 different supervisors found out about the (wrong) dx, plus the middle manager & head of department.

I'm glad you've had nothing but good experiences with the tests. But there are legitimate reasons to resent them. If the tests were free & just between me and my doctor, I say "test me any day of the week". But they are very expensive. Yes, I will have some money (if I walk the mile to work), but I was planning on using that to pay off my medical debt from 3 years ago. Sometimes we are tested twice a month -- if I show up for injections mid month b/c I'm in pain. That's $520 -- because again I am required to use an out-of-network U/A provider.

I'm glad that these tests allow my PM to keep his practice open, but with the cost of the U/A, that means that sometimes when I'm in serious pain I will have to do without treatment solely because of the huge cost of the U/A testing. That's why I am so unbelievably furious with the idiots who abuse or allow others to abuse the meds prescribed to them! The dimwitted addicts/dealers don't lose out. They just go find another clinic. My doctor loses the ability to care for his patients the way he'd like & the patients lose access to some medical care.

He says he feels really badly, but that it's not just the idiot patients who ruined it for us, but also some idiot doctors -- like one around here who eventually lost his license after prescribing (no, I'm not kidding) 108 oxy a day to one patient, who (no surprise) died of an overdose. No, this is not urban legend, it made the major papers. articles.chicagotribune.com/2008-04-11/news/0804101462_1_fatal-overdoses-highland-park-prescriptions Supposedly these tests are (well, the ones around here, anyways) also supposed to show that the doctor isn't prescribing such a ridiculous amount that the patient has a huge amount floating around in their system -- though I'm not really sure anyone would survive til their next visit taking 90+ oxy a day. I do know some malpractice insurers quote that case as a reason why doctors have to test so frequently -- sometimes multiple times per month.

So, I get it that there are multiple reasons to justify these tests -- I just wish those justifications didn't exist. :(

-frances

PS -- Isn't there some way we can get the addicts/dealers to have to pay for our tests? That would be nice.

Thanks, WB. I'm glad for HW too.
I think the biggest thing I feel I can do is to educate people. Yes, it's annoying b/c I feel like I shouldn't have to explain myself all the time, but what can I do? Fortunately, my job right now is in the education industry [I left that crazy place where everyone was talking about me] & the people here (well, except for HR) take 5 minutes to do a bit of research before jumping to conclusions. What a concept, right?

But the cost is just really a hardship. It's a catch 22 because if I walk the mile to work (plus a mile back) it aggravates my pain, but if I don't walk I can't afford the U/A testing even once a month. about the only way that will change is by demanding that the malpractice insurers find a way to improve their actuarial formulas. There is plenty of data out there about identifying addicts but not nearly so much about dealers and even less about idiot doctors (yes, there are a few other reasons, but testing a patient who has been on a stable dose for 7 years seems like complete overkill). My prescription insurance company has gotten a little bit around the idiot docs by saying that C2's will only be covered if prescribed by either a licensed pain management specialist (who completed a pain fellowship) or an oncologist. Unfortunately, Medicare & the largest private insurer in IL have yet to adopt that policy. But I understand that too could potentially cause issues for people [there are tons of PM's in my area, but most of them gave themselves that title & have little training in meds or many interventional techniques -- typically they specialize in only 1 or 2 types of treatments and most don't have DEA licenses; these "PM's" would not qualify under the rule my insurer requires b/c they did not complete a pain fellowship, though without a license it wouldn't much matter].

I think besides educating the ignorant people in the public & demanding changes in actuarial standards, we need to lobby for real pain management specialists. But who has the energy to do all that? I'm just worn out trying to handle my own pain. But I would like the system to change. That would be a good start. Then I'll keep working on educating all the dimwitted people out there who judge first & find out they were totally wrong years later (I'd eventually like to work professionally in advocacy for CP patients -- maybe writing for prof. journals but also working with the media to change perceptions of CPer's). But until then I just need to figure out how the heck I am going to come up with all the money to pay for the U/A (which, as it turns out is double the cost of my doctor's bill, after insurance). GRRR! So aggravating. Like I needed one more challenge in my life. :(

Sorry. Guess partly I'm so tired b/c my epidurals didn't really help on Friday. I waited 2.5 hours to be seen, then was given the wrong thing [which caused pain in a whole new part of my body] and then finally got the right epidural but it doesn't seem to be helping. I like my PM but Friday was just a lousy day. I just feel like things are stacked against me. I keep fighting & I am making progress but it seems like each time I'm finally getting some momentum, something else comes up and sets me way back. First it was the PT. Now I'm facing these astronomical U/A costs. What's next?!

PA & I are going to live on a private island that's only for people with CP who don't do anything dumb. We're gonna have free access to all the best doctors & alternative medicine specialists & therapists & researchers & everything. And the food is gonna be so healthy & tasty. And there will be an electric fence out in the water (hey, it's my dream & if I want a waterproof electric fence I can have one!) that will ward off anyone who could possibly ruin our little paradise. Any CPer's and their family & friends who aren't troublemakers would be welcome to come live on the island. No drug-stealers, though. Oh, so nice. Sunny days, air conditioning & everything one could want. Well... I can dream, can't I? :)

Keep dreaming Frances, I enjoyed the visual I had of this island, lol. You are right about the costs of the urine screening. My former PM dr ordered screening on the pump patients 2 months in a row before closing his practice. I am assuming to make sure everyone was on the straight and narrow before sending us to the new pump dr. He used a lab out California that charged around $1040 to do the screening. I nearly fell out of my chair when I got the EOB from my insurance company. Of course, they paid just minimal on the bill. That was just nuts as far as I am concerned.

My new pump dr does not do screening or contracts. In all my years of getting PM care I have had two screening done and it was the ones I mentioned above. I like WhiteBeard witnessed many, many people screaming and hollering over the results of their screenings.

I sure hope you get to feeling better soon, you were doing so well before.

Flower, I had BCBS when my testing was done and they paid little on the bill and yes they tried to bill me. It was Ameritox and no your PM dr cannot bill for the screening, only the company doing the screening can. I sure recognized their name, thanks for posting it.

You know its funny that you should meantion drs. that abuse the system. Here in KS there is a doctor that is currently on trial for 11 patients that od'ed in medications that he and his wife prescribed. I just cannot believe that there are drs like that out there in the world. They should all be rounded up and kick them out of the country LOL!!!

Hugssss

Scarred