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1st experience with a PM was a nightmare!!!

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Posted 6/3/2011 4:02 PM (GMT 0)
What a horrible last 24 hours!!!! 1st of all the lady at the front desk was like complaining and complaining to her co-worker (very loudly) about....well, life.

But then, when I meet the dr, boy was he wierd! A quack really. He sat down with his little laptop and told me to "start from the beginning." Meanwhile, interrupting me and giving me his viewpoint and 2 cents into my what I should do with my personal life. I appreciated it at first, but.....after a while of him interrupting me and not hearing the whole story yet coming to judgments on his own, I started getting a little suspicious. He didn't even let me tell him everything I was CURRENTLY TAKING (and I tried 3 times to interject it).

He then, after about an hour of this strange interview, got up and immediately started telling me of a drug they started using over in London (he's British...or English....or one of those - he has a thick accent). Subutex - the "cousin" of suboxone. He rambled (he rambled regularly) about how yes even though it's "used" for people to come off addictions to opiates, it also has an "opiate-like" quality given in a fraction of the dose for people NOT taking opiates (which I don't).

He then proceeded to get a 2mg tablet from his cupboard (about the size of a small woman's tip of her pinky) and cut it down so that he could get an 1/8th of a dose (basically crumbs). He had me put it under my tongue and let it dissolve. He told me to stop taking my tramadol, wrote me a rx for 5 more 2mg tablets and sent me on my way telling me to call him in a couple hours to see how I feel.

I felt nothing for a couple hours until I headed off to work....I started feeling tingly....when I got to work it was full blown: dizzy, running into walls when I walk, un-balanced. Unable to read, let alone look at my computer. I felt faint and nauseous....kinda like drunk with a horrible case of sea sickness. It was absolutely torturous! I immediately called his office and told the receptionist that it was an emergency that he call me right away! He did call back about 20 minutes later and was actually "excited" that this was happening cuz it "proved" his theory: that this stuff is THAT strong and even crumbs were too much!

He then started to "think"..... of something he could prescribe to help me. He asked me if I had any Tylenol #3's on me (I mean, does one just carry Tylenol #3's around with them without a script, what kind of ? was that?!?!?!) I said, uh, no! He said ok, I'm going to call you in a patch for "sea sickness" that you can put behind your ear that will ward off the nausea & dizziness.

I had to have my husband go get it, cuz I was in NO state to drive! But I work at a chiropractic office so the chiro did some work on my and had me lay down for about 45 minutes and I did feel a little better and was able to get thru the day without the patch (when I have a bad reaction to a drug like that, I "FREEZE" and don't want to take ANYTHING, no matter if it's over the counter or what! I guess I just want the stuff OUT of my system and then I'll go from there.

So, the dr told me to take just like a fingertip powder of the subutex the next day (today). He said just break it all up and make it a powder and lick you finger, dab it in the powder and that'll be my "dose." Well, with the suffering and "hell" I just went thru I wanted NOTHING to do with the subutex. I'm back on my regime today: tramadol, gabapentin, & xanax....and slowly slowly slowly feeling better.....

I'm DONE! I'm done with these dr's that wanna "try out" things and try this or that. I'm DONE with dr's that don't listen and unvalidate my personal experience of 15+ years with meds. From now on, I will face this thing head-on. I will simply walk into the dr's office and if I even sense a little resistance or wierdness or unvalidating my experience, I'm turning around and walking out, period.

Anyway, thanks for listening, I could use some encouragment, I'm sad.

-blondie cry
Posted 6/3/2011 4:23 PM (GMT 0)
Wow. I'm so sorry that you had to go through this! Can you try to find another doctor? I'm glad that you're not going back to him. I wouldn't want to go to a doctor that didn't listen and that was trying things out on me to see what would happen. It wouldn't sit right with me either. I would be sad too after that, but I promise you that there are doctors out there that care, and don't try strange things on their patients.

Lots of soft hugs,

Flower
Posted 6/3/2011 5:16 PM (GMT 0)
Blondie...I'm sorry that you had a bad experience with this PM...

I still am hoping and praying that you are not taking the Tramadol 8 at a time and are back to taking it exactly as prescribed...

Same with the Xanax....and until you can find another PM Dr....please follow all the prescriptions as they are written..

I want you to be able to find good care...but in the meantime we want you to not overdose on anything..

I forgot who you said is prescribing the Tramadol for you? Hopefully they will continue to do this until you can find another PM to go to..

I know lots of us have had to go through a few bad PM's appts. unfortunately until we found someone that we really love and wants to help us..

It sounds like this one you saw just cared about the Subutex..and I can't believe any Dr. would want you to drive on a new medicine!!..That is crazy!..

Again..PLEASE take care of yourself...and even though the Tramadol isn't working as well as you want...by taking it as directed...it will at least give you coverage througout the day/evening...

Hope you can call around and find someone else soon...
Posted 6/3/2011 5:20 PM (GMT 0)
Hi Blondie

My gosh I have not heard of that ever happening before. How dare he use like a guinea pig. I can not believe he would not listen to your history and what meds you have already had or are on. I have had experience with PM who dont want to listen and are not nice, but this is just too far lovie. I would be looking for another one as quick as possible and who ever told you to go to him I would be letting them know what happened as well. I really hope you find someone better, who will listen and care for lovie. There are really good ones out there, its just a shame you had this idiot. I am hoping you are having a better time of it now and I send you well wishes and loads of gentle ((((((hugs))))))

xxxx
Posted 6/3/2011 5:21 PM (GMT 0)
Blondie...

That's just bizarre.  I'm sorry you had a horrendous experience.  I would have ran out of there - and fast!! (Well, if I could run lol).

I'm w/ SB, too - I can't believe the doctor would give you a new medication - and have you drive home.  How did he know it wouldn't immediately take effect?

Hope you can quickly find a proper doctor that will listen... and really help you.  Everyone deserves that! 

--Tina

Posted 6/3/2011 5:25 PM (GMT 0)
Sorry you did not have a successful appt. I hope you are able to get in to see another quickly, they're not all that strange at least mine isn't.
Posted 6/3/2011 5:34 PM (GMT 0)
 

            Sorry you had such a horrible experience! Is this the same Dr that was recomended to you that has an "Addictionology" degree?...the same Dr...that you were to ask him about "Suboxen"?

     If he would have given you a whole pill of this med, you may have been in much worse shape, so while I don't know if this is the correct protocol for treating a new patient, I do think he was playing it safe in giving you a very small does. We never know how one will be effected when starting a new med, and there are certianlly risk involved.

     Yes maybe he should have told you to wait untill you were in a safer environment, where you were not at risk to harm yourself or better yet others. But, if your PCD recomended him, maybe you should reconsider and give the guy a chance. One visit is hardly enough time to make a solid decision. Have you looked up some of the side effects on this "Suboxen" ....many of the med's....and I will use just one for example... "Methadone" ...can have terrible side effects when starting the med, but it is not a reason to run away from it.

     Once a person gets past those temporary side effects, the end result can be very rewarding to say the least.

        I'm just suggesting a little food for thought here, and maybe others will share a very different view. I would like to point out, that he did tell you to see what type of effect it had after a little time, so it looks like he was using some caution with you. Was he aware you were going to work, and that you were driving? Did you make it known to him? These are just questions, so we can all better understand.

       Take care,

  SE

                

 

Posted 6/3/2011 6:15 PM (GMT 0)
You go girl, stand up for what you know.  Its amazing the amount of pompous  ........ that are out there with medical degrees.  The only thing that is different sometimes between us (cp patients) and some of these doctors is the amount of schooling they have supposedly gone thru.  I think I remember someone saying back a ways, that common sense was not always common. 

I cant remember the oath word for word that all doctors are supposed to go by, but I think it goes something like this "do no harm".  Now I know it says alot more than that, but in particular this quote is not enforced enough.  If you do not demand the treatment that is rightfully yours, its not even a sure thing that you will get treated like a human being, they (the doctors) hold all the cards.  They are the difference between a good quality of life, and a life of going from doctor to doctor, until you find a doctor with compassion, and knowledge of the disease of chronic pain.

I am sorry, I got a little 60s fight the power there.  I know its not smart to go around demanding, but we should be treated with respect and some compassion for the simple fact is, we are only trying, like everyone else, to live a good of quality of life as we can.  I do not think this is to much to ask.

I am sorry you had to go thru what you did, he certainly sounded like a "quack".  I am sending tender hugs to you and wishes that you are having a low pain day and days more.

Posted 6/3/2011 6:33 PM (GMT 0)
tongue  Go, Nini!! 

I agree w/ you - word for word!!  In fact, I've been known to say - verbatim - what you said in the first paragraph.... the only difference between us and these doctors is a different path of schooling. 

I wasn't around in the 60's but I have a bit of that in me, too! lol...

Anyway, agree w/ all you wrote.... yeah

--Tina

Posted 6/3/2011 6:34 PM (GMT 0)
I just want to put out there that I do believe the majority of Dr.s out there truly do care and want to help patients...We are always going to get a skewed views of a lot of Drs. because people who are happy with them and not living a life of chronic pain won't usually come online...

And I believe as SE mentioned...which I fogot about...if he was an Addictionologist...then Subutex or Suboxone is a typical treatment they will offer...so that wasn't off base...and yes...he was trying to start with the absolute lowest amount...

As well as...only starting about 15-20 years ago did pain medicine/narcotics become so prevalent and prescribed so much by Dr.s..

I remember having a broken foot as well as knee surgery back in my teens...and I was given Tylenol 3...which was the gold standard...

So just saying that 'narcotics' are not a 'given' and a 'have to' prescription from a DR...even though some people think these days they should walk in and be given these no matter what...or first thing..

NOT saying Blondie did this...just a reminder to some who are new to Chronic Pain..

There are many modalities in treating pain...and when seeing a new Dr...yes...you are a stranger to them...they will want to try their own treatments...maybe injections...nerve medicine...antidepressants...etc....

So..I know for Blondie that this was not a 'match' for this Dr. as you want to feel comfortable that they are caring about your health....I just want to remind that the Dr. is looking for us to be an active participant in our pain treatment too....and to try other things besides narcotics to help as well..

For lots of us...like myself...it's taken 10 years to get on the amount of pain medicine..and I am still on a pretty low dosage...only 90mg or less of Morphine per day...and then OxyIR 5mg for BT...

I always want the absolute lowest dosage of meds and use all my other 'tools' to help my pain to keep my tolerance as low as possible..

So...not trying to 'stick up' for this Dr....just like to show the other side...

I adore my PM...and have been going there for 4 years...as well as we are friends outside of our appts..and yes..I trust him completely with my care...because he is the Dr. and has 10 years of schooling in medicine as an Anesthesiologist...and no matter what I read on the internet...I will never be as smart as him in these matters...I can only know my own pain and express to him the best I can and work with him as a team...Just like my Pharmacist and my Neurosurgeon...

So it's important to find someone you do trust and feel cares for your well being..

As well as my PM has to follow all the rules set forth so he can stay practicing...Which is pill counts...urine test once a year...So I follow everything by the book as well and my prescriptions to a tee...that's why I am encouraging Blondie to do this as well to say safe!!

Post Edited (Snowbunny21) : 6/3/2011 12:39:40 PM (GMT-6)

Posted 6/3/2011 6:40 PM (GMT 0)
First, thank you all SOOO much, I just cried and cried thru everyone's replies cuz I feel so battered and needed encouragment. (I'm sure you all can relate!)

I'll try to answer all your questions....if I forget one, just ask me again.

I did call my MD about an hour & half ago and explained to his receptionist what's going on. I expected him to call right back as he usually does and it was right before lunch time, but he didn't so I just called him about 10 minutes ago and he said, "well, you did finally get to speak to the PM, right?" (well I never told the receptionist that) so I said, "how did you know that?" He then told me cuz Dr. Footerman (my PM) called him! I couldn't believe it. I feel so violated. I asked my MD, isn't that against HIPPA privacy,I said that I probably wouldn't have minded but don't you need my authorization to that? He then said, "Well, why WOULDN'T you want us to talk about your health?" I couldn't believe it. He then said, "I don't treat pain." I was so dumbfounded?!?!?!! I'm like, "What? what are talking about, aren't you treating me for my fm?!?!?!" He then said he couldn't talk and would have to call me later and passed me off to his receptionist.

I feel SOOO betrayed and can't stop crying! I hate doctors SO much!

Now, to answer ya'll's questions:
No, Dr. Footerman is not the same PM that has that "adictionology" degree cuz he was about 35 minutes away, while dr. footerman was only about 15.

I didn't take any of my meds yesterday just the "subutex." Today I started my Tramadol/gabapentin/xanax at the recommended doses, NO MORE, no less.

And, as of right now, I'm too emotionally unstable to try to call another doctor! I feel so betrayed......my husband is getting involved for me (he has a very meek way of speaking with people and has advocated for me before).

Thanks again, for your love & encouragement.....it's one of those days that it's SOOO needed. I had to call in to work (yet another day of no pay due to a bad drug reaction)

Hanging in there, one minute at a time,

blondie cry
Posted 6/3/2011 6:53 PM (GMT 0)
Snowbunny...,

I agree, too, with much of what you said - in terms of a doctor not being obligated to just hand out a prescription.... that there are many ways of treating a patient.... and so forth.  Totally agree.

I, too, have a wonderful relationship w/ my PM doc, and he too is an anesthesiologist.  It took going to hell and back to get to him, though!  My doctor follows a strict protocal, too (urine tests, making timely appointments, etc).  That being said - because I've been w/ him for almost 4 years - and he trusts me 150% - he's more flexible w/ me than anyone else in his entire (BIG) practice.  If the kids are sick (or me), I can call him and go pick up my prescriptions.  I try *not* to do this - instead try very hard to see him every month (which he knows - so that's why he gives me grace).

Anyway, the thing that I do NOT think is right about this doctor is trying the medication out in the office.... allowing her to drive home..... etc etc.  Not listening to everything she is currently on.  And so forth.  The whole thing just doesn't sit right.  I don't know.  That's why I was saying I would RUN :)

Just wanted to clarify!  --Tina

Posted 6/3/2011 7:01 PM (GMT 0)
 

             Tina, I do agree with the part about the safty issue, and thats why I asked the question.

     I think Blondie has some sorting out to do, to see what is going on, and why she did not understand what the appointment was for. Lets keep postive here, and support as we are good at. Her Dr should have communicated better thats for sure!

          SE

Posted 6/3/2011 7:05 PM (GMT 0)
A few thoughts along with the BIG hug I am sending you ((( )))

Just FYI...it's HIPAA....The Health Insurance Portability and Accountability Act...I used to write the two 'p's instead of two 'a's as well until I researched it...

And Dr.s are absolutely allowed to speak with other Dr.s....the Pharmacist...or Surgeons'...regarding anything to do with your health and anyone who has or is now treating you medically...

Just like in lots of states...like where I live in VA...there is a statewide monitoring computer system that can see anywhere I have gotten prescriptions filled at a pharmacy..(I only use one...just using me as an example)...

They are NOT allowed to tell a spouse, parent, or friends...or employer about your medical history or health unless requested by you...

And nowadays...with the DEA getting more strict in the governing of prescription medicine....they are encouraging people to get referred to actual Pain Management specialists to treat for chronic pain...and not having GP's or Rheumatologists or other Dr.s treating with pain meds..

This is a move starting last year and in the next years....This has nothing to do with the new health care law...it's been decided along with the AMA (Amercian Medical Association)...so that the Dr.s treating chronic pain...along with prescribing narcotics long term...are the one's that have the most knowledge and medical training with doing this...

This is because both addiction and accidental overdose has been on the rise...

So...all that being said...I know you are having a rough day Blondie...for this I am so sorry!...And thank you for telling us about your meds and I am SOOOO happy to hear you are taking them as prescribed!...

I know this can be hard to do...but TRY not to stress, worry, or get too angry over things as this will add to your pain level...I know easier said than done...but as of right now...all you can do is take the medicine you have...try to rest...and then get another referral to a different PM...it won't do much good getting upset over the Dr. with the Subutex...he was trying to help in his way..just move on from that as you aren't taking that anymore...

We just want to see you get the best care...and hope that comes soon !!!

Post Edited (Snowbunny21) : 6/3/2011 1:11:22 PM (GMT-6)

Posted 6/3/2011 7:11 PM (GMT 0)
 

     Her PM appointments will be autherized only by her PCD per Ins requirements. There in lies the problem, as she will be most likely be looking for a new PCD to make those request for her.

         Hopefully a solution will be found quiclky for her.

        Untill then, we are sorry you had to endure this, without you're knowledge or understanding. Really it was a rotten deal for you, and you have our sympathies.

     SE

Posted 6/3/2011 7:17 PM (GMT 0)
Wanted to add another thing to show there is light at the end of the tunnel...and there are wonderful Dr.s out there!..

I had my first yearly urine test this last month....and I don't have any insurance...I see my PM Dr. every 3 months and he only charges me $75 a visit...I had to take the test last month when I went by to pick up my prescriptions...they were so apologetic that this is standard now and that it has nothing to do with trust as they said we know you!! LOL...so no biggie for me to take the test...

The nurse said if I got a bill from the lab to bring to them...So my appt. was yesterday and I brought in the bill for $435 (which is less than I know how much they charge if people have insurance!!)..

My Dr. says to me...don't worry...I have an agreement with them to write off certain patients...and because I know you don't have much money...just do nothing and they will call me and we will tell them..and it will be written off...he says because it's not his request these tests have to be done now on everyone...not just people they think are abusing...and he doesn't think they should suffer a financial hardship due to regulations..

So...he is not only caring and all his patients love him!!! He looks out for people's financial situation as well..

I just wanted to share that as mentioned...I had to go through a terrible experience with a few Dr.s to find him!..So it can happen!!

Take care...rest up!
Posted 6/3/2011 7:26 PM (GMT 0)
just to clarify too, I don't have insurance.
Posted 6/3/2011 7:34 PM (GMT 0)
Ahh...in that case...you shouldn't need any type of referral to find a new PCP or a new Pain Medicine Dr...so that's a plus..but obviously finances are the downside..

Are you on Medicaid or SSD? sorry...don't know why my brain isn't remembering this..
Posted 6/3/2011 7:35 PM (GMT 0)

     Snowbunny, you have a great provider! Hopefully Blondie will find the same compassionate PM in her search.

          Thanks for the information.

         SE

Posted 6/3/2011 8:09 PM (GMT 0)
ssi? is that social security? no, I'm 37. And, I don't know how to get Medicaid....not sure about all that stuff. The only thing I do have is charity assistance to one of the larger hospitals in my area, which includes doctor's associated with that hospital.
Posted 6/3/2011 8:18 PM (GMT 0)
SSD is social security disability....

I was just curious when you mentioned not having insurance...so you and I are in the same spot right now with this...I am 42...

So you should absolutely let all Dr.s know that you see if they can work with you on price of the visit...they can decide on what to charge you..

Just like my medicines...I take all generic..both in my morphine sulfate er and oxycodone for breakthrough...as well as for the zolpidem (generic for Ambien)...

My Dr. also gives me samples of things like the muscle relaxer Amrix...which is the same medicine as Flexeril...just in a once a day pill...

So yes...I am very blessed to have found a caring and wonderful Dr...if you were in my area I would send you to him!!! People drive for hours to see him...as well as the whole Spine Institute Dr.s in the practice...

As I said..I had horrible experiences with two other PM's before him...so that's why I don't want you to give up...
Posted 6/3/2011 8:30 PM (GMT 0)
I just want to mention something, and that is since this doctor is British, using subutex is the standard in Europe for treating chronic pain, in small doses, in fact, very small doses, just as he did with Blondie.
He started her on a very, very low dose , 1/8th of a 2mg tablet and waited to see how she would react both pain wise and physically. I imagine that subutex, given to someone who is not used to it, might get side effects that would diminish as she got used to the medication, just as any of the rest of us do, when trying a new medication for the first time. How much of it was due to the actual medication and how much was due to anxiety over the appointment, there is no way of telling for sure now. I think it may have been a combination of both. We all know that our bodies must adjust to a new medication, and sometimes it can take a week before we do, so I am not so sure that discounting the effectiveness of subutex in her case or anyone's for that matter should be done so quickly. She may have found that if she continued with it for a few more days, once her body acclimated to the medication that it might have worked really well for her pain levels. It is well documented in Europe to be an effective, safe medication for the treatment of chronic pain. It could also be that she needed to either increase or decrease the dosage over the next few days but only by staying on it, would that be determined.
The other thing is important to remember is if this doctor was from Europe, they do things much differently there- it is common for patients to be able to go into a local pharmacy and be able to purchase medications like tylenol #3 over the counter, which accounts for why he thought that she may have some on hand. It may be that he is new to the US, and he needs a bit of time to adjust to how we do things in the US, and things that are available as an over the counter drug , we don't have access to here without a prescription.
Blondie, I am not so sure that you just deciding to go back onto the medications that you were taking before is a good idea. If they were working well for you, then that might be something to consider continuing, but if I recall correctly, you are taking 8 at a time- that is not effective and can be dangerous. Ultram is not supposed to be taken in doses of more than 400 mg a day- if you are taking 8 at a time, 50 mg doses twice a day, you are at the maximum daily dose. I might give the subutex another try over the weekend and see how you do. Get a pill splitter and cut the tablets into 1/8 doses. That way, you are getting a consistent amount of medication at each dose. If the side effects don't subside , then call them and try another medication.
Sandi
Posted 6/3/2011 8:42 PM (GMT 0)
Great information about how he could have been new to the US and why he thought she might have Tylenol 3...

And I was thinking that with reading the first post as well about how it sounded a lot like an anxiety attack...and could have been a mixture of this as soon as Blondie started to feel a bit strange....that it can make anyone really nervous that they get anxiety and also being upset with the Dr. after leaving the office...

I am a true advocate that if there are not life threatening reactions...that most side effects will get better over a few weeks....I have personally given medicine up to a month to figure out both the effects and the dosage....as one's body takes time to get used to it...

When I first took the MSContin...I had a lot of nausea and fatigue for 4 weeks....thankfully that is all gone now...

Blondie...maybe after getting a few days rest....you can certainly decide to either try this medicine again....(But I would absolutely recommend being off the Tramadol for a day or two to not interact or be on top of the Subutex)....or think if you possibly want to give this Dr. another try and see if he will work with you...

Good points mrsm...they do things much differently over in Europe...same with Canada....
Posted 6/3/2011 9:25 PM (GMT 0)
Lots of good food for thought....

Good point about the Tylenol #3, Sandi.... I know in Mexico and I think in Canada - it's OTC.

Overall, though, I hold to my original position - only going off what Blondie told us in her original post - that this was just a strange, unusual method of treating a patient.  (also, I have no problem w/ subutex being used as a pain med, either).

Re: an anxiety attack - as someone who suffers from anxiety (me) - I personally would be able to distinguish from an anxiety attack and medication side effects.

Anyway, that's why this board works.... we all have our slants on a subject. 

Regardless, I wish you welll, Blondie.  As I said before to you - I'd bring along your hubby to your next appointment.... and, hopefully, you'll be able to find the *right* doc that will treat you well.  Sorry it's been a tough journey....hang in there.

--Tina

Posted 6/3/2011 9:36 PM (GMT 0)
SB,
You and I are in agreement about giving medications a longer period of time before deciding they aren't working, especially when the side effects are not life threatening. I know that I have been on several medications that caused dizziness or a bit of anxiety that went away after being on them for a few days. That is , in large part the reason that I suggested getting a pill splitter and giving the subutex another try. The thing is , is that all medications, regardless of their intended purpose, have side effects. We have to decide , after giving them a reasonable try, if those side effects are bad enough that we can not continue the medication. Most of the side effects diminish or disappear after a few days and then we can truly gauge the benefits versus side effects of them.
I think that we are often too quick to decide sometimes if a new doctor or a new medication is "right" for us, when we are uncomfortable ourselves because something or someone is new to us. I have met doctors that I didn't think that I would like or would be a good fit for me, but then again, after a few visits , once we got to know one another, I have found that my initial impressions were wrong.
I am not saying this is the case for Blondie, just for myself. Only she can determine if subutex is going to work for her pain or not, or if this new doctor is a good fit for her, but I hope that she gives both another chance and then maybe re-evaluates how things are going.
Sandi
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