Rant and rage.

Okay, I went to see my doctor on Wednesday for a check up. It's a regular three month deal. I told him I had no refills on a couple of my prescriptions, including Tramadol. For nearly a year now, he's given me prescritions for 180 a month, to be taken as needed two at a time no more than three times a day.

He didn't spend much time with me or ask how I was doing on my other medications. The guy seemed a little hurried, actually. But he did write out the prescriptions and send me on my way. When I looked at the prescriptions after leaving his office, I noticed that he'd reduced the Tramadol to no more than four a day. That's a monthly reduction of sixty pills. He didn't say anything to me about reducing the dosage, either.

I felt like going back into his office and asking if he'd made a mistake, but was too wimpy to do so. Call me whatever, but I was afraid to get on his bad side and be yanked off the medication completely.

Am I wrong for thinking he should have discussed it with me instead of simply reducing the medication? Is it possible he was so busy that he wrote the prescription wrong? Either way, what should I do? Ask him about it and risk his wrath, or just deal with it?

I'd usually take five a day. Sometimes only four, but on other occasions six. Now I guess I'll have to stick to four and maybe toss in an ibuprofen every now and then. If I do start having any withdrawls, he's going to hear from me. I have done nothing to make him think I'm taking more or need less than what he's prescribed for the last year. So yes, I'd like to know what's up. That problem is, he's the man with the power. It's not like I can make him increase the dose back to 180 a month. All I can do is confront him and risk being taken off the medication altogether or damage the relationship between he and I, which has always been good up to this point.

I barely had the chance to mention anything.
@Snowbunny what was was odd in this situation was him drastically slashing the number of Tramadol I can use a month without explaining why. The reason I didn't notice he'd reduced the dosage until I'd already left his office is that he didn't say he was going to. Could I have gone back and requested to speak to him about it? Yes, but he was obviously very busy that day. I probably should have said something, but like I said, I was afraid of upsetting him.

Post Edited (newname) : 8/7/2011 4:43:25 PM (GMT-6)

i bet it was an honest mistake- i would have gone back and asked...my doc messed up last month- i was going out of town so i needed my script refilled 8 days early...when i got it the date was the normal one so i had to have him write up a new one...

Hi newname It was probably a mistake. My doctor accidentally gave me 30 tablets of oxycodone and told me on the script that I could take 2. I asked her about it Friday when I saw her, and she said that she didn't know why it happened. I would advise you to call your doctor's office later today and ask him about it. It could be an honest mistake since it's so much less than he's been prescribing.

love and hugs
Loretta

I also think this was probably a mistake. I would not wait a full month and asking him at the next appointment. If you do that, he may think that 4 a day is enough for you since you put up with it all month and did not mention it or complain about it.

Trudy

It's certainly your choice...but what I think might happen then if it was a simple mistake...and you don't call in..If you go through the whole month with the lowered dosage and not saying a thing...He may think that your pain is ok now to be at this dosage so he ends up keeping it this way from here on out..Because he figures if your pain level was higher..you would call and say something.

I don't think that it's tempting fate at all by staying calm, giving him the benefit of the doubt...calling and being very nice on the phone and asking about the change as it wasn't discussed in your office visit. You should never have to be 'afraid' of your Dr. and talking about your own health..

If this was blood pressure medication...you would call immediately when seeing the error as it matters going down 40 pills in the month.

Now..if you call and are angry...or start getting on the Dr.s case and it's a simple mistake...then that might ruin the relationship. But you have every right to kindly ask if it was a typo...or is he changing your prescription..

Again..it sounds like you are set in not calling...I'm just worried that it might backfire and he continues the lower dosage next time as a Dr. wants his patient to be on the lowest amount of medication to help your pain...so if you don't speak up...he will assume you were ok this whole month..

 

        I had this same thing happen to me several months ago, and I called right away. Found that he decided to script every two weeks, with the orignal 120ct Percocets. Dr told me he would rather have paper work with 60ct on it than 120ct. Med's have since been changed, and I'm back to the 90ct every 30 days, since the Ocycontin has been upped.

     One of the best things that has happened to me in a long time, was the extra added 20mg...now making it every 8hrs now. What a dfference it has made in my quality of life. The 12hrs was not cutting it by a long shot...and I'm going to shake the mans hand when I see him the next time.

    I would call the nurse, and have her double check on it, and not wait. However, it's your choice, and I understand the reasoning behind it.

   Take care,

  SE

Newname,

I take Ultram ER 300mg, which is the time-release branded tramadol. I assume you're being prescribed 50mg pills. So 180 per month = 6/day. That's 300mg and that's the standard peak daily dose in the U.S.. Seizure risk increases as the dose increases but 300 or 400 is thought to be safe. In Canada, some companies make 400mg time-release pills.

You might want to look at the prescribing insert for Ultram to help you get a better picture of the daily dosing: http://www.ultram-er.com/sites/default/files/ultramer.pdf

Of particular interest is the top chart on the right. It compares the metabolite levels over time between 50mg tramadol every 6 hrs and 200mg ultram ER. Surprisingly, the immediate release tramadol deviates from the Ultram ER levels only very slightly and thus 50mg 6x daily should be comparable to 300mg of Ultram ER, an acceptable and very common dose. Depending upon your relationship with your doctor, you might want to print out the pdf and bring it to him.