grandmaroses said...
medicalkid I'm sorry but I can not focus enough to read all of your posts, I am on oxycodone for bt pain and targin for long acting. I saw my family dr, gi dr, rheumy, and finally a pain dr who said you you should be on targin. Go ahead look it up its oxy and laxative all in one little pill that works amazingly well for me.
I don't know how much longer I will need this but I'm glad I found it. I am having a double steroid injection in my back the 4th of November they have already asked me not to be on any pain meds when I go in.
I hope your pain is less today.
Wow I just read about
that Targin! Thank you so much! I heard about
it but never knew it was actually in existence! Thank you! My Crohns pain in the past had to be treated conservatively by my GI's with narcotics because of the constipationl
Monty's Mom said...
From the perspective of a PM patient who has seen several patient dismissed from pain management practices for the behaviors you are displaying, I must tell you as misterkatamari and mrsm123 posted, you need to tell your PM and Internist that you went to the ER and were given the prescriptions they gave you. Most practices will dismiss a patient who gets a script for pain meds from another doctor without being directed to go to the ER or that physician by either their doctor or nurse. Your call entirely on what you do, but you run the risk of being dismissed from treatment. That is your choice. PM doctors and any physician that prescribes narcotic and non narcotic pain relief medications frown down on patients that go to another doctor or ER for pain medication prescriptions without being directed to by them.
I've already called all my physicians today to let them know I was at the ER last night. Though the ER doc said he left a message with my ortho and my Internist. No word with the PM doc yet as I haven't even been to my first appointment.
Personally, if your Internist is frowning on the amount of hydrocodone you took previously, you may want to rethink how you are taking your medications. It is a bad idea to change the way a doctor prescribes your medications without the doctor's instructions to make that change. I don't understand who you can think the way you do about this.
I understand her reasoning but you must realize that one doctor can't be the end all opinion. Internists are like the polar opposite of Surgeons; they will haggle over a diagnoses and whats going on for months on and end while the patient suffers while a surgeon aims to fix the problem; not just debate the issue. Of course I'm sure not every surgeon and Internist thinks black and white like this but in general that's what I hear from health care professionals unofficially and what I've dealt with
If you are planning on becoming a doctor yourself, would you want your patients to come to you, change the way you prescribe their medications, and then the go to the ER when then ran out early simply to get more? Would you continue to see a patient that not only changed the way you prescribed medication, but then went to someone else in order to get more without your knowledge? If doctors are paid for their expertise and knowledge, and you want to become one, it amazes me that you would discount the directions of your doctor and just do what you wanted. Especially taking more than prescribed, burning through the prescription before you should have, and taking more tylenol and hydrocodone to get relief is not responsible behavior. Your doctor and mother are right to think you are acting irresponsibly.
I can't say I disagree with you, but I'm sure you've gone near mad from discomfort no? By the book, rule for rule is lovely and fine in a perfect world where a diagnoses is provided in months not years and treatment is prompt. I honestly would say the same thing as you but like you probably know pain is uh painful. I'm not disagreeing with you or at least I'm not shutting you down in this post, I'm just trying to explain my rational. I did not mindlessly take hydrocodone when I had the slightest ache I only took it when I was in severe discomfort which happened to be more than what fit into "Take 5mg 2x a day". As for me wanting to be a physician; I certainly wouldn't encourage patients to go against my medical advise but I wouldn't have my head shoved so far up an anatomy text book to expect every diagnoses, outcome, symptom and effect to go by the book every single time. Also I'm a believer in inductive thinking meaning something may probably happen but it will never be 100% right meaning I'm willing to put my God complex down for a second to consider judgement errors and other peoples life styles.
I literally do not in my self see any harm what so ever in providing something slightly south of excruciating pain (from the prescribers point of view). Also I went to the ER because my symptoms got worse and when I called my Internist she basically said "Sorry I can't/won't do anything, if its really as bad as you say go to the ER but I would prefer you not if possible". I didn't want to go to the ER; both my parents told me it made the most sense, seeing as my dad had the same issue I wasn't about to argue about it. I'm not the only person/thing suffering from discomfort, my grades are not what I need them to be, I am short with people (you've already seen that though) and I cannot focus. I may be reckless, irresponsible, impulsive but someone needs to shoot the puck already.
It is hard for chronic pain patients to get doctors to take them seriously. Taking more than is prescribed of a medication is not the way to accomplish this. It is counter-productive in the way that your doctor may have to think twice about giving you pain medication since you are not acting responsibly, and if you are removed from the PM practice for this behavior, you may end up having trouble finding another practice.
As for your parents and your outlook on surgery, I think your parents understand much more than you realize. You may not have total pain relief from surgery. Surgery could make issues worse. There are countless people, including myself, that were told we would have total pain relief from surgery and are in more pain now than before, even several surgeries later. You don't seem to understand that you are no longer able to do the things you did before because of pain. The expectation that medication or surgery should make you pain free is unrealistic. You will most likely have to modify what you do for the rest of your life. Living with chronic pain means understanding your limits, doing what you are able to do, and sadly saying goodbye to much of what you "used to do". I would love to be able to do all the activities I did with my sons for years, but those are no longer possible at all. That is life. You may be lucky enough to have surgery heal your pain, but you may not. Many of us that have chronic pain never reach total pain relief with medications, EVER. I do not expect my meds to do this, I only take enough to have pain relief so that I can function and care for myself. Any more than that and I would be unresponsive, lethargic, and unable to care for myself or anyone else. That is a fine balance for many people, and that may be where your mother and Internists opinions come from, your unrealistic expectation that your meds should make you totally pain free.
I don't expect total pain relief, I never have....I have Crohns as well and that is painful, I just don't talk about it anymore because its an unchangeable part of life and my pain threshold is most likely higher because of it. I just think if something can be done it should be done or at least tried! If you had pancreatic cancer would you just lay down and die? Or would you fight it with your entire being? These physicians are telling me there is something can be done! Lets do it then! I really don't expect 100% pain free, just to a level I can handle...If I could handle my pain I would not be taking "large amounts" of narcotics. For the record the ER physician did not like the fact that I took more than advised but he sure did not waste anytime making me more comfortable and he understood the reason's why. He looked at my MRI, wrote the prescription and said very matter of fact "This is serious stuff, I've seen physicians get addicted to it you need to be responsible with it. I understand why your Internist did not want to prescribe you this stuff, she didn't have you on a significant dose but you still need to be careful. Looking at your MRI I think you will need something stronger for better pain control". Regardless of my expectations and maybe your negative outcome from whatever chronic pain disorder you have, my dad like I've said had 2 lumbar herniations repaired and has a cervical herniation that trumps mine but he runs marathons and works everyday. I can't help but compare my self to that. Is that wrong? I honestly don't know...
You can take my opinions and pick them apart as you have done for most of the posters, but I am concerned that you will be posting here shortly that your PM and Internist dismissed you from their practice because of your behavior. No one wants to see that happen. Dismissing other posters because they don't share your opinion is your choice, but we post this because we care.
Mindy
No no I honestly don't mean to dismiss other posters or yourself. You see I'm just really argumentative and things always have to have reason and make sense to me. I think about what you guys say regardless of whether I like it or not allot. In fact I was thinking about it with the whole ER situation...
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Post Edited (Medicalkid2) : 10/14/2011 3:19:08 PM (GMT-6)