Pain appointment today

Hey guys, I'm wishing you the best today~Anyways, I vented last week about a situation that I had with my pain doctor. When I first came to see him, right after my initial MRI, my insurance put me on a one year probationary period in which I could not recieve any benefits.  I told my pain doctors staff, and had this notated in my chart.  Because my insurance wouldnt cover me for one year, how could I afford to pay the office visits/procedure costs 100% out of pocket? So, each month for the first seven months, I called in and every 28 days my scripts were fedex'ed to my pharmacy.  No problem right?  Pretty convenient seeing as I live like a hundred miles away.  Well, as I said before in a previous post, I had had a problem with my fentora meds being sent to me short like 24 pills.  As I found out, this was most likely just an error that the packaging plant.  However, the manufacturer told me that I would need to get a new script if I wanted them to replace the meds.  Now, I am not naive.  I knew that at best, calling and telling my doctor about this could get me into hot water even if I didn't actually ask for a replacement script. However, I chose to tell them anyways.  As soon as I told them about this missing medication, my phone in for my medication scripts was rebuffed.  Usually, my office requires a three day pre notice about med refills, and this is what I give them.  I was told that I would get no refill until I came in for an appointment.  Now, this I had no problem with.  What I did have a problem with is that they waited until now to tell me; what made matters worse is that they told me that they couldnt get me in for an appointment until two days after my meds ran out. So, I was already short on my Fentora, which is my breaktthrough pain med. I would need to stretch my long acting pain med an additional two days.  They knew that this was going to happen.  Anyways, I scheduled the appointment for today and went in.  I didn't know what to expect, to be honest. I had heard horror stories about patients who had told their docs about medicine shortages, and were almost immediately discharged from the pain practice without any taper whatsoever.  I went in scared and nervous.  But, some good news.  The PA that I saw was actually pretty understanding.  She agreed that I did everything that you would expect someone who was telling the truth would do.  She even understood about the insurance issue.  However, one new thing happened that I did not expect.  The doctor ordered a urine analysis conducted through a company called Ameritox.  Now, on its face a Urine analysis is nothing to worry about if you aren't taking any illegal drugs or subverting the legal ones that the doc gives you.  However, I started to think about this later on: If this test also measures the amount of med in your urine, what if you don't necessarily take all of the pain medication the doc gives you?  I mean, how can this be an accurate way to tell if a person is subverting or not, seeing as all people have different metabolic rates, all drugs have different metabolic rates, and, a patient may also choose to take less of the meds than were prescribed...to my knowledge, that is not a bad thing as long as the meds don't end up on the street.  I just don't understand how the level of drug in the system can be an accurate predictor of abusive/illegal behavior. Now, if a person showed up with say, marijuana in their system, or another prescription drug which they have not been prescribed, I would completely understand why the doctor would discharge the patient.  If the patient is breaking the law with these other things, than why wouldnt they break the law with their pain meds? I understand that arguement. But, what if a patient just chooses to take less meds in a week period because they feel better? Taking less meds because you feel better would mean that the level of drug in your system is lower. I guess I am just trying to understand how a doctor could make such a major decision about a patient with a statistic that is so variable. I could really use some experienced input on this one guys. I would like to know what I can expect.  Anyways, Thanks for listening again to those of you who do drop by. You have no idea how important it is to me to know that you are just out there, reading my post, and thinking about my issue. With Affection for all "paniacs" ;) painKiller

I think that urine tests on patients are humiliating and an invasion of privacy, in fact i think that urine tests in general, at least for the purposes of investigations and for job screening and such are a tremendous invasion of privacy, including the one you were given. I would be very angry about giving depite the fact that I do not do illegal drugs or abuse my medications in any way simply because I believe that urine tests are invasion and humiliating, especially for a pain patient. They do not accurately predict drug abuse. for example, just because someone smokes marijuana, it does not mean they are going to abuse their medication. The best way to see if people are abusing their meds if to watch to see if they continually push their dose up and call for refills early. Urine tests that are required for jobs also do very little I believe, However on the job intoxication testing is much more important. That is, if someone is actually intoxicated while working they should be fired, but positive results on a urine test, especially for marijuana, should not result in being fired, because it has no bearing on whether or not the employee is actually productive or not. It just makes no sense to me to fire an otherwise productive employee just because of a positive urine test.

On another note, I hope that everything goes well with you and your doctor and you get everything straightened out. Hopefully your insurance situation will improve also so that you you dont have that to worry about.

Good luck with everything
Circa

Post Edited (Circa1988) : 8/31/2007 2:38:16 PM (GMT-6)