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Problems with my doc and dosages after 2 years

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Posted 9/24/2008 9:58 PM (GMT 0)
Heres the long and short of it...Its been a while since ive posted..hope everyone is doing well..but  I have a very bad torn rotator cuff and nerve damage in my neck and two herniated discs..and strained tendons in my shoulder as well...not sure what that is but...I have been on 40mg oxycontin 4X a day for over a year now with 30mg oxycodone for breakthru 4x a day as needed..my doc recently implemented urine testing after 2 years ive not been tested once...but all is well on that..i always come up clean except for the meds im being prescribed...he now tests evertime i go...and had begun to cut my meds im not down to 90 40mg oxys and 60 30mg oxycodone in two months...which is a steep cut down for no reason...and with no other options other than surgery..My problem is financially and family reasons i cannot have surgery until February or March the earliest..Ive tried explaining this to my doc but its like a bother to deal with anything that has to do with medication..as it is im on bi weekly trigger injections which help but due to my activity level  i cannot be without my meds and my quality of life a dropped considerably over the past two months...I can barely do anything..and no my business and my relationships are suffering cause im always pissy and in pain...My only option at this point is to look for another doc but now adays that throws up a red flag as a drug seeker...Ive never been to another doc other than my PM doc and ahve not had any problems other than once when someone destroyed my whole script which was an exspensive lesson to learn considreing my meds cost about $1000 w/o ins.  Anyone in North Western NJ or Eastern PA know of a good doc?
Posted 9/25/2008 4:38 AM (GMT 0)
Hi Centurion,

Welcome back. Gosh I'm sorry to hear about the awful treatment you've received. You might try going to a university/teaching hospital. It might help on the "drug seeker" thing. Someone seeking isn't about to go to a place with a very high profile. Have you been to a surgeon? Can he suggest someone? Or can you be open with this doc and tell him that you feel you need a better quality of life and can he recommend someone? That's probably pushing it but hey, it's a thought.

Also, check for Chronic Pain groups in your area. They may have ideas where the good docs are there. I'm no help...I live in NW Washington state not too far from Seattle...and yep, it's raining...lol

Stay in touch,
Chutz
Posted 9/25/2008 6:41 AM (GMT 0)
Ever though about the possibility your doc wants you to take less medication in preparation of the surgery? I often had to lower my dosages before anaesthesia (my surgery usually camein cycles of several opeartions a week during a couple of weeks, one cycle in Spring and one in Fall). It reduces the chance of complications during surgery and, as you will probably get other medication right after the surgery, it will prevent you from becoming increasingly dependent. It is a common practice here in Belgium.

If this is the case, then you have a good doctor. Taken into account the limkited amount of time doctors have in some countries, I can imagine they fail to explain their reasons, they often do, even when they do have the time. Could be he told you, maybe a long time ago, your initial levels couldn't be maintained for ever. A recent study in the Netherland pointed out that patients, for various reasons (anxiety, pain, shyness, etc.), do not consciously register about 70% their doctors tell them. The doctors on the other hand take notes and often do remember. If this doc has been good for you for two years, why don't you just trust him? After all, he's the expert.

Think about it will you.
Posted 9/25/2008 1:04 PM (GMT 0)
Hi Centurion,

To be honest with you,
you are not going to find another doctor that will prescribe oxycontin 4X/day. My guess is that the reason your doctor is cutting you dose is because the DEA is looking at his records. 40mg oxycontin is the most most valuable pill/mg on the street, and most desired dose to sell. More important, because of pharmacology, there is no reason to take oxycontin 4x/day. It should be only taken 2-3X/day. If 2-3X/day does not work, then the dose should be increase not the number of times it is taken per day. Add the short-acting 30mg oxycodone, and your doctor is likely concerned you are selling your meds, hence the urine drug screens. You may be able to find a doctor that will increase you to oxycontin 60mg 3/day, but you will not find another doctor to prescibe 40mg 4x/day. Unless the doctor himself is crooked, which unfortunatly does happen.

Best of luck
Posted 9/25/2008 2:30 PM (GMT 0)
Hi Centurion,
I'm SO sorry you're having such problems w/ your doctor & meds. I've been through this type of thing w/ my Dr. too. You're NOT a drug addict & I'm sure you're not selling your meds on the street! Heck, you need your meds too much for your own pain. Unless another person, including your Dr., suffers w/ the severity of pain you do, they cannot understand how badly you need these meds & dosages. Pain is such a personal thing. If we were Dx w/ cancer or "looked" sick, others would have so much more compassion & understanding. I hope you're able to get the meds you need. You should not have to worry abt your meds in addition to having so much pain!
My thoughts & Prayers will be w/ you.
Willow
Posted 9/26/2008 10:57 AM (GMT 0)
Centurion...kman is probably right about the not dosing oxycontin more than 3x per day. It's well known that most pain patients do not get the 12 hours of relief that's suggested by the labeling on oxycontin. However, the DEA doesn't like to see more than 3x per day dosing. It's automatically suspect to them. This is something that I've actually talked to my primary about and that is what I was told.

Chutz had a great suggestion with looking for some sort of a teaching hospital. Not only does it reduce the possibility of being labeled as a drug seeker, but also they may be able to help you with resources on finding assistance with the cost of the medications. Most teaching facilities are also charitable hospitals are are accustomed to dealing with people that have little or no income, and/or no insurance, so they are more familiar with what resources are available.

Or you could simply try talking to your current doc. I know that you're upset with him but you may be able to get him to raise the long acting meds so that the loss of the BT doses isn't as significant. Also, if he's not agreeable to that, then you might want to ask for some sort of referral to another PM doc with the explanation that you're not happy with your treatment anymore. If he provides you a referral, all the better as it's not so much considered doctor shopping and you're not likely to be labeled as such. If your doc happens to be under watch or investigation from the DEA then he may be happy to get you off his caseload.

I don't wish you to be out of meds. We all know how awful that is. But you may want to probe him to find out why the change. You mentioned that he did the "steep cutdown for no reason." Usually if doctors think that you're diverting (selling) or misusing they'll usually be blunt with you. As you posted in another thread about how it was that you popped a false positive for cocaine, you already know that this office and staff will tell you if they think that you're up to no good. Is it possible that your cut down could be related to that incident?

Sorry if you feel like I'm picking at you, I'm just grasping at straws for ideas here. I hope you're able to find some better relief soon. It's rotten being in pain like that and having it affect how you act/react. I know that when I'm having a day that I hurt more my poor bf usually gets the brunt of it as he's the closest to me.
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