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Question regarding my b/t medication

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Posted 2/8/2010 4:23 AM (GMT 0)
I need some feedback and suggestions here.  about 1/2 year ago I changed PM docs.  I went to my new doc on methadone with no b/t meds.  After my initial exam with the new PM doc we decided I needed b/t meds so they gave me oxy ir 5mg 2x every 8 hrs as needed.  They were helping me but now they are not.  I dont get the pain relief I used to get at work especially as I am on my feet for 10 hrs a day.  I was on oxy ir 15mg before for  years and it did help with my episodal pain.  I have mentioned this to my doc but he seems to stray away from the 15mg strenth.  It seems he wants to stay with the 5mg even if you have to take 2 of them at a time.  My problem is my b/t meds are not controlling my pain as well as I know they can and PM docs are there to make sure you are on the right track with your treatment plan.  I , as a patient expect for my physician to adjust my medication accordingly or change to another type if need be.  I am never the kind of person to continue to push my doc to do something so when they say they will keep me on what i am on i mostly just agree but now I am getting a bit upset.  I go in every month and tell them the same thing and they continue to keep me on the same medication management.  I just feel as if I am out of the loop sometime when I am the one who has the pain.  I have always been a good patient.  I never ask for early meds, never run out, always test good on urines, make all of my appointments on time and am courteous. If any of you have any suggestions on how I should approach this with my doc please let me know.  When I am at work sometimes my pain breaks through so bad I feel like crying or vomiting and what I am directed to take now does not do the trick.  THanks and have a wonderful day.
Posted 2/8/2010 4:54 AM (GMT 0)
Hi Shaw!

I do totally agree with you...your doc is taking the safe and easy road regardless whether it helps you or not. As a warning to my next comments, be warned that I'm tired, in pain and cranky...lol In my opinion your doc doles out a few light weight pills 1) to show he's helping your pain and 2) to play it way safe to cover his own hinie! That's not a doctor but a machine. If this is the doctor whom you will be seeing then you do need another approach, like you eluded to.

My first is it's easy for him to not treat you properly. As you mentioned you "tell him the same thing". I'm assuming you're telling him that your pain is not being controlled. He knows if he tells you he won't raise the ox that you won't do anything. What CAN you do without causing more problems...and they know it. It's an awful game to have to play. BUT...there are ideas that might help.

First I would keep a pain journal. It's a daily diary of your pain, what you may have taken, when, did it help, etc... It doesn't take long to fill it out each day. I do most of it at the end of the day just before I turn in for the night. There is a link to a free journal page, you can print off for free, in the Chronic Pain 101 topic. But here's the link so you won't have to look for it.
www.painfoundation.org/learn/publications/files/TargetDailyLog.pdf

If you can print on both sides of the paper one day's worth will fit on one piece...one page/day. Fill these out carefully and honestly. I kept mine in a folder so they were all together and stapled 1 weeks worth together. You could hole punch and put them in a binder also. Then each and every time you go to the doc, any doc, take your journal along, place it in the doctors' hand and ask him to look at it while you wait. If he says he doesn't have the time then ask when he DOES have the time for patients who's pain is not being controlled. (OK, my nastiness is showing thru...sorry. I just get so frustrated with doctors who can but won't treat patients with respect.)

By having your doc see exactly what your pain is like hour by hour, week by week then he might just get the picture. It's right in front of him and it's darn hard to just brush you off when it's staring him in the face. I do think this might get your some results. If not then my other suggestion would be to get yourself to a university/teaching hospital that has a pain unit. They most often are wonderful!

Please keep in touch, OK???
Chutz
Posted 2/8/2010 4:58 AM (GMT 0)
Hi Shaw,

 

Good to see you back at the forum, although I hate to see you having so much trouble with your dr. It is just not good when our pain is not being controlled and it affects us in so many ways. Pretty much all I can pass on to you is if this guy has dug his heels in as it appears this is exactly what he is doing, then you really have no choice but try to find another PM dr. I know that really is not what you probably wanted to hear but you cannot make or force this dr to give you medication. It is pretty obvious he is not going to move on this. I have been in your boat before and I hung around with that cat doing nothing and in the meantime I had no quality of life, nothing.  I just hate to see anyone waste their time thinking things will get better with these drs when it doesn't. The only thing that changes is us getting worse by the day and we deserve better treatment than that. I could kick myself now for staying with that dr. He robbed me of two years of my life that I cannot get back, please don't make the same mistake I did.

 

Do your homework and find a dr that will treat you and your pain. Good luck.

Posted 2/8/2010 6:40 AM (GMT 0)
Shaw,
You've already been given some great advice, and I'd just say "ditto" to that. I'd try taking in your pain journal. I'd also try (and you may need to practice saying this in a mirror at home if you're shy with your doctor) saying pretty much what you said in your post - especially how it's affecting your life, and your ability to work. If he still doesn't make any adjustments, then you know he's not going to and it's truly time to start looking. Actually, you can start asking around and looking now, as it may take some time to find another PM doc depending on where you are. If you have another name or two (make sure they prescribe meds. and not just do procedures like injections) you can either try to get a referral to a new doc from your PCP, or wait and try your PM doc one more time and see what happens.

Good luck!

PaLady
Posted 2/9/2010 5:13 AM (GMT 0)
Hello Shaw31!....Yes you have been given some great advice here, and I encourage you to try some of the advice shared with you. PM's are hard to come by these days, so I think I would give every effort to find a solution with the one you have first. You may even have to take a more direct approach with him, and just flat out ask him, why he has not responded to your request for more help dealing with your pain. However, I believe you should try the Pain Journal first...to see if it will get his attention. We all have to remember that, these PM's see patients like you several times a day, and may well become desensitized after years of treating those he should be helping.
I believe you will know, when you have done all that you can do to get his attention in addressing your problem. One question I have for you is..have you had any surgery to correct the source of your pain? Have you had any other procedures to help relieve your pain? Maybe I missed it, but what is the source of your pain? Could you please give us a little more history on yourself? Also...there might just come a point, that you may very well have to sever your ties to this PM, and find another one like Stray said.
Good Luck to you, and I wish you the best, and lets hope that this PM will wake up, and see that you truly have a need for some relief. Please keep us informed on what the outcome is. Take care, and we hope to hear from you soon.

Michael
Posted 2/9/2010 7:07 AM (GMT 0)
Thank you all for your wonderfull advice.  You all are awesome as usual.  To SCREAMING EAGLE:  I havent had surgeries on my back.  I have had trigger points, facet blocks, Rizotomies, sacraliacs, and epidurals.  So to answer your question yes I have had many other approaches besides just meds.  I have also gone through 2 rounds of PT.  Surgery is my absolute last resort.  I have a few things wrong with my back.  My MRI shows DD, spondylolethisis, bulging discs and a few other things I really do not know what they are.  I hope you all are doing well and again I appreciate all of your comments and advice.
Posted 2/9/2010 8:20 PM (GMT 0)
Hi Shaw, its either been so long or else I have forgotten all the different things you have tried to get some relief. You have done it all too. It is just so unfair for these guys to brush us off when we have done and tried everything coming down the pike. I guess what burns me the most is when they recommend something we really have little choice but to submit, otherwise, we can be looked at as being non-compliant. But, when we are simply asking for enough relief to get by it falls on deaf ears. Just burns me, lol.

 

If you have an appt scheduled soon to see the dr again, perhaps you do need to ask him point blank why he is not trying to find another avenue to take to decrease your pain. Just be firm not mad, make your point so that he has to give you an answer.

 

I would put my feelers out for a new dr anyway, you never know. Let us know how this all turns out.

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