appointment was canceled ugh

Had an appointment this afternoon with my PM, and they canceled it because my PM came down with strep throat. They said the earliest he can get me in is on the 30th, said they'll refill my other meds that they had me on before, which is Nucynta 100 mg, but not gonna refill the delauded until I see him face to face. It's gonna be a rough month. Ooohyyy.

Sorry to hear this, and here is you, the patient, that is going to have to bear the blunt of this until your appointment. I agree with Susie. I recently was about to run out of Fentanyl, didn't know my doc had just left on vacation for a week. Instead of making me wait the week without any patches, my doc's nurse got one of the other doctors in his practice to write me a script. Because I wasnt one of their regular patients, they did make me come in person, show identification, before they gave me the script. A little bit of a hassle, as it was a 40 mile drive, but beat being without the med.

david

Well, so I've been on and off the phone for the last few hours with my work.comp attorney, who's talked to my back surgeon's office, and my work comp claims adjuster, apparently they all agree that this is the last straw with this PM. He doesn't get his paperwork in, keeps prescribing stuff that he knows is gonna get kicked back by work comp, not to mention, when he did my lumbar injections, he did one at the wrong level, my surgeon said it shouldn't hurt anything, but it's definitely not right.

So, my attorney said that since this guy isnt in-network for the insurance, the insurance has no problem with me switching to a guy that is, so he's got me a consult set up for next friday (not tomorrow, but a week from tomorrow ) with a PM that he says, all the rest of his clients really like him. He says he called up the new PM to ask him if he's familiar with my gastric bypass, he says that the pm states that not only is he familiar with it, but he does anesthesiology for a weightloss surgery clinic every Wednesday, and that he's very familiar with the short span of medication effectiveness with the surgery and that he has a few trick up his sleeve to keep me comfortable.

My attorney said they'd be giving me a phone call on Monday for my medical history and intake info, and that if I decide to make him my new PM, we can fax a contract cancellation from my attorney's office, and I can go back that afternoon to the new PM and sign a new medication contract. Bummer part now is I still have to wait until next friday, but my attorney said if I bring anything that Ive been prescribed with me to the new PM and turn it in when I sign the contract, he.can start treating me and right me new prescriptions that day.

Well this gives me a week to get copies of my latest testing and stuff that they did last weekend so I can bring them with me, I just hope my old PMs office doesn't mess this one up, I guess the new PMs office will have to have discharge papers faxed from the old before they can take over. We'll see what happens, I'm really hoping this works out the way my attorney says it should and that hes not just blowing steam, guess I'll find out from the new PMs office when they call, and ask them what is actually realistic.
The way my luck has been going lately, if it wasn't for bad luck, I'd have no luck at all lol.

Can you make that decision after you have met him and had your first appt? Due to the possibility of running out of meds before your next appt with your current pm is it not worth the chance that maybe this new guy who comes referred is actually a better pm for you?

My family dr does not send in forms, does not word letters correctly and has no idea when I tell him I can not afford things keeps prescribing the most expensive anti biotics and such but he knows me by name, he does not need to read my file while I am in the office. We discuss weather, grandchildren, I know I should change but I do not want to, is this your problem as well?

Do to the amount of pain you must be in going without any of your medication will cause you major distress outing it nicely. This is a hard decision for so many reasons, I really hope you get it all worked out.

Hi, thank you so much for your input, Ive only been on delauded since last weekend, which was my back surgeon's idea, they had me on Nucynta before that, and it wasn't doing much, and my perfect bloodpressure went through the roof, so my back surgeon got permission from my PM to break the med contract one time and write me a script for delauded for a weeks worth. The problem is, I'm going to be having a lumbar fusion on September 4th, and he said if my bloodpressure is too high, the anesthesiologist may not want to put me under.

The back surgeon's staff told my attorney that they'll try to get him to write a refill for it, but I haven't heard anything about that yet. Well, I'm pretty well done playing this PMs games, I have tow bad discs, one is very minimal, and doesnt bother me too bad the other one, is a train wreck, its wrapped around my spinal cord, there's bone on bone contact, and a fracture in the vertabrate, and it has severed the left nerve root completely, the doc told me that those dont grow back. The PM did injections at the beginning of june, and injected the train wreck level, but then injected the level below it, which has no damage at all. It didnt make sence to me, and it made my surgeon mad.

On top of that, the PM was continuously trying to prescribe these crazy expensive name brand things, that work comp doesnt want to pay for, leaving me for weeks with nothing, and finally calling in a script for Norco, which doesnt even take the edge off, this has happened 4 times in the last 4 months. It's just completely frustrating. So I'm going next week to see a new PM, hopefully he actually has his act in gear. I'm gonna call into his office in the morning, instead of having my attorney do it, and see if he can squeeze me in tomorrow instead of waiting until next friday. We'll see what happens, I have enough delauded to make it through Monday but after that, all I have is the Nucynta, which works 1/8 as good as the delauded. But I'm very thankful to have anything at this point, the many weeks without anything have been brutal, inhumane might be the more fitting term. Ive got my fingers crossed and I'm hoping this new PM will come through the way my attorney says that he has for other clients of his.

What a nightmare.

It sounds like it will end up being a good switch to this new PM..

Now that you explained more though, I can see why your PM wanted to meet with you face to face before prescribing the Dilaudid for the first time (from him) since you said it was your back Dr. that prescribed a week's worth to you last week.

So I just wanted to share that the DEA and state regulations are pretty strict and usually require a face to face visit when changing or adding any type of Schedule 2 narcotic.

I'm curious though on why your back Dr. won't prescribe more to you if/when you need since he is the one who got you started on these if this new PM doesn't prescribe anything for the first visit.

And as others mentioned, whatever you do, do not fill any new prescriptions from the new PM until you are contractually done with the old one but I think you all have that set up to do which is good.

The only glitch that can happen is to make sure this new PM understands why you broke your contract with the old PM and got an opiate from the back Dr. So I would bring documentation that this was perfectly ok with your old PM and you had permission to do this.

This will show them that you always follow things by the books.

So, I just wanted to share that after you explained more, it makes sense that your PM didn't give you a prescription for Dilaudid without meeting with you as that is a change in your treatment plan with him.

But I understand with all the other issues you have with him that you want to make a change and I hope this new PM and you are a great match!

Keep us posted.

Post Edited (Snowbunny21) : 8/10/2012 8:15:18 AM (GMT-6)

Thanks for sharing more...

I guess I was thinking that your back Dr. should at least help you in the transitition since he is the one that just got you started on the Dilaudid. That seems so strange that he would be ok for a one week prescription but then not give you a few more weeks after telling him about your PM being out sick and cancelling the appt.

He should know, or you can certainly tell him, that as I mentioned, the states/DEA usually require a face to face appt. when prescribing a new opiate and that's why your PM refilled your Nucynta but not the Dilaudid.

Have you tried to speak with your back Dr. and let them know and ask them to help in the interim? Did he turn you down for this?

I guess if it still turns out to be a no go...then at least you have only just been on the Dilaudid for a week so you shouldn't have any withdrawals from it, and that you have lasted all this time without before (obviously I know it's been more pain) but I just meant that you can hopefully make it without it until seeing the new PM.

Ok, update on this, I got to talk to the new PM, she was very understanding and said this is not the first time she's had a mess to clean up. She said to come on in at 130 and bring everything that I can get, apparently her office is next to the hospital where I had the stuff done last weekend, she said for me to call ahead, and they'll have my MRI ready on a disk to pick up.

She said she'd go ahead and give me a full exam today, and work out a plan that's better than the delauded for the Gastric bypass, but said she wants to check all my nutritional levels with a blood test before writing any prescriptions. Said that there's a few things that I could have problems with, that can cause pain to be a lot worse than it could be, and other thimgs that if the levels are low, could cause my upcoming surgery to fail.

So she said to wait to discharge old pm until she's satisfied that she has an accurate plan, and that todays exam and a blood test are just part of consultation, and that I'll have to come back tuesday to go over everything with her to make up my mind if I want to switch or not and said that until I discharge the contract from the old pm, I can keep the Nucynta, which is better than nothing at this point.

Well, not quite as timely as I had hoped, but it's actually very relieving to see that she's wanting to treat all possible aspects, in a safe knowledgeable way, instead of just throwing meds at me and hoping. This is definitely a stress reliever, but it's gonna be an interesting day and weekend lol.

Laying down to take a nap now, but just want to say that news is great! Not instant, but darn close! Hopefully she will be a great match for you!

Hugs,
Shell

Ok, so, things went waaaaaayyyy better than I ever thought they could have, I think I have my own guardian angel looking out for me.

Got to the hospital about 12:30, went to the radiology, (I love this hospital, as soon as someone sees you walking with a cane you get your own chariot and driver lol) got my disks, and asked them if I could get any paperwork from last weekend, they said no problem, and printed up my whole chart right there, including blood test results from last weekend yaaaaayyy!

Went next door to meet the new PM, apparently I was her only appointment after lunch, so she took me right in after only a 5 minute wait (she said not to get used to that). We went over the lab results and the different scans and she said everything looked good on the labs and she did a quick physical exam she outlined a medication plan and then gave me some instruction on the difference between accute and chronic pain, she said most of the pain I'm having will likely remain chronic, but there's a level there that is only because the injury hasn't been repaired yet, so our plan right now will change after surgery, she said with the extent of the damage, it may not change at all, but we'll have to wait and see.

So, after listening to her plan and everything, I think Ive found a winner. Now we just have to wait for a discharge letter from the old PM, which will likely come Monday or Tuesday, and she said as soon as that comes, she'll have prescriptions ready for me to pick up that day, after I turn in all the old ones.

So her plan, she wants me on a tins unit at least three times a day to help with the back spasms, and flexeril during the day, and soma at night, and ambien to help me sleep. She said after my surgery, she wants to address the possibility of trying epidural injections in my upper bad disc, which everyone else has ignored up to this point, and said that disc is the one that would be causing the pain in my hips.

As far as the pain goes, she wants to put me on some custom made oxycodone capsules, that she says my body will obsorb way better than any of the pills I've been given up to this point and says shes going to start me on a two week supply of one every three hours, and then come back in, and she'll tweek it around if need be, and she says I will probably have better pain relief in my legs and hips from neurontin. She also said giving me delauded in a non hospital setting was dangerous since I had a bowel obstruction last year, she said it could cause another one if I was on it for long term.

Well, I am so happy right now to finally have some real answers! Dont think I'm gonna be sitting right for a few days since she decided I was due for my first time prostate check, she said my PSA was at 8, which is a concern, but could be a false reading, but she did say it didnt feel right, so I need to go see my family dr about that ASAP.

Well thats my story for the day, things are looking up I think, gonna have to ride out the weekend, but I think I got things moving really well now. Thanks everyone a bunch, I'll keep you posted on what happens.

Thanks sb, I actually do all my posting from my droid phone, my almost brand new laptop is too heavy for me to lift right now, so its been sitting in the closet for months, I have HW everywhere I go as long as I have cell service, all though I'm having to cut down to a cheaper phone plan because of $ next month.

The only new med will be the ambien, I dont know if you remember my post about costco, but the old PM had written me a script for 10/325 oxy to get me through the week while waiting for approval on the Nucynta.
As far as switching drs, this isnt the first time it's happened pretty fast. I hired my attorney on a Thursday, and by monday I was seeing my back surgeon who is now my primary on my work comp claim. Though they had scheduled me for 3 weeks later than the day I actually went, I had been calling them all day that Friday checking for opening due to cancellation. When you have two overly sadistic brothers like I have, you learn very quickly how to be a good negotiator and get things that you need.

I still haven't signed the contract with the new PM yet, she says we cant do that until she has confirmation of discharge. So I'm going to have to sign that and hand in any old meds next week. So if the old PM drags his feet, it could really slow it down, and he was already taking a week and a half to submit requests for meds, so I have no idea really, what kind of time frame I'm looking at for that so I might have gotten a little to ecstatic too soon. I am just so happy that it went so well.

I must include though, that the ambien really worries me, my twin brother took that for a while, and it turned him into a total zombie! He would sleep walk around the house at least twice a week, and even mistook a few pieces of furniture for a bathroom. I think when I go back next week I'll talk to her about a trial of the other medications first, without the ambien, to see what happens, or try a night with ambien, and no muscle relaxer. Gosh, that really worries me, I totally forgot about my brother's experience with it until I read your post, and we are identical twins. Gonna have to have an extra talk about that one, like you said, I like waking up in the morning.

Ok, you're gonna have to enlighten me further on these natural sleeping techniques. To date, my room is dark, and quite, other than a 2 y/o who I swear rattles the walls lol. My brother is supposed to put in a window ac for me thats just sitting in the garage, but he's been pretty busy so no ac yet. My biggest problem, pain and muscle spasms aside, is trying to get my brain to shut off. I think that has alot to do with stress, though my brain has always been a runaway train at night, just hasn't been this bad in several years. I'm just not sure what to do to shut it off, tv and books only wake me up further, while puzzzles and stuff like that can calm me way down, I cant do them in my bedroom because they'll wake my son. Its just starting to get depressing, because I feel like if I could get even 4 hours of solid sleep, my pain would be alot more manageable. The couple times that I was able to sleep extra, primarily from being completely exhausted, my pain wasn't as bad that day.

Thank you Tina, I will definitely discuss the ambien when I go back next week. I had to move in with my brother and his family, so I have a little help with my mini-me, but after 9 at night, everyone is in bed, so not very much help after then. But he's usually pretty easy to go back to sleep on the rare occasion that he wakes up in the middle of the night. He used to freak ojut whenever he woke up, but not too bad, so I put a night light in there, and now he hasn't gone hysterical since I put it in.

Anyways, when he does wake up, I'm going to need some kind of alertness. So I will definitely address that with the new PM when I see her. Thanks again.