doctor won't let me try modafinil or nuvigil!

I asked my doctor if I could try one of those two medicines and she wrote back saying absolutely not! What's the big deal with these?? I even told her I got a free months trial coupon of nuvigil. She said I need to see a sleep specialist and get treated from them. She knows I suffer from horrible fatigue and I figured she'd be happy I didn't ask for adderall or Ritalin!

Does anyone take these meds or have trouble getting them?

Thanks for the response :) at my last appointment I discussed it with her and she said the only issue was getting a prior authorization for insurance to cover it. She made it sound like she was willing to prescribe it so when I found that coupon for a free month, I wrote her and was surprised by her "absolutely not" response. These doctors are useless and nothing but a money pit. She can't even remember what we discussed 1.5 weeks ago! I did however, ask for a referral to a sleep doctor. So I figure another 4 months of waiting for that appointment.. While I'm slowly dying inside from the pain and fatigue (not a joke).

Post Edited By Moderator (Sherrine) : 1/27/2015 2:29:04 PM (GMT-7)

I am sorry to hear of your troubles.

I do feel I ought to reiterate a few topics on your post, which may be coloring your interactions with your doctors and the general 'face' you create as you post here. Hopefully, these will help you.

At times, you do appear to be moving rapidly from drug to drug. In order to find the help you are desperately searching for, you really need to give medications a good try. This means at least 4 weeks, though 6 weeks are better in order to let your body adjust to the new dosage on board. Switching, adding, subtracting multiple drugs is only confusing your body, adding to the stress it feels already. Drug, like lifestyle changes, are not an immediate fix. They take time to work properly. This is one of the many reasons that a doctor requests a two-month wait until you return for a follow-up.

Doctors use a lot of tools to make their decisions on how best to treat us. One of these tools is the patient's self-reported history, but that isn't the most important, not by a long-shot. Medication is not magic, but is an imperfect tool, wielded by people who have some answers, but not all. It is important to realize that, although we might not like the decisions they make, they have more information at their disposal than we do. Most here 'get' your frustration, but until science has better answers, this is what we got. Patience.

Secondly the "turn to the streets for relief" is not helping your cause. Neither is the 'dying inside.' Though I realize this is out of desperation, it is not helping you at all.

Third, and perhaps the most important, with chronic conditions, very few return to the level of activity/ feeling healthy that they felt before. It is not a question of a pain-no pain dichotomy, but one of managing the pain and its related by-products, like broken sleep and low energy. Changes have to happen on both the medical front, but also the lifestyle front. It sounds as if you are pushing yourself to your body quitting on you. Sleep, exercise, diet, managing work/activity, supplements take time to affect your physical symptoms.

IS it possible your drug changes/medical procedures/lifestyle stresses are making you feel worse rather than better?

Doctors can't prescribe medications just because a patient requests them. They could lose their license for operating that way I think. You have to go through testing to show you could be helped with a medication. This is what your doctor is telling you. If you go through tests and they show you could benefit from these medications, then they most likely will be prescribed.

You are not having problems because you are young and male. Women have been told for years that our pain is all in our heads and have even been sent to psychiatrists. But, if you are young and asking for specific medications, doctors could start wondering. It's unfortunate but you can blame it on the drug culture we have.

Here are my suggestions. Take them for what they are worth. First of all, find a doctor you trust. You probably do have a good doctor right now but you are upset that she doesn't remember everything discussed more than a week ago. I'm sure she has seen many, many patients, not only in her office but also in the hospital. She can't possibly remember everything about each patient along with medications and such. I always refresh my doctor's mind because I don't expect him to remember everything about me. I just had an appointment today and we have an excellent rapport with one another. This is very important. I understand the load he carries and he understands my problems and we have mutual respect for one another. So, this is what you need to do.

If you decide to change doctors, look for a board certified rheumatologist who treats fibro patients. Call your local hospital for a possible referral check the Yellow Pages because sometimes doctors list what illnesses they treat, and just start asking around. If you get a few names, check them out at healthgrades.com or vitals.com. These sites can be helpful.

Once you find a doctor you feel you can work with and trust, hopefully you will be run through a lot of testing to rule out other illnesses like Lyme disease or lupus that have many of the same symptoms...if you haven't had this done already. Once you do get a definitive diagnosis you will get help with the proper medications for your diagnosis.

You mention your labor-intensive job quite frequently. Perhaps you need to start looking for a job that isn't as demanding...a job someone with chronic pain can handle. Our mod, Michael, works 50 hours a week and it is something he can handle with the pain he deals with. The jobs are out there. It might take a little time to find the right one but it would be very helpful to you to make this effort.

Do try to set your anger aside. I know it's frustrating but this anger is not productive and is most likely causing you more pain. You are learning at a young age that life isn't fair but I can tell you that life is wonderful nevertheless. This is what you can focus on. You have a lot of things to be thankful for. You have a wife that gives you understanding and support, you have a job, a roof over your head, etc. We tend to forget our blessings when we are in pain. That why I highly suggest that you go to Fibro 101 and read the link about how to maintain a positive attitude when you have chronic pain. This really, honestly does help with pain.

With the right doctor and the right attitude you will be able to get the pain under control and have a full and enjoyable life in spite of this illness. We all have gone through or are going through this and we are here to help one another. I've had fibro longer than you have been alive and I've truly enjoyed my life and continue to enjoy it. Yes, I have pain when I wake up, all day long, and when I go to bed but it's under control now. I've found what helps me and I've shared it hundreds of times on this forum. Others have found different things that help them and they have shared this on the forum, too. It's a trial and error type thing. We all wish there was something that we could take to make the pain go away but it's just not out there.

I hope this helps you.

Sherrine

Oh! And magnesium!! Another huge helper.

I also don't go in there demanding narcotic pain killers.. I'm not that dumb. But if something isn't working for me, I do expect to be able to discuss those issues and come up with another plan to help control pain. My job is already upset about the time I've missed due to my problems and numerous doctors appointments..which is adding to my stress. I swear one appointment with her she's nice and willing to listen to my problems and help me come up with a solution and the next she treats me like a kid who just likes to bit*h

Not a day goes by that I wish I could quit my job and relax all day.. But that's just not going to happen. I've been trying to stay positive but lately I can't.

Ive been thinking about seeing a psychiatrist lately..I may look into finding one today and setting up an appointment. And to be completely honest, I'm not even sure I have Fibromyalgia.. I always think it's something worse that's slowly killing me. For some reason I have trouble believing the doctors even though I've done almost every test out there. I keep thinking they threw that at me because it has a history in my family.

On a side note, I got my second set of hand joint injections yesterday and they feel pretty good today. The doctor who did it wanted to know why they haven't taken over my medication yet and I had to explain the whole story of getting brushed off by the nurse practitioner during my first visit with them. I even told him how I had to straight up ask for injections because she said there was nothing they could do for me. But I tell you what, once I asked for injections, the xray and MRI requests started immediately and they were quick to schedule my injections. Leaves me wondering if she first thought I was just after pills or they are doing injections for the money. Anyways, I scheduled an appointment to come up with a med plan next week with that nurse practitioner and the doctor sent a note to her and my PCP saying he wants to take over my medication. He promised me a better quality of life very soon (second time I've heard that from them!)

My psychiatrist prescribes some of my fibro meds. He prescribes the Adderall that I take, though I don't know for how much longer. Without it, I will probably be no good... It is my age, and I have been on it for a long time.

I think that the thing is that with some of theses medications, addiction can come. I always figured what is the difference if we are going to have fibro forever, but they can do other harm to the body. Doctors now are very careful when prescribing these medications. They are abused a lot.

I have found that moving around really helps. The less I move, the worse I feel. Have you tried walking some? It doesn't take a lot to help. I find that is my best exercise. It is getting started that is hard, but once you do, you will notice that you feel better. Drink a lot of water too.

I hope that you find what works for you. Oh, I thought you said that the doc is letting you take three hydrocodone a day. Now you said only two... I thought that it was increased.

I hope you feel better soon.

Hugs, Karen...

Hydrocodone does nothing for my pain and makes me very dizzy. (It was fun navigating crutches on hydrocodone - I fell into a stack of computers). My now retired PCP told me that his opinion was that Hydrocodone doesn't fix your pain - it only makes you not care about it.

I'll stick with Tramadol. it likes me better.

Sherrine has a very good point. Maybe it will take a lifestyle change to help you feel better. Not only hard work can be too much, but mental stress can cause you to flare. Is it worth it? Maybe not. Sometimes we have to change the situation we are in for health reasons. This could be one...

I hope that things get better for you soon.

Hugs, Karen...

Just remember, everyone is rooting for you and certainly hope this doc you saw will be able to help you.

But a lot of it comes from helping yourself..i cannot take tons of meds so i take some , and work out other ways to help myself with energy and pain... There is no pain free with these illnesses, but there is a much more managable level... And you are working your way through that..

Lj