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Furious (and FRANTIC) at being told to come off lortab with 8 pills left

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Pain Medications
I am stuck between a rock and a hard place, please tell me what you would do.

I had a back fusion on Dec 30th. Neurosurgeon prescribed 30 mg long acting morphine and 120 10 mg lortabs for me to take 4 a day as needed. I had been taking them two at a time twice a day following with two aleve several times during the day.

The last appt with the NS was two months ago. I have one scheduled for tomorrow, Monday (23rd). When I went two months ago, he gave me one month of meds. When I called last month, Feb 24th, they called in the 120 lortab and told me I'd have to come to the office to pick up the morphine script. At that time I told her I didn't want to make the 30 minute tip and to let me see how I did.

Within days of running out of the 30mg LA morphine, I was in instense pain. Started taking the 15mg short acting morphine I had been given after surgery (still had leftover), instead of the loratab. The following week, I called the NS office and told them I needed the get the 30mg script and would come get it.

Every fine, they told me on that phone call they wanted to me start going to a pain management clinic. I said fine, I have one I was going to before my surgery.

To my surprise, I found out the one I had in my town had closed but the doctor had a couple other clinics. Had to wait 2 weeks to get referral from insurance through my PCP and then had to wait another week and a half for an appt.

I go to this appt last week with about a weeks or so left of loratabs. Saw new lady doc who said I'd never be on those meds (30 mg LA morphine and especially the 120 10mg loratabs at their clinic. Said she couldn't prescribe anything, had no records from my NS office, who said they had sent EVERYTHING over the day before and that had been confirmed by someone at the pain clinic (records received). Doc said she'd have to wait two week to get my urine and blood work back and she wanted me to start weekly exercise/therapy there once a week.

She also said the pain contract said I could not get meds from somewhere else but that she would allow the NS to give me one more script of lortabs because I told her I had TEN left and I could NOT PHYSICALLY WITHDRAW from the lortab in that short of time, given the months I had been taking them.

I called the NS's office to see if she could give me more lortab in the interium. His nurse said "he will give you no more, we told you we wanted you to go to a pain clinic". I explained that I HAD...that day, but that doc wouldn't prescribe anything for two weeks.

I feel this is totally unprofessional, unconscionable and unethical in regard to someone who has been on pain meds for almost a year.

Maybe I am over-reacting in the frantic-ness that those of us who are physically addicted feel when we know our drugs will be witheld. I have NO PROBLEM trying to come off the lortab, just don't think it's right to be left with two docs who won't prescribe more but gave me 10 left to come off them.

I will be calm going into his office and maybe my anxiety is unnecessary. He MAY give me a script to last me until I get fully into the pain clinic.


Do I have recourse, am I justified in my anger? I'm scared, I will be so angry tomorrow at my NS's office I will start to cry because that's what I do when I'm trying to defend myself, also I pain to take 3 0.5 mg of xanax before going to hope to be calm enough to talk rationally.


  • dilaurodilauro ConnecticutPosts: 9,839
    me is had no records from my NS office That really troubles me. If they are dealing with patients this way, then you just have to wonder what else could be happening.
    Oh so often, I read about a member leaving one doctor going to a Pain Clinic or another doctor and going through some of the same things you are..
    Going for a no pain contract to a pain contract, no urine tests, urine tests, etc
    You just dont know for sure.
    I know this is hindsight right now, but anytime you leave one medical practice for another, make sure you have everything documented, you have all your medications identified, doses, etc. You then have the existing practice send all that information to your new medical provider (you also have copies) and you ask to have the new provider either contact you directly with their concerns and/or approvals or at least contact your existing doctor.
    Once you walk in new, it can be frustrating. Its almost like your word against theirs... I hope it doesnt work out this way for you.
    But, in getting ready for tomorrow.
    1- Have a list of all your medications in the past 12 months, the dosages, times of refills, etc
    2- Date/Times of surgery and follow ups.
    3- Any other important dialogues you have had with the existing doctor.
    When you go in with a professional cool but stern approach, the better practices will treat you the same way, if you go in frantic or crazy, they will then treat you that way and you wind up loosing.
    To me a good doctor will not allow their patient who they know is in pain to be without the appropriate medications.
    There are many negative problems going through forced withdrawals
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I have gone through this many times and I know how angry you are. I always stay on top of both ends of the transaction until I am satisfied it's all been done. I hate when you hear the " we sent you records yesterday" and you come to find out "..no, we haven't received them yet". You sometimes have to be a pain you know where to get things done, and soon they will tire of hearing from you.

    Hopefully things will go smoothly tomorrow; just keep your cool and you will be okay.
  • I would ask for your records tomorrow and let the Dr know what the pain clinic said. I would go to another PM Dr and he should send you to someone else even your Primary Dr should send you to someone or even cover your meds. I've never heard of being on so much meds and still having pain and they want to take you off all meds. You'll end up in the ER where they already blame PM Drs for letting this happen. I wish you luck tomorrow with the Neuro. I think you should have a choice who you're PM Dr should be also I asked my Primary Dr to send me to someone else for a second opinion and it was worthwhile because he found the problems with my facet joints. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Thank you all for your responses. My NS's office has always been top-notch and way above board professionally and personally than any other doctor I have ever been too. They have been on the dot for forwarding all other information such as sending notifications to my employer.

    The pain clinic on the other hand, for the 4 months they had an office here in my town, they never once billed my insurance and when I asked, they said they were behind. There was a strange reaction when calling this new office, as they acted like they knew nothing about the other practice altho two of the doctors practiced there.

    In the PM office, I even asked a guy that I knew worked in the other office, where my old records were and he said "he'd go get them". I forgot to ask if he got them by the time the doc came in, but she was really wanting my NS's records which I truly believe were THERE, the office just wasn't organized enough to get them in my folder.

    My gut tells me my NS, or my PCP, if I can get an appt around this other appt, will give me more, once talking to them. It's easy to tell you know when you're on the phone. My PCP knows I've ALWAYS been upfront with him, after being his patient for 15 years.

    dilauro, I've always been above professional in the office and want to stay that way...dayum these female hormones. I understand exacting what you are saying. I have already printed out calendars of the last three months, especially the last showing the wait on getting the referral and then the wait for an appt.

    First and foremost, I DESPISE the way any office treated you like a drug addict. The ortho who did my first two surgeries did that and that's why I went to a NS for the third. And I detest this "oh, let so and so give you the meds"...and easy out to not prescribe narcotics with an attitude of "to heck with the patient".

    The other thing I don't like about this new female PM doc is she said "we will not be able to get you out of pain", you'll have to learn other ways of dealing with it...such as what I'm supposed to learn in these one a week classes/therapy/exercise I'm supposed to attend.
  • It is true however what your PM doctor said. You can't go in with the expectation of having all the pain gone, this just doesn't happen and you'll be in for a big disappointment I'm sorry to say. Pain management is to manage your pain, or else it'd be called pain elimination (don't I wish). They hope to bring the pain level down to where you can tolerate it and function in your daily life.

    Let's say that your pain is an average of 6 on your current meds- they may adjust or change it to something else to hopefully bring it down to a 2-3. It would be considered as your medication is controlling the pain adequately. I have been on strong meds for a long time now and not once have I had complete pain relief. The lowest it had gotten at one time was a 3-4; my doctors are trying to get it back down there again but it may take more procedures and another surgery.
  • meydey, I kinda understand that and I have no problem attending these "classes", whatever they are at the pain clinic as the doc noted I hadn't mentioned exercise in talking about what helps with my pain.

    And that doesn't speak well for the future, even at a pain level of 2-3, that kinda of ache has me skirming too and unable to concentrate on anything. If I'm home, there are ways I can...at this time eleviate the pain and that is by laying down and doing little throughout the day.

    My post was a frantic cry for help for suggestions or just suppport at the suddeness of wanting me off lortabs. I've only had two today though and am fine.

    Wait...would the long acting morphine I'm still on, help in anyway to ward off lortab withdrawal?

    And yes, you are right about being called "pain management" but I guess this new doc freaked me out because it didn't sound like she was keen on you being on anything other than rugs like xanaflex, lyrica, and and anti-inflammatory. Oh, don't I wish.
  • hope ur seeking meds for pain only, its illegal ford srs to prescribe meds to feed an addiction. so hpe ur going because ur in pain, didnt the sugery fix ur pain issue,? i hope u work it out and get relief.
  • I can stand for about 10-15 minutes and then have to sit down for twice that long before getting up again to attempt to finish what I was doing. I can sit in my computer chair for about an hour or so before I'm squirming. I use the handicap driving carts at Super walmart because if I walked in, I could get to the front end of the meat counter before hurting bad, but I still have to walk back and then wait in line...horrible pain that has me leaning over in line trying to shift the position of my back.

    After my last fusion, I hurt for a year and a half, then suddenly the pain was gone. I was diagnosed with arachnoiditis at that time but this new doc said he saw no signs of it.

    I am looking for meds right now to feed an addiction...a physical one, because I've been taking multiple ones a day for about a year now. I have lived probably 4 years now on lortab, the total of all my surgeries. I don't have any issue with a mental addiction and I can't help but have the physical one.

    The physical one is the one I need more pain meds for...to taper off them like one is supposed too.

    I got a 3:30 appt with my PCP today, so that will be perfect. I have to go in at 12 for x-ray, then over to the NS, and then I have the PCP appt if I need it.
  • "I've always been above professional in the office and want to stay thatw way"

    Hello, I was just thinking about this comment you made, and remember going to the dr is not like going to a job interview or speaking to customers that are buying a car. You are the patient for chronic pain being professional and being a rational well educated patient on your condition are two different concepts. At the Dr's office you are the patient and your Doc is the professional. Knowing your position can be critical to the treatment you receive especially in a time of pressure on the Doctors who prescribe narcotic medications. My thoughts, hope you find what you need in this game of chess.
  • *hugs*

    I've been in your situation before, it totally sucks! (except while I DO have a chemical "addiction" to pain meds, I also need them to function, as the pain from my various conditions is too great to function normally! Also, don't use the word addicion....it has a mental impact on YOU, even if you don't realize it!!!!)

    A word of advice (and from someone who's learned some VERY hard lessons in the pain medication department!), always carry copies of your medical records with you when you see a new Dr, AND if it's possible, get a record of all your scripts from the pharmacy. I get a new one every 6 months, and since I've used the same pharmacy for 6 years (nearly 7 actually!), they pull every narcotic (scheduled or not) that I've ever filled there. They are even able to pull the scripts I've filled at other pharmacies (as I from time to time, simply cannot resist those $30 GC's for transfering...I DO tell my NP about it before I do it...shoot, she's the one who encourages me to do it...as some of my medications can get expensive!!! It helps with the cost). I keep these in paper form in my house, and I also scan everything into the computer that I store on an off-site location, just in case we had some type of natural disaster here at the house (which includes one of the kids accidentaly wiping out the hard drive on a computer. That HAS happened before!!!!)

    Also, be honest with them. Tell them what you are thinking, what you are feeling, and how you just don't think you CAN mentally handle not tapering off the lortab. Ask them to help you come up WITH a plan to get off them, any Dr worth their weight in salt will do this. It's an ethic thing for them. I had a Dr (actually a NP...but there was more to the story) refuse to do it. I filed a complaint about all her unethical practices, and she currently awaiting trial for stealing schedule 2 narcotics from her patients during "med count" appointments. If I wasn't so busy with the million other things in my life, I would seriously consider sueing her for malpractice, because what she did to me was HORRIBLE. I'm happy just to see her get her liscense to practice pulled though. (she'd only graduated 8 months before it came out what she had been up too. Wicked wicked woman!)

    I wish you luck, and I hope today goes well for you! I will keep you in my thoughts and prayers....I understand what you are going through! Please keep in mind that to some extent that since you HAVE signed that contract with the PM Dr, your other Drs have their hands tied to some extent. My PCP treats me for my migraines (she prescribed fioricet), but it's with the permission of my PM Dr (or rather my NP. Although I think my NP is going to take over that as well...I had to see my PCP on a day my NP AND the Dr do not work...so I was desperate...and my NP totally understands that. Plus I was honest about it with her when I saw her 3 days later). Being honest is your BEST asset when dealing with PM docs. They do appreciate it, and it helps them treat you more like patient who does struggle with pain, instead of one who's simply seeking drugs for a "fix". (and believe me...there are SEVERAL at the clinic I go to...you can just tell...they come in acting drunk/high, claiming they need "more". Drives me UP THE WALL!!!!! Luckily they are weeded out really quickly, especially with the super-strict laws surrounding narcotics in the state I live in)

    *hugs* Keep us posted!
  • THANK GOD for my PCP appt at 3:30 as I missed the NS appt. I was scheduled for an xray before the appt (like last time) and I wrote down 1 PM which was what I thought was my appt for the xray and I'm positive I got this right, but when I got to the NS appt, they told me my appt had been at 1 and would have to be rescheduled.

    I asked about a letter because I only had a letter to stay off work through the 23 (Monday, same day) and they said "no, couldn't give me one". This would ahve meant I was LAID OFF, as I have been informed that upon the doctor's release for me to go back to work, I am officially laid off. Is legal, they let 20 go total.

    My PCP DID give me a letter off work until June AND he gave me 60 lortabs, which is what I asked for. I said since I got 120 last month, let's go with 60 and see if that will get me through getting off them.

    Was ironically funny (NOT) that upon leaving the NS's office, I couldn't get my daughter's car to start. I called her asking if she'd had any trouble and she said no. I had to be at my PCP's office in 40 minutes. I happened to look down and I had left the car in DRIVE. Good Lord, as soon as I put it in Park, it started fine. That few minutes didn't add to my stress as I was still nervous hoping no emergency had come up and my PCP had to leave...lol.

    Thank you all for your support. I feel like writing a letter to both my MS and the PC telling them I think it was totally unprofessional and unschionable (sp?) to do what they did. I also found out that while the PC told me they had NO records from the NS's office, their receipt of them HAD been verified the previous day by the NS's office. It was just a matter of them getting the fax and putting it in my file. Do they not realize how important some of these things might be to PEOPLE?????
  • ShoeLover, thank you for the reply. The PC doc had approved me getting a script from my NS for more lortab to taper off, so I figured since I missed that appt, she wouldn't mind me getting it from my PCP which she knows.

    I have been brutally honest with my PCP as for the previous 2 surgeries, he's the one who kept me in pain pills, like the last one...for a year and a half after surgery. And I remember telling him that time, when asking if the new anti-depressant was working, that it was hard to tell, with taking lortab, which made me feel better.

    I'm also surprised at my NS's office, because the last time I saw him, I had a half bottle of the short acting morphine left over from surgery and a couple weeks ago when he did refill the lortab, she told me I'd have to come pickup the Morphine script. I told her that I didn't really want to drive 30 minutes to pick it up and let me see how things go without it.

    The following week I was in so much pain, I called for it, and went to pick it up. But surely those two things, would show clearly I am NOT the junkie who just wants the meds.

    As my previous post, I am ok now,(for this go-round) but am still furious that the NS just so callously say "nope, no more refills, get them from the pain clinic" when it's my first visit. I did take a calendar with me showing the three weeks it took to GET the PC appt.

    I was on the up and up and I feel they clearly did not handle this ethically. My mistake for making the doc appt and my "not return to work" on the same day. I will never do that again.

    As you point out by sharing what you've gone through...live and learn and realize you are nothing but a number to many of these docs.
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