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have a question about pain management..

katykatkkatykat Posts: 1
edited 06/11/2012 - 8:50 AM in New Member Introductions
I hope that this intro is ok. It's more of a worried question, and really didn't know where else to turn.

I was in a auto accident in 2008, hit from behind while at a complete stop at a red light. My most recent mri one month ago showed L1 L2 L3 L4 L5 S1 all disk protrusions to disk herniations and each lateralizes to the right. I have quite a bit of pain in my lower back and even more in my legs. I had been seeing one doctor for just over a year, he would prescribe me vicodin 5/500 and then earlier this past year it just did not help anymore. He then prescribed vicodin 7.5/500. It was basically the same, I need to take two just to get a little relief. He wouldn't prescribe anything stronger. He sent me to a neurosurgeon because I also have spina biffida and more and more studies are showing that what was once thought to be harmless in the occulta form may not be as harmless and pain free as thought. The neurosurgeon gave me one script for 40 percs, sent me for a mri. Ins wouldn't cover it, (I saw him once. The reason for denial was insurance was new, it started in august and determined to be a pre existing cond)

So August new insurance kicked in, it went from medical mutual to kaiser due to job change. I saw a new doctor at kaiser but still kept my old doc. So new doc actually seemed to listen and prescribed perc 325 after me telling him that the vics do not help me, he tried vics first, his first script was for of course vicodin 5/500.. He has given me three perc prescriptions since August 2010, 90 count and 30 count. He wanted me to take one every 8 hours, that helped but never got rid of the pain completely, I began taking one and a half every 4-6 hours and it actually helped just fine and I also told him this. So he sent me to pain management, that was Nov 2010, they are in the same building and use the same computer system so both know what I was taking. Pain management gave me one script for 90 pills, and then another for 60 pills. these doctors were through kaiser, which if anyone knows about Kaiser you can only have Kaiser insurance in kaiser. Pain management there got the mri approved finally!

And then here's the kicker..On the first of January this year, after finally finding a doctor that would help me and took my pain serious, our insurance changed over to anthem, my husbands company left kaiser..so now my nerve block scheduled at the end of this month is of course not going to happen and I am back to square one with a new insurance and pretty much have to start over with the insurance company. I mean they just dont pick up where you left off and start paying for mri's and surgeries and pain docs etc. You have to go through a primary care doc, get the referrals etc. So I have started this all over again!

anyway, I ended up making a appountment with a new doc, I liked him and have decided I will just stick with him. So I went and saw him almost three weeks ago, The week prior I went to the ER because my leg went numb and the pain wouldn't stop no matter what I did. anyway I made the app and brought my ct scan results with me from the hospital, and the mri results, he listened to me, and he prescribed 100 vics, 7.5/500... they dont help like the percs do but you know what? If it takes even a little bit of the pain away i dont care anymore. So he referred me to pain management. I had that appointment today. I went in and first they drug tested me, took my info etc and then I went into the room. Now I will be completely honest, I never told my kaiser docs about my long term doc, and the new doc I didnt tell about the kaiser docs, I know I cant go back to Kaiser, cant see these docs anymore because they work within kaiser facility only, not just docs who accept kaiser insurance..so I just wrote them off because I can't see them anymore anyway. what I did sounds worse than what my intentions were though,

While I was getting the percs through Kaiser my long term doc filled four 60 count vicodin scripts since July of 2010. I also had been to the er two times since august. so FF to today. Doctor looks at my ct scan and xrays (I had xrays in october, showed bone spurs on multiple levels of my spine) so, does usual tests of move bend, tip toes, heel etc. Goes through the whole routine. I didn't tell her about any doctor other than the one that sent me, my new doctor, because I can no longer see the kaiser doectors since kaiser is done, my long term doc does nothing but throw a script at me every couple months with refills and I decided to not see him anymore since this new insurance kicked in. I decided it's new insurance I am starting over and keeping this doc, this PM doc, hopefully I can get the nerve block scheduled etc. That was my thinking anyway.

well suddenly she says well there is a matter of your prescription habits and she pulled a paper out. She went to the dea website or whatever and it gave her a list of every time I was prescribed a med, went to the pharmacy, the er etc. so she said I think you have a addiction problem. I didnt get upset, or cry or angry or walk out etc. I sat there and told her, i did not disclose to the other docs I had a different doc, but the kaiser docs are in same system, each knows what the other ordered, I told her the vics did not help, I told her I was referred to neurosurgery, I was referred to pain managment etc and now as of this month my insurance completely changed again and I again have to switch doctors, I cant see the kaiser docs anymore. I told her I am legitimately in pain, I am not addicted, if I could get rid of the pain now and not take another pill, I WOULD, and I truly mean that, I told her mentally I am not addcited to these pills, I told her physically? with my pain? yes, because its all that helps me get through the day without pain.. i told her I am a nursing student, I have neevr done street drugs etc. I am just in pain, and I had no idea that going to different docs like I did was doctor shopping... I mean I should have known though I guess. I dont know. I should have stopped filling the scripts from my long term doc, but I filled them and kept them for when the percs ran out. OH and I also had a dentist pull a baby tooth that never fell out about two months ago, he gave a script for 15 regular vics. So now I am scared as to what she is going to do or what is going to happen. She said she is not going to tell my doctors but under the law she has every right to, she said she is trusting me to, but I really didnt believe her, at all. so what happens now? I have my last script of vicodin, he sent me to pain management for them to help, they certainly wont now, oh the other thing is she said I can be evaluated by a mental health expert to see if I am addicted and then she will go from there, my choice. what does that mean? I know I am not addicted in the way she thinks. Am I afraid to be without my pain meds because of the pain I feel without them? absolutely, but do I feel like I will do anything to get them? no. would I resort to street drugs? no. I dont know what to do now, just kind of scared now.

So in total, these are the scripts I have gotten in the last year, just over a year actually---long term doc I had 21 scripts filled since september of 2009, all ranged from 40-60 count and he was the only doctor I saw until my pain simply had gotten unbearable in august of 2010, there were 7 scripts total with refills, equalling 21 scripts, new doc one script for 100 vics and I still have about 40 left, kaiser pain management two scripts for percs one at 40 count and one at 90 count since November 2010, kaiser regular doc 3 scripts since august 2010, two for percs at 90 count, one for vics at 30 count, dentist once in october for 15 count, Er since january of 2009, I went three times for my back and got three scripts for 15-20 count of reg vicodin.

I guess when writing it all down it sounds like alot, but I dont take them by handfuls or take them just to take them. I do take them every 4-6 hours though, mainly every 4 hours. If i dont then once the pain sets in it's almost impossible to stop. I am sorry for the long post, hope someone can tell me what will happen and I just wanted to give as much detail as I could.

has anyone else had similar experience or any advice on what I can expect?

thank you


  • While I agree that it is important to have our pain managed and then kept under control, it is equally important to be honest with our Drs and most importantly-ourselves. You say early on in your post that "what I did sounds worse than what my intentions were though", and I have to agree that it does look bad. Not only the different Drs, which I could almost understand with your insurance situation, but your ER and Dentist visits simply throw it over the top.. that's just the way it looks. Regardless of the true nature of your pain or if you were innocently trying to find relief for that pain, the fact that you were not honest with, and did not tell one Dr about the other says that you were hiding the amount of Rx's you were being given. There is simply no getting around that.

    Your question is "has anyone else had similar experience or any advice on what I can expect?
    ~I have never been in your situation, but I am fairly certain that you can expect to have a difficult time now finding a PMD. When you do go to another Dr. please tell them the entire story, be open and honest about your search for proper pain management, because as you can see, any Dr.or pharmacist can easily get a copy of all of your Rx traffic, and trying to hide anything or be sneaky will only catch up to you and possibly get you into big trouble. Dr shopping is against the law, if you are in nursing school I'm very surprised at your lack of knowledge on this subject, and I hate to worry you further, but this may put a damper on your career plans, or at the very least make things a little more difficult for you if this Dr decides to take action. Even if she does not, your pharmacy records will speak for themselves.

    Moving forward, if you are fortunate enough to find a PMD who will take you on as a patient, it will be in your best interests to use only one trusted pharmacy. Most PMDs have you sign a contract stating as much anyway, but even if s/he does not it is a good way to just help you "look" better, and quite possibly even feel better about yourself. Keep all of your prescribing Drs in the loop, but generally only one Dr should be Rx'ing any opiate/oid type pain medications. Also, if you need the Dentist or ER, you should contact your PMD (or have the ER or dentist call)-keeping them in the loop.
    Good luck!
  • Welcome to Spine Health. There is a wealth of information on this site just a mouse click away. You can enter queries in the search engine at the top of the page to research additional information about your condition.

    It sounds like your in a bit of pickle. I have a question cause I'm not sure if I understood you right. Were you getting the Vic script from the long term doc and Percs from the Kaiser docs at the same time? If so, that may be problematic and this new doc might have you jump through some hoops for her own edification. I've never been in this position but it sounds like this doc wants to help which is always a good thing.

    What has me concerned the most is your only treatment is taking pills to manage the pain. I would think you might want to exercise this new insurance and get to the bottom of your problem. There is a host of treatments that can be undertaken to hopefully help you feel better. I see you've been to a Neurosurgeon (how did that pan out?) and now might be the time to see if that path can be of some help some. You could even see if an Orthopedic Surgeon who is spine fellowship trained might be better suited for your needs. Pain management seems like you're hunkering down for the long term without considering the possibility of other approaches. Naturally, I do not have all the details for the past couple of years, so I apologize if I've overstepped my bounds.

  • dilaurodilauro ConnecticutPosts: 9,846

    For a Spine-Health Site introduction, Click on :

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    I believe based on everything you wrote, you are now in quite a dilemma.

    But for starters, you did yourself a major injustice by not telling the truth about all your previous doctors, their writing of prescriptions, sending you for MRIs, etc. It is so very important to tell you new doctor everything.. Hiding something from them, no matter if it seems innocent sends up a major red flag.

    From this point on, many doctors may not want to deal with you or treat you as a problem patient.

    Now , that is what you DONT need.

    I dont know how you can fix the past or attempt to change the mind of your new Pain Management doctor, but this is something you should do.

    You really want the focus of attention to be on your current medical condition, what action plans can be put into place.

    As Dave mentioned, pain medications alone are not going to eliminate your pain. At best they can mask it for a while. There is a total package, which not only includes medications but several other actions.
    Take a look at The Blend to see what I am talking about
    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
  • You have put yourself in a horrible situation. When a Dr. talks to you it is your responsibility to tell them who you have seen and what meds you have and are taking. I have had back problems for years and because of situations just like this, Doctors have started looking at ANYONE that needs pain meds as suspicious. I have never been given anything stronger than 5/500 hydrocodone except for two scripts just after surgery. They don't work. They won't give anything stronger.

    Nerve pain does not subside with narcotic pain meds, they may put you in lala land or give you temporary energy or knock you out but they will not touch nerve pain. If your pain mgmt doc. presented you this paper trail and offered to help pending a mental health eval, you should do the eval to make things right that way your pain mgmt doctor will be able to continue your treatment. Pain mgmt is good because they can also do injections which help lots of people but not all. Do what ever this doctor asks if she seems to listen and wants to help pending a eval.
    Good Luck!
  • i just want to welcome you to the forum! :H we are here to offer you support and answer what questions we can. you have been given alot of good advice already.. please have a good look around and make yourself at home.. stop by anytime! Jenny :)
  • Hi, I'm new but I was reading a few "new member introductions." First off, I completely understand your frustration with Dr.'s and proper pain management. I honestly believe that some Dr.'s aren't treating pain accordingly, they are mainly concerned with losing their licence. Unfortunately, with many people they are just trying to get a "fix." When I was seeing pain management, I had to sign a contract stating I wouldn't get any prescriptions from any other DR. Reason being, I had a pain killer script that would cover any other pain I might have. Getting another script from another Dr. automatically terminated the contract, and you could no longer be treated by them. I see you went to pain management as well, did you sign a contract? I've found that working with my main physician and my neurosurgeon, keeping each other posted results in the best care...three heads are better than one right? Also, do you exercise? I always feel better when I do, when I had PT, she recommended swimming. It's great exercise and it takes the pressure of your joints. Also, being in a car accident isn't all your visits/meds covered by your auto insurance? Anything to do with my accident is covered by AAA. Hopefully you can get this mess cleared up, sorry you're having a hard time with Dr.'s...I know it can be frustrating...hang in there:)
  • Hello! My name is Jodi, and I've had issues with my pain meds too. At one time, I was definitely abusing them. I had to get serious about my treatment, so I became HONEST with myself, my family and my doctors. I explained everything. I voluntarily and independently signed releases of information for all of my doctors (pain management, PCP, psychologist and therapist) to speak to each other and my family about my treatment. I have a family member hold my narcotics. I abide by the contract I signed with my pain management doctor. You've got to work on gaining your Dr.'s trust, or they can refuse to treat you. Doctors DO want to relieve you of pain, but you have to ONE doctor for pain issues and ONLY go to them with your issues. Prove those good intentions.
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