I'll try to keep this short, but for the new folks here, I want to illustrate why being painfully honest with your PM is so important. For quite some time, I was on several IR opioid meds. All at once, my PM changed his policy that you can only have one narcotic prescription at a time. By this time, I was on an ER medication (Oxycontin). I explained that I still have pain and issues with breakthrough and asked what should I take. I was told to take a Tylenol.
After a couple months of being miserable, I wrote the doctor a letter explaining what was going on with my pain level. The next couple appointments I had I was always drug tested and honestly felt like they thought I was just a seeker. The PM came in with a couple nurses to address my letter I sent him and my pain issue. He was having a hard time believing my claim of pain. He told me he was going to run a test and my treatment plan may be altered after the test. Essentially, it was a test to see if my body metabolizes certain opioids.
The next month, my APRN came in and said my meds were changing. I asked what was up. The test came back that my body does not metabolize Oxycodone or Hydrocodone, so my claim of poor pain relief was spot on. She moved me to Opana ER which does work very good for me.
During my last appointment, I told her that the med was working but for 7-8 hours not 12. She wrote another script for Opana 10mg IR to cover the discomfort in between doses.
I am absolutely confident that because I have always been truthful with them and willing to do what was necessary to prove it that they trust me with more than one script for pain and spaced my appointments out further apart.
Based on how I've seen some of their first time patients leave totally pissed because they wouldn't write a script based on their history, I feel confident that I'm at the right PM and I can trust them just as much as they trust me. It's a good feeling knowing I can go in and be totally up front with them and get great care.
Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2