Long. I'm sorry, I am a detail guy.
Last December 2014 my back finally gave out after years of managing it with medication. Oxycodone. The PCP that provided it knew that I was living in a cancer hospital with my daughter and that there was no money for a MRI or getting into treatment (covered by insurance.) Fast forward to now, when my private insurance hit $800./mo. and instead of telling me options I telephoned the insurance company and went through signing up for a new plan. To do this they required that I first terminate my current plan. I did as instructed. Wrong Answer! When all was said and done the computer decided that I qualified for California Medical - free insurance. I don't want Medical, free or otherwise. I was told I had no choice.
Finding treatment became difficult but I finally managed to find a Pain Mgmt. Clinic at a regional medical center of prominence. As a teaching hospital I first see a Fellow and s/he advises me this way or that. The main doctor then comes in for a recap. But each time I see a new Fellow I get a different course of treatment.
Lately I have been doing a lot of acupuncture and swimming every day. It appears that although the swimming has got me up and moving apparently I have aggravated a prior neck issue that I had surgery to correct 5 years ago with a Discectomy. I needed to reschedule an appointment last minute and was told that the next available was September 9th. I replied that I would be out of medication by then, do you have anything sooner. I was told that I needed to speak with a nurse and she had me race in today - I made it work to my detriment. My issue was not a medication refill but scheduling. My daughter,a cancer patient, was up all night vomiting and today I could not find a suitable babysitter. Once doesn't just pass of a seriously ill child to just anyone. I did find a retired nurse,a neighbor of mine.
Today I saw a young Fellow with the face of Doogie Houser. Young like Doogie  ! He went on and on an on about my tingling in my fingers and my neck surgery and this and that and this and that until I finally stopped him. I said "Respectfully doctor, I don't understand why every time I come here and see a new doctor I get a different course of treatment." "Well, what do you mean" asked the doctor. "Well, today you are asking about my neck but I am here for my lower back. Before I was given a cortisone shot. Then I was offered nerve burning. Now you are asking me if I am interested in a Spondilator or something like that." This  him off clearly and he retorted that the numbness and tingling in my hands was caused by a neck injury. It would have been nice if he had tied that up in the beginning. All I know is that I haven't been able to feel my feet for quite some time and now my hands are numb. To me it is related; to him it is something new. We can agree on that once presented like that.
I then see the main doctor and all is well. I was very happy to announce a decrease in my medications because of swimming. The doctor asked if I wanted to go down on the medication and I agreed without hesitation. I also asked about a chance of the cortisone injection but under sedation. He said no, it didn't work. Doogie Houser disagreed! I was to return in one monthly. While waiting I was called back into a treatment room now with the main doctor and the student and accused of either being a drug abuser or dealer. I don't know which. I was peppered with questions on how I could be out of my medication so soon (I was not and never said that I was). Why did you tell the nurse that you had to be seen today? I didn't! You got your refill on the third and you are almost out? No, I said that I am getting low. "You just said you have only three left?" "No! I said that I only have three in today's cup." I dispense my meds daily just like my daughter in plastic medication cups that are labeled with the time. It went on like this until I was told that I would be removed from the program. I begged tearfully not to be, that I wanted treatment, not drugs! I maintain this position. I was seated again in the waiting room. While waiting I approached the counter and asked to speak with the nurse about the scheduling confusion and did not get to. But Doogie Houser reappeared.
In the waiting room with other patients and staff I was asked if I was still using a Fentanyl patch. I answered in the affirmative. I was asked in front of others if I would mind showing the doctor. With no real option to refuse I removed my shirt and exposed my patch. HIPPA VIOLATION!!!! I had offered in private to submit to a UA and was denied by the main Doctor. "What would that prove?" That I am not using more medication than prescribed. I took my glasses off and asked the doctor to look at my eyes. "And what does that prove?" That I am not high. In retrospect it appears that I was not being accused of using too much, but of selling my medication. My acupuncturist told me that he was concerned with me not getting active or I'd end up in a wheel chair one day. I mentioned this to Doogie Houser in the waiting area and he replied, "That isn't likely. In fact, I don't think there is anything that wrong with you now."
My MRI, CT's and X-Rays say otherwise. HIPPA violations once again. Although I made a statement I did not reveal a medical diagnosis in public. The young doctor did. He also made a libelous and slanderous statement but I have no intention of muddying the waters.
Lastly, I telephoned the pharmacy and spoke with a really nice woman that has been filling my meds and those of my daughter for a couple of years. She knows me to be a man of character, honest, and caring of my daughter. At no time have I concerned her with filling my narcotics, an important point. She is required BY LAW to refuse to fill any medication that she feels is being abused. She explained to me that the way the main Doctor was writing the prescription is confusing., He writes that I am to take one every 6 hours for pain as needed but with a goal of 3 tablets a day. Every 6 hours is four tablets. The quantity is 90 because the doctor has written on the actual prescription not to exceed three times daily regardless of instructing me to take one every 6 hours. The math doesn't work. The prescription is for 23 days, not a month! I have enough to last until next month but only because swimming has caused me to decrease on my own. I thought that would be excellent news!
I don't know how to proceed. If I mention the HIPPA violations the doctor may boot me out of fear of a law suit or something. If I protest too much about being accused of being either an abuser or a dealer that too may be a red flag. BUT I AM NEITHER!!! I take my meds as prescribed and only as prescribed except that I am taking less and voluntarily agreed to a formal decrease. I maintained that I did not know why my on hand quantity was low and I tried to explain that the fill date was not the date that I picked it up. That suggested to the doctor even more of a problem. He did everything he could to trip me up and succeeded in confusing me. I don't know dates! I get telephone call reminders of appointments for both daughter and I, or my cell phone beeps and reminds me. I don't look at dates and actually thought we were further into August than we are.
I know that there are many that game the system and abuse it. I am not one of them. How can I proceed and still stay in a hard to find pain management program? I've done nothing wrong but have clearly been wronged. Instead of an appointment next month the main doctor made it for 2 months, denying me TREATMENT. Lesson learned: don't tell Doogie Houser you disagree with his medical assessment without his boss there also.