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Back Surgery and pain management

tigerlady46234ttigerlady46234 Posts: 1
edited 12/16/2015 - 2:50 AM in Pain Management
So I had a ua a couple months ago come back positive for cocaine!!!! I'm 57 and haven't done anything like that since my 20's!!! I was in such pain after a rhyzotomy facets was preformed that I almost went to the ER room but thought maybe I should call my pm first. I was rudely informed by the nurse that they couldn't have me running to the ER every time I was in pain. I informed her that I hadn't been to the ER since July when they referred me to an orthopedic Dr, who in turn after an MRI, x-ray and CT referred me to his pain management Dr. I was not informed until my next visit that I had a dirty ua which flabbergasted me. I explained to him there had to be a mistake, my daughter even told him that as we live together. She's 40 and we're Christians. What I'm getting to is he continued to treat me & give me injections but no pain meds!!!!' I've been to the ER since the discography every weekend for a month now because I couldn't take the pain. What I need to know is how to appeal this? Because now my job has me filing for long term disability which could affect the outcome of my decision. Once I decided on surgery and wasn't seeing the pm anymore, I asked my surgeon for pain meds which he of course gave me a prescription. When I called back for a refill they denied it and never told me why. He has withdrawn from my case, but hasn't informed me why. I haven't heard from him since I called about the refill. My PCM told me that what he should of done was call me back in as soon as he got the dirty ua and immediately done another test or even a blood test. I'd appreciate any help on how to appeal this. TIA

Welcome to Spine-Health

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I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

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--- Ron DiLauro, Spine-Health System Moderator : 12/16/15 08:48 est



  • And need to ask a couple questions first.....you were seeing a pm doctor , and had a failed ua that tested positive for cocaine, is that correct? Was this test an in office screening test or one sent out to the lab for confirmatory testing?
    Then you have had multiple trips to the ER for treatment for pain since the pm no longer prescribed pain meds for you? What was done at the ER for pain and we're you given any prescriptions for pain while there? How many visits have their been?
    Then you consulted with a surgeon, who also gave you pain medications , and when you called for a refill, they refused and withdrew from your care....

    If the information above is correct, your failing the ua is usually an automatic dismissal in pain management, and since you weren't immediately cut off, the ua must've been sent out for confirmatory testing before you were refused further pain meds.
    Multiple trips to the ER , is not a good idea, especially for a non emergency situation. If you were also given pain meds after your weekly visits, gives the appearance of drug seeking behavior, especially since your pm already refused to give you more pain medications. Filling prescriptions for opiates from other doctors, including ER's without the permission of the pm FIRST is another violation of the contract you have with your pm doctor.
    Then the situation with the surgeon, obtaining pain meds from yet another doctor, all reinforces the drug seeking behavior impressions, which is most likely why the surgeon said no and withdrew from your case.
    As far as the PCM saying you should be given a second test really has no bearing on this situation. Most pm offices use an in office screen , then send a ua out for confirmatory testing. Testing again now or even a few days later would prove nothing.

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