That looks close to the one I signed with my GP, who for now handles my pain medication.
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According to MRI impression readings: Chronic bilateral L5 pars defects with grade 1 spondylolisthesis at L5-S1 and marked bilateral foraminal stenosis.
After reviewing my records 10/17/08:X Ray DX via flexion/extension:
Severe DDD at L5/S1 w/ 2 mm of motion, 3 mm retrolisthesis at L4/L5.Spondylolisthesis due to Spondylosis.Time for a true 2nd opinion.
Gout in both feet, Type 2 Diabetes(diet exercise only), Bipolar 2, Panic Disorder, and Insomnia from hell.
Anyone notice you sign-away your basic human rights?:
" I agree to waive any applicable
privilege or right of privacy or confidentiality with respect to these
authorizations."
or that in a "contract", both sides state what they will do and in this case, the doc promises nothing except to kick ur azz out?
contract: "an exchange of promises between two or more parties"
Mt Dr has one and it is actually very good and informative. They need to do it to protect themselves. I am close to some of my Dr assistants and they have hundreds of calls and requests for medications and get bombarded with more and more patients who do not have chronic pain but an addiction. It really does hurt the people who need the services of pain mgmt not psychiatrists or addiction rehab
I don't have a pain specialist...but was wondering...do they really have you bring in your unused meds at EVERY visit?? Is that so they can count them to see where you are in your script? Just wondering cuz that would seem kind of intrusive...especially since we have probably ALL been there where we need to take maybe an extra or two a day...then even out the next.
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Bad back since early 1990's. Had a disectomy feb 07 at the L5 S1 level...LARGE rupture!!!!,DDD, disc buldges at levels L4 L5 L5S1 & T-11-12-- current massive sciatic pain. 38/female 2 duaghters 17 & 19. happily married for 20 years this aug.! Had 2ND Microdisectomy on Jan 15 2009...If possible...an EXTREMELY LARGER rupture at same level... Fentanyl 100mcgs and Norco for BT pain. Hope to wean down the patch soon. But not expecting miracles. Went to Post op appt.on March 10th and dr said that he had to not only remove the ruptured disc pieces, but go inside the disc space itself to retrieve broken up disc. Said I am NOT a good candidate for a fusion because I would need a double level, and he doesn't want to put me through that at my age (38)...but said I would be a great candidate for ADR (artificial disc replacement) and to wait about 3 mos after surgery to see where to go next.
Nov 2009
Had a Discogram done because the pain will not subside. It was very sucessful and showed two badly Degenerated discs and 4-5 grade tears in both (L4-5, L5-S1)
Have an appt. Dec 15th to see my surgeon and hopefully put in for the ADR... Am now told a fusion is likely..maybe its cuz I am older (39)? not sure.*crosses fingers and toes that its approved by my ins) But was told not to hold my breath and that we will prolly have to appeal it. I just dont want to live in this pain anymore
Had my Appt and was told my insurance will not cover ADR..so I opted for the fusion. I will be having it done on Jan 15th 2010. It will be a 360 double level (L4-5 L5-S1) w/ hardware and BMP. SCARED!!!!!
Jan 15th 2010:
Has a double level 360 fusion (L4-5, L5 S1) w/ Harware, BMP and disc decompression, Laminectomy. Healing now......
The place I went to did that to a point. If you always took in a few left over they did nothing. If you ended up using the meds up a day or two early all hell broke loose.Felt like what was said before "Guilty until proven innocent" and being sent to the principles office.
I have absoulutly NO RESPECT FOR PAIN MANAGEMENT. As one said on this stream of comments there first priority is to cover there ass, the second is to keep the addicts out, and the last is to treat you.
I'm not required to bring in unused pain medicine. I was surprised to read that you can have alcohol if you're not driving. On my contract, we're forbidden to have it at all. This is fine b/c you cannot mix alcohol with muscle relaxers or opoids, and I haven't had one drink in 3 years in fear of getting sick.
I had my surgery in Oct of 2007, I was fused from L3 to S1 with 8 screws two vertical rods and one horizontal rod. I attempted to return to work in Feb 08 with the Postal Service. It was not pleasant at all. On March 10 they had me unloading mail and a container of mail fell on me and knocked me to the floor. Since this I have torn muscle on my left side of my incision that seems to not be healing. I also injured my tailbone in this accident. I am still having pain and now have no reflex in my right leg. My surgeon won't see me because he does not want to be involved with worker comp with the government. I am not sure how to go about getting help and finding out that I don't have any reflex in my right leg is kind of scaring me. Is it normal to not have reflexs after a surgery like this? My pain management doctor is telling me I may have a failed fusion.
Hi charliesgurl~
I haven't had reflexes in either leg for about 10 years...several years before any of my surgeries...and now after having 3 of them I still don't. Don't know what this means...I have just gotten used to it...! I pray you can find a Dr. that will work with Workmans Comp...perhaps you could ask your former Dr if he can recommend a"good" surgeon that will...praying for you~
Dusty
new to site-dr wants to put those electrode stimulaters in back
I have 2 ruptured discs (L5-S1 I think) scoliosis, degenerative disc disease, and stenosis. I am not a candidate for surgery because I am allergic to steroids that are given during surgery and because I am also allergic to all pain medications. I have been in anaphylactic shock 4 times (3 of those were in the hospital because of medicine they gave me)and when I had a hip replaced I was put on morphine the first day. I had hallucinations and absolutely no pain relief. It was the worst day of my life. Finally they gave me codiene and valium and I was fine. Since then I have become allergic to codiene and to Tylenol, among other drugs, so it looks like the electrodes are all that is left.
I want someone to tell me they work wonderfully! Or if they don't work the first time they can keep trying until they do.
thanks so much!
i had to sign CONTROLLED SUBSTANCE AGREEMENT with dr. cant drink or use illegal drugs, randum urine test to see if you are takin meds and if your taking other street drugs, random pill counts. they can call you anytime for any reason and you have to go down that day and submit to test or pill count, but they are very good about it so far. usually there has to be a red flag. i also have to inform them right away if another dr, give meds. and i have to tell other dr,s that im on this and who im seeing.
i am a paramedic and for last number of years i have miss lots work due to my bulging disc l 4/5 .sometime it really gets me down just like to have a normal life again.
i am a paramedic and for last number of years i have miss lots work due to my bulging disc l 4/5 .sometime it really gets me down just like to have a normal life again.
I had surgery in oct fusion 1-4 with decompression and have a big problem with my pain both muscular and spinal the pain meds im on 15mscontin twice daily does not help me going back to therapy monday took a break cause of the pain there was popping with pain in my back does anyone have a clue?
Do you believe my dr had me sign a pain contract, then yesterday he said he is cutting back on giving people pain meds and will be slowly tapering people off pain meds , he doesnt want to loose his license. He told me to go the pain management clinic at the Hospital, unreal! I have documentation for having Fibromyalgia, degenerative disc disorder, spinal arthritis and other things. Currently i am taking percocet 10 mg maybe two times a day up to 4 times if i need it. And soma a muscle relaxer. Has anyone just been cut off by their Doctor. Isn't a dr supposed to help people keep from being in severe chronic pain? I guess i will have to go to the pain clinic or find another Doctor. I cant believe this crap, Its not like im a new patient with no documentation. I have been tried on other drugs and they either dont work or im allergic to them. When i find something that works for me, hes taking it away!
Unfortunately a lot of family doctors are turning their chronic pain patients over to a pain mgt clinic because of all the drug abuse and stigma related to prescribing narcotics. There is nothing wrong with going to a pain clinic- a lot of us do. In them, qualified doctors are able to treat you with many kinds of medications, spinal injections, or even try you out on neurostimulator or morpine pumps to control your pain. A PCP isn't able to do all this. Yes, we have to sign contracts and pee in a cup once in a while, but this protects them and keeps them open and it helps to build trust between them and us. Not everyone is a fan of this but this is a sign of the times we're living in. If you end up going to a pain clinic, you will have access to many treatments and hopefully it will benefit you and bring relief.
You can bet somewhere, somehow, there was an a-hole lawyer behind all of this. The damn doctors are running scared. They are afraid to do anything these days for fear of being sued. Why else would all of the ambulance chasers have the ads running non-stop on TV? I quit my pain doc because he became a robot. He said many times that he was worried and was no longer able to practice the "art" of helping people in pain. I finally jumped ship and went back to a doc I knew would be serious about treating me. He is aggressive and straight forward. The old doc gave me DOZENS of shots over the years. Then he would just shove a script for vicodin in my face and give me the bum's rush. Out of the office in less than 10 minutes... AFTER I waited an hour & a half PAST my appointment time to get in. He no longer wanted to treat patients that weren't "easy" fixes. I'm sure he could run 10 regular patients through the office in the same time it would take to spend the proper time with a chronic case. I liked the guy, but not enough to waste the rest of my life waiting for him to quit pissing around. Good riddance.
My back injury happened at work so I see a workmans comp doctor to check my progress.In the beginning he had me sign a pain management contract.I was unable to get controlled substances prescribed by any other doctor or be thrown into a pit leading straight to hell.
This led to major problems as I have serious chronic mental health issues and refractory rls/pld which have been treated with opioids/benzos or tranqs successfully for over 5 years with no abuse.
When I presented for my spondylolithesis and herniated disc with xray and MRI still I was looked at as suspicious.
I am a hard working,competent and had been a productive human being.
After I signed the contract I was prescribed percocet and then oxycontin but I lacked the other necessary drugs to keep me functioning.
Once I had my surgery my surgeon understood my situation and agreed to continue low dose opioids (vicodin) as I wanted to stay away from percocet.Unfortunately Im still in agony but I am able to get my necessary medications from my sleep specialist and psych. Which helps keep me from wallowing in depression and 5 out of 7 nights a week I am able to sleep.
The CT showed issues and now the doc has ordered an MRI and lidocaine injections as he believes the screws are causing my constant pain.
I fear the surgeon will be reluctant to continue helping control my pain as he is the only one willing at this time as I can not follow the rules of a pain contract by the workmans comp doctor.
It just really grinds my gears being in such discomfort and the doctors are skeptical and reluctant to help.
As a certified veterinary technician we have learned that if you do not limit pain you are limiting healing.I am sure the same goes for humans. I am just truly disappionted in the care and pain management as a whole. I just wish there were better drugs that didn't come with such a stigma and didn't suck the life out of yah.
My back injury happened at work so I see a workmans comp doctor to check my progress.In the beginning he had me sign a pain management contract.I was unable to get controlled substances prescribed by any other doctor or be thrown into a pit leading straight to hell.
This led to major problems as I have serious chronic mental health issues and refractory rls/pld which have been treated with opioids/benzos or tranqs successfully for over 5 years with no abuse.
When I presented for my spondylolithesis and herniated disc with xray and MRI still I was looked at as suspicious.
I am a hard working,competent and had been a productive human being.
After I signed the contract I was prescribed percocet and then oxycontin but I lacked the other necessary drugs to keep me functioning.
Once I had my surgery my surgeon understood my situation and agreed to continue low dose opioids (vicodin) as I wanted to stay away from percocet.Unfortunately Im still in agony but I am able to get my necessary medications from my sleep specialist and psych. Which helps keep me from wallowing in depression and 5 out of 7 nights a week I am able to sleep.
The CT showed issues and now the doc has ordered an MRI and lidocaine injections as he believes the screws are causing my constant pain.
I fear the surgeon will be reluctant to continue helping control my pain as he is the only one willing at this time as I can not follow the rules of a pain contract by the workmans comp doctor.
It just really grinds my gears being in such discomfort and the doctors are skeptical and reluctant to help.
As a certified veterinary technician we have learned that if you do not limit pain you are limiting healing.I am sure the same goes for humans. I am just truly disappionted in the care and pain management as a whole. I just wish there were better drugs that didn't come with such a stigma and didn't suck the life out of yah.
I had to sign a narcotics contract, for the first time this year, after using Vicodin for pain, since 2006, without abusing it.
These contracts do not protect patients at all, and I will treat my new relationship with my doctor as adversarial.
After years of being so careful with my medications I feel that I should switch over to a complete narcotic instead of using the codeine/acetaminophen combination, since a narcotics contract will be required in either case. No point in trying to manage without complete pain relief anymore. If I will be treated like a drug addict, I'm not going to worry about it anymore.
On a more proactive note, as anyone tried presenting their own medication contract to a doctor? I'd like to create one that incorporates a pain patient's bill of rights!
These "contracts" are just a way to guarantee a high rate of failure with little regard for patients rights.The amount of false positives is staggering.YES,there are abusers,but w/ no recourse to defend yourself if it occurs.Then trying to find another PM after being kicked out is even harder, with a possible red flag to boot.Like always, honest people suffer more in the long run.
_____________
According to MRI impression readings: Chronic bilateral L5 pars defects with grade 1 spondylolisthesis at L5-S1 and marked bilateral foraminal stenosis.
After reviewing my records 10/17/08:X Ray DX via flexion/extension:
Severe DDD at L5/S1 w/ 2 mm of motion, 3 mm retrolisthesis at L4/L5.Spondylolisthesis due to Spondylosis.Time for a true 2nd opinion.
Gout in both feet, Type 2 Diabetes(diet exercise only), Bipolar 2, Panic Disorder, and Insomnia from hell.
When presented with the contract I went through it with the doctor, before signing it. I made sure to note that any testing will be limited to blood tests to check liver function (acetaminophen), and made a couple of other notes that the doctor then initialed and we BOTH signed.
While I have yet to use marijuana-medical or otherwise, but will now look into it since it is legal in my state and it's obvious the medical community thinks less of me regardless of my history, I've never had a urine test that wasn't justified by the presence of infection and have never submitted a sample to get a job or for any other "monitoring" exercise.
It is an insult, plain and simple. One should NEVER sign a contract of any sort, without going through the finer points and making adjustments where warranted.
I'll tell you right now who is pushing this, the DEA. They scare the doctors by revoking their license for prescribing too much pain medication. It's not my fault that there are abusers out there. We also have a double standard, if a police officer or high ranking politician needs pain medication they are not questioned. This country is forcing people to have an us against them mentality. It's the have's against the have nots. This is not a good way of treating people in a so called democracy. Punish the people who are abusing and leave the rest of us alone, we have enough problems as it is. This is what you get when you have idiots running the country.
I'll tell you right now who is pushing this, the DEA. They scare the doctors by revoking their license for prescribing too much pain medication. It's not my fault that there are abusers out there. We also have a double standard, if a police officer or high ranking politician needs pain medication they are not questioned. This country is forcing people to have an us against them mentality. It's the have's against the have nots. This is not a good way of treating people in a so called democracy. Punish the people who are abusing and leave the rest of us alone, we have enough problems as it is. This is what you get when you have idiots running the country.
I agree with you that actions of the DEA is what is prompting a lot of doctors to resort to "contracts."
I respectfully disagree with your statement about law enforcement! There are a lot us that are law enforcement officers on this site (and I am federal by the way), and we too have to SIGN THEM! Please do not lump all into such a broad category, as that is just like saying because others are abusing that are between 18 and 90 and have x color hair are, so you must be too? One of the predicate offenses I enforce (cross designated)is the interdiction of illegal smuggling of all manner of drugs - and even I don't lump people as such.
Your closing sentence, couldn't agree more. Take care and stay safe.
Brenda
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ACDF C5/6 2/08 - C6/7 8/09 - Neuropathy right arm and both legs - Cervical Myelopathy 10-11-11 PCF C4-T2 - C4-C7 Lamies; Surgery #2 Emergent removal large Hematoma!
L2/3/4 & L5/S1 fusions and Laminectomy on hold till neck fused. For the full "Cliff Notes" please click my name! "Life can knock us down, but we can choose whether or not to get up!!"
I'll apologize for lumping groups together, you're right. Sometimes I get frustrated and go off on a tangent, (just ask my wife). We are all in the same boat together. Really didn't mean to offend anybody, I worked for twenty years and don't have any income, I'm angry with this country right now.
can seem unreasonable. Sure, with all the talk about pain medications in the news, its no wonder that doctors need to be careful.
But being careful and refusing to write scripts for a patient is something else.
There are many of us that need a good amount of narcotic pain medication to see us through the day.
Then when that situation becomes compromised, the doctor doesnt like your set of medications and/or wants to try something different.
Everyone has to answer to someone. The doctors need to answer to their review boards as to why or why not did they prescribe various pain medications.
Its an up hill struggle to get to the right medium so that your needs are addressed as well as your doctors
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Ron DiLauro Ron's Story Suicide Hotline Alcohol and Drug Abuse Arthritis _________________________________________ rdilauro@gmail.com SH Administrators = dilauro or tamtam SH Moderator Team =
haglandc , Numbskull , Liz, or Neck of Steel Cindy "In his eyes we're all the same Someday we'll all have perfect wings, Don't laugh at me." "That there's none so blind as those who will not see."
The information provided by members of Spine-Health should never be considered as formal medical advice. It is recommendations based on member's personal experiences only.
This can vary from person to person, so do not take comments as medical facts or rules
Good Morning~
I signed my pain med contract years ago and have never, ever heard of a pill count. Now, my Dr will from time to time make me do a urine test to make sure I am taking the drugs and not selling them. Also...one time when he changed me from my Percocet to a Fentanyl Patch I had to give him my unused percocet before he would give me the fentanyl script. I wouldn't of had to do this if I had chosen to wait until the script ran out but I wanted the patch right away. I really made every one in the office mad as when I brought the pills in I made them do a count and give me a receipt for how many pills I had turned in. They said they had never had a patient do this...well...I am sorry, but I don't intend to turn in x-amount and then they disappear...I mean for one thing someone there could turn around and sell them and tell the Dr I hadn't turned them in! The main thing that bothered me about my contract was that no matter what I can't get drugs anywhere else...I mean what if I am in a serious car wreck or something??? Confusing to say the least!
Dusty
There is no standard of practice that says doctors have to treat all patients the same, regardless of whether they have signs of misuse of opiates or do not. In fact, standards of practice say exactly the opposite.
I do not want to have to be treated with suspicion when I am a tough cookie and have never once misused my medications. Yes, I have signed a contract and have taken an entrance test. Past that, I'd hope doctors would base their actions on my actions. Until there are signs that things have changed, show some trust.
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11/2007- equestrian accident. Fractured L2, 90% loss of height, retropulsion, bone fragments. Moderate-severe chronic pain treated with epidurals, facet ablation, medication.
12/15/2010- L2 corpectomy and L1-L3 fusion via thoracotomy. Posterior plates installed next day. Total surgery time 9 hours!
and it seems like every 2 years I get the urine test.I don't care,I am not doing anything wrong and it is stated in my contract.I also have to bring all my meds to each and every appointment.My p.m. left and I followed him to his new office.At the old place,I took in "old" meds from being switched to new ones and they counted,made me sign, they signed and destroyed them in front of me.That was wierd!!
I have had other surgeries not due to my spine and given narcotics.Just let your pm doc know about it,a simple message on the nurse line,and that's it.It's tough all over for everyone.I guess I've just been in this so long,nothing surprises me anymore.Injured in 1997
never, ever give up.....ddd,chronic low back pain,(tear in annulus of S1),L5-L4 L4-L3 bone spurs with bulging disc,Fusion recommended,2007(not done),.Been thru tons of p.t. and treatments.Spinal Cord Stimulator with (T7 laminectomy Aug 2008, done in 2nd surgery to correct placement) Now on pain meds,Fentanyl Patch & oxycodone asked for reduction in meds due to obstruction of small intestine but....never ever give up!
I signed a pain contract with my PM in Octoboer 2010. I have been on Vicodin and Soma since April of 2010. I just recently decided to have a more experienced surgeon put in my SCS. My doctor's office called a few days later and said it would be unethical for him to treat me if I was going to allow another doctor to do the surgery. They refused to refill my meds with no warning. I've never broken the contract. I've never abused my meds, if anything I typically go over the time allowed for the presc. How is it that doctors are just allowed to dump you when the realise they can't make the most money off of you? How is it ethical to drop a patient off their meds with no safe withdrawl? No recommendation for another doc? NOTHING! I understood the need for the contract with them. What about the contract with me? Who makes them abide by the rules?
When I started a pain management in February 2010 I had to sign a very similar contract. I felt like I signed my life away. I basically gave up my rights to give input on my own treatment.
I was 20 at that time so right off the bat I was labeled as a possible teenage drug seeker. I was taken off the percocet that my PCP gave me and switched to Norco. I also was told to start PT (they had their own private PT in the same office).
After about a month or 2 of me complaining that PT was very painful, I was taken off Norco and given MS Contin 15mg twice a day.
That dosage eventually got increased to 3 times a day, then to 30mg twice a day, for a total of 60mg a day. Throughout the months of him prescribing me MS Contin I told him repeatedly that I refuse to take them when I have to work. He always just shrugged it off.
Then one day he started making his new PA see me (apparently he didn't want to be bothered with me). By then I had stopped PT due to increasing pain. Long story short: after 2 appointments with his PA (and me still telling them I refused to take the medication when I had to work) the PA made me flush more than half of my prescription down the toilet (which I had paid $90 for) and I was basically accused of being a drug dealer.
I definitely was not selling or sharing my medication and the random drug tests throughout my treatment should have showed them so. In July 2010 the PA just discontinued medication. She prescribed 7 15mg MS Contin to ween me off from 60mg a day. She said that since I wasn't taking it properly I wouldn't have side effects. She was very wrong. I had horrible withdrawal symptoms.
So the point of this story is: if you don't comply with every aspect of your treatment in pain management , even if you disagree with the treatment, too bad because you signed a contract.
Oh and a little side note: the reason the PT was so painful was because they were treating the wrong problem. When I asked if they could give one injection to confirm their diagnosis of SI disfunction (it only takes one epidural to rule in/out) he said there was no need because he was sure it was the SI joint.
Now after being treated by a few spine specialists since August, it was suggested I start pain management again. I don't think I'm signing that contract this time!
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21 year old girl. DDD at L4-L5 and L5-S1. L5 is a transitional vertebrae. L4-L5 is torn and slightly herniated. 360 lumbar fusion on July 25th.
You dont sighn contract you dont get treated. Its that simple, If they are trearing you then you cant treat yourself and take medicarions as you want.
If you did not want to take the meds when you are at work then you set it aside for back up meds if you have to. But if you tell dr you refuse to take it then he feels why are you there if you wont let him treat you as he feels he needs to.
If you can get by not taking it while at work thats fine. Thats just a plus for you and dr dont even care about that. Not even worth bringing it up,
But once a patient gets too complicated following instructions dr can get frustrated also and can releise you to find care somewhere else.
In my 20 years i never had a pill count.
When a person has surgery they have to sighn a form. Sure you can refuse it but good luck geting a dr to treat ya,
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L4 L5 disc replacement in 2004=causing nerve damage'Flexicore disc. 2006 fusion same level leaving adr in. Fusion did nothing to releive the nerve pain.Pain clinic=every injection procedure avalable inc,razadamy, ablation, nerve stimulater trial,morphine pump trial all failed. Pain can be described as burning pain in lower spine penetrating in to left buttock,down left leg. Refuse to take lyrica or nuorontin do to its side effect,Leaving me with norco,valume,and flexiril at night.Which these medications only help with the muscle aches and stiffnes does nothing for the nerve pain from the nerve damage sustained from the adr surgery.Coming up nov.19th 2009 Lami, and hardware removal from fusion,for hardware just causing more pain in other areas.Hardware block comfirmed hardware is also causing pain in diferent area aside from the severe nerve pain on left side.Emg showed some posible problem above surgery are at L3 L4.
My Dr explained to me that because so many people are abusing the drugs, he's required to do all of this paperwork to protect both myself & his office. My dr listens to me everytime I have an appt,never treats me like I have a drug problem. I am always worried he'll think I'm just looking for more drugs and he keeps telling me not to worry, the medications are necessary and as long as him & I continue to have good dialog about how I feel, he can help me. I currently take Oxycontin and Vicodin for breakthrough pain for cervical issues. Reading many of the comments here, I feel bad for those who have dr's that are not listening to them or helping them. Hopefully, those of you in that position will find the dr that understands and doesn't make you feel like you are an addict. I have never had to bring in my containers for a "count". I have never received a random call for screening. My random screening was done when I went in for a "sick" appointment that I had scheduled.
This trust thing between doctors and patients has to improve. My doctor's office staff makes me wait a LONG time and they look at me cross eyed when I need a refill, the pharmacists aren't any better. Oh yea, they make me the first or last visit of the day. Guess I need to be segregated from the rest of his patients. My doctor is pretty cool, but the urine tests and pill counts are getting old. Anyway he wants me to join something called the patient physician trust partnership. Anyone ever had to do this? I just don't get any of this, don't we suffer enough?
That looks close to the one I signed with my GP, who for now handles my pain medication.
According to MRI impression readings: Chronic bilateral L5 pars defects with grade 1 spondylolisthesis at L5-S1 and marked bilateral foraminal stenosis.
After reviewing my records 10/17/08:X Ray DX via flexion/extension:
Severe DDD at L5/S1 w/ 2 mm of motion, 3 mm retrolisthesis at L4/L5.Spondylolisthesis due to Spondylosis.Time for a true 2nd opinion.
Gout in both feet, Type 2 Diabetes(diet exercise only), Bipolar 2, Panic Disorder, and Insomnia from hell.
Meds: Norco, Wellbutrin XL(breaktime), Ativan(as needed), Ambien(on call), Zyprexa(manic rides gone bad)
I have been seeing a PM Dr. for about 6 years now and I have never even seen a contract like that. I hear all about them, just never seen one.
Someone should have proof read that pain medicine contract!!!!! Looks like a ten year old wrote that.
"Guilty until proven innocent".
Anyone notice you sign-away your basic human rights?:
" I agree to waive any applicable
privilege or right of privacy or confidentiality with respect to these
authorizations."
or that in a "contract", both sides state what they will do and in this case, the doc promises nothing except to kick ur azz out?
contract: "an exchange of promises between two or more parties"
Mt Dr has one and it is actually very good and informative. They need to do it to protect themselves. I am close to some of my Dr assistants and they have hundreds of calls and requests for medications and get bombarded with more and more patients who do not have chronic pain but an addiction. It really does hurt the people who need the services of pain mgmt not psychiatrists or addiction rehab
I don't have a pain specialist...but was wondering...do they really have you bring in your unused meds at EVERY visit?? Is that so they can count them to see where you are in your script? Just wondering cuz that would seem kind of intrusive...especially since we have probably ALL been there where we need to take maybe an extra or two a day...then even out the next.
Bad back since early 1990's. Had a disectomy feb 07 at the L5 S1 level...LARGE rupture!!!!,DDD, disc buldges at levels L4 L5 L5S1 & T-11-12-- current massive sciatic pain. 38/female 2 duaghters 17 & 19. happily married for 20 years this aug.! Had 2ND Microdisectomy on Jan 15 2009...If possible...an EXTREMELY LARGER rupture at same level... Fentanyl 100mcgs and Norco for BT pain. Hope to wean down the patch soon. But not expecting miracles. Went to Post op appt.on March 10th and dr said that he had to not only remove the ruptured disc pieces, but go inside the disc space itself to retrieve broken up disc. Said I am NOT a good candidate for a fusion because I would need a double level, and he doesn't want to put me through that at my age (38)...but said I would be a great candidate for ADR (artificial disc replacement) and to wait about 3 mos after surgery to see where to go next.
Nov 2009
Had a Discogram done because the pain will not subside. It was very sucessful and showed two badly Degenerated discs and 4-5 grade tears in both (L4-5, L5-S1)
Have an appt. Dec 15th to see my surgeon and hopefully put in for the ADR... Am now told a fusion is likely..maybe its cuz I am older (39)? not sure.*crosses fingers and toes that its approved by my ins) But was told not to hold my breath and that we will prolly have to appeal it. I just dont want to live in this pain anymore
Had my Appt and was told my insurance will not cover ADR..so I opted for the fusion. I will be having it done on Jan 15th 2010. It will be a 360 double level (L4-5 L5-S1) w/ hardware and BMP. SCARED!!!!!
Jan 15th 2010:
Has a double level 360 fusion (L4-5, L5 S1) w/ Harware, BMP and disc decompression, Laminectomy. Healing now......
The place I went to did that to a point. If you always took in a few left over they did nothing. If you ended up using the meds up a day or two early all hell broke loose.Felt like what was said before "Guilty until proven innocent" and being sent to the principles office.
I have absoulutly NO RESPECT FOR PAIN MANAGEMENT. As one said on this stream of comments there first priority is to cover there ass, the second is to keep the addicts out, and the last is to treat you.
I'm not required to bring in unused pain medicine. I was surprised to read that you can have alcohol if you're not driving. On my contract, we're forbidden to have it at all. This is fine b/c you cannot mix alcohol with muscle relaxers or opoids, and I haven't had one drink in 3 years in fear of getting sick.
PLS,nerve damage,facet arthropathy,severe DDD,DJD,scar tissue; Fibro
Back Surgeries: Microdiscectomy/ laminectomy,2 level TLIF/Laminectomy w/ hardware, Synchromed infusion pump
Meds: Dilaudid,Oxycodone,Lyrica,Robaxin,Cymbalta,Elavil,Plaquenil
Spineys Rule!
I had my surgery in Oct of 2007, I was fused from L3 to S1 with 8 screws two vertical rods and one horizontal rod. I attempted to return to work in Feb 08 with the Postal Service. It was not pleasant at all. On March 10 they had me unloading mail and a container of mail fell on me and knocked me to the floor. Since this I have torn muscle on my left side of my incision that seems to not be healing. I also injured my tailbone in this accident. I am still having pain and now have no reflex in my right leg. My surgeon won't see me because he does not want to be involved with worker comp with the government. I am not sure how to go about getting help and finding out that I don't have any reflex in my right leg is kind of scaring me. Is it normal to not have reflexs after a surgery like this? My pain management doctor is telling me I may have a failed fusion.
Hi charliesgurl~
I haven't had reflexes in either leg for about 10 years...several years before any of my surgeries...and now after having 3 of them I still don't. Don't know what this means...I have just gotten used to it...! I pray you can find a Dr. that will work with Workmans Comp...perhaps you could ask your former Dr if he can recommend a"good" surgeon that will...praying for you~
Dusty
"It's easy to be brave from a distance."
I have 2 ruptured discs (L5-S1 I think) scoliosis, degenerative disc disease, and stenosis. I am not a candidate for surgery because I am allergic to steroids that are given during surgery and because I am also allergic to all pain medications. I have been in anaphylactic shock 4 times (3 of those were in the hospital because of medicine they gave me)and when I had a hip replaced I was put on morphine the first day. I had hallucinations and absolutely no pain relief. It was the worst day of my life. Finally they gave me codiene and valium and I was fine. Since then I have become allergic to codiene and to Tylenol, among other drugs, so it looks like the electrodes are all that is left.
I want someone to tell me they work wonderfully! Or if they don't work the first time they can keep trying until they do.
thanks so much!
i had to sign CONTROLLED SUBSTANCE AGREEMENT with dr. cant drink or use illegal drugs, randum urine test to see if you are takin meds and if your taking other street drugs, random pill counts. they can call you anytime for any reason and you have to go down that day and submit to test or pill count, but they are very good about it so far. usually there has to be a red flag. i also have to inform them right away if another dr, give meds. and i have to tell other dr,s that im on this and who im seeing.
i am a paramedic and for last number of years i have miss lots work due to my bulging disc l 4/5 .sometime it really gets me down just like to have a normal life again.
i am a paramedic and for last number of years i have miss lots work due to my bulging disc l 4/5 .sometime it really gets me down just like to have a normal life again.
i go the the link.it's really usefull link .thanks for the link
I had surgery in oct fusion 1-4 with decompression and have a big problem with my pain both muscular and spinal the pain meds im on 15mscontin twice daily does not help me going back to therapy monday took a break cause of the pain there was popping with pain in my back does anyone have a clue?
pls help
Do you believe my dr had me sign a pain contract, then yesterday he said he is cutting back on giving people pain meds and will be slowly tapering people off pain meds , he doesnt want to loose his license. He told me to go the pain management clinic at the Hospital, unreal! I have documentation for having Fibromyalgia, degenerative disc disorder, spinal arthritis and other things. Currently i am taking percocet 10 mg maybe two times a day up to 4 times if i need it. And soma a muscle relaxer. Has anyone just been cut off by their Doctor. Isn't a dr supposed to help people keep from being in severe chronic pain? I guess i will have to go to the pain clinic or find another Doctor. I cant believe this crap, Its not like im a new patient with no documentation. I have been tried on other drugs and they either dont work or im allergic to them. When i find something that works for me, hes taking it away!
Unfortunately a lot of family doctors are turning their chronic pain patients over to a pain mgt clinic because of all the drug abuse and stigma related to prescribing narcotics. There is nothing wrong with going to a pain clinic- a lot of us do. In them, qualified doctors are able to treat you with many kinds of medications, spinal injections, or even try you out on neurostimulator or morpine pumps to control your pain. A PCP isn't able to do all this. Yes, we have to sign contracts and pee in a cup once in a while, but this protects them and keeps them open and it helps to build trust between them and us. Not everyone is a fan of this but this is a sign of the times we're living in. If you end up going to a pain clinic, you will have access to many treatments and hopefully it will benefit you and bring relief.
PLS,nerve damage,facet arthropathy,severe DDD,DJD,scar tissue; Fibro
Back Surgeries: Microdiscectomy/ laminectomy,2 level TLIF/Laminectomy w/ hardware, Synchromed infusion pump
Meds: Dilaudid,Oxycodone,Lyrica,Robaxin,Cymbalta,Elavil,Plaquenil
Spineys Rule!
You can bet somewhere, somehow, there was an a-hole lawyer behind all of this. The damn doctors are running scared. They are afraid to do anything these days for fear of being sued. Why else would all of the ambulance chasers have the ads running non-stop on TV? I quit my pain doc because he became a robot. He said many times that he was worried and was no longer able to practice the "art" of helping people in pain. I finally jumped ship and went back to a doc I knew would be serious about treating me. He is aggressive and straight forward. The old doc gave me DOZENS of shots over the years. Then he would just shove a script for vicodin in my face and give me the bum's rush. Out of the office in less than 10 minutes... AFTER I waited an hour & a half PAST my appointment time to get in. He no longer wanted to treat patients that weren't "easy" fixes. I'm sure he could run 10 regular patients through the office in the same time it would take to spend the proper time with a chronic case. I liked the guy, but not enough to waste the rest of my life waiting for him to quit pissing around. Good riddance.
Heavy is the head that wears the crown.
My back injury happened at work so I see a workmans comp doctor to check my progress.In the beginning he had me sign a pain management contract.I was unable to get controlled substances prescribed by any other doctor or be thrown into a pit leading straight to hell.
This led to major problems as I have serious chronic mental health issues and refractory rls/pld which have been treated with opioids/benzos or tranqs successfully for over 5 years with no abuse.
When I presented for my spondylolithesis and herniated disc with xray and MRI still I was looked at as suspicious.
I am a hard working,competent and had been a productive human being.
After I signed the contract I was prescribed percocet and then oxycontin but I lacked the other necessary drugs to keep me functioning.
Once I had my surgery my surgeon understood my situation and agreed to continue low dose opioids (vicodin) as I wanted to stay away from percocet.Unfortunately Im still in agony but I am able to get my necessary medications from my sleep specialist and psych. Which helps keep me from wallowing in depression and 5 out of 7 nights a week I am able to sleep.
The CT showed issues and now the doc has ordered an MRI and lidocaine injections as he believes the screws are causing my constant pain.
I fear the surgeon will be reluctant to continue helping control my pain as he is the only one willing at this time as I can not follow the rules of a pain contract by the workmans comp doctor.
It just really grinds my gears being in such discomfort and the doctors are skeptical and reluctant to help.
As a certified veterinary technician we have learned that if you do not limit pain you are limiting healing.I am sure the same goes for humans. I am just truly disappionted in the care and pain management as a whole. I just wish there were better drugs that didn't come with such a stigma and didn't suck the life out of yah.
My back injury happened at work so I see a workmans comp doctor to check my progress.In the beginning he had me sign a pain management contract.I was unable to get controlled substances prescribed by any other doctor or be thrown into a pit leading straight to hell.
This led to major problems as I have serious chronic mental health issues and refractory rls/pld which have been treated with opioids/benzos or tranqs successfully for over 5 years with no abuse.
When I presented for my spondylolithesis and herniated disc with xray and MRI still I was looked at as suspicious.
I am a hard working,competent and had been a productive human being.
After I signed the contract I was prescribed percocet and then oxycontin but I lacked the other necessary drugs to keep me functioning.
Once I had my surgery my surgeon understood my situation and agreed to continue low dose opioids (vicodin) as I wanted to stay away from percocet.Unfortunately Im still in agony but I am able to get my necessary medications from my sleep specialist and psych. Which helps keep me from wallowing in depression and 5 out of 7 nights a week I am able to sleep.
The CT showed issues and now the doc has ordered an MRI and lidocaine injections as he believes the screws are causing my constant pain.
I fear the surgeon will be reluctant to continue helping control my pain as he is the only one willing at this time as I can not follow the rules of a pain contract by the workmans comp doctor.
It just really grinds my gears being in such discomfort and the doctors are skeptical and reluctant to help.
As a certified veterinary technician we have learned that if you do not limit pain you are limiting healing.I am sure the same goes for humans. I am just truly disappionted in the care and pain management as a whole. I just wish there were better drugs that didn't come with such a stigma and didn't suck the life out of yah.
I had to sign a narcotics contract, for the first time this year, after using Vicodin for pain, since 2006, without abusing it.
These contracts do not protect patients at all, and I will treat my new relationship with my doctor as adversarial.
After years of being so careful with my medications I feel that I should switch over to a complete narcotic instead of using the codeine/acetaminophen combination, since a narcotics contract will be required in either case. No point in trying to manage without complete pain relief anymore. If I will be treated like a drug addict, I'm not going to worry about it anymore.
On a more proactive note, as anyone tried presenting their own medication contract to a doctor? I'd like to create one that incorporates a pain patient's bill of rights!
These "contracts" are just a way to guarantee a high rate of failure with little regard for patients rights.The amount of false positives is staggering.YES,there are abusers,but w/ no recourse to defend yourself if it occurs.Then trying to find another PM after being kicked out is even harder, with a possible red flag to boot.Like always, honest people suffer more in the long run.
According to MRI impression readings: Chronic bilateral L5 pars defects with grade 1 spondylolisthesis at L5-S1 and marked bilateral foraminal stenosis.
After reviewing my records 10/17/08:X Ray DX via flexion/extension:
Severe DDD at L5/S1 w/ 2 mm of motion, 3 mm retrolisthesis at L4/L5.Spondylolisthesis due to Spondylosis.Time for a true 2nd opinion.
Gout in both feet, Type 2 Diabetes(diet exercise only), Bipolar 2, Panic Disorder, and Insomnia from hell.
Meds: Norco, Wellbutrin XL(breaktime), Ativan(as needed), Ambien(on call), Zyprexa(manic rides gone bad)
When presented with the contract I went through it with the doctor, before signing it. I made sure to note that any testing will be limited to blood tests to check liver function (acetaminophen), and made a couple of other notes that the doctor then initialed and we BOTH signed.
While I have yet to use marijuana-medical or otherwise, but will now look into it since it is legal in my state and it's obvious the medical community thinks less of me regardless of my history, I've never had a urine test that wasn't justified by the presence of infection and have never submitted a sample to get a job or for any other "monitoring" exercise.
It is an insult, plain and simple. One should NEVER sign a contract of any sort, without going through the finer points and making adjustments where warranted.
I'll tell you right now who is pushing this, the DEA. They scare the doctors by revoking their license for prescribing too much pain medication. It's not my fault that there are abusers out there. We also have a double standard, if a police officer or high ranking politician needs pain medication they are not questioned. This country is forcing people to have an us against them mentality. It's the have's against the have nots. This is not a good way of treating people in a so called democracy. Punish the people who are abusing and leave the rest of us alone, we have enough problems as it is. This is what you get when you have idiots running the country.
I agree with you that actions of the DEA is what is prompting a lot of doctors to resort to "contracts."
I respectfully disagree with your statement about law enforcement! There are a lot us that are law enforcement officers on this site (and I am federal by the way), and we too have to SIGN THEM! Please do not lump all into such a broad category, as that is just like saying because others are abusing that are between 18 and 90 and have x color hair are, so you must be too? One of the predicate offenses I enforce (cross designated)is the interdiction of illegal smuggling of all manner of drugs - and even I don't lump people as such.
Your closing sentence, couldn't agree more. Take care and stay safe.
Brenda
ACDF C5/6 2/08 - C6/7 8/09 - Neuropathy right arm and both legs - Cervical Myelopathy
10-11-11 PCF C4-T2 - C4-C7 Lamies; Surgery #2 Emergent removal large Hematoma!
L2/3/4 & L5/S1 fusions and Laminectomy on hold till neck fused.
For the full "Cliff Notes" please click my name!
"Life can knock us down, but we can choose whether or not to get up!!"
I'll apologize for lumping groups together, you're right. Sometimes I get frustrated and go off on a tangent, (just ask my wife). We are all in the same boat together. Really didn't mean to offend anybody, I worked for twenty years and don't have any income, I'm angry with this country right now.
can seem unreasonable. Sure, with all the talk about pain medications in the news, its no wonder that doctors need to be careful.
But being careful and refusing to write scripts for a patient is something else.
There are many of us that need a good amount of narcotic pain medication to see us through the day.
Then when that situation becomes compromised, the doctor doesnt like your set of medications and/or wants to try something different.
Everyone has to answer to someone. The doctors need to answer to their review boards as to why or why not did they prescribe various pain medications.
Its an up hill struggle to get to the right medium so that your needs are addressed as well as your doctors
Ron DiLauro
Ron's Story
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They said they had never had a patient do this...well...I am sorry, but I don't intend to turn in x-amount and then they disappear...I mean for one thing someone there could turn around and sell them and tell the Dr I hadn't turned them in! The main thing that bothered me about my contract was that no matter what I can't get drugs anywhere else...I mean what if I am in a serious car wreck or something??? Confusing to say the least!
I signed my pain med contract years ago and have never, ever heard of a pill count. Now, my Dr will from time to time make me do a urine test to make sure I am taking the drugs and not selling them. Also...one time when he changed me from my Percocet to a Fentanyl Patch I had to give him my unused percocet before he would give me the fentanyl script. I wouldn't of had to do this if I had chosen to wait until the script ran out but I wanted the patch right away. I really made every one in the office mad as when I brought the pills in I made them do a count and give me a receipt for how many pills I had turned in.
Dusty
"It's easy to be brave from a distance."
There is no standard of practice that says doctors have to treat all patients the same, regardless of whether they have signs of misuse of opiates or do not. In fact, standards of practice say exactly the opposite.
I do not want to have to be treated with suspicion when I am a tough cookie and have never once misused my medications. Yes, I have signed a contract and have taken an entrance test. Past that, I'd hope doctors would base their actions on my actions. Until there are signs that things have changed, show some trust.
11/2007- equestrian accident. Fractured L2, 90% loss of height, retropulsion, bone fragments. Moderate-severe chronic pain treated with epidurals, facet ablation, medication.
12/15/2010- L2 corpectomy and L1-L3 fusion via thoracotomy. Posterior plates installed next day. Total surgery time 9 hours!
and it seems like every 2 years I get the urine test.I don't care,I am not doing anything wrong and it is stated in my contract.I also have to bring all my meds to each and every appointment.My p.m. left and I followed him to his new office.At the old place,I took in "old" meds from being switched to new ones and they counted,made me sign, they signed and destroyed them in front of me.That was wierd!!
I have had other surgeries not due to my spine and given narcotics.Just let your pm doc know about it,a simple message on the nurse line,and that's it.It's tough all over for everyone.I guess I've just been in this so long,nothing surprises me anymore.Injured in 1997
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never, ever give up.....ddd,chronic low back pain,(tear in annulus of S1),L5-L4 L4-L3 bone spurs with bulging disc,Fusion recommended,2007(not done),.Been thru tons of p.t. and treatments.Spinal Cord Stimulator with (T7 laminectomy Aug 2008, done in 2nd surgery to correct placement) Now on pain meds,Fentanyl Patch & oxycodone asked for reduction in meds due to obstruction of small intestine but....never ever give up!
I signed a pain contract with my PM in Octoboer 2010. I have been on Vicodin and Soma since April of 2010. I just recently decided to have a more experienced surgeon put in my SCS. My doctor's office called a few days later and said it would be unethical for him to treat me if I was going to allow another doctor to do the surgery. They refused to refill my meds with no warning. I've never broken the contract. I've never abused my meds, if anything I typically go over the time allowed for the presc. How is it that doctors are just allowed to dump you when the realise they can't make the most money off of you? How is it ethical to drop a patient off their meds with no safe withdrawl? No recommendation for another doc? NOTHING! I understood the need for the contract with them. What about the contract with me? Who makes them abide by the rules?
When I started a pain management in February 2010 I had to sign a very similar contract. I felt like I signed my life away. I basically gave up my rights to give input on my own treatment.
I was 20 at that time so right off the bat I was labeled as a possible teenage drug seeker. I was taken off the percocet that my PCP gave me and switched to Norco. I also was told to start PT (they had their own private PT in the same office).
After about a month or 2 of me complaining that PT was very painful, I was taken off Norco and given MS Contin 15mg twice a day.
That dosage eventually got increased to 3 times a day, then to 30mg twice a day, for a total of 60mg a day. Throughout the months of him prescribing me MS Contin I told him repeatedly that I refuse to take them when I have to work. He always just shrugged it off.
Then one day he started making his new PA see me (apparently he didn't want to be bothered with me). By then I had stopped PT due to increasing pain. Long story short: after 2 appointments with his PA (and me still telling them I refused to take the medication when I had to work) the PA made me flush more than half of my prescription down the toilet (which I had paid $90 for) and I was basically accused of being a drug dealer.
I definitely was not selling or sharing my medication and the random drug tests throughout my treatment should have showed them so. In July 2010 the PA just discontinued medication. She prescribed 7 15mg MS Contin to ween me off from 60mg a day. She said that since I wasn't taking it properly I wouldn't have side effects. She was very wrong. I had horrible withdrawal symptoms.
So the point of this story is: if you don't comply with every aspect of your treatment in pain management , even if you disagree with the treatment, too bad because you signed a contract.
Oh and a little side note: the reason the PT was so painful was because they were treating the wrong problem. When I asked if they could give one injection to confirm their diagnosis of SI disfunction (it only takes one epidural to rule in/out) he said there was no need because he was sure it was the SI joint.
Now after being treated by a few spine specialists since August, it was suggested I start pain management again. I don't think I'm signing that contract this time!
21 year old girl. DDD at L4-L5 and L5-S1. L5 is a transitional vertebrae. L4-L5 is torn and slightly herniated. 360 lumbar fusion on July 25th.
You dont sighn contract you dont get treated. Its that simple, If they are trearing you then you cant treat yourself and take medicarions as you want.
If you did not want to take the meds when you are at work then you set it aside for back up meds if you have to. But if you tell dr you refuse to take it then he feels why are you there if you wont let him treat you as he feels he needs to.
If you can get by not taking it while at work thats fine. Thats just a plus for you and dr dont even care about that. Not even worth bringing it up,
But once a patient gets too complicated following instructions dr can get frustrated also and can releise you to find care somewhere else.
In my 20 years i never had a pill count.
When a person has surgery they have to sighn a form. Sure you can refuse it but good luck geting a dr to treat ya,
L4 L5 disc replacement in 2004=causing nerve damage'Flexicore disc. 2006 fusion same level leaving adr in. Fusion did nothing to releive the nerve pain.Pain clinic=every injection procedure avalable inc,razadamy, ablation, nerve stimulater trial,morphine pump trial all failed. Pain can be described as burning pain in lower spine penetrating in to left buttock,down left leg. Refuse to take lyrica or nuorontin do to its side effect,Leaving me with norco,valume,and flexiril at night.Which these medications only help with the muscle aches and stiffnes does nothing for the nerve pain from the nerve damage sustained from the adr surgery.Coming up nov.19th 2009 Lami, and hardware removal from fusion,for hardware just causing more pain in other areas.Hardware block comfirmed hardware is also causing pain in diferent area aside from the severe nerve pain on left side.Emg showed some posible problem above surgery are at L3 L4.
My Dr explained to me that because so many people are abusing the drugs, he's required to do all of this paperwork to protect both myself & his office. My dr listens to me everytime I have an appt,never treats me like I have a drug problem. I am always worried he'll think I'm just looking for more drugs and he keeps telling me not to worry, the medications are necessary and as long as him & I continue to have good dialog about how I feel, he can help me. I currently take Oxycontin and Vicodin for breakthrough pain for cervical issues. Reading many of the comments here, I feel bad for those who have dr's that are not listening to them or helping them. Hopefully, those of you in that position will find the dr that understands and doesn't make you feel like you are an addict. I have never had to bring in my containers for a "count". I have never received a random call for screening. My random screening was done when I went in for a "sick" appointment that I had scheduled.
This trust thing between doctors and patients has to improve. My doctor's office staff makes me wait a LONG time and they look at me cross eyed when I need a refill, the pharmacists aren't any better. Oh yea, they make me the first or last visit of the day. Guess I need to be segregated from the rest of his patients. My doctor is pretty cool, but the urine tests and pill counts are getting old. Anyway he wants me to join something called the patient physician trust partnership. Anyone ever had to do this? I just don't get any of this, don't we suffer enough?
there's always someone worse
I would suggest you to go through yoga session to come out of pain
Thank You