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Is the Doc trying to kill me, or sommin?

Charlottes WebCCharlottes Web Posts: 44
edited 06/11/2012 - 8:55 AM in Chronic Pain
Three years ago I was in an auto accident. This was my first day driving after having screws put in my right shoulder 2 weeks earlier. I'm not superstitious, but just for fun, it was also Friday the 13th. It was later found that my spinal cord was torn and a cyst had developed, T-2 - T-3, now it's T-6, after bubbling last year. I'm quickly losing the use of my legs and the numbness and weakness has moved into my core muscles. I'm now using a walker or cane but this has caused more pain in my shoulders, arms, and hands. I am also looking into a motorized chair. I have constant pain in my shoulders/arms, and pain and spasms from the chest down. I've been lucky and able to tolerate the symptoms with minimal meds. (Hydrocodone 7.5/500, no more than 6 - 8 a day)

Well, like other States, if you need pain meds in TN you go to a pain clinic. So, I started one last December. Each visit I see a different doc, one visit there was a fire drill and the nurse handed me my prescription in the waiting room and I didn't see a medical professional, AND each visit, they write my prescription different, giving just enough medicine until the next refill or visit. No room for error! Important to me since I live in an area the flooded last summer and we could not get out for days, and if it snows, there's no getting out!

OK, I make an appointment to talk to a doc this past Tuesday. I just wanted to know why they are changing my prescriptions each visit and could they please get it like it was when I started coming. No big deal, right?....WRONG! I was put on some type of pill counting probation, he wanted to put a pump in my spine, until I mention my lumbar issues, next, how about Morphine. I asked him to please read my drug allergies and medication history (I do not tolerate meds well and have a lot of allergies). He then said he would change me to Hydrocodone 10mg/325. I agreed as long as the pills weren't yellow since I had a allergic reaction to the yellow dye in the yellow 5 mg once. Well the prescription was filled, no warning from the pharmacist, but the pills were yellow. I took them thinking, ok no yellow dye, I guess, sigh, and ta da, can't breath by morning.

Three days of calling their office, which closed at 1:00 today. They finally call me back to tell me the MA is NOT going to call me in anything...go to the ER! I no more than hang up and the MA calls and says she will call me in 20, 7.5, white tablets to last until Monday, BUT she didn't want to!

Is this the norm for pain clinics or do I need to make a change? I'm a bit puzzled why a Doctor or MA doesn't want to help a person in pain but rather make them feel like an inconvenience and/or criminal! :??

So, that's my question. Sorry this is so long, it's actually the short version! In any event, thank you for taking the time to read this, and I look forward to your replies!

Wishing everyone here a great day! >:D<


  • Hi Charlotte,

    Wow. I don't know if I'm right in thinking this, but I think it's kind of weird that you don't have a specific doctor assigned to you at a pain clinic. I don't think I've ever heard of anyone else who has not had the same doctor, unless their's is on holiday or something.

    Is there another pain clinic that you can switch to? That's what I would do, myself. Hope you get it all sorted out on Monday! Take care, and if anything else happens, I would go to the ER, especially if your breathing is affected.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Sorry to hear of your issues...

    I'm not quite sure of your lumbar or other issues...but have you had any surgeries for your spine like a laminotomy, disectomy or fusion?

    Even though those are last resorts...if you are having recurring nerve issues and having to use a cane or walker...then I would think you are a canidate for surgery.

    If you hold off too long...it can cause permanent nerve loss and paralysis in feet, legs, etc.

    So I would be getting both 1st and 2nd opinions from two different Board Certified Orthopedic or Neurosurgeons.

    On the pain clinic issue...it sounds like they run more of a 'mill' type office then other places that take time to really work with you, and your Surgeon/other Dr. on finding the best treatments to help manage your pain.

    As I'm sure you know...just relying on a narcotic is not what true Pain Management is about.

    Unfortunately though...most PM's around the country do 30/31 day prescriptions and unless there is some type of emergency...or vacation taken and need for a bit of extra medicine...then they stick to that prescribing time frame..

    Most of the time..I will take one less pill here and there on better days (telling my Dr.)so that you can have an extra day or two saved up for an emergency if they aren't willing to help you when the time comes..Obviously it's not good to do anything without letting your Dr. know.

    I say the next part gently..and I'm not trying to blame you...but I think you made a few errors on the last prescription that may give them a red flag about you..

    The first part is that if you know that you can't do a yellow pill. Then speaking with the Pharmacist when you drop off the prescription and showing him what it is for..and what your issue is...and whether they have a different generic that doesn't contain the dye...or...if he only has that one maker on hand...You could have him call the Dr.s office..(along with you)..right that minute and ask if they can change the order or fax over another prescription (or pick another one at the office)...

    By accepting the prescription and getting home and then taking it...this is showing the Dr.s it's not that big of a deal...And then since it's not a 'life threatening' allergy...or else I assume you wouldn't take the chance to take it...or would have called 911 immediately...by calling them for 3 days to get a new prescription 'after' you filled your other...It looks like you are trying to double up..

    Now...PLEASE know I don't think you were trying to do this at all...I'm just saying what it may look like to them as they unfortunately see so many addicts along with pain patients...that we have to do everything on our end to 'prove' ourselves..I know it's not 'right'..but it's that way unless you are seeing the same Dr. every time and build up a relationship/trust with them..

    What you can do is bring the entire bottle (minus the few you took) to your next appt. (tell them you are happy to do this to show you aren't taking both or diverting them)...This will help build up trust...

    Are there any other PM Dr.s or clinics in the area that you could make an appt. to go see? Obviously not accept any medication from them...but just to see if they might be a better fit for you?

    Since you have nerve issues...are you also on any nerve pain medication like Lyrica, Neurontin or Cymbalta?

    As well as a Ortho or Neurosurgeon to look into surgery to keep you from getting worse or further nerve damage..

    Because the bad part is that instead of trying this...and then getting Physical therapy and other treatments...your other muscles are going to atrophy by lack of use. Aqua therapy is very helpful with those with lumbar/walking issues..

    I've had 3 cervical fusions...and even though I am on opiates...I don't rely soley on those at all for my pm...I do daily exercise 30-45 minutes daily...I do yoga/stretching, aqua therapy, massage, acupuncture, injections when needed...a muscle relaxer when needed...a sleep med to get the needed rest for both my pain levels and immune system..I eat all Organic...don't smoke...etc..

    The list goes on..I live with a 5-7 pain level each day even with doing many modalities each day..But that is what is considered good by PM standards with chronic pain..

    Sorry for rambling...LOL

    I just hope that you can find some more options with getting opinions on surgery as well as another PM if possible..

    Keep us posted..
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  • Sorry, I forgot to sign my post, my name is Tina. Charlotte is the name I gave my injury, because the tear is in the arachnoid layer of my spinal cord. 8} Thanks so much for your reply and suggestions! I agree with you and think it's weird not seeing the same doc every visit. The first two Dr.'s I saw were of the opinion that what I was doing was working and they saw no reason to change it. Considering that my injury is rare and dangerous to mess with, and with my quirky drug allergies and reactions, I think you are also correct, and I need to research a alternative pain clinic. I've done some research on the web, and made some phone calls, but so far, I haven't found a place where you see the same Dr. each visit. However, I finally, (after 2 weeks of leaving messages), got a call back from my Neurosurgeon's office today and have an appointment to see him soon and will have my MRI on Monday, (I have an MRI every 6 months to watch for any changes). So, I can discuss the Pain Clinic Issues with him then. I also have another referral to check into. Finger's crossed! BTW, I've dealt with medication allergies all my life, and they have gotten worse as I've gotten older, so I keep Benadryl close at hand, even in my car, and purse. Anyway, thanks again for your reply! Being a newbie to the Pain Clinic experience, I'm eager to learn how they work for others. Have a great evening!
  • Wow - that sounds totally weird to me. You'd think they'd find something that works for you and just leave it at that instead of changing things up all the time. In Oregon, you can't call in a prescription for narcotic pain meds. You have to obtain a written prescription straight from the doctor. I go to my internist for my pain meds. I went to the pain clinic once -- they offered me no medication, just a spinal cord stimulator. No thanks - I don't want a pacemaker implanted in my butt! Anyway, my Internist listens to me and is very caring, so I'm in good hands.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • What you're describing sounds very much like what "pill mills" do down here in Florida - and it is getting them popped and shut down!!

    I to this day refuse to go to a pill / pain clinic. I have my scripts through my GP presently, but might get a true pain management doctor - but not a clinic for me!

    Is there any chance you can get to a regular "this is my daily job to threat pain patients" doctor in your area? Also too, have you mentioned these issues to your spine specialist or GP?

    I know for me, if each time I had a new doctor looking at me, and prescribing, I would be a cloud of dust with that office...

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • Tina: you most likely are allergic to tartrazine (its yellow #5); its probably the single most common dye allergy. Its also in a lot of orange-looking medications, even some brown ones, including multi-vitamins and supplements. You have a legitimate complaint to file with you State's board of pharmacy if you told them of the yellow dye allergy ahead of time; its a shame because not only was it a potentially severe reaction, but created hassles for both you & your doctor.

    Regarding the issue with replacing a controlled substance medication; yes, there are potentially two "flags" that come up when a pain doc essentially tries to replace one drug with another before the month is up - one can be from the insurance company/Rx plan, and the other from the DEA. Its not a "personal" or trust issue with you as the patient; and yes its because of drug-seekers & doctor-shoppers that these rules are in place. Still, the doctors do have to "play along" - its not meant to be personal. Twice I had to bring in "new" meds for replacement - one time I just gave the bottle back to my pain doc, the second time I had to return it to the pharmacy. The pharmacist had to call my insurance, verify return of meds and reason for return, did a count in front of me, and then added hot water to them (and told me to take the label off & throw away in trash at home).

    Final comment:you mention taking 6-8 of the hydrocodone 7.5/500's - that's pushing the liver toxicity limits of tylenol (acetominophen or APAP); and may be one of the reason they changed your meds to one with just 325...iust a heads up even one more of those pills w/500 on a bad day or "flare" day can be real serious to the liver...
  • Thanks for taking your time to comment, I so appreciate it. When my PM Dr. moved away, my PCP said she would be happy to take care of my meds. She thought with my condition it was crazy to see so many different Dr.'s. I was doing the happy dance when I left!!! However, by my next visit, 3 months later, she was under investigation for writing pain meds. She told me she felt bad but could no longer write my prescriptions for Lortab, but she would continue providing the Valium and Xanax. OK, I guess? That has me seeing her and the Pain Clinic every 3 months. Ugg!!! My goal is to get it under one roof.

    Believe it or not, this ping pong game with my pain meds has been going on since the shoulder surgery and then accident in 2008. At one point, my long time, and now former PCP, was yelling at ME, because my Orthopedic doc wanted him to write my pain meds. I left in tears. The only smooth sailing I've had was seeing the PM doc that left town. Not sure if I've mentioned this, but I called him yesterday, and he is NO longer writing pain prescriptions at his new location!!!

    Whew, I don't have any butt left to implant anything into and don't want that either!!! You are lucky to have such a great Dr.!!!

    Thanks again for sharing! :)))
  • ...AND, I can't wait to leave that place like a cloud of dust!!! Whoot, whoot! But, I need to be smart, hold my tongue Monday, so I leave with pills in hand! I learned that here! ;)) However, I bet you, he's going to make me come in every 2 weeks. To enter a new clinic, I will need a Dr.'s referral, and at the turtle pace my Neurosurgeon's office runs, I may be better off to ride this Pain Clinic out until I see my Neurosurgeon on Sept 1, and discuss the situation with him. After all, he sent me there, but to a specific Doctor.

    Oh, how I wish I had the option of avoiding the pain clinics "here", but it's not looking good! ~X(

    However, I'm jumping for joy (haha, not really jumping), to have found this forum, you, and the others! Great attitudes and good company here!!!

    I wish you a pain free day!!! Nice to meet you!
  • That's what I thought to, BUT the day the reaction started, I called the pharmacy, but was told it did NOT contain Tartrazine, it just contained yellow dye, and hung up! I called another pharmacy (same company, different location, not as busy) to compare the yellow 5 mg and 10 mg ingredients and was told they don't make the yellow 5 mg any longer and did not know the yellow dye ingredient in the 10 mg.

    Oh wow, you got me there! I've never had to pour hot water on pills! I've always taken my bottles back to the pharmacy, but they wouldn't take them back. Luckily, I've only had early refill issues once, just my luck, while going to this clinic, and that was a convenience thing for me (I had pills), was one day too early to refill, and instead of telling me to wait one day, well, I don't have to tell you the ending. But, funny story, my insurance company (bless there hearts, as we say in the South), told me to tell the Dr. and pharmacy that I can have 248 (Lortab)pills every 24 day, and to do a "therapeutic override" for my pain medicine in the future. I don't have to tell you how that ended either! =))

    I don't think I've even been handed a scrip that I didn't ask about my liver, and have been told "the benefits out weight the risk", same response by the other 2 doc at this PC! But, yes, this was the concern of the new Dr, and I am all for 325's, if they're not yellow. BTW, I had blood work done recently, and all is good with my liver, and I don't drink. But, I think when liver damage shows up in blood work, it's too late?

    Speaking of, what is the limit for liver toxicity? I know it was recently changed, and it says 4000 mg on my bottle, this Dr. said 2000? Also, it's a rare occasion that I take 8 in a day, but I do usually take 6. When I started this medicine, I could only tolerate, 2.5 mg, twice a day, and was not happy when I was bumped up to 7 mg. I'm told they do not make a 7/325... pity! I'm afraid of the 10 mg, if I have to go through another surgery, there will be no place to go if I need stronger medicine.

    I also want to mention, I have just recently learned, maybe on this forum, that the DEA is involved. Interesting! But, I DO get the concept.

    Anyway, sorry to have yakked on so long! Thank you for your time and post. You have been helpful, and I hope to yak with you again! I'm hope you're one of the few here without pain, but in any event, I hope you're having a great day!

  • I hear ya on "holding your tongue" for your next appointment. Nodding, I would for sure bring this up with your Neurologist. When you do, please make sure he knows the doctors keep changing, *and* that there is no constancy in your pain medications.

    Also too I would bring up as an example (a strong one in my mind) your allergy [the yellow dye] and these yahoos keep prescribing it to you! How caring for your health isn't the case at this clinic obviously. Please let us know how it goes. Gentle *HUGZ* to you.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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