PM here and I'd like to say I find this forum much better than most. Some seem like people trying to figure out how to get drugs and not solve the situation at hand.
SO here's my situation and how I resolved it:
I had (HAD being the operative word) a torn biceps/labrum tendon in my left shoulder and it is my non-dominant arm. I had this happen to me in late 2009 when my COBRA coverage was ending after I was let go from my company in 2008. Great time to have an injury right? I am an athlete and always have been. I play sports whenever possible -- doesn't matter what it is. I tore it a little playing tennis. Then a little more playing basketball...then finally the "kill" shot was a backhand ripped (literally!) down the line while playing tennis. I was in so much pain that I went to my PCP at the time since I was within the 18 month period of COBRA coverage. Also during this time, Obama had put through a COBRA subsidy so instead of paying the full premium of close to $450/mo for health insurance...it dropped to a manageable $130ish a month. I don't remember the exact amount. But anyway after seeing my PCP and then a surgeon I had an MRI and I could have told them what they saw -- a labral tear in the biceps tendon that connects to the shoulder joint.
The day after I had the injury I went to my PCP and he prescribed an anti-inflammatory and Vicodin 5-500. Since he did not know right away without scans what actually happened he just kept giving my Rx's of Vicodin. The Vicodin went from 5/325 to 10/325 in about a year so that brings us to 2011. I had been on Vicodin 10/325 for years. I would get 100 tablets and the instructions read take 1-2 every 4 hours as needed for pain. So that's 12/day if people are counting. I would get a refill every week for 2+ years. I then had to switch PCP's because I moved and my current PCP gave me the same Vicodin...but lowered my dose from 1-2 every 4 hours to 1-2 every 6 hours for 3 months and then finally we settled on 4 tablets a day. I went from 100 per 5 days to 120 tablets per 30 days. After the first year of taking the pain meds, I didn't even really need them. I took them because I was hooked mentally and physically. I honestly couldn't function without taking 2 tablets right away when I woke up every morning. It was terrible but my doctor knew my health insurance was going to lapse and had lapsed after a while. Luckily (I guess) I got some kind of discount card but my Rx's went from $10 per to around $40 per. There was a time I was paying close to $80/refill! It was insane.
I then moved to MA where health insurance is mandatory. I had found a great new job but messed that up as fast as you can read this. It was due to my meds and drinking. Drinking on pain-killers for those who have a high tolerance is not good no matter what...but a few beers mellowed me out pretty good on football Sundays. My problem was that I had no end in sight. Every 3 months (after I got fired) I would see my PCP, get my 120 pills with 2 refills and be on my way. All of a sudden June of this year, I had to sign an Opioid Treatment Agreement with my PCP. Obviously they can check to see if you're getting pills elsewhere or stronger ones from a different doctor because I had health insurance. The mandatory health insurance in MA saved my life. It's not because of an accident -- it's because I was (and still am) mentally and physically addicted to pain killers. That's the bottom line. It happens. It creeps up on you like a little campfire into a wildfire and finally I had surgery. I explained to my surgeon the medication I was taking as he spoke with my PCP as well. He had never seen someone so physically dependent on the meds. So as I type this I am currently tapering down from the Percocet AND Oxycodone Rx's (he gave both -- the oxy for breakthrough severe pain). I started off with 2 every 4 hours of Percocet and 1-4 tabs of Oxycodone 5mg every 4 hours. I was a walking zombie but I also had surgery.
I am writing this because it's a release for me (I am also in therapy if people can't tell) and so now I'm down to 2 Percocet's every 8 hours and 1-2 Oxycodone 5mg every 8 hours. Problem is...my 8 week Treatment Agreement with my surgeon is coming to an end pretty damn soon and I have 2 refills left on my Vicodin that I got in June that I obviously never filled. I am happy to say that I only really take the medication after physical therapy and at night! It's great. I don't think I could be happier. I have one more refill(s) of the Perc and Oxy (both 60 count) to get me past the 8 week mark and then I'm back to my PCP. My problem is my tolerance now. As great as I can say it and type it -- it's not the truth. My tolerance is through the roof on these pain meds. They last probably a day or two before I can refill again.
I am going to have to be honest with my PCP and tell him that physical therapy is seriously making me go through more pain than I remember. I had ACL Reconstructive Surgery in 2003 and I barely took the Vicodin 5/500!! Now look at me. One of those is pretty much a Tylenol. I wouldn't even feel it. I am asking people here how to approach this situation with my Surgeon and PCP. Once I run out of my Perc and Oxy, I won't have anything. But the goal is to be off the meds halfway through physical therapy. If I can go back to taking an Aleve once in a while (like once every couple weeks after a hard match playing tennis) or an Advil...I will be the happiest person in the world. I don't want to be on these meds and the people at the pharmacy look at me now as someone who is solving his problem via surgery because they can tell by the way the Rx's are written that I'm tapering down. It seems like they're happy too.
Question again is: what do I tell my PCP when I see him AFTER I see my surgeon again? Should I refill the Vicodin that I have leftover from the previous script after my 8 week agreement is over with my surgeon and go from there or should I not? He's not the type of PCP who really cares either so he won't return any call asking what I should do. I feel like I need an Rx of Oxycodone of a stronger strength while I go through physical therapy and take the Vicodin as needed. That's my thinking. My PCP will prescribe the Oxycodone if I ask I'm pretty damn sure because he'll be happy he's done prescribing narcotics to me. I just don't know what to do! Please help!
Thank you for reading all of this, whoever you are that might respond. I truly appreciate it.