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acute pain with chronic pain

My name is Stacey. I fell on ice in my apartment complex drive way on February 10th 2014. I broke my ankle in 3 places. I have a plate 9 screws and 2 rods, and it was dislocated. I also have very bad disc problems with my back and while in the hospital my docs continued my pain meds for my back and added morphine pump after the surgery and oxycodone to go home with. My primary care doc was notified about my surgery and I went to see her two weeks later because she wouldn't refill my pain meds that I get from her on a monthly basis. When I went to see her she gave me a broken opiod contract and said I took pain meds from another doctor and got it filled at a different pharmacy (the hospital pharmacy where I got all my discharge meds) she made me sign a paper that she's pulling me off my meds because of this. Has anybody ever heard of such a thing? Still on no weight bearing for at the very least 4 weeks till 50%. Thanks guys


  • and somewhere in the contract that you signed, it stated that you would not get pain medications from another doctor, without notifying the doctor whom was prescribing your meds first.
    What you should have done was to contact your primary since she was prescribing for your chronic pain, and told her about your ankle, surgery, and that the doctor in the hospital wanted to give you a new prescription for XYZ medication and asked if you could fill it or asked her what to do...instead, you filled the prescription from the hospital doctor and took the medication, then went for a refill on your regular medications, this is a broken contract.
    In every contract, it spells out the terms that the doctor will provide medications under, and what the patient is supposed to do in an acute situation regarding medications from another doctor.
    Had you contacted your primary, she either would have adjusted your dosage of your regular medications or given you permission to fill the new prescription, however you didn't and now you are going to find that it is very difficult to get medications prescribed from another doctor.
  • The contracts are pretty specific but I think in this case your doc may have gone overboard with the rule. Trauma is treated based on an immediate need. The hospital most likely was following the orders of the treating doc which was to give meds. This particular situation has so many "what if's" that it should make everyone think about what to do if your hurt.

    Based on the injuries you sustained and the pain management treatment plan directed from the Hospitalist, I'd recommend that you ask the hospital doc to speak with your PM to see if they can come to terms doctor to doctor.

    Even where I live, being discharged from an ER at 1:00 am, the only pharmacy that will be open is over 40 miles away. On the other hand, the hospital pharmacy is one floor up. Doesn't take long to figure that one out! My point here is that if the patient went in for non-specific pain and filled a script somewhere else, then it's certainly questionable. However, with a documentable incident, x-ray films to prove it along with a treating physician prescribing drugs there needs to be some wiggle room by the PM.

    All it "should" take is communication between the docs to clear it up.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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  • The issue here is that she filled the prescription from the hospital before she contacted her PM doctor/GP . In fact, she didn't notify the GP doctor at all until she went in for refills......and she took the additional medication , so in her GP's mind, she not only accepted the prescription but went ahead and filled, it at the hospital, and didn't let them now.
    I don't think that her GP is going to be very forgiving in this instance.
    Yes, she had an acute medical problem, but all of the contracts clearly state what to do if you are in an emergency situation and that is to call the prescribing doctor , in this case, her GP before filling the prescription......and that is what is going to be the problem.
  • EMS GuyEEMS Guy Posts: 1,596
    edited 03/13/2014 - 9:36 AM
    The one bit of info we don't have is "has there been any other aberrances to lead the PM to believe there is a diversion risk"?

    Given how healthcare is going these days, I do believe that instead of a PM saying you must contact them prior to obtaining meds from another source (especially in a trauma situation), they should say that notification will be within 24 hours of the first business day after the event.

    I know that my PM contract says that I am not to use my medication prescribed for back pain to be used for any other condition. Let's just say for craps and giggles sake that her contract says the same thing. She gets hurt on a Saturday and her PM isn't in until Monday. Does that mean she should go all weekend without pain relief? My PM doesn't have a 24 hour call line. I'm sure there are others as well the same way.

    Now, I cannot defend the length of time it took to actually make notification. The PM has a beef on that one. But, at the end of the day, if both docs discuss what happened, pill counts equal out and there hasn't been any other issues with her then I think there could be room for a one time pardon.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • there is no excuse for her doing this and there is no defense in my opinion. this is why people who use and need meds legitimately get messed over by those who don't follow the rules. the contracts and rules are specific and if there is any doubt one needs to contact all doctors and let them know what happened. when i had surgery i let all doctors, pain, family, ortho know where i was and what i was given. it is called cya.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
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  • EMS GuyEEMS Guy Posts: 1,596
    edited 03/14/2014 - 2:21 AM
    I guess we will have to agree to disagree on this one.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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