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Discharged from pain management! Need help.

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135

Comments

  • dilaurodilauro ConnecticutPosts: 13,425

    Keith, like you I am very close to EMR and everything associated with it.   I believe in the long run, it will be fantastic and only serve to help people everywhere (and on the flip side hurt those that have abused things)

    So much comes into play when talking about this type of adventure.   Patient privacy even further than HIPPA is built into most of these data bases.  Like Keith stated, anytime a patient record is opened, logs are kept to identify where, who and how it was done.

    Keith, you have a good solid knowledge about this.  One of the thoughts given out near the beginning is WHO can afford this?  It is not cheap, it would cost basically a complete overhaul of any hospital's IT system.   The bigger hospitals can probably afford this, but not sure with the smaller rural hospitals.  Same applies to medical practices outside of the hospital.

    Its an exciting project, I am glad that I have some involvement with this, even at a small level.

    I mentioned this before, there still is one major problem in connecting the USA  (not even approaching world wide yet)   There is no single fool proof identification for an individual.   Every time, I came up with what I thought was good, we found holes in it.

    Another piece that needs to be addressed and resolved, is a common software platform.  I know here, we have gone through three different software companies before settling on what is in place now.

    But its the future .  I only hope that before my shoulder and hip implants wear out this will be common place.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  •  Ron is correct about the implementation of EHR's in medical facilities. It is very costly so many are still utilizing hybrid medical record systems( EHR and PHR-paper documentation). Across the board EHR will be a reality in the near future. HIT (health information technology) field has expanded greatly during this transition to meet the standards of medical record keeping set forth by  HIPAA and the Joint Commission. 
    Ol' Spiney..Micro-D L4-L5, TLIF L4-S1 -post op central HNP L4-S1,stenosis, retrolisthesis, EF, facet arthropathy, lumbar& cervical DDD. FBSS- Medtronic pain pump & SCS
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  • What everyone says is correct.  But if I were in your shoes, I would have brought the prescription to the pharmacy and had it filled.   The pharmacy probably doesn't,t know about the doctor dropping you.  If you are in agony, you should use the Percocet, but only when you absolutely have to until you can get your situation corrected...........  I just know what it is to have horrible pain and no way to stop it.

  • If you need that second script then go have it filled.  I would at least try.  It may take awhile to find a new PM.  When you asked if there would be a problem filling it, it crossed my mind that the pharmacist might know what happened.  Geez it isn't like you stole it or anything.  It was made out to you for a specific pain issue which you still suffer from.  

    It really depends on your doctor.  I would imagine some wouldn't care one way or the other that you fill that last script. They may even expect you to.  Like another poster said, the worst thing that can happen is they refuse it.  For sure I would give it a shot because remember that lots of PM offices do not prescribe meds on the first visit so this last script might be very important.  Let us know how it goes.

    Cindy


  • kybluegrasskkybluegrass Posts: 1
    edited 09/23/2017 - 6:14 PM

    Hey guys, it has been a while. I have some updates to my last post.

    I did end up getting my prescription filled and ended up referred to a new pain management doctor. He asked what happened at my last PM and I told him how it went, he went on to say at 30 years old I was way too young for opioid treatment and was offering ever shot that you could ever imagine and completely neglected the fact that I had Lyme disease. Well I walked out on him because he was not cooperative at all. I told him I had already tried all of those procedures and I knew what helped me. $600 wasted for nothing. 

    Anyway, I continued my adventure and ended up getting referred to another PM doctor. Seen her last month and told her the same story I told him, I wanted to base our relationship starting off on complete honesty. She did not have anything negative to say, only told me that most PM doctors are very strict and you have to follow the contract to a T and always address her of anything I take or changes. Anyway, without any hesitation she said that we would pick up where I left off, 3 Norco 10/325 per day and ordered me a back brace that my insurance is not wanting to pay for. I would also like to note that she did not even give me a urine drug screening at my first visit with her even though i had the previous incident. So maybe i'm able to start out on new grounds.

    I have another appointment with her Monday. Well a new issue has arrived. The Norco 10/325's are not helping at all anymore with my pain. I can take one and nothing, don't feel anything, no relief, nothing. Sometimes I have to take 1 and a half or sometimes 2 to get any type of relief whatsoever. I have been on Norco now for over half a year. My grandfather is rx to percocet 10mg and at times he has given me a few to help with my back, these help tremendously more with my pain than hydrocodone. How can I get her to switch me over to Oxycodone? Do I just ask her to try oxy? Just tell her my meds are not helping at all anymore? Should i tell her at times i have to take one and a half or 2 10mg norco to get relief? I know out of all meds in my history i have taken, oxy has worked best for my pain. 

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  • So glad you found another PM and that you are getting things worked out.

    It is not unusual at all for a pain med to quit working as well for you when you have been on it for some time.

    I go back and forth between MS Contin and Oxycontin and that works well for me.

    Sometimes I go a couple of years between switches  but usually about a year is it.

    PM docs know that tolerance to a drug will happen so she shouldn't have a problem with switching you to something else for awhile. (If it works better for you, I would think they would let you stay on it permanently).

    Most times 6 months is enough for me and the I can go right back to the MS Contin and do great again.

    In fact I just made the switch 3 months ago and I always go in and just tell the doctor that this particular drug is not helping my pain anymore.

    Then I let him decide where to go from there.

    Sometimes he will ask me what I have done in the past when this happens and at that point I will tell him what I want to change to.

    It is usually best to let the Doctor feel they are making the med decisions, but if they ask, then tell them what you want to try.

    Have you ever been on a long acting med?

    When taken with a short acting for breakthru pain it works great for alot of people.

    I tried for a time to just take oxy short acting and felt like I was constantly chasing the pain and never getting ahead.

    Using the long acting and short acting just keeps me covered so much better.

    Please let us know how things go.

    Glad things are looking up for you!

    Cindy

  • Hello kybluegrass,

    I am new to the forum, but certainly not new to pain management.  I've read your entire discussion, and although your appointment was scheduled for this past Monday I really hope you got your meds changed to the Percocets if they help your pain more.

    If no problems occurred at that appointment, I would like to bring a couple of things from your last comment to your attention to prevent you from making the same mistakes you made the 1st time you got discharged from PM, and try to prevent you and your family from possibly getting into legal trouble too along the way.  I'd like to try to help you stop the problems before they occur.      

    #1) According to your PM contract if you are ordered (3) Norcos per day, that means you are prescribed 1 Norco every 8 hours, If you are taking 1  1/2 or 2 Norcos at a time because taking just 1 isn't helping, you ARE again violating your PM contract, and most likely will again be dropped when the doctor discovers that you are not taking your meds as prescribed.

    The thing is, you can't just take your pain meds how you want too without being in violation of your PM contract, regardless of whether you are hurting or not.  In order to remain in compliance with the guidelines of your PM contract,  you Must take your pain meds the way the doctor has ordered them for you, and no other way.  If they aren't helping, then you should call your doctor, and go back in to see about getting them increased or changed to something else,  but until you go to that appointment you need to continue to take your pain meds exactly how they are ordered, or risk possibly being discharged again for not complaining with the PM contract guidelines.    

    #2) If your Grandpa is giving you his Percocets, at any time, it is illegal, and both you and grandpa could get arrested. Those Percocets are prescribed for your Grandpa Only. Those are not your pills to take, and since grandpa isn't a pain management doctor he can Not legally prescribe any prescription meds to you, or legally allow you to take meds from his bottle.  

    #3) You are again violating your PM contract if you have taken any other pain meds (be it your own Percocets from your past Nov dental visit, or grandpa's Percocets, or any other type of pain meds, or any illegal street drugs, since you began seeing your new PM doctor.   You are currently being prescribed only (1) Norco, not 1 1/2, not 2, but 1 Norco every 8 hours, and anything other than that can and most likely will get you dropped again from this PM doctor too, as soon as the first urine test is collected, and I can almost guarantee you the issue (s) will sooner, rather than later, again be discovered.    

    Please know that I am not at all trying to sound harsh or be mean, but by your last comment it appears that you still aren't completely understanding exactly what is expected of You, and what You need to do in order to keep from possibly getting dropped again by another PM doctor.  

    I just want to try to keep you from making the same mistakes you've made in the past, or keep you from making new ones, and to try to keep you and your grandpa out of trouble, as well as, trying to keep your PM doctor out of trouble because she too could get in trouble for keeping you as a patient if you're not taking your meds exactly as prescribed, or if you are taking other pain meds that she has not prescribed for you.

    It sounds like you have yourself a really good PM doctor now, and she was willing to take you on as a patient and resume your pain meds even after being dropped by another PM doctor, which is usually very hard to find.  So if you will stick to the contract as the doctor has already said, "follow it to a T, " I'm certain together you, and her will get you to a place where your pain is a lot better controlled.

    Best of luck to you!! 

  • I was going to say essentially the same thing as Crackerjack earlier in the week but didn’t want to come off as too critical so I refrained from posting. 

    If you’re taking Percocets from your Grandpa and those show up in a urine screen you risk getting dropped all over again. 

    Just because your new PM doctor didn’t do a urine screen at the first appmt doesn’t mean she won’t the next time. 

    It was Percocet that caused the first dismissal. Please consider your actions currently so Percocet doesn’t cause a second dismissal (like Crackerjack said you’re quite fortunate to have found another PM doctor to agree to take you on, especially so soon after a dismissal).

    Good luck and if things aren’t working out and/or any adjustments are required please discuss these concerns with your doctor.

  • Hey guys, been a while since I have stopped back by, been really busy lately with life.

    I just wanna start off by thanking you guys for being so considerate of my issue and not jumping me over it. I no longer take any percocet, or any form of oxycodone since the first time I got discharged from pain management. I now understand the consequences for such actions.

    Here is how it wen't at my last appointment. I told the NP about my pain worsening since the last visit and that the Norco was not helping much at all anymore. I did not mention that I had taken anymore than I was suppose to, I did not ask for percocet or oxycodone. I don't know why but I am afraid to just come straight out and ask for it. So she asked me of I was taking any muscle relaxers and I said yes, taking zanaflex at bed time every night. She then said maybe I should take another during the day and then said that she had remembered that I farm for a living and maybe it wasn't a good idea since they make me drowsy, and they do, very.


    So she said, "How about upping you to an extra pill per day and let's see how that works before we move on with things?" I agreed.


    I walked out to the lobby and waited for my Rx and they handed me a script for 90 Norco 10/325's.. I told the receptionist that this could not be right, because she said she was adding an extra Norco per day so instead of 90 it should had been written for 120 instead, in order for me to take 4 per day. She said "Hmm, well your right sir, this doesn't look right then. Give me a moment and I will go talk to the Dr." A minute later she come back to the front desk and told me they had got the problem fixed and to wait for the Rx to change. Sure enough, they come back and handed me a Rx for 120 Norco 10/325's instructed to take one tablet by mouth every 6 hours as needed.


    Well this does help somewhat, better than 3 per day anyway but still is definitely not cutting it. Most days I still have to take 1 and a half at a time to do the pain just a bit of justice. I believe tolerance has a big play in this and also I had further hurt my back around a month ago. 


    When I go back I want to tell them that I still getting no relief, but I am afraid they will try giving me either a time released med that I do terrible on or something like gabapentin instead. Both of those I have tried in the past with not so good results. I was hoping she would have moved me over to oxycodone that day. Should I just ask for it? Or should I just tell her the Norco still isn't helping and then just hope for it?


    I don't wanna appear as a drug seeker but I also don't wanna be in so much pain either.

  • sandi123ssandi123 Posts: 757
    edited 10/15/2017 - 11:03 AM

    Kybluegrass,

    You appear to be disregarding the advice and wise counsel of the other members regarding your use of pain meds, and following the dose instructions to the exact way they are prescribed.

    So I am going to be rather blunt.

    YOU are creating your meds not being effective, because YOU aren't following the dose instructions.

    Your doctor increased your dose by 33%, adding a fourth dose, and shortened the dosage time from 8 hours to 6. There is no reason, other than you continuing to misuse the Norco for it not to work.

    Taking more than you are told to take CREATES false tolerance. It's not that the medication is ineffective, it's that you consistently take more than you are supposed to, thereby giving your body/brain an expectation that the 10 mg dose isn't 'working'. Continuing to do what you are doing WILL get you dismissed, just like taking Percocet from your relatives or friends, and will create more problems. If you think 10 mg Norco doesn't 'work' now, imagine what you will feel like if no one will prescribe ANY pain meds to you again.

    You are self medicating, and in the doctors eyes, ABUSING your meds. It's been pointed out several times, you can not take more than prescribed without your doctors permission FIRST.  

    The ONLY option is to stop taking more of the Norco than your Dr. prescribes and stick to the 10 mg dose EVERY 6 hours and get your body accustomed to the right dose.

    I have been on the same immediate release pain med for 10 plus years and because I take them as prescribed, don't find they no longer work.

    I don't mean to offend, but you are playing a dangerous game , one that puts not only your pain management at risk, but every patient that doctor sees. We ALL get judged by what others do, and in this pain management world we must exist in, it's extremely important that we ALL follow the rules.



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