Pharmer.org

I am somewhat updating to "Got Some Sad News" when I wrote on April 29th:

"I just found out I am losing my doc of about 3 years. He has worked with me through all my medical problems with my arm, and has me on a regular med schedule now. He has been understanding of everything that has gone on, and helpful with all my problems.

Two months ago he told he he was leaving in 4 months b/c his rotation was up and he was going elsewhere. My first concern was that whoever my new doc would be would come in and say you're on a high dose of narcotics, I don't think you need it, let's reduce it! But I talked to my doc about this so he said he would set me up so the new one can be informed about everything.

I'm still worried though..."

First for those who do not know, I am on #330 Norco 10/325 per month, #10 Fentanyl 50mcg/hr patches per month, and I use Lidoderm patches. Well, I went today to my new doctor. When I first came in they had the room set up for a pap smear! I told the doc as soon as he came in that I was nervous with a new doctor since there was so much going on with me, and because of my high doses of medicine. He said don't worry, that he's pretty laid back, but almost all docs say that. He wasn't sure what I was there for, so I explained it was a follow-up and "meet the new doc" appt.

I gave him the 'long-short' story of my medical problems, and he didn't ask any questions about it, or much else about me except if I had any other problems or if it has got worse. I explained my lifestyle and daily activities (school, social work, waitress, mother, etc.), then how my old doc usually handled my medicine. I explained dosing, writing the script, and when i get it, but made sure to add that that is completely up to him and what he was comfortable with.

I thought he was going to start in with "I don't feel comfortable..." or "Let's try this..." or just that he would be skeptical about my meds, what I need, my pain, or something, BUT HE WASN'T! He just said okay, which of your meds do you need filled? Oh, you probably need them all filled, right? Okay, I'll go write all these for you.

I could not believe how cool he was, how nice he was, how comforting he was, everything! I feel so much better now!!! Yeah for the good doctors, I've got two in a row now, whats the chances of that? Not all doctors are bad!!!

THANK YOU DR. E!!!!!!

I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.

 

You are so lucky. I moved here to Co from AZ about 9 months ago. I have had the same dr for about 3-4 yrs. When I came here (CO) i figured I'd just find a new dr, get my records transfered, and go about life as I always have. I have fibromyalgia and am able to work every day as long as I have my norco. I get 180# a month and have for several yrs. The dr I first seen here freaked out on the # of pills per month and said the most she could give me was 120 and that I would have to go through a mental evaluation,several tests,etc...for her to decide if she was going to continue with even 120. I have NO insurance and to go through all that was going to be expensive and then only to be cut back on meds.

I am currently driving 10-12 hrs one way, back to my old dr. every two months to get my pills.He will only give me a script with one re-fill, then I have to go into the office evry 2 months to get a new script. This is a pain, but the only way I can continue to get my meds that I need. Soooo, consider yourself blessed.

I wish I knew of a dr here in the Grand junction or glenwood area of Colorado that I could go to..but I cannot afford it financially to just keep going to different ones to find the right one.If anyone knows of a good dr. in these areas I sure would be grateful for your help. Thanks

(edited by admin) 

I think I spoke too soon...

I went back in today for another follow up, but my "new" doc did not have any available appointments for the entire week so I had to see someone else. I figured since they did not know me they would go through my chart, and I would just basically get a refill...boy was I wrong! let me apologize now for this being so long, but it was horrible, and it was a LONG appointment!

First, I come in already feeling crappy, and have a med student sit with me and I had to explain my entire history over to him. Everything from when all my problems started, to how it felt, everything that has been done with my arm in the past 5 years, all the docs and surgeries, all the pain symptoms, all the different times I have been in physical therapy, the EMGs, the braces I've worn, all my limitations, all the different medicines that have been tried in the past 5 years INCLUDING the nor and amitriptylines, all the anti-inflammatories, neurontin and Lyrica, cortisone shots, oxycontin, morphine, oxy IR, lidoderm, norco, and the fentanyl patches, my medicine schedules, and anything else that has anything to do with my arm. He had a paper where he took notes and wrote this all down (even though a lot of it should be in the computer, right?)

So after I talk to him for about 30 minutes he said he will get the real doc so I can talk to her. He comes back in the the doc I've never met, and the pharmacist I have worked with. They ask again all my history and I feel like they are having me just repeat everything I told him. I don't know if its cause he didn't explain to them well, or if it b/c they want to see if I tell the same story. They ask all about my pain, where it is, how long it lasts, when I get it, etc. They ask what I take now and (of course) raise their eyebrows in shock when I say 11 Norco a day, like they don't already know and haven't seen it in the computer.

Then they go into "the speech". You know the speech- we don't feel you should be on this high a dose, we don't know what should be done but want to try something else, blah, blah, blah. They ask if more PT will help- I say I don't know but if you think it will, ok. They ask if surgery is an option- I tell them what I've been told, that no surgeon will do anything else cause of how the last two turned out, but if it will work then ok, they suggest switching from narcotics to TCA meds- I guess this is the amitriptyline and I told them when I took it I blacked out, then they suggest neurontin or Lyrica- I told them I've had both, one doesn't work, the other puts me to sleep for 12+ hours, then they suggest me using a full lidoderm patch everyday instead of any narcotics (I use 1/2 a patch now for the bottom of my elbow)- I told them I already use 1/2, I use it everyday, and 1 full patch won't fit around my arm.

I told them if they have any suggestions or options that I am willing to try anything they've got, but I've been going through this for years and tried a lot already. Then they try to think again of other meds to take. We talk about how and when I take the Norco, and the patches. They want to switch me up from 50mcg to 75mcg fentanyl patches, but want me to take less Norco everyday. The pharmacist gives me the speech of trying to take less, how with the increase in the patch that I may not need as many pills, etc. I just nod my head cause I've heard it and know it, but don't want to blow her off. She finally said she knows I've heard it but wants to tell me again. 

The doctor said she wasn't sure what to do and asked the pharmacist what to do. I'm thinking this doc must not know much since she IS the doctor. Shouldn't she be the one to know what to do? Anyway, the pharmacist suggest oxycontin, which I've had, but can't pay for in times of no insurance. She suggests oxycodone w/ no tylenol, like oxy IR. I reminded her she gave it to me before (the 5mgs) and I had to take 5-6 at a time and they did not help.

They eventually just decide to give me the 75mcg patches, and said to try to take less of the Norco since I may not need as much. They all leave to get the scripts. Okay, done right?

The doc comes back in with yet another doc who again asks my history. She says I should not be on this much Norco, that Norco is only meant for short term, and only meant for ppl to take no more than 3 tabs a day! She asked repeatedly if I've had constipation, which I had kept telling her I've never had  problem with- are you sure, YES I'm sure, I think i would know. She then asks if I drive when I have my meds, I say yes. I've been on them for years, so I do not have a problem. She lectured me on how I shouldn't drive on them, and I am liable and could be arrested. I agreed, saying I know all of it b/c I teach others this same thing. She got very stern in how I CANNOT drive with these meds, yet another reason why she doesn't want me on them. I don't even know who this doc is!

She explains how after this long Norco isn't needed, and I should take other meds, possibly methadone. I told her I would like to be on something where I do not take so many pills per day. she suggests I may need a nerve block- I ask what it is, and she doesn't explain much, just that my nerve will basically have no feeling, but keeps saying its one of those need things where I may need to do it even if it had some negative consequences. I still don't know what it is, but I was interested cause if it will help I'm all for it.

She then does the "arm inspection" that the two other docs already did. She looked around, did tests, then asked about my pain. Where does it start, where do I get it, how long does it last, what kind of pain is it, etc. I explain, and she says it doesn't sound like chronic pain, that it just sounds like fatigue!! She said this isn't pain that needs to be treated with pain meds, that this pain doesn't even sound right. She's not sure what to do, but doesn't want me on these meds. She suggests PT, I say whatever you think will help. She suggests another EMG to see if there is even still a problem and what it may be- I was all for that. Then she said it may be something like RTD(?), she mentioned something about possible long-term nerve damage. Anyway, they said just to take the 75mcg along with what I have and come back in two weeks.

After I look at the prescriptions I see that even though they don't want me back for two weeks (14 days), they only gave me 3 patches- which is obviously only enough for 9 days. They also switch my 11 10/325 Norco per day (#330 month) to 8 Norco per day (#240 per month). This was without even waiting to see if the 75 mcg helps, or w/out saying anything to me. So now I have to hope the 75mcg helps enough to only take 8 Norco per day, even though I told them the 11 Norco per day was not helping. I have to take 3x for pain relief (been taking it for about 7 months now), but the doc just decided I don't need it and I only need 2x!!!

I'm sorry to rant on for so long, but I was at the doc's office for 3 hours. This is why I was so worried about getting a new doc. Now my old doc is gone and can't explain anything to these new ones. They even said he was doing fine and knew everything, but they don't know anything about me and my history and need to look it up, so thats why they just don't understand why I am on what I am. Shouldn't they have looked it up BEFORE seeing me and deciding to change everything?  Any comments or suggestions would be appreciated.

I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.