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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by greenhornet on April 29, 2006, at 13:53:53
Hi,
Well I am back. Same old complaint, docs who won't prescribe for pain or anxiety because ???? Lord knows why -- the only answer is they are scared sh------ of the DEA! I had very serious surgery on my foot back in February (triple arthrodesis, took five hours, I lost A LOT of blood and got an infection.) Everything was cool with the pain med for the first months (Vicodin 500's once or twice a day - sometimes it works sometime it didnt) So yesterday I called the ortho surgeon to get a refill and the nurse calls me back and tells me Dr. Yada Yada "wants me to switch over to Motrin or Aleve"!! Now, my foot is not my only problem, I have nasty arthritis in knees, hips and spine too. This guy knows this, but suddenly he had discovered that I take "psych meds" and whoops, no more Vicodin!! I am livid to say the least... now I have to go IN (four hours each way) and see the knee guy or spine guy (oh yeah they are that specialized!!) It will take over a week, if I am lucky, to get in; and in the meantime I a hurtin!!WHY DO THEY PULL THIS CRAP?? one or two Vicodin a day is hardly abuse...I'm over 60 and yeah I hurt. Hey I know we've been this route before.. I have several friends with cronic pain (fibromyalgia, arthritis etc) and they have no problems getting pain medication. Any suggestions?
Oh yeah, I also have to fight for my Ativan 0.5mgm bid with my family doc! -- Where can I do better any suggestions
Sorry to come back on with a gripe but I am up to my a** with this.... Oh yeah, this is a university med center too, not some little backwoods place!!
Posted by pseudoname on April 29, 2006, at 15:45:23
In reply to pain medication?, posted by greenhornet on April 29, 2006, at 13:53:53
Hey, GH.
I'm really sorry to read about your situation. That's so frustrating! We need a total re-evaluation of the status of opioids in medicine and psychiatry.
The surgeon is probably afraid of the DEA — and state & local police & prosecutors. Also, state medical boards and professional societies deal out sanctions, license restrictions, and bad publicity for “inappropriate” narcotic prescriptions. He's probably also afraid of you and your family: lawsuits by patients for addiction-related problems are a constant threat to doctors who prescribe narcotics. Often, their insurance policies won't cover such suits.
And it's really too bad. I take a prescribed opioid myself for an off-label use, and I consider myself very lucky that I can get it.
I don't know what you can do immediately to get Vicodin except maybe to have the docs call each other, but I have a few suggestions overall.
(1) Make sure ALL your doctors and psychotherapist are talking to each other explicitly about this issue. If they can spread the responsibility, they will be more likely to prescribe.
(2) Show willingness to comply with all other aspects of treatment. Do the physical therapy or exercise or diet or support group or weight-loss program or whatever they ask. Keep seeing your psychotherapist.
(3) Negotiate in concrete terms. Offer to make a written treatment agreement specifying how much of the drug you will take, for what kind of pain. Be clear about your pain-treatment goals: “I want zero pain” is not likely to be a persuasive argument. Be clear about what else you will do to manage the pain and how you are aware of dependency problems. There are examples of opioid agreements on the web, but I would think a surgeon would probably know about them.
(4) Document your drug use on your own. Keep a chart or diary of pain and dosage.
(5) Agree to use only one pharmacy for all narcotic prescriptions.
(6) If you have other family members in your household, make sure the doctors all know that they are on board with your opioid decisions also.
Unfortunately, the decision is still in the hands of the doctor. Using these same suggestions, you may have better luck with your family doc who has a longer relationship with you and is in your community.
(7) If even that doesn't work, then you may have to see a pain practitioner or pain specialty clinic. It sounds like that may be long drive, too. Sometimes, though, even mentioning that you might need a referral to a pain specialist can get the current doc off his/her bottom to prescribe what you need.
Also, I can't resist suggesting the book "Living Beyond Your Pain", which a friend has had great success with. It has some well-researched, unusual, counterintuitive strategies you can do on your own to help stay active & happier with chronic pain. If the docs know that you're doing something like that, it can also loosen up their prescription pads — as well as help you itself.
Good luck.
Posted by greenhornet on April 29, 2006, at 18:04:37
In reply to opioid prescriptions » greenhornet, posted by pseudoname on April 29, 2006, at 15:45:23
> Hey, GH.
>
> I'm really sorry to read about your situation. That's so frustrating! We need a total re-evaluation of the status of opioids in medicine and psychiatry.
>
> The surgeon is probably afraid of the DEA — and state & local police & prosecutors. Also, state medical boards and professional societies deal out sanctions, license restrictions, and bad publicity for “inappropriate” narcotic prescriptions. He's probably also afraid of you and your family: lawsuits by patients for addiction-related problems are a constant threat to doctors who prescribe narcotics. Often, their insurance policies won't cover such suits.
>
> And it's really too bad. I take a prescribed opioid myself for an off-label use, and I consider myself very lucky that I can get it.
>
> I don't know what you can do immediately to get Vicodin except maybe to have the docs call each other, but I have a few suggestions overall.
>
> (1) Make sure ALL your doctors and psychotherapist are talking to each other explicitly about this issue. If they can spread the responsibility, they will be more likely to prescribe.
>
> (2) Show willingness to comply with all other aspects of treatment. Do the physical therapy or exercise or diet or support group or weight-loss program or whatever they ask. Keep seeing your psychotherapist.
>
> (3) Negotiate in concrete terms. Offer to make a written treatment agreement specifying how much of the drug you will take, for what kind of pain. Be clear about your pain-treatment goals: “I want zero pain” is not likely to be a persuasive argument. Be clear about what else you will do to manage the pain and how you are aware of dependency problems. There are examples of opioid agreements on the web, but I would think a surgeon would probably know about them.
>
> (4) Document your drug use on your own. Keep a chart or diary of pain and dosage.
>
> (5) Agree to use only one pharmacy for all narcotic prescriptions.
>
> (6) If you have other family members in your household, make sure the doctors all know that they are on board with your opioid decisions also.
>
> Unfortunately, the decision is still in the hands of the doctor. Using these same suggestions, you may have better luck with your family doc who has a longer relationship with you and is in your community.
>
> (7) If even that doesn't work, then you may have to see a pain practitioner or pain specialty clinic. It sounds like that may be long drive, too. Sometimes, though, even mentioning that you might need a referral to a pain specialist can get the current doc off his/her bottom to prescribe what you need.
>
> Also, I can't resist suggesting the book "Living Beyond Your Pain", which a friend has had great success with. It has some well-researched, unusual, counterintuitive strategies you can do on your own to help stay active & happier with chronic pain. If the docs know that you're doing something like that, it can also loosen up their prescription pads — as well as help you itself.
>
> Good luck.
THanks for your cery concrete suggestions. I plan to read the book also..GH
Posted by Phillipa on April 29, 2006, at 23:31:43
In reply to Re: opioid prescriptions, posted by greenhornet on April 29, 2006, at 18:04:37
Vicodin and percocet can improve your mood. Love Phillipa
Posted by gardenergirl on April 30, 2006, at 13:08:40
In reply to opioid prescriptions » greenhornet, posted by pseudoname on April 29, 2006, at 15:45:23
Posted by pseudoname on April 30, 2006, at 13:21:56
In reply to Great suggestions! (nm) » pseudoname, posted by gardenergirl on April 30, 2006, at 13:08:40
Posted by spriggy on May 3, 2006, at 17:01:06
In reply to Re: opioid prescriptions, posted by Phillipa on April 29, 2006, at 23:31:43
I have chronic issues with pain; fibromyalgia. My doctor seems to nearly throw pain rx's at me.
I am blessed to have a doctor who understand's my pain and isn't afraid to treat it.
I know there are people who use online doctor's for pain meds. I know some are shadey but I know some are legal and legit.
I know ERmeds.com seems to be a reputable one.
So if all else fails with your dr. maybe try that route. I know they ask for medical charts and such so they would see your surgery and foot issue.
Posted by Phillipa on May 3, 2006, at 19:14:59
In reply to Re: opioid prescriptions, posted by spriggy on May 3, 2006, at 17:01:06
Spriggy hi!!!! Are you doing any better? Love Jan
This is the end of the thread.
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