Re: Suggestions Please

[Guest guest]

---, jbrosenfeld@... wrote:

>

> For the past few months I have been

> looking for a new pain doctor. The one I go to is ok, but he doesn't

> take my insurance and I can't afford to go to him anymore.

>

Jess -

Have you talked to your old doctor about his " cash " prices? Usually they are

very happy to

work with you if you are paying cash and not using insurance, to give you a

reasonable fee

that you can afford. It shouldn't be hundreds of dollars for an appointment in

which he

just writes a script!

If you look at your insurance records, they probably only paid that doctor about

$70 total

for a visit, and he had to wait months to get that money from the insurance

company and

went through a ton of paperwork (and thus paid staff time) to get it. He may

have billed

them a great deal more, but they always settle for a pretty nominal amount

That's why

doctors are usually willing to give you a big discount if you're paying cash -

they're getting

as much (or almost as much) as the insurance would pay, but they're getting it

right away

with no wait and no staff time for paperwork, and that's worth a lot to them!

When my doctor quit taking my insurance, he worked a deal with me where he

charged

me only $35 a visit for a visit with his nurse to get my monthly scripts.

Considering my

insurance co-pay would have been $25, that was a pretty minor increase in order

to stay

with a doctor I loved and get the right medical treatment! If I needed to see

him, I paid

more, I think $70, but since I was on maintenance meds by that time and didn't

need

many adjustments, I didn't see him very often. Of course I couldn't use him for

procedures, but I refuse to have procedures at this point anyway - all I needed

was my

maintenance meds.

If you haven't talked honestly with your doctor about your financial situation,

set a time to

do so immediately! Be upfront - tell him what you can and can't afford, and see

what he's

willing to do to keep you as a patient.

Good luck...

Cheryl in AZ

Moderator

[Guest guest]

I did talk to him. That's why I wouldn't have to pay him thousands of dollars

right away. It would be 100 for the vist and 200 toward past things. I have

used him for treatments and didn't realize how much it would cost.

-----Original Message-----

Have you talked to your old doctor about his " cash " prices?

[Guest guest]

Hi Jess

Have you tried talking to your old doctor about your insurance not covering your

service. My insurance doesn't pay for office calls and my doctor reduces his

fee when I go in so I can still see him. I hope you get it worked out, going

through withdrawals is an awful thing.

a

. Please help me with suggestions. I can't go

to my old pain doctor unless I pay him several hundred dollars which I

don't have.

Thanks

Jess

[Guest guest]

My question is this, is a doctor just allowed to send you off without some kind

of backup for people on these types of meds.

I to almost ran into this ans I got luck on the very day I was to run out only

because it was the pharmacy that kept running out of meds. I had one pill left

when I got my scrips filled. I had to drive in a snow storm on the absolutle

wort possible day but I would have suffered terrbly from the pain.

I assume it takes a few days before the real withdrawels kick in, is that

correct. I don't know because I have never had to go through it. I fear that day

should doctors or society

all of a sudden cut us off from our medications...God forbid.

Rich

--- Jess wrote:

>

> . I am afraid he will say the same thing and I

only

> have enough medication to last me through tomorrow.

>

[Guest guest]

I am trying to not worry about it and just hope this new dr covers me. I hope

that if he tries not to if I say please cover me till I can find a doctor, he

will have a heart. What do you guys think?

Even if the old dr said don't worry about the past bills it's 75 a visit when

you pay cash. I have to go every month and my scipts cost about 200 a month.

Can't aford that 75 anymore. So I need to switch.

I don't know what I will do if this new doctor won't help me. Since another

doctor refered me to him, and they are sending him my records fom that one visit

I went there, hopefully that will help.

This makes me feel like a druggie, I so hate having to worry about this. If it

was any other type of medication and I ran out all I would need to do is go to

the er and if there would be no problem getting a refill.

Jess

[Guest guest]

I think this question is very dependent on type of drug, length of time on the

drug, type of useage and body chemistry. For example, someone who takes a few,

(one two three, maybe four), percocets every day with no set pattern to his/her

useage, might be able to last longer than someone who takes 800MG of Morphine a

day, every day.

For me, I've got a four to eight hour window. If I miss my meds, or run out,

(and after the time I did run out because I didn't know that my doc would be out

of town, I have made sure that it has and will never happen again), I feel it

within about four hours, it's bad at about eight and it's call an ambulance bad

by about ten-twelve.

--

Dodge

---- frescasdad wrote:

>I assume it takes a few days before the real withdrawels kick in, is that

correct.

[Guest guest]

Hey Jess, Has he told you he will not treat you for chronic pain

anymore? Was this a pain clinic or just your MD? If it was a pain

clinic, they should at least give you a list of other clinics and I

beleive a thirty day supply of meds.

An MD, I'm not sure about because they are not clinics set up just for chronic

pain sufferers. If it's your MD, be honest about the way you will feel and could

he please give you enough until you can find another doctor or clinic.

Then make sure you follow through and tell him where you will be going. Don't

cut him out of the loop. Don't be afraid to tell him your fears of withdrawal

and the pain you will suffer.

They know about them and it does not mean you are an addict. It means you are

dependent as in heart meds or say someone who had diabities and needs their

meds. Be strong with him/her but respectful as well.

Rich

> --- Jess wrote:

> I am afraid he will say the same thing and I only have enough medication to

last me through tomorrow.

[Guest guest]

Dodge,

Your pain, withdrawal or both are bad? I have had to cut back a few

times to stretch my meds by a few days and noticed my pain levels

worsening but did not feel any major withdrawal effects. Or, are they

two in the same. I dread that day if it should come.

I just had a problem with my current doctor and may have the problem

of finding tratment sooner then later. It was over money as well. I

have to find a new pain clinic because of $125.00 and I was treated

for five years and this was the first time I fell behind. I think

these clinics look for any way out of what becomes long term

treatments for reasons other then medical. I thought I saw it comming

a couple months in advance and even asked why they seemingly were

trying to get rid of me but they denied it but it has now happended.

I don't like how they did it. It was totally unethical by all means.

Rich

Dodge wrote:

I think this question is very dependent on type of drug, length of

time on the drug, type of useage and body chemistry. For example,

someone who takes a few, (one two three, maybe four), percocets every

day with no set pattern to his/her useage, might be able to last

longer than someone who takes 800MG of Morphine a day, every day.

[Guest guest]

You should always take the same amount of medication each day as prescribed.

Your blood levels are used to the same amount each day so once you decrease the

amount you could show some kind of side effects. Not bad withdrawals but it

would be determined by the amounts you did not take of a certain drug.

 Your best bet is to ask you pharmacist.

Toni

[Guest guest]

adonah5@...

There is No Set Amount that is given to and fits to everyone

A lot goes in to the prescribing of medications.

Height, weight, injuries and yes how long a person has been taking a medication

how many in combination.

For some people what you described in the message could be enough

where others might need less or might need a whole lot More its all on the

person.

The best one who can judge that is you and with the help of your doctor to get

your pain within reasonable levels so that you can function do normal things.

Rob

New York

To: chronic_pain

Hi Folks , Could anyone tell me what the dosage of oxycodone should be for a

7-8 pain level? Any reply will be usefully im going to get a back injection

tomorrow and i want to say something about my small dose it's 5/350 every 6 hrs.

thanks jack from mass

_________________________________________________________________

[Guest guest]

I don't know if anyone should even attempt to answer that. Your 7-8

pain level is different then mine or anyone elses for that matter. Only

you can decide what releives your pain.

Rich

>

> Hi Folks , Could anyone tell me what the dosage of oxycodone should

be for a 7-8 pain level? Any reply will be usefully im going to get a

back injection tomorrow and i want to say something about my small dose

it's 5/350 every 6 hrs.

> thanks jack from mass

>

[Guest guest]

--- " frescasdad " wrote:

>

I have had to cut back a few

> times to stretch my meds by a few days and noticed my pain levels

> worsening but did not feel any major withdrawal effects. Or, are

they

> two in the same.

If you don't know whether or not you've experienced withdrawals, you

have NOT experienced withdrawals.

Just having your pain return to its non-medicated level is NOT

withdrawals.

Withdrawals can differ depending on the medication, but for opiates

it can include any or all of the following: nausea, stomach

cramps/pain, vomiting, fever/chills/shakes, horrific headaches,

inability to sleep, the classic " DT's " including

twitchiness/nervousness to the extreme and inability unable to sit

still, anxiety/panic attacks, muscle spasms and twitches, and even

delusions. These can last for several days.

Withdrawals from seizure meds can actually bring on seizures. NEVER

stop seizure meds (like Lyrica or Neurontin) cold turkey!

Withdrawals from anti-depressants can cause all of the above plus

anxiety/panic attacks for WEEKS or even MONTHS following the removal

of the last of the drug.

The key here is NEVER to stop a med you take on a regular basis cold-

turkey. It is not only painful but can be dangerous or even deadly.

Always titrate down slowly to avoid these symptoms, although you may

still have some of them no matter how slowly you remove yourself from

them. (Stopping the anti-depressant Effexor was one of the hardest

things I've had to do - even with doctor-managed titration I thought

I was losing my mind for WEEKS later due to withdrawal symptoms!)

We also never should be forced into withdrawals by a doctor. But it's

not their responsibility to make sure we get our scrips on time - we

have to be on top of it and make sure we plan ahead and schedule

appointments so that this doesn't happen. But if the worst happens

and you run out of medications, go to an ER if you have to!

Cheryl in AZ

Moderator

[Guest guest]

--- jadonah5@... wrote:

>

> Could anyone tell me what the dosage of oxycodone should be for a

7-8 pain level?

Hi Jack -

There is absolutely no way to answer this question. It depends on

too many factors, including your body weight, how long you've been on

opiates, your tolerance to them, and your type of pain. What works

for a " 7 or 8 " pain level for one person will be completely different

than what works for another person who reports the same pain level.

But to answer your question, simply tell your doctor that you are not

getting relief from your current medication plan. Talk to him/her

about how the pain is affecting your life - does it wake you up at

night so that you don't sleep? Does it keep you from doing daily

hygiene (like showering/bathing/brushing your teeth)? Does it stop

you from being able to feed and dress yourself? It is not enough to

say " I hurt! " List out exactly how the pain is affecting your life

and then ask for help in changing those situations.

Do NOT go in and ask for a higher dose of pain medications or for a

particular medication by name - that's a red flag that someone

is " drug seeking " (even though I know you are not.)

Keep a pain journal and take it in to help talk to your doctor. This

gives him/her written evidence that they can use to justify giving

you more or different medications.

There are many examples of pain journals online - just google " pain

journal. "

Cheryl in AZ

Moderator

[Guest guest]

OK, so I am not going to be able to get any meds. I went to the new doctor

today and he said he doesn't prescribe anything to anyone on the first visit.

When I explained the situation to him he apologized and said it is the old docs

responsibility. When I called the old doc he said I went to a new doctor so I

broke my pain contract and he won't prescribe me meds.

I have been on pain meds for about 4 years now. I am actually taking the least

meds I ever have now. I take 5/325 percocet one pill 4x a day and I also take a

extended release ultram every day. I still have a couple of refills on my

naproxin and lyricia. Those I am not worried about.

I only have 3 percocet left. I don't know what to do. I need to be able to

work. What do I have to look forward to with the withdrawals? Any suggestions

on how to make them not as bad as they have to be?

I am sitting here in my office at work balling my eyes out. I can't believe I

am in this situation. I am a real person with real pain.

Thanks,

Jess

________________________________

F

--- " frescasdad " wrote:

>

I have had to cut back a few

> times to stretch my meds by a few days and noticed my pain levels

> worsening but did not feel any major withdrawal effects. Or, are

they two in the same. If you don't know whether or not you've experienced

withdrawals, you

have NOT experienced withdrawals.

[Guest guest]

--- jessica rosenfeld wrote:

>

> I take 5/325 percocet one pill 4x a day and I also take a extended

release ultram every day.

I don't know how much it will help, but the Percocet can be safely

cut/broken into two pieces. If you have a few days worth of meds

left, it might be worth trying to reduce your dose with what you have

left so that you don't stop completely cold turkey.

Stretch the time between doses (if you're taking the Percocet every

six hours, then stretch it to 8 or 10 or 12 hours if possible), and

then also try taking just half the dose by cutting the pill. This

may help reduce or eliminate the worst of the withdrawal symptoms.

Do NOT break/cut/open the Ultram, however! It can be fatal to do so

with a long-acting medication like this because you'll release the

entire 24-hour dose into your system all at once.

The good news is that you're a really low dose of percocet, so

hopefully the symptoms won't be too bad. I went through withdrawals

of percocet after my surgery years ago (from four times your dosage!)

because the surgeon cut me off with no way to titrate - and I felt

like I was going to crawl out of my skin and didn't sleep well if at

all for about three days, but that was it. Hopefully it won't be any

worse for you, and if you can titrate even a little bit it should

help.

Cheryl in AZ

Moderator

[Guest guest]

It might be worth a trip to an emergency room and explain what's going on.

Or just wait till you are in pain and go in for that and tell them you need

enough to get through till your new doc kicks in. Don't cry and make a scene

in there, be as matter of fact as you can be. Someone with more experience

can comment on which of these options are the best.

Also, if your old doctor didn't give you a written 2 week notice he's probably

violating the law. You might call and explain that to his office people. I

suspect if you haven't spoken to him directly that the office people are

making it up as they go along. You can sue him if he doesn't handle the

breakoff properly and he knows this. Tell him all you want is enough to get

through the period till the new doc starts taking up where he left off.

Now, as far as the withdrawals.

www.nationalpainfoundation.org/MyTreatment/MyTreatment_Abrupt_Withdrawl.asp

the dosage you are taking you will be fine. You won't sleep well, you will

feel like a rat in a cage, muscles twitching, but taking muscle relaxants if

you have them, will help. The naproxyn and lyrica will help a lot for the

achiness. Laying in a hot bath will feel really good and make it possible to

sleep some.

I would take one percocet in the AM when you go to work is your biggest

concern take one tablet on the first day and then try to split them in half

on the next couple of days, taking one half AM and one half PM., That will

get you working and through the worst of this. If sleep is your biggest

concern then reverse that.

It's not going to be anywhere near as bad as you think. Right now your brain

is making it much worse than it will actually be if you just calm yourself

and keep telling yourself it will be over soon. Then when you get stable

again, I wouold strongly suggest that you think about doing what other on

this list have done which is to build a backup of meds by saving a few each

month. If you are not fortunate enough to have a stable medical situation

everyone needs to think about this.

Now, get through the next 4 or 5 days and by next weekend you'll have it

licked.

I thank God daily that I've had a stable doctor for the last 18 years.

" Sweet Goat Mama "

Carolyn Eddy

www.goattracksmagazine.com

[Guest guest]

Doctors who prescribe the pain meds are supposed to give you

medications until you get another doctor, it doesn't matter if you are

in a pain clinic or not. Call the local hospital for a referral. Keep

a pain diary and it will document your pain levels and problems and a

doctor is more apt to assist you when they have this. You can download

one through a Google search or just write out your pain levels, how

your medications controls your pain, when you have

problems.

I just started a pain clinic and was short four medication and could

not remember it but a medical assistant gave me " the lecture "

and then I came home and remembered I threw up my doses and I had gone

in early and saw the doctor and it was in the chart

that I was vomiting for four days and had trouble keeping my meds down

and the doctor even gave me some phenergan if it started

back up.

I called back and spoke to a nurse that annotated why I was short and

she saw where i had been vomiting. I told them I don't count

my pills everyday and have been on this medication for three years and

they can call the pharmacy and see that I never had early refills

or duplicate ones. I told them that in the future I will save my vomit

with the pills that had not been digested for prove.

I was very respectful, started keeping my pain diary again, as I will

not have some young girl tell me , Mrs. I do not know what you

did with your pills but you had enough for thirty days. She was so

rude and I told the nurse, I would prefer to speak to someone else

who could have said, Go home and count what you have, let us know , and

try to remember what happened, and then let us know and

we will figure it out.

I will not be put in a position anymore that I am treated like a drug

addict and will follow their instructions. It is very hard not being

rude but

taking up for yourself. I was glad that the nurse was nice that I

talked to and I let her know I don't think about my medications 24/7

and

will buy a med minder and put my medications in so I will remember what

happens, do my pain diary daily as I would have it written down,

and that way it is documented for everyone. She said those were good

ideas and not to worry, the chart reflects I could not keep my

medication down.

This is just an example that doctors have to have more information from

the patients and may be more receptive if it is presented in

an understanding format. Bennie

frescasdad wrote:

> Hey Jess, Has he told you he will not treat you for chronic pain

> anymore? Was this a pain clinic or just your MD? If it was a pain

> clinic, they should at least give you a list of other clinics and I

> beleive a thirty day supply of meds.

>

[Guest guest]

Ok, since we are on this topic and I fear it comming my way due to a

disgruntled doctor. Let me ask you this. Does this sound ethical?

I had been caught up in a move in the middle of last winter because

the land owner I rented from rented me an illegal dwelling and I was

told to leave by the town.

So, during this time, I had to pack by myself, move by myself, unpack

and get settled. During this time, I spent alot of money I had not

planned on so I fell behind in my doctors fees by a whole $125.00.

A few visits to the doctor, he started dropping hints about my moving

on from their pain clinic practice. I questioned why they were

seemingly trying to get rid of me and their answers were all over the

place. No ligitimate reasons. I had been treated by them for almost

five years. Never had any issues with them whatsoever.

They started asking why I could not work and they just didn't get how

difficult my life was being alone with severe low back pain. One

week, he hands me a list of new clinics. Then the following visit, I

am asked to take a urine test. I agreed because I had nothing to hide

but asked why. They said it was protocal. They had never done this

before.

Two weeks go by, I'm thinking it was a blood test they took

and I wanted to know the results as if I might be sick or something.

They say the doctor is still reveiwing it. Two more weeks and it's

time for my refills. I call for my meds and the doctor gets on the

phone and asks where did I get such and such a drug? I was huh? No

way, no how, never did any such thing. He says, before you get your

scripts filled, you must take another test. I said no problem. there

had to be an error and I have nothing to hide.

Well, on my ride to their office, 1 hour away, I realized the

compleexity to all this. If they were indeed trying to get rid of me,

this was the way.

In the car, I began to panic and thought about the ramifications

should this turn up on my medical record, I could have problems

finding treatment. I tried in vain before getting to their office to

get an independent test but because it was a holiday, I could

find no one open. Also, the one I did find open, would not do it

without a script. Who was going to give me this? Right, no one that

day.

So, I ent up at the docs office and I ask to speak to the doctor, the

nurse comes in and says, the doctor gave you instructions, she does

not want to speak to you. Now, I have never had any words with my

doctor in any combative way. This seemed even more obvious to me now.

So I said, if they wanted me to leave a urin sample, I want to take

two and have the doctor label one for me to take to another lab. They

refused, I refused to leave a sample and the doctor came in screaming

at me and threw two ten day scripts at me and said don't ever come

back. This was some show they put on.

Now, I received a letter from them that I was being released for

opiate protocal infraction which was not true. What if anything

should I do gang? I fear this could prevent future treatment for my

back pain. I would not be able to manage my life without it and I'm

afraid. As I mentioned in another post, I have tried to wien off meds

a few times in five years to see if I could handle the pain, I could

not.

This is just one more wrench in this whole hellish life of living

with chronic pain. I don't think any other illness is treated so

poorly. It's not fair.

How can this be changed?

Rich

[Guest guest]

Jess,

Have you attempted to enroll in one of the prescription companies

discounted medication programs? It is always worth a try when you're in

a pinch.

Also, have you tried to go to WalMart for their discounted medications?

I just thought it might help you to pay the $75 to see the doctor.

Wishing you the best,

Lori

Jess wrote:

Even if the old dr said don't worry about the past bills it's 75 a

visit when you pay cash. I have to go every month and my scipts cost

about 200 a month. Can't aford that 75 anymore. So I need to switch.

[Guest guest]

Jack,

The doctor is liable to adjust your medication if you tell him/her

that your pain level is just as bad or only one level lower.

I think you need to definitely talk this out with your doctor because

he/she will know the best answer for you.

Wishing you the best tomorrow,

Lori

Jack wrote:

Hi Folks , Could anyone tell me what the dosage of oxycodone should

be for a 7-8 pain level? Any reply will be usefully im going to get

a back injection tomorrow and i want to say something about my small

dose it's 5/350 every 6 hrs.

[Guest guest]

Rich,

If I were you, I would begin by contacting your state board that the

doctors are lisenced through.

Did you tell the doctor or her receptionist that you didn't deserve to

be treated like that because you had trusted her all of this time to

care for you? To think that doctors have such power over us as

patients. They say they are there to cure the ill & the motto of " First

do no harm " is certainly contradictory of what is going on there.

Also, you may want to contact a lawyer to find out your rights in the

case she defames you. Therefore, when you do get into another doctor

that says they won't prescribe you medication because of what she wrote

in your medical records, you will know what recourse you have to act on

the misery you're liable to suffer at her hands.

I am not one that believes in filing a law suit just to do it, but I do

believe in protecting your good name & the treatment you should be able

to get for your pain.

God's speed,

Lori

Rich wrote:

Now, I received a letter from them that I was being released for opiate

protocal infraction which was not true. What if anything should I do

gang? I fear this could prevent future treatment for my back pain. I

would not be able to manage my life without it and I'm afraid. As I

mentioned in another post, I have tried to wien off meds a few times in

five years to see if I could handle the pain, I could not.

Rich

[Guest guest]

It's time to involve an attorney. Did you sign a pain management contract?

If not, they don't have a leg to stand on.

You might want to send them a note back saying your attorney will be in

contact, whether or not he will. This will possibly affect what gets put

into your chart, as doctors like to put as little as possible about these

things since they are a legal document and can show up in court to bite them

in the butt.

" Sweet Goat Mama "

Carolyn Eddy

www.goattracksmagazine.com