Am I good or no?

[Cycot50]

I have been in pain management for over a year no issues.  Several weeks ago I took a urine test and I am currently taking Tylenol #4. However, I had temporarily misplaced my Tyelonol #4 so I took a 5 or so  tramdols from a previous prescription I had from the same pain management clinic. In addition I had started taking creatin, amino acids, glutamine and mass gainer protein shakes. On to the question. I normally get a urinalysis bill from 400-800. However, this time I received one for more than 10x the amount (one being over 4K) with 6 different test including one for creatin. Should I be concerned and why on earth is it so expensive?
Note: I did tell the person taking my urine about the tramadol, but I'm not sure if it got through.

Thanks

[jsycz]

As for your bill, they probably used a different lab or used a more in-depth test to "medmatch" or confirm the results which is more sophisticated. I would ask the lab to negotiate with the insurance companies and with you to see if they would give you a cheaper rate... maybe $600. Creatine is a routine test. Btw, most tests are negotiated down to 10-25% of the price...definitely less than half of the original price

[Tuckamore]

Thank you for the update.

It appears you dodged the bullet. Great news. I am so relieve and happy for you.

You would think had they seen an issue with your UDT - they would have said something at your appt. Looks like all is well. Be cautious going forward.

Again great news. :o)

[Cycot50]

I went into my appointment today and everything was fairly normal and got my same script. However, I did see a PA, but it appeared that the PA was seeing multiple patients. The PA went to ask my normal doc if my scripts were good, but I honestley never saw him there. Other than that nothing was said, so I'm guessing I'm good for at least now.

[Tuckamore]

Hello fellow Chronic Pain Patient,

Oh dear! You took Tramadol without a current RX? I am sorry to say you may be in trouble with your PMP.

I'm only guessing here, using my common sense. I assume (I hate to assume) that your initial (quick and easy) UDT (Urinary Drug Test) results were different than they had been in the past. They returned negative for the level of Codeine that should have been found - hence the additional UDTs to determine exactly why the UDT was "abnormal" and exactly what was in your urine. Those more precise and accurate tests are expensive - but honestly I have never heard of one costing over $$$ four thousand dollars!!

Sadly my friend in pain, I think you may have made a not-so-wise choice by taking the Tramadol. You'll either have a lot of explaining to do - and rebuilding of trust with your PMP - or worse - you may be dismissed as a patient. I hope I'm wrong.

When Tramadol was initially approved/released for use in the USA by the FDA - it was classified as a non-narcotic pain reliever. Physician's quickly began prescribing it as they felt "safe" in doing so. However it made no sense that it was released as a non-narcotic since it acts as an opiate. In the body, tramadol is converted in the liver to the active form of the opioid, called O-desmethyltramadol. Tramadol is a synthetic 4-phenyl-piperidine analogue of codeine. I don't do chemistry well - but basically it means that Tramadol is and always has been an opiate.

In Aug of 2014 the DEA-  in all it's wisdom - rethought this drug and placed Tramadol in the Schedule IV category. Some states even beat the DEA to the punch and classified it as a controlled substance before Aug 2014.

So that's what you may be facing - taking a controlled substance without a current RX - or approval of your PMP. But that's the worst of it - and I'm hoping your PMP will be very understanding.

The 4k is a ridiculous charge - but that's another subject - one that also sets my blood boiling. I would challenge that cost.

Please let us know the outcome. I'll be interested to hear how your physician handles this situation. I'm hoping for the best. If you had better pain management you would have had better choices than falling back on an old RX to control your pain.

I'll look forward to hearing more from you.

Good Luck,
~Tuck