Discharged from Pain Management

[Taz45103]

I just received a letter from my Pain Managment Dr. office saying i was discharged for missed appointments and an abnormal drug screen.. There is no way I could have failed a drug screen because I do not use any drugs, i dont even drink alcohol. The only thing i can think of what that means is maybe they didn't find the drugs they prescribe me in my system.. I am prescribed a 30 day supply and i usually run out about maybe 2 days before my next appointment.. I have spoke with my Dr. about this and she has asked me if i want my dose taken up to 7.5 percocet instead of the 5mg percocet and i have told her i don't want a higher dose because of the risk of addiction and all that stuff that comes with getting higher doses. I asked my Dr. if some days i need to take an extra 1 or 2 if that was ok and she said that if i do take any extra that i need to try and take less later to make sure i have enough for the entire month. So to my understanding everything i am doing is ok and that it is possible for my percocet not to be in my system at the beginning of the month if they drug screen me..

Now with missed appointments. I have been with this Dr. for 9 months. The first few months they were doing a couple procedure's with shots into my nerves on my back.. I had to reschedule 1 of those procedures. A few months later after insurance gave the go ahead they wanted to do a EMG on me. I asked a little bit about it and its about an 2 hour procedure where i can not bring my 1 year old daughter with me. I am a stay at home dad with an 8 and 9 year old boys and a 1 year old daughter and the only baby sitter i have is my parents, which during this time of year they go on trips. So i schedule this appointment 3 times and missed it 3 times. My last appointment I spoke to my doctor about missing the appointments and she said everything was fine and that i try to get it done when i can because of my situation.

I have called the Dr. Office and spoke to someone about this.. She looked into my file and instantly saw that i spoke to my Dr. about missing the appointments. She explained to me that it wasn't the Dr i see every month that discharged me, it was the MAIN Dr that I only see when they do procedures. She also explained to me that after i missed my EMG appointment for the 3rd time that the front desk sends something back to the MAIN Dr.. She is sending a letter to the MAIN Dr. to see if he will take another look or maybe he missed that i talked to the Dr. and take back the discharge.. To me it seems like after i missed the 3rd EMG appointment a notice was sent back to the MAIN Dr. and he had a tiny glance at my file and gave me the boot. If i was discharged for missing appointments then why would they put abnormal drug screen and concern for opoid abuse on my discharge paper's. They knew I was running out a few days before the end of the month and even wanted to give me higher dosage but I refused. If there was a concern or suspicion of opoid abuse then why didn't they ever drug test me any other time during the 9 months or bring me in for a pill count.. I know they have grounds for discharging me because I have broken the contract I signed for missing appointments but since I explained to the doctor i see every month about my situation and she said it was ok before i missed my appointments, can they really call that a breach of contract?? also can they put abnormal drug screen and concern for opoid abuse on my records when they knew i was taking the minimum amount i had to take to deal with the pain and running out before the end of the 30 days?? Will someone that is abusing opoids refuse to have a higher dosage of medicine?? None of this makes since to me..

I don't know alot about how all this works so any information would be helpful and i don't know what to expect on monday when the MAIN Dr. gets back to get the letter. Do they take back discharges??

[Bionics]

I am amazed that your pain dr would give you the OK to use a c2 other than prescribed.in your OP you did mention that she gave OK for more after you refused a bump but did tell you some days take less must last 30days.. there's no exception to this unless otherwise stated in contract you signed...I don't think she understood you had already been running out early..you had a great one sounds like but yeah the clean test is permanent and is going to cause headaches for a very long time...I think it was innocent error and not an addict..to them it's noncompliance same thing with 3emg's missed Red flags everywhere again noncompliance... sounds like they were decent it's so hard for us documented pain patients as it is Good luck to you

[Tuckamore]

Hi Taz,

Just wondering of you were able to get in touch with your PMP. How are you doing?

Regards,
~Tuck

[remar]

Please keep us up to date on how things are going.
I'm kind of shocked that your pain Dr let you go with no prescription. He is a Dr and he should know that going cold turkey off of pain medications can sometimes be terrible.
Your primary Dr should have been there to help you out until you got everything straightened out with your pain Dr, or, until you found a different pain Dr.
We're here to support you and offer advice. Hopefully the main pain Dr will understand what happened and you will be able to get back in to see him very soon.  

[Tuckamore]

Hi Taz,

Excuse my tardy welcome to our community. I find your post very interesting and hope that you are still monitoring our site - and that you'll be active in our forum.

I agree with Remar and fntn - as always their input is valued. I also agree with you. You don't sound like an abuser to me.

Sadly as you said - you broke the contract. In today's opiate phobic climate we have little if any rights. Second chances or considerations are rarely  given. A PMP needs no real reason to dismiss anyone. It is my hope that someday this will change. I know it won't be soon.

I think you have taken the right course. Hopefully your PMP will be able to reverse the "Main" doctor's decision. Either way this will most likely remain in your permanent medical records. You don't want that! It will hurt you down the road - especially if they refuse to reinstate you as a patient.

I suggest your write a letter to this clinic, address it to the main physician and do a cc to your PMP. Your "side" needs to be placed in your records. A letter should do that - if not request that it be placed in your records.

Request a copy of all your records from the clinic. You'll need it in the future - either way - plus it's always good to know just what they contain. I've found some real surprises in mine.

Please let us know how this turns out. I'll be very interested in hearing more from you. I wish you the very best.

Take Care,
~Tuck

[Taz45103]

Thank you for your info about writing a letter and making sure it is put in my records.. Well I went over the discharge letter they sent me and it was suppose to contain a copy of my "Abnormal Drug Screen" but it didn't. So I called and spoke to the front desk and she said that my Drug Screen came back clean, it didn't show the percocet I am currently taking. I explained to her how i spoke to my Dr about how I run out a few days before the next refill and she said it was a combination of the drug screen coming back the way it did and me missing appointments.. Then she just kept saying she can't speak for the Main Dr. and I will have to wait until he gets back from vacation.. Tomorrow is the day he gets back, so I am pumped right now waiting to hear his response and try to move forward.. Long night for me.

[fntn]

Fingers crossed Taz ... !!

[Tuckamore]

I hope you'll have good result from your discussion with the main physician. Please let us know how it goes.

I'm so sorry this has happened to you.

Good Luck to You,
~Tuck

[fntn]

Remax is right and this is a crazy workd we live in now. Our own goverment is treating us as drug addicts and criminals with their ever increasing limits and restrictions. So any patient that doesn't compile within these limitations and doesn't adhere to the pain contracts, will be left alonw and without any treatment by their own doctors that fear repercussions.

And as you have found, the dosages are so restrictive for some of us, dosage management can be a life altering issue. Your life is also controlled by your frequent appointments, drug testing, pill counts, unneeded/ineffective shot and all of this for an increasing price as our insurance companies clamp down as well.

I hope you can get an appointment with your main doctor to work things out. But many doctors walk away and you will not get a second chance, red flagged. These are truly appaling days, and all based on a misguided war on drug. And they will find more and more chronic pain patients moving towards self-medication, likely through illegal means.

[Taz45103]

I agree. Real people with real problems are the one's that are getting hurt. I have reached out to my PCP and asked if she would be willing to refill my pain prescriptions until I am able to get into another Pain Management Facility and she said she will not. I was completely honest about why I was discharged and she didn't even ask to get records so she could look to see if I was telling the truth.. So i am already being labeled..

[remar]

I would recommend making an appointment to see your Dr, the main one, and go over everything. Maybe he did miss something in your files.
If you're running out of medication at the end of the month either none of it or very little will show up in your urine test. So, it does sound like you need an increase.
I don't think your Drs are doing this to be mean. They have guidelines they have to follow and you have to honor your contract. I do understand why you had to cancel your 2 hour appointments because you have a baby. Do you feel like this is a procedure you truly need? Or do you feel like they're trying to push it on you? Sorry for asking that question but that can happen with some pain Drs and clinics.
Did they give you a prescription for a months worth of your medication? It's the right thing for them to do so you're not going cold turkey off of your meds.
Try and make that appointment tomorrow. The sooner the better. Your Dr needs to know about everything that happened. Hopefully once he understands he'll start seeing you again.

[Taz45103]

Yeah, I know I should take the increase of dose but my uncle was on pain meds for a long time and i have heard about how he had to get increases of medicine just to keep up with his tolerance for the meds.. I am willing to do almost anything if it will get rid of this pain but no the Dr. i saw every month actually said it is my body and it was my choice to get this procedure done..
No he didn't give me a prescription for a month. He wrote the reason for that was because "concern for opoid abuse".. Well I didnt schedule an appointment with him but the front desk that i talked to said she was sending a letter to him stateing that i would like to speak with him and that there was notes in my file saying i spoke to my Dr. about missing the appointments.. Tomorrow is the day the Main Dr. gets back from vacation, so hopefully things were documented and he actually reads it and things turn around for me because I talked to my primary Dr. said she will not write any prescriptions for me because of what the pain clinic wrote..