High Risk Patient

[larbec7]

I will try to make a long story short.  I have been going to pain management for several years and on the same medication.  My doctor is a personal friend and my spouse worked for him.  She was getting tired and stressed out from all the BS going on in the office and he was not willing to change his ways and allowed certain people to just play around 50% of there day on computer playing games, face book, myspace, stc...

Well, I told her to quit and she did about 7 months ago.  Ever since then he has given me one drug test after another and changed my medication amounts as well.  I became disabled about 18 months ago.  When I went to see him this week, I confronted him and was very blunt as to why he keeps messing with me.  He claims that I am considered a "high risk" and I should not be on the dosages I am on since I am disabled now and I do not have to function in a work environment.  He also claims that because I am tan and have muscle tone I must not be in the pain that he thinks I am in and in the same breath he says "you seem to be in more pain the past few months than I have ever seen you.  I'm sorry but WTF????  He also says that since we are friends I may want to consider seeing another PM doctor.  Everything he said to me I called him on it and told him he can't baffle me with his BS and what is the deal.  He just said, well, you are considered a "high risk" patient and should not be on as much of medication as you are on since you are disabled.  Is this not discrimination or what.  Let me tell you, I am only on 40mgs Oxycotin a day ...10 mgs every 6 hours, 3 Darvacet for break through pain and soma/zanaflex for spasms.

What are your thoughts?  have you ever been told or heard of being a high risk patient?  Just seems strange to me to be treating me for 7 years and now all of the sudden since my spouse quits to be doing this to me.

[Tuckamore]

Opus, I agree with you. Some ppl are on very high doses of narcotics. I am fortunate that I have avoided the Big Dog Meds for the most part. I hated the loss of control I felt and the never-ending headaches.

It doesn't mean that I don't have horrid pain, I do. I have days and nights that I think I cannot bear it a minute longer. But I like you Opus, I use other measures that work or don't work to varying degrees. I am "in love" with my heating pad. I also throw in a muscle relaxer now and again. And though I wouldn't necessarily call it lucky I am no longer able to work either. That allows me (sometimes) the advantage of be able to rest as needed. If I don't sleep all night I don't have to go to worry about going to work and conduct 8 hours of training, hours of preparation and wrap up or whatever the day would have held for me.

I feel very fortunate that I have avoided the huge doses of opiates some ppl must rely on for pain management. My heart goes out to all of them.

UniquelyMe42, the burning pain could have been a side effect of the medication working on the nerve impulse fibers. We are all different and often respond differently to medications. I am glad that you no longer have to deal with that particular side effect.
      

[opus88]

wow...some of you people are on very high doses..I can understand we all are caught in the cycle of trying anything to give us some quality of life....
I'm still fortunate enough to be able to get my pain(usually depends on the day and the activities)...under moderate control with a relatively low dose. I prefer to just take enough for moderate control for now, my mind may soon need to change?
yes I take oxycontin 10mg every 8 hours like you I could NOT function on the 12 hr regime.
My PM doc also gave me an RX for percocet for BT...I use sparingly...he also mentioned Methadone if this 3x day isn't working...we will see what the future holds, I could also allow a higher dose of oxy, unsure what to do as of yet, when I first took oxycontin my condition actually got WORSE so the increase of it is a trial, I may not be an oxycontin candidate????
Lately(on my own...have an old rx on hand) I have been adding Flexeril at bedtime, this combination appears to be helping, I sleep better at night and my leg muscles during the day are not as tight and achy....but flexeril too becomes not as effective over time...my we are all stuck on a never ending rollercoaster aren't we!
we only hope for a med or combination of to allow a somewhat 'normal' enjoyment of life......i'm lucky in the fact that I'm no longer in the work force and have the 'luxury' to lay down frequently with my much loved heatind pad!!
I have NO upper back burning on this dose...luckily.

[Preacher1970]

16 years on methadone 150 my a day I quit cold turkey ....like to died....3 months off and was still feeling full Detox ...I quit March 26 2017 it's Dec 23,2017 and I am still Detoxing...Dr said it takes 2 year's.....I have cancer no insurance and can't find a pain management Dr that will touch me everyone is saying go back to methadone....I'd rather DIE any advice would be nice Merry CHRISTMAS to all ....Preacher

[larbec7]

yes my upper back would burn as well.  I thought I may have worked out too hard.  I knew it was not my kidney;s....I wonder why it does that

[UniquelyMe42]

I have a question... When I was taking 30 Mg. Oxy IR for BT pain I noticed that my upper back muscles would be on fire...literally on fire...Anyone else have this happen?

[UniquelyMe42]

Sorry, I meant to add that I think that PM Dr. was actually trying to watch his own ***!! What a joke he is...Any Dr. that tries to get you to buy Pot from his son is needing his liscense revoked...I am sorry that you are having a hard time with your meds...I hope that you get this new Dr. to help you...I have a great PM Dr. and am lucky...not many are.

[UniquelyMe42]

Hi, I am new here but not new to CP.  I have been taking 120 mg. Methadone along with 30 mg. Oxy IR 4Xdaily for a long time...Methadone for 6 years...I wanted to change up a bit due to length of time on Methadone.  My PM Dr. wanted to change me to Opana ER 20 mg. 2Xday along with only 80 mg. Methadone a day...due to TennCare I couldn't get both Methadone and Opana ER so he did this...he increased Methadone to 150 mg. daily and no BT meds!!!  After I complained his NP (new) added 5 mg. Oxy IR 3Xdaily...what a joke!!  After taking 120 Mg. Oxy IR daily they put me on 15 a day?  No Way!! Anyway, I go back on Monday and really want to try the Opana ER but am scared to decrease Methadone to 80 mg. a day... What should I do?

[bmdad]

You said you are taking 10 3 times a day....Is that one 10mg oxycontin 3 times a day? I am no longer taking them as my pain subside so I dropped back down to the 10mg hydrocodone. I was on the oxy's for about 8 months or so. I was taking two of the 60mg every 12 hours. They normally wouldn't last the whole 12 hours though.
I agree on not wanting to have to keep increasing your dose. It is a pretty strong med so you the lower you take the better. But you want to make sure you are able to control your pain for quality of life. Have you talked to your doctor about a immediate release pain med for break through pain? When I was on a lower dose to start I was also prescribed 10mg oxycodone for break through pain as needed. I would usually (but not always) have to take one around the 8 hour mark until I could take another oxycontin. I wonder if you talked to your doctor about trying the 20 mg and then maybe you wouldn't need anything for break through pain? There are so many different options out there that you could try. Just talk it over with your doctor until you both agree on a regime that will work for you. It sometimes takes trial and error but eventually you will get to where you need to be.
I hope you find the right dose that works well for you.

[larbec7]

Thanks for your comment.  I am having to take the hydrocodone about 4 hours after I take the Oxy.  I can tell the Oxycotin is helping a little but we are not there yet.  I will keep everyone informed but the 15mg does not effect me mentally at all and I like that because I do not like being "out of it"

[opus88]

HI Brian...glad ur stabilized now on 60mg...can I ask you HOW LONG have you been stabilized??
I am currently on 30mg and not stabilized I am taking 10 3x a day because the moderated pain control only lasts abt 6hrs...so when i take it every 8 hrs...I still get pretty sore before I can take my next dose, but I hate to keep increasing this med.

I guess what I am looking for is some reassurance that at some point there will be a therapeutic dose where us CP  people will stabilize for LONG TERM.

THX

[bmdad]

Oxycontin and percocet are the same that they both have oxycodone in them. The oxycontin is time released as you said. Like Opus said, percocet has acetaminophen  in it and is not time released. I was prescribed oxycontin in the past and one thing I like about it is that it lasted for quite awhile. I was prescribed 1 every 12 hours but usually around the 10 hour mark I could feel my pain creeping back up on me. But there were also times to where I didn't have to take the one at night and could make it 20 hours or so without one. My doctor started me off on 20mgs and we worked my way up from there. Eventually you will get to a mg that is effective. Once I got to the dose I needed I didn't have to take anything for break through pain. I think I finally stabilized on 60mg. I think the reason I required that high of a dose is that I was opiate tolerant from being on pain meds for a extended period of time. Just do your best to stay at the lowest dose possible yet at a dose that is still able to control your pain effectively.
It sounds like things are finally coming around for you and your pain is being treated the way it should be. I personally feel if someone requires narcotic pain meds due to chronic pain the extended release are the way to go. When I was on norco's I got so sick of having to make sure I had my meds even if I was only leaving the house for 6 hours!
Keep us informed on how well your new meds are working for you.

Best of luck!
Brian

[opus88]

percocet also has the tylenol combination   thats what the /325 is...325mg tylenol...10mg oxycontin

[larbec7]

My doctor put me on 15 mgs Oxycotin for two weeks with 10/325 Hydro for break through pain and he said when I come back in two weeks he will up the dosage to 30mgs if needed

I thought Oxycotin was the same as percocet except for the time relief?  I hope this helps

[larbec7]

And he gave me the marijuana

[Tuckamore]

You are probably correct that the high risk is for the physician. A physician that sets up his patient with illegally obtained marijuana does not have the patients best interest at heart, through his son no less. And than he drug tests.

There are a lot of reg flags with this physician!! I think he is the high risk!

[kolo13]

Hey, I just read through this and if you don't mind me putting my two cents in...
I was talking on the phone to a friend in health care while I was reading and I asked "What does this mean - high risk patient?" Well it could mean anything; high risk for what? So I told him more of your story and mentioned the medical marijuana thing and where it was obtained and he said, "Oh now it's clear, he's a high risk for the doctor. he could put him out of business."

[larbec7]

I am feeling this new doctor out and I KNOW them telling me it takes 2 weeks for a med to take effect is a liar.  I am going to start  a new post on my meds because I tried something and want to get some feedback from others if I should tell my new doc or not.

Because I have so many diff meds I decided to try some things on my own to see what works well for me.  I took a percocet 10/325 along with 10mgs of OXYIR and I got pain relief for about 3 hours.  I normally take darvacet for break through pain which is useless to me, it never did any good so I did not even attempt to take any of that. For my break through pain, I took another 10mgs of OXYIR.  My question is, should I tell my doctor what I tried> OR will he think I am a bad person?  

Basically I am taking 4 10/325 Percocets a day and 8 to 12 OXYIR a day and it is working.  I am not having any issues, no side effects, I am sleeping well at night now where b4 I was lucky to get 4 hrs a night.  I can think clearly, no constipation etc...

What are your thoughts?

[larbec7]

I did not leave anything out and he owns the practice.  I went to see two other PM docs and they both said he was treating me incorrectly.

Just curious, how is it discrimination by him putting things in my chart about my appearance?

[AmazonGirl]

Actually getting a prescription for Soma is getting more harder everyday, lots of doctors will not prescribe it for any reason, so what that doctor did is not unheard of. I guess when mixing soma with prescription pain meds like hydrocodone and oxycodone gives the person a heroin like high...atleast thats what I've heard and been told by many doctors and nurses.

Also taking Percocet has a very short half life so their is no waiting a week to get it's full effect like you would with long acting pain meds. So this doctor is lying to you cause either they dont want to deal with it or have some other weird issue with it.

Also last but no least, just because their's so much misunderstanding out their about Suboxone...it's main ingredient, Buprenorphine, has been used in other countries (Europe mainly) for many years for moderate to severe pain and they're also doing trials right now in the states for Buprenorphine to be in a patch form that will FDA approved just for chronic pain. And also lots of doctors are starting to prescribe Suboxone/Subutex for chronic pain....I take Suboxone after trying every other pain med out their and it's the only thing I've found to help with my pain, and I have pain from cancer and other problems. But because Buprenorphine has a peak level befre taking mroe is useless and blocking other pain meds is the reason for it being used for opioid dependence, but it is a VERY stong narcotic, 50 times stronger then morphine.

But as most of us with chronic pain know, finding a good doctor is like a needle in a hay stack sometimes. Just remember that you hired that doctor, and if they treat you bad, then fire them.

[concerned621]

I'm not so sure I agree with everyone about the writing on the wall and just get out of there. He has documented in your MEDICAL FILE you are HIGH RISK.  What did you do to make him say, think, or write that in your file.  Unless you are leaving something out it doesn't appear to me you are high risk.  Being tan and tone is him making a judgement of you based on your appearance, that is discrimination.  On a side note: be careful of that, disability could view that the same way.  Back to him.  Does he own the practice? If not find out who does. Ask to meet with that person, the office manage and their human resource manager.  If you can talk with an attorney and/or bring someone professionally dressed who is good in a business setting to this meeting.  You dress professionally as well.  Have notes about what occurred. It will show them you documented what happened.  Prior to this meeting sign a request to have your medical file sent to the attorney if you get one or to you personally.  review all of his notes.  The sporadic changes in medications makes no sense, that wouldn't help you as a high risk patient so what was his plan, why was he doing that. If he did not want to treat you any more he should have said so and not treated you so poorly.  Your wife worked there and left for good reason. Don't just drop this. If you ever do return to work companies check you medical for insurance, also for life insurance this also could be a big problem.  So good luck and don't let someone do this to you.

[larbec7]

I wish he would just give me something that will ease up my pain.  I have been a pain level of a 7 to 10 for over a year.  When I was taking 20mg of htdos 4x and 4 to 6 soma a day for two years prior I was pain free all day and slept like a baby

I may just have to ask him flat out to prescribe the hydros again BUT he wont do the soma and the zanaflex puts me out

[Ghilly]

Yes, Oxy IR and Percocet are the same drug, but Percocet have tylenol in them.  The Tylenol acts as a catalyst for the oxycodone in the Percocet, kind of like the caffeine in aspirin does.  I don't know why he'd take you off one and put you on the other, since too much Tylenol is very damaging to the liver, and pure oxycodone is a much safer choice for someone who is on pain medication long term.  That makes no sense to me.  It would have made more sense to just have you take a couple of Tylenol twice a day rather than having you take 325mg four times a day.  While that's still well under what is considered the toxic level of Tylenol, it's just kind of stupid when Tylenol is so readily available.  I'd be interested to know his reasoning.

Ghilly

[larbec7]

I went to a new PM doctor last week.  he took me off my Soma and told me that Soma is what killed Michal Jackson and Anna Nicole.  I argued with him a little but did not want to push it because he said he would not give me Soma and if I wanted it to go find another PM doc.  He claims Soma magnifies all pain medicine and it can cause me not to wake up.  INMO that may be true if you abuse it.  I have been on Soma since 1998 and HELLO...I am still here.  I do not abuse anything.  The sad thing is Soma does help me ALOT.

Anyway, he took me off my OXYIR 10mg 4x aday and put me on Percocet 10/325 4x a day.  Well, I can't tell where I am getting anymore relief than I had before.  From what I have been toild OXYIR and Percocet is the same substance????

I called his office 4 days after I stated taking the Percocets and spoke to the nurse and told her I was not getting anymore relief and she told me it took a couple of weeks for the Percocet to get into my system.....I wanted to say BS but I did not.  IMHO when you take a pain pill it should work right then and there ....  am I wrong???  I go back to him for an update next week.

I will see what he says when I tell him I am not getting any relief.

[larbec7]

My PCP and I had a long talk last week and we are together and he is on board (or at least he acted and said he was)  I also heard my PMP is doing meth or some type of injections in the arms...he is skinny as a rail but like I said I had heard this....although from a reliable source

I am just so tired of these Dr.s that "act" like they know if you are in pain or not and they tell you..."you look like you hurt"  : you look fine today"  urg.....I know how I feel, not him

Now my disability company wants me to go for a FEC...I think because the doc that has me out on disability says I am loosing strength and can hardly lift anything...and my PMP says "I look fit and tan and muscular"  I am not sure what the FEC is and also...do I give in my best at 100% or if it hurts back down and tell the doc doing the FEC "I simply can not do this or do thet"???

[opus88]

wow u have really had the gears!
medical MJ doesn't come from the streets it comes from a prescription....
My PMP told me medical mj does help with back pain yes however it has to be in a brownie and a person would need to eat alot of these brownies to get enough pain control so than there would be the weight issue...I don't know if he is right on this or not, just what I was told.
besides if he supplied you with this through his son....there is really something wrong with this guy!!!....what else is he getting 'through his son?'
now you will have further problems because of what he has and could write in you're disability report...make sure you're PCP is aware of all you have posted and is ready to stand behind you whether you look 'tan and healthy' or not.
good luck