reasons to get fired from a pain management clinic

[midnightoil101]

Okay so here goes nothing...I will try to be brief but I am really fretting over this. So a year ago I had a bad surgeon get ahold of me and well long story short and 7 surgeries later I am on pain management.  I was scheduled to have surgery this past Weds but at the last minute my surgeon and anesthesia decided that because of my seizures which are medically induced the could not operate.  So that's a brief summary, but my concern is this so I thought I was going to have surgery and like a idiot I didn't make a pain management appoint I just figured my surgeon would take care of everything after surgery.  Anyway I didn't have any pain medications left my PMP had me on 10 mg Norco and I was able to take 4 a day well I ended up taking 5 a day so of course I ran out early.  So after I found out I couldn't have surgery and I didn't have any medications I called my PMP to see if I could get in and of course they were booked up so I talked to my PMPs nurse who informed me to take ibproufen 800mgs, Xanax, and my other normal medications.  I was completely honest with the PMPs office I ended up finally going to urgent care as I fell and was in god awful pain enough to where I was seizing and getting sick.  So the urgent care doctor gave me Norco 7.5 twenty a day until I can get in to see my orthopedic doctor as I do have a appointment with them next week as well as the PMP doctor.  So I called my PMP to inform them I had to go to urgent care and that they prescribed me the pills and I at that time didn't get them filled but I did later that day as I couldn't take the pain anymore.  So I am beyond fretting now as I have a appointment next week with the PMP do I need to be honest with him and show him all the notes from the urgent care along with xrays and tell him that the dose he had me on isn't working and I knew he couldn't get me in until next week or do I keep quiet and not say anything as I want to be honest and well since I already called the clinic and told them what happened I think honesty is in my best interest here.  I am only new to pain management for three months now and I may need to be with pain management for awhile as surgically I don't think I can be operated on.

[midnightoil101]

Hey all just to let you know it all worked out as a matter of fact better than I thought as they got me a new script for something stronger to help out along with the regular stuff I was taking.  I also learned some valuable things through this process.  I thank god my PMP was so gracious and just said to not let it happen again I got a second chance thank goodness as until I find alternate medications the pain meds are the only thing getting me through the day.

[midnightoil101]

Thanks all I appreciate it...I am sorry I don't want to sound like a nut.  I just am stressed to hell and back as until I can get surgery done which means I need to find a new doctor with a new anesthesia team that can handle my seizures.  I am so new to this pain management thing and I know I signed a contract and I feel like a idiot for blabbing to the staff I just thought that it was best at that time to let them know what was going wrong thinking they may have helpful advice for me.  Which the nurse I talked to was not any help whatsoever I just wanted to tell her you know wait until one day someone messes you up like the surgeon who messed me up and you have to go down this road of pain management until someone has mercy on you and fixes you completely.  I really lost some of my empathy being a nurse myself and watching a lot of frequent fliers come in some yes were drug addicts others were like me needing help to solve a complex problem.  I feel terrible for the way I treated some of them now.  No I am not over exaggerating I can show you pictures of my leg to show you how messed up it actually is, what started off as a simple perineal tendon tear/sublax tendon surgery landed me into a nightmarish hell.  I just cant believe one surgeon messed me up so bad which I am the process of filing a medical malpractice suit on and then I had to have 7 surgeries to debride the leg so it could be saved and start rebuilding it.  The last surgery I had was in May to fix a rupture in my gastrocnemius muscle which ruptured because the supporting tendons couldn't hold my leg up.  I am unable to hold weight on my leg and if I do I chance me falling everything I do has to be very calculated when I move.  This is my first experience with pain management honestly as I thought for sure by now I would be fixed and healed and I didn't know that your normal PCP couldn't prescribe long term pain medication nor could your surgeon that operated on you.  You had to go to a PMP which I have to say is terrible because you do see a lot of drug seekers there and then theres folks like me an some of you it sounds like that are in need of medication because of accidents or bad doctors.  
I am just scared to death since I signed a contract with my PMP that I screwed up by going to urgent care and getting a script filled because I was in dire straights not because I needed the drugs but because I was hurting so bad it was causing me seizures and my leg to be cramped up not to mention the nerve pain holy heck.  I was throwing up from the pain and in the process of trying to make it to the bathroom quickly I fell and broke my nose cause my ankle buckled.  
I am sorry to sound confusing as that's not my intent I just need good honest folks to talk to who have had to go the PMP route to let me know no pun intended do I have a leg to stand on for going to urgent care and getting a pain script filled or should I start seeking a back up plan doctor just in case because if I get fired from the PMP I am in big trouble if these seizures come back I am emergency room bound and I really don't want to pay that fee.  
I am just struggling as the pain contract I signed stated no medications from any other doctor should be filled, but I think I had a valid reason.  

[omhome]

well......i really hesitated to say this but i think you need to read what you wrote again and see how many times you brought up the whole "honesty"  thing. Makes me think there may be an issue there for you.  Like----are you being honest with yourself? Under or over-exaggerating? And it really could just be me projecting .....there just seems to be something missing......"Better" is right about the  whole rehearsal thing........if everything is cool there is no need to worry or rehearse.....you just relax and talk to your doctor and "be-friend" him or her. If you are nervous or tell a long complicated story it sends up a red flag for the doc......so relax and say what happened and all will be well in the end.  
      I hope this makes sense to you and please don't think i am saying you are being dishonest----i am not-  It just sounds confusing is all.
So..right....head held up and trust the doc to listen to you and tell what you need to tell them.
     Good luck!

[midnightoil101]

I just gave a brief synopsis of kind of where I have been with this issue let me give you the whole story...ok so September of last year I had a bad surgeon grab ahold of me and well like a idiot I let that surgeon operate on me two more times before I got a second opinion so when I walked into the second opinions office he took one look at me an said omg you have to go to ICU now and get operated on immediately so that was mid October....I ended up in four debridement surgeries and 12 weeks of picc line therapy.  So fast forward to January 7th I went back into the ortho doctor who saved my leg to get a reassessment and to start rebuilding my leg an ankle from the ground up so the leg was un operable unless it was by a vascular reconstruction specialist so that led me up into two more surgeries.  So at this point my PCP referred me to pain management UGHHH! So I went got established.  The last surgery I had was in May so its now October and I was just supposed to have surgery but I was denied by anesthesia due to not taking my seizure medications or that's what they said anyways.  So at this point I had no appointment with my PMP due to thinking I was going to be on surgeons care and he was going to provide my medications.  I overused my medications to be honest and I ran out the day before my surgery date.  Anyways so I didn't get the surgery and I had no medications to help treat this chronic pain so I tried to cold turkey it and just take ibproufen not a good idea I was hurting so bad by day 2 it was awful I had no choice but to go to a urgent care where he x rayed my foot and then prescribed me medications enough to get me through until I can get in to see a doctor.  I let my PMPs office know everything as I didn't want to be dishonest or labled as drug seeking as before all this crap I was a horse trainer and a nurse. So now I have a appointment with my PMP and I just don't know do I be honest with him and hope for the best or what?

[philnoir]

Sorry, could not follow your story

In a standard controlled substance agreement you promise to follow certain rules in order to receive controlled medications. These rules usually involve:

1. getting controlled Rx from only one practice
2. getting Rx at one pharmacy
3. not using illegal drugs
4. not giving/selling your medications to anyone else

There is probably also language regarding notification if you receive meds from other providers.

Re-read your contract. Find out what you agreed to.

Although you should have consulted your pain doc before any surgical procedure, you did notify afterward (I think that's what you said.)

As far as being honest -- of course. You must be completely open with your pain doctor in all things medical.

I have no idea what they will decide to do with you. That's up to them.

I suggest that you walk in with your head up, and with whatever information you want to bring. Don't blab to the staff -- your business is with your pain doctor.

When you get into the exam room with your doctor, explain the situation, your reasoning, what you were told by the hospital/surgical staff, and ask your doctor to explain what you should do if this situation arises again.

Give it your best. You have no reason for guilt or fear, but after reading some stories here, anticipatory apprehension is completely understandable. You have to remember that you never get the entire story here -- only the unhappy ending.

Best of luck.