Need Advice on where to turn

[Johnny19130]

Hello, I have been suffering from long term chronic pain for close to 20 years now. I have pretty bad arthritis in both knees and ankles along with venous stasis ulcers and nerve pain. My current doctor of about 10-15 years has been helping with my pain. He currently prescribes 30mg oxycodone (every 4-5 hours) and 800mg (every 8 hours) gabapentin. My problem is he has indicated he is no longer comfortable prescribing oxycodone to me and has asked me to try pain management. My primary doctor wrote me a referral but told me that they would not be taking me as a patient and the only explanation they gave me is they can't help me. My arthritis doctor has been patient and is trying to help me but what can be done if he doesn't want to give me the meds I need and pain management refuses you as a patient? I don't know where to turn

[GuitarRox]

This is really hard and I feel for you.  First, FIND a pain management clinic.  EVEN if they don't agree to your oxycodone script continuing. Because what you don't want is to just be out and have to go through painful withdrawal. You need a doctor overseeing how to help you.  Unfortunately, doctors do this thing now of abandoning patients when they decide maybe there is a dependence issue.  Don't feel insulted that I say dependence issue related to oxycodone because that is so common. It's harder and harder to find anyone to prescribe that long term. It really irks me that after they get it going that way, they want to pull the plug so dramatically.  You'll need some strategy to go to what can be next for you.  Are there any other pain therapies that could work for you?  That's really the question to explore but right now, you need to sort out how you will deal with no oxycodone.  Again, this is so tremendously hard.  I'm sorry

[Johnny19130]

Like I said my current doctor is being patient at the moment. He's promised not to let me go without but like many doctors he's uncomfortable continuing to prescribe the meds. I tried a pain management clinic my primary referred me to and they denied me without much of a reason. They just said they couldn't help me which really shocked me. The doctor has asked every one of my doctors to take over the writing of the prescriptions and they all denied him. He even asked my podiatrist lol. He want's me to find another doctor to continue writing the prescription but how do you ask a doctor you've never seen to begin writing the script for you? I would fully expect to get thrown out of the office. I sure would like to know why the doctor no longer wants to write the script but the only answer I get is he's uncomfortable. I've abided by my patient contract and never created any problems or asked for meds before they were due. It just really sucks. The meds help me be more active and make me feel like a functioning person. I don't want to become a shut in who never leaves the house because of pain. I don't know. It just really sucks to be in this position.

[Hoosier_Carry]

It's very simple. Most doctors are cowards now-a-days. The Gov, DEA, and the CDC have succeeded in frightening them into submission. There only a few docs and presribers left with integrity who still follow their hippocratic oath. It's a sad thing to watch in America. If The Constitution was still the framework of our nation, the gov wouldn'y have all this control over The People. All I can say is "Good Luck" in your search for a real American doc!

[GuitarRox]

This is part of the psychological component.   Chronic oxy is just problematic for many reasons. Do you see a doctor for treatment of arthritis or a physical therapist?  I hope they can help you. I'm glad your doctor is going to wean you off properly.  I'd find a pain management clinic that will take you and follow your contract to a T. Best of luck to you  and I don't want you to be a shut in either.  At all.  This may spur a new chapter in your life that you can't see now because of the oxy.

[backhurtz]

180 mg of oxycodone is a rather high amount of opiates for arthritis - how long have you been at that dosage?
Long term chronic pain management usually involves using a long acting opiate as a baseline medication- typically dosed twice a day and possibly a smaller amount of a similar med in immediate release version as a rescue or breakthrough med for severe episodes of increased pain. The breakthrough med is typically not meant to be used every day or regalarly as a supplement to the long acting but reserved for days when pain levels spike occasionally..
Extended release or long acting versions of opiates provide consistent levels if medication typically over an 8 or 12 hr period - depending on the particular medication and are only taken 2-3 times per 24/hr period- rather than immediate release versions which only provide short term relief for 4-6 hrs. and often create an up and down level of relief az the med wears off.
Arthritis treatment also typically involves some anti inflammatory type of med since flare ups are often related to activity levels and weather as well.
It sounds like you might be better off seeing a pain management Dr who can tweak your medications and find a better , effective medication plan that would allow you to do what you need to do but at lower, more effective doses.

[backhurtz]

Long term management of chronic pain should be managed by a pain management or physical medicine and rehab physician. The goal of a PMR physician is to manage both your pain AND have you able to function to the best. Level you can given your conditions.
Many PM offices provide both procedures AND medications - although they usually require a consult first and evaluation before they will prescribe medications.
You must keep in mind though - no doctor is obligated to continue medications that you were prescribed by another Dr. They may want to try you on different medications to see if they ease the pain levels more effectively.

[ellijaygal]

Try other pain management facilities.