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1524811 tn?1333241301

PCP DR & PM DR

My PCP has recently referred me to a PM doctor after me asking her for 2 years to do so.  I received a call from their office about 2 weeks ago to book the appointment & with everything I've had going on didn't get a chance to book with them.  Anyway I contacted my PCP last week to explain that this particular PM DR is about 5 hours by bus from my house, I'm 8 months pregnant & now have a blood clot in my lung so travelling to them is not something I can do.  Today I get a call back from my PCP office telling me that my PCP would like to me to book the appointment anyway & after I have the baby (being induced in 3 weeks) they'll ATTEMPT to transfer my file to a local PM DR, but the local clinic is a 6-8 month wait.  They honestly expect me to travel 5hours EACH WAY  with my 2 kids & husband ... soon to be 3 kids.... with a large clot in my lung to see this doctor.  I explained I have no problem waiting to see the local doctor, but can't get to & from this referred DR at which time I was kindly told that failure to book an appointment with the dr that I've been referred to for now is alarming & that if I chose not to then I'll no longer have my meds prescribed once I run out in a month.  Can they legally do this?  If the clinic were closer it wouldn't be an issue, but the fact that I'm set to give birth VERY soon, live so far away with no one who will drive me to the appointments, have been in preterm labor several times & not to be left alone (OB orders)  & have this blood clot in my lung all makes it impossible.  

Can she really force me to see this doctor?  I've been asking her for 2 years to refer me to a PM DR & am happy that she finally has, but it's not possible for me to get to appointments with him now.  
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Avatar universal
Force you? Of course not. But this sounds like a very frustrating situation.

What diagnosis, if any, is the reason for the referral to the PM? As you've probably noticed on this and related forums, many PMs are not as helpful or useful as patients would like. In some cases, a PCP can provide everything a PM can.

From what I understand of your situation, it simply isn't safe, let alone realistic, for you to see the PM until well after you deliver. So I'd suggest focusing on your current health and forthcoming delivery, and working with your PCP on pain management as best as you can.
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Avatar universal
I'm glad your PCP finally has agreed to refer you to a PMP, but sorry that you're having such trouble with them about the appointment.

My suggestion would be to see if your OB will either call your PCP or better yet, give you a letter to take to them (your PCP) stating that it is unsafe at this point in your pregnancy, with the history of preterm labor and the blood clot, for you to travel that distance.  If your OB basically forbids you to do this travel, then your PCP has absolutely no right to force you to do it.  If they will do it, it might also help if your OB will put in writing that it is also dangerous for both you and the baby for you to go without your current pain meds.  That may help you in requesting that your PCP continue your pain management until after you have safely delivered and can get in to see the PMP.

Best of luck and please keep us posted.
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Avatar universal
Hi Melissa,

Geminigirl is ABSOLUTELY correct.  You MUST get your OBGYN involved IMMEDIATELY!!!  Call him/her TOMORROW, if you haven't done it already!!  DON'T waste ANY TIME as YOUR well being AND your Babies may depend on this.

PLEASE keep us informed as you KNOW that we care about you AND your Baby. We'll be looking for your update. :)

I'll keep you in my thoughts and prayers............Sherry  :)
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1524811 tn?1333241301
TY Ladies for your posts.  I received another call from my PCP & informed her by NO means am I going to travel that far at this point in my pregnancy with the complications & that the PM wouldn't even be able to see me until after the baby was born anyway.  I DEMANDED that they refer me to a local PM & the receptionist I was talking to (as the dr NEVER calls but has her staff do it) tried to inform me that there are no local PM dr's even though I know there is.  She got extremely rude with me at which point I snapped & told her that both she & my DR need to get off their ***** & do their jobs. There is a pain clinic at the hospital I'll be giving birth at which is less then a 15 minute drive away or an hour after 2 buses.  I hung up at that point feeling bad about what I had said, but over the last few years they've gotten worse & I've had enough of their incompetence.  

ANYWAY they called back today & since I've been having contractions since yesterday I got the ex to talk to them.  They FINALLY agree that yes there is a PM clinic through the hospital & it would probably be best for me to be seen there.  BUT I'll have to organize it all myself..... fine by me.  I made sure he told them that I'll be delivering in 2 weeks anyway & have this clot in my lung so traveling ANYWHERE else would be extremely dangerous & irresponsible of the PCP to expect it.  She still won't prescribe any other meds once I run out so thankfully I still have some to last me & the next time I see my OB I'll get him involved in the fight against her.  He's already shown how unimpresssed he is with decisions she has made in regards to my pain management while pregnant so hopefully with my determination & his help we'll actually get somewhere.  He's far from the perfect DR himself as he refused to look at the pain in my leg beginning of the February when I was in & shrugged it off...... had he bothered to order the right test he would have seen it was a clot & it would have been caught BEFORE it ended up in my lung causing all the other issues.  

TY ladies for your support. I can't believe that I actually got that nasty with them, but with all the BS they've put me through over the last year alone I'm not surprised.
Helpful - 0
655875 tn?1295695107
I'm so happy that you are being treated through another pm clinic.  I've learned that we need to be our own advocate for ourselves, especially now that we have chronic issues.  I've learned that there are very few doctors that actually care about how we are doing.  Most doctors treat us like a number rather then a human being and they want to do the more expensive treatments.  I've always organized everything myself.  Not all pain management clinics are the same either.  Some treat pain much better then others.  I went the first year and a half of my injury with barley and pain medicine and I had a disc on my spinal cord.  Good luck with the new pain clinic.  I pray they help you with your pain.  Also, good luck with the birth of your baby.  I hope all goes smoothly.
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1524811 tn?1333241301
Just when I thought things were gonna be ok I tried to renew my prescription for the 25mcg Fentanyl patches today as I need a new 1 for tomorrow & apparently they can`t & won`t because my useless PCP DR has decided to wean me off WITHOUT telling me even though she just bumped the prescription up 4 weeks ago. Any other patient she has on fentanyl she weans them down over a few months 12.5mcg at a time...... not me.  She drops me 25mcg at a time & every 4-8 days she drops it again.  She knows how badly I react to the weaning so much so fast & while I`m pregnant & it honestly looks like she doesn`t care.  Every time she has attempted this while I``m pregnant I end up being rushed into the hospital by ambulance with an unstable heart rate (beats 40 beats a minute & then jumps to 250+ & everywhere in between), trouble breathing, fainting, high fevers, unable to eat or drink, pre-term labor & the baby in distress. She wasn`t supposed to attempt this again until AFTER the baby was born, but of course she`s changed her mind & there`s nothing I can do. She of course isn`t in until Tuesday so now I get to start going through the withdrawals YET AGAIN. THANKFULLY I`ll still have the 100mcg patches to help.  I called & left a really nasty message warning that I have covered my *** with research & maybe she should do the same before it ends in a lawsuit as I`ve been told I should do because of her negligence.  I then called the PM clinic at our local hospital & left an emotional message explaining everything to them & being sure to explain how scared I am now for the safety of my baby since my DR seems to pick & chose when the hypocractic oath applies to her & when it doesn`t.  

In pain as it is with not only my usual back pain, but it`s been getting worse as my body is entering into labor, plus the pregnancy aches & pains & tonight my 2 yr old daughter decided she was gonna grab my left pinky & bend it in such a way that it is at the very least dislocated, quite possibly broken. OUCH.
Gotta feed the rugrats now but will update more later this evening if time & kids allow.
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Avatar universal
Melissa,

Call your OBGYN IMMEDIATELY and tell him what she has done and BEG for his help in this matter IMMEDIATELY!!!

Honey, DON'T hesitate!!!! PLEASE do this now!!

MEGA {{{{{{{HUGS}}}}}}}...........Sherry
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1524811 tn?1333241301
Sherry

My OB isn't in until Monday & I see him Tuesday anyway.  Thankfully the last time I ended up in the hospital from the withdrawals & my lung clot he was there & treated me well.  He was extremely busy delivering 6 babies within 2 hours, plus 2 csections, yet when I got there & he heard my name he made sure the nurse ordered demerol to at least help with the extreme pain I was in.  I've already started suffering the withdrawals & can't believe how bad they are.  Why the hell would my PCP decide to do this YET again knowing the effect it has on me & knowing that I'm due so soon?  I can understand if she never saw me, but I;m in to see her EVERY month & I know that my OB who found the blood clot in my lung has sent her the records from each visit I've had with him & each visit to the hospital, so she knows what's going on IF she bothered to read the reports.  

Unfortunately up here they don't have on call DR's in DR offices after hours.  If the office is closed you have 2 options: 1) a walk-in clinic which will not prescribe ANY narcotic pain relief &  2) the hospital & chances of getting any relief through them involving narcotics is slim.  You will rarely get a sympathetic DR there that will prescribe something to help, but always told after 2 or 3 days to follow up with your PCP.  The problem is my PCP & her refusal to treat.  

I'm hoping that when her office opens tomorrow they'll actually get her to call me, doubtful as she NEVER returns phone calls, instead she'll pass along a msg to her staff & get them to call.  I made sure to leave in my msg that I'm due to have my baby within 2-3 weeks, on blood thinners for a blood clot & the last time I had been in to see her we had agreed to weaning down AFTER the baby was born unless I was being seen by a PM DR by then.  I also mentioned that this has gone on long enough & if she refuses to treat again I will be contacting a lawyer. Explained that she is knowingly endangering my unborn child & if anything is wrong with this baby or myself I will be suing.
I followed up with a call to the local hospitals pain clinic.  They were also closed, but left a message with them explaining the type of care I'm receiving from my PCP & the way my pain is not being treated.I asked that someone call me when they open on Monday & that they get me in asap as I'll already be suffering & I'm worried about what is going to happen to my unborn child.
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Avatar universal
My Dear Melissa,

Again, I'm SO SORRY that your PCP is SO INCOMPETENT as to treat an expectant Mother with as MANY COMPLICATIONS as you have SO EXTREMELY CARELESSLY!!!  

In this case, I DON'T blame you for what you said in your message. In MOST cases I would have said that threatening with an attorney MIGHT not be the BEST idea, BUT as I said in THIS case I think that you said EXACTLY the correct thing.

From the VERY beginning, she has treated you TOTALLY incorrectly.  She has been lowering you in INCREDIBLY RECKLESS abandon.  NOBODY and I MEAN NOBODY should EVER be weaned off the Fentanyl at the rate that she was lowering you at the beginning of your pregnancy.  You CANNOT lower these patches by 25 and 50 mcg's EVERY 6 days as she TRIED to do to you!!!  They REALLY should take her license from her or at the VERY least she SHOULD NEVER be allowed to prescribe narcotics to ANYONE EVER AGAIN!!!  I'm PRAYING that AFTER your Beautiful Baby Boy is born you will find a loving and caring PCP like I have as WELL as a WONDERFUL PM Doctor, TOO!

PLEASE keep me informed as to how you are doing as I'm VERY concerned NOT ONLY for YOUR BABY"S HEALTH but ALSO for YOUR HEALTH!!!

I'm keeping you in my Prayers and I'm here for you.............Sherry :)
Helpful - 0
1524811 tn?1333241301
Normally I would NEVER threaten a DR in a msg left on an answering machine, but I've hit my breaking point.  I've tried reminding her of the problems SHE caused with her carelessness while I was pregnant with my 2nd daughter & the fact that we both almost died  SEVERAL times due to her & the OB's failure to listen.  This time I assumed it would be different, but she's pushing harder this time & it's causing permenant damage.  My girls wakeup EVERY DAY & ask me if I'm ok. My 2 yr old spends half her day watching my every move & if I cry at all BOTH girls will grab for the phone & yell for me to call an ambulance.  I'm 100% sure that my pregnancy could have been pretty much pain free if she had bothered to listen to anything that was said to her. Instead she rushes me out the door when I'm there.  She has ABSOLUTELY no problem renewing fentanyl or ANY other narcotic prescriptions for my mother who was in a car accident 2 yrs ago & ended up with a few broken ribs.  She hasn't attempted to wean her down AT ALL since the accident, yet her ribs have healed & it's not a condition that lasts FOREVER.  My stenosis is considered live long & will get worse over time  & is known to cause extreme pain. If this were not the case then I would not have qualified for government disability assistance.  
Why the hell should my kids & I have to suffer?  I do everything I can to be a good mom, but it's EXTREMELY hard on days that my pain is bad. Add in that this useless DR seems  to be utterly clueless to what she's doing to me.  For 2 yrs when I was trying to explain that my pain wasn't being monitored well & there was a change needed she refused to up my prescription or provide anything for breakthrough pain, which doesn't happen every day, but is happening.  I didn't know that there was a 12.5mcg patch available until my mom mentioned it to me cuz that's what she's on. When it comes to my care she jumps & drops ALWAYS by 25mcg intervals & usually VERY quickly.  I mean honestly what was the point behind upping my dose from 100mcgs to 125mcgs for 1 month & then dropping it when it takes a week or so to adjust to the new dose?? I can't make any sense of it.  By the time bedtime for my kids hits I'll no doubt be screaming in pain again & need yet another trip into the hospital.  Once the pain starts it hurts HARD & FAST. I can go from uncomfortable to screaming in less then 10 minutes. Problem being is I go in blindly not knowing which OB is on as they won't tell u & only 1 or 2 of the 11 OBs that have clearance for that hospital will order anything for relief.  

I didn't ask to be put on these damn patches to start with, but I EXPECT to be treated properly by my DR. Love how Canada claims to have the best health care & DRs, yet there are DRs like this 1 causing un-needed pain. I miss the DR she use to be. :-( when I 1st started seeing her she would sit with you for an hour if that's what you needed.  When I had my 1st daughter (2003) she actually came to the hospital a few hours after she was born to see her & to check on me.  After I had my 2nd daughter (2008)  I could barely even get an appointment with her even with the hospital demanding that I be seen.

TY for the prayers Sherry.  Right about now I'm sure it's the prayers alone that have kept me from throwing in the towel & giving up.  The pain gets so bad & the withdrawals hit so hard & fast that I have caught myself saying some horrible things about the pregnancy & being willing to do ANYTHING to make it( the pain/withdrawals) stop.  I love my kids, & would never hurt them, but the pain & withdrawals hurt so bad that at that moment nothing matters.  Of course it seems to be the time my oldest acts out the most & causes the most hell.  Today is already 1 of those days with her, now combine it with the pain, withdrawals & everything else  & you get a day where I lose it & just want to walk away to a dark hole alone & not come out again.
Helpful - 0
1524811 tn?1333241301
WARNING LONG RANT

Well it gets better. I just got a phone call from 1 of the receptionists at my PCP's office.  I was told that they relayed the message to my DR & they were told that if any screw up has been made it was on my end by not listening to her. Apparently I was supposed to come back in to see her after trying the new dose for a week & since I didn't do that then my pain & withdrawals are no one's fault but my own.  I was reminded that she will not call through ANY narcotic pain relief to a pharmacy & since I'm so unhappy with how she is handling my care to find a new DR as she will no longer see me.  I explained that the prescription was the EXACT same as the other one she filled wrote for 2 months except 1 is 25mcg & the other is 100mcg.  I asked why she would expect a woman due any day with a blood clot in their lung to make the long trip to her office to ger the prescription for the lower dose monthly & the higher dose every 2 months as it didn't make sense to me. I explained that we had agreed AFTER the birth of my baby we would try to wean down, but not until then & that this is not the 1st time she's decided to make this decision on her own knowing that it negatively affects not only me but my unborn child & she is now putting us both at risk daily by doing what she is doing.  I informed them that by having them call instead of her & her refusal to see me combined with the continuing lack of care from her has left me with no choice but to file a complaint with the College of Physicians and Surgeons. I will also be filing a report with the Pain Coalition of Canada & be looking into a lawyer.  
Her receptionist said she suggests I get in to battle it out with her in the office, but then refused to tell me when her next available appointment is or when she's on walk-in again.  How am I supposed to see her if I don't know when she's there? I swear between the ignoranance of the dr & the games that the staff like to play with the patients I'm EXTREMELY surprised that there is no record of reports being made to the college of Physicians yet.  She use to be such an AMAZING Dr that she had ppl from 6-8 hours away trying to get into her practice..... now she's losing patients.  Why would it take 6-8 weeks to get an appointment with a family Dr? what if something came up & you really need to see your DR...... gotta wait 6 weeks? she refuses to have patients squeezed in between others even if it's something as simple as a medication renewal.  When I was in the hospital the day they found the blood clot I was told by my OB to call her office to have my asthma inhaler immediately switched to something different so that when I was discharged I could pick up the new one & start taking it immediately. I called & was rudely informed that she refused to do it without seeing me EVEN knowing that I was currently in the hospital with a deadly clot & needed the prescription called in so I could be discharged.  It was a prescription she had me on before so it's not like she didn't know how I'd react to it... she was just being difficult.  The same DR that has refused to treat my depression while pregnant not just once but twice now. She's acting more & more like a child it seems & I've had it!

SO NOW WHAT? I have to find a new DR even though there are none anywhere close to me...... and I get to suffer through the pain/withdrawals cuz it's my own fault I didn't listen to her when I was there, yet I had my ex & 2 kids with me & there was ABSOLUTELY NO mention of coming back in until after the baby was born.  
Helpful - 0
1375159 tn?1311688344
Hi Melissa. I just wanted to ask how you're doing...any better?

Hugs,

Flower
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356518 tn?1322263642


Hi Melissa,
I am sorry your having problems. I want to ask you first of all if you are out of you medication completely? I understand from your post you do have the 100mg but not the 25mg, is this correct?
It is very important that you know withdrawal will cause you to go into labor.

Most Doctor's will try and reduce your medications before birth so that is not unusual.
I think in retrospect you may agree that there are many ways in handling situations like this and getting angry is not productive not is it helping your pain levels.
One very important thing to remember is that when the Doctor ask you to do something you do not agree with it is best to handle the situation calmly and with respect. The Doctor is trying to treat you and if you do not do what she ask then you are not following her instructions therefore she can release you from her care. I do not want to sound like I am being mean I am just telling you the way things look form her view.
I do understand it was impossible for you to see a Doctor five hours away. I believe this may have been a way to drop you. It is not right but doctor's are known to do this sort of thing, it is immoral yes but it has happened before.
I suggest that you do refrain from discussing your anger toward your PCP to the pain clinic as it can be seen as a problem. By all means when you do see them explain the situation but
do it respectfully. Do not even bring up the fact that you threatened your Doctor with legal suit.
There are laws protecting us but you must follow the Doctor's instructions for them to help. Being that you did not work with the clinic she referred you to she can say you were non compliant.
All Doctor's have their own way of handling refills. When you were in the hospital and needed the refill for the inhaler then the Doctor there should have written it. It was not your Doctor's place to stop her daily practice to do that. I know it may sound like I am being judgmental but I really am only trying to point some things out.
When you are angry and hurting it is hard to see all sides involved.
It is not the Doctor's fault that you had your children with you when she ask you to come back and that you did not hear her. It sounds like there may have been some problems with communication for awhile.
again I am only trying to help and hope you do not take this the wrong way.
You should go to the hospital and have then check both you and the baby out and make sure they know your out of medications ( if that is the case).
I hope all is well and you do get some relief soon. i know how it is to be hurting and have the children needing you and household duties to handle also:)
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Avatar universal
First & foremost...you have a clot in your lung? GET TO THE HOSPITAL ASAP!!! I had one several years ago and they're not fun! Plus, it could brake off and go to your brain at any time. As far as seeing a PM, best thing I ever done. But this is about you right now, get that clot taken care of immediately if now sooner. It's called Pulmonary Embolism. The mortality rate could be a lot better and if you are home with no Drs. or Nurses watching it, you are seriously in trouble.  Go to emergency as soon as you can. We can talk about the other issues after!!! Please just go!!!!!
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Avatar universal
Go to the hospital once again....so many things are NOT in your favor.  Do you want to leave your 2 kids alone?  This is very very serious. The hospital will be able to give you  what you need. Also, if I were you, I would bring that dr. up on charges or sew him. If you don't have insurance, they will still call them. No car, call 911. Just get there!!!! You are a ticking time bomb! Good luck friend, let me know how it turns out.
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1524811 tn?1333241301
FLOWER -  TY for ur msg.  The last few days have been VERY rough.  I did make a trip down to see her & was treated just as rudely in person as I was on the phone.  The second she walked into the room she looked at me & said " you have 1 month to find yourself a new DR since you seem so miserable with my approach". I started crying & tried to explain that she's been my DR for 16 yrs & I've done my VERY best over the last several years to bring up any issues that I've had, but as a patient who is relying on her for care I usually bit my tongue.  I also expressed concern over her deciding to drop me less then 2 weeks before I'm being induced with my baby.  She FINALLY agreed to change the PM referral to the pain clinic at our local hospital after I told her I had already spoken with them & would be seen within 2-3 months.  

Things are kind of left up in the air as it stands right now cuz she left mid appointment & didn't come back in. I was told then by 1 of her receptionists that she had to go.  NO answers on any of my questions.  I had another appointment 45 minutes later so didn't have time to fight it out & left. I've called a few times & left messages with no response.  Now what?


SANDEE - I'm completely out of the 25mcg patches, & have enough of the 100mcg ones to last until the end of the month. BUT the 100mcg WEREN'T lasting 48hours & that's why I was bumped up to 125mcg.  We had set on a schedule that day 1 I'd put on the 100mcg & then 24 hours later the 25mcg would go on, & repeat so that when the 100mcg was just starting to wear off (usually around 38hours in) I'd have the new 25mcg patch to cover it.

I COMPLETELY understand that wtihdrawals will cause me to go into labor & I've tried explaining that to my PCP but she denies it.  I've done my research & have spoken to OB's & other DRs whether through the hospital or clinics & 3/4 of them agree that it's not safe, but only half of them acknowledge that a change so low can cause it.  

I know most DRs try to reduce the meds before it is time to give birth so that the postpartum effects on the baby are less BUT with such a strong medication Fentanyl is 1 that takes a lot longer to wean down & should've been started BY 3 months gestation.  I didn't get angry about the weaning of the medication, but by the way she suddenly decided to do it without mentioning it to me AT ALL knowing the difficulties the pregnancy has already endured.  By the time this all took effect I had been rushed in 5 times in pre-term labor, & had several other issues she was well aware of.  PLUS had the report from the OB  & 2 DRs from the hospital & the high risk clinic in the hospital advising her NOT to change the meds now as there wasn't enough time & the risks to baby & I were too high now.

When my DR asked me to go to the pain management DR 5 hours away I made it VERY clear as calmly as I could that it wasn't something I could do & refreshed her memory as to why I couldn't.  I hadn't gotten mad about it until she absolutely refused to even look into the local PM DR's.  I know that by refusing her orders she can refuse me care, so I made sure that anything I had asked of her was within my rights to ask & my quality of care or lack of care is within my rights.  
I haven't been to see a PM DR yet & know not to speak ill of my PCP as they are all DRs & it doesn't help me any in the long run. The legal action was only mentioned after 3 years of continually declining level of care which has resulted in untreated depression, ignored pain management,  poor treatment of asthma & that is just with me... her lack of care branches out to my husband (almost ex) & my 2 daughters.
I understand she can claim I was non compliant, but she knew BEFORE the referral was made that I couldn't get to & from the clinic so if she made the referral anyway it is her issue.
When I was in the hospital it wasn't a refill I needed on my inhaler but needed a prescription change & the DR there said it should be handled by my PCP as she is the DR treating my asthma.  No one was expecting her to stop her daily practice to write out the prescription, just to take 30 seconds time to contact the pharmacy when she had a chance to call it in so that I had it.  
I NEVER said it was her fault that I had my kids with me when I went to my last appointment with her. I was stating that I had them & my ex with me & NOT 1 OF THEM HEARD HER ORDER ME TO RETURN IN A WEEK.

I've got 1 week left until I'm induced, & seem to have made it thus far.  I lost my  mucus plus a few days ago & have been timing contractions since.  Things are progressing & the blood thinner has been stopped so  that there is no issue with the blood thinner & pain relief if I chose any.  The hospital refuses to give narcotics, so it would be a wasted trip on my part.  I am SO thankful that this is almost over & will be happy to be able to move past this & finally have my son in my arms.  Then the new DR battle begins.


MIBANA-TY for ur concern.  The blood clot was diagnosed February 16th & I was IMMEDIATELY put on blood thinner injections twice daily.I was taking the injections right up until yesterday morning when I was told to stop taking them due to the threat of labor progressing right now.  I lost my mucus plug & started having strong contractions so labor was supposed to imminent.  My lil man is just biding his time til I'm not expecting it.  As for the issues with the PCP I'm definitely gonna look into my options.


I hope that covers everything by everyone.  
Helpful - 0
356518 tn?1322263642
I hope you understand I in no way was trying to upset you. You have every right to great health care. I hope your feeling better and the birth goes well. In the meantime try and rest and relax as much as possible.
I hope your appointment with the new PMP goes well. We are here for you in any way we can help:)
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