Opioids How to get Pain Management Dr to understand i need an increase in meds

[db7132]

Hi all,

I am prescribed 120 10mg roxies per month and used ti be at 150 per month but I got a new doctor who has lowered me to 120. I am too tolerant to this dose and I just feel like crap all day. How do I get my doctor to increase my medication dose or even change it to something besides Hydros and morphine (they make me too nauseous)? I am not getting much pain relief, if any at all, and I do not want to sound like an addict trying to get more meds, as it is normal to build up a tolerance especially since I have been taking narcotic pain meds for 5 years or so and my dose has been steadily increased every 6 months to a year or so. It is just so hard to get it increased anymore without sounding like I am just trying to get more meds for the wrong reasons. Please help! I can barely even work anymore without taking more than I am told to and I can’t do that or I run out early. Please help, as I just want my doctor to understand my situation without me sounding like a pill shopper!

 

[Jnowhere]

Hi all,

I am prescribed 120 10mg roxies per month and used ti be at 150 per month but I got a new doctor who has lowered me to 120. I am too tolerant to this dose and I just feel like crap all day. How do I get my doctor to increase my medication dose or even change it to something besides Hydros and morphine (they make me too nauseous)? I am not getting much pain relief, if any at all, and I do not want to sound like an addict trying to get more meds, as it is normal to build up a tolerance especially since I have been taking narcotic pain meds for 5 years or so and my dose has been steadily increased every 6 months to a year or so. It is just so hard to get it increased anymore without sounding like I am just trying to get more meds for the wrong reasons. Please help! I can barely even work anymore without taking more than I am told to and I can’t do that or I run out early. Please help, as I just want my doctor to understand my situation without me sounding like a pill shopper!

First, of all, I hear you. Are you in America? Then you might be stuck. There are 15mg ones but that would be a 40mg to 60mg jump. 50% increase. That would be an issue.

Do your Roxies have ( acetaminophen, paracetamol, Tylenol, they are the same)
are they 10/325? if so 8.9 mg of oxycodone per tablet and Tylenol.( liver killing)
The ones without 11mg of oxcodone or is it 11.1 we will say 9 vs 11 mgs

If your's does have have Tylenol, switch to the no tylenol version.

Tell your doctor you don't want to regularly take acetaminophen like that.
See, if he will switch you.

If you take the tylenol ones and you switched you would have 8 or more mgs a day without technically going up.

Also, acetaminophen is OTC and if you need it then take it also. But, see if that is the case.

 

[db7132]

First, of all, I hear you. Are you in America? Then you might be stuck. There are 15mg ones but that would be a 40mg to 60mg jump. 50% increase. That would be an issue.

Do your Roxies have ( acetaminophen, paracetamol, Tylenol, they are the same)
are they 10/325? if so 8.9 mg of oxycodone per tablet and Tylenol.( liver killing)
The ones without 11mg of oxcodone or is it 11.1 we will say 9 vs 11 mgs

If your's does have have Tylenol, switch to the no tylenol version.

Tell your doctor you don't want to regularly take acetaminophen like that.
See, if he will switch you.

If you take the tylenol ones and you switched you would have 8 or more mgs a day without technically going up.

Also, acetaminophen is OTC and if you need it then take it also. But, see if that is the case.

Yes, I am in America. It is definitely harder to get an increase here than in EU it seems like, but I do already have the ones without tylenol because of the liver issue. I get what you are saying though, a 50% increase would be too much anyways. I just want to be at where I was. 150 10s was usually fine, but they said 5 a day was too much since I am prescribed Alprazolam too by my psych. I do not take it religiously like I take my pain meds but I understand that it is still a worry for the doctors when looking at increasing my dose. Are there any meds that I could switch to besides hydros or morphine? Those just make me nauseous and to my knowledge the only other one is hydromorphone which apparently is a huge jump from oxy so I dont think they would go for that lol. Let me know if you have anymore suggestions and thanks so much for the advice!

 

[red22]

Is it even necessary with 7-OH-MG?

 

[Jnowhere]

Yes, I am in America. It is definitely harder to get an increase here than in EU it seems like, but I do already have the ones without tylenol because of the liver issue. I get what you are saying though, a 50% increase would be too much anyways. I just want to be at where I was. 150 10s was usually fine, but they said 5 a day was too much since I am prescribed Alprazolam too by my psych. I do not take it religiously like I take my pain meds but I understand that it is still a worry for the doctors when looking at increasing my dose. Are there any meds that I could switch to besides hydros or morphine? Those just make me nauseous and to my knowledge the only other one is hydromorphone which apparently is a huge jump from oxy so I dont think they would go for that lol. Let me know if you have anymore suggestions and thanks so much for the advice!

No, That is Dilaudid and it is way stronger. Not euphoric like Oxy, an added bonus, for a pain patients. But it is very stron f but not to good orally like morphine.
Zofran, might help nausea.

You gotta be careful. You don't want the doctor to think you are druggie.

I would ask about an increase if you switched to Valium or a lesser benzo.
although xanax can be very hard to get.
But ask if you switched to a weaker benzo; could you get the 150?

If your breathing is good and you have been on it for a long term; you should be good.

Same dose for a long time and an increase, sounds reasonable but it could be the state and or the feds that have them nervous. War on opiods and any scheduled med.

 

[Just a little pinprick]

Hi all,

I am prescribed 120 10mg roxies per month and used ti be at 150 per month but I got a new doctor who has lowered me to 120. I am too tolerant to this dose and I just feel like crap all day. How do I get my doctor to increase my medication dose or even change it to something besides Hydros and morphine (they make me too nauseous)? I am not getting much pain relief, if any at all, and I do not want to sound like an addict trying to get more meds, as it is normal to build up a tolerance especially since I have been taking narcotic pain meds for 5 years or so and my dose has been steadily increased every 6 months to a year or so. It is just so hard to get it increased anymore without sounding like I am just trying to get more meds for the wrong reasons. Please help! I can barely even work anymore without taking more than I am told to and I can’t do that or I run out early. Please help, as I just want my doctor to understand my situation without me sounding like a pill shopper!

This is just a guess but I’d say the doctor cut you down to 120 a month is because Oxys are to be taken every 6 hrs, that’s 4 per day multiply by 30 days equals 120 pills,,Giving a patient 30 xtra pills per month is/was a mistake that needed to be corrected..


It’s just a guess but I betcha that’s the reason…

 

[db7132]

This is just a guess but I’d say the doctor cut you down to 120 a month is because Oxys are to be taken every 6 hrs, that’s 4 per day multiply by 30 days equals 120 pills,,Giving a patient 30 xtra pills per month is/was a mistake that needed to be corrected..


It’s just a guess but I betcha that’s the reason…

This is actually incorrect. The half-life of Oxy is around 3.5 hours or a lil less. I know people who have prescriptions for one pill every 3 hours. It is most common to see it prescribed for every 6 hours, but with severe pain, especially in opiate tolerant patients like me, the drug doesnt last more than 4 hours EVER. It is unfortunate because most other opioids last longer besides maybe codeine, so they think you will be fine with every 6 hours but every 4 hours works for me perfectly. If its every 6 hours, I am in pain for about an hour or two every day between doses, which is what is happening now.

 

[db7132]

No, That is Dilaudid and it is way stronger. Not euphoric like Oxy, an added bonus, for a pain patients. But it is very stron f but not to good orally like morphine.
Zofran, might help nausea.

You gotta be careful. You don't want the doctor to think you are druggie.

I would ask about an increase if you switched to Valium or a lesser benzo.
although xanax can be very hard to get.
But ask if you switched to a weaker benzo; could you get the 150?

If your breathing is good and you have been on it for a long term; you should be good.

Same dose for a long time and an increase, sounds reasonable but it could be the state and or the feds that have them nervous. War on opiods and any scheduled med.

I could try to switch to either a lower benzo dose or switch back to Klonopin. Valium doesn’t work for me really tbh. When I was on Kpins though, my doctor was never worried about breathing issues, as long as I took like 2 hours in between taking the oxy after taking the benzo. Never had an issue. With the Xanax, i totally get why they are worried, as it makes me so tired if i dont wait at least 3 hours in between taking my oxy and xanax. If can get back to 150 10mg i think ill be fine. We will see haha Thanks for the help! Hopefully it works out, my appt is on the 23rd.

 

[Just a little pinprick]

This is actually incorrect. The half-life of Oxy is around 3.5 hours or a lil less. I know people who have prescriptions for one pill every 3 hours. It is most common to see it prescribed for every 6 hours, but with severe pain, especially in opiate tolerant patients like me, the drug doesnt last more than 4 hours EVER. It is unfortunate because most other opioids last longer besides maybe codeine, so they think you will be fine with every 6 hours but every 4 hours works for me perfectly. If its every 6 hours, I am in pain for about an hour or two every day between doses, which is what is happening now.

I agree with you regarding how long it stays effective but I believe that’s not how the world works,the doctor only writes the script for the drug and its quantity,the powers that be dictate the frequency of the dose,if a stronger drug is needed then it is prescribed and there is a dosing schedule for that drug ..
I find it amusing that you think you are special because you have a tolerance to opiates,,that actually sets off the alarm bells with the doctor that you admitted you are very familiar with taking opiates,<<<< that’s not a good thing…

That’s totally BS regarding pain meds (oxy) being prescribed every 3 hrs,,,total hogwash…

 

[Dextro .45]

Tell new doctor EVERYTHING you just told us…..just level with doc

Hey doc, I’m glad you’re my new physician, I’ve read/heard nice reviews (you could drop that one lol) …..I’d just like to get your professional opinion on a particular matter. See, previously I was on X which was very effective and kept my pain under control. Originally I was on a lower dose but due to years of use my previous doctor stated that tolerance has set in as I am considered an “opioid talent patient” he said.

I’ve noticed lately an increase in discomfort with pain levels in A & B and I’d be interested in exploring the option of having my prescription back to the original regiment, as this was specifically tailored to my needs from previous physician, which was low originally, but gradually increased over time.

Run that shpeel by your doctor……even read it many times so key points are fresh in you’re head before appointment

Fail safe/ Option B ……IF doctor is a weak little B!tch and shuts down your request…..perhaps explore some alternatives in analgesic meds…….medical journal studies have shown adding low dose Pregabalin (Lyrica) 150mg capsule increases pain relief and has moderate anxiolytic properties

Also….if you’re scripted 120-150 tablets of IR tablets …..you COULD entertain “opioid rotation” which is a well known practice in pain management. You could switch to an XR long acting opioid formulation + a few extra IR opioid tablets daily for “breakthrough pain” …..if this doc is outta their league, kindly & respectfully request a referral to a pain specialist as you’d be interested in hearing options & traditional therapy from pain management specialists

I went to CPM - Centres for Pain Management ……best advice EVER

Oxycodone (Oxy-IR 5mg) and OxyContin 20mg
Dilaudid 2 & 4mg IR and Hydromorph-Contin 9mg XR capsules
Metadol (Methadone) 25mg tablets (100 tablet sealed bottle) 160 per 30 days

As a potent, long acting full Mu-Opioid Agonist …..Methadone 100mg IR is an Amazing analgesic (for an extremely tolerant patient taking the medication for 20+ years)

 

[Keif' Richards]

Hey @db7132

I just want to say that I absolutely feel for you. Being in pain in this country is not easy. Doctors are unreliable, alternating between over-prescribing and under-prescribing based upon what they think is safe for them and their careers. It is extremely difficult to find an even-handed approach to pain in this country. There is no other way of putting it.

The thing is, we at Bluelight are opposed to any kind of content that is dedicated to the sourcing of drugs. This can mean anything, from a pain patient looking for an increase of medication to an addict trying to get Fentanyl (not that they need help). We are supposed to be a repository of information meant to help users learn the safest, least harmful means of using these drugs. In short, you´re supposed to BYOB to this forum. It´s just who we are and what we are about. We are constantly fighting for credibility as this country devolves into more right-wing, anti-drug, anti-homeless stances. If we are seen as helping people acquire drugs, that really harms this credibility.

That doesn´t mean there aren´t places to get the information that you´re after. I´m sure there are Reddit pages dedicated to pain management where people are discussing your exact issue. See, I have a lot of answers regarding drugs, but I am not an expert on the system of pain management as I´ve only ever read anecdotal stuff.

My understanding, and I know you´ŕe not going to want to hear this, is that you´re actually one of the luckier individuals to have 120 10mg Oxycodone per month. I´m not speculating on your condition in any way, I just know I see people getting pulled off their scripts left and right in this country.

The harsh reality is, you could try to find a different doctor, but these pain management people can be extremely callous and brutal in how they treat people once they have decided you are a ¨problem user¨. The problem is that there is not a ton of scientific evidence to separate an ¨addict¨ from ¨a person in pain¨. This is mostly up to the doctors to make pretty complex psychological determinations that can have a huge impact on your life. If you try to go somewhere else, which is in fact your right, you risk the possibility of even worse treatment. Then, if you decided you wanted to switch back, well, that´s just more bullshit that muddy´s the water in the eyes of these people.

The only thing you can do is to be straight with your doctor. Be honest and tell them how you´re feeling. Yes, I would highly recommend ¨selling¨ your presentation as best you can short of being dishonest. Don´t go in there with a glass of brandy in one hand smoking a cigar and shoot the shit with the guy. Make sure you embody the pain that you´re experiencing, that´s all I can say. Do not be dishonest. There was a time where dishonesty was actually an okay policy to get what you needed in this country. Nowadays, they are on you like a laser and any inconsistency can be grounds to move you into the ¨problem¨ group.

I´m not going to close this, although I feel it is not totally appropriate. I admit I feel for anyone who is struggling with pain and doesn´t know what to do. If this is where you came for answers, I will throw you a bone and leave this up for a day or two but I will eventually close it. If you have any questions, you can ask me, although I´m not a true expert on any of this or you can ask anyone else here. Feel free to message people you think might be able to help.

 

[db7132]

Hey @db7132

I just want to say that I absolutely feel for you. Being in pain in this country is not easy. Doctors are unreliable, alternating between over-prescribing and under-prescribing based upon what they think is safe for them and their careers. It is extremely difficult to find an even-handed approach to pain in this country. There is no other way of putting it.

The thing is, we at Bluelight are opposed to any kind of content that is dedicated to the sourcing of drugs. This can mean anything, from a pain patient looking for an increase of medication to an addict trying to get Fentanyl (not that they need help). We are supposed to be a repository of information meant to help users learn the safest, least harmful means of using these drugs. In short, you´re supposed to BYOB to this forum. It´s just who we are and what we are about. We are constantly fighting for credibility as this country devolves into more right-wing, anti-drug, anti-homeless stances. If we are seen as helping people acquire drugs, that really harms this credibility.

That doesn´t mean there aren´t places to get the information that you´re after. I´m sure there are Reddit pages dedicated to pain management where people are discussing your exact issue. See, I have a lot of answers regarding drugs, but I am not an expert on the system of pain management as I´ve only ever read anecdotal stuff.

My understanding, and I know you´ŕe not going to want to hear this, is that you´re actually one of the luckier individuals to have 120 10mg Oxycodone per month. I´m not speculating on your condition in any way, I just know I see people getting pulled off their scripts left and right in this country.

The harsh reality is, you could try to find a different doctor, but these pain management people can be extremely callous and brutal in how they treat people once they have decided you are a ¨problem user¨. The problem is that there is not a ton of scientific evidence to separate an ¨addict¨ from ¨a person in pain¨. This is mostly up to the doctors to make pretty complex psychological determinations that can have a huge impact on your life. If you try to go somewhere else, which is in fact your right, you risk the possibility of even worse treatment. Then, if you decided you wanted to switch back, well, that´s just more bullshit that muddy´s the water in the eyes of these people.

The only thing you can do is to be straight with your doctor. Be honest and tell them how you´re feeling. Yes, I would highly recommend ¨selling¨ your presentation as best you can short of being dishonest. Don´t go in there with a glass of brandy in one hand smoking a cigar and shoot the shit with the guy. Make sure you embody the pain that you´re experiencing, that´s all I can say. Do not be dishonest. There was a time where dishonesty was actually an okay policy to get what you needed in this country. Nowadays, they are on you like a laser and any inconsistency can be grounds to move you into the ¨problem¨ group.

I´m not going to close this, although I feel it is not totally appropriate. I admit I feel for anyone who is struggling with pain and doesn´t know what to do. If this is where you came for answers, I will throw you a bone and leave this up for a day or two but I will eventually close it. If you have any questions, you can ask me, although I´m not a true expert on any of this or you can ask anyone else here. Feel free to message people you think might be able to help.

Oh shoot. I am so sorry, that was not at all my intention. I am just trying to relieve my pain. I read through your post and I appreciate all of the advice. It is definitely tough for us pain management patients who are there for actual pain and not to doctor shop. If you would like to remove this post, feel free, as I do not want to get myself or you or the forum in trouble! I was just looking for some advice if possible, and it looks like I have gotten what I came for. I will try to be as honest as I can with my doctor, I just got too scared to say anything at my appointment last week. I don’t think it is worth the risk, but then again, my doctor trusts me so much, she stopped counting my pills and drug testing me because she knows I have never failed a test or messed up a count in 5-6 years. I hope I grow some balls next month and figure out a way to convey my pain that I am feeling even on the meds that she gave me. Hopefully she will understand, as she used to be a patient herself in the early 2000s she said. So she did say she completely understands why I need my medication, but I just am not sure if she would understand an increase. Again, I sincerely apologize if I broke the rules of the Forums. If you need to remove the post, no worries. If you are able to keep it up, though, I would appreciate it since this advice has been super helpful so far and I hope to receive more in the future on those thread. Thanks again!

 

[db7132]

I agree with you regarding how long it stays effective but I believe that’s not how the world works,the doctor only writes the script for the drug and its quantity,the powers that be dictate the frequency of the dose,if a stronger drug is needed then it is prescribed and there is a dosing schedule for that drug ..
I find it amusing that you think you are special because you have a tolerance to opiates,,that actually sets off the alarm bells with the doctor that you admitted you are very familiar with taking opiates,<<<< that’s not a good thing…

That’s totally BS regarding pain meds (oxy) being prescribed every 3 hrs,,,total hogwash…

I promise you that is true. My mom had breast cancer and I had to give her the medicine every 3 hours. Go ahead and think what you want, but there is a reason why they say “stay ahead of the pain”. Only way to do that is to take the medicine around when the half-life ends. I am not saying I need a pill every 3 hours, but it would be nice to have the option on days where I am in extreme pain and need to take it earlier than 6 hours in, which I cant because of my prescription. Just because you haven’t heard of something happening that seems unlikely to happen doesn’t mean it is impossible. There should be no judgment on these forums.

 

[db7132]

Oh shoot. I am so sorry, that was not at all my intention. I am just trying to relieve my pain. I read through your post and I appreciate all of the advice. It is definitely tough for us pain management patients who are there for actual pain and not to doctor shop. If you would like to remove this post, feel free, as I do not want to get myself or you or the forum in trouble! I was just looking for some advice if possible, and it looks like I have gotten what I came for. I will try to be as honest as I can with my doctor, I just got too scared to say anything at my appointment last week. I don’t think it is worth the risk, but then again, my doctor trusts me so much, she stopped counting my pills and drug testing me because she knows I have never failed a test or messed up a count in 5-6 years. I hope I grow some balls next month and figure out a way to convey my pain that I am feeling even on the meds that she gave me. Hopefully she will understand, as she used to be a patient herself in the early 2000s she said. So she did say she completely understands why I need my medication, but I just am not sure if she would understand an increase. Again, I sincerely apologize if I broke the rules of the Forums. If you need to remove the post, no worries. If you are able to keep it up, though, I would appreciate it since this advice has been super helpful so far and I hope to receive more in the future on those thread. Thanks again!

just wanna clarify here, I am seeing a new doctor, but it is still the same office. they have all my records since I became a PM patient. She actually seems more understanding than my previous doctor. I am just worried she will take anything I say the wrong way since I have only been seeing her for a few months, but again, she used to be a patient when she got in a bad car accident, so I am hoping this means she will understand my side. I just do not know what to do.

 

[Keif' Richards]

Hey @db7132 do not freak out brother. This is not the Spanish Inquisition

I kept this open as I was unsure of what to do with it. I have done some soul searching. We are a Harm Reduction resource, right? I cannot help but look at your situation as the potential catalyst for a lifetime of harm.

Do you know how many Fentanyl addicts out on the street right now were former middle-class pain patients who went off the furrow? Too fucking many.

Doctors know this. They know that withdrawing pain management abruptly can cause the complete destruction of a person's quality of life. They know that pain is something that a person will try to relieve themselves of at any cost. Still, if someone comes up short for a pill count, gets cut off and then overdoses on Fentanyl, its not as if the doctor has any liability whatsoever.

It is pretty disgusting like this neo-technofascist-capitalist world we are living in. For the record, im sure if Kim Kardashian wanted some Oxy's all she would have to do is ask.

As money gets tighter every day, the stakes are raised for all of us. Someone who cannot work due to withdrawal/pain can lose their job. Unable to function, they become homeless.

Doctors have all of the power. They can do anything short of literally murdering you with their barehands in front of the medical assistant.

Not all doctors are bad. Of course not. However, if you ask me about the totality of medicine in this country, I would say there is a cancerous rot in the body as a whole. The medical community has demonstrated time and again that they will violate their paths for a new set of golf clubs. They will then tell the family that the dude was an addict and escape blame.

The entire practice of medicine has morphed into a terrible farce in this country. We give obese people shots so they can remain sedentary, gorge themselves, refrain from exercise etc,; all so that person has more time to doom scroll on Tik Tok.

Yes this is a diatribe. I do not feel it is ethical to give human beings a shot that is nothing more than allowing them to escape the responsibility of proper diet and exercise. Exercise itself not only is healthy for your body, but your mind as well. We have no fucking clue what the long-term effects of these medicines are and we already are seeing things like Ozempic-Face.

Good doctors are great. The bad ones... well they are going straight to hell if such a place exists. I know some are just thoroughly brainwashed and believe they are doing the right thing. I think there are just as many who wake up in the middle of the night and cant get back to sleep for thinking of all the lives they ruined for a little bit of money.

 

[Dextro .45]

No shit what so ever….as the gods as my witness, I’ve actually corrected a few doctors before, and completely embarrassed one overseeing my Nonna/ grandmother care prior to her passing. This doctor has incompetent knowledge of the the drugs they were prescribing, nor their MOA ……I had to point out a DDI that could be an issue due to a geriatric patient with 5 separate meds ……docs face was beat red embarrassment written all over lol

For 20+ years I’ve been educating myself after getting RA and more fckn meds that I could handle ……so I read everything I could…..all genuine pharmaceutical medical journals, every drugs entire pharmalogical profile, MOA, DDI’s, you name it …….i became fascinated with organic chemistry and pharmaceutical compounds ….how different ROA’s can significantly effect the drugs profile, clearance, etc

Although LSD 100ug to me is the most beautiful molecule ever synthesized……..only 2 drugs in my entire lifetime ever gave me TRUE powerful Euphoric Bliss ……oral Oxycodone & Ritalin (Methylphenidate)

Simple unreal

 

[db7132]

Hey @db7132 do not freak out brother. This is not the Spanish Inquisition

I kept this open as I was unsure of what to do with it. I have done some soul searching. We are a Harm Reduction resource, right? I cannot help but look at your situation as the potential catalyst for a lifetime of harm.

Do you know how many Fentanyl addicts out on the street right now were former middle-class pain patients who went off the furrow? Too fucking many.

Doctors know this. They know that withdrawing pain management abruptly can cause the complete destruction of a person's quality of life. They know that pain is something that a person will try to relieve themselves of at any cost. Still, if someone comes up short for a pill count, gets cut off and then overdoses on Fentanyl, its not as if the doctor has any liability whatsoever.

It is pretty disgusting like this neo-technofascist-capitalist world we are living in. For the record, im sure if Kim Kardashian wanted some Oxy's all she would have to do is ask.

As money gets tighter every day, the stakes are raised for all of us. Someone who cannot work due to withdrawal/pain can lose their job. Unable to function, they become homeless.

Doctors have all of the power. They can do anything short of literally murdering you with their barehands in front of the medical assistant.

Not all doctors are bad. Of course not. However, if you ask me about the totality of medicine in this country, I would say there is a cancerous rot in the body as a whole. The medical community has demonstrated time and again that they will violate their paths for a new set of golf clubs. They will then tell the family that the dude was an addict and escape blame.

The entire practice of medicine has morphed into a terrible farce in this country. We give obese people shots so they can remain sedentary, gorge themselves, refrain from exercise etc,; all so that person has more time to doom scroll on Tik Tok.

Yes this is a diatribe. I do not feel it is ethical to give human beings a shot that is nothing more than allowing them to escape the responsibility of proper diet and exercise. Exercise itself not only is healthy for your body, but your mind as well. We have no fucking clue what the long-term effects of these medicines are and we already are seeing things like Ozempic-Face.

Good doctors are great. The bad ones... well they are going straight to hell if such a place exists. I know some are just thoroughly brainwashed and believe they are doing the right thing. I think there are just as many who wake up in the middle of the night and cant get back to sleep for thinking of all the lives they ruined for a little bit of money.

Thanks for the understanding! I totally agree with you here. Our healthcare system is fucked up beyond repair. Unfortunately, I am one of those people who has to rely on medicine just to function as a normal human being. Doctors know this and know how much power they have and it is unfathomable how they just fuck with people’s lives just to make a quick buck. I believe I do have a competent doctor on my side luckily, but I have been put through the wringer with many other ones that were just downright awful. Had multiple cut me off when I called asking questions about my medications and would call on the emergency line after hours if I really needed help (severe pain and/or high fever). This just made them hate me more, since I was “inconveniencing” them. It is just so frustrating to have doctors have all this power and not very many checks and balances. I just hope my doctor will understand my situation when I finally decide to convey it to her.

 

[ind33d]

Hi there, @db7132 - please excuse me for being late to the party. I will try to be concise here - generally seconding the gist of both @Dextro .45 and @Keif' Richards : I would aspire to communicate an honest depiction of the reality of your situation, as you are doing with us here, and do so not as if you are expecting or suggesting a particular course of action in response (i.e. going back to 150 count per month, or q. 4 hr dosing) but rather simply looking for a tenable solution to the problem of inadequate pain control.

Honesty, being well-informed for the interactions with your doctor, a willingness to compromise and work through a smattering of potentially unhelpful typical PM routines - a course of steroids, injections, physical therapies, off-label/non-opioid medications like amitriptyline/duloxetine/gabapentin/pregabalin/various NSAIDs and/or muscle relaxants of wild variety, etc. - may be your best bet.

Being an already-established patient at this clinic should afford you some benefit of credibility. If you are held liable to some bullshit pain management contract, be sure you keep in line with that.

As a potential alternative: I might consider over the medium-term looking to get your pain management outside of a PM clinic - that is, such as from a PCP. In my experience, PM clinics and the doctors/nurses/staff there are not so such collaborators in a patient's well-being, but neurotic sociopathic types running a glorified MAT/methadone clinic and offering no real benefits in terms of specialized/expert care or solutions.

I mean, does it take all that much to gatekeep you on some medication that's been around for over a century, and berate you if you don't like it?

Best of luck.

 

[Keif' Richards]

It is really quite disgusting when you encounter a physician that clearly enjoys the power he or she has over a patient. First, they have before them a ¨drug seeker/addict/not a ¨real¨ patient¨, guilty of slowing down the wonderful system of medicine meant for ¨real¨ patients. You´re already insulting their art/science by being in front of them. Then, they have the ability to reduce you to a being completely devoid of dignity, as they make you dance for the drugs that only they can give you.

There are priests who join the order because they love God and want to better the lives of those in their congregation. There are likewise priests who join the order for the easy access to children combined with the tacit trust of their congregation. There are doctors who become doctors because they are dedicated to lessening human suffering. There are people who become doctors for the money. There are people who become doctors because they watched one too many episodes of House M.D. and walk into the craft with a ready-made God-complex and an expectation tbat every hour-long episode will end with them solving a seemingly impossible problem.

There are people who become doctors because their parents make them. There are people who graduate medical school, begin practicing only to discover that they actually hate the practice of medicine, as it its completely different to what they had imagined it to be.

My point is, there are evil people secreted in all areas of our lives; all professions. When we discuss the relationship between doctors and pain-patients, the relationship takes on a dynamic similar to dealing with the police. There is an assumption of fair treatment, whereas it is a known fact that you´re playing a game that is set up for you to lose. You are supposed to have the right to other opinions in your medical treatment. Truly, this seeking of alternative treatment can, in itself cause you to suffer.

Doctors have an easy out of all of these situations. They can prescribe until the point that you become trouble. They can then label you an addict. Of course an addict is going to bitch, that´s what they do. They never have enough. Nobody has your back. They can label you, kick you out the door and move on to the next patient.

The right doctors are out there. I am grateful that I have encountered a doctor or two whom I truly believe in. When you find them, you´ve gotta be grateful, be honest and be willing to play ball with their suggestions. Do not ever be dishonest with doctors if there is even a chance they can find you out.

 

[HCKrod314]

Yes, I have met many different personalities in healthcare. In May 2025 my rt femur started hurting. At first just now and then but the pain ramped up fast to where both femur bones felt they were breaking inside my body. I went to my GP and told him the situation. He is a doctor that works for a huge healthcare system. I had been seeing me for 5 years w/out incident. He did some bloodwork and I came back to review. I mentioned that my kidney function was low. He said “I’m not worried about that as much as your calcium levels are high and white blood cells are quadruple what they should be. I just asked him what is the plan and I need some relief from the excruciating pain. He called in Tylenol 3 tid. Okay.He set an appointment for the Hematologist but she couldn’t see me for 2 months. I agreed to see a NP against my better judgment. My wife went to the appointment with me because at this point my GP was talking Leukemia or multiple myeloma. We were in the office waiting for the NP to come in. In she came introducing herself as doctor xxx. I started to speak and she held the finger up like “hold it” and she got on her laptop and was giving notes about another patient. Well, there goes HIPPA! She then started asking me rapid fire questions. I have stuttered all of my life and usually tell people that I stutter and if they don’t understand me ask again. This NP (doctor) was actually huffing as I was trying to answer the question from 2 minutes ago. Okay, she may have been late 30’s early 40’s. I’m 61 years old. This woman put her fingers about 12” away from my face and snapped her fingers and told me to “focus!!!” I generally don’t put up with that kind of bullshittery but I was afraid of multiple myeloma and she had all of the power. I looked over at wife and she looked as confused as I was. What did I do to anger her so badly. She continued with her word salad as I wasn’t listening any more. I walked out of there totally humiliated. My usually quiet almost timid wife wanted to go back and beat her ass. Wife is 44 and I’m 61 so I have mellowed in the last 10 years. Luckily, my wife had the presence of mind to start recording early on. Tennessee is a one party state. You are under no obligation to inform them they are being recorded. We listened to the meeting twice and there was no misunderstanding. That NP tossed my salad then smoked me. Here in NE Tennessee Ballad Healthcare owns all the hospitals, doctors, nurses etc.Well, I got the name of the manager at cancer center, I got name and address of President-Southern Region and name and address of Chief Executive Officer. I used ChatGpt to draft a letter that was very professional. It explained what had occurred and I made sure everyone that came in there were probably in a vulnerable situation more than me. The letters went out accountable mail, certified with “Signature Required.”. Two days later my phone was buzzing on my nightstand doing a little dance. I went to the health portal and found her clinical notes. They aren’t easy to find ( that’s by design) but when I saw her assessment of our (her) meeting I turned livid. She described me as a poor health historian, said that I “claimed” that I had been abstinent from alcohol for 32 months. She wrote that I needed “constant refocusing” and I had diminished cognition. She also reported that I was noncompliant (I missed one GP appointment 14 months ago because my car wouldn’t start.) She even mentioned my wife by name saying “wife Sarah was there but she didn’t contribute anything at all. She wrote that I didn’t seem to be in any pain despite using a cane. Mmmkay, here is where ChatGpt came in wonderfully. I had a letter that was notarized and went to the records department and gave them a copy of what I wanted changed on this NP’s clinical notes. The girl that I spoke with said “I don’t think the notes can be changed.” I had knowledge on my side I responded “no, they don’t have to be changed although that is what I desire. If she doesn’t want to change her notes my notes that I just gave you have to be inside of my cancer chart.” I informed that they had 60 calendar days to remove NP notes or put mine on top of the pile. I asked her to sign my copy and date it for my records. She replied “I don’t sign shit” in which I took a picture of her with a newspaper that I was carrying. Days drug by and on the 59th day my notes were changed. She though incorrectly that it was over. Wrong ! In the state of Tennessee it is illegal to identify yourself as a medical doctor. If you have a PhD you can identify yourself as a doctor as long as you make it clear you are not a medical doctor. She was recorded identifying herself as Dr XXX and when she gave me orders for bloodwork she wrote Dr Mary May MD on the orders which I had a photocopy of. So, I filed a complaint with Tennessee Board of Health and with the local magistrate. I had to explain to her what the deal was and she said “what difference does it make?” I told the magistrate that I would show her when/if I came back. Long story to short she had to go before state nursing board and she lost her prescribing privileges for six month. I was then called to the hospital so she and I could meet before a peer to peer session. She looked like a dog that had been beat once too many times. I got a written apology from her and she got a stern reminder that she worked with cancer and leukemia patients and she had a certain decorum to keep at her workplace. They gave her 2 weeks suspension without pay. Ended.
Did I go too far? No, I don’t think so. If she treated me that way how did she deal with fragile patients that had nothing left but their dignity. She was a narcissistic bully. I owned a worldwide company in Miami for 34 years. I learned to recognize men/women with Antisocial Personality Disorder that includes psychopaths, sociopaths, narcissistic tendencies. Actually only 1/2 of 1% have homicidal tendencies. But, in business you have to stay 1 1/2 steps ahead of them. They are a spiteful bunch. That is how I handled my appointment which ended in very poor results for me and my wife. Word must have gotten around via word of mouth or the online portal which houses all of our private medical information. Remember you don’t have to be treated like shit at a medical facility that you are paying money to. BTW, I don’t have leukemia or multiple myeloma. It still remains a mystery and my last shot is Neurologist next month. Regards