what should i tell my pain doctor?

[Neuropathic1]

My Doctor finally started to give me 1 month of pills at a time. It was once a week. I have been suffering from chronic pain for over 5 years

Anyway, I have used more of the pain meds than I am supposed to, now I am running low and starting to worry of the predicament I put myself in. I did not abuse the meds, I took more when I absolutely needed them.

Anyone else have this happen to them and what did you do? Did you get labeled by your doctor as an abuser?

 

[herbavore]

I think that you should tell your doctor that you took more because you absolutely needed more and that, while it has you worried, you felt that it was necessary; then ask her/his opinion. Do you have a long relationship with this doctor? I think it is always best to be as honest as possible with your doctor.

 

[effie]

^ I agree entirely.

It is unfortunate that people with legitimate pain can get labelled as a drug-seeker, but you do have a genuine need for the pills and hopefully you have a doctor who can see that. It might be worth ringing up now, to give them a heads up that you are in pain and have had to take more than you needed?

Good luck

 

[Neuropathic1]

Good advice, I will be straight with him and tell him I needed more. He has been quite judgemental towards me from the start. Whenever a type 1 diabetic gets sick or has pain issues like me they tend to blame us patients of not taking care of ourselves properly, it is a 'Its your fault' attitude even though clinical data has proven how even good blood sugar control can still lead to complications like I have.

 

[herbavore]

If he is judgmental is there any chance of changing doctors? No one deserves that.

 

[Neuropathic1]

It took me 3 years just to get into a pain clinic, things move very slowly in the Canadian healthcare system. I do plan on trying to get another doctor, this one has even acused me of selling my meds....my goodness, no amount of money could satiate my chronic pain or justify selling what makes my existence bearable! I have even thought about trying to purchase pain meds online however I have no knowledge of where to look, and no evidence the medication is what they say it is. I can just imagine getting anything legitimate!

 

[TJ5]

If he's been a judgmental fuck this entire time, what makes you think he still won't be once you have confirmed what he has predetermined about you from the start? While, granted, I defo agree that ideally, its the best thing to do (be completely honest with your doctor) but in the real world, 100% honesty is NOT the best option, but depends on the doctor, the patient, the problem, how long you've been his patient, ect. If I were in that situation you described, I would find a different doctor that will NOT be judgmental, or at least be open enough to hear what you have to say before jumping to any premature conclusions. I've been both a medical professional behind the scenes hearing the snide comments and snickers everytime a "drug seeker" came in, and while staying silent and professional, but compassionate as possible to the addict, I was freaken thankful no one knew MY double life. Haha if they only knew. If they did, the gossip never got back to me anyway, but my point is better to be cautious and conservative to feel the doc in question out, rather than risk getting a big old KDS fuckin lable on your chart. I'd keep my mouth shut to him, but say, look doc, is there maybe something else I could try? The prescribed amount for pain just wasn't cutting it. Emphasize you had intense breakthrough pain, but I wouldn't tell him you took more pills than he prescribed. This also raises red flages to prick pharmacists, if they, too, want to be dicks. Maybe he will switch you to a stronger Rx, or up the dosage, and in the mean time try to find a different doc if this one's a dick. In emergencies, when my Rx is running low, I stock up on white grapefruit juice, drink one 8 oz glass of it on an empty or not full stomach with a half dose--and it should do the trick to get you through til refill time. It has to be white, not pink, and it has to be juice, not grapefruit drink. It enhances your dose double time, does for me anyway, and I'm only on codeine, a weak opiate. Tagamet if you have some will make the effects last longer. Hope this helps.

 

[Missykins]

It took me 3 years just to get into a pain clinic, things move very slowly in the Canadian healthcare system. I do plan on trying to get another doctor, this one has even acused me of selling my meds....my goodness, no amount of money could satiate my chronic pain or justify selling what makes my existence bearable! I have even thought about trying to purchase pain meds online however I have no knowledge of where to look, and no evidence the medication is what they say it is. I can just imagine getting anything legitimate!

I am just going to play the devil's advocate here: if you are running out of your meds weeks early , the fact that
you may be diverting your medications is something that your physician must consider.

 

[Dave]

Pain management is incredibly difficult, and it can be very hard to distinguish between seekers and genuine tolerance/changing pain issues. The fact that this happened shortly after bumping you to monthly dosing would raise some red flags, most certainly, but may not be a deal breaker. Be honest-- tell them that you had breakthrough pain and needed to take more than you normally would on occasion. You may need to have a change in the meds that you're taking for chronic management if you're getting breakthrough regularly.

A good pain management doc will look at the bigger picture. Unfortunately, many are not good, and those that have been stung by seekers before will be over-cautious. Be honest, but try to understand their side as well, and work with them. Hypothetically, at least, they are there to help.

 

[effie]

^ Dave gives some very good advice here! Unfortunately ther are people who try to abuse the system, and it can be difficult for doctors to distinguish who is genuine and who isn't, and some do get it wrong - but hopefully your doctor will be able to tell that you are being honest and will appreciate that you do need more medication to control your pain. Be prepared to work with your doctor - I wouldn't go in demanding more medication, I would simply explain the difficulties you are having and ask what they suggest. This should hopefully build trust between you and your doctor, and together you will be able to come up with a regime that works for you.

There is a thread you might be interested in - the Pain Management Megathread in the Other Drugs forum - link to version 1 here and version 2 here. Be aware that Other Drugs doesn't have the no-triggering rules that we do, so some people find it easier to stick to TDS, and they focus more on medical ways to manage your pain rather than ways to support you and strategies for bulding a good relationship with your doctor like we do here - but you may find it useful

 

[Hooddood78]

I´ve now been a patient with the same doctor for years and years. This one is really one of the "founders" of pain management in Finland. She is extremely nice and treat you as a whole person not just a painful bodypart or some. I have been quite honest with her for over the years. Actually I really haven´t use these drugs of mine recretionally more than sex months now and I have had this neurostimulator and it really takes the pain away from my legs. I have this hederitary nervous system/muscular desease since I was 10-11 years old. It started to cause me pain only when I was some like 22-23 years old. Now it has gone little ovet ten years from that.

The start was a struggle with communal healthcare but then I got appointment with one specialist that put me on medications at once and started to send me forward for example to the pain clinic in main hospital. There the first doctor was a total jerk - but luckily he left and this wonderful doctor took me as her patient. We have had a very loyal relationship. I can email to her to prescribe the medicine which I need put still she is a supervisor of my use. Now first time it has gone out of my hands, the use I mean.

But my advice is to seek another doctor who really is specialised on treating patient with chronic pain issues and who is able to write the meds you need - even the stronger ones if needed. He/She then is your supervisor but as professional he/she will understand that you get tolerance and the dosage must go higher every once in a while and you might get some bad moment when you need to take some extra. The real professional will understand that. And treating the pain I think you might have needs more than just strong painkillers. In the end the total would be a coctail of pills but if that´s the way it goes, it goes.

-Hooddood78

 

[michael]

it's perhaps a little late for this advice, but it's something to keep in mind: i am a chronic pain patient and if i were to need to take something extra you can be sure as shit i would be on my phone to the doctor's office THAT DAY instead of waiting out the month.

 

[Dave]

^ Good call. If for no other reason so that there's a paper trail, showing exactly when BT pain is occurring. They probably really appreciate it.