Doctors and poor pain management

[Lisa J]

SWIM has had chronic neurological pain for years and appears to have been lucky as she lives in the UK and gets good pain relief. SWIM has fentanyl, codeine/paracetamol, gabapentin & baclofen.
SWIM had a little "blip" a few months ago and started using heroin, she thought the GP would stop the pain meds but he didn't and she now gets methadone as well.
SWIM'S current problem is that she started reducing the methadone and found her pain was getting bad, GP upped the fentanyl and SWIM was able to reduce the methadone further. She has now reached a point again when she can't go any lower on the methadone and the GP says he can't increase the fentanyl (now on 125mcg) so she's waiting for an appointment with the pain clinic to see if they can find an alternative to methadone for the pain.

Reputation Comments on this post:

hope all is well

[JJx23]

Oxycodone is used for Chronic pain, at least for me since I have a wrist injury that deals with tendons, etc. Anyhow, each state would probably be different I'd imagine.

[samuraigecko]

The type of opiate prescribed is dictated by a number of factors

1] the doctor prescribing it.
2] the type of person he see's you as.
3] the type of pain it is
4] how intense the pain
5] how prolonged the pain is likely to be.

it is a combination of these determining factors which dictate which drug the doctor will prescribe. Any number of these combinations can steer his decision in different ways.

A big factor is also "promo's" and "Bonuses" .
Example: Doctors receive cash bonuses in some instances depending on what brands etc they prescribe. This can also help to dictate what they are likely to prescribe you. Oxycodone can be prescribed for both acute and chronic pain, but it depends on the above factors weather or not that is what you will get.

Hope this has helped.

[HighCountryHero]

If swiy is unhappy with what the doctor is prescribing him than he should go to other doctors and pain clinics. At least in the US, one can usually find a doctor willing to give him stronger/better/more appropriate meds. It just takes some searching and a lil bit of luck.
Swim has ACL sugery recently and was given morphine by IV for the 2 days in the hospital, then 60 5mg percs, 40 vics, and 40 lorcets. Swim was in so much pain he had little recreational effect from the pills but they did keep him from going crazy from pain. Swim can't imagine being given anything less as he was in lots of pain. Swim thinks its wrong to give useless meds to those that are in real pain and in need of real relief.
So if swiy thinks he needs something more effective than he should go find a doc or clinic willing to give him those meds that will work more effectively. If one does have real, legitimate reasons, than it shouldn't be too hard. Just look around. Swiy will find something better.
Peace

[samuraigecko]

Originally Posted by HighCountryHero

If swiy is unhappy with what the doctor is prescribing him than he should go to other doctors and pain clinics. At least in the US, one can usually find a doctor willing to give him stronger/better/more appropriate meds. It just takes some searching and a lil bit of luck.

In some countries they call this "doctor shopping" and can quickly get a person black listed from being able to obtain a certain class or type of drug. The doctors in some countries have a computer database network which will show up when one such person is blacklisted from being able to obtain these types of drugs. After this event the only chance of one of these people being able to get that type of drug is if there is an emergency situation that calls for its use and/or continued prescription.

Hope this has been of some help

[OhCasey]

Originally Posted by samuraigecko

In some countries they call this "doctor shopping" and can quickly get a person black listed from being able to obtain a certain class or type of drug. The doctors in some countries have a computer database network which will show up when one such person is blacklisted from being able to obtain these types of drugs. After this event the only chance of one of these people being able to get that type of drug is if there is an emergency situation that calls for its use and/or continued prescription.

Hope this has been of some help

Thats not doctor shopping its called a second opinion. Its perfectly legal. Doctor shopping is Going to multiple doctors and getting pain meds from them and not informing them so you can get more pain meds. You can go to a million doctors looking for one who agrees with you and gives you the diagnosis you want and its legal.

[samuraigecko]

Originally Posted by HighCountryHero

he should go to other doctors and pain clinics. At least in the US, one can usually find a doctor willing to give him stronger/better/more appropriate meds. It just takes some searching and a lil bit of luck.

This can imply more than just a "second" opinion and some doctors in some countries will certainly see it that way also so SWIM was merely stating to be careful during this so that some doctors do not interpret it as Doctor shopping if a SWIMMER happens to be in one of those such countries. This may be helpful for those whom do not want their meds taken from them completely (which has already happened in a few of the cases here if SWIyou bothered to read the rest of the posts).

One is not even going to entertain the rest of the snide inconsistencies. Please stop following SWIM around and quoting every post he makes, SWIyou are just embarrassing SWIyourself.

One hopes that this has cleared up any information which SWIyou may have misinterpreted, and one hopes this has helped others.

[norcolepsy]

Originally Posted by samuraigecko

In some countries they call this "doctor shopping" and can quickly get a person black listed from being able to obtain a certain class or type of drug. The doctors in some countries have a computer database network which will show up when one such person is blacklisted from being able to obtain these types of drugs. After this event the only chance of one of these people being able to get that type of drug is if there is an emergency situation that calls for its use and/or continued prescription.

Hope this has been of some help

+1

swim's friend got caught doctor shopping by his insurance co. and subsequently was blacklisted from virtually any opiate (shortly after, he settled for getting the 'tram-doll'...which i guess isn't an opiate?)

[bloodred1889]

yes you should be carfull about doctor shopping because if doctors get a slight reason to think your drug seeking thats it.
then you are screwed.

swim has seen about 5 diffrent doctors all had pretty much the same view, they didnt want to give me the DHC because they said its too adictive and has a street value.

one doctor took swim off them the moment he saw swim.

now swim is seeing her original doctor and he is happy at the moment but said if the MRI scan dosnt show anything serios then he will take me of the DHC.

which is abit stupid because some things wouldnt show on an mri.
swim now suspects she has arthritus which will need further tests, but swim is NOT prepared to just be told nothing is wrong when she is in constant pain and its getting worse.

[samuraigecko]

wouldnt arthritis show up on an MRI? that is inflamed or damaged cartilage and joining tissues in the joints isnt it? This should certainly show up on an MRI scan if it is a full body scan they are performing.

Hopefully they can find the source of SWIyour pain so it can be managed in the proper manner. SWIM hopes for the best for SWIyou.

[Orchid_Suspiria]

Swim knows a person in a drug rehab program who broke his leg but is only given ibuprofen because of this program.Disgusting,the fanatacism of NA and the antis would rather have someone in severe pain than find any relief.The sickening part is this persons problem isn't even opiates,he is in the program due to methamphetamines.

[bloodred1889]

well lol if swim wasnt a student with no job, swim would be happy to pay for a doctor like all these celebratys seem to be able to do.

i cant strand the fact most famouse actors singers ect can go to there doctor and get vallium, vicoden ect even if there not in pain.

no im not having ago at heath ledger, im more talking about people like kelly osbourne and eminem.
and im not really having ago at them, im just surprised.

the time swim was told it is phantom pain was not by a doctor it was by a rumatologist, you know one of those nurses who gets to to do exersises.
she didnt bknow i was on opioids so she couldnt have been thinking withdrawel.

you see 6 years ago swim was attacked by a group of ppl, 3 girls and 2 boys.. yes boys.
anyway since then everything has gotten worse so swim always says to doctors that she thinks that is where it all started, and this women i saw said well you think that when you were attacked you were damaged and so your never going to beleive your not in pain without proof!
so im not giving you any exercises to do untill you get an mri so you can be prooved wrong!

swim was so upset and angry at the fact this person who had only just met swim could think such a thing, and swim totally thinks she was patronising and put it all down to age.

just goes to show the thought patterns of some doctors and how some ppl no matter how much they are in pain and really telling the truth will always get turned away at least untill they are about 30 years old, or dying!

[OhCasey]

Originally Posted by bloodred1889

well lol if swim wasnt a student with no job, swim would be happy to pay for a doctor like all these celebratys seem to be able to do.

i cant strand the fact most famouse actors singers ect can go to there doctor and get vallium, vicoden ect even if there not in pain.

no im not having ago at heath ledger, im more talking about people like kelly osbourne and eminem.
and im not really having ago at them, im just surprised.

the time swim was told it is phantom pain was not by a doctor it was by a rumatologist, you know one of those nurses who gets to to do exersises.
she didnt bknow i was on opioids so she couldnt have been thinking withdrawel.

you see 6 years ago swim was attacked by a group of ppl, 3 girls and 2 boys.. yes boys.
anyway since then everything has gotten worse so swim always says to doctors that she thinks that is where it all started, and this women i saw said well you think that when you were attacked you were damaged and so your never going to beleive your not in pain without proof!
so im not giving you any exercises to do untill you get an mri so you can be prooved wrong!

swim was so upset and angry at the fact this person who had only just met swim could think such a thing, and swim totally thinks she was patronising and put it all down to age.

just goes to show the thought patterns of some doctors and how some ppl no matter how much they are in pain and really telling the truth will always get turned away at least untill they are about 30 years old, or dying!

Ya Phantom Pains usually refer to severed limbs, severed nerves or a pinched nerve where the pain is coming from the location of damage but feels like its coming further on down the line like arms, hands, feet, and legs. Who knows what sammies talking about. The age thing is tough im 21 and have been on pills for some years from a very major accident where i lost all function in my right arm and some docs (mostly my family physician) have told me that my pain should be gone in a couple weeks or so even after being diagnosed with chronic pain and being on meds for years. Pain mangement docs seem to be better but they just cant comprehend what its like to live in pain.

[bloodred1889]

omg swim finally got diagnosed with somthing.

swim has Fibromyalgia.
a condition that just genrally hurts and causes widespread pain.
also causes depression, fatigue and other stuff.
if your interested look it up on wiki, if anyone else has this then a reply would be really helpfull.

anyway thought id just say that.

[OhCasey]

Originally Posted by bloodred1889

omg swim finally got diagnosed with somthing.

swim has Fibromyalgia.
a condition that just genrally hurts and causes widespread pain.
also causes depression, fatigue and other stuff.
if your interested look it up on wiki, if anyone else has this then a reply would be really helpfull.

anyway thought id just say that.

SwiBR I was wondering if you've tried Lyrica(pregabalin) I take it for nerve pain and it helps a lil but I've heard good things about it helping with fibromyalgia at the very least it could help take the edge off. I'm not sure if its available in the UK though.

[samuraigecko]

SWIM is glad that SWIyou finally got a real diagnosis, this is great for SWIyou.
SWIM knows about fibromyalgia because it is (distantly) related to his particular bone disorder in a way and he was originally thought to have this also.

Finally SWIyou may be able to get some more effective meds
but one would adivse to stay smart about it once SWIyou do have those meds as the resulting build up to "dependence" or addiction" can lead to other problems also which if or when the meds are discontinued for some unforeseen reason, would be unbearable.

This is not to say that SWIyou will become "an addict", it is just an unfortunate circumstance for those whom are in real need for pain meds if it happens to get discontinued for whatever reason.

One is happy for SWIyou.

[bloodred1889]

thanks gecko

[Mint boi]

So my ferret has a new story about poor pain management.

His Mother and her partner were in a high speed motorcycle accident (don't ask!!), they hit a telephone pole at 100+ mph. SO anyway, my mother was fine, a bit bashed up, bruised and concussed, but otherwise ok.

Her parter on the other hand broke his collar bone and shoulder blade, really badly, it was literally shattered into 8 pieces, and the socket of the joint was ripped apart.

In the er he was told he had a fracture and sent home with nothing but tylex: 30mg codeine, 500mg paracetamol. The guy couldn't even move his arm at all and was screaming in pain.

So after spending one night with no sleep in totaly agony we brought him back to hospital, where he was given a cat scan and the docs realised the extent of the problem and he was given surgery and put on morphine ect, so its all good now.

But the original prescription was a joke, he actually passed out with pain at one stage it was so bad. We were talking to the resident in the hospital today, and he actually said if it was him in that situation he would sue the hospital for negligence!

[davestate]

SWIM broke his leg in a nasty rugby injury about 2years ago, had surgery and was on a PCA (patient controlled analgesia) unit for a week. This godsend of a machine gave me 1MG morphine with every press of a button, to prevent OD'ing it would only work every 5mins and would shut off for a certain amount of time if used excessively. He was then prescribed 150 (!) Tramadol for recovery, when he only needed about 30-40, so he (stupidly) handed them back. Tramadol had a powerful effect on SWIM btw.

Now two years on and hes having severe trouble as there was ankle damage, after numerous reviews, GP and consultant appointments he hasn't been given anything for the pain. Is it any wonder SWIM or SWIY can be forced into buying online and doing CWE's on Co-codamol?

[bloodred1889]

haha
its so funny.
swims doctors are allways concerned about the amount of opioids she is taking.
but swim went again to hospital last night due to severe vomiting which turned out to be a kidney problem again.
anyway after a night in hospital and on oramorph pain relief, swim was discharged with a 100ml bottle of morphine!!


haha swim jjust thought that was funny.

[samuraigecko]

SWIM only once had IV opioids when at the dentist. This was a prior arrangement because he was having all 4 wisdom teeth taken out and they were in a rather difficult position. He had to go into a specialist for actual dental surgery and they were also considering putting him under a general anesthetic instead of using locals.

They decided on the locals in the end but also IV'ed him Morphine because of the amount of pain endured as it was a long and hard operation because of the way the roots of the said teeth had grown (almost spiraled).

This was, however, a prior arrangement for dental surgery and not just a standard extraction.

[norcolepsy]

When swim had all 4 of his pulled out he was IV'd sodium-fentanyl. not sure what that classifies as..all swim knows is that the dentist caught his attention when he mentioned fentanyl!

[Psych0naut]

Sodium Fentanyl does not exist. Fentanyl can't form a sodium salt. Barbiturates are commonly encountered as their sodium salts for IV use though, and I'm pretty certain you might have mixed it up, IV barbiturates are often used to induce general anesthesia.

[norcolepsy]

Sorry about that. Swim was quite certain at the time the dentist mentioned 'fentanyl', but then again it was a long time ago so you're probably right.

[bloodred1889]

swims wisdom teeth are starting to come through and hurt alot, thankfully swim has opiods to help with the pain, but swim is thinking of getting a dentist to pull them out, we will see then if they give me opioids for the pain and stuff.