Pain Management Drs. & New Fda Rules

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Marg Says:
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I have been in pain management for a long time due to a congenital cervical fusion which caused the need for a 2 level surgical intervention in 2009 at C3/4 & C4/5..That area remains pain free but all the pain moved up to base of my skull, C1/2 & C2/3 & all muscles on both sides of my neck & upper back, myofascial pain. So, my pain Dr. is decreasing patients dosages due to the new FDA rules. I am now going on my 3rd day of severe neck pain, ruined Christmas, and am ready for a bullet. I have been on & tried every therapy, medication, acupuncture, biofeedback, traction, tens unit, you name it I have done it several times. I have had no life for so long, dont go out, dont even want to talk on phone, its horrible. And now this decrease in dosage I might as well be on nothing. Has anyone else experienced this? I really like my pain Dr. but this is intolerable. I have left 2 msg at his office for tomorrow. I have no cushion left between my vertebrae, its bone on bone. He knows how bad my neck is. How do I get him to stop this fooling around with the decreasing? I've been crying in pain for 2 whole days, I am so miserable. I wouldn't treat my dog like this & I dont know what to do.

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Marg Says:
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Hi, I am back online adding a bit more to my post of 12/26/16. Oh, This is Marg & I was discussing my pain management doctor, the new FDA rules & how he has been decreasing his patients meds or I know he is trying to do so & add in other treatment options such as physical therapy, or massage, other modalities. So as I stated I left 2 messages on the office phone on the Monday following New the office was closed but I thought at least I would be called on Tuesday. So long story short, I did NOT get called back & I finally called the office at 3:30. When I asked the one & only office receptionist if she got both of my messages she replied yes, that she had. I already knew thats what happened & she wasn't going to do anything about it. This happens ALL the time with her. I asked if I could see my Dr.'s partner or if he could at least call in a script just so it would help me get rid of my pain. Well I was put on hold only to find out the covering physician was not active in my health plan so I could not see him nor could he call me in a script. I asked her if she would ask one of the N.P.'s to call in a script but there were no N.P.'s in the office. She should have called their other office & had a N.P. from there do it, but this gal cant think that far & I was exhausted & in too much pain to even bring it up or do it myself. The last thing I did was bump my f/u appt. up to this week Fri, & my husband is coming with me. I will be letting my Dr. Know just what went on. He also will be told about the need for coverage for all patients when he is gone and also that he needs to have yet another talk with his receptionist. You do not just ignore patients who call for help. You return the call. I am really irate about that one. I worked in a medical clinic for 26 years. 2 Orthopedic-Surgeons, 1 of whom patented the BAK cage used for anterior interbody fusions and owns the company, 2 Neuro-Surgeons, 5 Physiatrists, 5 Physical Therapists & 4 Chiros. Not one employee in our office would have ever treated a patient like that. I know no one is perfect, but thats just not called for. So, my neck pain and muscular symptoms FINALLY eased up after taking Aleve along with my RX that has not helped at all. Along with that I did my therapy exercises & went on the internet & found some more to do. Also used heat, did my biofeedback, jaw drop, just tried everything. On the 30th of Dec. I had a new RX that was waiting to be filled first on that day. It was given to me at my last f/u appt & not to be filled til I completed the one I was on which was Opana 20 mg 1 every 8 hrs. This opana worked well for me about 2 1/2 yrs. ago, but after giving it another try now for 2 months it does not help at all, thus the reason for this new Hydromorphone 4mg. every 6 hrs. I have been on it now for 3 days & I do not think its going to do the trick, but I do have a few more days to go before we will be discussing everything. Hubby is coming along so he can tell my Dr. just how bad it gets when my neck/muscles are acting up. I am feeling like I don't say enough or explain myself very well to him. I did note there are a lot of patients on here from the southern & western parts of the United States, or so it seems. I live in Wisconsin, small town. It seems to be that some of these patients have a hard time finding pain management doctors or even getting their scripts filled. Is there a reason for this? I feel really bad for them if they are having hard times either finding a good pain management dr. or getting their medication. There just is no way to explain to someone who has never suffered with chronic pain just how really bad it is. They can say yeah, they understand. But, there is no way they would or could ever understand. If the depth of the pain alone isn't enough to make you want to call it quits, then the life that passes you by, the loss of yourself, your friends, your money, a million other things are. It sucks the life right out of you, it takes your soul. We make peace with our Savior many times. For all of you in the same situation, I hope you & your doctor find something that works. Take Care!

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VerFree Says:

Hello, Marg! I am so very sorry about what you're going through.

Due to a spinal deformity, I have dealt with pain, off an on, for most of my life, so I do understand. I try to avoid medications, and mostly use a TENs unit and heating pad, but they don't always cut it. I suffered a bad fall back in February, due to black ice, and recently had to talk to my doctor about the pain, since it has gotten worse since then. I'm trying Gabapentin, which can help with nerve pain.

The main issue with doctors wanting to taper patients, or not prescribe, at all, is due to the new DEA directives that cap how much is allowed ot be prescribed to any given person, unless the person is suffering a possibly terminal illness, such as stage 4 cancer. If they DEA feels they are overprescribing, they risk sanctions, which could include losing their license to practice medicine, and jail time. Thus, most of them are truly afraid to prescribe opiates, and when they do, they are reluctant to prescribe large quantities, or high doses. There are some details available on the DEA website, though this is just one article with directives regarding prescribing controlled substances.

As to the people having trouble finding a doctor, or getting prescriptions filled, there are various reasons that could happen, so we could only speculate.

How are you doing, now?

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marin5 Says:
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Marg, Have you thought about medical Marijuana? You don't have to smoke it! I'm sure you are eligible! I am also but my doctor refused to give me a script for it! I could find out who prescribed in my area and ask them. I have COPD so would never smoke it. I would like to be able to add a little to the CBD. I heard it would help to kill the chronic pain! Months ago I had my Opioid brand name taken from me saying they're not making it anymore, after being on it for 2 1/2 yrs! 2-4 times a day=8 I took 225 or 240 a month, but when the pharmacists started treating me like I was an abuser with a legitimate script in my hand from my doctor from a reputable hospital I am disabled with many autoimmune diseases can't walk without a walker or cane I got angry and swore that they would never control me with a drug again, so I took myself off of them cold turkey not knowing what I was doing, and kept going into withdrawal and getting sick. It took about 2 1/2 mths, but I'm completely off of them since 12/31/2018. But in twice the pain! I am looking to go on LDN, but need something natural to help even there. I have been trying CBD but have so many things wrong that none of it has touched my pain! I have been taking Tylenol 8 hr. Arthritis 650mg 2 every 8 hrs and some Cbd in between. I have been lucky with the cbd company I order from, who give 60% off of all their products if you are disabled, poor or Veteran. My order this week should have cost $130. but was $57. They are a great company with great products! I am very fortunate! It is true that the opioids make you sicker and in more pain in the end! I am so happy they're out of my system. I didn't even tell my doctor what I was doing, only told him last week! No more constipation! That's the best part!

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