Morphine
morphine
diluadid
benzo
benzo
anti depressant
bp
bp
gout
AS AN ASIDE, THE FENTANYL AND TEMAZEPAM 30 MG WOULD BE WONDERFUL.
Actually, anything that would reliably put me to sleep would beat the hell out of this game MD is playing - the 1/2 dose temazepam (that’s the sleeper, folks!) she was forced to write is for qty 15 and is now dead - no more refills until she approves. Again
I actually got in a full day today - the first since 2/15/17.
If this continues, I might get something done.
Like call atty, then find new MD if atty agrees it will not harm an abandonment action.
new treatments for sleep.
How many times have I heard that?
If there are these wonderful new treatments, and PCP is a competent and caring MD, why have I not heard of them?
Especially when she discontinued the one pill which actually worked and will never again write that script?
You can’t have it both ways - if MD is great, why have I no way to get to sleep? If PCP is crap, I will need to find all these wonderful new treatments myself.
You keep trying to defend the inexcusable. It will not work.
and Dr B has not responded to my request for renewal of the 1/2 of a pill she provided.
Because you aren’t listening to anything. You just keep demanding narcotics.
Probably because she has learned that your only response to anything is long, semi-coherent explanations of why you need more drugs.
Regards,
Shodan
Was Dr B the one who you convinced to write the2nd script, or the1st?
No i am not going to dig through the semi coherent notes again. I’m pointing out that you convinced another doc to write a duplicate script so you could double up. According to their records you don’t need a refill yet.
I don’t know that anyone had said your doctor is great I have no idea. i do know how you come across here, and your reaction to not getting your pills. The doctor said she was going to talk to the sleep department.
Does this thread give readers a little better understanding of the difficulty doctors are facing in the midst of our opioid epidemic? This is not unusual. This is how many patients act. The patient very clearly needs help, but the kind of help they’re demanding isn’t really helping. It’s not that there isn’t a need, or the doctor can’t see the need. The doctor wants to help, but everything they try is seen as an attack, incompetence, or “malpractice”.
It does help me a bit . I have chronic pain, too, and we are exploring different options to try and alleviate it and get me back to where I want to be, physically. I did have a doctor many years ago accuse me of being a drug seeker, as I was trying to explain my pain and *get set up with PT. * Yes, as I was asking for physical therapy, I was accused of being a drug seeker.
I understand why doctors are cautious, and why many have stopped prescribing narcotics altogether. It certainly cuts out the patients who walk in and say “My only requirement is that you give narcotics.” It must be a lot easier to weed out the patients that do not want to look at any other options.
iF THIS THREAD HAS TAUGHT ANYONE ANYTHING, AT THIS POINT, ALL SHOULD UNDERSTAND THAT “NARCOTIC” IS NOT THE SAME AS “ANY NASTY DRUG”
But we still can’t quite grasp that there are two very different classes of drugs under discussion.
Short form:
Pain
vs
Sleeping
The new, much better Fentanyl pain med is also a “narcotic” - it is another opioid.
I have explained what “opioid” and “opiate” mean (they are NOT synonymous).
I have also explained, repeatedly, that the sleep is a “benzo” - short for benzodiazepine, which I have explained, were the new, improved way to do things previously requiring barbiturates. including sleep inducing.
I also covered the “Z Drugs”, which were the new, improved way to induce sleep - to replace the benzodiazepines.
Please note that, in each case, the “new, improved” proved to be:
Much better, but that was not saying much (benzo replacing barbie)
Actually, not all that great after all (“Z drug” replacing benzo)
For historical record, I think I also noted that Heroin was hailed as the salvation of Opium addicts.
Which is why the great "salvation for heroin addicts, Methadone, was not wildly popular.
Methadone’s only “advantage” over heroin was “it is legal, heroin is not” - not a medically significant distinction.
So, aside form the bizarre references to the signage on the building - See Pain Clinic! - See Sleep Center! - to which I ask "just what do you suppose goes on in those buildings that cannot be done anywhere else?
After 55 years of insomnia, I may just, maybe, have tried “Sleep Centers”.
I used real ortho MD’s for pain. I know one of the local “Pain Centers” was widely hinted at as being a "pill pusher’ - not an improvement.
But, no, I’m being unreasonable IN OBJECTING TO HAVING STUFF WHICH WORKED REMOVED AND NOT REPLACED with anything.
The only way I got the new, improved opioid Fentanyl, was to go into renal failure and nearly die.
This is not MY idea of a pro-active treatment plan.
If the doc doesn’t want to write the benzo sleeper, I gave an option of a Z drug which also works for me.
She has said nothing about the Z drug - only that she will never again write temazepam (this is the Benzo. It is the sleeper. It is NOT a narcotic, opioid, nor opiate) in the 30mg dose.
She has not only ignored the Z drug suggested (Lunesta 3 mg (this is the Z drug. It is a sleeper. It is not a narcotic, opoid nor opiate), she has not suggested even a “sleep clinic” so loved by some on this thread.
Now, I’m going to the clinic and going to try to find some way to sleep day after tomorrow.
This is the first time I have had 2 consecutive days of feeling well enough to drive since 2/15/17.
The drug lists posted above were all* written by my competent, compassionate, evidence-based PCP - before the “Lists” were published with her name on them.
-
- except the gout drug, which I have learned to have a few on hand - if you ever have gout, you will quickly realize that AFTER the attack is not a good time to try to drive
We know what benzos and narcotics (both opioid and opiate) are. Guess what? ADDICTIVE. DANGEROUS. ABUSED BY CURRENT PATIENT.
While your apparent belief that none of us know what medicines are, or what pain is, or what good a specialist might do (here’s a hint - you specifically said you went to a sleep clinic expressly to dx apnea - guess what, you need more!) While all of that PLUS incoherent ranting is UTTERLY charming, it’s mistaken.
Good luck.
I am abusing these?
What is your evidence?
Your qualifications?
Guess what - that sleep clinic took one look at my chart and said “bring your drug - we can’t do better”.
The one in SF all those years ago said the same thing.
ONCE Again - idiopathic MEANS “HAVING NO CAUSE, JUST IS”
And guess what - the PCP just blinked and renewed the benzo at my request - maybe she doesn’t want to fight a battle she will lose.
If she will do the benzo and the “new, improved” opioid like a good little MD, I can deal with the dilaudid dosage later.
But excuse me - I have to pick up the benzo I’m abusing, provided by the rational, evidence-based PCP.
I really enjoy abusing the benzos - I’ve been at it for 17 years!
It’s nice, Raven, that you know the difference between the various drug classes - tell me quick - what DEA schedule is Marijuana on? Heroin? Opium? Ativan? Morphine?
The idiot who though a second benzo script was somehow “Uh Oh!” probably still hasn’t grasped it.
p.s. - I’ve been following the Fentanyll development for over a year now. My PCP has never mentioned it - she was too busy pushing morphine to the exclusion of dilaudid to notice?
Why do my critics keep insisting that I have no reason to object to drugs being withdrawn without replacement.
If you were snowed in with just enough food to get you through until the roads cleared in spring, and I stole all your food and told you “this is bad for you! You can’t eat this!”, exactly what do you suppose your reaction would be?
You still don’t get that “no med = no sleep”, do you? That is so far outside your world of experience that you will insist that I must be insane to think there is a problem.
Oh - I did find the note on the hospital discharge paperwork (3 pages!).
It actually does suggest I quit the benzo - without specifying any replacement.
Then again, it really does tell me to take 3 325mg Tylenol 3 times daily for pain. While prescribing the Fentanyl.
Either there were two people writing without reading the other’s words, or I am not the biggest “mistaken” author involved.
Forget this fight for a moment, this is just too good:
I have, on one document, the following instructions for “osteoarthritis” and “chronic lower back pain” (both on my chart - see above):
Fentanyl 25mcg/hr patch every 72 hours
Dilaudid 2 mg 1/day
Tylenol 975 mg 3x daily
One of these things is not like the other.
There are 4 MD’s listed as attending for the 5 days.
And yes, I did buy Tylenol and took it as directed for 2 days. With the exact same result as it had in 1972 or 73 when I first tried it.
Before the OA, all the typing in my job gave me mild carpal-tunnel/repetitive stress pain in right forearm.
Yes, I did revisit tylenol, and ibuprofen when it went OTC. Even 6-8 pills had marginal, if any, effect.
When I told the kidney people this, they assumed I had continued taking the massive dosages.
Actually, I kept elbow and wrist braces in my desk. Others kept bottles of pills.
ONCE AGAIN: I DO NOT LIKE PILLS
but I"m abusing them…
For someone who doesn’t like pills, you sure demand a lot of them.
Regards,
Shodan
Why are you so violently against the idea of having an advocate who is not a lawyer?
Marijuana is schedule 1, For absolutely no good reason, IMHO.
Heroin - 1
Opium - 2
Ativan (my husband takes that) 4, just like Xanax, which I take on occasion (Psst - both benzos, whatdyaknow)
Morphine is 2, and what is your point?
(I think those are all correct.)
I said you are abusing them because you are not taking them as prescribed, which is generally seen as abuse. You have a right to be pissed about being cut off, without a replacement, but at this point Mr. “NO PILLS = NO SLEEP DONT YOU GET THAT!!!” I don’t see you as a reliable narrator.
Wont it be wonderful if your doctor loses the ability to prescribe scheduled drugs at all, won’t that be GREAT? I mean, she is clearly on a list as over-prescribing, but hey, as long as she gave in.
So I give up. Enjoy your pills - oh, I forgot, you HATE pills. Enjoy your outrage, then.
Hey! I’ve added “unreliable narrator” to "“drug abuser”! Yea me!
Oh - how is it I am not using them as prescribed?
Which prescription is the controlling one?
The 45 mg morphine is better than 40 mg dilaudid, never mind it will finish destroying your kidneys?
The 15mg morphine and a few 4 mg dilaudid?
The No dilaudid - just morphine?
Or the hospital docs: Fentanyl patch every 72 hours, plus 2 mg dilaudid a day?
All of those have been on the table.
Since you know I’m not “using as prescribed”, you must know:
How they were prescribed
How I am using them
So tell me - what did I do wrong?
Never mind - the doc cut the dosage in half and I am being stubborn and using the minimum dose required for the purpose (yes, as a matter of fact, I DID try to use 15mg. That’s when the shit hit the fan the second time)
Even the hospital docs admit I used the drugs as prescribed and nearly died as a result.
But you know me better than they, obviously.
But, frankly, your claim to know what I do/have done/reason for same better than I do is a bit of a stretch.
And how is your and your hubby’s use of benzos so much more civilized than mine? Can you trace your use back to 10/00?
My apologies:
THis:
(snipped)sounded like you got the duplication in order to not taper, contrary to doctor’s orders. Or are you taking 30 mg after all? You seem to be going back and forth on that.
I am sorry you are suffering. I never said that my husband’s use was more civilized, but he doesn’t take anywhere near his max allowable and tends to have it pile up because he doesn’t need it. No, he hasn’t been taking it since October 2000, and I don’t know how relevant that is. More than a decade ago, but less than 17 years. MY occasional Xanax use has been since about 2000, but I take it once or twice a year. Longer term use is generally not recommended for any benzo, and if he took it every day he would probably be dependent on it. You have a dx of “benzo dependence” that you shared with us.
But it doesn’t matter to me, I hope you find some relief.
Couple questions:
-
What is a UCD report?
-
What is a dup script and how did you get the doctor to write it?
-
Can the doc get into trouble for writing the “dup script”.
There are many reasons I am a pediatrician and not an adult doctor but experiencing patients like this during training is one of them. My empathy for the person is swamped by the knowledge that the person has been and continues to be so much of the active cause of his bad circumstance and is not only doing nothing to help himself but is continuing to cause himself more harm and to undermine any effort to help him. Kids who do that I can get (and there are very few in my experience) but I would never be able to tolerate a circumstance in which I care and am working harder for an adult’s health outcomes than the patient is.
Why the PCP has not already dismissed this pile of pathology at this point (with the 30 day notice for urgent care) is beyond me. I believe most would have.
I am happy that there are those who can work with this sort of population but so much more happy that I don’t have to.
Still not getting why the OP hasn’t changed doctors. There must be hundreds of primary care MDs in Davis. Without terminating the relationship with his primary MD, unless he has a Medicare HMO (he never answered me on that point) he is free to seek a second opinion from any physician that takes Medicare.
Meanwhile, to respond to some of his posts:
Now this sounds like a reasonable regimen. You have a chronic narcotic medication (the Fentanyl) along with a small daily dose of a short-acting narcotic and a third pain medication that has a different mechanism of action and can work in concert with the narcotics. What is the problem with that?
With regards to the sleeping medication:
According to the OP PCP suggested he come in to discuss his sleep problems. He does not say when he last had his sleep medications reevaluated. He has not indicated whether he has tried the newer medications such as suvorexant or even silenor. If he has not tried these then it is time to go back to a sleep specialist.
To the OP:
I give up. I have tried to see things from your point of view but to be honest, if you come across in person the way you do on the internet, I do not blame your doctors for being concerned about prescribing controlled substances to you. I will also be honest that your PCP may be using the DEA as an excuse to avoid confronting you with suspicions that you are an addict. Some doctors (especially female ones) have trouble with confrontation and telling patients things that they do not want to hear. Just as it is easier to just give in and prescribe antibiotics for a cold, it is easier to blame the DEA for not wanting to prescribe controlled substances. I’m not saying it’s right, but there are time when I find myself wanting to use “my license would be in jeopardy” as an excuse to avoid dealing with a patient who is demanding medication and blaming you for making him suffer. (True addicts can be VERY manipulative). The only reason I say this is because apparently your doctors (at least doctor B) are apparently easily bullied into caving in to your demands.
That said, I don’t know you and have not treated you. I do not know if you are an addict or not. I believe that you have pain and insomnia. I also take you at your word that you know some medications that work for this to some extent. I also take you at your word when you complain that your life is not optimal. I also see that you flat-out refuse to acknowledge that there may be newer approaches that work better than your prior regimen, even though by your own admission, you have had help from one of the newer medications, Lunesta.
You express contempt for your doctors and for the knowledge of people here.
You delight in manipulating your doctors.
You have open contempt for their treatment plans and brag about subverting them.
Yet you refuse to seek another doctor, saying only that “they” won’t treat you if you change your PCP.
A quick Google search turns up 36 internists directly affiliated with UCD. There are more than 60 internists in Davis itself, some affiliated with other hospitals. I count at least 4 large practices and multiple other smaller ones. If you feel you are not getting adequate care then you need to find another doctor (and as pointed out multiple times, it is NOT abandonment to refuse to treat you with the medication of your choice.