22nd October 2007
Dear Syribo,
While my reply is one of the first, I'm sure you will receive others that are more helpful and specific. However, I will try to answer your questions in the best manner possible!
Even though I completely understand that most doctors don't like Rx'ing opiates, I ALWAYS find it irritating, lacking in compassion/understanding, and passing-the-buck--ish when doctors won't prescribe during the Pain Management process. Furthermore, you've tried stronger medications but settled on the less-potent Tylenol 4. So, you don't come across as someone who is out there to simply obtain drugs.
I don't live in a large area--just a moderately populated one. We have 6...yes, six...Pain Management Clinics. Three of them closed within 4 or 5 months of opening. My point is that it isn't particularly easy to "just get" a Pain Management appointment. I think that these various physicians you have would help you out with your prescription difficulties. YET AGAIN, I am so glad my Internal Medicine Physician (a D.O.) Rx's my Pain Management medication since my PM doctor packed up and left the area!!
BY THE WAY, YOUR PT DOCTOR IS FULL OF "IT" WHEN SHE IMPLIED THAT "ONLY A PM DOCTOR CAN DO IT NOW". Even if you're under some sort of specific contract that addresses prescription pain medications, it is not illegal for various doctors to Rx pain medicine to you. HOWEVER, if you accept opiate prescriptions (and fill them at a pharmacy) from several doctors while not informing them of each others' existence--that is another story.
1. I started with a PM doctor in 1996--an Anesthesiologist/Pain Management Internal Medicine physician. He was a D.O. (not an M.D.)--if that matters to you. While my pain was eventually reduced by 70%, a 50% drop is considered VERY SUCCESSFUL (and often is the goal). My suggestion, though, is to be prepared for smaller amounts of relief--and be thankful for whatever you can get!
2. & 3. I have Systemic Lupus and the Lupus Anticoagulant. In the past, I utilized a number of stretching and other PT-type modalities, as well as a variety of TENS-type units. However, the opiate medications have worked more effectively than anything. I use the Sandoz generic form of the fentanyl patch (75 mcg), the generic form of Actiq (fentanyl citrate lozenge 800 mcg), and Roxane's generic of Dilaudid 8 mg. Another pain medication I use that is NOT a technical opiate is Fioricet (butalbital, caffeine, and acetaminophen). Butalbital is a barbiturate. IT WOULD BE A PM's SERIOUS DOWNFALL to not consider everything that has worked for you. I'm not saying the doc will Rx what you want/need, but it seems ridiculous to me to discontinue utilizing a medication or any other modality that works!
4. I have not been able to return to work. I was a full-time teacher. However, I am able to work--on an extremely limited basis--as a Church Musician. My schooling involves a Bachelor's in Music Education (Vocal and Instrumental) and a Master's in Choral Conducting. The Lupus became way too much for me to finish my Law Degree--something that will always cause me sorrow! Nonetheless, I am thankful I can offer something of a Musical nature when it is possible.
Syribo, we welcome you to our board! Keep checking on this thread because I'm just positive that others will have a great deal to offer your situation!!
Take care,
Jon (Conductor)
While my reply is one of the first, I'm sure you will receive others that are more helpful and specific. However, I will try to answer your questions in the best manner possible!
Even though I completely understand that most doctors don't like Rx'ing opiates, I ALWAYS find it irritating, lacking in compassion/understanding, and passing-the-buck--ish when doctors won't prescribe during the Pain Management process. Furthermore, you've tried stronger medications but settled on the less-potent Tylenol 4. So, you don't come across as someone who is out there to simply obtain drugs.
I don't live in a large area--just a moderately populated one. We have 6...yes, six...Pain Management Clinics. Three of them closed within 4 or 5 months of opening. My point is that it isn't particularly easy to "just get" a Pain Management appointment. I think that these various physicians you have would help you out with your prescription difficulties. YET AGAIN, I am so glad my Internal Medicine Physician (a D.O.) Rx's my Pain Management medication since my PM doctor packed up and left the area!!
BY THE WAY, YOUR PT DOCTOR IS FULL OF "IT" WHEN SHE IMPLIED THAT "ONLY A PM DOCTOR CAN DO IT NOW". Even if you're under some sort of specific contract that addresses prescription pain medications, it is not illegal for various doctors to Rx pain medicine to you. HOWEVER, if you accept opiate prescriptions (and fill them at a pharmacy) from several doctors while not informing them of each others' existence--that is another story.
1. I started with a PM doctor in 1996--an Anesthesiologist/Pain Management Internal Medicine physician. He was a D.O. (not an M.D.)--if that matters to you. While my pain was eventually reduced by 70%, a 50% drop is considered VERY SUCCESSFUL (and often is the goal). My suggestion, though, is to be prepared for smaller amounts of relief--and be thankful for whatever you can get!
2. & 3. I have Systemic Lupus and the Lupus Anticoagulant. In the past, I utilized a number of stretching and other PT-type modalities, as well as a variety of TENS-type units. However, the opiate medications have worked more effectively than anything. I use the Sandoz generic form of the fentanyl patch (75 mcg), the generic form of Actiq (fentanyl citrate lozenge 800 mcg), and Roxane's generic of Dilaudid 8 mg. Another pain medication I use that is NOT a technical opiate is Fioricet (butalbital, caffeine, and acetaminophen). Butalbital is a barbiturate. IT WOULD BE A PM's SERIOUS DOWNFALL to not consider everything that has worked for you. I'm not saying the doc will Rx what you want/need, but it seems ridiculous to me to discontinue utilizing a medication or any other modality that works!
4. I have not been able to return to work. I was a full-time teacher. However, I am able to work--on an extremely limited basis--as a Church Musician. My schooling involves a Bachelor's in Music Education (Vocal and Instrumental) and a Master's in Choral Conducting. The Lupus became way too much for me to finish my Law Degree--something that will always cause me sorrow! Nonetheless, I am thankful I can offer something of a Musical nature when it is possible.
Syribo, we welcome you to our board! Keep checking on this thread because I'm just positive that others will have a great deal to offer your situation!!
Take care,
Jon (Conductor)