Chronic Pain Support Group
Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not...
I'm curious. When I 1st began with my new doctor (my doc of many years died over a year ago) he said that he couldn't keep me on the same doses my previous docs had, b/c of some rule or law that had been passed. He said he was very sorry b/c the doses had worked for me for 14 years w/o ever needing an increase, but he had to follow the rules and he'd feel terrible if he had to stop helping people fight pain just b/c he broke the rule.
The rule is, a patient cannot take more breakthrough or short-acting medications a day than long-acting meds. For instance: I USED to take MSContin 60 mg 3 x a day with two 30mg MSIR pills every 4-6 hours as needed, averaging 6 a day, maybe 8 in the winter. (8 would be RARE- it would be the worst possible flares.)
3 docs before this doc had discovered that I responded better to quick acting or, instant released meds. But because the INSTANT release only came in 15 and 30mg, to prescribe what I'd taken before would be breaking the rule.
Now, I never thought of them as breakthrough meds really- I just thought of them as a regime- just a way to take the same medication in different doses so it covered the pain and I was able to work and be a mom and wife, etc.
He changed the long-acting to a stronger dose but cut the quick acting to 3 a day. I was okay for awhile, but now I'm having trouble. I have an option to go to a stronger medication but I do NOT want to do that. This med works for me and if only I had a little leeway, I'd be back to where I was a year ago. I also don't want to start a new med b/c I have a young son and a job. I can't take the time to start all over.
I'm okay on what I'm on, but it'd be so much better if I was on the old schedule. I would never ask him to break a law- not in a million years! He's a great guy who follows the rules to a T and I respect that! I just wonder where this rule came from.
Has anyone heard of this? Is it a Federal law or a guideline or what? How did my docs before this prescribe it the old way for all those years? It just basically says that if I take 3 long-acting, I can only take 3 quick-acting. They don't take into account that the quick-acting doesn't come in a stronger dose.
Anyway, it's bugged me for a YEAR and now I want to know if anyone has heard of it, and if so, is it a LAW? Is it the Fed Govt or a state thing? I just want to know what I'm dealing with before my next appointment. If it's a LAW I won't even bring it up. But if it was one of the weird rules that the govt was putting into effect and then pulling back, etc., I would ask for the switch. At least a small switch.
After 15 years, my RSD has decided to take over, and I'm not liking it much. I have just a small area to work with, and only when the RSD is unbearable.
Anyone? And thank-you. :)
The rule is, a patient cannot take more breakthrough or short-acting medications a day than long-acting meds. For instance: I USED to take MSContin 60 mg 3 x a day with two 30mg MSIR pills every 4-6 hours as needed, averaging 6 a day, maybe 8 in the winter. (8 would be RARE- it would be the worst possible flares.)
3 docs before this doc had discovered that I responded better to quick acting or, instant released meds. But because the INSTANT release only came in 15 and 30mg, to prescribe what I'd taken before would be breaking the rule.
Now, I never thought of them as breakthrough meds really- I just thought of them as a regime- just a way to take the same medication in different doses so it covered the pain and I was able to work and be a mom and wife, etc.
He changed the long-acting to a stronger dose but cut the quick acting to 3 a day. I was okay for awhile, but now I'm having trouble. I have an option to go to a stronger medication but I do NOT want to do that. This med works for me and if only I had a little leeway, I'd be back to where I was a year ago. I also don't want to start a new med b/c I have a young son and a job. I can't take the time to start all over.
I'm okay on what I'm on, but it'd be so much better if I was on the old schedule. I would never ask him to break a law- not in a million years! He's a great guy who follows the rules to a T and I respect that! I just wonder where this rule came from.
Has anyone heard of this? Is it a Federal law or a guideline or what? How did my docs before this prescribe it the old way for all those years? It just basically says that if I take 3 long-acting, I can only take 3 quick-acting. They don't take into account that the quick-acting doesn't come in a stronger dose.
Anyway, it's bugged me for a YEAR and now I want to know if anyone has heard of it, and if so, is it a LAW? Is it the Fed Govt or a state thing? I just want to know what I'm dealing with before my next appointment. If it's a LAW I won't even bring it up. But if it was one of the weird rules that the govt was putting into effect and then pulling back, etc., I would ask for the switch. At least a small switch.
After 15 years, my RSD has decided to take over, and I'm not liking it much. I have just a small area to work with, and only when the RSD is unbearable.
Anyone? And thank-you. :)
Remember, just like parents sometimes doctors fib a little.
I was shocked because I know take 4 to 6 pills a day just to live a fairly decent comfortable life!
Has anyone else heard this from their doctor??
Cindi
I was taking quite a few 5mg oxys and the doc said we need to do my meds in higher mg so it makes it less pills, she said they do "watch" the pain clinics and others doc s too I suppose.
Thanks all- I leave for my Caribbean meeting tomorrow, then get back just in time for my doc appt. I'll ask him if there's been any changes. And if I DID mention my hubby I wouldn't be fibbing. He's been almost as put out by this as I have. He has to watch our son a lot more now, and that's fine but I'd rather do it. And he's always mentioning how much better I was with the old doctor.
Still, I won't blame a good PM doc for following the rules.
RissaLM- you sound like my hubby, lol. We are polar opposites- he gets the right side of the lawn and I get the left for political posters. Our neighbors think we're nuts but I'm a Democrat through and through, while hubby is a PUBBY. It's amazing we agree on anything! ;)
It's really a shame that a population who is in so much misery (chronic pain patients) have so many hurdles to overcome in getting the treatment they need.
They wanted to build my tolerance and get me taking morphine daily, slow release. I refused. I work with addicts and have seen normal people get dependant and their lives get destroyed so for that reason I am sort of paranoid of it. Plus I have such a low tolerance to drugs, so I take the liquid morphine when the pain comes. However, I am constantly told by the pain clinic I keep taking it too late. So now I take it when I feel a bad bought of pain coming, or on rainy days because when the weather changes quickly my body gets nasty with me.
There has been medical research done to show that long term pain can cause neurological problems if not properly dealt with. You are better off to up you slow release meds and lower your quick release, at first it will feel like it is not working but in the end it will. This is what I was told at the pain clinic. I have started taking a daily non narcotic med and only use the morphine when I have to. Seems to lesson the frequency of unbearable pain and consequent seizures from it. Many people I know are on the fentenoal patch (not sure of the spelling) which I would have been okay with accept I can not tolerate a pain killer at that high a dose and they do not have a low enough dose for me, I could seizure and I vomit a lot. As it is I take an infants dose of morphine, as I said I have no tolerance to pain meds.
That regulation is in Canada too and in most 1st world nations. Also, they have to be careful, my docs have me on two drugs that if I take them the same day I will stop breathing and die. So first I try the pain meds if they fail, I suffer a day and then try the ativan to calm the muscles and altimatley seizures too. Because of this I have to get my meds at the same pharmacy with a warning to the pharmacy about amounts and frequency. It is really for our own protection.
I don't mind that they have to put the warning on it, I am not a drug abuser nor an addict, I appreciate that they are trying to keep me safe. I know it seems unfair but the slow acting ones are easier on your system so for long long term pain it is better to try and manage it with them and sporadically use the fast acting. If you have to use a lot of the fast acting, your slow release are not adequate.
(i take 4 30 er so... 120mg/day
5 15 ir soo... = 75mg/day )
ok i'm within the rules. maybe that's why i'm in so much pain.
i don't use the ir pills for breakthrough either. my doc has me make sure not to miss any of the daily allowance.
if it's a rule, it's silly.
damnit.