Re: Pain Management Agreement - DEA required?

On Nov 5, 6:10 am, trisha f <plfrei...@xxxxxxxxxxxxxx> wrote:
Legend,

Trust, me I; didn't take it personally. (Please read this in the same
frame of mind)

However, being in the position I'm in, needing the medications I need
in order to do what they so casually refer to as "activities of daily
living," which include getting dressed, eating, going to the bathroom,
and making it from point A to point B here in my home without being in
an inordinate amount of pain...

If my doc requires testing to get those meds...

I'm gonna give them to him.

Unfortunately, there are very few docs in this area that will give you
pain meds at all for my condition. You cannot see Atypical Facial
Pain on an x-ray, MRI, MRA, or CT scan. There is no known cause for
the condition, and way too many of even the current articles link this
condition to psychiatric problems, thereby implying that the pain is
more from the psych issues than an entity all its own. Add to that
the complication of having a list of drug sensitivities and allergies
- documented, mind you, on charts and by reports from docs who treated
me for the effects - and it becomes almost impossible to find a doc
who will treat me or others like me who, despite the prevailing
attitude, still need pain control, or at least a modicum of relief.

I'm not happy about having to pee in a cup. I don't like the fact
that it implies suspicion and lack of trust of someone who has never
given anyone reason not to trust. However, if that is what I have to
do right now to get the meds I need, until I can find a doctor who
will see past the current stereotypes and prejudices and treat me as I
am, a person in pain, then I will do what he asks.

That doesn't mean I don't advocate speaking up or standing up for the
right of the chronic pain patient to obtain relief in a non-biased
way. In fact, I think it's ridiculous that we have to do what we have
to do to get what we need. However, like several other things in life
I could name here, a few have screwed it up for the many who
legitimately need the services, and we are the ones who pay the
price.

I live in a rural area and travel either to St. Louis or Columbia for
my doctors other than my PCP. The main reason for that is because
there aren't docs out here who treat what I have...some of them have
only read about it and even the neurologists in this immediate area
have no idea what to do with this situation, and tell me I need to go
to the city. St. Louis, like most big cities, has a bad drug
problem. I am finding the docs in Columbia tend to be a little more
up on current issues, but it is a further drive and finding someone to
go with me isn't always easy, and if my head decides to act up, I'd be
stuck there, possibly in the car or a hospital waiting room, till the
meds I have to take for it wear off and I can drive agin.

St. Louis has a headache clinic, which dropped me for missing 3
appointments due to severe pain. Their policy states 3 missed
appointments ends their obligation to the patient, regardless of
cause. They don't care if it was because you hurt so badly you
couldn't open your eyes. They are far more concerned with the bottom
dollar than the headache patient, as evidenced by the fluorescent
lighting, music, and smells in the waiting room. The Behavioral Med
unit at SLU also treats headaches, but the first thing they would do
is take me off all my meds and start from scratch, and the level of
relief I have finally obtained after almost 2 years of figting with
doctors would be out the window. They also don't use opiates,
preferring biofeedback and other similar "treatments" in their
approach. Now if I can hardly get to St. Louis on the drugs I'm on,
wearing old-fart surround style sunglasses to block out the UV light,
how do they think I'm going to make it to their clinic and back up to
3 times a week in the beginning on no meds at all? I'd be back to
where I was when I was going to the headache center before they booted
me.

Diamond Headache Center in Chicago also uses biofeedback and such, and
doesn't prescribe narcotics. They'd want to do ALL my tests over, and
I'd have to stay in the city alone in a hotel we can't afford while
they were doing it, with no drugs. I'd have to pay for some of the
services cash, submit the bills to the insurance company, and wait for
reimbursement, while living on - what, air??? - in the meantime.

The Behavioral Med Center in Springfield, MO, is the same. No
narcotics. Just the shrink, neurologist, and the same meds I can't
take all over again.

So, for me, doing the pee test or blood test when requested is the
most practical solution that presents itself at the moment. I don't
like it, but as the situation stands, I'm not going to argue with the
one place in this immediate area that will prescribe the meds that
allow me to cook for my husband, care for my chickens, do the laundry,
and spend an hour or two with my grandchildren during the week when
possible.

I agree fully that it sucks, but it's not just the pee tests and blood
tests that need to be changed. It is the prevailing attitude that
patients in chronic pain from invisible diagnoses are fakers or nut
cases and are just looking for an easy way to avoid the
responsibilities attached to living a "real life." I am not lazy.
I've been working in one form or another since I was 12. I supported
3 kids and raised them on my own while working up to 3 jobs at a
time. If I had my choice, I'd be at work today instead of sitting
here in the dark, feeling the approaching cold front in my sinuses and
knowing the day is going to be a bad one again.

We need to educate the medical community on the plight of the chronic
pain patient as a whole. Most of them see us as druggies looking for
a fix, and if we can't get it on the street, we run to the hospital
with a variety of complaints so we can get hooked up to an IV and get
drugs through that till we have enough in our system to skate for a
few weeks. I know this because I've worked with these people and
treated some of the people on that side of the fence as well as the
genuinely chronically ill in genuine need of genuine pain relief.

I guess maybe my point...from half an hour ago...is that fixing the
urine testing and blood testing will only put a bandaid on a severed
artery, so to speak. The whole attitude needs to change. We need to
be seen as people, not annoyances or addicts or whatever they call us
today. Unless the attitude changes, making changes in small parts of
the system will only cause the ignorance to appear somewhere else in
the continuum of care.

Trisha in MO

Trisha,

I'd probably do the same thing...it was just getting to the point
where, some people were almost challenging those who were against drug
testing, and saying, in effect, 'if you have nothing to hide, you
shouldn't mind doing everything a doctor tells you to'-which is a
dangerous attitude. I'm not even saying it's wrong for a doctor to
take this attitude; if he's against addiction, vehemently, he does
have a right to run his practice as he chooses. But, what I'm against
is the power the DEA is given, to arrest and prosecute doctors and
patients, and favor those who do drug tests.

The original post here, in fact, was by a woman who was told that she
had to sign the agreement because it was the law! Her doctor lied to
her-something which is unethical, and seethes inequality-how would the
doctor feel about his patients lying to him? The fact that he
requires this contract answers the question-loud and clear.

My objections were to 1.) doctors lying to their patients; and 2)
people going soft on this issue, because of being challenged and
intimidated for 'having something to hide'. I'd just like to 'hide'
my urinary tract, and extremely painful, deep veins. Already I have to
have 'bloodwork' done about 4 times a year-standard for diabetics my
age. If I have to use them for these tests, which are really the
doctor's toys, pretty soon, I wouldn't be able to go into surgery with
confidence. Already, I hardly feel any of the anesthesia during
epidural injections.

So, at least one type of testing isn't harmless. Not to me.

But, getting on to reality your plight is incredible! Wouldn't a PCP
agree to prescribe for you, now that your condition, and the pain
you;re in, is established? I know you don't mind the drug testing
much, but you may find someone closer. Well, you've probably tried
everything-I'm glad that you're getting the help that you do get!

So, I;m glad that we made it clear between us, that I wasn't singling
you out. it's just that your answer was pretty much at the turning
point-where people began to challenge each other.

Hope you have as pain-free a day as possible.


-Legend

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