TL Mafia Community Thread - Page 172

On December 28 2016 09:15 geript wrote:
I hope the best for you Onegu. I don't know what the answer to pain is. I've seen a lot of drug seeking behavior that's heavily overmedicated and I've seen a lot of real pain that's undermedicated. I shit you not, one night I had a patient who doctors and nurses had fucked up (not us fortunately) because her graft leg was dying and they hadn't caught it early enough. She was going to get an amputation later that day but was on Oxy 5mg as needed every four hours. Needless to say it was ineffective. Trying to get an MD at 4:30am to order even one extra dose was a pain since on call wasn't answering; I felt so bad for her. Really some of the worst minutes of my life fighting for that. The dosage was criminal. Then of course there are drug seekers who get dilaudid 6mg scheduled every 4 hours who are fucking high as a kite who get to their dosages upped. It's crazy to me.

On January 01 2017 09:53 Onegu wrote:



I understand. Things are really fucked up now. And holy shit 6mg of Dilaudid every 4 hours. I dont think there is a answer now, because it is sometimes hard to figure out when someone actually needs it and someone has something wrong but is using it for getting high and people who are just lying and it is hard to figure out who is who.

Let me tell you what happend this week. I got breakthrough medicine for my surgery to go home on. 1-3 pills every 4 hours as needed. I got 120 pills. I was switching pain management doctors this month because my old one was 45 minute drive away and these people came to your home. I saw them once before my surgery. I got out last Tuesday. This tuesday I called and told them I was out of my medicine. I didnt word it right. I was out of this new medicine not my methadone. The PA thought I was out of both went to the Pharmacy and tried to put them in for me. Well the pharmacist goes my methadone shouldnt be out until the 29 as a 30 day supply and my other medicine was a 20 day supply. She calls and tells me this and I go I dont understand and she tells me she will look into it. Wednesday morning I get a phone call that they are going to see me anymore because I have abused my medicine. So I still have my methadone, and I am out of the other. I go look at the bottle. I was taking the max because it fucking hurt. That is 18 pills a day. 120 pills. That is 7 days. If I only took 1 pill every 4 hours that would be 20 days. So I call I cant get ahold of anyone leave messages tell them what is going on. 330 I get a phone call we already made our decision and we called your old pain management team to tell them what is going on. Well my old pain management group was closed wednesday thrusday friday this week. I will be out of my methadone on tuesday of next week. Lucky I called my surgeon and told him what was going on and he wrote for a refill until monday when I see him to get my staples out.

So now I dont know if I even have a pain management doctor any longer. And I did nothing wrong the pharmacist that put the first script in the computer made the mistake not me. So right now I am in alot of stress. Hoping 2017 will be a better year for me as this one has sucked.

On January 01 2017 15:16 geript wrote:

Thing 1: The PA is lying to you (or in the least being unspecific). A PA can't write for methadone; I'm sure that's the case in every single state because there isn't a state that I know of that lets Physician extenders (PAs and NPs) write for class 2 drugs. So clearly there's a communication problem on both ends.
2: It's pretty common to cut drug seekers off pretty hardcore unfortunately. I'd recommend going to see them in person to explain it, but I don't think that's possible for you. If/When you go, bring all your meds with you (even your non-narcs) as well as any accounting you have for your pills (if any).
3: Respect your narcs. By this I mean, make an explicit recording of each and every time you take them. This may be required for you already, but make sure you count your pills religiously as well. When you take any prescription narcotics (methadone, oxycodone, oxycontin, ativan, clonazepam, ambien, etc.), write it down and keep an accounting. This will actually help whoever does your pain management get the right dosages.
4: Don't go doctor shopping. I understand calling the surgeon to handle the situation in the short term. But find one that works and stick with it; not works in the sense that you get what you want, but who actively tries to work with you. Distance is a pain, but convenience isn't always worth it. My experience in the medical field is that there are 33% good personel (MD/PA/NP/RN/LPN/etc), 33% ok personel, and 33% awful personel. Find the top third if you can, but settle for the middle group.
5: If you want a hand, PM me here. There's a bit of legal documentation that we'd have to do (HIPAA and stuff), but my license might help cut through some of the red tape. I wouldn't stick my neck out for you without actually seeing/assessing you, but I'm actually quite good at kissing ass and getting what I want for my patients and I might be able to find a way to get people talking in a productive manner (which I'm sure is quite a shock to everyone on these boards).
6: You need to have a plan for scaling back on how you take the drugs. I don't doubt you have pain and opioid tolerance and dependence are real. But IIRC, opioids killed more people last year than guns (as it relates to the US); if not accurate, I'm pretty sure it's close. I want you to talk to pain management about working in a plan to scale back on the meds at some point when it's appropriate.

On January 01 2017 15:37 Coagulation wrote:
Holy drunk post

On January 02 2017 06:47 Onegu wrote:



PA in Ohio can write for it. My previous pain management that I will try to go talk to in person Monday, I saw the PA twice as much as the Dr. and she wrote my scripts and had her name on them. And I do take my meds as written. It just upsets me that it was in the computer wrong and caused problems for me. I hope since I can prove what is going on and show them my pill bottles and what not they will take me back.

On January 04 2017 12:32 kitaman27 wrote:
For those who may not read the sticky posts, the database is up to date once again.