I think I screwed the pooch

[oc80tn]

Hello all...
I have been going to this site and looking around for a couple of months and have enjoyed reading the posts. Up to this point, I haven't really had anything to say, but I have just had a little bit of a scare from my pain management doc and need some advice on what to do.
A little background: I broke my back in six places (T5-T11) three years ago and have been doing pain management since October 2003. I had a surgery to repair one of the vetertebrae in 2004, but have still had quite a bit of pain in my back and into the ribs. I take OxyContin 40mg BID and recently got OxyIR 15's to take 1/2 to 1 QID PRN. I had been on OxyIR 5's 1 to 2 TID for a couple of months, but my insurance did not pay for the quantity I got, so that's why the increase. I thought he was only going to have me take 1/2 four times a day on the 15's, but he put that with the 1, so I thought it was okay.
I called last week to ask if it was a mistake and his "nurse" said it wasn't and if I ran out to just call. Well, I am about out of them, so I just called to request a refill. The nurse called back and said that I was taking more than I should be taking and that HE WANTED TO SEE ME ON WEDNESDAY when he's back in the office. HELP! I am freaking out here because I am afraid that he is going to cut me off for non-compliance or something. I have always followed the rules, but when you get that kind of callback, my mind is racing off into the worst scenario possible. I don't know for sure that that's going to happen, but I don't know what I will do if it does.
I hope that all makes sense, but I do need some advice on what I should do come Wednesday afternoon and if the worst does happen.
Peace

[jab]

Make sure that when you go in there you explain your story to the doctor Explain why you are out and let them know that if they want to alter the schedule you'll be willing to "test the waters". Don't go in there fearing the loss of your script or the doctor could very well pick up on it and start labeling you as a "drug seeker".

Also, I wouldn't go in there kicking, make sure your as "normal" as possible and coherent. Explain that if there was some confusion that you apologize and that you will not let it happen again. Dress professional, show up early, and don't even bother arguing or squabbbling with the nurses; deal with the doctor.

Don't worry till there is a reason to worry. This could just be a standard practice, as many pain specialists have, if you run out early. Good luck and I hope for a good outcome!

[SomniGod]

Remember, you are the customer. There are MANY other docs....of course this can cause issues with insurance...but where there is a will, there is a way. Be assertive, yet humble... I mean, don't go in there with a "Billy-Bad-Ass Attitude"... but also don't get 'walked-on.' You have pain and are there seeeking legitimate pain care..not trying to SCAM DRUGS... I think you will be OK.


~S~

[oc80tn]

That's the thing about it. The way he wrote my script, I could take up to 4 a day, which meant I could conceivably run out in two weeks instead of four. I even called last week to make sure that it wasn't a problem to take 4 and one of his staff said that is how he wrote it and if I ran out "early" call back and they'd try to get it filled for me. Then I get the call yesterday that I was taking too much. How can I be taking too much if it says I can take up to 4 and I don't take more than that? I have always followed his rules and regs to the best of my ability. And this is really the first issue we have had in the three years of pain management. I don't doctor shop or go to the ER every other week. In fact, I have only gone twice and one of those times was when the T9 had just completely ruptured back into my spinal cord and I lost sensation in my legs. And I told him that I was going. I may be overblowing this, but the nurse just had this sound in her voice that I'd done something wrong.
Thanks for the advice.
Peace!

[oc80tn]

Follow up to last week's crisis. I finally went to see my pain mgmt. doctor on Monday about the above mentioned issue. After spending the following night puking up my guts and having the explosive craps (not w.d.'s, 100% stress), I go into the examination room and he asked me why I was taking so much. I tell him that I had had a really bad couple of weeks (working 12-13 hours a day for 8 straight days), so I needed quite a few more doses of my OxyIR. I told him that I wasn't taking more than the Rx allowed. Well, I am still baffled about this, but he said that that was way too much and sometimes I just have to deal with it.
Uh, okay, then why did you write it to where I could take up to 60 milligrams of OxyIR a day if you didn't want me to do that? If you only wanted me to take no more than 30 mgs a day of immediate release, you should've written it that way. Whatever, I guess.
Fortunately, he wasn't pissed about it. He said that the chances are that I will have to be on the meds for the rest of my life and he wants to keep my tolerance in check as much as possible. That's fine with me, but I still want to know why he wrote the meds that way if he didn't want to take that much.
The good news is that he did refill the script for the OxyIR's and the OxyContin 40's, so all is still good, other than some confusion!

[antony]

^^^he probably wrote it as an upper limit, "max dosage" type thing not to be done everyday, but your body can handle that much, so if needed type thing


maybe

[blackdog]

BREAKTHROUGH DOSE