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When should I cancel my pain medication contract?
When should I cancel my pain medication contract?
I have extremely severe chronic lower back pain with degenerative bulging disks in the L-1 to L-5 Range, canal stenosis, sciatica, pain that wraps around to my groin and shooting pains down my leg and out my big toe, along with insomnia (There was a time before I started my current meds where I could not sleep for longer than 15 minutes at a time due to the pain, and this went on for over a month). I could not get comfortable in any position. I tried Chiropractic with very little success. I have been going to the same pain management doctor for the past year almost, and I am no longer happy with his services.
He decided to make me sign a pain management agreement as a condition of my continued treatment, and after this, he actually believes he is God! He even told me that I could walk away or sign it, but if I did anything he didn't like, he would see to it that no other pain management doctor would ever treat me again. I used to see my monthly visits as a minor inconvenience in time and money, now I dread going there, having no idea what this mad doctor is up to, or what he is scheming.
I thought things were going to go OK, so I signed it, but now the fun has begun, and so has his God-like syndrome. He replaced my MSIR for breakthrough pain with a weak NSAID, which does nothing. He has tried to trick me by trying to lower my dose, even though my pain is increasing, or at least I am developing a tolerance to the medication.
If this is any indication, when I first started going to this doctor, I was taking MSIR 30 mg. six times a day, as the original hospital doctor prescribed it because it was cheaper than MS Contin. Now I am taking 100 mg MS Contin two times a day, an increase of only 20 mg of morphine over a years time. I am also taking other adjunctive medicines which are working fine, and he wants to change one of those, even though it is not even a controlled substance. Speaking of control, that is exactly what he is: a control freak.
I happen to think I have been toughing it out long enough, but the doctor refuses to increase my dosage, instead he wants to decrease it to 60 mg three times a day, and not give me anything that works for breakthrough pain! What a crock. There is so much I cannot due now with the pain at it's current level. I can't fix my car, I can't start my garden, which is my main livelihood right now, even though it is not much. I could last year with the medicine, but now I am so used to it, that it does not work nearly as well as it did. The list goes on and on.
The worst part is that a GI bleed is what put me in the hospital around a year ago. I was taking Tramadol 400 mg a day, along with 2600 mg of aspirin every day, and even that did not control the pain, or come close. It made my pain level go from a 10 to maybe an 8 or 9. I vomited black coffee ground looking stuff, and there was a lot of it, and then immediately after that I had diarrhea that was also black like coffee grounds. I was pale as a ghost, and very weak. After talking to a buddy who is a EMT, he told me to go to the hospital right away.
I went to the ER, and was in the hospital for 3 days, and had stomach surgery, with which they had to put me to sleep, just to stop the bleeding. I was told that the procedure took much longer than anticipated. I was in the section just below intensive care for a day. I required a blood transfusion, due to the amount of blood that I lost.
There were times that I was doubting my survival. One jackass doctor there told me at one point that there was a chance that I might not make it. They gave me 6 mg IV morphine every 4 hours for the pain, along with 2 mg of Ativan, and the Restoril for sleep, and stomach medicines. I could not even drink water for several days! They allowed me to suck on ice chips, but I could not swallow the water, I had to spit it out.
It was for that reason that I told my current doctor that NSAIDs were not for me, but yet here he goes prescribing them again, a year after not taking them, and aside from the side affects and my fear of dying from an uncontrollable bleed, they simply do not work. He does not seem to care. It is time for a new doctor. I wish him the best, it is just time for me to move on.
He also handed me a prescription for a sleeping medicine that I had never even heard of at my last visit. I asked him about it, and he said he had been prescribing it to me all along, which was a ball faced lie. He lied right to my face, and even went on to proclaim that the pharmacy must have filled it wrong. He agreed to change it back to the Restoril which I had been taking for the last year approximately. I have a bunch of empty pill bottles to prove it. Even though I do not use any other drugs, they have decided to drug test me three months in a row. I don't have the extra money for these worthless drug tests, and it makes me feel like I am being treated like some type of criminal, or a drug addict.
He has developed a God-like syndrome, and has decided to play mind games with me now. The other doctors in the practice were never like him, but seeing as how he is the owner, there is nothing I can do, except replace him. Remember that he said that if I did anything contrary to the agreement, which I have not, he would see to it that no other doctor would see me. Thankfully, I already purchased my records from my current but soon to be prior doctor, and have faxed them to my new doctor, along with my MRI, X-Rays and Pharmacy printout for the last year.
I have scheduled a visit with another pain doctor the day before I have a visit scheduled with my current doctor. As part of the new patient paperwork, I have filled out another pain management agreement for the new doctor. I intend on canceling both my appointment with my current control freak of a doctor, and the pain medicine contract, but I have lingering fear, for example, what if this new doctor doesn't want to prescribe the same or equivalent appropriate medicines? Then I would need to go back to my old doctor after all, the following day.
My thinking is this: I will go to my new doctor, and if all goes well, after the appointment, I will immediately drive over to my old doctor and cancel my pain medicine contract, cancel my visit for the following day, and tell them that I will no longer require their services, as I am pursuing other options. Doesn't this sound like the smart thing to do? I just don't want to break any laws.
I have thought about canceling the appointment and the contract before going to the new doctor, but I am worried that if I do that, I will be up the creek without a paddle if the new doctor does not treat me properly. Then my old doctor will probably tell me to go perform a physical improbability with myself if I try to keep my appointment after canceling it and the contract.
I have been wanting to fire this doctor for several months now, but have just gone with the flow, afraid of the unknown, and as a self pay patient, that first visit to a new doctor is expensive, although this doctor has worked out a very good deal with me, so in reality I have no reason to anticipate that things will go badly.
I guess what I am saying is that I will want to be able to fall back on the other doctor if the new one does not pan out. I do not want to do anything underhanded, but I don't want to close the door prematurely. There is still that "what if". I can't very well cancel my visit and contract, and then expect them to take me back with open arms if things don't go right. It is for reasons like this that I wish that I did not have to take medicines like this, but I cannot live with the pain uncontrolled. Literally.
If I sign the new contract, and cancel the old one on the same day, should I be OK? My thinking is that it will be OK, as long as I cancel the appointment, the contract, and do not go back to the old doctor for the appointment. Any and all advice would be greatly appreciated.
Thanks in advance!
Last edited by photolurp; 03-12-2011 at 04:32 PM.
Is the pain management contract something I can revoke after signing a new one, or do I have to cancel the old one first? I desperately want to replace my current doc, but what if I go to the new one and he says here is some Advil? Obviously I would tell him no thanks, and begrudgingly run back to my old doc. I am trying to not burn any bridges prematurely, while acting lawfully and ethically. Will anyone give their valued opinion?
Let the new dr know the whole story, just as you've described it here first. Best of luck to you, and keep us posted.
I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.
Well I went to my new doctor today, and I explained everything. He had seen me previously at my old doctors office, but has since opened his own practice. He just shook his head when I told him what his former boss was up to. I am very satisfied, as he was very thorough, and covered all of the causes of my pain, and the treatment options. It couldn't have been any easier.
I mistakenly left my cell phone at home, but when I got home, I called my old doctor's office, but it was closed, and the voice mail would not let me leave a message. I will call back tomorrow and cancel my appointment, and tell them that I am canceling my non-legally binding pain management contract, and that I will no longer require their services. I would have given them 24 hours notice, had I had my phone on me. I wonder if they are going to try and charge me $25 for my missed visit. If they do, I will tell them to pound sand. Goodbye, good riddance, praise the Lord God Almighty. Freedom! I haven't felt this good in years. They do not own me, and that old doctor is NOT God, as I proved today.
I will give you a very good tip. If you go to a pain management practice with multiple doctors, get to know the doctors you like the best, and watch for tell-tale signs that they are leaving. I had another doctor at my former practice who I was also fond of, and was the doctor who treated me most often. My next appointment, and he was gone. He had mentioned something about a certain practice accepting a certain insurance, and maybe he was trying to let me know that he was leaving. If you like certain doctors at a practice, ask them to let you know if they are leaving, and then you can follow them there if you want. My transition was 100% painless, and this doctor has his act together. That is the secret.
You don't have to take their b.s. There are other doctors out there, and ones with newer practices usually will appreciate all the business they can get. A well established doctor who doesn't care if he loses a patient is the worst kind of doctor you can have. I want the best for all of the good doctors. Keep in mind that in a newer, growing practice, you and a couple of patients might be the difference between them paying the rent on time.
I woke up happy today for the first time in six months, with no worry, and no anxiety. I am no longer doing a daily countdown till my next appointment, fearing what will happen next time. I am in control now, not my old doctor or his practice. They are no longer in a position of power over me.
I called my old doctors office today at the time of my appointment. When the receptionist answered, I identified myself, and told her that I was canceling my appointment scheduled for today. She asked "when would you like to reschedule?", and my reply was "I wouldn't". She said ok, I said thank you, and we hung up.
Good by and good riddance. If you can't tell, I am elated by my bold decision to seek out a new doctor. This has got to be on the top 10 list of things in my lifetime that have made me the happiest. Good luck to those of you who think you are stuck with a doctor you hate. May you have the courage to seek out and find a replacement doctor who will treat you with respect and dignity. Do not be afraid. No one owns you.
Last edited by photolurp; 03-16-2011 at 05:57 PM.
Wow! I could have written this post!
Hi Photolurp! I am right now in the same boat as you were. I'm so happy for you that you braved through the tough decision making that some of us pain patients find ourselves in. I, too, absolutely hate it that I need these medications to get through the day with the pain and being so scrutinized by doctors as to what my true intentions are. It just sucks big time.
Just yesterday I was at my orthopedic doctors and asked them if they would be willing to take over prescribing my pain medications until my appointment with a new doctor that I have been encouraged to see. My ortho doc has known me since 2006 and did 4 surgeries on my legs. He knows me and said he trusts me. Boy, that is good to hear after so many doctors have looked down their nose at me as if I'm a junkie looking for a fix. Anyway, the ortho doc wants to make sure all the 'i's are dotted and 't's are crossed, so he is having me fax a letter of discontinuation, or whatever, to my current pain doc and then they will call and verify that I did send the letter and that my/our contract is void. Then as an extra precaution they are calling my pharmacy to make sure I'm only getting pain meds from the current pain doc. They told me not to take all this personally as they would do it to anyone, but its hard not to be paranoid and second-guessing myself if I am doing the right thing. The thing with my current, soon to be OLD, pain doc is that he would only allow me 2 measly hydrocodone pills a day for breakthrough pain. I asked for an additional 2 pills a day and he refused based on his opinion about the risk of abuse and addiction. Nothing I did, just his thinking I guess. I have given him nothing to cause alarm or red flags that I am not who I say I am and what I am needing. I dont think I should be denied an additional 2 pills to help with the breakthrough pain based only on the risk of abuse and addiction. I'm very well aware of the risks. I'm also very well aware of the pain I endure and the lack of mobility I experience when the 2 breakthrough meds I've been given wear off. I take them first thing in the morning to get mobile and it lasts until about 2pm or so. Without the extra 2 pills for the afternoon, I am very limited on what I can do and the pain sucks so bad. So, each day I ask myself if I can bear the pain or not and to go ahead and take 2 for the afternoon and then run the risk of running out halfway through the month. #1 - I am then not following the prescribing instructions and will get in trouble OR #2 - take an extra 2 pills and get relief from the throbbing, stabbing pain in my legs? I should not have to be in this situation where I have to decide to get in trouble or to get pain relief. The pain doc has the power to make my life miserable or to make it considerably better and to me, that is just too much power. I am long overdue to switch to another healthcare provider that LISTENS to me and I've been encouraged that this new doctor will be compassionate and understanding. The only thing is that I cant get into see him until April 13th. So, that is why I asked my ortho doc, who understands the pain I am having with my legs, to carry me with the pain meds - at the dose that works - until my appointment with the new doc. They agreed, so long as I get my contract canceled and they can verify it. I just hope to get the prescriptions before the weekend. The only problem could be the ortho docs nursing staff - they are really ditzy.
And I'm not without worry when it comes to seeing the new doc. As it is right now, I just do not trust doctors or nurses or P.A.'s. I trust other patients word about a doctor more than anything. I just hope, for once, things work out and I can move on with my life. The biggest and most important thing I want to do is exercise and go to pool physical therapy. Without adequate pain meds, that is next to impossible. Yeah, I can get in the pool and it feels great - but the pain hits immediately when I try to get out of the pool and I cannot handle it.
Anyway, photolurp, thanks for your informative post! I wonder why more people didnt respond to you....??? Oh well, I'm so glad things worked out for you! Take care!
Wow you both sound like me... My current Pain dr. went from giving me 6 10-325mg of percocet, a day- had my nerve burnt in hip. which DID NOT work, caused more pain and other issues. He doesn't believe me-that I'm in pain- he lowered my meds down to 2 hydrocodone 10-325mg a day! You know what a big difference that is! I hurt, I can't get anything done (housework, grocery shopping, etc not to mention I care for my 4 year old grand daughter for 9 hours a day!) He is playing GOD too. What is wrong with these dr's??? They do have total control of our lifes. I've called left messages, talked to the nurses, all they keep telling me is this is the way it is till I come in and talk to him, well for some reason, I can't get in to see him for over a month and I'm an established patient!!!!!!!!!!!!!!!! WT .... I just don't understand. I'm so glad you have the nerve to find a new dr. I am trying to get my nerve my up. Oh by the way, I have no pain contract. I am scared to go dr. shopping, which is what he is forcing me to do... I can NOT continue on this way.....
The nerve burning did not work cause the pain is from a bone issue. I told my dr that- almost a year ago, but he kept telling me this injection will take care of it, when it didn't, oh guess what??? there was another injection that woould take care of the pain.... on and on cause you know he- as all dr's can make more money off the injections from the good ole insurance company..... I also think he dosn't like the fact that I KNEW what was going on with MY BODY. Proved him wrong...
I too completely understand where all of u are going thru. I have 5 autoimmune diseases among other things like waiting to see if I have cancer. The family medical clinic I go to I've been there 5yrs. I've been on mscontin 100mgs 3x a day & oxycodone hcl 10mgs 4x a day for years. However when I explained it's not working as well anymore. Their solution is to reduce my dosage. I'm so frustrated I cry alot from the pain. Why would they do this to me?