F2F with physician coming up, any suggestions?

[esbayne]

That is great news Dentscllyfe. In my state when you get any narcotics that have to put it into a database that day. This is reviewed by the DEA and the drug stores can tell if you are doctor shopping, etc. This is so if you are getting Pain meds that if you go to the dentist you cannot get the same thing. They are really getting tough on this stuff.

Regards Edddie

[TVNerd]

That's awesome, Dentscllyfe! I hope your relationship with your new doc is long, therapeutic, and successful.

I have actually had a lot of luck with just sort of overwhelming them with information. My medical history is long, complicated, and many doctors do not understand much about my chief conditions. So when I started seeing my PM doc, for instance, I basically went in with ALL of it. I brought lists of symptoms, and I didn't just ask for one drug specifically- I also tell them "well, this medication does THIS, exactly, and I didn't think it was successful because of THIS, and then that had an interaction with that..." and, ultimately, the appeal for knowledge. Instead of "and I would like this," I went for more of a "and I thought that this was successful, so if you know of anything that will also work for me, I would really appreciate it," or something along those lines. At one point, his eyes sort of glazed over, and he finally just said "well, if something works, it works," and wrote the scrip for that.

And I live in a state that's widely regarded to be one of the most if not the most difficult on PK docs- a decade or so ago we were real famous for basically having a pill mill in every strip mall, and they cracked down REALLY hard. My doctor and pharmacist both complain all the time that patients have trouble getting the meds that they need- but it seemed pretty simple to me.

[Dentscllyfe]

Thank you all! TVNerd, I hope so as well! He did seem like he actually wanted to help me which I do not always get. Even tho I am very familiar with meds and what works for me I did not go in asking for anything specific. Just told him what was going on and that I need some help. Also told him that it was not my idea and that family and friends have been telling me I should see a doctor for a second opinion on what my current doctor had me on. I did show him my info but played dumb when it comes to certain things such as what different meds are for. I told him that I usually just trust the doctor and take what he tells me because that is their job. I mentioned a couple meds that I think help but told him I'm open to ideas and that whatever he thinks will work ill try, but that sometimes I feel like I am just being experimented on and would like to limit the amount of drugs. Like you said TVNerd, he said well lets start with what you think has worked in the past and go from there! I have also noticed that it does make a huge difference the way that you come off (dress professional, clean shaven, hide tattoos if you have any). First impressions for a doctor are huge in my opinion. Even tho it sucks that it seems people judge you on appearance as opposed to what is actually going on, I have always had a better encounter when I look professional, and somewhat together. There was a time a couple years ago when I went to see a doc for a new pt consult and I was in rare form (basketball shorts, tank-top, unshaven, ect). I am a relatively muscular guy with a decent amount of tattoos, but clean up very well. Honestly most people that would see me in a work/school setting would never guess that roughly 60% of my body is inked (none visible if I'm wearing a tshirt a long pants). Although like I said before, it sucks that some people judge a person based off of things like this, it did seem like I was dismissed from the very start...

[esbayne]

Hello fireplaces. i wanted to let you know about the database in my state. Narcotics used to be able to be updated once a week and now they must do them daily. The DEA can come in at anytime and check the RX history. You have to wait till the 30th day now before a refill. The doctors also have access to this and my PM doctor or has someone check this. If the filling drug store sees you have gotten the same thing or something similar they will not fill it for you. If I go to the dentists and get a prescription I have to take it to my PM doctor and if they deem it necessary they will rewrite it. I also have heard thier is a max mg amount you can have filled. In other parts of the state it is a little more lax but here they are very very strict. This has not been caused by the people who need the meds as I feel every one is living longer so there is chronic pain now where in the past people may have already died. I feel the issue is people coming in and getting meds when they have nothing wrong with them. The financial incentive is just so high for diversion and for the doctors writing ridiculous amounts of narcotics.

As others have indicated the best way to approach a doctor is to read him and make a choice of what to say. I have always sad less is more and when you say something to a doctor and they write it down it is like trying to unring a bell.

Sorry for the long reply but I just wanted to share my knowledge about this.

Regards Eddie

[Dentscllyfe]

Good info esbayne. It is very similar in my state. It's funny but I was at a cooking class yesterday and one of the couples my gf and I were paired with where both pharmacists. My gf is a nurse and I'm in school and will also be in the medical field in a couple years. The conversation some how got on the topic of meds and the pharmacist was saying that even though the systems are connected that they rarely actually look at it. They automatically see what has been filled at there specific pharmacy but as far as what a person fills in other pharmacies unless they actually check they don't know. They said they are supposed to but rarely do bc it is time consuming and that they are usually rushed or behind. I am by NO MEANS saying that it is a good idea to doctor shop and fill scripts at different pharmacies bc you will definitely eventually get caught. I am just repeating what a pharmacist said. It is also the same as far as refills go. Some of my meds I have to physically go to my doctor and get the script once a month and my pharmacy will not fill anything until past script is completely done.

[solarpunch]

I am having to consider going to a separate doctor for my anxiety issues currently. I feel that my NP can't make any decisions besides my blood pressure management and small amount of pain management. I've tried the whole honest boy scout routine and it seems to have little to no effect with him. Long story short I suffered from severe panic and anxiety attacks 8 years ago. The doctors at that time were like oh you need antidepressants. I kindly said no. I explained I felt like dying. Not wanting to die. That was a huge difference. They sent me to therapy. I worked with a councilor and a psychologist. They came to the conclusion that long term benzo use was best for my situation. I've been on 1 before bed every night for all these years. My doctor at the time agreed that vals were the best option for me since it also was a muscle relaxer. Now that I've been with a NP for the last two years since the doctor moved I started getting the line "this is not a long term solution" BS. Then when the CDC guidelines came out the words taper were thrown around. This last week I was called by the NP's physicians assistant that my NP would only be filling half my script. Saying that according to the new guidelines that it can cause severe respiratory depressions and that I am in danger when taking both pk and benz. I almost had to laugh as it was like he was reading off the CDC script word for word. I then asked him so you've had me in danger this whole time I've seen him? They were caught off guard about that question. I left it as I'd see him at my next appointment to discuss this and the NP was not the person I needed to explain this to. I honestly think the PA has never even read my chart completely to know I went to therapy for a year for my course of treatment. Anyways I plan on discussing this at my next appointment and hope for the best. I most likely though will be looking for a new REAL doctor and not a PA. I have private insurance through my work and figure my chances are better suited at another practice. I plan on informing him that I plan on keeping him for my blood pressure issues but since he can't properly treat me the patient/customer. That I'll need to be referred to someone who can. Not something I want to do but feel I have to do. Doctors forget sometimes that we are there customer/patients and after so many years and different medications you know what works best for your body. So yes you should alway be honest though your patient bill of rights (yes that does exist) says if your doctor can't treat you effectively they need to refer you to someone who can.

[Dentscllyfe]

Solar,

I know this situation all to well. It is almost like someone can not have or be treated for more than one condition. I was basically told I would have to choose between taking my anxiety meds or sleeping meds not to long ago. I was kind of caught of guard since this doc has been prescribing me both for some time and out of the blue he said sorry, I cant anymore! I started explaining to him that he was actually putting me in danger by stopping my meds and he just looked at me with a blank stare and said sorry. Complete negligence. The docs are right when it comes to mixing depressants, it can be risky, and the fact that these are commonly miss used drugs and that there is a lot of pressure and attention on what they prescribe, does put some pressure on them but there is a big difference between being cautious and them just not doing their job. Find a doc who will listen to you, there are some good ones left out there. Good luck.

[esbayne]

Hello again Dentscllyfe, That is pretty scary that your doctor told you to choose between anxiety and sleeping meds. Anytime you take benzos and you do not taper off it can actually kill you. There are some good docs out there who will tow the line and still give you the meds you need. If it is within their DEA lic specs and you need it then they should give it to you. Life is too short to be suffering. That is why I love this site so much. I think it helps people to be able to discuss these type of issues without having to be worried about being judged.

Regards Eddie

[Dentscllyfe]

Esbayne,
I know, I was shocked... he "advised" me it would be better to stay on the benz but he could not prescribe both anymore.. I was almost pleading with him to at least taper me off sleep meds, it was degrading.... I felt completly helpless. That's when the hunt for online meds began and I found all you wonderful people! I Should go back and thank him

[solarpunch]

This issue of the cut off between benz and other medications ( in my case pain meds). Is happening everywhere. In cases where people have been on benz for long periods of time such as myself it's life altering. I've went without them before and it was torture to the mind. Between my psychologist and my doctor almost 8 years ago they decided that it was safe and benafital to my health to take one benz before bed every night. Seeing that I don't take pain medication in the middle of the night it could never be conflicting and the chances for respiratory depression was slim to none. But I am back again with a new doctor for the past year who has been quietly trying to remove me from them. I again refered him to read into my charts that predate my time with him but he has yet to do so. Probably since he sees a new patient every 15 minutes or so. I have remained polite and will continue to do so when I respectfully ask him to refer me to a doctor that can manage me properly. As a patient I have the right to request that and he must comply. They won't tell you that you have the right and even will lie to you and say they can't. Don't listen and stand firm. I'll keep everyone updated on what happens at my next appointment. Sorry for the spacey reply I had some bad luck this week and I am still trying to trade it in for good luck. Not an easy task but I'll manage.