What can I do about my pain medication?
I have been seeing a neurologist for a herniated lumbar disc for a while now, and I have right leg radiculopathy from the disc compressing my nerves in my spine. I have been on hydrocodone 10/500 for almost two years now and have developed a really high tolerance to it (which is normal I know) and I am uninsured, so I can’t afford the stronger stuff which most people recommend. I get a 15 day supply of the medication and I usually run out between 10-13 days and get it filled early. My Dr. has already made it clear that I am on the maximum he feels comfortable prescribing, and basically has told me to just quit my job, stop doing housework, and stay on the meds until I can find a job with benefits so that I can have surgery. He hasn’t explored any other options (which being private pay I’m not sure what I can afford to do anyways) but when I asked about steroid injections he said that they are too expensive and won’t fix the problem. I need help. I am a mother of a 9 month old and a 6 year old, and a nurse. My occupation usually requires me to do the lifting and bending that I am not supposed to do as well as taking care of the kids and helping my husband with the daily household duties. My life has been taken over by pain. It has caused me to not be able to get out of bed some days, to put off grocery shopping, to lose my job, to not be able to play with the kids, etc. I am depressed, and cannot function like I used to. Which interferes with every aspect of my life. I know I cannot stay on the meds forever, nor would I want to because being a nurse, I know what it is doing to my body. But I can’t just snap my fingers and have surgery either. Right now my Dr. is on vacation for a week, and the nurse that handles all of my refills is out of the office too. I called to get my meds refilled and another nurse has been really rude to me and told me that there is nothing she can do and I shouldn’t have a 15 day supply that it should be a months worth and that I can’t get them refilled. This has never been an issue before now. I am going through narcotic withdrawals in addition to severe pain, and dragging my leg around like its dead weight sometimes. I know all the tricks to ease the pain, hot baths, massage, ice & heat, etc. They won’t even call me in something for the blood pressure/withdrawal symptoms. I thought about telling her that she can tell my Dr. when he comes back that he has lost another patient. How can they get away with being so hateful when I have to pay an ungodly amount of money for them to tell me to just quit my job and get surgery?
Oh my dear. Where do we begin? My first instinct is to tell you to just pack up and go to the ER and then file for one of the state programs that covers the uninsured. In MY local ER we would get you comfortable with injectable pain medicine and then give you enough medication to cover you until Dr. Useless gets back from his vacation.
Now, where you are, I dunno what you’d get. It’s entirely possible they’d treat you as a drug seeker and send you packing with a script for Motrin (ibuprofen). I would think that at the very LEAST your neurologist has someone covering his patients for him while he is gone and the ER doc could page him and get his advice.
As far as what to do, I wonder how your doc would feel about using something like Endocet/Percocet (oxycodone with acetaminophen) or maybe even Dilaudid (hydromorphone). Endocet may not be that much stronger than the Lortab 10/500 that you are taking now as most docs who move from Lortab usually go for Percocet 5/325 (a switch to THAT dosage wouldn’t offer you any additional analgesia as 5mg’s of oxycodone is roughly equal to 10mgs of hydrocodone). There is however Endocet and Percocet tablets that contain 10mg’s of oxycodone which WOULD be stronger than the hydrocodone dosage you are taking. I wouldn’t imagine the price would be a large sum more than what you are paying for the Lortab you are on now.
Before I get blasted for suggesting Dilaudid for non-cancer pain, I want to say that I suggest this as it is a good alternative for patients who require long term treatment for chronic pain as it does not have acetaminophen in it. Before going to Dilaudid I would definately suggest you exhaust the Endocet/Percocet route before going to a much more potent opioid.
If I can help more, please feel free to ask.
September 11th, 2009 at 10:41 pm
I think you should consider seeing another physician about "bridge prescription" to avoid withdrawals. The pain management approach in your case is different from most cases with which I am familiar. Usually the narcotic is introduced after the neurosurgeon has performed the diskectomy or whatever is indicated. Perhaps, a family doctor would give you a limited prescription to to either wean off or to reconnect with your neurologist.
References :
September 11th, 2009 at 11:26 pm
Call your pharmicist and explain what is going on. Sometimes, with an established patient, they will give a a few days worth of medication to get you through until your doctor is back. If that doesn’t work try waiting until the office is closed and call the after hours line. You may be able to get a hold of your doctor or the doctor on call that way. You might need to leave the part out about needing medicine and just tell them about the pain. Then when you get the doctor on the phone, mention that you need your refill and how much pain you are in and what the nurse said to you. If all else fails, go to the emergency room and let them know what is going on. You will be able to get a prescription for a few days worth of pain medication from them. They don’t ask about your billing information until you are leaving. When they do, be sure to tell them that you cannot afford to pay. They will give you paperwork to fill out and you can get some or all of the bill paid for by the hospital. I also suffer from constant 24/7 chronic pain and I have been in your position before. I did not have insurance, ran out of medication, and was in horrendous pain one night. My husband finally scooped me up, put me in the car and took me to the E.R. I was worried about the cost but he said there was no way he was going to watch me in that amount of pain for another minute. We talked tot hem about not having insurance and that we couldn’t afford the bill and they gave me the paperwork to fill out and I ended up getting the whole thing paid for. I hope one of these works for you.I know. If it comes down to the hospital being your only option, go. You can get financial help. There is no need to suffer any longer. My heart goes out to you and I really hope you are feeling better sooner rather than later.
References :
September 11th, 2009 at 11:52 pm
Oh my dear. Where do we begin? My first instinct is to tell you to just pack up and go to the ER and then file for one of the state programs that covers the uninsured. In MY local ER we would get you comfortable with injectable pain medicine and then give you enough medication to cover you until Dr. Useless gets back from his vacation.
Now, where you are, I dunno what you’d get. It’s entirely possible they’d treat you as a drug seeker and send you packing with a script for Motrin (ibuprofen). I would think that at the very LEAST your neurologist has someone covering his patients for him while he is gone and the ER doc could page him and get his advice.
As far as what to do, I wonder how your doc would feel about using something like Endocet/Percocet (oxycodone with acetaminophen) or maybe even Dilaudid (hydromorphone). Endocet may not be that much stronger than the Lortab 10/500 that you are taking now as most docs who move from Lortab usually go for Percocet 5/325 (a switch to THAT dosage wouldn’t offer you any additional analgesia as 5mg’s of oxycodone is roughly equal to 10mgs of hydrocodone). There is however Endocet and Percocet tablets that contain 10mg’s of oxycodone which WOULD be stronger than the hydrocodone dosage you are taking. I wouldn’t imagine the price would be a large sum more than what you are paying for the Lortab you are on now.
Before I get blasted for suggesting Dilaudid for non-cancer pain, I want to say that I suggest this as it is a good alternative for patients who require long term treatment for chronic pain as it does not have acetaminophen in it. Before going to Dilaudid I would definately suggest you exhaust the Endocet/Percocet route before going to a much more potent opioid.
If I can help more, please feel free to ask.
References :
http://www.percocet.com
http://www.webmd.com
http://www.aapm.org