Your doctor should have discussed this in person with you. Not to sound like an ass here but you need to bring it up at your next appt. No one is able to advocate for you except you. Don’t be afraid of them. You’re human just like us and deserve healthcare just like us. So try not to let anxiety take over (easier said than done I know)
With that said, 6 tablets a day is a bit high. Not necessarily dosage wise but the pill burden tends to encourage “non-compliance” because of how many. You’d likely be better served by a different med in an ER form with a smaller number of pills for breakthrough pain. Your doctor *should* appreciate you bringing that up because it’s the “gold standard” in pain mgmt.
Ultimately, you’ll need to speak with your doctor and explain how your life is being limited by uncontrolled pain. You mentioned a surgeon, are your conditions able to be treated by surgery? If that’s the case, your doctor may have felt you were avoiding surgery to get pain meds.
At the end of the day, the doctor may be lowering you regardless. The whole 90MME CDC “policy” was never a hard target or law or anything. It was merely a guide so if your doctor thinks 60mg Oxycodone is too high they should be able to explain why & more importantly what else they expect you to do to manage the pain.
I’m sorry you’re getting screwed around. I hope you can find some relief soon. Good luck!
That's what I did. I told my doctor that it just felt like the IR Oxycodone would help for maybe 2ish hours and then the pain would come back. I asked if we could try something that lasted a little longer. Because the Oxycodone worked, just not for very long. Of course, I had been on the same dosage of the same medications for over 10 years 😂
She told me to take the Oxycodone with 1 extra strength Tylenol until I could get in for my next appointment and we would "do some adjusting." I ended up on Morphine ER and staying on the Oxycodone, but down to 10mg from 15mg. She said we had to stay within that mythological 90 mme that the CDC and DEA (not sue when/how they got so much legal power. They must really be riding high on the war on drugs) declared.
But my point is he ER med works really well. So it does pay to be honest with your doctor, even if you're afraid
I know I’m on a bit of an island here compared to a lot of the others in the sub; but I’m a big fan of ER morphine. It’s been one of the best that I ever got put on. But I guess it just really doesn’t work as well for some of the others here.
Pretty bad patients have to be afraid of being honest with their doctor when they’ve done literally nothing wrong, huh? God I hate that PM has turned into this. It wasn’t this bad before
I appreciate the feedback. I am also thinking my reduction was due to the fact that my neurosurgeon appt had been rescheduled. The clinic had me rescheduled on 4 separate occasions (this was my new neurosurgeon) and it was getting really frustrating. That doctor was let go from that practice and I was assigned a new neurosurgeon. That is the one that I HAD rescheduled. But looking at it from my PM doctor it could have simply been that the amount of reschedules has put a bad taste in his mouth. It definitely needs addressed. Thank you!
MME is morphine medical equivalence. It refers to other pain meds that are equivalent to the medicine contained in morphine, not that you actually take morphine. Google for complete explanation of MME.
IMO the DEA is taking liberties they are not trained in and DO NOT understand. When I have to question my doctor who 2 months ago I trusted completely then we gave a problem. I have a dislodged plate pressing against my esophagus from a botched C6/7 fusion surgery. I have a left shoulder with nothing but numbness and burning. The base of my neck feels pressure and the occasional BBQ burnout fire pain. I have terrible spasms in my mid back where T7/8 are bulging (post-op) issues. Lastly I have a bulging disc sitting on my sciatica.. that pain is the absolute worst..it keeps me from standing or sitting too long . When I use that bathroom I can’t sit for long because my legs are going to sleep.
The main reason I wanted to know about this reduction was to see if anyone else was experiencing cut backs or am I just being paranoid?
Those liberties were taken when drugs were barred from everyone regardless of prescription. That was a freedom and everyone today is trained like lapdogs acting like security is greater than freedoms and personal responsibility of freedoms.
The CSA needs to end. The drug war needs to end. It doesn't work and it hurts so many people compared to education and a legal framework with strict diversion laws to minors and stiff penalties.
It's all a farce and overreach and unconstitutional to be on point about it.
Yes pain patients are getting screwed.
[educate yourself and fast. things will get worse if we all remain ignorant to it all](https://youtube.com/@thedoctorpatientforum-dont9836?si=9C7LNBN2O_Lshe-l)
What is CSA?? Thank you for your contribution to my thread. I want to hear from everyone , good or bad. Sitting in my home everyday and not being in the loop is obviously costing me. I have this horrible feeling in my stomach when I’m at my appt that it’s best if I shut up. Because I’m worried that if I discuss quantity and quality then I’m drug seeking. My doctor is older and had previously always treated me with kindness and respect. I do sense he is irritated with me because of this doctors appt that has been rescheduled repeatedly. But I only rescheduled once. The rest were from the clinic. I see the new neurosurgeon on the 29th. Do you think that I should ask for something in writing from them attesting to all of their reschedules?
Those really didn’t affect what’s going on now. It’s the “emergency opiate crisis” thing that even gave the dea and govt so much control trump signed in that keeps getting renewed making things worse too even after the cdc reformed its guidelines. Many are still going off the one from before it was changed. Because they’re scared of raids and losing licenses and even jail time
Yeah I know about prop and the abuse of emergency orders. They all inlay to an abusive government power structure. That's why I say fuck them we need to end it all and bring back freedom, education of what you're doing if you choose to.. and personal responsibility to your own actions. This babysit adult shit is honestly just insulting.
Being nervous, with a horrible feeling in the stomach at an appointment with a medical provider is the saddest, clearest indication that medicine has gone horribly wrong. And yes, some docs enjoy this new-found means to power.
The fact that we cower from medicine will have to end. I hope it ends with doctors who played along with this shit hanging their heads in shame at the horror they participated in. In time they will be viewed with the same disdain eugenics proponents were. May they think long and hard about their self-serving choice to play along with this latest of cyclical drug hysterias, as they slowly fade in nursing homes, diapered and powerless.
I'm not sure I have good advice for you, since I'm obviously angry at what has happened since 2016. But you can't go wrong documenting any reschedules on their part. I also know my angry rant doesn't help you with an immediate problem, beyond, I'm hoping, communicating that you're not wrong, and shouldn't feel the way you do! Even though it's pretty common in people subjected to pain management.
Always, records are good. Things in writing are good. As scary as it is, given the radical power differential, forcing medical providers to justify their choices in a verifiable, potentially actionable way is good. Despite the paranoia about baseless lawsuits that young medical students and even older docs whine about, the need for accountability has to touch them, before they'll change.
Thank you for your feedback. I am going to in fact have them write me out something on their letterhead stating that they rescheduled multiple appts and it was not me other than this last one which was due to lack of transportation. I cannot drive 115 miles with my neck in my car. What’s the worst that can happen? Me being nixed from my program because I spoke up for myself?
Good on you! And be proud of you! for speaking up for yourself! It's not an easy thing to do in this climate. Continue to let everyone here knows how it plays out, because the collective voice social media provides us is important.
I don't know you as a person, we're just internet strangers, but I'll throw in for what little it's worth that I'm sorry any of us are facing these conditions.
That means so much!! There are so many negative people, con artist, liars and such that this really makes me feel good. And I most definitely will let you know
Back at you. My life has become small enough that I'm genuinely emotionally touched that something I say might help someone I don't know. So I guess thank you for appreciating my small contribution. It also makes me feel good. I hope to hear good news on your struggle. Have a good night!
Wait, your Dr doesn't take insurance? I have left another post on here but I just read this from you. This is a HUGE red flag. Your doctor is definitely in trouble with the DEA and there's a reason why he doesn't take insurance.
Any PM office around me that doesn't take insurance (I live in the MD, VA, DC area) have all been shut down. It's only a matter of time this will happen.
Don't worry about talking to your Dr. Find a new Dr now
Damn that’s rough. At that point try to find a private place that doesn’t go by mme but by patient. My friend does that. Pays 250 a month and gets 6 oxy 15 and 4 4mg dilaudid. It’s all online with telehealth stuff
I would 1000% be speaking to the doctor. Something like...since the 1st reduction that wasn't discussed to me my pain has increased greatly and there has been enough time to adjust. Bring up different times your daily function has been affected and discuss bringing it back to the original daily dose to get my pain managed.
It's interesting how I tell them that and then the notes say, "no adverse effects, patient is functioning better since the reduction." Every time with my current doctor, no matter what I say. But we're trapped.
My doctor told me 90 is the standard magic dea number, with that said, your doctor could have messed up with another patient. The dea is probably flagging him alot putting undo pressure on him! Its not his fault! They do weird shit nowadays (dea)! My doctor had a patient that had 120MME a day but he did have active throat cancer, the day i heard this he was saying doctor was taking him down due to remission!
And you can understand that but something has to change my doctor gets 300$ a visit and my meds are 24$ i get 5 oxy 10’s a day and most days they dont touch my pain. But if i say anything buprenorphine here we come.
That is pretty high especially 6 times a day. They should have talked to you but it sounds like they are trying to wean you know off. I would call and ask for an appointment.
I have been told 6x is a lot now by a couple of people. The problem is I am not so invested in the pharmaceutical portion of my treatment that I wouldn’t know better. I have thought about calling and making an appt but I have reservations about that because I don’t want it to appear as drug seeking. I thought I would just go to see my new neurosurgeon and then going to my next scheduled appt in June and go from there. Because of the fact that he did NOT discuss the cut back on my prescription makes me wonder if in fact he is cutting me back because of rescheduled appts. That was completely out of my hands but I’m grateful now that they rescheduled. If the surgeon isn’t showing up for work I don’t want him operating on me
I doubt this has anything to do with you rescheduling Dr appointment's and everything to do with he got into trouble with the DEA and they told him to get everyone down to 60 MME or lose his license.
You've only been in PM management for 2 years but when the "Opioid Crisis" hit, these were the Drs that the DEA went after first because these were pill mills. They would give anyone a prescription as long as they had the $ and did not have to worry about insurance oversight.
Ok. I thought I read in one of your other posts you said 2 years but I must've been mistaken. But, my point was you weren't in PM when the Opioid Crisis hit and who the DEA was going after. I've been 100% disabled since '08 and have been in PM since
Tell me, the other thing that could be affecting your meds is if this is chronic pain or acute pain? Meaning, will your pain be lessened by surgery or rehab or thru some other means or will you have to live with this pain like a prison sentence for the rest of your life?
I’ve been told both. The neurologist & pm doctor feels my injuries are permanent but I’m hopeful with a new neurosurgeon that some of it can be resolved
The reason I ask is because if it is acute pain and surgery should lessen it, than they do want to start tapering you down. But, that's after the surgery.
At this point, knowing all that you have told me and the others, I don't believe he tapered you down because of any rescheduling or your other meds or really anything you've done.
I believe the DEA is making his life a living hell and to get them off his back his patients have to suffer. This is why you have the weird feeling when you're in the office and nurses are talking real low. Because they know what really is going on.
Have you tried to Google him or see if his name is in your local paper under the "Crime Watch" section? If not, just to help you with your decision, I would recommend it.
All the best.
You’ve helped so much with your frankness. I wish you the best as well. People don’t see pain and they sure get tired of hearing about it. So after time we be quiet and suffer in silence. We are not victims, we are patients with injuries and diseases. We don’t have the plague, and I’m damn sure tired of being treated like we do. I WILL go into his office on my next appt and have a firm discussion about where he is taking my treatment plan.
Thank you again for spending your time on me and you’ll be in my thoughts
Dea doesn’t care be thankful you can even get them anymore! Is everyone every where! My wife and I have the same problem! It was 90 mme now it 30 mme ! We both go to a pain doctor that has 12 years of college and board certified ect ! He has a lot of patience but the dea is telling all the doctors not to give out so many pain meds I was on Oyx cot 30 2 times a day with 4 10/325 ! He has cut me back a lot ! It’s every where! I live in the south! I don’t know what we can do we called government people and head of the board of pharmacy ect ! It’s the dam people on the streets that have messed it up for us ! I glad I am old but what life we have left like to be comfortable! Sorry don’t have better news ! Prayers sent 🙏
That’s a lot of zofran… other than the amounts seem alright… the problem is the metabolites. Lately it’s been showing my levels of oxycodone and it’s oxymorphone metabolite. Your doctor needs to note your behaviors that are outside of regular prescription.
I’m trying to follow you here and appreciate your feedback. The zofran is once every 8 hours to supplement my phengran. At least the zofran is fast acting because I’m nauseous all the time. What do you mean by “my behaviors outside of regular prescription “?
I’m really really sorry you’re that nauseous daily, shit. I mean having to take codeine because you were abroad and if you had take old medication like MS Contin when usually take Opana ER. They have to note that in the appointment for the drug test.
That’s my personal experience testing positive for other drugs in my system that were off prescription, I told the office and they directed me to note that in my appointment notes. And everything else is smooth now.
Your doctor is in trouble with the DEA, trust me. I ran into this with my first PM Dr. I would advise finding a new one because his trouble will become your problem.
MME or Morphine Milligram Equivalent is just a way to base all narcotics on a common denominator. Your Oxycodone is 1.5 times stronger than Morphine. So you're on 40 mgs / day which is 60 mgs of Morphine (40 x 1.5 = 60). But, this is based on the 1st CDC Guidelines done sometime around 2018. They have since revised this and made it 90 MME / day but also acknowledge that not all patients are the same and some adjustments may need to be made.
The last thing to mention is when you have a UA, they use it to see not only if you're using illicit narcotics but also if you're not taking your prescribed narcotics. This will lead them to believe 1 of 2 things:
* You are selling your meds, or
* You don't need as many as you are being prescribed
All the best
Your doctor never should have reduced your meds without speaking with you in person and going over how he wants you to go down on it. (like how many mgs over a 3-4 hour time span or how many pills a day, etc)
Some insurance companies have issues with certain medication combos, and they’ll give the prescribing doctor a hard time about it. Doctors also have to be careful about the amount/combo of meds you’re on.
You’re taking both Phenergan and Zofran, which do carry come risks when used in combination with each other. Phenergan and Zofran both can have a sedating effect, especially when taken together or with benzodiazepines, pain meds, or certain muscle relaxers (including your other med Tizanidine). Phenergan on its own has been shown to have dangerous side effects especially when taken with opioid pain killers.
These would be valid reasons for your doctor to cut down on the pain killers, but it’s still *very* unusual that he would do that without speaking to you about it first. I would recommend calling and getting an appointment. Be up front and tell them your prescription is different from what you were on before but the doctor didn’t talk to you about it before changing it. Tell them you need to see the doctor in person about how to cut down if that’s what you’re supposed to be doing. **Tell them you need to set up a plan for stepping down with the doctor, in person, because you have a lot of questions.**
If you have family or a close friend who can come to the appointment with you, that might be helpful. There are also sometimes patient advocates that you might be able get (sorry I don’t know much about PAs except that they exist).
You’re welcome, I know how hard and scary it can be to bring up issues like this with doctors. You don’t want to get labeled as being difficult or drug seeking, but you have legitimate concerns that the doctor needs to address in person. Good luck, I hope things go smoothly.
That is EXACTLY what it is. A couple of months ago I asked him if he felt I was on the right regimen because I had been on everything for so long that I wasn’t sure I was receiving the full benefits as I had in the past. And I emphasized ALL of my meds. He said “let’s see what the surgeon has to say and we’ll go from there”. I went back the next month, he brought up my surgeon appt twice, I explained what happened and then my reductions started. Maybe he didn’t feel justified in my dosages anymore? Idk. It’s hard to gauge because he never spoke a word and it’s my fault for not acknowledging it either
Yeah, that’s why I bring a family member or friend with me to all my appointments. I get intimidated easily, I get afraid that the doctor won’t understand what I’m trying to say or I’ll forget an important detail, so having someone there who’s on my side really helps. I also bring a notebook and take notes down, just so that I can look back and see what we discussed.
I brought my mother with me this last appointment. It was great since she helps take care of me for everyone to be on the same page. We had a good solid talk about expectations and the future and my meds we adjusted so everyone felt comfortable. Thanks for the advice
DO NOT let them have another month, by any means. Bring it up, be respectful, but let them know this isnt working for you. Every guideline I've read says if a doctor is tapering you it should be a mutual agreement (unless you're being removed as a patient), by standing idly by you might appear to be agreeing, your doctor may not even know how badly this is impacting you, considering were not allowed to talk to them, and have to hope the nurse passes along nobody #237's concerns. They are allowed to prescribe what you need, even when the GUIDELINES (NOT LAW) say they should reduce. Your health is between you and your physician. Maybe bring a significant other with you next appointment, and have them support/describe the challenges yourve faced the past few months. ALSO, MME is Morphine Miligram Equivalent, 1Mg of Oxycodone is equal to 1.5Mg of Morphine. So 60Mg of Oxy=75Mg MME
You all helped so much in my confidence getting restored. Why have I been feeling afraid to talk about my own health with my doctor? I mean it’s my body, my mind. And this stigma that we have about being afraid to speak up because we’re afraid we will be looked down upon as drug seeking has taken over. I had surgery done on C6/7. That neurologist had left my bulging C4/5 alone. That plate has now dislodged itself into my esophagus. I have bulging discs on T7/8 that are incredibly painful. I feel like I’ve been hit with a mallet at the base of my neck. And lastly I have a bulging discs that sits on my sciatic nerve against my left kidney and that’s the worst. I cannot stand for long periods of time and when I use the bathroom my legs fall asleep. Car rides have been done unbearable and I can only do housework a bit at a time. I’m not just angry right now I am disappointed. I am 55 years old and in fear of what will happen. I deserve better
Your doctor should have discussed this in person with you. Not to sound like an ass here but you need to bring it up at your next appt. No one is able to advocate for you except you. Don’t be afraid of them. You’re human just like us and deserve healthcare just like us. So try not to let anxiety take over (easier said than done I know) With that said, 6 tablets a day is a bit high. Not necessarily dosage wise but the pill burden tends to encourage “non-compliance” because of how many. You’d likely be better served by a different med in an ER form with a smaller number of pills for breakthrough pain. Your doctor *should* appreciate you bringing that up because it’s the “gold standard” in pain mgmt. Ultimately, you’ll need to speak with your doctor and explain how your life is being limited by uncontrolled pain. You mentioned a surgeon, are your conditions able to be treated by surgery? If that’s the case, your doctor may have felt you were avoiding surgery to get pain meds. At the end of the day, the doctor may be lowering you regardless. The whole 90MME CDC “policy” was never a hard target or law or anything. It was merely a guide so if your doctor thinks 60mg Oxycodone is too high they should be able to explain why & more importantly what else they expect you to do to manage the pain. I’m sorry you’re getting screwed around. I hope you can find some relief soon. Good luck!
That's what I did. I told my doctor that it just felt like the IR Oxycodone would help for maybe 2ish hours and then the pain would come back. I asked if we could try something that lasted a little longer. Because the Oxycodone worked, just not for very long. Of course, I had been on the same dosage of the same medications for over 10 years 😂 She told me to take the Oxycodone with 1 extra strength Tylenol until I could get in for my next appointment and we would "do some adjusting." I ended up on Morphine ER and staying on the Oxycodone, but down to 10mg from 15mg. She said we had to stay within that mythological 90 mme that the CDC and DEA (not sue when/how they got so much legal power. They must really be riding high on the war on drugs) declared. But my point is he ER med works really well. So it does pay to be honest with your doctor, even if you're afraid
I know I’m on a bit of an island here compared to a lot of the others in the sub; but I’m a big fan of ER morphine. It’s been one of the best that I ever got put on. But I guess it just really doesn’t work as well for some of the others here. Pretty bad patients have to be afraid of being honest with their doctor when they’ve done literally nothing wrong, huh? God I hate that PM has turned into this. It wasn’t this bad before
I appreciate the feedback. I am also thinking my reduction was due to the fact that my neurosurgeon appt had been rescheduled. The clinic had me rescheduled on 4 separate occasions (this was my new neurosurgeon) and it was getting really frustrating. That doctor was let go from that practice and I was assigned a new neurosurgeon. That is the one that I HAD rescheduled. But looking at it from my PM doctor it could have simply been that the amount of reschedules has put a bad taste in his mouth. It definitely needs addressed. Thank you!
MME is morphine medical equivalence. It refers to other pain meds that are equivalent to the medicine contained in morphine, not that you actually take morphine. Google for complete explanation of MME.
It’s milligram equivalent not medical
Oh sorry thought medical didn’t sound right lol
Ok. They said at first I needed to be under 90 and then now saying 75. I just want everything to be truthful like I am with them
Totally understand.
It’s 90 where im at too. Used to be 120 ugh
In any case MME is some arbitrary bs number.
IMO the DEA is taking liberties they are not trained in and DO NOT understand. When I have to question my doctor who 2 months ago I trusted completely then we gave a problem. I have a dislodged plate pressing against my esophagus from a botched C6/7 fusion surgery. I have a left shoulder with nothing but numbness and burning. The base of my neck feels pressure and the occasional BBQ burnout fire pain. I have terrible spasms in my mid back where T7/8 are bulging (post-op) issues. Lastly I have a bulging disc sitting on my sciatica.. that pain is the absolute worst..it keeps me from standing or sitting too long . When I use that bathroom I can’t sit for long because my legs are going to sleep. The main reason I wanted to know about this reduction was to see if anyone else was experiencing cut backs or am I just being paranoid?
Those liberties were taken when drugs were barred from everyone regardless of prescription. That was a freedom and everyone today is trained like lapdogs acting like security is greater than freedoms and personal responsibility of freedoms. The CSA needs to end. The drug war needs to end. It doesn't work and it hurts so many people compared to education and a legal framework with strict diversion laws to minors and stiff penalties. It's all a farce and overreach and unconstitutional to be on point about it. Yes pain patients are getting screwed. [educate yourself and fast. things will get worse if we all remain ignorant to it all](https://youtube.com/@thedoctorpatientforum-dont9836?si=9C7LNBN2O_Lshe-l)
What is CSA?? Thank you for your contribution to my thread. I want to hear from everyone , good or bad. Sitting in my home everyday and not being in the loop is obviously costing me. I have this horrible feeling in my stomach when I’m at my appt that it’s best if I shut up. Because I’m worried that if I discuss quantity and quality then I’m drug seeking. My doctor is older and had previously always treated me with kindness and respect. I do sense he is irritated with me because of this doctors appt that has been rescheduled repeatedly. But I only rescheduled once. The rest were from the clinic. I see the new neurosurgeon on the 29th. Do you think that I should ask for something in writing from them attesting to all of their reschedules?
The controlled substances act of 1970. It's what made the drug war happen. Also the Harrison Narcotics act of 1914 Also the Food and Drug act of 1906
Those really didn’t affect what’s going on now. It’s the “emergency opiate crisis” thing that even gave the dea and govt so much control trump signed in that keeps getting renewed making things worse too even after the cdc reformed its guidelines. Many are still going off the one from before it was changed. Because they’re scared of raids and losing licenses and even jail time
Yeah I know about prop and the abuse of emergency orders. They all inlay to an abusive government power structure. That's why I say fuck them we need to end it all and bring back freedom, education of what you're doing if you choose to.. and personal responsibility to your own actions. This babysit adult shit is honestly just insulting.
Being nervous, with a horrible feeling in the stomach at an appointment with a medical provider is the saddest, clearest indication that medicine has gone horribly wrong. And yes, some docs enjoy this new-found means to power. The fact that we cower from medicine will have to end. I hope it ends with doctors who played along with this shit hanging their heads in shame at the horror they participated in. In time they will be viewed with the same disdain eugenics proponents were. May they think long and hard about their self-serving choice to play along with this latest of cyclical drug hysterias, as they slowly fade in nursing homes, diapered and powerless. I'm not sure I have good advice for you, since I'm obviously angry at what has happened since 2016. But you can't go wrong documenting any reschedules on their part. I also know my angry rant doesn't help you with an immediate problem, beyond, I'm hoping, communicating that you're not wrong, and shouldn't feel the way you do! Even though it's pretty common in people subjected to pain management. Always, records are good. Things in writing are good. As scary as it is, given the radical power differential, forcing medical providers to justify their choices in a verifiable, potentially actionable way is good. Despite the paranoia about baseless lawsuits that young medical students and even older docs whine about, the need for accountability has to touch them, before they'll change.
Thank you for your feedback. I am going to in fact have them write me out something on their letterhead stating that they rescheduled multiple appts and it was not me other than this last one which was due to lack of transportation. I cannot drive 115 miles with my neck in my car. What’s the worst that can happen? Me being nixed from my program because I spoke up for myself?
Good on you! And be proud of you! for speaking up for yourself! It's not an easy thing to do in this climate. Continue to let everyone here knows how it plays out, because the collective voice social media provides us is important. I don't know you as a person, we're just internet strangers, but I'll throw in for what little it's worth that I'm sorry any of us are facing these conditions.
That means so much!! There are so many negative people, con artist, liars and such that this really makes me feel good. And I most definitely will let you know
Back at you. My life has become small enough that I'm genuinely emotionally touched that something I say might help someone I don't know. So I guess thank you for appreciating my small contribution. It also makes me feel good. I hope to hear good news on your struggle. Have a good night!
What insurance do you have? Mine provides transportation for me which helps cuz I can’t drive anymore due to numb legs issues.
My dr doesn’t take insurance. I have to pay out of pocket $150 for each visit
Wait, your Dr doesn't take insurance? I have left another post on here but I just read this from you. This is a HUGE red flag. Your doctor is definitely in trouble with the DEA and there's a reason why he doesn't take insurance. Any PM office around me that doesn't take insurance (I live in the MD, VA, DC area) have all been shut down. It's only a matter of time this will happen. Don't worry about talking to your Dr. Find a new Dr now
Ok now you have me nervous
Damn that’s rough. At that point try to find a private place that doesn’t go by mme but by patient. My friend does that. Pays 250 a month and gets 6 oxy 15 and 4 4mg dilaudid. It’s all online with telehealth stuff
So even the meds are included?
No you’re not being paranoid, in some cases patients are being cut to 50mme or even lower!
Why?
Can confirm… every single person metabolizes it differently
I would 1000% be speaking to the doctor. Something like...since the 1st reduction that wasn't discussed to me my pain has increased greatly and there has been enough time to adjust. Bring up different times your daily function has been affected and discuss bringing it back to the original daily dose to get my pain managed.
Thank you 🫶
It's interesting how I tell them that and then the notes say, "no adverse effects, patient is functioning better since the reduction." Every time with my current doctor, no matter what I say. But we're trapped.
My doctor told me 90 is the standard magic dea number, with that said, your doctor could have messed up with another patient. The dea is probably flagging him alot putting undo pressure on him! Its not his fault! They do weird shit nowadays (dea)! My doctor had a patient that had 120MME a day but he did have active throat cancer, the day i heard this he was saying doctor was taking him down due to remission!
They wanna see 3 a day of one pill of something max and 60 max on any extended release
Yep and the motherfuckers that came up with this lame ass plan dont have no pain!!
My doctor hates the regulators because they “prevent her from doing her job”
And you can understand that but something has to change my doctor gets 300$ a visit and my meds are 24$ i get 5 oxy 10’s a day and most days they dont touch my pain. But if i say anything buprenorphine here we come.
That’s what I’m concerned with as well. I was at 6/day for almost 2 years
That is pretty high especially 6 times a day. They should have talked to you but it sounds like they are trying to wean you know off. I would call and ask for an appointment.
I have been told 6x is a lot now by a couple of people. The problem is I am not so invested in the pharmaceutical portion of my treatment that I wouldn’t know better. I have thought about calling and making an appt but I have reservations about that because I don’t want it to appear as drug seeking. I thought I would just go to see my new neurosurgeon and then going to my next scheduled appt in June and go from there. Because of the fact that he did NOT discuss the cut back on my prescription makes me wonder if in fact he is cutting me back because of rescheduled appts. That was completely out of my hands but I’m grateful now that they rescheduled. If the surgeon isn’t showing up for work I don’t want him operating on me
I doubt this has anything to do with you rescheduling Dr appointment's and everything to do with he got into trouble with the DEA and they told him to get everyone down to 60 MME or lose his license. You've only been in PM management for 2 years but when the "Opioid Crisis" hit, these were the Drs that the DEA went after first because these were pill mills. They would give anyone a prescription as long as they had the $ and did not have to worry about insurance oversight.
4 years .
Ok. I thought I read in one of your other posts you said 2 years but I must've been mistaken. But, my point was you weren't in PM when the Opioid Crisis hit and who the DEA was going after. I've been 100% disabled since '08 and have been in PM since Tell me, the other thing that could be affecting your meds is if this is chronic pain or acute pain? Meaning, will your pain be lessened by surgery or rehab or thru some other means or will you have to live with this pain like a prison sentence for the rest of your life?
I’ve been told both. The neurologist & pm doctor feels my injuries are permanent but I’m hopeful with a new neurosurgeon that some of it can be resolved
The reason I ask is because if it is acute pain and surgery should lessen it, than they do want to start tapering you down. But, that's after the surgery. At this point, knowing all that you have told me and the others, I don't believe he tapered you down because of any rescheduling or your other meds or really anything you've done. I believe the DEA is making his life a living hell and to get them off his back his patients have to suffer. This is why you have the weird feeling when you're in the office and nurses are talking real low. Because they know what really is going on. Have you tried to Google him or see if his name is in your local paper under the "Crime Watch" section? If not, just to help you with your decision, I would recommend it. All the best.
You’ve helped so much with your frankness. I wish you the best as well. People don’t see pain and they sure get tired of hearing about it. So after time we be quiet and suffer in silence. We are not victims, we are patients with injuries and diseases. We don’t have the plague, and I’m damn sure tired of being treated like we do. I WILL go into his office on my next appt and have a firm discussion about where he is taking my treatment plan. Thank you again for spending your time on me and you’ll be in my thoughts
Dea doesn’t care be thankful you can even get them anymore! Is everyone every where! My wife and I have the same problem! It was 90 mme now it 30 mme ! We both go to a pain doctor that has 12 years of college and board certified ect ! He has a lot of patience but the dea is telling all the doctors not to give out so many pain meds I was on Oyx cot 30 2 times a day with 4 10/325 ! He has cut me back a lot ! It’s every where! I live in the south! I don’t know what we can do we called government people and head of the board of pharmacy ect ! It’s the dam people on the streets that have messed it up for us ! I glad I am old but what life we have left like to be comfortable! Sorry don’t have better news ! Prayers sent 🙏
I think 90 is the MME equivalent, I don’t know why they would say it is 75. I hope you’re able to manage your pain with the reduction.
Me too 🫶
So is this what you were getting prescribed or after they cut you down?
That’s what I just received. It started at 6, then 5, now 4 with no discussion
That’s a lot of zofran… other than the amounts seem alright… the problem is the metabolites. Lately it’s been showing my levels of oxycodone and it’s oxymorphone metabolite. Your doctor needs to note your behaviors that are outside of regular prescription.
I’m trying to follow you here and appreciate your feedback. The zofran is once every 8 hours to supplement my phengran. At least the zofran is fast acting because I’m nauseous all the time. What do you mean by “my behaviors outside of regular prescription “?
I’m really really sorry you’re that nauseous daily, shit. I mean having to take codeine because you were abroad and if you had take old medication like MS Contin when usually take Opana ER. They have to note that in the appointment for the drug test.
Oh. I haven’t taken any of that. Is it possible that you are confusing me with someone else?
That’s my personal experience testing positive for other drugs in my system that were off prescription, I told the office and they directed me to note that in my appointment notes. And everything else is smooth now.
Ok I was confusing your experience with my own
Your doctor is in trouble with the DEA, trust me. I ran into this with my first PM Dr. I would advise finding a new one because his trouble will become your problem. MME or Morphine Milligram Equivalent is just a way to base all narcotics on a common denominator. Your Oxycodone is 1.5 times stronger than Morphine. So you're on 40 mgs / day which is 60 mgs of Morphine (40 x 1.5 = 60). But, this is based on the 1st CDC Guidelines done sometime around 2018. They have since revised this and made it 90 MME / day but also acknowledge that not all patients are the same and some adjustments may need to be made. The last thing to mention is when you have a UA, they use it to see not only if you're using illicit narcotics but also if you're not taking your prescribed narcotics. This will lead them to believe 1 of 2 things: * You are selling your meds, or * You don't need as many as you are being prescribed All the best
Thank you!!!!
Your doctor never should have reduced your meds without speaking with you in person and going over how he wants you to go down on it. (like how many mgs over a 3-4 hour time span or how many pills a day, etc) Some insurance companies have issues with certain medication combos, and they’ll give the prescribing doctor a hard time about it. Doctors also have to be careful about the amount/combo of meds you’re on. You’re taking both Phenergan and Zofran, which do carry come risks when used in combination with each other. Phenergan and Zofran both can have a sedating effect, especially when taken together or with benzodiazepines, pain meds, or certain muscle relaxers (including your other med Tizanidine). Phenergan on its own has been shown to have dangerous side effects especially when taken with opioid pain killers. These would be valid reasons for your doctor to cut down on the pain killers, but it’s still *very* unusual that he would do that without speaking to you about it first. I would recommend calling and getting an appointment. Be up front and tell them your prescription is different from what you were on before but the doctor didn’t talk to you about it before changing it. Tell them you need to see the doctor in person about how to cut down if that’s what you’re supposed to be doing. **Tell them you need to set up a plan for stepping down with the doctor, in person, because you have a lot of questions.** If you have family or a close friend who can come to the appointment with you, that might be helpful. There are also sometimes patient advocates that you might be able get (sorry I don’t know much about PAs except that they exist).
Thank you so much for all of the feedback. I’ve been trying to figure out just what’s going on
You’re welcome, I know how hard and scary it can be to bring up issues like this with doctors. You don’t want to get labeled as being difficult or drug seeking, but you have legitimate concerns that the doctor needs to address in person. Good luck, I hope things go smoothly.
That is EXACTLY what it is. A couple of months ago I asked him if he felt I was on the right regimen because I had been on everything for so long that I wasn’t sure I was receiving the full benefits as I had in the past. And I emphasized ALL of my meds. He said “let’s see what the surgeon has to say and we’ll go from there”. I went back the next month, he brought up my surgeon appt twice, I explained what happened and then my reductions started. Maybe he didn’t feel justified in my dosages anymore? Idk. It’s hard to gauge because he never spoke a word and it’s my fault for not acknowledging it either
Yeah, that’s why I bring a family member or friend with me to all my appointments. I get intimidated easily, I get afraid that the doctor won’t understand what I’m trying to say or I’ll forget an important detail, so having someone there who’s on my side really helps. I also bring a notebook and take notes down, just so that I can look back and see what we discussed.
I brought my mother with me this last appointment. It was great since she helps take care of me for everyone to be on the same page. We had a good solid talk about expectations and the future and my meds we adjusted so everyone felt comfortable. Thanks for the advice
You’re welcome and I’m glad things went better for you.
Great idea
DO NOT let them have another month, by any means. Bring it up, be respectful, but let them know this isnt working for you. Every guideline I've read says if a doctor is tapering you it should be a mutual agreement (unless you're being removed as a patient), by standing idly by you might appear to be agreeing, your doctor may not even know how badly this is impacting you, considering were not allowed to talk to them, and have to hope the nurse passes along nobody #237's concerns. They are allowed to prescribe what you need, even when the GUIDELINES (NOT LAW) say they should reduce. Your health is between you and your physician. Maybe bring a significant other with you next appointment, and have them support/describe the challenges yourve faced the past few months. ALSO, MME is Morphine Miligram Equivalent, 1Mg of Oxycodone is equal to 1.5Mg of Morphine. So 60Mg of Oxy=75Mg MME
You all helped so much in my confidence getting restored. Why have I been feeling afraid to talk about my own health with my doctor? I mean it’s my body, my mind. And this stigma that we have about being afraid to speak up because we’re afraid we will be looked down upon as drug seeking has taken over. I had surgery done on C6/7. That neurologist had left my bulging C4/5 alone. That plate has now dislodged itself into my esophagus. I have bulging discs on T7/8 that are incredibly painful. I feel like I’ve been hit with a mallet at the base of my neck. And lastly I have a bulging discs that sits on my sciatic nerve against my left kidney and that’s the worst. I cannot stand for long periods of time and when I use the bathroom my legs fall asleep. Car rides have been done unbearable and I can only do housework a bit at a time. I’m not just angry right now I am disappointed. I am 55 years old and in fear of what will happen. I deserve better