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How to answer the doctors when they catch you on a good day?

Aug 05, 2015 12:14 PM

I have an appointment the day after. My meds was modified slightly and I'm feeling a lot better than I was last two weeks flaring.

I'm going to get asked how are my meds for now......and how I've been coping lately.

I was doing good about 3 appointments ago, so about 3 weeks ago. I told her I was feeling great and my pain was very manageable. That same day after I honestly told her how I had felt, she changed my dosage on a need to need basis and refused to refill script even after I told her I'm doing a lot worse because I can't control the pain on a need to need basis. Some of you might understand that some pain killers are used as controlled, but once you flare up, it's too late to take the medication as it will not give you any relief when flaring. So after flaring the last two horrible weeks, she added some muscle relaxants in my meds which really had stopped me flaring and my muscle spasms seems controlled.

So in saying that, I've finally gotten out of my flare up and feeling more functional, I'm not sure how to put it to my GP that this is just nice. All meds are at the lowest dose and when flaring, I will only take the muscle relaxants. I didn't really like the feeling of being spaced out anyways. I run a business so I need to keep sharp most of the time.

At the moment, after weeks of muscle spasms, I do need the relaxants to give me the chance to stretch out my over tightened muscles. I'm giving myself about two weeks so I will take it once a day before my stretches. I'm just not sure what or how I can put it to my doctor that I'm fine. I don't want anything to change at this point. I don't want to lie about what I am going through because I'm not an addict, I've always been genuine and I want to keep it that way. Change is bad for me now as I have a lot on my plate in terms of work. I can't afford one day working and two days recovering. I need to be constant, I hope you all can give me some sort of non-manipulating advice on how I can be genuine and still make it a win situation for me.

Many thanks for hearing me out, have always appreciated the comfort you guys/gals have shown me.

Aug 05, 2015 1:58 PM

Octobot, be as honest as you feel comfortable being without lying, but don't ever say you're "great." Doctors misinterpret that as "cured of pain." Think of it as just alleviating some facts. Unless they ask point blank questions you aren't obligated to give details. But if details are needed to help them understand then do so. 🙏🌼

Aug 05, 2015 2:30 PM

I hate to say this, but there are times when you could try lying. I'm a teen, so I get to lie to everyone in a daily basis, except when they find me sobbing in the hallway. Few people believe me when I tell them (honestly) how I feel. I always need a chance to get to know a doc before trusting them. It's partially due to the PTSD from the clinic my insurance forces me to go to.

I'm perfectly willing not to tell them how I feel, because only a week later I don't feel confident about noticing side effects or long term uses. I also read the side effects, and many drugs I've been prescribed say not to take with a weak immune system, or as a kid, or as someone with my diagnoses.

Flappy has a good point about how doctors choose to interpret your words. I told one doc I was feeling better, and wanted to continue the dose and she immediately decided I was a drug seeker, and (my dad and I got an ironic laugh out of this) told me I would be in antidepressants because they're not "addictive". I'm thinking she has not read anything about those drugs.

I like my (local) neurologist, he doesn't suck like my primaries. He's been compassionate and willing to research things before saying no. He wasn't familiar with LDN, but other than that he's very friendly. I usually only go to the doctor in good days, and I usually just say "okay" and shrug when they ask me how I am.

Aug 05, 2015 4:01 PM

Thanks for the advice flappy and ferret. Like you, when asked by any random people, I'll say I'm great, even after I was full of pain in bed sobbing.

I never thought about the doctors misinterpreting till flappy brought it up. But after four years of complaining and so many frequent visits to my GP, how could they even think it's a cure. I'm always genuine in expressing my feelings to the GP but never shown any aggression to them. They are the ones with the brains but them being so judgemental, I let them dictate me all the time. I'm quite well known in my small community, so I always have to act a lot older than I am all the time.

I can't afford to lose pride and respect as it will affect our family business. I only can rant here and to my wife when I'm down. It's really tough. I've written formal letter to the head doctor here, but obviously no action was taken. I've organised a partition before, had about 400+ signature out of 2000 local members about asking our local minister here to take action on her, obviously nothing was ever done.

Now I'm blabbering about rubbish forgive me. Anyways, still contemplating whether to be vague as in I did better than before but unsure of how I am reacting to the meds as its much too short of a period to justify. This might mean that she will want another weekly review!! Yet another visit. Sigh.

I need to somehow stop all this weekly visits. So sick of it.

Aug 05, 2015 4:04 PM

The head doctor was the one sending people home with no help. It wasn't just happening to me, it was happening to many locals. Because we don't have specialists here, we can get funded to fly to the mainland for such nerds. She denied many people seeing specialists even me. Last trip cost me $10,000 for flights and accommodation. I was desperate and she was sending me home telling me to use my tens unit and drink plenty of fluid. Sigh...I miss good doctors ..

Aug 05, 2015 4:07 PM

Sorry about the constant posting, there's one thing I want to add. If I say I'm not feeling better, they might increase the dosage which I really don't want or need. Worst is they might change my meds altogether.

Aug 05, 2015 4:28 PM

Octobot, you could say, in all honesty, that the meds are helping you remain active right now and that is a good thing. You could also say that a change may send you back into a flare, which means you become inactive. Maybe the GP will understand what you mean and allow you to have your meds on repeat without continuously fiddling and judging. Worth a try?
If the GP tries to suggest any alterations, question it. Why do they want a change. If what benefit will it be, or be forthright and calmly say no, right now the medication is keeping the pain (and anything else) under reasonably good control and to change anything may start another cycle of problems.
It might also be of benefit to take a witness with you so anything said can be verified by your supporter. Sometimes it is enough to give the GP pause before attempting to run roughshod over our treatments! You can also arm yourself with information to back you up if need be. But only use medical articles or peer reviewed work etc. Medics will ignore or show utter contempt for layman writing (such as a newspaper, magazine or websites like ours, no matter how in depth something is).
Sending you a truck load of luck for your next visit. Do hope the GP sees reason for your sake.

Aug 06, 2015 3:52 AM

I know where you are coming from PJB and thanks for your advice. I manage more than 20 staff at work and prior to that I had managed over 50 staffs. Every time I visit my GP I feel so small letting them dictate me which I hate. I can't seem to find the courage to say or do what I want because if I do point out corrections, I'm afraid of being labeled an addict. Worse is they have full control of what I have and maybe that's why I'm so passive.

Aug 07, 2015 2:59 PM

Had my appointment today. Didn't tell her I felt great even when I was feeling so. When asked how I was feeling, I told her I felt more tolerable to pain but was too early to tell as the added relaxants I was given 2 days worth. I've taken the advice of PJB, walking in looking like crap. She didn't ask me too much after that. We talked about organising the new MRI that needs to be sorted with my specialist. End of that she asked me what meds I didn't have enough off, wrote me my scripts and was good to go.

It had never been that easy to refill my script. Advice from this community surely helped. Anyways, as with my other thread about the frequency meeting their doctors, my doc wants to see me again next Friday as my meds should last till then. Again!!! Non stop weekly visits is driving me super nuts!! I'm so tired of it and what do I need to do to bloody just get repeats of my scripts!!?!? Frustrated with this matter definitely. Yet too afraid to give her a piece of my mind,..sigh

Aug 07, 2015 7:36 PM

I get all my scripts from ONE doctor (pain management). I had to re-sign a new contract because the original one I signed 20 years ago was no longer valid. Basically, the contract states that my medications will be gotten ONLY from that office and no other. Even if I went to the emergency room for an injury and they wrote me a script, I am not allowed to accept it. The other thing is that I go in to see her every month. I get a 30 day supply of each of my medications and I go every month to get them refilled. When I am there, I undergo range of motion tests, lengthy questions of my pain levels, locations and changes. urine tests so they know that my blood levels show that I am taking only my medications and that the proper amount is in my system when they run the test. I am also only allowed to use ONE pharmacy to fill my scripts and had to sign a contract with them as well saying that I will not use another pharmacy or I will be reported and my medications would not be given to me and that I would be dismissed from pain management. Also that NO prescription will be filled early under ANY circumstances at all. These measures are put into place to prevent doctor shopping and filling scripts at multiple pharmacies so that medications can be stockpiled and/or sold or the patient is getting more drugs and taking more than they are supposed to. It is all government red tape but it also is in place to try to keep prescription drugs off the streets and to prevent patients from either selling or overusing them. Ask your doctor if you can make a monthly appointment to come in and be assessed and have your prescriptions refilled. I can't imagine them saying no. The other thing is that if you go only once a month, then you are saving money on co-pays, which as you know, become very expensive. Especially with many that are on disability and cannot work and those who can't work and have been denied disability. I wish you good luck and I hope it all works out for you.

Aug 07, 2015 11:44 PM

You know it makes u wonder how much it cost us taxpayers to have all this extra crap we chronic pain people have to do to get medicine. I know there is a prescription epidemic in the world right now but the things we have to go through is crazy! I can't get over the fact that we r all in some kind of pain and just need some relief but the government doesn't care let's make them go through 20 test then make them come to the Dr every month! Like we have the energy or the pain isn't bad enough but we have so any rules to go by. It is very much bullshit!!!

Aug 08, 2015 6:13 AM

Wow!! I don't mind signing such contracts with my doctors if I have to. Although they are strict, it's better than me going to the doctors every week to beg for medication. Alwayz, I know that you are in a bad situation but your med list is pretty potent compared to many of us.

Is there another way any of you would recommend to gain more trust from the doctors? I just don't have the courage to ask the doctor for anything at all due to the power they have ove me and also due to the fact that I'm from a little island and there's no other doctors whom I think is better.

Aug 10, 2015 10:39 PM

Be honest with yourself and with others. Clear, concisive language at all times with detailed notes. Do not walk in "looking like crap" for empathy. Get dressed as you normally would, or can. Write down your symptoms, your detailed questions, and what you expect from your physician-goals if you will. Tell your doc How many flare ups you experience in a day or a week, what you do to treat/manage, the meds used, and the script isn't adequate enough for your pain level. If there are alternatives, let you know-a larger script (convenience is key), a combo of anti inflammatory/neurologics perhaps, or series of injections, if you're a candidate for a pain pump, etc. Do your research before you go to an appt. Opioids are important in managing pain, but lying makes patients look like drug seekers. I'm not calling anyone here one that at all. I'm stating be honest. Your medical record depends on it. What works, what diesnt work, your diagnoses, your health timeline, if and when you apply for disability, etc. If you are having that much communication issues with a physician, seek a second opinion.

Aug 10, 2015 11:13 PM

Octobot, you're right, my med list is quite a bit more potent than most of what I see here. I have never asked my pain doctor for any specific meds, we worked on different strengths and combinations based on my pain levels and functionality. It has been over 20 years with the same doctor and he has had to change, lower and adjust my meds several times. I have never asked for an increase in my dosages and when he cut things down, I never complained but let him know the following month if my pain levels were the same or became worse. There have been meds he cut down and when I said pain was worse, there was no increase, I deal with what I have. Even on all of that medication it JUST makes me able to get out of bed and function. Sometimes I've read the amount of meds doctors give folks on here and it wouldn't even allow me to get up and move around. I hope you get the help you need. My doctors have never been given a reason to mistrust me (one time he gave me an extra week of meds because he was going to be away, the next month, he copied over the last month's script and I handed it back and told him that he gave me too many. He looked at me puzzled and said most patients wouldn't have said anything, they would have taken it. I said, I don't work that way). At any rate, some people require more meds than others, it all depends on your situation. I hope your doctor becomes less reluctant to help you and gives you what you need.

Aug 11, 2015 6:41 AM

I agree honesty is best. But overdressing or overstating (under dressing/understating) can bite you. As if talking to a friend, parent or sibling, just be yourself.

Aug 11, 2015 9:48 AM

I find it distressing that to get proper treatment we have to watch our words. I had severe breakthrough pain overcpast 48hrs and try to be as truthful as possible but this means I can have breakthrough pain so bad in one day that nothing works and then other days that I am fine. I have a pain clinic in two weeks time and as this is a dr I have never seen before and have to drive 5hrs to get there I am worried that they will think I am exaggerating

Aug 11, 2015 11:28 AM

Talamasca, I've found that by taking my hubby with me, he gives his own descriptives of my various days, and the docs seem to appreciate and both of our input. When you go, can you take anyone who can describe what they've witnessed? 🙏🌼

Aug 11, 2015 11:47 AM

Talamasca, Flappsy is right. Try to bring someone with you who can go in with you and verify they have seen the drastic ways that your breakthrough pain can be. Tell him/her flat that sometimes it's so bad that no meds help and other times it makes the pain bearable. Just be calm and listen to what the doctor asks you and answer truthfully. After driving 5 hours to get there, I don't think it will be difficult to see you're in pain. Bring any pertinent medical records with you from other doctors that have treated your pain so they have some guidelines as to exactly what your treatment has been. I wish you the very best of luck and hope that this doctor is able to give you the relief that you are in need of. 🙏🏻🌻

Aug 11, 2015 12:27 PM

Poeta: I agree with what you've said. I'll be myself this Friday. She trusts me I think, if not I wouldn't be given these meds weekly and always hoped I had better management. But watching what I have to say (like talam described), isn't that close to lying already? I'm worried about being misinterpreted because that has happened one too many times before.

Alwayz: I never gotten any extra scripts or had any chance to show my honesty as there's one pharmacy, one hospital only here. Outside of work, they see me managing my staffs, they see me in public relations with other business people, but during those times, even in pain, I don't look it. You can't look like crap talking to your customers. So when bumping into my doctors, they see me smiling and would probably think I'm faking it when I visit. That's just my impression. During my flares, they don't see me at work maybe they understand. Sigh...

I can almost guarantee that I will get no repeats for my scripts but to go back for another review with a chance that it may be fortnightly now. Frustrated and lost with words. I just want to stay away from the hospital. Going there each week, I know all the staffs and nurses already and they have probably judged me already..... People like us are always being judged. The comment "but you don't look sick" is just so hurtful.

Aug 11, 2015 1:30 PM

I agree with Alwayz and Flappsy the best thing to do is take a family member or friend with you. They can tell the Dr what they have seen when you are in pain looks like. Just try and communicate to the Dr what you go thru. How bad your pain levels are and if your meds are working. Good luck

Aug 11, 2015 1:37 PM

Thanks weezie. My wife would go with me sometimes. But weekly visits were just boring her so much as it's always the same questions about meds and what I've been doing. I'm not sure the aim of the weekly visits. Meds control seems to be the most likely cause. There are several young adults in this community whom do abuse the system even in this tiny island. I think others in the community have really ruined it for me. Recreational drugs are hard to come by when you are on an isolated island, so they fake injuries and all sorts of excuse to get some prescription drugs. It has been a growing problem in the community.

Aug 11, 2015 1:54 PM

Octobot it is the same for us in the USA I have to see my Dr once a month I have to take all of my medications to each visit. The druggies have ruined it for us as well. It's a pain in the neck , I get so tired of going all the time. Wishing the best for you.

Aug 11, 2015 1:56 PM

My advice, which may have been given is just be honest. Tell her that you can't control when it happens but that you need something on standby for when it does and that you don't want or don't have the ability to call her in the middle of the night when the pain is unbearable. People who take muscle relaxers are not often thought of as addicts since they are not opiods. Opiods control how you feel about pain where muscle relaxers acually relax the muscles. I think if she is a decent doctor, she should understand that you can't control when it happens to you. Best wishes to you.

Aug 11, 2015 2:37 PM

Octobot, I have been on the other end of that sentence many, many times. What's really funny is that usually when I feel my utter worst, haven't slept or gotten much rest is the time when they're telling me that I look great and must be having a good day. I have already walked in, looked in the mirror and was horrified by the person who was looking back at me... It's those days I smile and say, "Thanks, I really wish that when I come here like this that I felt as well as I look!!

Aug 11, 2015 2:41 PM

A couple of problems with the ideas guys. 12 months ago I lost all my medical records in the fire that destroyed my house. I live in a small town as you might well have guessed by the 5hrs to get to pain clinic, and my only witness that I can take with me has had 3 spinal fusions, 2 knee ops and 3 ankle and is actually on a higher does of pain meds himself which means my GP pretty much assumes that he is just trying to get extra meds himself, or at least thats what I think he probably thinks. I saw dr today having just filled my weekly script, was in so much pain I was vomiting. I don't know what to do anymore, I'm reaching 48hrs with no relief, our local hospital is useless, ie they would just give paracetamol if I went in now and its 5am. Is it so unreasonable to not want to be in pain. I haven't slept in 48hrs which is just making it worse. It feels hopeless, I even being through 2 tubes dencorub and jar of tiger balm, hot baths, packs etc, before the fire I did have a acupuncture tens machine but on a veterans pension can't afford to replace it while I am trying to rebuild.......any suggestions? Currently on hydromorphone (4mg x 2 daily) 2 valium daily and panadiene forte for the breakthrough pain, which tears my guts to shreds so also taking anti ulcer meds. Was previously on ordiene which had the pain perfectly under control but no dr in my state will prescribe it unless cancer patient, and mull illegal here and doesn't help anyway.

Aug 11, 2015 2:49 PM

Talamasca I take Hydrocodn / Acetaminophen 325 / 7.5 every 6 hrs as needed for pain, Fentanyl Patches 50 mg change x 3 days, Savella 50 mg 2x day, Gabapentin 800 mg 4 x day. These help some my pain level lately has been 7 - 8. Today though my pain level is a 8 - 9.

Aug 11, 2015 2:54 PM

Was previously at one point on fentanyl patches 75mg, bur they were peeling prior to the 3 days and it is another one that I have been told that unless I was a cancer patient and even then would be reluctant. Is anyone being treated with conefish venom? Its meant to be highly effective and non addictive but no one will prescribe it here due to lack of research so they say?

Aug 11, 2015 2:57 PM

Just be honest, you'll never get cought in a lie if you don't tell one. I'm very honest with my pain doctor and his staff. They have not changed my meds at all exception is if I'm having the RFA shots done then he will prescribe 10 extra pills on that month because he knows the pain will be worse for at least a week before it calms down some.

Aug 11, 2015 2:58 PM

What are RFA shots? Is that like a nerve block?

Aug 11, 2015 3:06 PM

Yes, its Radio Frequency Ablation. They go in your back with several needles on side of your back and make leasions in your back bone somewhere and sends radio frequency pulse to kill the pain receptor to your brain they do one side and 2 weeks later they do the other side. They last anywhere between 1-12 months but with my back problems they do it every 6 months it usually wears off at the 4 month mark for me but it gives me 4 months of relief of sever pain. Still get dull but it's a start and relief!

Aug 11, 2015 3:12 PM

I looked at it a while ago but when I mentioned it here I got heaps of warnings against it, the radiology dept at my old dr surgery had just artarted doing it, claiming up to 3 years relief, can I ask what your injuries are? Extremely scared of doing something that will make it worse.

Aug 11, 2015 3:14 PM

Suns coming up. Sigh.

Aug 11, 2015 3:20 PM

I have a couple herniated and or bulging dic's and I also have sciatic nerve that stays pinched. I also have chronic migraines and IBS, still trying to figure out what the deal is with the burning in my left shoulder and left foot sometimes my right foot. Got to find a new primary doctor now since mine moved out of state.

Aug 11, 2015 3:25 PM

I have burning in left shoulder and knee. A break at c5 so they think nerve pain across shoulder though my partner thinks stuffed rotar cuff, also have torn common peroneal nerve which causes the knee problems. Have you tried lyrica?

Aug 11, 2015 3:31 PM

No, just started having the foot problem a couple months ago and the shoulder started burning a couple days before I fell. I had pain go down the leg with burning and a couple of people brought up it could be because of my sciatica. Now I have the burning shoulder pain that came on before my fall so I have been combing through the insurance book again looking for a GP so we can't try and figure this out.

Aug 11, 2015 3:32 PM

*can stupid auto correct

Aug 11, 2015 3:43 PM

Good luck, I know how frustrating that can be. I was having seizures for a while because of how bad the pain was and ironically that caused nerve pain in a few areas that I hadn't been suffering pain before, so bad that clothing rubbing on it felt like scratching bad sunburn, recommended lyrica as worth a try, especially if it feels like a constant itch but then when you scratch it burns.

Aug 11, 2015 3:54 PM

Yeah, that's what it feels like at times and other times a deep throbbing burring pain. Today is one of those days I wish my floor was made up of clouds so it didn't hurt to walk on them. I just pray that the school orientation/ meet the teacher day is short and my daughters classroom is not a long walk so I can get in and out! The killer is those stair's! You have to walk up like 2 long flights of stairs justvto get into the school lol! You'll get your exercise that's for sure!

Aug 11, 2015 8:01 PM

Mopar, quick question. With your sciatica, does yours go down the entire length of your leg? I'm just curious because ortho said to me the last time that because mine only went down above the knee, that it wasn't sciatica. Go figure!

Aug 11, 2015 8:05 PM

Sometimes it Doe's, and other times it goes to mid calf.

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