Workers' Compensation Discussion Forums

Still In Limbo, a great post.

I recently asked my doctor to monitor my liver since I am taking meds.
Liver problems run in the family and I have one sister that has had a transplant.

My doctor refused to monitor me, and just said I must be okay because the bloodwork done 6/08 showed everything was okay.

The doctor's statement worries me.

Bummer, and yet you still go to this Doctor?

I have had one blood test ran in the last year. It was done to make sure I was taking my Narcotics at the Pain Clinic. I have no idea if they were looking at anything else.

I get concerned about all the meds I take But then again they do help. I hurt with the meds; I hurt bigtime without them.

I feel for me to have any Quality life, Narcotics is not a choice. What is one to do?

Narcotics makes me tired, moody, constipated, lowers sex drive,but the relief out weighs this.

I will never accept the fact that PM is not for me. Do I believe PM is a money making machine? Yes, yes and again yes.

I used the Fentanyl Patch 25mcg/hr changed every 2 days; Lortab 10/500 5X a day as needed, Lyrica 150 mg 2x a day, and Ambien at night 5 mg.


I do worry about my Health. I also know I have chronic back pain that I have to live with all my life. No more surgeries period.

As long as the meds help, I feel it is my only course of action. I have tried the Facet nerve burnings with little relief. 6+ years of this is a long time but hopefully I will live many more years.

I could have easily died; I rolled a commercial van end over end 3 times going 55 mph. I am lucky considering also I fell asleep at the wheel, crossed lanes, got in the opposite ditch and hit a driveway concrete drain pipe and lived to see another day.

Merry Christmas.

Old Wives Tales busted dept:

To those who are concerned about organ toxicity of opiates, please be aware that there is none as long as you do not have liver disease form some other cause. Opiates are metabolized in the liver but even at extremely high overdose levels they have no ill effects on the liver cells themselves.

Liver toxicity may be caused by acetaminophen and other added agents to the opiates but a pure opiate is neutral to the liver and so blood tests are never needed as long as you do not have liver disease.

If you do have Fatty Liver Disease ( it's a real disease not just fat on the liver btw..) or hepatitis C etc or any other type of liver disease, the cells themselves will not be as able to metabolize and process the opiate leading to an higher blood level and therefore overdose potential than the same dose in a healthy individuals so the recommedations is the dose must be adjusted downwards.

Just ONE MORe reason to eliminate all NSAID and acetaminophen from the medication treatment of chronic pain patients.

Thanks for the Input Cycler, right after the Holidays, I'll Contact My PM Dr., and the Gastronomic Speialists, and Correct Them, and Tell Them They are Wrong!! And I guess I won't have to keep Working on Losing Weight, to Help with the Liver Count. Now I have been to the Dr.'s, had the Conversations, had the Tests Done, and had the Treatment Course for Me Mapped Out. I May have Mis-Heard Fat on vs. Fatty, but I'll be Damn** that I Missed Everything else, and I Surely felt the 14 Tubes of Blood Coming out of My Hand and Arm!! Opiates aren't the Only Meds. I take, there are Others and to Tell People not to Worry about the Liver and getting Blood Work is a Pretty Dangerous bit of Information for People that are putting the amounts of Meds. that some of Us are into Our Systems!! I'm Sorry, but I'd rather be Checked and be Sure, as per Doctors suggestions, instead of Waiting too Long and finding out the Hard Way!!! Also Please Note the Sentence that Stated that if My Body would start to Reject the Methadone (Opiate) and Other Meds. They could become Toxic by My Liver and Actually Poison Me Words Straight from the Doctor!!

Maybe I should of Listed All of My Meds. before Posting about My Original Blood Work Thread, All 13 of Them, but I Really didn't Think it Necessary when I was Only Speaking of Preventive Proactive Care of Ones Person via a Blood Test 3 or 4 Times a Year, just to be Sure All is Well. None of My Dr.'s felt it was not Necessary, and were Actually Glad that I wanted to be as Safe as Possible with these Dam* Pills I have to Throw down My Throat Daily, 21 Total Pills, and Testosterone Replacement Gel on My Shoulders!!!

I have a full round of blood tests every 3rd month...My Dr is also watching the liver as well as my thyroid that for some reason is acting up and my stomach as I only have a tiny tummy since I had a gastric bypass about 5 years or so ago....I dont ask why my Dr wants these tests so often....it is enough that he wants them and has been there for me all thru the WC hell...I trust him with my life

My primary doctor writes the scripts for all medications I take, I do not see a pain doctor.

After Christmas is over I will be visiting with my pharmacy to see if part D is of benefit to me. If not I will discontinue some of my meds because I can not afford them.

Go ahead Limbo, that should get you a strange look... get a picture on your phone for us !

They are not wrong at all and I understood that you are on many medications any of which can cause complications so monitoring is good medicine. I was speaking ONLY about single agent opiate use in general terms as there is an almost universal misunderstanding about narcotics and the liver.

I never comment on any one patients medical conditions or treatments as A) it's none of my business, B) What the hell do I know about it and, C) Everyone is different so may or may not fit the data.

What I am concerned with on my end, and what informs my forum postings ( when not exercising my dark side....) is population based data from the scientific literature on impairment, the industry built up around the medicalization of normal life experiences, and the changing public perception of cause and effect, Entitlements , Workers Comp and the Disability Industry.

Your understanding of what your Dr. said about methadone is probably a somewhat convoluted way of what I said about increased drug levels when there is a liver disease present but I can assure you, I can also prove it, that methadone is not directly toxic to the liver at doses that a human would consume and still be breathing. Your body will not "reject" methadone either.

http://www.ncbi.nlm.nih.gov/pubmed/3509697

http://lib.bioinfo.pl/meid:54330

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070708/

Methadone is not hepatotoxic in any meaningful way; however, the liver has a central role in methadone metabolism, clearance, and drug storage. Methadone can persist in the liver unchanged for up to 6 weeks, and methadone disposition can be significantly altered in patients with moderately severe but compensated cirrhosis.

( Fatty Liver Disease IS a disease however. Look it up. )

For those who can't see the distinction raised. I hate to see people making ill-informed choices or putting off very reasonable care suggestions because of reliance on old wives tales or serious misunderstandings of the facts. I assume anything I say that would provoke interest would lead one to investigate further by going to the sources or researching the matter further on one's own.

Always do only as your Dr. recommends and consider any advice or opinion gathered on the internet or elsewhere to be worth exactly what you paid for it.