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primary vrs physiatrist
#1
I was injured in 07, had 3 surgeries and went through pt and returned to work on full duty a year later.. Since then reinjured low back and have been off almost 2 years. I have had a slough of procedures, all were short lived.. Been on narcotics from vicodin to oxxy and now percocets, my physiatrist has been giving me hell about filling my scripts. He filled it yesterday but said he will no longer fill them, he is pushing me to accept and have the 2 level fussion on l4-l5, l5-s1. He knows I cant work and knows I dont want the surgery because of all the hardware I have allready..

My question is will a primary (family dr) in which he feels I will be on narcs for life, hurt my case.. ?

I have been to 2 different pain clinics, procedures only....Would they be better at directing my meds/changes as needed...?

What would be the pros and cons of this situation of kicking my physiatrist to the curb and letting my primary handle my meds..... Wc is no longer involved since last feb,.
 
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#2
Bronco you have to decide soon.My primary takes care of my meds he works with a pain clinic in Tulsa to keep me going as Tulsa is a 3 hr drive away....if your primary is willing as mine was go for it making sure he is able to do all the testing needed to keep on top of liver and kidney damage...I like it this way as he is in charge of my whole medical needs...
........I love cats, I just cant eat a whole one by myself......







 
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#3
Well today had appoinment with primary, and I popped the question.. I had asked him he he will take over my pain meds and further treatments.. We discussed the problems with my physiatrist, and he agreed with me that I do need pain meds. But also stated he no longer directs care for narcotics... Feels there is to much bull S--t that goes with it and doesnt have the time to do blood tests to see if people are taking them or abusing.. He sends his patients to the painclinic (been there) . He said he will make an exception for me since I have to have blood work all the time because of thyroid and mrsa.. He set up a follow up apt in 6 weeks, and if my injury dr doesnt write my scripts then he will take over and consult with the painclinic if needed...... He also stated he doesnt want me to have the fussion because if I can tollerate it with the amount of narcs I take I would be better off waiting for the pain to be untollerable..
 
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#4
you have a good Dr then
........I love cats, I just cant eat a whole one by myself......







 
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#5
Are you sure about the blood test thing ? To the best of my knowledge urine testing EMIT /GCMS is used to confirm opiate compliance in COATS programs and none that I am familiar with use blood tests. The reason being that the detectability window time line for blood is very short - a few hours max. So even if you had taken your prescribed pain meds the morning of you appointment you still risk a negative lab result and so in violation of your contract and discharged. Blood is very useful in determining impairment, especially for marijuana, while urine is not but urine is best for determining compliance while blood has significant limitations.
 
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#6
Nice to see you cycler, its been a while... I guess my dr told me that for a reason, I went in to get blood tests and he did a suprise urine test with it......lol. Sneaky litle devil, every thing was ok but he has still not confirmed weather or not he will take over everything.. I have an appoinment with my physiatrist next week and 2 days later with my primary incase the physiatrist dont refill my pain meds....

Just out of being curious, on a urine tests how long does the narcotics stay in your system before they show a negative......?
 
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#7
I am doing my best to stay off of pain meds other than a Loratab when needed. But this cold weather is not agreeing with me and the nerve pain is increasing.

Guess my main worry is the increase in blood pressure due to the increased pain.

My normal BP is 90/70 but it has been recently 145/110 and higher.

Bronco, Cycler or Jayne is there a point I need to draw the line, give in and take the meds due to the long term effects of the high blood pressure?

Good thread Bronco!
 
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#8
I have always had high blood presure and after my injury the pain made my blood presure shoot through the roof. My normal while being medicated is 138/80, when I go see my dr and have to walk and by the time Im in his office the pain level shoots up to 8 and the blood presure climbs as well 165/105 some times more and sometimes less. Its really a choice that you have to make, Some of my meds alone increase my bp. I dont like taking my pain meds but without them I would probably stroke.
 
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#9
Thanks Bronco, I did not realize some meds could increase BP.

My doctor's nurse dosen't check my BP, sometimes the doctor will depending on my symptoms.

THis summer it was thought I had a light stroke, fortunatly not!
 
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#10
I had to stop my celebrex, even after cutting down to 1 a day kept my bp up... I know i have a few other meds that do it to, but cant think right now.
 
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