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Forced Taper Question

I’m a by the book type cp patient. Moved 1 1/2 years ago, totally disabled for 6 years, but for the last 2 have been better due to proper med dosage. Was thinking about trying to work part time. My current ‘pain specialist’ who signed my prescriptions for the past 15 months, but never met me, comes into the exam room and immediately said “you’re taking too much medicine, you’ll to have to find another doctor.” I said I don’t know any other pain doctors. So then he suggested cutting my MS Contin from 2x day to 1x. I was kind of panicked so I said ok. Got home and realized he cut it 40% MME.  Isn’t that too fast? Is he not following some kind of guideline? 

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Comments

  • memerainboltmemerainbolt IndianaPosts: 4,122

    Welcome liz532 to the Veritas Health Forum.

    I'm so sorry you are having to deal with this. But, if it were me, I would call my PM doctor back and ask that very question to him. Every PM doctor have different ways of tapering.

    While you’re waiting for a reply to your first post, please take a few moments to review the Code of Conduct and FAQ section, located under Forum Tools. There you will find important information about posting in the forum and helpful tips for new members.

    You’ll find a number of informative resources in the Pain Management Health Center on Spine-health, including doctor-authored articles about Cold Laser TherapyElectrotherapyNerve Blocks, and Spinal Cord Stimulation (SCS). I hope you find these resources helpful.

    Again, welcome to the Veritas Health Forum.
    Sandra
    Veritas Health Forum Moderator

  • I live in Indianapolis Indiana. I moved here a year ago from Georgia. Started with a large pain practice here, and they will only give me HALF of the meds that worked for me in Georgia. I got so frustrated that I have stopped going and now I just deal with the pain daily. I have been seeing a neurosurgeon in hopes that I can be fixed and no longer need pain management. Tired of the system, and tired of hurting. However. I am not tired of paying all that $$$ to a pain management practice that is NOT controlling my pain. Soooooo.... Right now.... I am hurting, but I am money ahead. LOL!!! Doctors should listen to the needs of their patients, and NOT the Governmental suggestions about daily MME. 

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  • memerainboltmemerainbolt IndianaPosts: 4,122

    Chris

    I am so sorry to hear that. I was hoping you were getting somewhere.

    Sandra

  • ChanrightCChanright Posts: 115
    edited 02/06/2020 - 10:28 AM

    I try hard Sandra. But it would seem that OTHER people.... Such as the PM I have now, know more about how I feel than I DO!!! I am out of patience with all of this. It is never ending. Sorry to vent. But I am just so frustrated. Pain management in Indiana is a joke. A money draining joke.

    Chris

  • Liz did your doctor discuss a taper to a 40% reduction, ie over a period of time?  That is a drastic drop but the long acting seem like the first to go. Do you do a short acting as well?

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  • memerainbolt That’s a good idea. I’m only a few days on the reduced dosage and not adjusting well. I’m also going to ask for my records, so I can make an appointment with another provider.
    I used this forum a few years ago when it was Spine health, but will read the posts you mention, to be sure I know the guidelines and rules. Thank you!
  • Joel1Q Thanks for asking. No, he didn’t discuss anything. It happened almost exactly like I wrote above. The very first thing he said was that I was going have to find another Dr. (Which I am doing) When I told him I didn’t know of another pain dr, he said I would have to take 1 extend release (xr) instead of 2.
    When I started going there the PA continued the same meds I was taking at that time: 2xr (low dose) and 4 short release (sr). That worked really well, but after a few months, she said she had to reduce the number of pills, (DEA?, Med Board) so she increased the xr, and reduced sr to 2 per day. It was an increase of 10 MME. That was working so well. Now it’s 1 long acting and 2 short release. 40% reduction in one day.
  • Chanright I’ve been fortunate over the past 2-3 years, but kind of figured it wouldn’t last. I’m sorry you’re suffering and understand your frustration. What surgery are you considering? I hope you have better results than I did. I resorted to a double ACDF 3 years ago (after a single level years ago) because I was under-treated with meds. Dr. said it might help reduce pain 60%, but it only helped maybe 20% and now choke a lot. Makes me mad BC I wouldn’t have done it if I had been treated properly with meds. Are you doing anything that helps? Have you heard of Kratom? This situation just gets worse and worse. Still, I try to be grateful that I get some treatment and don’t live in countries that have no pain meds. Hope you get some relief!
  • After I find a new Dr I’m thinking of writing the medical board. I wonder if we all did that, would it make a difference?
  • Thanks Liz. I am looking at a revision surgery for my prior 4 level lumbar fusion. They only instrumented me on one side of my spine, so that is what the doctors think is my problem. I go see the neurosurgeon on the 20th of this month to go over the results of my recent myleogram. I pray that he has good news. I have tried Kratom in the past and all it did for me was give me horrible stomach cramps and diarrhea. Plus it makes me nervous that I could not really find any dosing recommendations. I am doing nothing to control my pain for now. Need a break from all the pain management stuff for now. It stresses me out and drains my wallett. Tired of all the medical expenses. My PM Doctor doesn't seem to care if I am comfortable or not, so I am not concerned about stuffing his wallett with my hard earned money. I will keep everyone posted. Thanks Liz.

    Chris

  • memerainboltmemerainbolt IndianaPosts: 4,122

    Chris

    I had no idea you are considering revision surgery, I am so sorry to hear that. And, your pain is not being controlled, except by you? 
    Please let me know what the surgeon says.

    Sandra

  • ChanrightCChanright Posts: 115
    edited 02/11/2020 - 12:17 PM

    I feel like I have been jerked around by my PM. Being talked into all kinds of spinal injections and also a pain pump Sandra. I had an injection in January, and my PM was on vacation. There was a substitute doctor there to give me my shot, and when she got me under the fluoroscope she said what is this? (referring to my one sided instrumentation). She said this may be the problem as it is causing my spine to bend. Almost like scoliosis. She immediately got me a referral to a neurosurgeon to investigate. I am getting to where I just don't trust my PM any longer. I believe he would have just kept draining my bank account. Seems very similar to the old Frank Zappa song "Trust Your Mechanic". I will certainly keep you posted Sandra. I may need some of your Angelic voice of reason thru this. You never steer me wrong. And yes. I was so mad at my PM that I called them and told them I would not be back due to their lack of functional treatment. I have been in Indiana since last February, and the whole PM thing has been a nightmare. Pain management here in Indy is everything BUT PAIN MANAGEMENT.

    Chris

  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 289
    edited 02/12/2020 - 11:47 AM

    It seems like this is a problem nationwide. A few years ago I was attending a pain clinic that I'd used for several years. Never had any issues but I was in more pain than usual and wanted an increase in pain meds. After I told the PA that, he replied I'm sorry but the doctor said I have to cut your pain medicine in half because you've been on pain medicine too long. I asked the PA why wasn't the doctor talking to me about my dose as I understood patients were supposed to be involved in their medical care in the 21st century. The only answer the PA had was "I don't know!" Unbelievable! I obtained a pain management doctor referral from my family doctor - probably one of the best things I've done for myself. IMHO, people that have not lived with chronic pain typically don't have a clue about what it takes for us to exist (not live, just exist). Good luck with finding a good PM doctor. Jerome

  • Thanks Jerome.... I will keep you guys informed as i progress thru this mountain of crap... LOL!

    Chris

  • memerainboltmemerainbolt IndianaPosts: 4,122

    Chris

    You have done a great job on your own, being your own advocate for your health and standing up for what you know is right. I highly admire you for that, knowing what kind of pain you are in. You know you have support here, we will do all we can for you.

    Please take care. Sending you some cajun dust ************, spread it around the next doctor you go to. Tell him if he doesn't have the answers you need, that dust can be bad juju!!! LOL.

    Sandra

  • Sitting here chuckling to myself about the Cajun Dust Sandra!!! Haaaa ha haaa!!! Thank you for hanging in there with me. I have been off all pain meds for a little over a month now. I am hurting very bad, but I am making it one day at a time. I am very hard headed. Once I feel I am being taken advantage of. Hopefully this whole exersize in futility works itself out in the end. But man.... What a process. Thank you for being my friend Sandra. I appreciate you, and all the other people on here. 

    Chris

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