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May get kicked out of PM and scared

On my last visit a couple of months ago PM told me that I had tested positive for morphine. I had just gotten out of the hospital which is where I received the morphine. They gave me a perscription for two weeks (it is usually a month) and got my signature to get my hospital records, and then drug tested me again. No big deal but a bit of a hassle but I get it. Right at the time of the hospital I was taken to the hospital by ambulance because suddenly I couldn’t walk anymore and was having the worst pain of my life in my hip. I was admitted to the hospital and tons of tests were run. It was found that I had bacteremia (infection in my blood), infection in the lining of my heart, septic emboli in my lungs, and the pain causer was infection settled in my SI joint in my hip. I was in that hospital for two weeks. On IV antibiotics for 6 weeks. PM came to see me in the hospital. Pain meds and transferred to a new hospital for rehabilitation of my hip and I’ve been here for two weeks. I’m being discharged on Friday. I set up a telehealth appt with my PM for Monday morning. I was already afraid that my PM was not going to go with my pain med changes that the 2nd hospital dr made. I was on oxy 5 twice a day from PM. Been there a little over a year. New pain meds are morphine slow release and oxy 10 every 4 hours. But I checked my labs from my appt a month and a half ago online and the morphine was gone as I knew it would be.  But my oxy wasn’t showing up at all and I had taken the last dose the day before and my lyrica was showing up as it should but it was showing high. The only reason I can think that might be is that the day before I had missed a dose so I took two doses at my night dose. The Lyrica isn’t prescribed by the PM. Now I’m worried I’m going to get dismissed but my PM on Monday. My dr here at the hospital is going to prescribe a bridging dose of my meds here at the hospital. So I’ll have a few days of what I’m taking here. I’m scared that not only will they not perscribe me what I’m taking now and I’ll have withdrawal and crazy pain but also I may be kicked out and have withdrawal and crazier p



  • Don’t put the cart before the horse. What you’re fearing hasn’t even happened. Many opioids (metabolites) remain in your urine for 4-5 days. Therefore it’s odd your script wasn’t showing up. Paging @sandi123 in case she has any thoughts there.

  • Welcome jenniren1976 we’re glad you’re here!

    I would talk to the PM doctor at the hospital and ask if he/she would be willing to talk with your regular PM to explain everything, I would also keep any and all documentation that you could show your regular PM doctor.

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  • Hi Jenn,

     I’m sorry for all you have gone through the last month or so. It seems the concerns about the initial morphine may be resolved, and given the more recent health issues and in patient treatment- before you are discharged, sign a HIPPA WAIVER to provide all records to your regular PM doc BEFORE you are discharged. Then contact your PM, advise him you signed the waiver so he can review the records before your tele-appt on Monday. 

    The two concerns I do see is the Lyrica and Oxycodone. Where are you getting that? Who is giving it to you and do you have a valid CURRENT prescription for it for the time you were taking it? It is NEVER advisable to double a dose of ANY medication unless your dr specifically tells you to. If there is no valid prescription for the Lyrica, you could feasibly see yourself being dismissed for self medicating. Even if you have a valid prescription, the high levels are a concern, along with you not informing your PM of the prescription before taking it. He may or may not choose to dismiss or warn you. 

    If you were taking the Oxycodone as prescribed there should have been metabolites present in the results, even if they were low. 

    Sorry to be a bearer of cautionary news, but in this world of PM, we have to follow the rules and guidelines strictly or risk loosing access to those meds. Doctors aren’t usually too forgiving when it comes to non compliance. 

    Your current PM may not continue to dosing or meds you were on while hospitalized. He would assume if you are well enough to be discharged, the same levels of meds provided in patient aren’t necessary in the same amounts. He may opt to put you back on the previous meds he had you or or reduce the doses/frequency of the current meds if he does continue them. Having the inpatient PM call your outside PM could help , but ultimately, the decision about your ongoing treatment once discharged is in your regular PM’s hands. 

    Good luck, hope it all works out. 

  • My Lyrica is prescribed by my primary and the PM knows about it. They wanted to prescribe gabapentin in the beginning but when they found out I was on Lyrica they PM said I could stay on the Lyrica prescribed by the primary. So they already knew about it and approved. I sincerely don’t know why the oxy didn’t show up in my system. That time is so blurry because I was pretty sick and didn’t know it yet so I don’t know if I missed taking it the day before or what could have happened.  It’s only ever happened before one time but that was because my appointment was two days after I ran out. Everything has been so crazy the last couple of months. I guess I shouldn’t have doubled up the Lyrica that one day but since I’d missed a dose I thought it would be fine. Stupid mistake. Having my inpatient PM talk to the current PM may work. They knew I was still in pain when they discharged me but the pain wasn’t the goal. The goal was the ability to walk and the major levels of infection in my blood. They even discharged me on an IV so they taught my husband yesterday how to give the IV and he will be giving it to me three times a day for at the very least 3-4 more weeks. The PM at the inpatient did give me his card  and told me to call if I had any issues. If they have to reduce my dose I’m okay with it I’m just worried about having withdrawals. I am just really worried that this one time issue with my levels is going to get me dismissed.  Maybe I’m worried for nothing. 

  • I did call the PM and let them know about the change in meds and what to do and the person that I spoke to said I’d have to discuss that during the tele appt. 

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  • Jenn, 

    Hopefully, everything will work out with your current PM. Since your primary prescribed the Lyrica and the PM is aware, that elimates the concern about using it and your PM not approving it. It does still leave how he may react to a high level if it’s in the latest result. If he asks, simply tell him the truth. The truth is always the best policy when it comes to dealing with PM. Even if they don’t like the answer, there is a benefit to him knowing you are going to be honest, no matter what. 

    If the current meds are managing your pain levels more effectively right now, you should tell him that and hopefully he will consider that when you talk to him. 

    Best wishes

  • My visit went well. They didn’t even mention my previous levels. We focused on what to do with my new pain med regimen. There was a lot of discussion and they got a different doctor to consult and decided to keep pretty much what the hospital PM prescribed except that they changed my Percocet to every 6 hours. They will definitely be doing an aggressive wean down going forward.  

  • Jenn, Good news about your television! Glad things worked out for you. 

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