LIVID after a routine appointment to my new (NOW OLD!) PCP!!!!!! WARNING--LONG

Yesterday was a very, very bad day for me.  I am (obviously) still very upset about what happened at my new PCP's office so here goes.  YOU'VE BEEN WARNED!  LOL!

I moved to Nantucket in mid-October of this year with my fiance and our 3 kitties for 2 full-time jobs that we got through my fiance's company.  We scrambled to find housing here in the off-season (very limited) and went through 3 prospective landlords, being turned down by the first two.  Our current housing situation was ending at the end of October and we had the two jobs waiting for us that we had been training for during the month of September.  After finally securing housing, we moved here and began our new life on Nantucket.

As many of you know, I suffer from a chronic back/hip problem that includes sciatica down my right leg.  Since May of last year, I have been in treatment for this and had all the necessary tests.  I have been taking Tramadol since May and a lot of it (2 pills, 3x a day) that my last PCP prescribed for me (In addition to Lyrica and Gabapentin, which I no longer take because they never really worked).  I have made significant progress since coming to Nantucket in October, more out of necessity due to the physical nature of our jobs.  Before we came here, I hadn't worked since February of 2012, and it wasn't a physical job (I was a social worker for parents of special needs children).  I came off temporary disability, and began work with my fiance.  I had some REALLY bad, painful days after working with this condition and haven't ever really been able to get comfortable since being diagnosed.  The Tramadol, in the dose I've been prescribed, barely takes the edge off.  Over the summer, I did two rounds of steroid injections directly into the back and hip.  They offered no relief.  Before getting our new full-time jobs, I had an appointment booked with a neurosurgeon at one of the top hospitals in Boston.   I canceled it and we moved.  I found a new PCP here on the island after going to the ER at the tiny hospital they have here.  He was the only one the would take me on as a patient, as there is limited healthcare here and only a handful of doctors to treat the whole island.  I went to him, got my records (finally, there was a glitch in forwarding my mail and they came a month late).  He was aware the DAY I started going to him about my condition, and need for Tramadol.  I was in intense pain and voiced with him my concerns that the Tramadol wasn't the right pain management medication for me.  I asked him for a temporary round of narcotic pain medication (he gave me 10 Percocet, reluctantly) and during December, he refilled my Tramadol, only after getting my records from the other PCP. 

The new PCP ordered physical therapy and I started going in November.  This has also been an uphill battle, because usually I go to PT (twice a week) and the entire next day I have to take it easy because my pain level and sciatica increase.  This is finally starting to pay off, and the pain is less now, the stronger my core/hip gets.  The sciatica is now intermittent instead of constant.  Yesterday morning, at 8:30, I saw my new chiropractor, and appointment I've been waiting 2 weeks now to go to.  She is fantastic and I'm hopeful I can beat this demon on my back (literally!) as is she.  After my chiro appt., I went to the hospital to register for labs that I had my wls surgeon fax over directly to the hospital to check my levels as I've been lazy about my supplements since moving.  I have been working with the PA and nutritionist at my surgeon's practice (who are top-notch!) and they did this for me.  I was fasting (and starving!) at the hospital and after going into admitting for the paperwork, it was discovered that the PA didn't check every test off, just a group of tests.  The hospital admistrator was very, very nice, and even called the PA for me, but being that it was New Year's Eve, they were closed.  So I went to the cafeteria, got something to eat and proceeded over to my NEXT appointment, at the PCP's office.  I got there and after speaking with the nurse, waited for an HOUR in the exam room.  I was reading my new book, and I told the nurse that my Tramadol needed to be refilled at the beginning of next month (the 6th) so could they fax over the script to the pharmacy so they have it ready and on hold.  I also told her that I went to the chiropractor that morning, and I was starting to feel a lot of pain as this was my first adjustment in many, many years, and asked her to note a muscle relaxer needed to be called in.  I also wanted to address the issue (AGAIN!) about the Tramadol not being effective as a long-term pain medication.

The doctor comes in (after an hour! GRRR) sits down and says to me 'I am not comfortable prescribing your pain medication.  You received 180 Tramadol on December 6th.  I called the pharmacist and canceled the rest of the prescription."  I was stunned.  He then accused me of drug-seeking behavior, even though I have been taking this medication long-term AND under a DOCTOR'S care!  I was LIVID, and very very angry.  He told me he'd double-check with the pharmacy to make sure I got the Tramadol filled, and left the room.  While he was gone, I placed a call to my old PCP and left a message.  He came back, and verified that I had it filled.  I told him that I didn't appreciate being accused of this and yeah, I started to get loud.  He asked me to leave, and I said gladly, yelling the whole way out that I hope he had good malpractice insurance because he'd be hearing from my lawyer real soon and that I'd be telling everyone on the island that will listen to me what a horrible doctor he is.  I got in our car, and called my fiance shaking.  I have never been accused of ANYTHING like this before and took it as a personal attack. 

Now I have no PCP at all or Tramadol after the 6th.  I've been weaning myself off the Tramadol since this blow out yesterday, because now I'm worried he's going to label me a drug seeker (like they do if you repeatedly go to the er for pain meds) and I won't be able to secure a new PCP (there are 3 here that's it).  I'm already on one waitlist for a PCP to become their patient and tomorrow I'm calling the other 3.  I am also going to call my old PCP, as I saw him for over 5 years and he knows me and my history.  Hopefully, my old PCP will call me in a script, but I'm not expecting it. 

My goal for the new year was to get rid of the Tramadol anyway, just not like this.  I don't know if I'm going to be experiencing any withdrawals from it, being that I have been on it for so long and such a high dose.  Hopefully, after a few more adjustments and getting orthotics done up at the chiro and the PT will alleviate my need for any pain medication.  That was my new years goal so I guess I'll just deal with it soon than I expected. 

Any thoughts or advice from you guys is always appreciated, even if its telling me I overreacted, which I have been known to do in the past!!! LOL 

Thanks for reading!

M'Lane

Yowza! I just read your whole post, and from one chronic pain sufferer to another I'm livid on your behalf! I hope the doc doesn't try to blackball you with the other docs.

 

I know nothing about Nantucket, but how difficult would it be to find a pain management doc off the island? 

Unfortunately, I can't get off-island anytime in the near future (financially) but might have to go that route if this asshole blackballs me here on the island.  Its a 2-3 hour boat ride to Hyannis, and its like $40 round/trip.  Right now, we aren't allowed to wor****il Jan 7th (we've been off since 2 weeks before xmas) and there was a company change for my fiance's position so he didn't get paid.  W\e are in survival mode right now because we've only been getting half the pay we normally would, and won't get another paychec****il almost the end of January.  It also doesn't help that our landlord is and asshat and we've had multiple issues with him, so we're looking to move, hopefully once we get back on our feet again.  Luckly, it's almost tax-return time and I always get a lot back so we could use that as our moving fund.  We also just had an interview for a new job (full-time for me and part-time for him, he could keep the job with the new company because he gets awesome benes now) that pays for all of our housing costs and we'd get a good salary too.  We are very excited and hope this opportunity comes through because then we wouldn't have to worry about living expenses at all and would have a nice surplus of money.

M'Lane

You didn't over react in my opinion. I just love how Drs get that god complex and think we are all drug seekers or complete idiots! Grrrr.......

Ugh! That's awful!

I visited Nantucket once, and there is a huge alcohol problem there--so much so that they have support groups for the kids! Yikes! LOL I'm sure he's being extra cautious because there are a lot of people with drug issues. I know you've been taking it long-term, and he doesn't know you that well--even with medical records backing up your history. Anyway, my suggestion would be to go to Hyannis. I know it's off the island, but if you're having limited options on Nantucket, at least you may have a better chance of finding someone on the mainland. I would have suggested trying someone in Boston, but that would be a day of driving, which I'm sure you don't want to do. Good luck!

Might there be someone better on the Vinyard?  That's about a 2 hour boat ride away, but typically more populated in the winter.  If not, maybe a doctor in one of the port towns like Wood's Hole.  I'd rather take a ferry to the doctor than see an idiot like that guy.  You poor thing.

 

I hope you find a new and caring PCP.

I would have been angry, too!  I am very thankful that I have a great relationship with my PCP and that he trusts me (and my xrays!) enough to know that I'm not drug seeking for the pain in my knee (for which I take the same dose of Tramadol that you have been taking every day and Vicodin before bed and occasionally during the day in lieu of one of the Tramadol doses).  On a couple of occasions, I have stopped taking the Tramdol and Vicodin for short periods of time (concern about potential addiction) and I have not noticed any particularly bothersome effects.  Just the pain, of course, and one day where I felt very restless -- even king of jittery -- physically.  Fortunately I felt fine the next day, but I am pretty sure it was a physical withdrawal reaction.  I have been on both drugs for almost two years and am finally going to get my knee replaced on March 19th. (Yikes!)

i sure hope you can find a PCP who isn't such a jackass.  I understand that they have to be on guard against drug seekers and addiction, but this is Tramadol we are talking about not a strong narcotic, for heaven's sake! (I, too, find that all it does is take the edge off the pain). 

Lora

Thanks Lora!  It sucks to start the new year like this when things were starting to look up as far as my pain goes.  One foot in front of the other though, where there is a will there is a way.  I have my next chiro appt. on Wednesday.  She did a ton of adjustments on me, even telling me that she had to stop or I wouldn't be able to walk! lol  I really like her and she suggested acupuncture too for my pain (as well as my anxiety).  Soon as I get some extra money, maybe tax time, I'm doing it and she even had a recommendation for someone on the island!  Whoohoo!

Here's to a pain-free new year for both of us!

M'Lane

As a HCP, don't yell at a doctor or threaten lawsuits.  It only confirms our suspicions and will not help your case in any way. Being verbally abusive and being asked to leave will actually hurt your case. Next time try a rationale approach.  Also asking for specific drugs will be a red flag every time. They need to make that determination.  Don't tell them how to do their job. You kinda screwed yourself on this one.  

Do your physical therapy. 

Jill

Thanks for your viewpoint.  I never asked for specific drug, just a refill to be placed on file after a particularly nasty experience with one of his office staff about their refill policy.  Live and learn.

M'Lane