My pain Dr. Recently cut me lose… Her reasoning, was because I had to move my appointment up…because I had no ride. I live about an hour away…she says oh well theres public transportion…I said well I had no money. And also my roommate threw away my pain med bottle, so I didn’t have that with me. I had been out for 1 week. She said oh well how do I know that your not overtalking your meds… I said well ive been out for a week, can’t you tell , by my UA? Just don’t know how to feel about all of this
Pain management specialists are caught between a rock and a hard place. US CDC and DEA are on a witch hunt to prevent pill mills from dispensing opioids to drug abusers. CDC just issued guidelines which significantly restrict the maximum daily dose recommended for people in chronic pain -- and the guidelines are nonsense! But that doesn't help doctors or their patients.
In the not distant future, I think we're likely to see patients told that they must purchase a pill safe of some kind, in order to use opioid medications at home. One option would be a lockable canvas bag similar to those used for carrying cash from small businesses to the local bank. Doctors' offices may also do random pill counts using video from an iphone rather than requiring the patient to appear in person. These two measures aren't perfect, but they might cut down on the diversion or theft of opioid meds which are causing so many drug overdose deaths.
If you're not on opioids, then I'm more than a little puzzled concerning what your doctor thinks you're doing that would cause you to take more of your meds than prescribed.
Regards, Red
If you are taking an opiate pain reliever, the doctors are being very careful about refilling those. They're very addictive. In my experience Neurologists are not known for being warm and fuzzy. It's too bad because we need that. If I were you I would switch doctors and find a new med. Opiates they don't usually work for this condition. I hope this helps.
Sounds like it must have been an opiate for the Dr to be concerned about refilling script. Opiates prescription are very closely monitored. That said opiates do not generally help trigeminal neuralgia pain. I agree with Red's post
Interestingly, I would once have agreed with you, Mick and Siminative. But I've gotten a little more careful these days. Some patients don't metabolize either opiates or anti-seizure meds efficiently. And for them, the statement is true that opiates are not effective in their pain. But there seem to be quite a number of folks on Facebook who have been prescribed opioids under careful medical management and who have found them effective for years in controlling pain. These are people who DO metabolize opioids efficiently.
Regards, Red
mickchick1962 said:
Sounds like it must have been an opiate for the Dr to be concerned about refilling script. Opiates prescription are very closely monitored. That said opiates do not generally help trigeminal neuralgia pain. I agree with Red's post
Interesting Red. I have always been told by my neurologist that opiates are not effective against trigeminal neuralgia. He has however prescribed me tegretol several times. Gabapentin sometimes (not very effective in my case) and most recently dilantin and baclophen in addition to tegretol. Since I have had good response to anti seizure meds I wonder if I would have had good response to opiods but my neuro was just reluctant to prescribe same. I have been told by a few neurologists in his group that opiods are not effective for TN. Never tried opiods while in pain TN crisis Food for thought.
I have 5 braun tumors, one of which causes ny TN, I cannot tolerrate the normal, TN meds…
The genetic factors for anti-seizure meds are distinct from those affecting efficient metabolization of opioids, Mick. Some folks have markers for one or the other issue, and some for both. Others are able to take either type of medication and get benefit from it. However, the opioids have risk factors that anti-seizure meds don't, so it's wise for doctors not to recommend such meds unless the patient is unable to get relief from other measures.
mickchick1962 said:
Interesting Red. I have always been told by my neurologist that opiates are not effective against trigeminal neuralgia. He has however prescribed me tegretol several times. Gabapentin sometimes (not very effective in my case) and most recently dilantin and baclophen in addition to tegretol. Since I have had good response to anti seizure meds I wonder if I would have had good response to opiods but my neuro was just reluctant to prescribe same. I have been told by a few neurologists in his group that opiods are not effective for TN. Never tried opiods while in pain TN crisis Food for thought.
I am curious as to what people deem "tolerating" the meds. Yes I have been able to take the meds and they have been effective at relieving my pain. HOWEVER my LOA is up. I must go back to work. I am still a bit ataxic and dizzy at times. and I am a nurse who works with babies.Not driving..Working on increasing my strength & endurance. Neuro refuses to wean meds until I see him in July Hopefully I can wean then I can see his point as I do not want pain to return but I would not say I am TOLERATING these meds. For this reason, I am planning surgery but currently out of balloons required for balloon compression and I hope that is effective. I have not had any blood work so I wonder how my liver & kidneys are as I have been on heavy meds x 3 months. I guess it is all subjective
Well in my case , I broke out in hives and was having a hard time breathing…