Pain Management Doctors Patients Rights

[Macadwel]

Some of you have read my past comments in some of these threads but I am not sure I mentioned I was recommended to leave my neurologist and go to a pain management doctor, pmd, as my neuro doctor could not prescribe opioids. I am also trying the low oxalate diet with some success on my past medication tramadol and pregabalin. My past prescription has been for the past couple of weeks, 2-50 mg of tramadol at 5 or 6 pm and then 2mg extended release at 9 or 10 pm, pregabalin 75mg at 7am, 2pm, 9pm and I would sleep through the night, except when I did not follow the low oxalate diet. Since I am at the top of the tramadol dose and prior to the low oxalate diet I had been augmented on the tramadol, that is why I was on the high dose, started on 50mg once a day, and built up to the dose with the pregabalin added over this past 9 months, and now that has to be increased, except it makes my brain mush and I feel like I have Alzheimer's, that it was decided I go to the pmd.

The pmd put me on methadone and I had a really bad reaction, only one day, so they put me back on tramadol, but in stead of 2-50's three times a day they put me on the 2mg extended release with the 2-50's. The NP told me she could not write the script for my original 2-50s three times a day.

Now I am on a two-month holiday using 5/325 hydrocodone acetaminophen 3X per day. The new hydros are not even touching my RLS during mid-day, evening, and night. I have asked to increase the dose and to up the dose to at least 4 per day.

As a new patient at a pain management facility, what are my rights? How long do I have to wait to go back on the tramadol? I sent a message today to see what they have to say. My next doctor's appointment is in a month and I don't think I can wait a month to change this medicine.

I know the goal for pmd is to get patients off opioids and on the least amount but I want to at least be comfortable and able to sleep.

Any guidance will be helpful! Mel

[Rustsmith]

With pain mgmt docs, about the only rights that you have is that they cannot discharge you without providing at least a month's worth of meds to tide you over until you can find a new doctor.

I am sorry that hydrocodone isn't helping. It doesn't have a very long half life, which is what you have found. I will add that the acetaminophen, which is important for pain, is totally useless for RLS and taking it continually can be hard on your liver. If she will not put you back on tramadol, at least ask that the next opioid that you try is not one that is combined with Tylenol.

Perhaps if you try providing your doctor with the Mayo Clinic document on the proper use of opioids for RLS, she will learn enough and will realize that you are a long term patient. https://www.mayoclinicproceedings.org/a ... X/fulltext

[Macadwel]

Thank you for responding, I think I put this in the wrong section!
The next drug they want me to go on is Nucynta (tapentadol) which is not covered under my insurance.
Thanks!