Hallelujah Appt. with PCP Went Great (New Thread)

Discussion in 'Fibromyalgia Main Forum' started by pam112361, Jun 13, 2006.

  1. pam112361

    pam112361 New Member

    Hey everyone! I wanted to start a new thread (see old thread: Horrible Experience with Rheumatologist/Rough Weekend) since I had such a great appointment with my PCP yesterday.

    I was terrified that my PCP would turn me away after receiving my rheumy's letter. He actually had not sent a letter yet, so I spilled my guts in my fax to my PCP before the rheumy got to him. It was really for the best because I could not have told him everything without crying. I cried just telling him a little bit. He's going to call for the notes from my visit.

    He was concerned that my rheumy had been so unconcerned about my wellbeing (he must have been having a bad day). He said that he was in the business to help people in pain and if he wasn't going to do it, then there was a problem.

    Anyway, we DISCUSSED everything that I had a concern with and decided to take a step by step approach. We started with the change in my arthritis medication. We went back to Mobic samples. I'm to call him on Friday to let him know how I think they are working. If I feel that there is a difference he will get a pre-authorization from the insurance company so they have to cover them.

    Second, if there isn't a significant enough change, he wants to change my Neurontin to Lyrica and see how that works.

    Then, after we see how the Mobic and Lyrica work, we're going to further discuss long acting narcotics, specifically Methadone, with Darvocet for break-thru pain. He said if he were going to have to use something for chronic pain, that's what he would choose (let me know what you think).

    We discussed the consequences behind going to narcotics long-term and I explained to him that I had to do whatever it took to make me comfortable so I could live my life. And he understood! He actually said he would help in regard to my husband's aversion to "pills" because he knows how he is.

    I feel so much relief today. I'm still hurting but my stress level has dropped dramatically now that I know he will be the one to help me from now on.

    I also got a call from the Vanderbilt doctor that originally referred me to Dr. K because I had sent him an email requesting a copy of the letter he should have received from Dr. K. Of course, I found out yesterday that the letter hadn't been sent yet so I recalled the email.

    He called to see if everything was OK and I told him in as few words as possible what Dr. K had done. He was unhappy about it and apologized. He said that some people react to confrontation better than others but that in my situation, it was the wrong tactic for him to use. I told him that professionally I would not refer anyone else to him. I also let him know that I had heard several comments from this board regarding some great internists at Vanderbilt (Dr. Rankin specifically) that might be a better route to take. He was pleased with the information.

    So hopefully, through my experience, he and I both learned a lesson regarding Dr. K. I just hope he doesn't refer anyone else to him.

    I want to thank everyone who has listened to me over the last couple of weeks. It has helped more than you know. Now just stick with me through my "medicine conversion" and I will be indebted to you.

    Big soft hugs!
  2. nonnie1967

    nonnie1967 New Member

    I am so happy that you had a positive experience with your PCP...and that it sounds like you will get some HELP. :)

    My one question/concern would be about the Darvocet for breakthrough pain. Darvocet is not very effective as a pain reliever, IMO...though you may have better luck than I had with it. Will you have fairly quick recourse to a stronger med if the Darvocet doesn't work? You may want to ask this question.

    Otherwise, this turn of events sounds great and very promising. Keep us posted! :)
  3. baanders

    baanders New Member

    I know how hard it is to get through to these doctors. Yipee!!!!


  4. pam112361

    pam112361 New Member

    Nonnie and Baanders: Considering the problem that I had before (with my rheumy), this is a huge step. And since we are taking everything step by step, I'll have to wait to see about the Darvocet as a breakthrough med.

    Right now I can use a Darvocet and 2 Ultracet and it will take the edge off of the pain long enough to get me through the workday. He wants to try to get me on something that will be working continuously and then use the Darvocet if needed.

    I pray that what we're doing will prevent me from having to even use the Darvocet, but if I do I'll just have to see what happens.

    I hope someone responds about the Methadone. I'm going to do some research because I know nothing about it. If it comes down to me having to use it, he's just going to start it and get the dose regulated. Then I guess we'll go from there.

    Thanks and hugs!
  5. nonnie1967

    nonnie1967 New Member

    I don't know much about it except that it is pretty heavy duty stuff...it is used to help heroin addicts kick the habit. My guess is that your doc suggested Darvocet as a breakthrough med because he didn't want you taking a stronger med along with the Methadone (due to possible interaction effects). You might check drugs.com to see what it says about Methadone.

    I am concerned about one thing that you mentioned. If you are taking Darvocet at the same time as two Ultracet, you are getting a LOT of acetaminophen...and that is not good for your liver. If you think you may do that for any period of time, you may want to switch the Ultracet to plain Ultram (tramadol without the acetaminophen). It may not be quite as effective at killing the pain, but you don't want to risk liver damage. (All of us taking so many medications ought to get blood tests done at least once a year to check liver and kidney functions, anyway, just to be on the safe side.)

    Hope this helps, and I am so glad that things are going so much better. :)
  6. pam112361

    pam112361 New Member

    Thanks Nonnie! I've already started reading up on methadone. I guess I'll just have to wait until he decides exactly what we're going to do.

    I actually had a liver check done a couple of months ago because I had surgery and had a lot of bilateral edema when I went back to work. He wanted to make sure the acetaminophen in the pain meds I had after surgery hadn't damaged my liver.

    Fortunately, he's being very thorough. I feel very pleased and confident that he's going to help me through this.

  7. nonnie1967

    nonnie1967 New Member

    I'm glad your doc is being so thorough!

    I also wonder what he'll say to that rheumatologist the next time they run into each other....;-)

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