What to do when your rheumy won't prescribe pain meds?

Discussion in 'Fibromyalgia Main Forum' started by kaymac42, Jan 30, 2009.

  1. kaymac42

    kaymac42 New Member

    I recently was referred to a rheumy by my primary physician after several years of FM/CFIDS and then arthritic complaints. The first rheumy was rude and I heard of another who I asked my doc to refer me.

    I LUV'd her! She was sooo knowledgable in FM and explained it all and was patient while she listened to my every complaint. Then she addressed everything step by step and let's get this
    taken care of, get this done, etc.....I left content and addressed the lab work, xrays, etc...then I was to follow up.

    I called to for my follow up appt only to be put off because of her booked schedule...till end of April. That is a long wait for a follow up.

    Red flag went up, but I luv this doctor, right. So this week things began to flare, and after working harder than usual I found myself in severe pain and hardly able to move, let alone walk and go into work, so I called the nurse to ask for pain meds. I haven't had any pain meds since about Sept. Well I was told this doctor doesn't prescribe pain meds for Fibromyalgia. Just like that. Like THIS condition is not worthy of pain meds! I was insulted. I felt ashamed because I should have checked this out in the beginning anyway. I asked what does she recommend for breakthru pain or flares then. She then went over my current medications, like the Lyrica and Nebumetone and how much I took and like that was already a high dose, they didn't see why I would need pain meds. I felt so insulted. Then she said she would consult the doctor and get back to me after I would not give up.

    She called back later and said the doctor suggested I try physical therapy! I said fine and didn't want to argue. She faxed me a rx for physical therapy.

    I am in shock that doctors don't think Fibromyalgia is real pain and that those of us who ask for pain meds should be put off. I don't abuse pain medications and I use them when I think I need them.

    Anyone else have doctors who refuse to prescribe something for pain?
  2. robin1667

    robin1667 New Member

    My Rheumy will not prescribe pain meds either. He did try me on Lyrica which made my pain worse. I tried it twice. He also told me to do physical therapy and water therapy. I cannot do either. Physical therapy seems to make me feel worse and I am allergic to the chemicals in the pool! I don't understand it either. I will be interested to see what others think of this also.
    I have tried many pain killers, muscle relaxers, sleep meds and have not found anything that helps for long. And I have had allergies to most of these!
    I've recently been told to take Tylenol 650mg, 3 times a day and Tylenol PM at bed time and they upped my effexor. So far I haven't seen much of a change.
    Your not alone, I know how you feel! Robin
  3. AuntTammie

    AuntTammie New Member

    I have actually had just the opposite happen....Drs pushing meds on me after I have told them that I don't want them....I react badly to most meds and the Drs I have seen mostly (with one exception) only want to push meds on me

    Robin, I would be really cautious about that amt of Tylenol....from everything I have read tylenol does nothing for fibro pain and high doses are really bad for the liver....and our livers are already way overstressed....sorry I don't have another better solution, but if it isn't helping you anyway, please stop taking it
  4. luckyman

    luckyman New Member

    Between the doctors fear of losing their license for prescribing too many narcotic pain killers and muscle relaxants, especially benzo's, the "new" information that is being distributed through their journals and continuing education discourage their use. Alternative meds are being pushed, like the Lyrica your on. They are being told that there are newer and more effective ways of treating the pain. Unfortunately for us it's gong to be an uphill battle.

    Narcotics are the most effective for nociceptive pain the type of pain an average person may experience after injury, or surgery. Their healthy nervous systems respond very well to drugs such as morphine. People that have compromised nervous systems, such as those with diabetic neuropathy, fibromyalgia and other conditions where the nerves have somehow become impaired have neuropathic pain in which the previously big guns (narcotics) are less effective. Unfortunately the doctors take this to mean that they don't work, and there are better treatments. While this is somewhat true, and they aren't as effective for neoropathic pain, they are often the most effective treatment we have. We need to re-educate the doctors that they are of great use to many of us, at least until a better treatment is developed.

    The benzo's, are the gold standard of the muscle relaxants. Unfortunately. they have side effects, and can be addicting. Addiction is usually not a problem for those patients that really need them. Patients take enough to alleviate their symptoms, and have no desire to get high on them, in fact they often don't even get that effect. Try another doctor, or pain clinic, and ask how they are willing to treat pain before comitting to an appointment.

    Good luck
  5. jasminetee

    jasminetee Member

    FMS is so excrutiatingly painful disease. She just doesn't get it. Sorry to hear that.

    I'm one that can't handle meds either and my rheumy usually asks me if I'm ready to start meds yet... I've been seeing him for years. lol I really think that's how it works, you have to say you don't want any pain meds at all and then complain about your pain a lot and they'll start pushing them on you. It's a crazy world we live in.

    Hope you get some relief soon.

  6. justjanelle

    justjanelle New Member

    I'm sorry to read that you've run into the rheumy road-block on the pain medication issue. So many here have been frustrated by this same problem -- it seems like they don't believe we really hurt, or that we should just be able to "deal with it!" Very frustrating.

    I've been seeing my rheumy for 6 years, and only at my last appointment was I finally able to get something for the pain. Previously, he recommended I take Tylenol! Even when I tried to explain that Tylenol didn't begin to touch the pain I was in.

    What changed? At that last appointment I directly said, "We have to talk about pain." And then I described to him how many days a month I was in severe pain, and exactly what that pain was like. "By late afternoon on those days, I become completely nonfunctional. I take my maximum dose of muscle relaxers and my maximum dose of Tylenol and I'm still in so much pain that all I can do is hunch over in my chair and try not to moan. Every muscle in my body is as tight as it can possibly go, and then I get sudden pains like being stabbed over and over with a knitting needle. I've had 2 children with no medication whatsoever, and this pain is worse. I need something to help me on those days because I cannot deal with that level of pain. I can't take it anymore, and I shouldn't have to."

    And surprisingly, he took out his prescription pad and wrote me a prescription. He even said that if that medicine didn't work we'd try something else. Thankfully, it does help.

    But, if your doctor actually won't provide pain medication, please learn from my mistake -- be more assertive sooner.... Also, I do know that some people here have had some good results from seeing pain specialists. Maybe that would be an option for you?

    Best wishes,
  7. tandy

    tandy New Member

    After going thru yrs of nothing given for my pain I asked my Rhuemy who he can refer me to if he won't help me?
    well,..that worked finally. But I'll tell ya,...even my drs. were so hesitent in prescribing pain meds.
    I don't understand for the life of me how they can not consider Fibromyalgia a severely disabling illness!! I was in really bad pain for a very long time before I finally had a dr. LISTEN and maybe try to understand.
    It was frustrating for sure.
    I did'nt cry when I asked him,..I just simply said "I can't do this anymore without nothing to take for pain,..and if your not willing to help,...I guess I understand buy that I'd need a referral to someone who could treat me.
    try it and please post us back~
    I understand so well what must be like for you,and I'm keeping my fingers crossed that you'll have luck~
  8. SolSerenade

    SolSerenade New Member

    first, sorry you're having problems - i hope things improve for you.

    second, do not take it personally - switch doctors if they wont help you with pain. there is quite a trend (due to misuse, etc. - nothing to do with *you* ) for docs to simply say "No, we don't do pain-management".

    i suggest you don't get upset about *why* -- simply phone another one, and another until you find someone who will treat you properly.

    take care.