chronic pain ~ pain docs ~ docs in general -- NEVER AGAIN

[nashville_brook]

i have to share my story. i've had a really shitty day and i just have to get this off my chest.

i have chronic pain in my back and hips resulting from an infection in my spine a couple of years ago. it's bone pain rather than the electrical nerve pain most people have some time in their lives. i've done plenty fine on going to the creepy pain clinic up until today. retrograde mercury -- i don't know what -- but my doc told me he was going to need some urine for a liver test and next thing i know railroaded me into a RANDOM DRUG TEST. pain clinics are already creepy places -- but to have a pimply teenager take your purse away from you and are escorted to a non-private piss test room WHEN YOU WERE TOLD YOU WERE DOING LIVER PANELS is enough to make anyone a little angry.

you sign a paper when you go into treatment about drug testing. i signed it -- i have no problem with them keeping their books straight. plus, i'm a tea-totaller. had addicts in the family and i'm thankfully not one. never intend to become one.

BUT when my doctor LIED to me about the test and then required me to sign a paper saying i knew what it was for -- which i didn't -- he was asking ME TO LIE about something that i thought i ought not. that was my REAL DRUG TEST. how bad do i really the 45-minute drive once a month to hell's suburb... the dirty rooms... the insane turnover of techs and nurses... the altogether science-fiction-esque role of post-modern healthcare... the real question is: are you addicted enough to this pain treatment to become a person who can give up this much dignity?

the lies got bigger as i asked my doctor to explain what just happened. i said, "you told me i was getting liver panels and i was asked to sign a paper that I KNEW i was being drug tested and what for."

charmingly, first he responded that the test would just look for opiods. makes sense b/c you don't want someone taking the meds except as prescribed. it's just as bad to have too little morphine in your blood than to have too much, because you might be selling it.

but then he said it would also test for "everything else." and i wanted to know what that "everything else" was at this point, to save face. i also wanted to underscore the fact that he should never have to trick me into any test -- but especially this one.

then, very seriously, i said "i feel incredibly violated that i was LIED to. you can have the sample and continue on, once i get to see the paperwork, but you have me feel like a criminal today. i'm already not feeling well, or else i wouldn't be here and i need to expect a level of professionalism."

so, that was supposed to be fine and the assistant came back with the form to sign and still no list of what the test is for. i felt like, you have to be kidding.

so i to talk to my husband on the cell, i was so angry at this point b/c none of my concerns had been met and they still wanted me to sign the waiver without seeing the list.

so i call hubby again, hoping he'll talk some sense into me. i'm not in any danger of being busted for anything, so what's the damn big deal? alright, you're right. i returned to sign the paperwork, they told me to "leave the premises." i had been discharged for refusing a drug test.

on the 45 minute drive home i had plenty of time to sort thru some of the emotions i was feeling. i was kicking myself for being such a troublemaker. it's who i am. i ask questions and expect answers. i expect fair treatment.

The Drug Test tells people more than what's in your piss. it tells them what's in your soul. "if you want the pills bad enough, you'll suffer any humiliation to get them." if that isn't the dictionary definition of addiction, i don't know what is. i consented to a drug test by accepting their therapy -- not a SHAKEDOWN. they literally acted as if had i KNOWN they were going to give me a test, that i might have not taken it.

so, i come home and call my primary care physician to let her know that i'd be going cold turkey on the morphine and that i probably needed to see her to get that liver test. well, she refused. flat out. said she "doesn't do chronic pain." and went on to say that she wouldn't even help me detox.

the worst part is i'm kicking myself for having such a kneejerk reaction to the whole situation. i made clear how specific my concern was -- I DON'T WANT MY DOCTOR LYING TO ME. i have to believe they are on 'my side.' whatever that means. today, in this situation, it would have simply meant letting me know what they were doing and not tricking me. it felt militaristic. it felt like i fell down the rabbit hole.

driving home i felt the dull ache running from my back down my legs and turned up The Sweet (into the night) real loud to go with my New Freedom Pain.

why am i writing this here?

i'm going to be mentally torturing myself over this forever. it makes absolutely no sense at all that i reacted this way -- except that maybe something in the fiber of my being just went into complete danger mode. i felt attacked in the worst way. it was all emotional. if he hadn't lied i would have been fine with it. i want to believe that this is the manifestation of some sixth sense.

and the larger thing -- i want no doctors at all -- ever. i got sick in the first place from a hospital. while i was in the hospital i got sicker and sicker as i was fed chemicals that my liver didn't like, and poked in my pancreas and nearly fucking died. all from the treatments. $240,000 in hospital bills.

we need NEW FREEDOM HEALTHCARE. we need doctors working for us and not the FRISTS or the damn DEA. i was in perfect health 2 years ago. now i walk around like Egor. my face is twisting into a permanent grimace. where's the fucking hippies? where's the alternative medicine? how do you get out of the system. i want to disappear and never ever go back. i don't want to be on anyone's records. or have to buy their expensive drugs -- i just want out of ALL OF IT. forever. i'm done.

[Digit]

1. I am sorry this happened to you

It sounds like it was a gut reaction and you reacted like you were being accused of a crime when you have been the victim.

I would try to find another doctor who is more sympathetic to the type of pain you experience. You should not have to suffer.

[nashville_brook]

4. you put it better than i could.

the taste left in my mouth is bitter. their reaction: "ah HA! only a drug-user would react to a drug test like this." now, off the premises.

they would NO patients/clients/prisoners left if they present their promised drug screen in such a manner in every case. only the most addicted, hopeless, sorry-sack would go along to get along given this treatment. so, i'm a bit freaked out. why'd they pick me for this? at this time? in this manner? what made them feel like such strong-arm tactics are necessary?

i keep coming back to this place. who wouldn't?

is it my DU bumpersticker? the fact that i read from my laptop instead of browsing their Christian literature? i don't recall ever wearing my I Had An Abortion tshirt to an appointment -- but, i DID just publish an editorial in the Southern Medical Journal against religion in medicine. wait a minute...

fuck.

[nashville_brook]

5. fuck that's it! they're nigerians -- i bet they're here b/c of church

connections. Nashville has a remarkably large African ex-pat population due to missionary workers who are based here in the protestant vatican.

i just fucking published an piece of commentary in a regional medical journal. december issue which prolly came out this week or last:

Should Physicians Incorporate Spirituality in the Care of Patients? One Patient's Negative Experience.

Early in my career I was employed by a small firm that did
not offer health insurance. Experiencing a set of symp-
toms including migraines, nausea, persistent vomiting, and
fatigue, I was losing work days. As my only access to health-
care was through the relatively new state-financed insurance
program, I was forced to see the only physician in town who
accepted my insurance.

I initially was impressed by the doctor’s thoroughness in
collecting my medical history; however, when I indicated that
I had obtained an abortion several years before, he became
agitated. His tone and manner shifted from friendly and pro-
fessional to mean-spirited and abrupt. I became aware that I
had touched a nerve. He promptly discontinued collecting my
medical history, failing to chronicle my long history of mi-
graines, including a lengthy childhood illness that may have
been related. He recommended a “victims’ recovery program”
for women with “postabortion trauma.” He further suggested
I “find a church that would take me,” and sent me home with
a 3-month supply of Paxil. He provided no explanation for his
assumption that my migraines were caused by postabortion
trauma, even though I mentioned no emotional issues regard-
ing that procedure. In my opinion, he transferred his religious
beliefs onto my medical problem; he assumed that I shared
his morality and concluded that this previous “trauma” must
therefore be the source of my migraines.

I am passionate about keeping medicine and religion in
their respective corners: the physician’s office should not be
the center of moral issues. The doctor-patient exchange is, by
nature, an intimidating experience for many patients, and
introducing religion into this environment may be considered
coercive and even potentially manipulative. By bringing re-
ligion into the examination room, the health care provider’s
religious and moral beliefs seem to become part of the deci-
sion-making process. These beliefs may not be in the best
interest of the patient. As long as I have a choice, I will accept
no less than scientifically-minded medical professionals who
respect my privacy of belief.

_____________________________



there you go: problem patient.

[knitter4democracy]

8. Did you report him?

That dipwad shouldn't practice. Period. I say that as an internist's wife--he needs his license revoked. If he can't handle all of life's problems that walk through his door, he's in the wrong profession.

Then again, most docs don't read all of the opinion pieces in the journals. There's just too much to read. I think you got the shaft because that clinic sucks and needs to get a visit from the state and JCAHO.

[REP]

2. FYI: Liver Panel is a Blood Test; Urobilirubin is a Urine Test

A full liver panel is a blood test (I have them every 30 days). There is a simple dipstick test for bilirubin in the urine (urobilirubin) that's a part of almost every routine urine analysis.

You were dealt with unethically. Report them to the state licensing board and make a formal complaint.

[nashville_brook]

3. thank you for your input -- i'm working on the letter today

when i was acutely sick, my bilirubin was the test that i hung on every day b/c it determined if/when i could leave the hospital. once it went up it took forever to get it back under control.

so, when they took me to a bathroom-type area, at first I thought that they wanted the quick look at that bilirubin number, even tho the language he used indicated a blood test. my anxiety rose every second imagining i was going down again (pee's been too brown lately; is my diet doing this? sugar? stress? STRESS!) i'm escorted to the drug bathroom (no privacy, no water, no paper towels) and all my stuff is brusquely taken away. i was in major cogitive dissonance. is this the only facility available?

in most areas of life, especially business-life, ethics and interpersonal manner doesn't play any significant role. you have no reasonable expectation of ethical treatment at the mall or the Dollar Store. these pain clincs operate with most of their soul in the business world. The monosyllabic Nigerian who runs the operation appears to me to have no empathy for his patients or staff. he's SELLING drugs -- not providing healthcare. add to that all the pressure from the DEA, and it's nothing short of foolish to expect ethical treatment. right? i put my trust in those people b/c i had NO CHOICE. for more than a year they've been the only people who would even talk to me about pain issues. the betrayal i felt was off the scale.

so, ethical treatment? as i write this letter i know how it's going to be received -- but write it, i will. and spread the news of what happened to me? YOU BETCHA.

[Warpy]

6. There is a huge difference between addiction and dependence

Opioid dependent pain patients take their drugs as prescribed and consult their docs when breakthrough pain occurs. Often, they can remain on the same dose for a very long time. There are physical symptoms if the drugs are stopped suddenly, but the person doesn't have drug cravings either during the period of physical withdrawal or after.

Addiction is a completely different phenomenon. No matter how much drug an addicted person has, s/he will always want more, chasing an elusive high that's just out of reach. Prescribed doses are routinely exceeded without consulting the physician and the required dosage escalates quickly. Cravings occur even when the addict is satisfied, that is experiencing none of the symptoms of withdrawal.

Consider that people can be dependent on a number of things, from insulin through cortisols through antidepressants through thyroid replacement, all of which produce alarming physical symptoms if the drug is stopped quickly. Dependence is not the problem. Addiction is.

Few pain patients get addicted, although even post operative patients can display classic drug seeking behavior if someone has been stingy with their pain control. Drug seeking is not the same as addiction, either.

It's high time more physicians learn the difference between these two phenomena. Then maybe we can work on the public, and finally the DEA.

[RedOnce]

12. Excellent post! Thanks for this information.

[knitter4democracy]

7. You followed your gut and did the right thing.

What happened to you is so wrong on so many levels, I don't know what to say. If I ever found out that my internist hubby ever treated one of his patients that way, trust me: he'd pay for it. That is disgusting treatment.

A liver panel is not a urine test, so that jerk lied from the beginning. Lied--and did not get informed consent. Informed consent is the bedrock of our medical system, and bypassing it in any way is disgusting.

He needs to be reported to the state medical board asap. Write up exactly what you said, exactly what he said, exactly what happened after that (having a lawyer look it over is a good idea, even if just at a free legal clinic, just to make sure he can't sue you for libel afterwards--some as$#oles do later, especially deep-pocket specialists), and file a complaint. If it doesn't get investigated, find out why.

Just because you need morphine (and anyone with bone pain will--that's one of the worst levels of hell, as anyone with an MD should know) doesn't mean that you can leave your rights at the door.

Btw, you need a new PCP. She may not want to help you, but it's her job, so she should. You're her patient, and she can't refuse to treat you for that, if I understand the regs and all right. If anything bad happens, she's committed malpractice.

[gulfcoastliberal]

9. Demand your medical records from the fuckwads

Try seeing an oncologist for your pain management. Even if you don't have cancer they are pretty compassionate about helping pain patients.

My other suggestion, if you can afford to pay cash, is to register with a legitimate online medical consultation service that requires medical records. PM me if you'd like a referral to a reputable one.

[Duppers]

10. What she said. They're quacks! Get your records and report them.

And speaking of QUACKS, I just found this info:

>>
Don't Believe in Alternative Medicine

12.13.05 - The American Medical Massage Association (AMMA) has issued a position statement denouncing six categories of metaphysical, paranormal, and pseudoscientific practices that are part of the massage therapy marketplace. The paper states that many subjects taught in massage schools and/or practiced by massage therapists are "so extreme in nature as to constitute health care fraud." The objectionable practices include reiki, polarity therapy, therapeutic touch, touch for health, crystal healing, craniosacral therapy, subtle energy, aroma energy, aura reading, hypnotherapeutic massage, chakra healing, five-element healing, vibrational healing, zero balancing, emotional balancing, unwinding, and many others. (CHD)

12.13.05 - The U.S. Food and Drug Administration has ordered BODeSTORE.com, Chozyn, LLC, Healthworks 2000, Iceland Health Inc., Melvin Williams, PolyCil Health Inc., PRB Pharmaceuticals Inc., Sacred Mountain Management Inc., Vitacost.com to stop claiming that their products could be effective against preventing the avian flu or other forms of influenza. (CHD)

12.13.05 - The Washington Department of Health is seeking a court order to stop Joyce M. Tasker of Coleville, Washington, from continuing to practice medicine and veterinary medicine without a license. The motion for summary judgment states that Tasker, who is not a licensed health-care provider, has been using electrodermal testing (EDT) to diagnose a wide variety of problems in humans and animals. EDT is a bogus procedure based on the notion that health problems can be detected by measuring skin resistance to a tiny electrical current. (CHD)

12.13.05 - A 24-week study of 26 patients with relapsing-remitting or relapsing secondary progressive multiple sclerosis has found no benefit from bee-sting therapy. Live bees were used to administer bee venom three times per week. The treatment did not reduce disease activity, disability, or fatigue and did not improve quality of life. (CHD)

11.29.05 - Dorothy Merritt, M.D., who operates Southwest Wellness Solutions (a chain of clinics formerly called Chelation Centers of Texas), has signed a consent agreement with the Texas Board of Medical Examiners under which she was assessed $3,000 and must retract misleading promotional statements she made in advertisements for chelation therapy and BioMeridian testing. (CHD)

11.22.05 - James Michael Shortt, M.D., who practiced "longevity medicine" in Greenville, South Carolina, is now facing criminal charges that he improperly provided drugs on 42 occasions between about December 1998 through about September 21, 2005. Thirty instances involve prescribing the anabolic steroids testosterone, stanozolol, nandrolone, fluoxymesterone, and/or oxymetholone "not for a legitimate purpose" and "outside the usual course of professional practice." The other instances involve providing human growth hormone "for a use . . . other than the treatment of a disease or other recognized medical condition." (CHD)

11.22.05 - Four former Cell Tech executives have launched a multilevel marketing company whose flagship product is an alleged "stem cell enhancer" extracted from blue-green algae. The company claims that (a) circulating stem cells repair body tissues as needed, (b) stem cell circulation tends to decrease as people get older, (c) the product (which costs $60 to $120 per month) releases stem cells from from bone marrow, and (d) the cells then circulate where they are needed and replace dysfunctional cells. A few studies-most done in laboratory animals-have shown that circulating stem cells from bone marrow can develop into a few other types of mature cells. However, no study has demonstrated that increasing the number of circulating cells is safe or makes people healthier. (CHD)

http://quinnell.us/b2evolution/index.php/all?cat=14

[flamingyouth]

11. God, this story is a nightmare

I feel awful that this happened to you. I agree with everyone who said you should get your records from them and report them.

I just got referred to a pain clinic yesterday. So far, just trying to get an appointment with them is giving me a migraine. x(

[Celebration]

13. keep us posted on this

By the way, depending on the wave length used, you might want to look into low level laser therapy for bone infection. I got interested in the subject after it sort of miraculously cured an infection in a root canal of mine. Subsequently I wrote an article about it in a diabetes magazine. It is used a lot in Europe and Russia. There are devices that have FDA clearance here. I have NO IDEA why it isn't used more often in the USA. You kind of have to look around for a doctor or chiropractor that has the device. Tons of research summarized for various things at http://www.laser.nu/ --The Swedish laser society-- I think one reason why more people don't use it here is that it almost seems like a Star Wars type healing system because it works for so many different things so that gets everyone's antennas up. Ok I am pretty alternative and actually used a Radio Shack laser pointer one time to help heal my father in law's bedsore. Worked like a charm. I doubt if that would reach a bone infection in a hip. You might either have to rely on a multiple frequency device or else something in the infrared range. Hey I am no expert.

[Maraya1969]

14. I swear a holistic chiropractor's assistant used one of those light lasers

that you can buy at the drug store or pet store to play with your cat. She just put it on several point in my lower back and the pain got better. Now I see another doctor relative using similar things but with about ten different lasers in a circle. Seems like the same thing to me except hers are about $300 a piece and mine was about $4.

I get lax and don't use it though even though I think it would help.