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When to Start Over with a New Doctor
10 Replies
vavaughn - March 18

Up until this point my PCP has been wonderful. He has been very empathtic and has prescribed me the medications I need to maintain some sort of life. However, I am at the point now where he does not want to increase my breakthrough medication. I am currently taking Norco 5/325 for breakthrough and have asked to increase this to 7.5mg of hydrocodone. He has made it clear that he does not want to increase anymore of my pain medications. Is it time to see a new doctor? Do I consider a pain management doctor? I know it is really a headache to "start over" with a new doctor but I do know it is time to increase my breakthrough medication.


Fantod - March 18

vavaughn - You are so lucky that your doctor has been willing to get you this far. At this point, I'd say you've exceeded his comfort zone.

I'd recommend that you see a pain management specialist. Shop around for one in your area that sees FMS patients. You can go online to your local hospitals website or just call the physician referral service. See if you can get matched up with someone that way. Google whomever you pick to see what kind of feedback there might be available about them on the web.

Get a complete copy of your records to take with to save time and money. If you have an underlying condition like degenerative disc disease or OA with accompanying xrays and/or a MRI take those too.

And, be prepared to sign some sort of an agreement with the pain management specialist regarding the use of medication that they may prescribe for you. In many offices these days, that is SOP.

My pain specialist will not renew a script unless the patient comes in barring hospitalization and/or a body cast. Be sure that you understand what your obligations are as a patient. With today's litigious society, many pain specialists are super sensitive to even minor deviations in patient responsibilites. Good luck with your search and enjoy the weekend.


Stacey373 - March 21

Hi Vavaughn - I was having problems with my doctor about my pain meds too. I wanted my meds upped (by quantity-2 more a day) but he wanted me to take methadone instead of the extra Norco. I have to say I was being stubborn about this and fought him for about 3 months. I finally ended up giving up and doing what he wanted me to do....and I now admit that it was the best decision and I'm feeling so much better. (needless to say I'm eating a lot of crow now! LOL)

anyways...I wanted to tell you this because maybe you could talk to your doctor about adding in another pain med instead of upping the Norco? I have noticed that a lot of doctors are more willing to prescribe methadone especially when you are normally taking Norco (hydrocodone) Just wanted to offer another option for you to think about....

Take Care, Stacey :o)


January - March 21

Hi Stacey - could you share a bit more about taking methadone? Does it help the pain as much as the opiates? Any side effects? Do you have to take it on a regular schedule? Or can you just take it as needed? Thanks.


mdak - March 21

vavaughn- You are very lucky that your Dr. continued your pain meds. The DEA really checks on these guys. Making sure they are not writing scrips for the wrong reason. They have closed them down here. The best way is through the pain management. The DEA reallly monitors them closely, but they have more room to write these scripts if the paper work is being done correctly. You have to be prepared to do a random UA and follow by the rules. First time it's abuse the rules they fire you. It is the way to go with your FM. Some Pain management Dr's are on their own and some are with a group. Make sure you do your Homework. Like some at mine are DO. Dr's, Anestologist. Some have hospital privilages and some dont. I have had FM for many years and I started taking narcotics at low doses and then my body over the years became immune and dependent on them. After many years a new drug came out and it help me to not be dependent on high doses of narcotics. You are not taking very much compared to what I was on before. I hope you can make a decision.


mdak - March 21

january- Remember I was telling you about my new drug subutex. subutex or suboxen is the new replacement for methodone. The Dr's that are new or informed are using suboxen or subutex now for chronic pain or trying to get off narcotics. Methodone is hard drug and very addictive more then mine. It is hard to come off too. I have done that. A lot of reason you see methodone still because of the cost. Methodone is just cheap drug due to the age. Subutex or suboxen is very expensive even with insurance. They are getting ready soon to come out with a generic. Thank heaven. I have severe chronic pain without anything, to the point my body becomes very ill. I know you have read on suboxen, but all those side effects are real if you decide to abuse and shoot the drug up. Other wise I love it becasue it last up to 72 hrs and i dont have those depenednt withdrawl pains if I forget to take it.I have stop it to see if I could be without. I had no withdrawls, but my pain was there. I was disappointed because I wanted off so bad.


January - March 23

mdak, thanks for the info. I'm really glad you have found something that helps you. Daily severe pain is hard to live with.

So far, I'm doing really well on my prn pain meds - I don't need a lot (but I do need some!) and I've managed well over many years. This is what my original fibro doctor told me, and my current rheumy tells me the same. (However, I have been to some "regular" doctors who just go crazy when they see I'm taking pain meds at all!)

It's always good to have information for the future - you never know when your pain level will increase. And it's good to know about different drugs before you have to talk with a doctor; they sometimes want to switch you to other things - like Stacey's dr. (I think if it's not broke, don't fix it!) But - as long as Stacey is happy with the treatment, and she seems to be, that's what counts.

Medical books say that opiates are a very good treatment option for pain in people that can stay on a monitored dose. But tolerance does happen over time, and then why not increase the dosage by a few mg? As long as it's being used responsibly, I don't see what the big deal is. A person in pain needs appropriate medicine to live a normal life just like a diabetic needs insulin. I have no side effects from the pain meds I take - but Cymbalta made me really sick. I am a little suspicious that the push away from the older pain meds has something to do with expired patents and drug companies making tons of money from the newer drugs. But it's good to know there are options out there like the ones you have mentioned, and you've probably helped many people out by posting your information.


Stacey373 - March 23

Hi January! I take 6 Norco (10/325mg) and 2 methadone (10mg) pills every day. methadone is the type of medication that builds up in your system, so you have to take it every day and not only when you need to. You just have to be careful to not "over take it" because you can OD on it. I guess a lot of people don't feel like it's working so they take another pill, but because it does build up in your system, you have to make sure you take it AS prescribed.

Honestly, it didn't help at all when I was taking it by itself (one of the reasons I was fighting my doctor about taking it in the first place) but when I take it WITH the Norco, it works great. it actually feels more like it's making the Norco last longer through the day.

The only side effects I've had is I break out in a sweat like I'm having a hot flash. but even that only lasted a couple of months and now it's rare for that to happen. it also sort of made me sick to my stomach and tired at first...but most meds do that to me and that didn't last long either.

I know mdak isn't too "keen" about taking methadone, but it's really helped me alot. the way I look at it is that ALL pain meds are addictive and horrible to stop taking....but I'm never going to get off of them anyways and I'd rather feel like I'm halfway human than suffer with this. I also like the methadone because I've been able to cut back on the Norco. So for me, it's been good because by adding the methadone in I don't have to "up" my other pain medication (either by quantity or by going to a stronger pain med)

If you think this would work good for you, I suggest you talk to your doctor about it. Like I said before, I feel SO MUCH better with this combination of meds.....less pain and more energy....and because of those 2 things, I feel 100 times better mentally.

Good luck and let me know what the doctor says...Stacey :o)


January - March 23

HI Stacey - I'm really glad you have something that is working well for you. I know every post helps somebody out there who is looking for a better treatment. I'm doing well, keeping meds as low as possible. I lower my dose when I can because I'm trying not to build up a tolerance, but I know it happens. I found several meds that work for me - that was hard - so I'm not changing anything at this point.

I plan to be an annoying B and keep asking for better research and treatment for all these weird diseases linked to fibro. (What IF they find a biological cause, give us a few weeks of pills, and we're all back to normal! The only big losers in that scene would be the drug companies!) I do NOT think fibro is psychological at its root, but many doctors do, so they dismiss us. Many of us look "normal," and pain is such an "invisible" condition. WIsh we could all organize some kind of big push - like writing Congress? Or publishing our stories in magazines? Well, that's what we do here - so this is good! I ask my friends who don't know about fibro to come and look at this site. Most people think fibro is what the TV ad for Lyrica implies -- and granny's doing just fine on those ads, smiling, walking, doing her artwork. No side effects, no weight gain. hahahaha!

Right now, I think the treatment of chronic pain in the US is atrocious - getting adequate treatment is difficult - even when people are dying! (Like many, I've been traumatized by ignorant, arrogant, too-busy doctors. I want to cry when I read about the horrible run arounds people get. If your pain is taken seriously, you are LUCKY.) I guess it must start with the medical education system and the general hysteria and fear about opiates. Maybe, like mdak said, they are afraid of the DEA and overly strict rules. I know there are addicts and people who party with pills (I don't know how falling asleep is a party!) But they're usually NOT the people with chronic pain who want their meds TO WORK. Still - such a stigma attached to this condition! You really have to find a doctor who has pain, or a relative with pain, for them to understand. OK, January off soapbox now! TREAT PAIN NOW! (I believe California has a new law in place requiring med professionals to do a better job of assessing and treating pain. And there's medical marijuana in a few states. In Canada, I think you can buy codeine OTC, but in the US, we can't even do that.) If anybody has the energy out there, write your Congressperson?

I agree with you Stacey - we just want to feel human and be able to move around without agony. Work, and have a normal life! There's no way I could do the normal "activities of daily living" without my pain meds. Again, I'm glad you found something that helps! You sound good! YAY!


axxie - March 25

I'm with you January, it's true that doctors have a fear prescribing opiots. I also had to stop cymbalta because it was making me crazzy and didnt really help me with pain.

I'm now on ralivia 100mg, (tramadol), except the ralivia is extended release and works very well to keep you comfortable for the entire day. I need to keep taking every day, it should be taken consistently that's the trick to all medication to help you with pain management.

Consistency is the key for your pain management regime. Wether you take your medication everyday at the same time with or without food, will help you.


Lee2010 - March 25

Hi everyone! I've been off for a long time - pain levels are extremely high. We've had rain 20 days out of 24 and the weather is really affecting me. Anyway, this thread is very timely for me. I am so very lucky to have a doctor who is unafraid of prescribing pain meds at high levels to help me try and get a grip. I have an unfortunate medical condition - the area of the brain that processes opiates does not work in me. I have been to so many docs I've lost count, and my Pain Mgmt. Spec. finally diagnosed this problem. It's apparently been shut off since birth. He said that it's quite rare. The result is that I can take 2 Norco (10/325) 4x per day with extras to take as needed for break-thru pain, and it acts like one Ibuprofen in my system. I'm also on 2 600mg Gabapentin 3x per day. Needless to say I have regular liver tests. Anyway, I have a doc appt. in a few weeks to try Methadone. She is hopeful that this will work. If not, she is going to try and get me into a pain clinic where I can possibly be in one of their trials.

The good parts of my story are that I have an incredible doc who has tried just about every drug on the market for me and has been so helpful and caring that I almost cry when I think about her and how lucky I am to have found her. The other, and most important and amazing part of my story, are the incredibly supportive family and friends that I have. My husband does everything in his power to make sure that I don't overdue anything and get the rest that I need. My children are grown up and going to college, but when they're home, they treat me with golden gloves and help out as much as they possibly can. My extended family and friends understand FMS (they have all researched it and offer suggestions, support, and love) and are there for me 24/7. Not a day goes by that I don't thank God for these gifts. I read all of your posts and wish that I could be in each of your towns to offer you the kind of in-person friendship and support that I've been blessed with. Each of you is in my thoughts daily as I struggle and know that you are all struggling. Everyone on this site is so caring and helpful - you've all given me so many ideas to take to my doc, many of which we've tried.

Stacey, hearing how successful the Methadone treatment has been for you has given me such hope! This may finally be the magic bullet. Like you wrote, I know that I'll be on pain killers of some sort for the rest of my life, so the addictive quality is not an issue. And frankly, with the condition that I have, I've noticed that I don't suffer withdrawals as others do. I guess that part of my brain doesn't accept the opiate, so I can't get addicted to something that it doesn't accept. Medically I don't understand it, but I know it to be true as I look back over my life. So I am really looking forward to the possibility of success.

Thank you all again for the information and support that you give every day. This site is a rare and wonderful gift. I so wish that I could meet each and every one of you, but lacking the ability to do that, I visit the site and feel like I'm chatting with old friends.

I wish all of you better days with less pain. Some day FMS will have a cure, and I'm hopeful that it will be in our lifetime. However, until then, we have this wonderful place to come and vent, share, and leave feeling just a little bit better. Thank you all and I'm sending you all cyber hugs - gently of course. :-)




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