Discharged from pain management & have questions

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retiredteacher70
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Hello everyone! I hope today is a low pain day for all.
I am brand new here and hope I am doing this correctly, if I'm not, please let me know.
I am female, almost 50 y.o., married with teenage children in college, and unfortunately a chronic pain sufferer. It began approx.11 years ago with all over body pain, excruciating migraines, very painful neck issues, and some fatique. Fast forward to now, I was diagnosed with fibromyalgia, migraines, cervical dystonia, alkalizing spondylosis (sp?),pancreatic SOD (soon after gallbladder removed),chronic urinary tract infections, kidney infections, and chronic fatique.
I have been with my pain doctor for about 7-8 years and have always had a great rapport with him. He uses a combo of injections, blocks, PT, Tens, massage, and meds for my treatment. I have always followed his instructions and never been in "trouble" with him. However, the past year he began practicing at a local hospital pain management instead of having his private practice. During this past year, since he has been practicing with the hospital, he has changed a great deal. His usual compassionate, caring,empathetic nature has morphed into someone who no longer takes the time to listen, distant, and abrasive. Totally different. With the switch to the hospital, also came all new staff and nurses. Should not be a big deal, right? Wrong! For the most part, the new nurses are kind, but for some unknown reason, one of them has gone out of her way to be rude, short, intimidating, etc. I do not see or hear her treating other patients in this manner. She does not make any.secret that she does like like me. I have no idea why, I do not even know her. For instance, my PD always, for many years, had me come in every 28 or 29 days for my follow-up and med refills. He said it was a good idea to have meds filled at 28-29 days and not wait until the very last minute bc you never know about weather, sickness, travel, med shipments, insurance snaffaus, and so forth. She came barging in the exam room a while back and had a paper, she proceeded to tell him I had my scripts filled 1 or 2 days early and stood there glaring at me. So, he just told me we needed to start doing 30 days, no problem, I'm fine with doing that. To try to make this shorter, I'll just say that every visit I have had the past year, she seems to do whatever to be my nurse, even if a different nurse has already began my intake. Then, once she takes over, she is just mean and treats me like I'm a criminal and is constantly going over me trying to find any discrepancy and/or act to get me in "trouble". I realize that some ppl just do not hit it off, there are ppl that I don't know, but for whatever reason I don't care to be around them. Very simple solution, I just stay away. I don't understand why she doesn't just keep her distance and let the other nurses do my intake? Now, I do not sell my medication,nor give it away, I do not abuse my medication, I do not take illegal drugs. I keep my medication in a safe at home and if I am away from the house for the day I only carry the amount I would need if I were at home for the day, with proper medication identification as well. I have been with my PD for many years and have never been wrote up, never had my meds stolen, never lost them or asked for them to be replaced. My PD does drug holidays, they are are awful, not only bc of return of pain, but withdrawals, but I still comply. I comply with all my drug screens and procedures.
Short and sweet on this, I was away from home for a few days, and evidently she called me for a random pill count and could not reach,me. So, I got discharged for noncompliance. She did not leave a message saying I had X amount of time to call,or X amount of time to bring my meds in for a count.
I'm just having a difficult time trying to comprehend how I was discharged after so many years of being a compliant patient, doing what was asked and/or ordered, passing uds, never missing appointments, etc., because I missed her phone call. I was never told, nor in my contract, that I must notify them if I'm not going to be home for a day,a week, or however long. Unfortunately I am not a mind reader. Had she left a message stating why she was calling, my daughter would have relayed the message to me and I could have immediately returned the call and made arrangements to call my trip short, take my meds to a pharmacy to be counted But she simply left a message for me to call back when I can, so my daughter just left the message on the machine for me to hear when I got back some days later.
Does any of this sound right?
What should I do?
Although Ive done nothing wrong, I feel humiliated.

sandi123
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It sounds as though

She took issue with you filling a day or two early for an extended period of time and her in office treatment of you is just wrong.
Did you ever file a complaint with the doctor or the person in charge of the clinic regarding her treatment of you?
If you did and can prove that she singled you out, you may have some leverage, but if not, I don't think there is much you can do.

retiredteacher70
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No, I did not. I detest

No, I did not. I detest confrontations and/or the thought of getting someone in trouble. Other than my husband and mother, I told no one.
About a year has lapsed since the last ten I filled my medication at 28 or 29 days, and that was not my request, my doctor told his patients to do this so we didn't run into unforseen issues with getting our medicine. Loooooong before he left his private practice and went to the hospital clinic.
I really don't understand how a long term,patient with a clean record gets discharged bc a nurse called, didn't reach me, and also didn't bother to leave a message explaining that I had X amount of time to return her call, or even X amount of time to bring my meds in for a count.
Anyway, thank you for taking the time to read my long post and replying.
I guess this forum will allow me to vent, research, and learn :)

sandi123
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Unfortunately

Most pm contracts have a stipulation that the patient can be called in at any time for a pill count, and failure to comply is grounds for dismissal.
Some contracts spell out a specific time frame in which the patient must respond, some don't, and unfortunately since you didn't make anyone aware of her treatment towards you prior to now, it is a she said/she said scenario.
If you had documented your concerns regarding her behavior before, it would be easier to defend your dismissal.
I'm sorry you are in this situation

retiredteacher70
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Actually, I have a journal I

Actually, I have a journal I began writing in several months ago, basically it was A) an outlet for me to vent and B) I was very strongly considering speaking to the hospital's HR person. So, I do have the dates, times, and how the visit went.
Regardless of how she treated me, whether she liked me or not, those things are irrelevant. What is relevant is the fact that she did not even bother to leave a message to let me know I needed to call them back by,X time, or to bring my meds in for a count by X time. I feel like I am being punished bc I left my house. As I mentioned earlier, I was never told that I would be required to be a hostage in my own home, nor that I had to let them know anytime I went somewhere. Pure insanity!
At this point i,just want my records and move on. I need to hit the pavement to find a new PMD and I'm clueless where I need to begin.
I do hate it bc I've been with him for many, many years and he knows all that is wrong with me,what works/doesn't work,etc.
Thank you for your kind reply.

sandi123
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Good luck

I hope you can find a new pm . The best place to start is your insurance website.
When I had to change pm offices because they decided to close my local one, I checked my insurance website for pm by specialty, then called to arrange a consult visit with a couple to decide who might be the best choice.

retiredteacher70
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Good idea. Thank you! I guess

Good idea. Thank you!
I guess I'm just shocked and heartbroken--and aggravated that the PMD I had been with with so many years can't or won't stop tolerating a nurse treating patients so poorly. Especially ones who have been there a Loooooong time and have built trust and positive rapport with the dr. So now, bc I did not know she called to do a count (remember, she left no message to come in or to call back within X time), she has had me discharged. Had I known I definitely would have gone. I had/have no reason not to.
You know, ppl with chronic pain already have more than enuf to deal with w/o having staff who think they can dictate our treatment. If they don't like that CP patients are treated with narcotics, then they need to NOT work I a pain clinic. Pretty simple deduction!
Thank you again for your advice.

sandi123
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I think if it were me

I would write a certified, return receipt requested letter to the actual pm doctor and state what you have said here.
It may be that he is unaware of her treatment, and while it may not get you reinstated, it may open his eyes to a problem and prevent her from doing the same to anyone else.
Good luck.

Lisa with EDS
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Nasty Nurses and Pain managment

As a nurse, myself, I have experienced other nurses that are judgemental and clueless about pain management. They seem to think that they have the wisdom to determine if a patient needs treatment, or is being treated fora "real" problem. These few seem to want to have power over those that they are supposed to be helping. They can cause pm patients a great deal of difficulty, and have the power to do so! You have to go thru the office staff in order to get appointments, or help of any kind, from the doctor. I have seen some nurses that are on a power kick and will not let you reach the doctor for help, because of whatever false notion that they may have in their heads. This really puts the patient at the mercy of these staff members. I have actually been refused an issue or concern being brought to the doctors attention, due to a nasty, judgemental office person.
I finally called the doctor at night, when he was on call, to get the treatment that I needed. It was the only way that I could get to him!
Pain management is really touchy, though. I believe that I would first, request a call from the doctor, himself. If they won't let you through, the only other option that you have is to write that certified letter, to him, and explain your situation.
Sometimes, when you have been discharged from a PM program, it's almost impossible to get into another PM doctors office, due to the discharge! I would first try to communicate with your old PM doc. If that and a letter doesn't work, I believe I would go to your primary care physicians for help with a referral and possibly an interventional phone call to your PM doc. Sounds as if this office is causing you more stress than helping you. I'm sorry that you have run into one of these staff members that have forgotten who is in charge of the office!

goat
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nice post

 thanks for joining in  Smile
welcome tpo Pharmer.    what is EDS ?

 

DyBNaps
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My wife is a Nurse

My wife is a Nurse Practictioner, and I am in healthcare, as well as a long tern PM patient. There are many out there in healthcare, not just nurses that are terribly judgemental to long term pain management care patients. Either because they are not trained in the the field, or are just hardened because of past experiences with difficult patients.

With that being said, and the bad rap that pain pills get in the media, and because of the abusers out there, many offices get easily spooked, and will sometimes discharge patients for minor, but very needed rules. How were you discharged? Although offices can discharge you for many of the smallest things, normally the Dr would see you at your next apt, and explain the discharge personally. And if he has seen you for years, it is crazy to think you were discharged by the nurse, without the Dr seeing you first, and giving you a chance to explain. Most clinics will put you on probation for a first offense.

If that Dr did not take the time to help you, and you were treated so poorly by the staff, unfortunatly like another said, the recourse for any dicipline is very small. Especially in the PM field. Dr's are getting scrutinized for the smallest of issues in their practices these days.There are many out there looking to cheat the system, and more often than not, we are guilty of infractions first, and then have to prove innocents second. And if you are made to feel guilty every apt, than it isn't a positive situation, that is likely to get better. Find a clinic that is willing to treat you farely, and respectfully. But be prepaired for this process to possibly take some time. Discharges will travel with you in your records, so make sure you know what they documented about you, so that you can defend your actions.