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Regular Contributor
Posts: 186
Registered: ‎11-18-2018

Re: I this normal protocol today?

I seriously doubt we are getting the whole story here. First of all , it would be extremely unusual for a doctor to order an opiate like vicodin for anyone for arthritis pain.And second of all , doctors don't just cut people off from addictive meds , they have to be weaned.There are a lot of holes in this story. If someone really was withdrawing from an opiate addiction they would be way way too sick to making a turkey dinner for company.

Respected Contributor
Posts: 2,916
Registered: ‎03-14-2010

Re: I this normal protocol today?


@patofl wrote:

I seriously doubt we are getting the whole story here. First of all , it would be extremely unusual for a doctor to order an opiate like vicodin for anyone for arthritis pain.And second of all , doctors don't just cut people off from addictive meds , they have to be weaned.There are a lot of holes in this story. If someone really was withdrawing from an opiate addiction they would be way way too sick to making a turkey dinner for company.


I don't know the whole story. She is my neighbor- I know what she's told me and what I know of her from years past. She told me she was given vicodin 5 years ago for pain in her feet and ankles which turnd out to be severe arthritis. She's been taking them ever since, first thing in the morning so she isn't in excrutiating pain when she's getting ready for her day.

Supposedly she has been free of the vicodin for a few days, but is taking this new anti depressant, neuropathy med.

She was in big pain this morning when I went to put the turkey in. I offered Aleve or Motrin but she said she can't take it because of another med she is on.

 

I'm glad she's got company today. I will check in later tonight or tomorrow am when her company is gone. It sounds like this is a concerted effort to force people off the opiates- comfort, mobility, emotional state be damned. I wasn't sure if she was a disgruntled addict or if this was the new protocol.

 

Respected Contributor
Posts: 2,916
Registered: ‎03-14-2010

Re: I this normal protocol today?


@GraceLady wrote:

@bathina wrote:

My 75 year old neighbor has been taking Vicodin for 5 years for severe arthritis in her ankles. She walks with a walker and is in pain, even after taking the Vicodin.

Long story short, she had her annual exam with her primary care doc and he told her he would no longer prescribe the Vicodin. He sent her to a pain clinic for an evaluation and they sent her home with an antidepressant. That was last week. She has been off the Vicodin now for 3 days and she is in agony. She called me this morning and asked if I would help her put a turkey in her oven for company she is having this afternoon.

I cannot believe the doctor would cut this woman off without a plan to manage her pain. She is clearly in withdrawal- heart racing, nausea, diarrhea. Coupled with the pain in her ankles and her inability to walk, I am very concerned.

I understand there is an opiate epidemic, but is the protocol now to remove that option for people who have been successfully taking an opiate for pain?  Does anyone have experience with this?


I love that you are concerned for your neighbor.  She does need help to manage her pain, and an advocate like you to help her understand what her providers are telling her.  She may be inclined to hear things differently right now because she is in distress. 

 

If her arthritis is so bad, she needs to see a rheumatologist.  There are so many things that can be done for arthritis that don't involve pain meds.  You don't say what type of arthritis she has, but that does make a difference.  The problem with "weaning her off" opiates is that she has access to them.  She has a dependence/addiction.  The pain will get the better of her and she would most likely take her usual dose at some point. 

 

Her doctor, in fact any doctor, would be irresponsible to continue prescribing pain meds to her.  Addiction to opiates can happen in a less than a week.  Once you have built up a tolerance to opiates, that is irreversible.  Should she need surgery in the future, pain control could be compromised.  Urge your neighbor to see a rheumatologist to see what treatment options she has. Should the rheumy decide she needs to continue on pain meds instead of the newer treatments available, a pain clinic will be better equiped to handle her pain.

 

Again, she is lucky to have you caring so much for her.  Best of luck to you both.   


This is wonderful advice. I know nothing about opiates. I would hope that Doctors would do the responsible thing. She had been seeing the primary doc for over 30 years. He's getting ready to retire, so I'm assuming he's deliberately trying to shed some patients. I am going to talk with her later on or tomorrow. If she doesn't seem to be open to the conversation, I'll call her daughter. Thanks for this information!

Esteemed Contributor
Posts: 5,028
Registered: ‎10-26-2010

Re: I this normal protocol today?

The "opioid crisis" seems to be at the forefront of care today.  Unfortunately for years many docs prescribed pain meds for patients dealing with chronic conditions.  Today it seems that those same docs are referring patients to pain management centers for care.  Some of those providers want to go right to surgery, others say PT.  Neither option will help someone who is debilitated by severe pain!  But, the docs are being pressured not to give pain meds.  Someone in real pain is not going to abuse their medication.  But, it isn't politically correct in today's society to prescribe pain meds.  Ridiculous!!!  Any good doc can tell the difference between patient in real pain and someone who wants a fix.  In addition, pharmacists track those prescriptions and will call a doctor's office concerning dosage and frequency.

 

As far as the elderly are concerned, we prefer to live as best as can.  Aches and pains, arthritis, etc, they are all part of everyday life.  For those in severe, debilitating pain the stronger meds just take the edge off.  Most of us are in pain constantly, worse with damp, rainy weather.  I had injections in my back 2 years ago and spent 5 days in hospital due to side effects!!!  I take arthritis strength Tylenol daily and only get minor relief if any.  

 

Today, healthcare is a big business.  Docs don't always make the best choices for their patients, often due to outside interference!

Honored Contributor
Posts: 10,432
Registered: ‎05-15-2016

Re: I this normal protocol today?

How terrible. Pain management clinics are a joke. She has zero quality of life and reduced daily activity which is causes more harm than needing to use a pain killer every day. It is a dreadful direction to throw the baby out with the bath water, so to speak. 

 

Its inhumane. 

Respected Contributor
Posts: 2,916
Registered: ‎03-14-2010

Re: I this normal protocol today?

I went to check on my neighbor today and her daughter was there. We discussed the situation and it seems my neighbor will find another doctor who is not a D.O. She was given a prescription for half the previous Vicodin amount and was told she needed to take the anti-depressant/neuropathy meds (she's now decided she doesn't want to take these as they make her sick). Her daughter and I both feel she should try to follow the pain clinic protocol, but she wants to be put back on the same dosage of her pain med and she's going to find a doctor who will do that for her.

 

Her daughter seemed exasperated and I told her I'd continue to check in. I hope my neighbor is able to find some kind of happy medium. Thanks for all your advice.

 

Honored Contributor
Posts: 9,283
Registered: ‎03-09-2010

Re: I this normal protocol today?

In some states PCP's aren't allowed by law to prescribe pain meds.  You have to go to a pain management practice.

 

Valued Contributor
Posts: 988
Registered: ‎03-09-2010

Re: I this normal protocol today?

[ Edited ]

This happened to me also.  I'm 73.  Dr. prescribed for 7 years.  1 or 2 a day.  I have Fibro and I had rotator cuff surgery 6 months ago and I have various other pains.  Boom...no more Hydrocodone.  Just like that.  Cut off.  Offered to send me to a pain clinic.  I didn't go yet. Sounds like they didn't help your neighbor.  It is CRUEL!!  and, dangerous and very unfair to us elderly.  THIS IS THE NEW FLORIDA LAW !!!

Esteemed Contributor
Posts: 7,213
Registered: ‎03-30-2014

Re: I this normal protocol today?

Old fashioned pain management can be a blunt tool.

 

If you can get a referral to a chronic pain clinic it can be life changing.  They are headed by a MD and offer PT, OT, ST, dietary management, and mental health.  They first require that all relevant medical services are done.  You have to have an open mind and do the work.  Many more tools than just pain meds.  I am proof.

Honored Contributor
Posts: 9,283
Registered: ‎03-09-2010

Re: I this normal protocol today?


@patofl wrote:

I seriously doubt we are getting the whole story here. First of all , it would be extremely unusual for a doctor to order an opiate like vicodin for anyone for arthritis pain.And second of all , doctors don't just cut people off from addictive meds , they have to be weaned.There are a lot of holes in this story. If someone really was withdrawing from an opiate addiction they would be way way too sick to making a turkey dinner for company.


Oh yes they do...

They tried to do it to my m-i-l.

For some reason her PCP decided she didn't need a pain management doctor anymore, he would prescribe the morphine for her instead.

I told her to make sure she knew what she was doing by allowing this and lo and behold, shortly after the law was changed and this PCP could no longer prescribe it for her.

She had to be set up with a new PM doctor that said he did not prescribe pain meds he only did cortisone injections, so basically, you're out of luck lady.