This was a very very bad appointment. About a week and a half before this appointment I had to go to the office and get a few (10) pills of my breakthrough medication. I did this as I wanted to get my doctor to figure out a new breakthrough medication to help with the pain so I didn't want to get too many of them.
So I got to my appointment with a few things I wanted to go over, it was an appointment for a thyroid check but for me it was more to get him to change things up for my pain levels. I get in and he was happy about my thyroid levels, that they have stabilized and that the dose I am on seems to be the dose that I will be staying on. He asked if I notice and differences and I told him that yes it was helping. I needed a few medications refilled so he did those and then we started in on the pain issue.
I told him that I needed to change my medications and so he asked what I wanted for long term and I told him what we normally switch to and he was fine writing that one up. I asked him if we could try the same total daily dose (90mg) and instead of taking it twice a day (45mg) could I take it every 8 hours (30mg) as the long acting meds don't seem to be lasting the full 12 hours. He did not want to do this because he felt that just changing the medication was enough of a change to my body and that we could revisit that idea when I had my next appointment (I see him every 3 months unless something else pops up). I don't agree but I can see his logic so I will just wait the 3 months and see how it goes.
He then notices one of the medications that I am on and wondered why I was on such a low dose! I told him I had been higher with my old doctor but that the dose I was on was enough to stop the nerve pain in my shoulder. My GP then said he wanted to triple the dose and see if it helped my overall pain levels. I told him I was hesitant about it as quite a few doctor's had prescribed it years ago and it never touched my overall pain and that I really didn't want to increase it. So he told me that he was going to write that I could increase it to triple my dose but that it was up to me (Such a weird statement from him). I really don't want to increase it as this is the medication that caused me to gain almost 15lbs when I started taking it!! I'm trying to lose weight not gain it! Also made me mad because the last time we discussed my headaches and a new medication I wanted to try he said I couldn't strictly because of this medication. I was honestly thinking about discontinuing it and instead he wants me to triple it!
Then I say that I need something new for breakthrough. He asks what I used to use and when I told him he just said 'I am not prescribing' and how it isn't used in practice anymore and how 'dirty' it is. So I asked him what I could use instead. He then proceeds to tell me that I shouldn't need anything for breakthrough with the other medication changes! I was so shocked that I couldn't speak then started almost crying. I told him that wouldn't work, that if I injured myself I needed to have something extra (I had just dislocated my wrist the night before and it was wrapped up so I used that as an example). He finally said well I don't know what to give you so I want you to find what would work best then I will write it for you (WHAT!?!?!). I then asked if I could get some of the old stuff as even though it didn't work well it at least did help more than just plain advil (which I can't take two days in a row or I dislocate like crazy). He then hands me a sheet and wrote it out for 40 pills! I questioned that and he tells me that the last prescription he had written was only for 10 and this was quadruple the amount. I said that the 10 pills where only to cover a 10 day time period as I had wanted him to change it. He fixed it up then told me that all he wants is to get my pain controlled (funny way of showing it). I left the appointment without making my follow-up appointment because I was so upset and mad (and crying because of how mad and upset I was).
I went home and got mad. I had asked my mom to go to the appointment with me as he tends to take me more seriously when she is with me but she didn't want to go so I didn't push it. I came home and I think she felt bad that she didn't go and said we would go back. Because that would look so good and help me with credibility. I just told her I would figure it out.
Since Then: I love my pharmacist! Not only did she completely call him out she worked so hard for me. She asked me why he wouldn't just give me the old med and I told her why and she just looked at me for a minute and said that the fact that no one used it anymore was a surprise to her as she filled it quite often and had no idea as to why he would call it a 'dirty' drug to someone who used it responsibly! I told her how he wanted me to find a new medication to use and she remarks "So he will write what you want - as long as he 'likes' it?" I had to laugh at that. She was on the same wavelength as I was and we both agreed what was the best thing to do. It was late in the day when I talked to her so the doctor wasn't there so she said she would write a note for the pharmacist in the next day so when the office called they would know what was going on. I called the doctor's office the next day and after back and forth calling between me, the office and the pharmacy we finally got it figured out and called in. Can you believe that the doctor's office wanted to even know what dose I should get? Like they couldn't figure it out themselves?!? When I picked it up that night I noticed the note that the other pharmacist wrote and it had on it "Doctor doesn't "like" -(other drug)- doesn't know what to give" then something along the line that me and the pharmacist brainstormed and came up with the answer.
It was a very easy answer and I really really have to question why the doctor couldn't figure it out. The one set of meds was "Drug X Contin" for long term and "Drug X" for breakthrough. So now that I was on "Drug Z Contin" didn't it make sense for me to just get "Drug Z" for breakthrough?
The new breakthrough is helping, was even able to get a way with a half dose a few times before the pain got too bad and it seems to last 2-3 hours (supposed to last 4-6). Unfortunately the long term medication hasn't seemed to really help me. However, I dislocated my shoulder the night I started it as well as made adjustments to my bed (I have a water bed and we had just added some more water and 'burped' it the same day).