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GP's and Phone Approval's / Pain Meds

  • Pained NSW
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4 years 1 week ago #20206 by Pained NSW
Pained NSW created the topic: GP's and Phone Approval's / Pain Meds
Hello,
I have had chronic lower lumbar pain for over 4 years now. I have been using the same GP that i have had for many years when treating my pain. It has been a slow and painful crawl to finally start getting the right pain management. We have been through the Celebrix / Tramadol, Lyrica and anything else the doctor could give me before using opiad's.

I was on the maximum amount for Tramadol at 200mg x 2 a day, and 3 x oxynorm 10mg a day for BF pain. I kept finding that after 18 months the Tramadol wasn't working and i would need to use more oxynorm and run out and go back within the normal month time frame that GP's prefer.
So having small children and needing to be able to function as my GP wasn't listening, i went to another GP and was given oxycontin 30mg x 2 a day. What a difference that made to pain and i stopped taking the Tramadol.

But of course there is always the dealing of BT pain and i would still go back to my other GP for my script of oxynorm. He finally understood that the Tramadol dosen't work and put me onto Targin 20mg x 2 a day. So with the combination of both GP's i no longer run out of pain med's and can thankfully function normally.

My concern is though whenever they ring through for the phone authority i'm worried that the PBS people will say something to one of the GP's. Both GP's prescribed different named medication and i wanted to know that as long as i only return monthly for my normal scripts, can the person on the other end of the phone that authorizes the scripts say "oh that patient get some oxycontin the other day that is like the Targin you are giving the patient today" Niether GP prescribes the same thing.
GP 1 - Oxycontin slow release
GP2 - Targin slow release + Oxynorm
I live in nsw if that helps if anyone else there my have the same system to ensure that there pain is manged correctly, even though it means using 2 GP's. I'm just worried one day the phone approval person may say something. I only go to the GP's within the correct time frame and never attend within the one month period.

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4 years 1 week ago #20207 by Mary
Mary replied the topic: GP's and Phone Approval's / Pain Meds
Hi Pained NSW and welcome,

I guess that the chance of getting caught out is always there, but I think I would be more concerned about your health. You are basically taking two quite potent pain medications and neither of your GPs knows. I can sympathise with the fact that you have small children to look after. I can't imagine how difficult it is to do that when you also have chronic pain.

It would be worthwhile talking with one of your GPs about other options. The current research is telling us that medication is only a small part of pain management. We all develop tolerances to it and therefore need to increase the dosages or change to another medication. A good multidisciplinary pain clinic can help you with both medication and other approaches to help you manage your pain. This may sound a bit simplistic, but it does work.

In the meanwhile, have a read of this website. It has a plethora of information about chronic pain, what it is, how it is treated etc. It is a very worthwhile read.

www.aci.health.nsw.gov.au/chronic-pain

Keep talking to us and all the best,

Mary

Not every day is a good day, but there is good in every day.

"“It’s delightful when your imaginations come true, isn’t it?” ― L.M. Montgomery, Anne of Green Gables

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4 years 1 week ago #20208 by Mary
Mary replied the topic: GP's and Phone Approval's / Pain Meds
PS. Pained NSW,

You are in the best state for pain management! Your government has set up a lot of good programs and you have more facilities for pain management than anywhere else in the country!

Mary

Not every day is a good day, but there is good in every day.

"“It’s delightful when your imaginations come true, isn’t it?” ― L.M. Montgomery, Anne of Green Gables

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4 years 1 week ago #20209 by grappers
grappers replied the topic: GP's and Phone Approval's / Pain Meds
Hi Pained NSW,
All I can say is I hope you don't get caught, the department we have in SA comes down on you like a bucket of bricks if you fill a authorisation script early, or you run out of meds early, or in my case the chemist buggered up my prescriptions so I had my case scrutinised, with the vary chance of not ever having my meds approved again, but lucky they found the mistake.
If the Authorisation section doesn't pick it up Medicare soon will as the electronic system gains speed across Australia so be careful, I would suggest you get a referral to a good multidisciplinary pain clinic, they are the best ones to sort out your pain medications and a plan to get it under control, a pain management course that follows the ADAPT or STEPS programs are the best

Don

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4 years 1 week ago #20211 by Pained NSW
Pained NSW replied the topic: GP's and Phone Approval's / Pain Meds
Yes i know it's always a worry. From what i can gather, as long as you do not return to the doctor before the one month due date it's meant to be ok. I certainly do not doctor shop. It's just hard to be able to have the correct amount prescribed due to those in the community that have abused S8, it make it difficult for us that really do benefit from these pain meds.
I have often thought that a pain clinic is the next step so i don't have to use to doctors to achieve a pain free result. I'm currently collectively taking around 120mg of oxycodone daily and have found this level perfect and been stable for over 3 months now. As i said my main concern was that cause i use to doctors i get worried that one day the Authorisation section may say something, but again they are different styles and brand names which is why i think it doesn't seem like a problem for the Authorisation section. I certainly don't advocate this method to achieve the correct outcome, and i hope that i can eventually go back to just having the one doctor, as cost is another issue.
Thank you Mary and grappers for your feedback and advise.

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4 years 1 week ago - 4 years 1 week ago #20213 by Peter
Peter replied the topic: GP's and Phone Approval's / Pain Meds
G'Day Pained NSW and welcome to our forum.

Mary and Don have covered the topic well, because they have more experience in the areas they speak about than I do. However, I just felt that I should chime in and say something to further back up what they are saying.

If you are not investigated or let's say the authorising body doesn't twig that you are using two different doctors to get Opioid medication, then you may still suffer from another problem.
You say you have had 3 months of good pain control. That is great. However, this may not continue on indefinitely like that. Our bodies tend to get use to the drugs after a time, then we need more to keep getting the same amount of pain relief. Plus there is the added issue of Opioids causing more issues with our pain levels.

It is so good that you have found a level that fits you and helps you get through your day. But they are strong drugs and you don't want to be on them for too long. So it would be wise to try and find an alternative to using the drugs in the long term, which is where the pain clinic can help, providing you attend the pain clinic in the right frame of mind.

There is no cure for spinal pain. Some people are lucky enough to have their pain reduced to such a level that their brains can cope easily and they return to a normal life. These people are in the minority unfortunately. For the rest of us, we suffer chronic pain till the day we die. Adding strong drugs to it long term, only increases the stress on our systems and our pain only increases, until we can learn to deal with the pain, find alternative methods of reducing the stress and the pain levels, so that we can then live some semblance of normal living.

You also need to know that there are many people out there who are living normal lives, plus working in physically demanding jobs, but who have spines that make doctors cringe. The doctors cannot believe how some of these people are still standing and not crippled by the damage they see in their spine. Yet, these people will tell you that they get a bit of pain every now and then, but just let it pass and then get on with living again. This is proof that our brains can cope with long term injury and we don't necessarily need to suffer the pain all the time.

Some of us suffer the pain constantly, because our brains have over done it with the protection stuff. It's the 'flight or fight response.' Our brains are too active in this area. Instead of our neural pathways resisting pain signals, they are opened up like super highways and we are over loaded with pain signals that would equal a major injury, yet there is nothing physically wrong with us, because the original injury has healed.
There is a lot more to it than that. That description is very simplified and only scratches the surface. You will learn much more from the pain clinic.

I have suffered chronic pain for 54 years and I have found that in the end, the drugs have to be the smallest part of my pain management plan.

I found over all these years that ALL drugs have a honey moon period. This can last just days or even a year or two, but for pretty much all of the drugs I have tried, they only ever lasted for several months at most. Then comes other issues, like increased need for the drug, because my pain levels are up or I stop sleeping, which sends me into a flare up spiral. Once it all settles down, I find the I can't get back to the original prescribed amount of the drug, because it doesn't have much of an effect on my pain levels anymore. So, I have to ask for a different drug and get off the other one. In the end, you go through the list and get to the point where you may run out of options.

What you need to do is get to the pain clinic and learn how to live with your pain condition. Learn to accept it and learn to be happy while suffering a certain amount of pain that is not dulled down by drugs. Once you get control over your mind and your subconscious brain, you will start to see you can live and cope with pain that you once couldn't. Many people can often lower the amount of drugs they take too, once they get back some control over their brain.

But there are a lot of other skills that you must learn so that you don't injure yourself and so that you can raise your fitness levels and strengthen your spine.

All I am trying to say I guess, is that while you are living in this honey moon period of the drugs you currently take, make use of this time productively to find the right strategies to live out the rest of your life NOT relying on drugs.

As for whether or not you will get into trouble with the script authority people, I have no idea. If it was me, I wouldn't take the risk, because once they cut you off, you will not be able to get these drugs again. Worth considering!


Peter

I wish the ring (this Chronic Pain) had never come to me. I wish none of this had happened. (Frodo Baggins)

So do all who live to see such times. But that is not for them to decide. All we have to decide, is what to do with the time that is given to us. (Gandalf the Grey)
Last Edit: 4 years 1 week ago by Peter.

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