I realize that most people cannot to do what I did $$$ but because my practice (even when it was more routine such as anasthesia pain mgt or regular TRP injecions) they just didn't bill to your insurance... they coudl also give you as a paitent hours of time and very personalized attention. these guys are at top of food chain.

so -- that being said -I AM SO SORRY U HAD OT GO THRU THAT. I remeber once i ahd a doc tell me to examine my marriage since the pain started one year after i got married. I WAS furios! but of course the more emotional the more they can deflect -- call you over emotional -- I woudl be angry too and scared too -- IT IS SCARY TO FEEL HIGH AND DRY but time to get busy -- you what? ahve 30 days to refill?

I know what u ar going thr - went thru it for 2 yrs -- I have little or NO reaction to most drugs and ahd doctors give me all kinds if crap until one specilaist #9, looked at me bawling my eyes out and immediatly put me on fentanyl patch. Then 3 weeks later she closed her doors -

1.) so if i understand you got a scrip for the immediate future which means you gotta hustle now to locate doc. It is often hard ot be seen in ext 30 days.

2.) at my practice they have a policy IF they think a patient isn't participating in their own recovery and only refilling or asking or early refills, lost meds etc.. they will write ONE more scrip (for wihtdrawal) and say bye-bye.

3.) others will say tuff - go to ER but sounds like you will not go into withdrawal now. Many docs do not like to manage pain w/short acting drugs but it sounds liek you are taking only TWO Vico a day ES? that is not a LOT and 50mg Fentanyl is 2nd to lowest on chart. Kinda surprised he upped it to 200mg of kadian - wow. It is high --

Sorry kadian didn't work - it is good drug but for yardstick -- i take 80mg to replace 50mg of Patch.

4.) Write succinct non-whiney letter to whoever boss is, recap your experience in one page or less (not whole history -- they have chart right). be respectful tell her you appreciate that she understands and you do too -- every doctor is diferent as is every patient. (hell i have NO reation to like 90% of narcotics and no reaction to any numbing agent - novocaine ets. NONE. while it is rare better docs know there are some paitenst that are tolerant NOT because ofoveruse just their chemical makeup). Some docs know this and listen others are burnt out and have heard it all. Plus they do not like to be second guessed when they are like that

PUT IT IN HER LAP, tell her you need a doc to manage your pain, confirm you stay in touch w.med team, participate activley in your own pain mgt - follow suggestions and you are NOW in a bad place. IF you write it without characterisation - like "he was mean, nasty" -- then firmly ask her what your options are within that pracitce and WHO she would recommend.

for all you know -- she doesn't like the guy either

she overrode him once -- an in the end he has the right to refuse seeing you and sounds like u don't want to see him anyway BUT she might make someone else in the practice take over OR give you referral.

I manage my pain w/short acting drugs daytime and kadian at night. OTHER docs call it "chasing the pain" and they will not let you do this. BECAUSE i am very thorouhg and keep charts, show up for all appts - etc. my doc lets me do this because it is all about what works for you BUT yes -- when i wanted to drop the kadian down and add extra dose of percocet he said NO for asme reason -- better to take stron time release when u need it than increase short drugs and take more.

She is right - you know your body -- sicne she saw that - called you reasonable - then get back to her ASAP (of course you are reasonable)and submit to her you need her assistance. Remember this -- focus on the HOW not the WHY. Ok - so... tone shoudl be - "thanks for "getting it" i appreciate help, recap fast - I have seen this doc etc. for so many yrs - do this and done that, here i am w/current situation, (sure say you are cocnerned, confused etc.)butDO NOT get emotional or bitchy about the guy NO MATTER how right you are. If you are going to use emotion or langauge and want to make a poitn -- don't focus so much on how crappy he was to do what he did - she got it when you called - Use strong or emotion to describe HOW YOU NEED a solution. Be professional but prgamatic and firm --- focus on solution, not his problem BUT yours.

Can you put this on biz letterhead? IF NOT put it in Memo or Facsimile format and FAX IT. OR if you have email send it read reciept.

EITHER WAY -- YOU GOTTA HAVE YOUR RECORDS OR NO-ONE WILL JUMP IN FAST --

Becasue my guys are like always quoted etc... and sit on a million chairs, lead research ETC -- I WILL ASK THEM TOMORROW WHO they rcommned in your state and then you will have to ask about insurance BUT even if the reference isn't good - if they give me a name THEN you can call ans aks them .....

I NEVER do this but if you reply here and offline give me email i will send u what names i get - i run biz so my name is on web and cant give u mine here - (search engines)

nerve pain/daamge right hand - use voice activts software at work ---but pls know - i will happily ask --like i said these guys are nat'lly known - top in FM and CMP treatment and really kind..

i spent so much time in bed first year i was like rainman reseraching socities and docs -i was lost and had 30 days to replace #9 -- i found someone -- u will too --

Another thing you might consider is the pharmaceutical sites often have advocay departments and referrals to practioners. We had to fight to get Blue Cross to pay for the Fentanyl Lollipops at a $1ooo a box when they were paying for the patch because it was a "cancer" apin drug and i don't have cancer. BUT the pharmas are incentivised to have the docs dispense so they had great help so that CP patiens coudl get access. Maybe call the maker of your patch and see. GOOD LUCK

Coming from a similar situation, yes, he can legally drop you as a patient and there is little you can do about it except reporting him to the medical board for stopping your meds cold when it is against procedure to do so (but you better be able to show proof he was out of line).

Regardless, the doc should have sent you a letter, in writing, dropping you as a patient.

Now, be prepared if you contact the medical board, for word to get around in the medical circle and having real trouble getting another doctor.

If he/she did not write a formal letter, then perhaps make an appointment to talk to the doctor in the office about what happened. I am on your side, but I want you to consider that it is possible the high level of pain you were experiencing was partially due to withdrawal symptoms. That kind of pain is not all together uncommon of a symptom for the meds you were on and taken off of so rapidly.

Best of luck to you!

I think if you were to insist on assitance for treatment and or referral so that your pain could be effectively managed and i guess, i was thinking that they woudl take you seriously. gosh i hope it goes well. such a pain in the ass

I hope you are feeling well and I hope by now they have helped you in some direction.

happy easter