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<blockquote data-quote="Marguerite" data-source="post: 331744" data-attributes="member: 1991"><p>Susie, why can't your pain specialist see your daughter? Or failing that, recommend a name for you? Hopefully he would also have a quiet word with the doctor whose name he recommends, letting the bloke know that you and easy child are 'legit' and not drug-seeking.</p><p></p><p>The problem is, there ARE a lot of patients out there who are drug-seeking. Plus sadly, many of them are parents of a disabled kid (or a pretend-disabled kid) and will use that kid to get supplies for themselves. Sad, but true.</p><p></p><p>I've been doing my darndest to help a friend of difficult child 3's, a younger boy (he's now about 11) since he was a pre-schooler. The boy was diagnosed at 4 with autism (mild, high-functioning) plus ADHD. Finally the mum followed through and took him to the specialist who prescribed Concerta. Now, I happen to know that the mum does dabble in drugs occasionally - mostly pot. Any time her son is prescribed stuff (other than antibiotics) she will take it herself "just to see what it will do". In vain I point out that first, it's been prescribed FOR HIM and the supply is limited; what she takes, he misses out on (so she just leaves him without medications for a day instead); and second, that his brain works differently and the effect it will have on her is not the effect it will necessarily have on him.</p><p>She was also cutting his Concerta in half. This had a little use in that it showed that the boy did better on a lower dose, but it DOES interfere with the sustained-release side of the drug.</p><p></p><p>My point is - you and I might be responsible parents, but this doctor, especially if he's an ER doctor, will have seen too many of the other sort of parent to be willing to hand over pain medications readily.</p><p></p><p>The problem - easy child needs pain medications, clearly (to me). I know you better than that doctor.</p><p></p><p>WHat I think you need to do - build up a case with documentation form other doctors who have easy child's long-term history. She needs continuity of care with one doctor who isalso willing for an ER pain specialist to telephone him for confirmation.</p><p></p><p>I had a nasty incident some years ago when we were on holiday in beautiful, drug-sodden Sunshine Coast of Queensland. I ate a dud batch of oysters (I suspect) and got food poisoning. Not too much of a problem for most people, but it meant my pain medications could not get on board. Day 1 the pain medications I took sat there mostly unabsorbed; Day 2 the pain medications were clearly not working well and over that day my pain was escalating badly. By mid-afternoon when the vomiting stated it was obvious nothing was absorbed because I saw the pain medications I brought back up (little white beads). We called a GP but we were on holidays and I was unable to get in to a surgery. So after waiting some hours and being told we'd need to wait a few more, husband called an ambulance which took me to the district hospital. We brought my diary which had my doctor's lettter in it (a letter on his letterhead which stated what medications I take and that if for any reason I can't keep those medications down, or I develop severe headache symtpoms, I need an immediate injection of antiemetic plus pethidine). I did not bring my bag with me as well with my oral medications - since nothing oral was staying down at this point.</p><p>Well, the hospital put me under observation. They did inject an antiemetic which did not immediately stop the vomiting (thereby making it clear I needed injected medications). But, they told me, they had no pethidine. Yeah, right. Meanwhile there were car crash cases being wheeled in. and other injuries.</p><p></p><p>Finally it was in the wee small hours, my vomiting finally stopped. I was a mess - they still said they had no morphine, no pethidine. They gave me a couple of Endone tablets which, for the state i was in, as little more than useless. But it was a slight improvement, enough for me to be able to get up and walk, assisted, to the car with husband. Fortunately it was not quite daybreak (the sunlight always made me a lot worse when I got to this state). We got back to the unit to my own supply which thankfully stayed down this time. I spent the day in bed recovering, all curtains drawn and blindfold on. easy child took the kids bowling for the day so husband & I could both sleep. I was so angry, I had been left in a lot of pain for far too long, because the hospital thought I was drug-seeking. The trouble is, addicts can put on a really convincing act, including preparing fake doctor's letters.</p><p>But what they SHOULD have done, if they doubted the letter, was telephone the doctor and talk to him. A few questions on something medically technical would have ascertained his credentials. When I got back home and talked to my doctor, he said, "Why didn't they ring?"</p><p>I said, "Maybe because by that time it was in the middle of the night."</p><p>He said, "I take calls any time, especially from hospitals. Remember that next time."</p><p></p><p>Unfortunately, he's no longer our GP - he moved, and now he's begun to specialise - in pain management and addiction medicine. By the time my current pain specialist retires, my old friend will probably have his position.</p><p></p><p>The thing is, you need to think like a suspicious doctor and try to have the answers ready. Have her medical evidence there with you - actual X-rays indicating spinal problems or whatever, for example. Letters from the GP she sees regularly and who has her long-term history with him/her. And you need to be firm in what you want. "We need her pain managed. If you won't do it, tell us who she needs to see in order to get the help she needs."</p><p>When they prattle on about addiction, make it clear that you know about the risks but are trying to keep her ALIVE. Try to downplay the suicidal bit though - strong pain medications can also be used to suicide.</p><p></p><p>You probably already did a lot of this.</p><p></p><p>Doctors are more scared these days of litigation, than of breaking their Hippocratic oath. Then there is the "First, do no harm" bit which they take to the nth degree and use to justify doing nothing. Make sure you tell the doctor who sends you away, that to send her away with nothing done IS to do harm.</p><p></p><p>With doctors in general, you need to be concise. VERY. Up-front about what is needed. Do not diagnose, but instead say, "She has been diagnosed with...". It's a fine distinction.</p><p></p><p>I also suspect, Susie, that you, like me, upset some doctors simply because we project an air of knowing what we are talking about. It's difficult to hide your own light but especially when dealing with a new doctor, sometimes we need to do this. I tend to do it by shrugging and making it clear, I am at the mercy of a medical system where other doctors tell me things which I am now relaying. Only when I know a doctor well do I say, "But I think it may have been X because of Y." I might even phrase it with, "Is there a possibility of Z?" Or "Someone suggested..."</p><p></p><p>But when seeing someone new for something important like this, you need to be a tricky combination of concise, up-front but also not challenging.</p><p></p><p>And with some doctors, you simply are never going to get what you need.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 331744, member: 1991"] Susie, why can't your pain specialist see your daughter? Or failing that, recommend a name for you? Hopefully he would also have a quiet word with the doctor whose name he recommends, letting the bloke know that you and easy child are 'legit' and not drug-seeking. The problem is, there ARE a lot of patients out there who are drug-seeking. Plus sadly, many of them are parents of a disabled kid (or a pretend-disabled kid) and will use that kid to get supplies for themselves. Sad, but true. I've been doing my darndest to help a friend of difficult child 3's, a younger boy (he's now about 11) since he was a pre-schooler. The boy was diagnosed at 4 with autism (mild, high-functioning) plus ADHD. Finally the mum followed through and took him to the specialist who prescribed Concerta. Now, I happen to know that the mum does dabble in drugs occasionally - mostly pot. Any time her son is prescribed stuff (other than antibiotics) she will take it herself "just to see what it will do". In vain I point out that first, it's been prescribed FOR HIM and the supply is limited; what she takes, he misses out on (so she just leaves him without medications for a day instead); and second, that his brain works differently and the effect it will have on her is not the effect it will necessarily have on him. She was also cutting his Concerta in half. This had a little use in that it showed that the boy did better on a lower dose, but it DOES interfere with the sustained-release side of the drug. My point is - you and I might be responsible parents, but this doctor, especially if he's an ER doctor, will have seen too many of the other sort of parent to be willing to hand over pain medications readily. The problem - easy child needs pain medications, clearly (to me). I know you better than that doctor. WHat I think you need to do - build up a case with documentation form other doctors who have easy child's long-term history. She needs continuity of care with one doctor who isalso willing for an ER pain specialist to telephone him for confirmation. I had a nasty incident some years ago when we were on holiday in beautiful, drug-sodden Sunshine Coast of Queensland. I ate a dud batch of oysters (I suspect) and got food poisoning. Not too much of a problem for most people, but it meant my pain medications could not get on board. Day 1 the pain medications I took sat there mostly unabsorbed; Day 2 the pain medications were clearly not working well and over that day my pain was escalating badly. By mid-afternoon when the vomiting stated it was obvious nothing was absorbed because I saw the pain medications I brought back up (little white beads). We called a GP but we were on holidays and I was unable to get in to a surgery. So after waiting some hours and being told we'd need to wait a few more, husband called an ambulance which took me to the district hospital. We brought my diary which had my doctor's lettter in it (a letter on his letterhead which stated what medications I take and that if for any reason I can't keep those medications down, or I develop severe headache symtpoms, I need an immediate injection of antiemetic plus pethidine). I did not bring my bag with me as well with my oral medications - since nothing oral was staying down at this point. Well, the hospital put me under observation. They did inject an antiemetic which did not immediately stop the vomiting (thereby making it clear I needed injected medications). But, they told me, they had no pethidine. Yeah, right. Meanwhile there were car crash cases being wheeled in. and other injuries. Finally it was in the wee small hours, my vomiting finally stopped. I was a mess - they still said they had no morphine, no pethidine. They gave me a couple of Endone tablets which, for the state i was in, as little more than useless. But it was a slight improvement, enough for me to be able to get up and walk, assisted, to the car with husband. Fortunately it was not quite daybreak (the sunlight always made me a lot worse when I got to this state). We got back to the unit to my own supply which thankfully stayed down this time. I spent the day in bed recovering, all curtains drawn and blindfold on. easy child took the kids bowling for the day so husband & I could both sleep. I was so angry, I had been left in a lot of pain for far too long, because the hospital thought I was drug-seeking. The trouble is, addicts can put on a really convincing act, including preparing fake doctor's letters. But what they SHOULD have done, if they doubted the letter, was telephone the doctor and talk to him. A few questions on something medically technical would have ascertained his credentials. When I got back home and talked to my doctor, he said, "Why didn't they ring?" I said, "Maybe because by that time it was in the middle of the night." He said, "I take calls any time, especially from hospitals. Remember that next time." Unfortunately, he's no longer our GP - he moved, and now he's begun to specialise - in pain management and addiction medicine. By the time my current pain specialist retires, my old friend will probably have his position. The thing is, you need to think like a suspicious doctor and try to have the answers ready. Have her medical evidence there with you - actual X-rays indicating spinal problems or whatever, for example. Letters from the GP she sees regularly and who has her long-term history with him/her. And you need to be firm in what you want. "We need her pain managed. If you won't do it, tell us who she needs to see in order to get the help she needs." When they prattle on about addiction, make it clear that you know about the risks but are trying to keep her ALIVE. Try to downplay the suicidal bit though - strong pain medications can also be used to suicide. You probably already did a lot of this. Doctors are more scared these days of litigation, than of breaking their Hippocratic oath. Then there is the "First, do no harm" bit which they take to the nth degree and use to justify doing nothing. Make sure you tell the doctor who sends you away, that to send her away with nothing done IS to do harm. With doctors in general, you need to be concise. VERY. Up-front about what is needed. Do not diagnose, but instead say, "She has been diagnosed with...". It's a fine distinction. I also suspect, Susie, that you, like me, upset some doctors simply because we project an air of knowing what we are talking about. It's difficult to hide your own light but especially when dealing with a new doctor, sometimes we need to do this. I tend to do it by shrugging and making it clear, I am at the mercy of a medical system where other doctors tell me things which I am now relaying. Only when I know a doctor well do I say, "But I think it may have been X because of Y." I might even phrase it with, "Is there a possibility of Z?" Or "Someone suggested..." But when seeing someone new for something important like this, you need to be a tricky combination of concise, up-front but also not challenging. And with some doctors, you simply are never going to get what you need. Marg [/QUOTE]
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