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PostPosted: Sat Sep 18, 2010 9:13 am 
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Joined: Sat Jul 10, 2010 2:37 pm
Posts: 53
Hi All,

Today is day #6 since my doc put me back on sub (thank God), after my 16 day long
jump at .1 mg- It was absolute hell, I wasn't ready, and it was only by the grace of
God that he showed me mercy and re-induced me when I laid out the absolute truth to him.

Since my "heated" previous appt, I'd gotten into therapy, had X-Rays, Seen my Surgeon,
and done "here to help"- these things, I think were the only reason he eventually
caved in to my begging and re-induced me. Because first he walked in the room and said
"I'm not prescribing you anything whatsoever-Nothing!"- he didn't even say hello.

I was in absolute tatters, taking max Rx anxiety meds, with severe dysphoria, insomnia,
sweats, the whole nine yards. And when he finally induced me at 8mg it was all taken
away almost instantaneously.

Since then, I've been sleeping for long periods during the day and night. I've gone from
requiring heavy doses of psych prns to none at all. Like an unwinding spring.

I'm wondering if the somnolence thing is because of the sub, or because (I thought), my
body is still playing "catch-up" from the incredibly stressful situation it went through.

As I mentioned earlier, I'm a pain patient- I have Transverse Myelitis, with a paralyzed
bowel and bladder and multiple spinal surgeries. I'm bipolar also, but my psych is not a
sub doc. I'm very well controlled, but I think my paindoc is concerned about treating
a psych patient, even though he's been doing so for 2 1/2 years.

At this visit, doc was still very upset that I wouldn't go inpatient 3 mos ago when I told
him I felt I couldn't "taper" off of oxy and he wanted me to go inpatient, which I couldn't
since I care for My Mom- and at that time he said I was "way too toxic" for him to give
me sub- I'd shown up higher than a kite- "Mr. X, your pupils are pinned-you are over
dosed". I made a direct ammend to him for that, and told him I was very wrong for what
I did.

Yesterday his office called and said he's ordered a "behavioral evaluation" for me. I'm
willing to be honest about my wrongs, and let them know how extrememly grateful I
am that he put me back on sub. I'm doing "here to help", have a therapist, and am
going to 12 step meetings....I'm 85% stabilized now and want to stay on sub.

Of course my fear is that he may want to refer me to another doc, so I think I need
to emphasize that having a pain doc is important to me- I'm planning an elective
colostomy in the near future and need his help there. Also, he provides me with
copay assistance , is very close to my house, and I don't have the $$ to pay
for a new doctor. I've done everything by the numbers, and will bring my meds in.

I really am praying this isn't a formal patient discharge process....

Is there anything I should be aware of regarding the "behavior evaluation"? I did
some very wrong things, including not following the doctors orders, in my active
addiction to my pain meds. But I think I've been "behaving" well, and following
marching orders- I hope this interview is not a precursor or paper-trail to getting
canned. Fact is. he's not in the addictionology business so I think that convincing
them that I have pain needs (surgery, injections, spinal stimulator) may be important.

Any tips on how to handle this would be appreciated. I knew all along, as you suggested
that I needed to be on sub longer, and for the moment the world has been lifted from
my shoulders! The cost is a bear, but like someone else here said I don't care if I have
to take this pill for the rest of my life.

Earlier in my treatment, I'd self-pt'd myself out of my wheelchair and completed several
5ks with my walker- even got on tv. I showed the doc a finish line photo and he made
a copy of it. When he came in next visit, my Mom was with me and he told her
"this guy is my hero, I have his picture in my office". I'm thinking that I'm not exactly
his hero any more....makes me very sad....I did work my butt off to overcome paraplegia.

FYI, this community falls right in with all of the other support systems I've got in place.
I'm on Medicare, and like many who've come here I think I'd give my left arm to be a
patient of Dr. J but I'm sure it's costly (as it should be-he's awesome), and he's proabably
got a full-house too. Of curiousity, can anyone speak about his telephone treatment
program ?

Thanks,
Runner.


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PostPosted: Sat Sep 18, 2010 10:07 am 
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Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Good morning, Runner,

To be honest I've never heard of any kind of behavioral review by a pain doctor before, so I cannot help you there. If he's concerned about treating you because of psych issues, just stress to him that you have a terrific psychiatrist and counselor and are stable where you are at. Such a diagnosis as bipolar that shouldn't affect your treatment from him, but you just never know. Maybe he feels you'd be better served by someone who specializes in dual diagnoses? I'm just grasping at straws here. I hope for your sake that he has no intention of discontinuing your treatment with him. Maybe he just wants to be confident and comfortable that your current psych needs are indeed being met. If that's the case I would think that's a pretty responsible attitude for him to take. But we don't know his motivation for this, now do we? And it's left you to imagine the worse case scenario. All you can do is what you're already doing.

I'm really glad for you that you're doing so well back on sub. It's possible that your somnolence is just you making up for lost time after being such a mess for awhile. You'll just have to wait and see. Hang in there and let us know how it goes. I'm really happy that you're back on track.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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Dr. Jeffrey Junig, M.D., Ph.D.

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