Author Topic: methadone dose ceilings  (Read 25311 times)

sapphire

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Re: methadone dose ceilings
« Reply #45 on: April 13, 2014, 01:38:14 PM »
So he is supposed to be doing it but he's just dragging his arse? Good job that you do have some stashed so you don't have to take yet more time off work. They are supposed to tale things like you working into account when treating you, perhaps he needs reminding of that, lol?!

Filskit

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Re: methadone dose ceilings
« Reply #46 on: April 20, 2014, 01:17:45 PM »
Thought I was getting somewhere, have contacted my DSP twice this past week to ask if there was another prescription waiting for my PRN medication & on Weds. recieved a text from the Nurse saying it would be sorted by the weekend.  :) 

Then recieved a text at 5:20pm on Friday saying the prescribing Dr. wont be back at work till next Weds. & they " understand my situation, but can't go over his head " !?  Also that the Dr. want's to talk to the pain consultant " to make sure he's doing the right thing " .    >:(

It's only 2 friggin DFF's that I have previously been prescribed for a year, stopped taking them without any bother when they asked me to ( though had to be signed off work as I couldn't take them for pain when needed ). They were told to re-instate the prescription 3 weeks ago at least until I was seen at the pain clinic. I was told this by the Nurse when I gave them a dhc free u/s & expected to get the script there & then, but after she went to get the script she came back saying that " the Dr. wants to have this confirmed "  by whoever she spoke to.

I have now recieved a letter from my employer to attend a meeting to discuss the two week's I was signed off work. So not only is this new prescriber playing some sort of game to see if I will give up trying to get my much needed PRN medication prescribed again, I am now in the position where because of his lazy fat arse I'm in the shit at work.

I'm thinking that he is trying to not prescribe anymore dhc until the next time I am called in for a u/s , so when I come up as positive he will try to say that I've been using again or that if I had enough dhc to keep me that I don't need it.

I know that it's not the nurse's fault but to leave a text message at that time on a Friday, when I can't phone back is a bit shit. Especially when I had already told them about my work situation. I thought ( until now ) that treatment providers were meant to support patient's that were employed.

I've got enough dhc for a few more day's, if nothing happens by then I will have to buy some. I wonder what will be the outcome if I tell them I have had to do that ? Not good I think as I will be then taking un-prescribed medication.

Before this fellow arrived I was considered to be one of the more responsible people in treatment, the GP doing the prescribing knew I wasn't trying to scam any meds. to divert them anywhere else because I'm earning a decent wage & it's not like I'm going to get high on them given the dose of meth I'm on. I just can't understand what this new fellow imagines I am doing with them ? The reason I was prescribed them was for pain-relief which is why I keep phoning to see if the prescription has been re-instated. If I was on a lower dose I think I would just start using again, just so I don't have to go through all this bloody hassle.


sapphire

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Re: methadone dose ceilings
« Reply #47 on: April 21, 2014, 03:11:42 PM »
In this situation, as it's affecting you work, I think I would speak to someone like PALS. I have found them pretty useful in the past.

Quite bad form to leave you hanging all week and then text you last thing before a weekend and tell you the script is not ready.

Filskit

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Re: methadone dose ceilings
« Reply #48 on: April 21, 2014, 05:19:20 PM »
Yes I'll be doing that tomorrow. Can't understand why they won't just write out another script when at my last visit ( 3 weeks ago ) the Nurse told me that the pain consultant had advised them to do this. I think the man with the prescription pad is playing games with me & is going to say that I don't need them as I've gone for so long without a new script for them.

What he doesn't know is that my GP gave me a script for a bottle (56) the week before he said I had to stop taking them, I also had my own little stash of them because I take 1 before bed & someday's that's all I need if I'm not working.

sapphire

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Re: methadone dose ceilings
« Reply #49 on: April 22, 2014, 01:38:55 PM »
Yes, I think it's got to the stage that this doctor is messing you about, rather than just being cautious about prescribing other opiates on top of methadone.

When it starts affecting your work to the point that your employer is getting at you about it, something has to be said.

Filskit

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Re: methadone dose ceilings
« Reply #50 on: April 23, 2014, 05:43:35 PM »
Well that's a surprise ( NOT! )

5minutes till the close of the DSP's working day & no reply from them even after I've left a message asking if the situation has been resolved yet.
I wonder what excuse they will come up with this time ? On Friday it was because the Dr. was on holiday until today, maybe he couldn't make the flight back because of the weight allowance on the plane, morbidly obese bag of shite that he is.

Yip I'm so cheesed of with the whole carry-on I've resorted to petty name calling.

How this can be any improvement from my previous prescriber is beyond me. Could it be that treating your patient's with the same respect as you would treat other's, listening to their health issues ( instead of just telling them what is wrong with them, without referring to notes ), prescribing appropriately & maintaining a theraputic relationship with said patient's has now " gone out the window " at my DSP. It certainly appears that way, though it's more than likely just down to the attitude of one man.
I was under the impression that our NHS / shared care affair was the way forward, certainly isn't at present.

Come back key.....all is forgiven!   ::)

I've got an appointment with old key on Fri. When I explained to him that the new prescriber was " concerned " about respiratory depression as I was prescribed a low dose of dihydrocodiene for pain while at the same time as recieving meth even key couldn't help but laugh & questioned whether he had any knowledge of methadone prescribing at all. On our first disasterous meeting he told me substance mis-use was his field of interest   ::)  I can only think that when he said substance that he meant pies as that appears to be his only interest.

I'd love to know what medication's he has to take to keep his current lifestyle going. Statin's for cholestarol, med's for type2 diabetes I'd guess, asprin of course & no doubt a few other's to keep his poor heart pumping.

The word's banging & brick wall come to mind.

sapphire

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Re: methadone dose ceilings
« Reply #51 on: April 25, 2014, 12:59:01 PM »
When you saw the keyworker and mentioned that the doctor would not continue your DHC script, and as a result of the returned pain you were/are unable to work?

If so, what did they say? Are they in a position to do anything about it?

Filskit

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Re: methadone dose ceilings
« Reply #52 on: April 27, 2014, 06:25:52 PM »
Key was quite supportive & thought the whole situation ridiculous, but he knows me this new locum has seen me twice. First time he asked me to leave because he realised that I wasn't junk & wouldn't accept junk treatment so had to re-think his game plan. I'm sure I saw his hand move towards the phone for security, not that I was being at all agressive more assertive & asked him to do me " the courtesy of looking at my notes before he saw me again ". Apparentley this is considered to be sarcastic to ask a DR to do this. I thought that this was why medical records were kept. So the information is at hand should you have to be seen by another DR.

It has now been rectified though ( much to his disgust I'm sure ) practice Nurse sent me a text at the end of the week saying that the prescription is now ready to collect & so I should have no more bother with my pain relief until my referal to the pain clinic. According to the Nurse the problem was to get 3(!) Dr.'s in the same room at the same time to agree with this, in this modern world of emails & phones that are mobile that's a tough explanation to believe. I can't believe the NHS are that badly off & I'm sure I saw a pc in his office, possibly just for show?

So this battle has been won, I forsee another one in the pipeline now but forewarned is forearmed & I shall be going to see the Dr. in charge of clinical governance with my own GP to back me up this time. It may not be that bad, possibly the fat git will not be bothered & let what has been working for 10+years carry on working, or he may hold a grudge in which case I'll have to go through all this again. Something that I'd rather not do, in general I am a placid , easy-going character but I'm not going to be dictated to when the medical evidence is in my general file. It's never been a substance mis-use matter & the medication was started by a hospital consultant & then backed up by a NHS sleep-clinic, years before I went on a meth script.

I hope I have a bit of a reprieve before he start's messing with my other meds, wears you out & gives you a lump on the forehead when bashing it against a brick wall.
We've had a lovely sunny weekend to boost much needed vitD depletion & no more worries about managing pain at work. Which will hopefully be a relief to my employer.

sapphire

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Re: methadone dose ceilings
« Reply #53 on: April 28, 2014, 12:58:06 PM »
3 doctors just to get a DHC script restarted?! What are they thinking, no wonder the NHS is haemorrhaging money! At least it is sorted though, and hopefully as it has come out in your favour this time, the locum will think twice about messing with meds that are very much required and stop you working if ceased.

I hope that the regular doctor is back before this locum can do much more damage.

Filskit

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Re: methadone dose ceilings
« Reply #54 on: April 28, 2014, 05:59:24 PM »
I know, even old key asked if they had mistakenly thought I was wanting i/v diamorph.  ;D
I think it was possibly just an excuse for the amount of time it has taken the new prescriber Dr.FB to actually get around to doing it. If I wasn't in need of them I wouldn't of had the energy or time to keep reminding the practice Nurse about the situation. It was the Nurse that took the brunt of my phone call's / text messages for the last few weeks, unfortunately a Nurse that can't prescribe. Though I don't think he would of gone over this new Dr.'s head. It would of been nice if the Nurse had the balls to stand up & say that I was not using them for anything other than pain relief though.
They should now be on repeat until my referal to the pain clinic by which time I hope my old prescriber is back doing what he does best & has studied for many years on issues surrounding alcohol / substance use.
That does seem to be one of the problems of living in a rural setting, there is only one Dr. who has any knowledge on substitute prescribing, so if they are out of the picture for any length of time situations such as this arise.
That knowledge isn't just about the policies & proceedures of substitute prescribing, the Dr. get's to know his patient's very well, treating them without discrimination. This Dr. in particular has basically been the backbone of the service for many years & has fought hard to have maintenance as an option. Before that the service may as well of had a revolving door.

I know quite a lot of users who have left the service under the new regime & overdose's appear to be on the increase. I'm possibly making 5 out of 2+2 but even I was wishing that I wasn't on a theraputic dose, simply so I could tell them where to shove it. No way I could afford to just now on the dose of meth that I'm on. 100 notes don't grow on tree's around here & even my wages wouldn't be able to keep me going for much more than a few day's. So will just remain employed with my weekly pick up's even if it does mean having to do battle with this new Dr.
I've got too much of my "recovery capital" to lose.

So the battle has been won but I'm quite certain the war is not over yet & that as long as Dr.FB is prescribing he will want to mess with other medication that I have been on for over 10years. Medication that was started by the medical consultant at the hospital & then backed up by specialist consultant in Edinburgh before I was on a script for meth. Medication that has never had anything to do with the substance mis-use team, because I don't mis-use them.
But for now I will just breath a sigh of relief & wait...

Filskit

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Re: methadone dose ceilings
« Reply #55 on: April 29, 2014, 02:50:41 PM »
Went to pick up dhc today, the script was there so no problems but instead of me recieving them on my monthly prescription I've now to pick them up weekly along with my meth. It's not a big deal I know but how bloody petty can you get ?

God only knows what they think I'm going to do with them. Until this new prescriber darkened the sky with a morbidly-obese figure I recieved a bottle a month. Street value maybe 35-40 ? I am in full-time employment, do they actually think that I could even be bothered to go to the hassle of diverting them for that amount ?

I feel sorry for the pharmacy having to go to the trouble of opening a full bottle just to count a meagre 14tabs out before putting them in another bottle.

This new Dr. obviously has the attitude that as a patient on methadone I cannot be trusted one inch. What next , unannounced visits to the house to check that every tablet is accounted for ?  Better not joke about it.   ::)

Jackwhan

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Re: methadone dose ceilings
« Reply #56 on: April 29, 2014, 03:14:05 PM »
This new Dr. obviously has the attitude that as a patient on methadone I cannot be trusted one inch. What next , unannounced visits to the house to check that every tablet is accounted for ?  Better not joke about it.   ::)

How about home-based supervised consumption, observed by the 'Flabba the Hut' himself? :'(

I have been following this strange occurrence with interest, but unfortunately without a great deal of surprise.

Glad that it's sorta sorted out

Filskit

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Re: methadone dose ceilings
« Reply #57 on: April 29, 2014, 06:34:15 PM »
Oh my God, " Flabba the hut "...so you've met him have you? lol! I was informing a friend currently on a very small script about this fellows attitude in comparison to our last prescriber, he suggested that Flabba was maybe unable to read my notes possibly due to the difficulty he must have getting close enough to the desk. It at least made for an enjoyable journey to collect my 14tabs .  ;D

I don't know whether it's due to Flabba's ignorance around prescribing, or whether he regards people on meth as junk & so gives them all junk treatment. He say's that it's his area of expertise, if this was the case then I'd of thought that he would already of learnt that people with dependancies come from all walks of life & wouldn't just stereotype everybody ?
Who knows, the sooner his locum contract comes to an end the better.

Thanks for the " Flabba the hut " reference Jack it's a perfect description & has put a huge smile on my face.

All the best.