Article I Read That May Explain Some Doctor Reactions

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mariposa

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This was very interesting... an article I read recently. It makes sense when you think about it. Turns out that tons of ever-present drug seekers are claiming to have fibro pain just to get medication. :cry:

Maybe everyone else already knew how widespread this is, but I didn't. And I'm sitting here thinking that's *probably* one of the major reasons doctors don't immediately "believe" the real fibro sufferers. All the fakes have to do is find a doc who is fibro-friendly, knowing their testing won't show anything.

This makes me soooooooooo upset. :evil: It probably does explain why so many doctors are completely hesitant to treat, though... they could have much trouble if it's found out they gave drug seekers drugs without testing that found an illness.

Still one more reason why there MUST be a breakthrough with diagnosis!
 

qweenlindy

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Before going in to talk to my doctor regarding FMS I'd also read that doctors are hesitant to give a fibro diagnosis because there are people that take advantage of it in other ways as well, such as trying to get disability when it's not really warranted. I didn't realize how long i'd been going to the dr. trying to find a cause for my pain and fatigue until i sat and really looked at my medical record the other day. For four years i have actively been going to the doctor for various different ailments. I've had a number of blood tests and x-rays trying to determine the source of my pain. Up to this point, the pain is more of a nagging annoyance, with some days being far worse than others. I know it's not right for what i've been doing physically. and the fatigue has definitely been unwarranted. But with my last dr visit, i came prepared to ask her how she felt about FMS. If she had started out opposed to the idea I was prepared to get a second opinion. Having a diagnosis for FMS doesn't make it all better, because it still hurts. But it is validating that I'm not just going a little bit crazy!
 

jrk1288

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I totally believe that...people will do anything to get their hands on painkillers, especially controlled substances, when they have no medical need for it. I work in the veterinary industry and we even have people asking for hydrocodone, oxycontin, etc, when a lot of those drugs aren't really used for animals. Not a common occurrence, but it does happen. Human doctors probably see this almost every day...sucks for the people who have a legitimate need for it but can't get it.
 

Trellum

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Before going in to talk to my doctor regarding FMS I'd also read that doctors are hesitant to give a fibro diagnosis because there are people that take advantage of it in other ways as well, such as trying to get disability when it's not really warranted. I didn't realize how long i'd been going to the dr. trying to find a cause for my pain and fatigue until i sat and really looked at my medical record the other day. For four years i have actively been going to the doctor for various different ailments. I've had a number of blood tests and x-rays trying to determine the source of my pain. Up to this point, the pain is more of a nagging annoyance, with some days being far worse than others. I know it's not right for what i've been doing physically. and the fatigue has definitely been unwarranted. But with my last dr visit, i came prepared to ask her how she felt about FMS. If she had started out opposed to the idea I was prepared to get a second opinion. Having a diagnosis for FMS doesn't make it all better, because it still hurts. But it is validating that I'm not just going a little bit crazy!

Actually that does make sense, now I see why a lot people is having trouble getting disability. After all the government must be wary of people who actually want to apply for disability without even deserving it. No wonder! I had thought about that already, but didn't think it was so widespread, there are evil good for nothing losers everywhere tho, who will do everything it takes to get some effortless cash.

Pisses me off, because now the people who are supposed to help them no longer trust them and must be wary us! Really sad to read people who doesn't deserve it got it and as a result ruined it all for those who really need it now.
 

Trellum

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This was very interesting... an article I read recently. It makes sense when you think about it. Turns out that tons of ever-present drug seekers are claiming to have fibro pain just to get medication. :cry:

Maybe everyone else already knew how widespread this is, but I didn't. And I'm sitting here thinking that's *probably* one of the major reasons doctors don't immediately "believe" the real fibro sufferers. All the fakes have to do is find a doc who is fibro-friendly, knowing their testing won't show anything.

This makes me soooooooooo upset. :evil: It probably does explain why so many doctors are completely hesitant to treat, though... they could have much trouble if it's found out they gave drug seekers drugs without testing that found an illness.

Still one more reason why there MUST be a breakthrough with diagnosis!

Very saddening indeed. It makes me sad to think that many doctors think we are just seeking drugs, when we are genuinely interested in finding out what's wrong. I've seen several doctors in my life, and totally hate it when they think my motives to be there are others than my real concerns to have something else and finding out the truth.

I experienced all this first hand and is painful. But those doctors who assume the patient is looking for drugs are acting wrongly as well... they shouldn't jump to conclusions too fast!
 

mariposa

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Very saddening indeed. It makes me sad to think that many doctors think we are just seeking drugs, when we are genuinely interested in finding out what's wrong.

This isn't exactly what I meant, Trellum. I really don't think a doctor assumes most patients are trying to get drugs... but rather that because *some* are, they have to be sure before handing medication out. They could have their license revoked if they prescribe things to drug seekers.

So no, I can't see doctors assuming that their fibro patients are drug seekers. They just need to by law be sure to have a solid diagnosis before prescribing, and it's so difficult to have a solid diagnosis for fibro. (Of course that statement is for decent docs... I know that some still don't even deal with trying to help at all. :( )
 

mariposa

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Before going in to talk to my doctor regarding FMS I'd also read that doctors are hesitant to give a fibro diagnosis because there are people that take advantage of it in other ways as well, such as trying to get disability when it's not really warranted.

Ah yes, disability... I never even thought of that aspect of it! If I'd have to guess, I'd say that claiming fibro would be the #1 way that healthy people try to get disability. It's sickening. :evil:

I worked at a hospital for a short while, and I was always amazed at the creativity of people trying to cheat the disability system. (This was before fibro was well known.) Those who end up paying for the cheating are always the people who need to *have* a disability determination.
 

resmdpa

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Hi, I just joined the forum, I am a physician with Fibro.

If you are fortunate enough to find a doc who will provide pain medicine,, there is risk as you have mentioned. Doctors can lose their license to practice BUT, they are permitted to prescribe narcotic pain meds if they follow the rules. You have rules also.

Take your prescription to the same pharmacy every time. They will get to know you,, they have risk also! Never try to cheat or say that you lost the medication or 'double dip' with another Pharmacy. Your Doctor will find out and you will be cut off! The Doc has to write notes in your chart and document the need, make copies of your Rx and be able to "pass" an audit from the DEA. In other words, frequent documented visits,, a written game plan and reason for the medication, and a reasonable exam of the patient. Your job is to count your medication and make it last for the prescribed amount of time. Never cheat! Never risk losing your doctor's trust and comply 100%. You will find help out there,, since true FMS is not an inflammation, the 'anti inflammation ' meds rarely work. The OTC drugs might not do anything and if they do help,, be grateful. A low dose narcotic has saved me from staying home every day! Good luck to you. Dr Bob
 

1sweed

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Dr. Bob,
Welcome to the forum. Thank you so much for these words of advice in getting meds and proving that the meds are not being sought just for drugs, but for the real need in dealing with fibro pain. Some might cheat, but most if they do as you mentioned above, do so without thinking of the way it looks to doctor's and not realizing that it could cost the doctor his or her license to practice.

We all need to learn and follow the rules in this regard.

I have a question, Dr. Bob, why are so many doctor's rude to their patients. We come in with a trusting and faith, and often leave offices a shattered mess. I can not even tell you how many times I left doctors offices in tears because of the rude treatment I received. I was not as upset about the lack of diagnosis, or the all normal test results as I was by the insulting remarks made by the different doctors. I came to almost believe that most doctors believe women are all basket cases that are not worth their time. Do you have a understanding of this problem from a doctors point of view?

I hope you will continue to come to the forum and share your knowledge, as well as, learn from the postings on this forum. :)
 

mariposa

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If you are fortunate enough to find a doc who will provide pain medicine,, there is risk as you have mentioned. Doctors can lose their license to practice BUT, they are permitted to prescribe narcotic pain meds if they follow the rules.

Great advice, Dr. Bob... and welcome to the forum! Excellent points about rules that the patient needs to follow as well. It will be so much easier when a cause and solid diagnosis are possible. That would totally cut out the seekers claiming fibro to get drugs... and patients who are actually suffering wouldn't have such a hard time.

Question... why do so many doctors still believe it doesn't even exist? Have you seen any CME concerning fibro? My physician friends haven't. I think it's time to get some further education to the medical community about this. Having done the med school years and internships back before it was known really isn't much of an excuse not to come up to speed on it.

Since you're suffering yourself, have you done any publications on it? I think that would be very helpful to a *lot* of colleagues.
 

resmdpa

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Great advice, Dr. Bob... and welcome to the forum! Excellent points about rules that the patient needs to follow as well. It will be so much easier when a cause and solid diagnosis are possible. That would totally cut out the seekers claiming fibro to get drugs... and patients who are actually suffering wouldn't have such a hard time.

Question... why do so many doctors still believe it doesn't even exist? Have you seen any CME concerning fibro? My physician friends haven't. I think it's time to get some further education to the medical community about this. Having done the med school years and internships back before it was known really isn't much of an excuse not to come up to speed on it.

Since you're suffering yourself, have you done any publications on it? I think that would be very helpful to a *lot* of colleagues.
FYI, there is always new information about Fibro. Journal articles come out and classes are offered. If a doctor has the time, they would need to scan thru thousands of CME opportunities and chose whatever they are most interested in. The information in the Medical field is coming out faster than we can keep up with.

Many practices have been placed on hold to learn about conforming their practices to all of the new laws being mandated. A patient doesn't realize that it takes time and money for a practice to become paperless as we are ordered to do. We must learn computers and new coding every year or we don't get paid. There are the confusing issues with ObamaCare. We are not superhuman and we are bombarded with issued that don't seem to make it better for a patient to receive care. The "Doctor" has become a pawn in keeping statistics on patients, figuring out the billing procedures and has lost the old time doctor-patient relationship that you all are missing. Basically, we have become a drone,,,a provider of health care, a statistician of the conversion into a Socialized Medical reality with large patient deductibles and longer waiting times. The world is changing and the worse is yet to come. This is what our President is causing and Insurance companies are have their own problems. It will not return to the way it was,,, my health care is over $30,000/year for the family and had gone up after we got dropped and re-instated. Bigger problems are coming your previously pleasant Physician might become short tempered as he struggles to pay his staff and conform to the new laws. You will be noticing a difference as they don't seem to have any time to talk with you. Some Docs are retiring earlier that anticipated just because of these changes of computerization, coding, and record keeping.

Your doctor wants to spend time with you but can not afford to run his business unless he limits the time with you. Once you finished, your visits is not over! The paperwork,,and the computer entries , and the interaction with insurance companies are killing us. Only a 'fee for service' practice will afford the time you desire,,or a true Socialized Medical System will be difficult to accept,,,financial incentives might allow your doctor to spend more time with you. Money drives the system and the current administration has created change within the health care system. I am afraid that our medical care will become worse as the doctors are losing incentives to improve their knowledge with so many requirements placed on them to run their business. Its a sad thought,, it is coming true. It is getting harder and harder to be a patient.

Back to Fibro: Lots of Doctors don't even believe that Fibro exists,,,the same complaints are heard in Depression, Sleep Disorders and Psychological Pain disorders. The indication to treat pain is very specific and they are covering there behinds,,, need proof before prescribing pain relief. This is too sad for words. Far too many people are suffering or are under treated .

I have had success with a very low dose opioid and I can functionI have been on Lyrica, Cymbalta, other SSRI's and anything that the FDA approves for this condition. Non narcotic pain relievers do not help me. Well, its not an inflammatory disorder!. A course of steroids was tried and ultimately,,, the only things that help in a pill form are Xanex to relax and help me sleep , and the low dose opioids. Light exercise helps,,,,keeping your weight down helps,,avoiding drama and stress helps, keeping busy helps, a good sleep is rare and that is most helpful. You must all do your own research and take control of your disease.

Someone suggested that I write a paper. That would be a good idea but there are many written that are current. Maybe the only way that your MD would believe you would be if he had it himself? I can't tell my MD all of my symptoms because he would think I was a nut case,, ha, ha, like the rest of you! I can't tell my wife everything because I feel bad for her and only share what is relevant. She doesn't need to know about the ants crawling across my back or another headache again. However,,,I invite you all to share your feelings and others will know that they are not alone. I believe you because I have it too,,,you believe me as well. For example,,,So strange to explain what we mean by 'overwhelming fatigue'. They don't get it! "Why not just rest and you will feel better" Sure, what a great idea! How can they understand what we feel? How could you still be tired after sleeping 12 hours? I get it!I understand these issues also.

I am so saddened by this illness but,,and get this! I am not afraid of it any more! They are just symptoms of misinterpretation of pain signals and not related to true pain. Benign pain and benign fatigue will not get worse or take your breath away. We will survive by changing our activities and doing all the things that we can still do,,,and learn other things to do that we never had considered previously..We still have our lives to live(with or without understanding people) Maybe ,,,a friendship lost was never really a friendship/ Count your blessings if you have an understanding family. Don't complain constantly to the spouse because they already know. You need them as your best friend and don't want them to burn out! Complain to me instead!

We all have good days and bad days, like the weather, like your activity the day before. Why should I exercise if 24 hrs later I can't get out of bed? Maybe the Princess and the Pee was a true story?

God bless you all and stay with it. Avoid the snake oil and learn good nutrition, walking or swimming in a warm pool, eat foods with the appropriate nutrition, nobody needs more that a multivitamin and that's probably a waste, good hydration, avoid smoking , too much caffeine, and alcohol, and practice your best sleeping habits. My wife and I sleep apart for my sake. You must not sit around in a chair all day. Keep your brain working. Be careful about withdrawing too much. Have only those close friends who understand and won't suck your life from you. Avoid watching the bad news on TV more than is necessary. Family support and understanding. Breath and slow down,,,remember that life is a journey and not a race. There is a lot of research being done and I believe that there will be a medication that will control the symptoms but not cure the disease,,I believe we are close,,,stay calm,,,Fibro will not kill you and you will have good days ahead of you. Good luck.
Dr Bob
 

Loftpat

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Dr Bob. I just recently shared some chronic pain/fibro research with my PCP who was pushing to change my meds because she "doesn't prescribe Tramadol for fibro." I think that she now understands that I am not a passive patient looking for her to "fix" me. It's a two-way street. I'm committed to living as best i can with fibro. I need her help to navigate the options. I take my notes with me and try to focus on the biggest issue at each appointment. Fibro is so overwhelming at times that it works best for me to take small bites. I am hopeful that we can build a solid relationship like I had with my former doc. Thanks for being here.
 

resmdpa

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I wanted to address Tramadol or Ultram for a moment. It can work very well with some people. The mechanism of action is interesting, not an anti-inflammatory but treats pain centrally, where your brain perceives the pain. When it wears off, the pain returns. When first introduced,, the literature said It is not an opioid! New research has changed this opinion,,, and it has been found to be addictive and act like the opioids.

Like all meds, there can be side effects and this one can lower the seizure threshold and must not be used if a person has a seizure disorder,,it can cause a seizure in otherwise healthy people. Dosage must be monitored and never take more than prescribed. When you first use it, you might get a little euphoric because it lessens the pain and might release endorphins that feel like a 'narcotic high'. I would certainly try it,,not mixing it with Tylenol. One or two pills a day might make a huge difference in your productivity.

Just a thought,,,,bring an article to your doctor which reports that Ultram relieves the pain of fibro. You might be able to fax it before your visit so the the doctor has time to understand the article without take time away from your visit. A fax might actually serve to avoid an office visit by having the doc agree to try it and phone it directly to your pharmacy. You can report on it at your following visit. You might be able to take 3 per day if it helps and you have no allergy or side effects. Start slow,,one pill might make you feel lousy and then don't take any more. You might feel great! Please let me know how you make out. One of my patients actually had a seizure while abusing this medication,,,,taking more than 6 per day. I hope I helped,,,your doctor is the boss!
Dr Bob
 

Trellum

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This isn't exactly what I meant, Trellum. I really don't think a doctor assumes most patients are trying to get drugs... but rather that because *some* are, they have to be sure before handing medication out. They could have their license revoked if they prescribe things to drug seekers.

So no, I can't see doctors assuming that their fibro patients are drug seekers. They just need to by law be sure to have a solid diagnosis before prescribing, and it's so difficult to have a solid diagnosis for fibro. (Of course that statement is for decent docs... I know that some still don't even deal with trying to help at all. :( )

Oh I see. I made that assumption because I have heard so many horror stories of many fellow firo sufferers who went to see a doctor for help, but the doctor assumed they were seeking for drugs. But let's face it, some doctors are just jerks >.< I know that so well, I know some aren't tho :) My former GP was an angel... :cry::cry:
 

Trellum

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Hi, I just joined the forum, I am a physician with Fibro.

If you are fortunate enough to find a doc who will provide pain medicine,, there is risk as you have mentioned. Doctors can lose their license to practice BUT, they are permitted to prescribe narcotic pain meds if they follow the rules. You have rules also.

Take your prescription to the same pharmacy every time. They will get to know you,, they have risk also! Never try to cheat or say that you lost the medication or 'double dip' with another Pharmacy. Your Doctor will find out and you will be cut off! The Doc has to write notes in your chart and document the need, make copies of your Rx and be able to "pass" an audit from the DEA. In other words, frequent documented visits,, a written game plan and reason for the medication, and a reasonable exam of the patient. Your job is to count your medication and make it last for the prescribed amount of time. Never cheat! Never risk losing your doctor's trust and comply 100%. You will find help out there,, since true FMS is not an inflammation, the 'anti inflammation ' meds rarely work. The OTC drugs might not do anything and if they do help,, be grateful. A low dose narcotic has saved me from staying home every day! Good luck to you. Dr Bob

Hey Dr. Bob! It's nice to have someone like you over here! I must say it's great to hear the opinion of a doctor who also happens to be a patient ;) Thanks for all that info, it's great to have someone who actually knows what the protocol of a doctor is. I really value the info you have given us :)
 
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