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This place has an amazing array of experts in so many fields, and I find myself at a loss as to how I can help a friend who is suffering. I hope to find some ideas I can share with her as she tries to get on her feet, health-wise.

I will call my friend "Mary."  Mary and I grew up in the same small town and our parents were all teachers.  Mary spent some extended time living in Seattle and working for a couple of software giants as an editor, but both companies have gone the way of hiring people for a "project" and have not included benefits.

Mary moved to California to teach for a few years and accrued a small retirement amount and had health benefits. Then bad health struck...fibromyalgia, and one doctor told her she has RA. It became increasingly hard for her to work, and then her father died. She moved back to Oregon to take care of her mother who was ill with cancer, and her mother died shortly after.  

Her health has grown significantly worse and she is pain most of the time. Once, she went to the ER to see if there was anything they could do--because she had no insurance.  They called her estranged brother...a cop....who promptly told the doctors that she was just fishing for narcotics ( untrue) and they sent her home with a lecture.
Eventually she qualified for SS disability so now Medicare pays a little toward her prescriptions that another doctor finally got her. Sometimes I pay for them if she has run out of money.

She called me today, crying hysterically. Her latest doctor "fired her" because a young doctor at an urgent care facility called her and said that Mary had had medicine (narcotics) from two different doctors--without researching why. She had kept her old doctor in Seattle but could not make the trip anymore, so the doctor transferred her prescriptions to a doctor in Portland.  All Mary wanted from this trip to urgent care was to talk to someone about adjusting her meds for the next time she picked up her prescriptions. The doctor flipped through her records quickly, saw the names of two doctors and he picked up the phone an "reported her" to the primary care person who had been the intermediary to refer her to the doctor in Portland.  She spoke with Mary over the phone and "fired" her, which meant no refills and also cancelled the MRI she was going to have to see what might be going on in her neck.

She is frantic because she feels nobody wants to help her. She is a good person and is not out seeking a fix of drugs.

Does anyone have any ideas of what she can do to find a doctor who will LISTEN to her and EMPATHIZE with her situation. She has no money left..she has been forced to cash in all her retirement just to keep her parent's house running, and to have food and gas for her car. She is in over her head financially and because she is young (52) she does not qualify for a lot of other help.

It hurts my heart to have my friend in this condition.....

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Comment Preferences

  •  Controlled substances are tracked through driver's (9+ / 0-)

    license numbers. Probably, those are the records the urgent care doctor checked. He entered her DL# into the data base and found the other prescription. I would suggest she visit a legal pain clinic (not a pill mill), after the date on the other prescription expires. Good luck. My prayers are with Mary.

  •  I don't have a thing except to get on the phone (6+ / 0-)

    with the doctor who fired her and ask what the process of redress entails. The doctor made an accusation and it was mistaken. It will be a PITA to fix, but if she keeps after it she might be able to find the way.

    I'm really sorry to hear this. I hope someone here has better advice than mine. :)

    Poverty = politics.

    by Renee on Sat Oct 13, 2012 at 07:36:06 PM PDT

  •  i agree with suesue (10+ / 0-)

    the only choice for chronic pain sufferers is to get a referral to a pain clinic, they can dispense more freely and regularly, but she will have to go to their doctors and check in to get her prescriptions.  In my state (Virginia) narcotics are dispensed by paper prescription alone, and without refills, due to the widespread abuse of narcotics.  She has to follow their rules.

    "Kossacks are held to a higher standard. Like Hebrew National hot dogs." - blueaardvark

    by louisev on Sat Oct 13, 2012 at 07:36:39 PM PDT

  •  I'm not understanding something (14+ / 0-)

    She lives in Portland -- where she moved from California.  She has a primary care physician in Portland who is handling her medicine management.  Prior to Portland she was in California.  How did Seattle (two moves back) get into the mix -- especially when you say her diagnosis was in California?

    Why was she in the urgent care clinic talking to yet another doctor about prescription meds? Is the urgent care where her primary doctor works?  If so, why was she seeing someone else instead of him?  If not, why was she going to a facility other than her primary doctor's facility?  

    And if Dr. YoungSnot could see in her records that she had previously had a doctor in Seattle,why wasn't the transfer of care clearly written in the record -- and why wouldn't her Portland doctor have known about potentially overlapping prescriptions?

    Was Mary actually filling narcotics prescriptions from two separate physicians who were not aware of the others prescriptions?  Be honest with yourself -- I know she's your friend, but she's been through a physical and emotional wringer the past few years -- could the pain she's suffering drive her to the point where she actually was not using the medications properly, or attempting to get meds from multiple sources?

    Who is this intermediary physician?  Is that the doctor in Portland? If this is the doctor who took over or handled the transfer of care from Seattle, why weren't they aware of the fact that of course she would have a potentially overlapping doctor (or prescriptions) from Seattle?

    On another note, and assuming that what's happening here is a huge misunderstanding, your friend Mary needs to be able to tell her "30-second medical commercial" wherever she goes.  "I'm Mary, I used to live in (Seattle or wherever).  I was diagnosed with X and Y and I was prescribed Drug A and Drug B by Dr.Yes and Clinic No in (Seattle or wherever).  When I moved down here to take care of my mother, who recently died of cancer, I transferred to Dr. J at Clinic Uh-huh.  Dr. J is my current prescribing physician, but there's a little overlap from the prescriptions previously prescribed by Dr. Yes."

    And for heaven's sake, she should not be going ANYWHERE else or talking to any other doctor about prescription management.  If Dr. YoungSnot who spotted what he thought was an anomaly was in the same practice as her primary care physician, then he should have called THAT DOCTOR and no one else -- who should have been aware of the circumstances.

    However, if Dr. YoungSnot was from some unrelated clinic, and Mary came in looking for prescriptions without mentioning either of the other two doctors, then she looked like exactly what they thought she was -- a drug shopper.  Even if she wasn't.

    On Monday morning, she needs to call her primary care physician and get this straightened out.  And from here on out, all medical management has got to be through ONE doctor and preferably, one pharmacy.  This is for her own protection from drug interactions, as well as protecting her from looking like a narcotic shopper.  If she has prescriptions from any other doctor besides her primary care physician, those should be null and void and she should ignore them like they'd never been written at all -- for her own safety and for her continued ability to get the care she needs where she currently lives.

    Good luck to her.

    "There isn't a way things should be. There's just what happens, and what we do." — Terry Pratchett (A Hat Full of Sky)

    by stormicats on Sat Oct 13, 2012 at 07:42:17 PM PDT

    •  Thanks, I was a little steamed when I wrote this.. (9+ / 0-)

      I have spoken to her this evening and she corrected me on a couple of things...

      She had a fabulous doctor in Seattle. He was patient and understanding. He was her doctor for 20 years.

      When she left California moved back to her hometown south of Portland ( l left that out sorry) she continued to drive up to Seattle to see her old doctor.  As her condition worsened, she could no longer make the trip. She found another doctor in Portland, a much shorter drive away, who agreed to take over her case and her prescriptions..

      I was mistaken also in that it is this Portland doctor who fired her. She is the one who took the call from the Twerp and even knowng Mary's  background she fired her. The records showed that Mary had gotten her meds from Seattle and Portland, but not at the same time. This doctor knew that.  But Mary was confused about what the Twerp was asking her..she thought he was asking for a history of what meds she had taken in the past. He assumed she was there to get all those drugs at one time. Thats when he picked up the phone.

      I believe my eyes are wide open to potential abuse of the narcotics, and I dont believe she is trying to fool anyone. She sometimes has gone in just to get advice and has asked not to be given anymore pills. But it is hard for her to communicate when she is in severe pain, and she was so stunned by this last disaster that she just sat there, burst into tears and had a friend drive her home. And fibromyalgia is not always an acceptable diagnosis for some doctors....

      We all have photographic memories. Some people just don't have any film.

      by fireflynw on Sat Oct 13, 2012 at 08:57:22 PM PDT

      [ Parent ]

      •  Okay, that makes things clearer (0+ / 0-)

        She needs to go back to the Portland doctor on Monday and get this straightened out.  But -- and this is extremely important -- she needs a patient advocate with her.

        A patient advocate does not need to be a professional.  It can be any friend who understands the case and is not in pain and can straighten out misunderstandings and make sure information is clearly understood by both sides.  When you are sick and stressed and in pain, you do not always communicate clearly and you don't always understand all the details.  A patient advocate can be a sanity-saver and in some cases, a life-saver.

        In my family, no one goes to the doctor alone.  I accompany my husband, he accompanies me, at least one of us accompanies our daughter.  We don't have to be in the room for physical examinations, but all discussions will happen in the presence of at least two people.  

        I also have offered to do this for friends and when I lived alone, asked friends to help me (sometimes they did, sometimes they didn't, but that's another story).

        Fireflynw, you would be doing your friend an enormous favor by either going with her, or if that's not possible, making sure the person who does accompany her understands that they must be more than just a ride -- they need to be friend enough to help her through the red tape her case has just been wrapped in.

        "There isn't a way things should be. There's just what happens, and what we do." — Terry Pratchett (A Hat Full of Sky)

        by stormicats on Sun Oct 14, 2012 at 09:35:42 AM PDT

        [ Parent ]

        •  One other thing (0+ / 0-)

          If necessary, she should get an email/letter/note from her doctor in Seattle confirming that she is not "double-dipping" by seeing him and getting prescriptions from him, and that all care is currently being handled in Portland.

          "There isn't a way things should be. There's just what happens, and what we do." — Terry Pratchett (A Hat Full of Sky)

          by stormicats on Sun Oct 14, 2012 at 09:38:15 AM PDT

          [ Parent ]

  •  I am sorry (4+ / 0-)

    I don't have any ideas.  But I did just message a Kossack who knows lots of folks on the site and she may be able to suggest something.

    My best to Mary and thank you for being such a good friend to her.

  •  I think you have to find someone in the same city (5+ / 0-)

    she lives in who may know what services are available.
    Crisis Hotlines are good too. They usually have the most updated list of services available.

    It sounds like she needs a social worker to help her navigate the system. She needs a primary physician who cares and some sort of support group.

    Tracy B Ann - technically that is my signature.

    by ZenTrainer on Sat Oct 13, 2012 at 07:44:25 PM PDT

  •  She needs to get a primary care physician where (7+ / 0-)

    she is living (Portland?) and get a referral to a rheumatologist so she can get a diagnosis is my advice -- there is a lot more that can be done, particularly for RA, than just pain meds.  And a rheumatologist will prescribe pain meds.  
    It also may be possible for her to make an appointment with a rheumatologist herself -- don't know how Medicare works.  If there is a med school affiliated hospital in Portland that would be a good place to find one.  And if worst came to worst would suggest she go to er there (will get referral to rheumatologist) not urgent care.
    Good Luck to her.  

  •  my advice- (0+ / 0-)

    the old squeaky wheel. complain loudly and every few seconds.

    and id start with that doctor who fired her.

    "With malice toward none, with charity for all..." -Abraham Lincoln not a modern republican

    by live1 on Sat Oct 13, 2012 at 08:27:00 PM PDT

  •  she needs to find a pain specialist (0+ / 0-)

    or a specialist in fibromyalgia

    because those people are used  to managing chronic pain.

    tell her she is not alone...please tell her that. This happens to many people with pain. It happened to me in a bit different way. It really sucks

    If she has an advocate (you?) someone should go with her to see that ER doctor that judge her. Or write him a letter. Write his hospital a letter about what he did, how wrong he was. There needs to be consequences for him but she need to get care first so probably doesn't have the energy to do that. Most people go into medicine to help people this doc needs to know that he's hurting people with his lack of informing himself on the facts before jumping to conclussions.

    Is she not eligible for Medicaid as well? Many on disability have medicaid as the secondary insurance (medicare is primary).  Medicare and medicaid should let her get a primary care doctor...someone she can get to know and trust who can advocate for her.

    Maybe she just got disability so is waiting for Medicare to kick in? It takes a year, I think.
    Sorry I can't be more helpful. Hope others are. sorry what I posted was already said.

  •  I have severe fibromyalgia (3+ / 0-)
    Recommended by:
    JamieG from Md, marykk, gramofsam1

    and I'm desperately sorry to hear about your friend. I'm not American but know through online support groups that American women with Fibromyalgia often have a terrible time getting treatment. Untreated pain often leads to suicide. The National Fibromyalgia Association might be able to point your friend in the right direction.

  •  sexism at work too? (0+ / 0-)

    The combination of spotty work/moving around, gender, age, and a diagnosis that is one of those hard-to-pin-down-but-I-need-narcotics ones, and I can understand why some zealous doctor or nurse red-flagged this one.

    I agree with the advice of other comments: with a Medicare card, get a local specialist in RA -- and push for solutions other than/in addition to controlled-substance pain meds. Also settle down with a single pharmacy, single doctor, and don't ever ever try to refill a prescription early, which is another red flag for addiction.

    And consider the possibility that she is actually addicted -- for good reasons, perhaps, but once addiction takes hold, it can be very hard to break.

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