I know my wife gets tired of hearing my rants and I suspect you all would enjoy this more that she did and I might get some sympathetic responses.

I dislike my neuro. It took a few years for me to like my primary provider (I'm with Kaiser; it's a great model for delivery of health and medical care, but suffers from the usual Soviet-style impersonal mood of a large organization).

{Look -- for those of you reading at work, this may be a long story -- I think the history and details matter.}

She's my second neuro after I finally had enough of my first one. Some tell me that neuros have poor bedside manners because they are science nerds first and foremost. And I know English is her second (or third) language.

I'm taking Lyrica 150 mg 3 times a day (with second 2 pills taken together). For pain I take morphine CR 15 mg -- 1 pill in the am and 3 in the pm.

For everyday regular pain (which sits at 2 or 3 most mornings before moving up to 5 or 6 most days and 7-8 on my bad days. Marijuana is my go-to drug for additional pain relief and sometimes I take Vicodin -- 3 500 mg pills.

Of course, I take Senna-S for all the opiate side-effects.

In order to switch medical providers in Kaiser, you have to make your request in writing to the head of the particular department who then asks the current doc if they object. When I first met with #2, she seemed brusque (what did #1 say about me??), but did order up a whole new set of tests which verified the progression -- which will be helpful when I do my disability application later this year. The last time I saw her, she ordered a set of blood tests.

My wife and I went to the lab together (she had tests of her own) to provide the required blood.

A few days later she gets a letter that says "congratulations"; I get a call from my primary care provider (a CNP) to schedule a telephone conference.

I mumble something to my wife about her getting stars on her tests and I get a call to the principal.

I review the results and they helpfully had put an asterisk beside my RBC which was 2 points below the norm (the two hemi tests were sitting on the lowest number in the acceptable range). Looks like I'm a candidate for anemia. I at least know what we'll be talking about when she calls.

Wrong!

She wants to tell me that my urine test showed the presence of marijuana. She's clearly uncomfortable lecturing me, but according to Kaiser "protocols", if I'm on opiates, I must not smoke marijuana.

Both she and the neuro have copies of my state-issued patient card, but apparently Kaiser hangs on to their 20th Century protocols. I asked he directly if she/Kaiser will discontinue my pain treatment (I was just itching for a fight) and she said No, but I will have to take another pee test next month and another lecture from her. She suggested I talk with the neuro about it so my record is stronger.

After my talk with her I sent an email to my neuro reminding her of our previous discussion about MM and asking what is going on.

She writes back -- my use of MM is OK and she is canceling the pee test, but she "cannot provide you with marijuana".

Huh?

But she did promise to read the research I send to her and include it in my records.

Why the rant? Because the call from the primary was about marijuana and nothing about my low RBC pre-anemia numbers.

And we are supposed to trust that these people know what they are doing and are acting in our best interests?

So -- I come away from this (a) with lowered regard for Kaiser, although I completely understand why my CNP called me to hassle me and wanted me to get an MD -- the neuro who ordered the tests in the first place -- to sign off on it and (b) glad to be able to provide my neuro with research that probably doesn't come through to her about the uses of medical marijuana.

Anyway, thanks for reading. I'm glad to get it off my chest.

Cowbo