I am a Kaiser member. 7+ years. In their system, they assign everyone a "primary provider" who serves as the gatekeeper of sorts for the member. Many, if not most, of their primary providers are Certified Nurse Practitioners.

Mine is named Julie M.

It took me several years to learn to trust her; it has taken her about 3 weeks to destroy that trust.

Years ago when I first went to see her about this strange tingling in my feet, she ignored my suggestion that it might be PN and sent me on a series of tests to rule out diabetes and maybe something else.

{At the time I was a bad boy. I smoked (tobacco and pot), drank (daily and periodically, to excess). I ate lots of fast food and/or fatty foods. I wouldn't blame her for not thinking I was serious about taking care of my health.}

She then referred me to a Kaiser neurologist. He did some more tests and then confirmed I have peripheral neuropathy. I was started on gabapentin; after maybe 6 – 8 months he switched me to nortriptyline (why can't I spell that) which gave me panic attacks (I'll never laugh again when someone says they experience panic attacks – they are not fun).


Then to Lyrica – which was recently bumped to 3 pills a day – the highest dose the neuro has ever prescribed. [Julie M. also prescribed Vicodin for periodic use.] Since I've been experiencing increased pain (7.5 – 8.0 for several hours at night) as well as a new tye of pain (periodic shooting pains), the only thing that works consistently (and sometimes dramatically so) is the medical marijuana.

Which shows up in the urine tests I have been providing.

As a result of that, Julie M. has stopped prescribing Vicodin (it might have worked to reduce pain between .5 and 1.5) and has told me that she will be stopping the morphine.

Not only that, the neurologist and Julie have disagreed about the medical marijuana issue (neurologist wrote me that if it works for me, she thinks it is great); Julie asked me to speak to Addiction Medicine. When I did, the PA I spoke to told me that since I admit to drinking 4 – 6 ounces of wine every 7 – 10 days, I am probably an addict (not in so many words, but I certainly understood the implication) – without taking the time to review my chart.


I think they have put something on my chart because when I went to pick up what will probably be my last prescription of morphine (I take 4 15 mg. CR pills a day), the pharmacy tech looked me over, quizzed me about why I was picking up when I had a few days left on the prior prescription, accessed what I thought was a private email system while I stood at the window and then read me the first sentence of an email Julie sent to me that said “If you continue to drink alcohol and smoke marijuana I cannot prescribe morphine” -- in the presence of another patient who was picking up her medicine.

Adding to the mix of problems – I'm experiencing a lot of anxiety and stress about care for my elderly parents and disputes among siblings about what to do. Julie had previously prescribed something for the anxiety periods (on an as-needed basis) and is now stopping that because of the marijuana.

Needless to say, I am angry and scared.

I've reviewed the Kaiser appeals/grievance procedures and it appears I need to exhaust my appeals before I can file a lawsuit. So – I need to add the grievance/appeal issue to my list of things to do.

But I did talk with a friend of mine who has done injury litigation for many years – and he said he'd represent me. So I have lawyered-up.


Because Julie has done this, I no longer trust her and will have to ask for a new primary doctor (which will no doubt be interpreted as “doctorshopping”, a form of addict behavior) and spend all that time getting to know him or her.

I don't think the morphine works (at least not at this dose), so if she stops me, I can probably taper off over a week or so, but then there will be nothing for the pain except the MM (I am speaking about prescribed remedies – I do exercises and other non-doctor involved things).

I am only vaguely familiar with injury law, but it seems to me if they started prescribing narcotics to me at a time they knew I was using MM, and then knowingly stop providing pain relief – well, I've seen cases where doctors get slapped pretty hard. I mean financially. It is called “Intentional Infliction of Emotional and Physical Distress” and allows a jury to impose punitive damages. I think there may also be some other violations as well, but am not generally familiar with federal laws in a case like this.

Anyway – just thought I'd share this. I'll post updates periodically.

Cowboy

I don't know if you read the "How to Handle" thread - but sounds like Chrissy is in somewhat the same situation.

Mrs. D made the suggestion that the MJ can magnify the effect of the MS, thus putting you at risk for slower/lower respiration (risk of death) - docs may cite that as a defense.

Sadlly, the abuse of pain medication by those who use it as a "high" has made it tougher and tougher for those of us who need the meds and take dosages as directed to be able to obtain the drugs.

I was warned a couple of weeks ago that here in FL, a new law is going into effect that will make the process more stringent and lengthy. As it is, I must physically see my doc once every 3 months in his office and pick up my methadone prescription monthly. I guess it is going to something like a monthly office visit with urine testing, and some other rigamarole.

Good luck with your fight.

It was exactly this kind of big brother behavior that made me go off the stuff....I do have a small script for vic, that is it....and, no, it isn't enough, but, the option is losing my dignity.....and I have a GOOD doc. The problem was the other docs in the clinic!

I felt tied by an invisible umbilical cord, that left me open to abuse from any physician with a bug up their butt....pain seemed a better option.

I don't use MJ....I only used my prescription drugs as ordered....but, historically, I found that as soon as you add a substantial pain med, docs act funny.....you get fewer diagnostics, they don't return calls, etc.

I am not saying this is right....it's not. It simply IS.

I weaned down from substantial fentanyl and oxycodone and I am doing about the same as when on the stuff. I was in pain then and I am still in pain now. A well placed vicodin seems to do as well as fentanyl patches.

Like I have said before....pain management is in hideous shape. If you are stuck with a pain condition in this country....docs seem to feel, 'oh well, better you than me".

As I said, I have a very good primary, who is very willing to prescribe for me and feels I should be on more pain meds, however, if ever she was NOT there, and I got some other dupe from the clinic, it was really hard to get my scripts. Once I sat for 2 hours waiting for a doc to give me my script for oxycontin. On another occasion, I had to sign a contract! I gave up and just use the vicodin.....and no, the tylenol in it is not good for me...

If you are on major pain meds, they have you by a chain around the neck....I got tired of my chain being jerked.

Julie has promised to get me a copy of this "protocol" or "policy" (and what's the difference??) for a while. She couldn't include a link in the closed Kaiser email system, so she tried to send it to me through my Yahoo account.

At the bottom of that email was the text of the email she had sent to someone within Kaiser, which read, in part:

"I have several patients with history of drug abuse, including MJ abuse, who have obtained these cards. They do have pain, and say the MJ makes them feel instantly better."

In her opinion, apparently, any use of marijuana -- legal or otherwise -- results in a categorization as a drug abuser.

Sheesh.

CB

PS: The link didn't work, so I still haven't seen anything.

As long as it's fashionable to challenge the government through populism of either variety, perhaps it's time to challenge the medical establishment.

Many, many states now allow patients to sue their providers for under-managing their pain. After talking with my daughter, I'm thinking she may be right -- the only way this problem is going to be addressed is through lawsuits.

do you have a list of states that let a patient sue for undertreatment of pain? that could come in handy for quit a few people who come through here.

Yes, very good point, Echoes, and if anyone has this, please assist.

***Well, since I live in Oregon, that's the only law I'm familiar with, but my friend/lawyer commented that it is a development in the legal field that took a long time to come. The more conservative states (where the right to jury trials are more strictly regulated, I guess) may not be there yet.

*** I'd suggest opening the phone book and finding an advertisement for a medical malpractice attorney. Call him/her up and ask 'em. ["Does Washington law allow recovery for under-treatment of pain?"] Shouldn't cost anything.

*** Knowing your rights and knowing when to exercise them is another thing. I haven't mentioned lawyers or legal rights at all with Kaiser. But -- having a lawyer as I go through Kaiser's "appeal/grievance" procedures cannot hurt.

CB

That is such a shame Cyclelops. It is true, we can be 'labeled' by misinformed docs. I went to a GI doctor a while back who did a colonoscopy. Well, he did not administer enough med during the procedure and it became the procedure from hell. I asked him to give me more sedation but he just kept saying "we are almost finished". I could hear myself crying from the pain. I don't think you are suppose to be alert for such a procedure. After words, he said he was "astounded" that I felt it and then proceeded to tell me... "Well you are on narcotics, that is why it didn't sedate you enough". The tone of voice and way he said it was as though he implied that I was a junkie. And no, I am not overly sensitive about it - it was quite implied. I did not go back to him.

It seems that some docs want to 'label' you when you take narcotics. I don't take a large amount, but nonetheless, he should have adjusted for my tolerance and my "princess and the pea" nervous system perhaps caused by PN and FMS.

What a jerk...

Gawd, Mere, stuff like that makes me sick to my stomach.

My first colonoscopy, they neglected to tell me to bring a driver with me, so wouldn't sedate, only gave me some valium. (This was 20 years ago) They did the procedure, but it was a ticket to hell.

I wish these freakin docs had to live one week with the kind of pain some of us experience - maybe they'd be a bit more empathetic.

In my opinion, surgeons are THE WORST

Cyclops, have you tried Vicuprofen? I have that, instead, for a continus glucose monitior, for some reason you can't use Tylenol with it.