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I need your advice: my pain mgmt dr is failing me
  1. #31
    User88 is offline Junior Member
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    Default Monday morning Suboxone

    I am home

    The Dr and staff were UNBELIEVABLY professional, polite, supportive, helpful, CONCERNED for my well being, and most of all, kind and sincere! I have to drive a long way to get to this new Dr but I am so glad I found him! I would never hesitate to refer someone to the Dr and the clinic after watching them in action today.

    I chose to take the Suboxone. It was some serious contemplation on my part today but I felt in the long run, the positive of using the Suboxone overweighed the negatives. That and I really want to sleep tonite and after last night < maximum of unpleasant!!! and I am not kidding >

    Dr and nurses did use the COWS chart and I forget what it was but they said that there was NO question that I was ready to start the Suboxone treatment. So, we did and I do agree, the flavor/taste of the stuff isn't anything to look forward to, but...I understand their logic, they certainly don't want it to be a good taste. It makes sense. He started me on 4mg and said that if I want or need to I can take another 4mg today. So at this point I have 4mg in me.

    I am glad that I forced myself to stop taking the oxy about 40 hours before the appt this am, that helped alot, so that I didn't have to leave and come back later.

    I am looking forward to a good nights sleep. I feel 90%+ myself again and THAT is a huge relief!!

    NOTE to anyone ever considering this program: do NOT have ANY oxy or pain meds or H or whatever your cup of tea is, in the house, not one PILL. Do NOT take the chance of getting part way into quitting and having the option of taking just one pill. DO NOT have ANY pain medications available to you during this phase because its a good chance you will relapse and that would be shame!
    Last edited by Anonymous; 08-28-2017 at 04:12 PM.
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  2. #32
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    He wants me to take 8mg daily, or one full strip. Forgot to mention that part.

    One of the worst parts of the appt this am, hilarious really, was me trying to fill in the 6+ pages required to start the prg. I highly doubt anyone that isn't an absolute cryptographer will be able to interpret it! My writing was NOT impressive. lolol
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  3. #33
    User88 is offline Junior Member
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    The pain started to get unbearable so I did take another 4mg, the other half so I have had 8mg today.

    I have 6 damaged vert (not a whine session, sharing so you know what my situation is) 3 in my neck, all in a row, and 3 in lower thoracic. Then, with fibromyalgia, arthritis, COPD, asthma, etc etc. my body is coping as best it can but I find that I need some help, medically, to cope.

    I will say that the people that invented Suboxone were brilliant in that they made it taste like poison so that you don't take it unless you REALLY need it. There's no incentive to take it, not something to look forward to tastewise, and that's smart on their part. You remove the pleasantness and make it a "in a worst case scenario I will take this >>>>" type situation. Im not taking it because I like it, that's fer sure!
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  4. #34
    Catrina is offline Diamond Member
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    I'm glad that you did well today and that you like and trust this doctor and his staff. I'm impressed that he didn't prescribe more than he did but 8mg is still more than you need. I'm fairly certain of that but this is your show and I know that you trust this doctor and want to follow his instructions. Do you think that you would be willing to take less tomorrow to see how you do? You can split your daily dose in two and dose once in the morning and again later in the afternoon (8-10 hours between doses). It would be great if you'd at least try 2mg in the morning and the other 2mg in the afternoon. I think that it would be plenty and you still wouldn't be sick. Remember too that at least half of what you took today will still be active in your system tomorrow.

    Hope you'll give it a try. If not, please keep posting anyway. This Forum is invaluable.

    Peace,

    Cat
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  5. #35
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    Cat and Randy, your people skills are really good and your desire to help people just leaps off the page! Thanks much to both of you for your support and kindness!

    I have been taking Promethazine for nausea over the last two years and wondered if it's safe to take this med withe Suboxone? I typed it into Yahoo and saw no real concerns but...I never assume, and am incredibly safe wwith my meds. (who else do you know that charts his meds and keeps track of what they take, daily? that kind of safe so I know whats in my system, and keep track of doses and times, type of safe.

    Lastly, is it safe NOW for me to take it, bad headache and nausea. Migraine quality bad.

    and yes, I am willing to discuss levels. Wide open for discussion!
    Last edited by Anonymous; 08-28-2017 at 11:25 PM.
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  6. #36
    User88 is offline Junior Member
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    I mean nothing impolite by it but if you can break your posts up every few sentences it would REALLY help me because with ADD its tough to keep track of where I am and when I get lost, then I get overwhelmed and just give up reading after fighting to concentrate.


    NO NO NO offense intended, I have jjust learned to ask my friends to do this so I dont get lost in their messages and most importantly, then I dont give up.
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  7. #37
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    Another interesting sidenote...

    I am guessing that this matter is DIRECTLY related and tied to, my use of Suboxone, starting Monday morning (8/28/2017)

    I am very pleased that my appetite is back and I heated up some chicken fried rice that I also got from the sushi place. After I got it served up and ready to eat, I took a bite to see if I Needed to season it. Bland...and needed soy. put some on, nothing, no taste.

    Poured on enough so that if I was going to taste a response, I surely would have. No response, tastebud wise. NOTHING. I poured cheese on, nothing. I realized suddenly that my taste was affected and that I was getting 10-20% taste from the food. ate a chocolate cookie. same problem.

    Odd but I would bet the farm that this is directly tied to the Suboxone sublinguals. I would take that bet to Vegas!

  8. #38
    Catrina is offline Diamond Member
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    Quote Originally Posted by User88 View Post
    I mean nothing impolite by it but if you can break your posts up every few sentences it would REALLY help me because with ADD its tough to keep track of where I am and when I get lost, then I get overwhelmed and just give up reading after fighting to concentrate.


    NO NO NO offense intended, I have jjust learned to ask my friends to do this so I dont get lost in their messages and most importantly, then I dont give up.
    No offense taken! I'll try to remember to do that.

    Your headache and nausea may be related to the amount of sub you took. No way to know for sure but others have reported having those issues.

    Try to take 2mg this morning and another 2 about 10 hours later to see if that will make you feel better.

    As far as the nausea medicine goes, I don't think there are any issues with that but to be sure, give your pharmacist a call and he'll tell you for sure. They're usually pretty remarkable because they are the ones who are trained to know interactions with different drugs and often catch things that a doctor won't catch.

    Hope to see you check in later to let us know how you're doing.

    Peace,

    Cat
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  9. #39
    User88 is offline Junior Member
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    Thanks Cat!

    I did end up giving the Nurse line a call because I wanted to take that anti naus med bad. She said absolutely NO problem. I took it and it surely did its job. The headache and the nausea left rapidly after taking the Promethazine.
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  10. #40
    Catrina is offline Diamond Member
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    Quote Originally Posted by User88 View Post
    Thanks Cat!

    I did end up giving the Nurse line a call because I wanted to take that anti naus med bad. She said absolutely NO problem. I took it and it surely did its job. The headache and the nausea left rapidly after taking the Promethazine.

    There you go. Glad it worked. Check in later.

    Peace,

    Cat

  11. #41
    Randy35 is offline Platinum Member
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    User88....Good Morning!

    I'm so happy the induction went well. That's the most critical part of sub therapy. Get it right and you'll have a positive experience. And this new doctor is impressive. Glad you found him and his staff. Sure makes a difference huh?

    I agree 100% with Cat about the amount of Suboxone you're taking. I promise you 8mg is a WHOPPER of a dose in sub land. People and doctors underestimate the strength of this drug all the time. A little bit goes a long, long way.

    I agree with Cat that you should at least try taking 2mg in the am and 2mg in the pm, 8-10 hours apart. I bet you'll find that does the trick. If it doesn't you can always add a bit more later.

    Give that an honest try for a few days giving your system time to accept that dose. I'm certain that will be plenty of sub.

    As for the taste of the Suboxone....I can see where some might not be impressed with the taste. Lol.

    Be sure to let it all disolve under your tongue. Don't spit out any of the juice because you'll never know for certain of you've received all of the dose you're taking.

    Also make certain not to drink, eat, smoke, etc about a half hour before and after dosing. That's important. Let the sub do it's job and get fully in your system without any deterrents.

    Please continue posting and let us know how you're feeling throughout the day. Any potential issues can usally be taken care of quickly.

    You did great!

    Randy
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  12. #42
    Catrina is offline Diamond Member
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    Sorry if it's beginning to feel like a lot of information is being thrown at you all at once but it's all important right now.

    Both Randy and I have suggested that you adjust your dose of sub. NOW is the time to do that to get stabilized at the lowest dose possible and that can take a few days. Try the 4mg/day for the next few days to see how you feel. Randy mentioned that you can always add a bit more if you need to but it's important to remember that tweaking your dose should only be now to get the right dose.

    Once you find the dose that works, if you have a rough spot it will be very important to NOT take more and ride it out because your body will adjust to it. You have to allow the time for your body to do that.

    The bottom line with this post is to never go up and down with your doses. Little adjustments now and then leave it alone and be absolutely consistent with your daily doses. You will adjust to it so give it time. Subs are NOT like the other opiates you have been given. They should never ever be taken as needed.

    Peace,

    Cat
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  13. #43
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Catrina View Post
    Sorry if it's beginning to feel like a lot of information is being thrown at you all at once but it's all important right now.

    Both Randy and I have suggested that you adjust your dose of sub. NOW is the time to do that to get stabilized at the lowest dose possible and that can take a few days. Try the 4mg/day for the next few days to see how you feel. Randy mentioned that you can always add a bit more if you need to but it's important to remember that tweaking your dose should only be now to get the right dose.

    Once you find the dose that works, if you have a rough spot it will be very important to NOT take more and ride it out because your body will adjust to it. You have to allow the time for your body to do that.

    The bottom line with this post is to never go up and down with your doses. Little adjustments now and then leave it alone and be absolutely consistent with your daily doses. You will adjust to it so give it time. Subs are NOT like the other opiates you have been given. They should never ever be taken as needed.

    Peace,

    Cat

    Exactly, Cat. Well said.

    User88 - It's also very important to take your sub at the same time(s) everyday. This keeps a level amount in your system at all times which will help you feel your best on the sub.

    Randy

  14. #44
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    information you shared is properly noted and acknowledged.

    will take 2mg (1/4 of a strip as I understand it?) 8am and then, 2mg again at 6pm.

    Thanks for the support! Your concern and help is duly noted and appreciated!!!
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  15. #45
    Catrina is offline Diamond Member
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    I know that this can be confusing. Post often with how you're feeling and someone will be around to help. Just let us know in as much detail as you can how you're feeling and what symptoms you might have and how bad they are. That way we can give you some suggestions about what you might try. That will make things a little easier for you I think.

    Peace!

    Cat
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  16. #46
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    Honestly, I am having what I consider is zero symptoms of wd at this time. literally it all stopped within 5 min of taking the Sub.

    the headache I got last night felt like every other headache I get that eminates from my hneck, BUT, you surely could be right on why I got it. I am not the expert here, I am the student and a willing one! Thanks!!
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  17. #47
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    1/4 strip taken and am enjoying the awful taste of it as I write just got an email from the dr advising I take 8mg per day, ie, one whole strip? whew. huge difference.
    Last edited by Anonymous; 08-29-2017 at 11:20 AM.

  18. #48
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    emotionally I am strong, positive and NO issues of depression felt. I feel very good at the moment.
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  19. #49
    Randy35 is offline Platinum Member
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    Quote Originally Posted by User88 View Post
    1/4 strip taken and am enjoying the awful taste of it as I write just got an email from the dr advising I take 8mg per day, ie, one whole strip? whew. huge difference.


    We're asking you to trust us here and not take that 8mg per day. The doctors just don't fully understand how strong sub is because they've never taken it. Just tell the doctor ok an save the extra sub. They get all their info from an online 8 hour course and Big Pharma and not from personal experience.

    As for those headaches....Suboxone is notorious for giving headaches. Believe it or not but what seems to help "sub headaches" is puonding down lots and lots of water. It works for lots of people on subs. Certainly worth a try and hope it works for you.

    You're doing awesome!

    Randy
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  20. #50
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    Ok. NOW I am in a bad spot. I asked for help with pain and he suggested as follows. I have a BAD situation on my hands because if I don't follow his directions in this situation I am liable to get cut from the Sub program!

    *************************************************

    (my initial message from me to the Dr)

    Sent: 8/30/2017 1:02 PM CDT
    Subject: Non-Urgent Medical Question

    Dr,

    I am concerned about the pain levels that I am of course now experiencing. The trouble is, the Suboxone is not muting the screaming of the pain. Its just...barely even muffling it, if that. This migraine quality headache has lasted 3 days so far and I am in my own private hell.

    I have gone almost a decade of not feeling 75-90% of this pain daily...and now its roaring at me like an ANGRY lion! I respectfully need your guidance and input on how we can try to address this unpleasant houseguest that is here to stay!

    I USED to be in great shape, I used to be strong, tough, gung ho and a non stop powerhouse of energy! And now, here I am...I am not to proud to admit it, I need your help, Doc.

    ******************************

    My doctors reply and medical suggestion:

    08/30/2017 02:34 PM

    Lets add another 4 mg of suboxone daily so you will be up to 12 mg. In another day may increase 4 more mg to a total of 16 mg daily.

    Dr.L

  21. #51
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    I am taking what....4mg, and he is suggesting 16mg????

    Advice? Input? Do I tell him that I am not willing to follow that medication direction he just made? Because there is no way I am going to take 16mg! From what I am finding out, 16 mg is a dose a smack addict might use after 5 yrs on the sub?

  22. #52
    Catrina is offline Diamond Member
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    Hi,

    I hope Randy comes along soon to share his opinion and gives his advice to you. I really respect him and would trust anything, ANYTHING that he may say.

    Having said that, I think you may need to re-evaluate what your goal is and that will guide you with what you want to do from here.

    While I have seen that doctors will prescribe subs for pain management because they are so strong and have a tremendously long half life, they are really intended to be given to those who are dependent upon opiates with the end game of tapering off of them to be free from any and all opiates. In the meantime, for those who have chronic pain we hope that they are able to find something different to relieve their pain that is non-narcotic combined, if appropriate, with therapy, acupuncture, etc.

    If the subs are not controlling your pain and it is NOT your goal to discontinue narcotic pain medication, I honestly don't see the point in going down the sub route at all.

    You have to remember that one of the active ingredients in those subs is to block the effects of ordinary opiates. It's this ingredient that is supposed to eliminate any of the euphoria we get from a plain narcotic. Because of the long half life, the subs are stacking in your system and will continue to do so as long as you are taking them daily. The longer you take them, the longer it's going to be to switch back to an ordinary opioid. In order to do that, you would have to abstain from the subs for days in order for the subs to diminish before other opioids will be effective.

    If you decide to switch back to an ordinary opiate and you stop taking the subs immediately, it would probably take a couple of days at least before another opiate will be effective. The longer you take the subs, the longer it will take.

    I think that it's important right now to decide if beginning the subs has been a mistake. If it was, I think that you should find yet another doctor for pain management and get back to using the same pain medication you had been taking before the subs.

    This is your decision but it's an important one. The longer you take the subs, the longer it will take you to switch back leaving you without any pain control.

    I think it's crazy to be taking as much as 16mg of sub everyday especially if they aren't controlling your pain. What's the point?

    I just think that subs are a poor choice for pain control.

    That's my opinion and others may disagree with me. I hope that Randy sees your post and your question and gives you his input.

    Peace,

    Cat
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  23. #53
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    Thank you, Cat.

    I had mentioned medical cannabis to this same Dr and he seemed in favor of it and mentioned he would be willing to discuss it as an option, before we started the suboxone. I would MUCH prefer using that. No high and no opiates.

    sigh. I am concerned now as I feel that I have a complicated mess on my hands.
    Last edited by Anonymous; 08-30-2017 at 08:15 PM.

  24. #54
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    I honestly about fell out of my chair when I got his response to consider bumping it up to 16mg!!! Especially so early in the dosing, I was SHOCKED. and frankly, still am.

    My first thought when I read it? Uhoh...that seems like a naive, innocent, complicated error in his professional judgement!!!
    Last edited by Anonymous; 08-30-2017 at 08:19 PM.
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  25. #55
    Catrina is offline Diamond Member
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    Quote Originally Posted by User88 View Post
    I honestly about fell out of my chair when I got his response to consider bumping it up to 16mg!!! Especially so early in the dosing, I was SHOCKED. and frankly, still am.

    My first thought when I read it? Uhoh...that seems like a naive, innocent, complicated error in his professional judgement!!!
    I wouldn't consider it an error in his judgement. The truth is that as hard as it is to believe, these doctors just don't really understand subs. They just don't. He thinks he's giving you sound advice.

    You haven't made a big mess because it's not too late to backup and do something different. It's just important to decide now.

    Give it some serious thought and I think that your first step is to decide what you want to do.

    Option 1: Don't increase your sub dose and complete the taper plan.. In the meantime, find something other than opiates to control your pain.

    Option 2. Switch back to what you were taking before you began taking the subs.

    Option 3. So far, the subs aren't controlling your pain. You could take your doctor's advice and up your sub dose to see if a higher dose will provide more pain relief.

    If you choose Option 3, I believe that you'll be signing up to be on large doses of subs long term. This option makes no sense to me at all. I'm not buying his suggestion that if you take massive doses of sub that it will provide you with more relief. Nope. Not buying it.

    If it were me, hands down, Option 1 is the choice I'd make. It that doesn't work, then Option 2 is still an option.

    HOWEVER,

    This is your choice and not mine. This is just my opinion.

    Decide which option you want to go with, let us know and we'll take it from there. One step at a time. Yes?

    Peace,

    Cat
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  26. #56
    Randy35 is offline Platinum Member
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    Quote Originally Posted by User88 View Post
    I honestly about fell out of my chair when I got his response to consider bumping it up to 16mg!!! Especially so early in the dosing, I was SHOCKED. and frankly, still am.

    My first thought when I read it? Uhoh...that seems like a naive, innocent, complicated error in his professional judgement!!!


    User88 -

    Suboxone has never been a good choice for pain control. It was first used overseas for pain issues alone, but given in extremely small doses of 0.2mg and maybe 0.4mg per DAY. It just doesn't work well for any pain. Sorry.

    I GUARANTEE if you increase the sub it will NOT help one bit. Instead as Cat said you'll only be adding much more sub to your system unnecessarily.

    Your doctor just doesn't understand subs and the strength of them. He's flying by the seat of his pants and going strictly by what the Pharma reps have suggested he do. These doctors think subs are just like other opiates where more is better. Definitely not the case with Suboxone.

    In your case I like Cat's "Option 1" best....Taper off the subs and find a different way to treat your pain. There are strong pain meds available that aren't addicting such as Toradol. That particular med can't be taken often, but it does work great for pain as I've treid it before. There are others available too. Ask your doctor.

    Perhaps a pain pump would be beneficial in your case? Maybe tell the doctor you really don't want to increase the Suboxone as it's not helping now. Tell him you're worried about getting off the sub and want to try something different for the pain. Medical Cannabis is another option as you mentioned?

    Whatever you decide I hope you won't increase the sub. You'll get no relief by doing that.

    If you do decide to go another route other than the subs you don't necessarily need to taper off. You can if you want of course, but if it were me and I was going to another source for pain control I would simply stop the subs for a few days then switch to the other pain med.

    Think it over carefully. I feel bad for you my friend. Take care.

    Randy
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  27. #57
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    Okay.

    I had pretty much concluded from your comments and my readings that amping up the dosage to 8mg, much less 16mg, was unnecessary and not what I wanted to put my body thru, but after your responses, I agree, its not the route to go.

    This Suboxone must knock my blood sugar levels WAY down because after I take it I get the shakes and an immediate need to eat sugar. IMMEDIATE. I am hypoglycemic.

    I am not adding the extra mg, I will stay at 2mg and 2mg per day for now.

    As before and as always, thank you both a million for your concerns and help!
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  28. #58
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    Here is my gentle and hopefully polite attempt to nudge him away from using more Sub for pain control;


    Doc,

    Right after I got your last email to bump the mg, the headache went away. Secondly, I would prefer not to add the extra mg if you are okay with that. I would like to stay at the 2 and 2mg per day for now, and honestly, would very much prefer to explore other pain control options. From everything I read Sub is great for helping me thru the wd but it isn't very good at pain control. This isn't me trying to tell you what to do, it's just me saying politely that I am not comfortable putting more opiates in my system, at this time. Perhaps in a week or month but for now, no thank you.

    Could we explore the cannabis, if you are comfortable with that? It seems less damaging and after this week, I am ALL for less damaging!
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  29. #59
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    Quote Originally Posted by User88 View Post
    Here is my gentle and hopefully polite attempt to nudge him away from using more Sub for pain control;


    Doc,

    Right after I got your last email to bump the mg, the headache went away. Secondly, I would prefer not to add the extra mg if you are okay with that. I would like to stay at the 2 and 2mg per day for now, and honestly, would very much prefer to explore other pain control options. From everything I read Sub is great for helping me thru the wd but it isn't very good at pain control. This isn't me trying to tell you what to do, it's just me saying politely that I am not comfortable putting more opiates in my system, at this time. Perhaps in a week or month but for now, no thank you.

    Could we explore the cannabis, if you are comfortable with that? It seems less damaging and after this week, I am ALL for less damaging!


    Sounds good. Hopefully he'll comply.

    One thing does come to mind....Doesn't the doctor believe you're taking 8mg per day?

    I went back and reread the posts and I see where he wanted you to take 8mg a day originally. Cat and I suggested you begin taking 4mg a day instead and you agreed.

    If you tell him you're taking 4mg instead of 8mg he may have something to say about that?

    Are my facts correct? It's something that popped into my head when I read your letter to the doc. Or did you tell the doctor you're on 4mg instaed of 8mg?

    Randy

  30. #60
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    To be honest, with ALL the confusion over the last week, if I am supposed to be taking 8mg per day, he knows now that I am taking 2mg in the am and 2mg in the pm, either way. (oooops?)

    I do think you are correct, and taht I was supposed to be taking 8mg daily. I screwed up and was honest. lol
    Last edited by Anonymous; 08-31-2017 at 02:52 PM.

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