Author: finallyachance

Posted: Thu Jan 19, 2012 10:42 pm

I can deal with constructive criticism. This has been a long two year ordeal for me with alot of ups and downs so please no insults or attacks. Just don’t comment if you have plans of such. Thanking you in advance.

Well I went back and seen the doc today. For all of you that know my story somewhat, I want to tell yall that I am not paranoid and afraid anymore of this clinic, the nurses and/or the doctor like I used to be. Six weeks ago when I went in there to be re-admitted, I was real afraid. I had left the clinic because of these two nurses and a grievance and I left before the doctor had received the result of my P&T. Well anyway the director called me and ask me to come back thank god I hated my new clinic but anyways the doctor wanted to see me about the P&T results so anyways I just broke down and told the director all my fears about being decreased or discharged because I have what they call QT Prolongations (527) which the doctor believes is medicine induced not like real, but apparently it is a risk that doctors don’t like to deal with (liability) Well over the last six weeks I have had 30 milligram increase since I have been back at the new clinic and split dose too.

I have struggled with the fact of being honest and telling the doctor that although I feel like the 30 mgs has improved my stabilizing I am still not there. So I went ahead in with my little diary documenting day to day accounting and showing him the results of what effects I got from the split dose and thirty milligram increase. I stayed positive but got my points in that I have felt improvements but I still have some long nights of withdrawal symptoms and cravings too. We talked about his concerns and we discussed my concerns. He told me each 5 or 10 mg increase he signs off on can and does endanger me with my heart and the longer delay in between my heartbeats could be just one time too many and I could die. Methadone must cause this "medicine induced prolonged qtc’s" in my case as I have no family history of such. Well of course my next question/remark was well wouldn’t any opiate do the same? He said yes of course and so I said well if I am not on methadone, no matter what the reason, I will be on something else DOPE not monitored etc…He then said how old are you I said 48 and he had me tell him about my rehab history…12 step history….suboxone attempts and he ask when and if I had ever any real sobriety I told him a year here and there over 30 years but one time I worked in the field so I stayed clean 3 years. He asks me if I had insurance, I said no. At this point I am getting a bit nervous wondering where he was going with all of this. I still don’t know where he was headed with all that DO ANY OF YOU KNOW WHAT HE WAS GETTING AT? I would be real interested to know but I was too afraid to ask because I didn’t want to know either. I mean he is taking this all in. Even sitting back in his chair closing his eyes in silence and thinking real hard. Opening them up and asking me something else closing them in silence and thinking about it even longer etc…

Well he said he was hearing from me that I pretty much plan on being on methadone for a long time maybe forever and it has been the only effective mode of operandi in my recovery history and although he worries and would like to keep me on the smallest amount of methadone he can but he wants it to be working for me also and I am saying if I don’t get stabilized on methadone I will be right back on the dope in no time etc…etc…etc…

So in the end he is giving me 10 more milligrams this week and 10 more milligrams next week. Then I wait two weeks and do a peak and trough He wants me to continue split dose and even when he does the P&T do the split dose which to me makes no sense because of the strategy they have in place for peak and troughs. So Okay, now here is the weird part I wanted to tell yall about and want you all to tell me what you all think about this, After 2 weeks of being at 210 mgs dose I show up at 5 am take my am split dose of 105 milligrams in front of the nurse (which works out great because that’s Thursday my normal clinic day anyway). Wait 15 minutes then I leave and come back at 9am and HE WILL DRAW MY BLOOD HIMSELF IN MY FEMORAL ARTERY. I have had a pic line put in my neck many times but never a femoral vein IS THIS GOING TO HURT???? If you remember I am a terrible stick and they tried three times to do peak and troughs on me for over a year so I could get an increase and but they never were able to get blood. Finally they got one with 12 sticks 6 for the Peak and 6 for the Trough. He said he was not going to put me through that again and he is not so sure why or what he is aiming for by doing a P&T but to have a record documented that they are doing their part to provide me adequate relief but because of the liability and my choice to exercise informed consent. He feels it is necessary. He wants it all there in the chart. He more of less admitted he was going to cover his ass and the clinics ass. He was very nice about saying that though. Plus I will sign all my EKG strips showing that I have been informed about the risk involved in qtc’s regardless their informing me of any dangers, I still chose to take increases. Okay so there is the Peak. Then the next Thursday I am to come in at 7 am and he will draw the trough in my femoral artery before I dose. He called it an unorthodox way to do peak and troughs but he will figure the math out about it being a split dose etc… But what about the three days of taking your meds at exactly the same time in front of staff/nurses and the 30 minute window to get these levels drawn in for any accuracy?? Are those procedures put in place for a good reason so as to get some accurate result or do they implement all that hubbub of dosing in front of staff and being so strategic about dosing at exact time three days in a row etc just so we don’t do things to try to deviate the results? Will my results not be a little compromised by not doing it the regimented way? He told me not to worry myself about any of it because it really will make no changes in increases and/or dose regardless of the numbers he comes up with he just has to have the results to show their attempts to follow procedures. He said he will continue with increases if I need regardless the numbers as he believes in the patients’ complaints and his physical evaluations more than any P&T results. Not so sure who he has to answer to etc…but if it’s not going to make any difference why do it at all especially since I am such a hard stick and he has to go with a femoral artery etc…. He validated me that today from just a physical exam he can see the withdrawal symptoms enough that he is convinced I am not stabilized. He told me then to lie down on the exam bed and he looked at my groin and said he didn’t think it would be any problem at all to do the blood work. Anytime they ever did the neck or femoral artery with me in hospital settings, the doctor had to do it so I understand that part, but they also put me in or under twilight. So is that anything for me to worry about??? IS IT GOING TO BE PAINFUL?????? I was too afraid/embarrassed to ask him like a BIG WHIMP. AND….DOES ALL THIS SOUND COPESETIC TO YOU GUYS?

I left the office today feeling good about everything. He was very nice and even sympathetic. He was seriously studying on his thoughts with my case this morning like I said shutting his eyes, thinking hard, talking it all out with me and the director and my counselor. When I got ready to leave he walked me out shook my hand and said don’t worry be patient but we will get you stabilized. He apologized that I have been struggling with this but commended me for not giving up and/or using. OF COURSE DUE TO A LOT OF WHAT ALL YALL SAY I CANNOT HELP BUT WONDER IF HE IS JUST HUMORING ME OR PLACATING ME FOR SOME REASON. The clinic is not my friend. The staff at my clinic will never be my friend etc… So I am wondering what you all think about: The way he is proceeding with my dose/increases? The way he is trying to help me in a sense but admits to covering their butts with excessive documentation (what he said to the director today)? Peak and Trough is such an unorthodox manner, (no three days consistent dose with my entire dose and not only half due to split dose)? The Femoral Artery route? I would really appreciate any thoughts or ideas you all might have.

OH YEAH YALL ONE OTHER THING I AM HAVING THIRTEEN TEETH PULLED ON MY UPPER MOUTH MONDAY. WILL I HAVE ANY PROBLEM GETTING NUMB DIE TO METHADONE? AND IF ANYTHING GOES WRONG LIKE DRY POCKET/SOCKET IS THERE ANYTHING I CAN DO SINCE MY DOSE IS SO HIGH ON METHADONE I WILL JUST HAVE TO LIVE WITH THE PAIN MORE THAN LIKELY HUH?