Long-Term Care Provider Terminated Patient's Pain Treatment

[Confusedinillinois]

My question involves medical malpractice in the state of: Illinois (and potentially New York)

I'm at a loss and need either validation of my anger or a swift dose of reality. I'll try and bumper sticker this and if anyone needs more information I will gladly post more.

in 2001/02 my wife began having terrible pain in her back. We proceeded through a long line of Doctors from our GP, to Podiatrist's, to Rheumatologist's, to Neurologist's and seemingly everything in between. Each diagnosis was different, from restless leg syndrome, to potentially MS, to fibromyalgia and she was put on a laundry lists of medications. She is now in her early 50's.

In 2003 she was referred to a pain management specialist and had an MRI done. At the time she was diagnosed as having degenerative changes at T11-2, L5, S1, small herniation at L4-5, and central herniation at L5-S1. It was at this time that she was put on Oxycontin (originally 40mg / 2x day) and Norco as needed, after having been tried on Duragesic patches, Vicodin, Neurontin, etc. It was during this time that she also tried chiropractic, physical therapy and acupuncture care. This was all done in New York and involved two (2) separate pain management doctors. One in 2003 and one who took over and continued her cared between 2003-2005. At the time she was put on the Oxy it was done knowing that she would have to stay on it and that she could not simply quit taking them.

In 2005 we relocated from New York to Illinois and initially we continued to go back to New York for treatment. Ultimately we began looking for someone to continue her pain management care in Illinois as the trips were too rough on her. We located a GP (ironically he had the same issues and had opted for back surgery and was a functional cripple after three failed surgeries) who took over her pain medication prescriptions. Ultimately, she began looking for another pain management doctor because the GP could no longer continue his practice. She located a new doctor who took over her care in 2005. At this point her dosage was at 40mg / 4x day and norco as needed. This same regime continued from 2005 through 2010 when she indicated that she was not happy with the medication and the way it made her feel. She also did not want to increase the dosage. She tried to switch to Suboxene but this left her in severe pain and she went back to the Oxy. She continued on the Oxy till 2012 when she again told the Dr. that she wanted to get off the Oxy and she was put on Morphine. However, the Dr. put her on a significantly reduced dosage which left her feeling crippled. If you are taking 40mg of Oxy, the comparable dosage of Morphine would be 80mg and she was under 40mg.

During the time period of 2005 - Present we repeatedly asked for a new MRI to be done, but it was never ordered. In addition to the back pain my wife also suffers from Barrett’s Esophagus, Pitting Edema, and Carpal Tunnel Syndrome. In 2011 she had a torn meniscus and needed surgery. Recently she was diagnosed with arthritis in the same knee and is on the 2nd of three shots to inject chicken comb into her knee. She cannot take NSAIDS, because of the Barrett’s but because she has no pain relief she does. To this date we still have no answer as to the cause of the pitting edema, just that she is on water pills.

Now, after the last visit to the Dr. and telling him that the morphine is not doing anything to relieve her pain, he sends her to get another MRI...........Finally !!

The results are in: C3-4 mild degeneration, C4-5 mild degeneration with central disc bulge, C5-6 more pronounced degenerative change, C6-7 minimal. L4-5 early degenerative disease, L5-S1 more pronounced degeneration with slight narrowing of disc space.

His answer, everything is fine. You need to go to rehab to get off the pain meds that your addicted to.............

This latest MRI never even mentions the T11-2 degeneration. I guess that must have healed itself............

Seriously, I asked him this question at her appointment today "if everything is normal, then why was she put on the meds in the first place?" His answer..."I don't know, I didn't put her on them."

While it is true she was treated in NY by two Dr's for two years in 2003-2005 who prescribed the original meds, this current Dr. has treated her with these same meds for over seven years (2005-2012) and now he does not know why........ WTF ?

I'm Livid !!!!!!

I literally am sitting here with a stack of medical paperwork over 3" thick and no one knows why she was put on these meds. Incidently, in the beginning he was dismissive of the Fibromyalgia, but then that all changed and over the last few years all he brought up was the Fibromyalgia. So I guess it is all in her head.

So here I sit and wonder, after thousands of dollars in prescriptions, monthly Dr. visits, and my wife apparently hooked on a narcotic medication she should have never been prescribed, screwed up lives because of this crap, and now he wants to ship her off to rehab to get off the drugs he now says she shouldn't be on................ I don't know whether to cry or rip someone’s head off.

Help !!!!! Is this something that we should pursue legally, or are we just wasting more time ? I feel like they have just fed us BS over the last few years. We tried over and over to get someone to look into things more. We repeatedly asked for a new MRI, she pursued alternative medications and raised these with her Dr. and now they are dumping the problem they created on us.

[Mr. Knowitall]

If your wife wants medication that her doctor does not believe are appropriate for her condition or treatment, she can go to a different doctor and attempt to get them from the new doctor.

I'm not sure what you mean by "the problem they created". If you are stating that your wife is addicted to drugs, then the doctor was trying to help her by getting her off of the drugs to which she has become addicted. If you are stating that your wife is not addicted to drugs (addiction being something apart from dependency) and needs the pain medications she has been receiving, how is that a problem created by the doctors?

[Confusedinillinois]

Mr. KIA

First, thanks for replying. I think my problem was when I wrote the above I was 25% stumped, 25% disenchanted and 50% angry. So let me try to rephrase.

No, wanting drugs is not the issue. In fact she has been the one that has continually brought up trying to get off them because of the way they make her feel and the cost. She actually has been proactive in researching and asking about alternatives. This is not something that has arrived overnight.

A little over ten years ago my wife developed pain in her lower back and numbness in her arms. Between 2002-2003 she went to nearly twenty doctors in New York trying to ID the cause of of it. Ultimately she was diagnosed with pinched nerves and degeneration / herniation of some discs. They then tried her on a variety of medications, finally settling on her current medications. Again, it was not her, but the doctors that diagnosed her and prescribed the meds. Hell they had her on a bunch of stuff that they now have lawsuits over (Paxil, Zoloft, Vioxx, etc)

In 2005 we moved and her current Dr. took over her treatment. He was provided with all the medical documentation from NY including all medications taken, all doctors seen, and all tests conducted. From 2005-2012 she remained on her current medications. All of a sudden (this month) the Dr. is now telling her there is no reason for her to be on these med's and wants her off. Her most recent MRI, that we have been asking for, for years, came back with several new things and yet they are calling it "unremarkable" and so she needs to be taken off the med's and should go to rehab.

So I guess my point when I said "the problem they created" is, if her condition , originally or currently, does / did not warrant the medication she is on, why was she ever put on it in the first place? and more importantly, when the current Dr. took over her care seven years ago why did he continue it ? In fact, I specifically raised this issue well over a year ago when we began asking for a new MRI. My concern, even then, was what are the pain meds masking ? Is the issue getting worse ? Neither of us has medical degrees, so we trusted the doctors when they said she needed to take the meds. Now they are telling her she can't have it anymore and somehow it's her fault that they prescribed it.

I mean we feel blindsided on this. The problem is, not only is she on the pain meds but also takes advil / tylenol to cope with the pain because she doesn't want to increase the dosage. In fact she has been the one that has been telling them she wants off. People addicted to pain meds don't take advil and tylenol, theres no point. It would be like an alcoholic drinking water.

We have been going to Dr's appointments, every month, for the last decade. The meds cost an arm and a leg, and now, after spending thousands and thousands of dollars, they are telling us there is no justification for it................. ??? You've billed me (and the insurance company) for something I never needed ???

Please bear with me, I am really frustrated by this all. If I'm not being clear I apologize. I have just watched my wife continually suffer with pain for the better part of a decade, with no answers, no solutions, no suggestions, just a monthly supply of meds and a bill. Now I am watching as the very people she trusted for her care blame her for the med's they prescribed and tell her she needs to go to rehab. Your 100% right, there is a difference between dependence and addiction.

CIL

[Mr. Knowitall]

What you now appear to be stating is that following the MRI the doctor concluded that your wife's complaints of pain are not consistent with the actual nature of her injuries, and thus that he has concluded that she is drug seeking. You and your wife appear to be taking the position that the pain is real and that the medications are necessary. So you're back to what you were previously told: if she wants the medications she will need to get them from a different doctor.

There is nothing wrong with a doctor relying upon your wife's description of her symptoms and pain, and treating her accordingly. There's no law that says that a pain patient must have a MRI before a doctor can prescribe pain medication.

[Confusedinillinois]

Mr. KIA

Oh boy, for someone who writes a lot I seem to be failing miserably here. Let me try to once again restate my concerns:

What you now appear to be stating is that following the MRI the doctor concluded that your wife's complaints of pain are not consistent with the actual nature of her injuries, and thus that he has concluded that she is drug seeking.

Yes and no. The issue for me is that her current Dr. actually had her MRI from NY (performed in 2003). That's whats bothering me the most. He is stopping the med's because, based on the 2nd MRI, he now doesn't think she needs to be on them...... but when he took over her care seven years ago he had the 1st MRI. Why did it take him seven years to figure this out ? Even the results of the 2nd MRI are not consistent. The 2nd one shows more damage, but then somehow some of the original damage is gone................I don't think these things heal themselves.

You and your wife appear to be taking the position that the pain is real and that the medications are necessary.

No, not at all. Yes, she is in pain. Over the last decade she has never been pain free, even with the med's. But we have been the ones who have been asking for possible alternatives. In fact on two seperate occasions she went to him to try other things. It has been us doing the research and asking the questions. The problem we have now is that the med's she is on are not the type you can just quit taking. He's talking about her just going into rehab instead of weening off of them. So now we will have to pay for rehab?

There is nothing wrong with a doctor relying upon your wife's description of her symptoms and pain, and treating her accordingly. There's no law that says that a pain patient must have a MRI before a doctor can prescribe pain medication.

You're right, that is a Dr.'s perogative. But again I can't get past this issue of why, when he had the original MRI, did he take seven years to figure out she didn't need to be on these med's. I feel like we are not being told the whole story.

Maybe that's it in a nutshell. It's like someone "finally" looked at the originally MRI and said "oh crap, she shouldn't be on this medication"............ and now they are back peddling quicker than a politician. Instead of saying something like "listen, we need to draw back on the med's, get you back to a baseline, and then figure out how to better address your pain issues" they are making us feel like we held a gun to their heads each month and forced them to write the prescriptions. Somehow we are guilty, despite the fact that it was us asking repeatedly for alternatives and to have a second MRI done.

Does this make more sense ?