Unexpected trip to the Rheumy

I had an unexpected trip to see my Rheumy yesterday.  I woke in the middle of the night with excruciating pain in my left knee.  The kind of pain that makes you whimper.  Pain medication didn’t touch it and an ice bag didn’t do anything.  I lay in bed from 1:30am to about 5:30 writhing in pain.  I think I finally dozed a bit and then got up by 9am and started to cry all over again.  Thankfully the doctor could see me in a few hours.

He didn’t have anything conclusive.  He felt that with the inconsistent dosing of my biologics and metho for the past few months due to my many respiratory infections, perhaps I was having a bad flare.  “In one joint?”  I asked?  Shrug.  He offered a cortisone shot – which I usually don’t want to have, but I couldn’t tolerate the pain.  He also gave me a script for an Xray in the event that the pain hasn’t subsided in 10 days.  Then we chatted about pain meds.  We discuss them regularly during visits and he knows that I’m a responsible user.  He said that going forward the rules were that he couldn’t prescribe opioids to me unless he’d seen me in the past 90 days.  Which normally is fine with me.  I see him every 6 months and he typically will give me a script for 60 vicodins which lasts for 6 months at least.

So I mentioned that I had read some of the CDC guidelines and he said that the rules about 90 days had nothing to do with the CDC.  He hasn’t even had the chance to really review and digest the new CDC guidelines.  What he did say is that years ago, opioids were strictly for end of life situations or cancer patients.  The were not used in rheumatology.  A couple of decades ago the rules were softened as the medical community tried to offer more options for those in pain.  Well thank goodness.

My grandmother had RA – she was diagnosed maybe 1970-ish.  I remember at some point in the late 70’s or early 80’s when my father got her some of the 800mg motrin pills.  Remember those big orange pills?  Those were a huge relief for her, and better than anything she had used to date, but I know she lived in pain until she passed away.  I don’t think she ever took anything stronger than 800 mg motrin.

I started on the 800 mg motrin initially upon diagnosis in 1999.  I remember that I bruised like crazy and the pain was slightly diminished.  I’m actually very glad that I don’t have just 800 mg motrin to rely on now.  I am still working full time and am productive and active.  One trait I carry with me that I learned from my grandmother was to not complain.

However, if the new CDC guidelines are going to get in the way of my RH doctor prescribing me 10 pills a month for pain, I just might have to start complaining.




9 thoughts on “Unexpected trip to the Rheumy

    • Thanks for the concern. I have made a pretty quick recovery, even doing some walking today. I don’t wish that pain on my worst enemy….not that I have any enemies. Onward and upward

  1. This is a very serious matter that I’ve been thinking about since I read about the new CDC guidelines. The suits who make up these rules don’t really grasp what intractable pain is. As a nurse I’ve seen it and as an RA patient I’ve lived it. Even having an MD after your name does not shine the light on the matter. Unfortunately. Pain management is a fairly new discipline in medicine, but many doctors forget that it exists. I hope you did achieve some pain relief with the steroid shot.

    • Irma thanks for the support. I find all this very worrisome. Like priests counseling about marriage, how can a doctor know what’s best for pain? I would be hard pressed if they took away my meds. I average 2-3 per week. That’s all.

      And yes, the shot helped, ice helped and I did some walking today without pain.

  2. Well, you know where I stand on the matter. At least your doctor broached the subject with you. The 90 day rule went into effect with the previous FDA guidelines in 2014 which also dictated that patients must go to the doctor every 30 days for refills instead of the prescription being automatically refilled. I, too, am grateful there are more effective medications than Motrin (although I generally only take Tylenol). I hope you continue to do better.

    • Carla – thanks for the info. And the stand!! We spoonies need to band together. So I wonder if that 2014 change is when I had to sign the paper stating that I wouldn’t get another script, I wouldn’t sell or give away the drugs and they would only be for my own consumption?
      Anyways, I’m feeling a bit better but I believe it’s a flare. And I’ve not had one in a while so I’m going to rest, relax and pamper myself.

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