Is it time to fire/leave my doctor for changing me medication for no good reason!?!

[Tim]

Is it time to fire/leave my doctor for changing my medication for no good reason!?!

Hey guys, I got a problem with my local GP I have been seeing. About 6 months ago I began seeing him as my new general doctor who I could hope work together with my Crohns specialist doctors (My Gastroenterologist and Pain Management Doctor). And Since meeting him things were going great, he had a great bedside manner and we got along well. Only recently I have been seeing him more and more inbetween visits to my specialists as he is easier to get an appointment with and I feel he is starting to lose patients with me. In the last few months I have been flaring quite alot and been up and down on Prednisolone and pain meds and still had trouble with not going completely into remission.

Anyway he got frustrated and sent me to my GI doc for a follow up which I thought was necessary too and my GI added a few medications to my daily regime in an attempt to get me on lower doses of steriods and pain meds. The problem is since I seen my GI doc things have been going great and my energy and pain and appetite has all gotten much better. But last week I went to visit my Normal doc just to get a refill on a script for one of my Pain medications and out of the blue he got upset and said he wanted to take me off them and although I have talked about hopefully getting off strong medication or lowering the dosages if or when I can get my other Crohns meds to help, I still want to and rely on these medicines as they are great in treating my symptoms and increasing my quality of life and i was very surprised about how abrupt he was and did not know why he had become like that. It was very strange and just like that he refused to write a script and said I need to start dealing with the pain without medication and it's best I learn sooner than later. Although my GI thinks it would be good for me to reduce my steriod and pain medications, the problem is my pain specialist and I are very happy with the increase in quality of life the medications he is prescribing me are providing me and I am on quite low and safe doses anyway, which makes continuing treatment not a problem or risk anyway.

So my GP doc is kind of making decision against what my specialist think to a degree and it scares me how he could take me off my medications one day when i'm unable to get to my specialist and I would be left to get sick and flare badly without them to control and reduce my symptoms. He (My GP doc) also sent me to surgeons to see if I could get surgery instead of taking meds for pain, despite both my GI and pain doc saying it would be useless and my case of Crohns would just come straight back and the surgeons also
laughed and said it was unnecessary and my GP is jumping the gun in how is trying to treat me.

So my question to you guys is, Do you think It's time I part ways with this doctor as he is not treating me appropriately anymore and should I even keep using him to prescribe my specialist medicines anyway? Or should I go back to my specialist for my prescriptions who know my case better and are the ones who put me on the medications in the first place and are not going to make sudden changes that could endanger my condition?

My Specialists are awesome, but he is not working well with me and them and I really don't want to fire him as my GP but I'm thinking if he wants to change treatments like this when it's going to put me at risk I don't know if I should see him based on that fact!!I was extremely upset when my GP did this as I went home without a script and was in tears as all the stress of knowing I was just told by a doctor to suffer in pain and have that quality of life potentially taken away from me was extremely scary and upsetting. I must also note I did have to see him again the next day for a follow up on a meeting I had with a surgeon and my GP was in a better mood that day in did end up prescribing me my pain meds, so I am covered for a couple of weeks until I see my specialist. But he did say after that he was going to stop prescribing me them soon as he doesn't like me on them anymore, which means the convenience of getting them off him has gone and I will need to
start seeing my specialist for them again, which is a shame as it was good having my GP prescribe them on days when my specialist was busy! I dont get why my GP would suddenly fear me on these pain killers as they do nothing but improve my pain levels and quality of life and I am not addicted to them or anything. The fact he is going to try and change my treatment without my consent and so abruptly when it is working and helping me and potentially make me in a position where I get sick without these meds is so
concerning.

So what should I do? Should I just go back to my Specialist and just get them to prescribe me my meds(which they are more than happy to do and they understand me and we get on well). And/or should I tell my GP I feel I can no longer see him as a patient if he can't prescribe the meds I require to keep my Crohns under control and find a new GP who can prescribe me my Crohns meds in situations where my specialist are out of town and unable to but apart from that just go back to using my specialist for all prescriptions? What should I do guys?? suggestions please?? Thanks so much in advance and God bless - Tim

 

[Trysha]

Hello Tim,
You are certainly in a difficult situation with all of this.
It is somewhat surprising that your GP is going against the advice of your pain specialist and your GI.
You could mention to both of them that your GP is reluctant to prescribe their medications..and ask them to sort it out and speak with him.
Or you could find another GP.
If you no longer have confidence in the GP doing the right things for you then you do need to find a doc who will work closely with your specialists.
It is bad enough having a painful and chronic disease without doctors adding to the suffering they are supposed to relieve.
Feel better soon
Hugs and best wishes
Trysha

 

[shamrock15]

Sounds like big communication issues here to me. My take - if the pain is due to Crohn's, and it is ongoing, I think your GP is probably doing the right thing in considering surgery (or another med such as Remicade or Humira). Ongoing pain from Crohn's usually means something is active, and it needs to stop. Don't assume immediately that just because a doctor is prescribing pain meds that they are doing what is right. They could just be masking a problem. That problem needs to be resolved. I did the reverse - I fired my GI because he wasn't taking my concerns seriously.

I do think as well that, if you have a specialist dealing with your pain, he/she should be the only one prescribing pain relievers so that the full extent of those meds is known. Your three doctors need to figure out what is going on, and how to act together to deal with your issues. Your role in all of this is to become fully informed and look for the best, not necessarily quickest, solution.

 

[Tim]

My GI is just a typical GI with pain meds, he won't prescribe them but is happy if someone else does, he says surgery is not going to help and he wont change my medication. his only thing against pain killers is something called narcotic bowel syndrome which develops after years of prophylactic use. Whereas the pain guy says my GI is a doctor and shouldn't be saying he has a problem and how he treats dozen of Crohnies with pain meds and none of them including the long term ones have problems. So my GP has hooked onto the GI bringing up the possibility of bowel issues, which was only a warning not in anyway saying to stop, just to minimise it if possible as with steriods. the less medicine taken in any condition is better, obviously! The fact my GP doctor has only hooked onto the GI opinion and turned it into a drama and then ignoring the Pain Docs opinion. Both My GI and Pain Doc to me are important and neither one of their opinions my GP should take preference over. I thought it was about balance. Should I be getting a new guy who keeps in balance with working with the specialists and doesn't chop and change meds without strict directions from the specialist? I mean surely its dangerous he is trying to do that? Remicade and stuff is out of the question so I dunno. Does that change things? Should I still be sticking with my specialists to sort things out and not trying to get my GP if he is doing this? and is it still enough to stop seeing him in the future all together? or is he on the right track in some ways and should i steer clear for a while but give him the benefit of the doubt? You mentioned he may be doing the right thing in some ways. So know I'm curious . Thanks for a relatively quick reply too ya'll

 

[DustyKat]

Tell the GP to go root a boot! :ybiggrin:

You don't need to be at the whim of a moody P#&*$ like that. I would either lay it on the line with the GP and ask him what his problem is and to change his attitude or change GP's. You shouldn't have to go to a specialist to get a script, the GP should be acting on the specialists directions, and if the GP is unsure then they pick up that thing called a telephone and ring them.

Dusty. xxx

 

[littlemissh]

You could call your pain specialist and ask him to drop a line to your gp asking him what to prescribe and why. That way the gp has it in black and white and can see its not you just asking but a specialist in this area advising these meds.

 

[Tim]

The only problem with doing that littlemissh is he knows the Pain Docs want me on the analgesics but thinks my Pain doc is just creating more problems keeping me on the pain meds. Originally I met this GP as he was a friend of the Pain specialist and he recommended him as I needed a GP who could prescribe for me when my Pain Doc was on holidays or out of town. The irony is now my GP has turned on my pain specialist and has tried to get me off them saying my GI wants me off them. Even though when I spoke to my GI he is happy for me to use pain meds when in pain as long as I keep it to a minimum as obviously that would be alot better on my body and stuff in the long run. I just can't understand why he would turn on the specialist he is friends with and tell me I am becoming addicted, whn I am completely not. Between my Mesalamine, Prednisolone and Pain meds when I take them all it keeps my symptoms so well under control it's like I don't have Crohns and him taking and one of those away from me, specifically the one that helps me when I get uncontrollable pain. Well I think he is cruel to do that. I am curious if anyone can't comment further. I'm pretty sure what he is doing is worthy of me firing him as he is playing god with my disease and not caring whether him taking meds away is going to affect me. He seems to be making these decisions to assert some new attitude he has towards pain meds. Maybe I should ask him if he doesn't want to prescribe pain meds anymore, for whatever reason, that is fine. But to tell me so I can find another doctor to work with my Specialist when needs to be. I really think what he has done is very dangerous and no good doctor should be putting a patient through this if he/she truly cares and has compassion for their patients. Any comments, suggestions. I'm still quite confused and other people input would help as I'm not dealing with the stress of this situation well and don't want it to cause a flare. Thanks guys and gals - God bless and look forward to hearing back.

 

[Rebecca85]

Do I have this right, you are only on mesalamine, prednisolone and pain meds?

It really sounds like you need to step up onto stronger drugs. From the sound of it, the pain meds are masking your symptoms, they can't treat them. So you need to find a drug for your Crohn's that will treat your symptoms, and you can stay on long term (pred should ideally be used for a short amount of time).

As well as the problems that being on pain meds can cause long term, if there were any changes to your condition, the worry is that taking pain meds would mask it and you could get very sick.

I was first put on meds in April 2010 (pred), then in May Pentasa was added. By July I had very few symptoms except for low level pain, treatable by paracetamol, but it was happening daily. I spoke to my GI about it, and they said that any regular pain is a sign that your disease is not under control. This could be causing scarring in the intestines, and scar tissue once you have it can only be removed through surgery. In August azathioprine was added, and since then it's like I don't have Crohn's- with no painkillers or symptomatic treatment needed! (I only have to avoid a few tricky foods like sweetcorn)

Maybe your GP hasn't gone the right way about it, but I think he is right to try and explore other ways of treating you without the pain meds.

Please go back and see your GI and ask for your treatment regime to be stepped up.

 

[Tim]

Hey Rebecca85, yeah the current meds I've been put on are low doses of Mesalamine, Prednisolone and Oxynorm. My GI thinks with the pred and mesalamine it should get me under control and in the mean time thats why i have pain meds. I have o admit I'm not happy with the whole situation at all and some of the meds have alot of side effects. But for the mean time they are the most reliable thing I have to keep my symptoms under control and as much as I would like to be put on stronger Crohns meds my GI is not willing to go there until we give the steriods and 5asa's a good try. from my understanding the mesalamine takes a good 2 months to work and the plan for me is to cut back on all the potentially nastier drugs like steriods and pain meds once the mesalamine is doing its job. The thing I need to know how to handle is what to do when my GP doctor is trying to change my meds my specialists have me on and he is doing it abruptly. Is that really bad, should I be saying something to him. Because it really upset me. I think I am slowly getting to the point I have my Crohns under control and him messing it seemed to take back to a place of fear and unknowing which I had only recently overcome and so I hold that against him for doing this. I have only been diagnosed for 1 year and it has been hard but I am getting on top of it slowly and was just wondering what people have done in similar situations. I will see my GI again soon and try to organise some stronger meds so I'm not a slave to so much other meds and that way I cant have people take me off the others I need and it wont be a problem. What should I do though? should I keep using hin as my GP doc and try to get him to work with my specialist or should I change docs because he is playing around with my med regime without my specialist strict approval. Any ideas would still be appreciated. God Bless - Tim

 

[Rebecca85]

Sorry- I didn't realise that you have only just been put on the mesalamine. I thought most times people went straight on it at (or before in my case) diagnosis.

As for the GP, I don't know what to suggest, if it were me then there are lots of doctors at my GP practice, and I would simply ask to see a different one. Because if he has (usually) a great bedside manner I would want to have the option of seeing him for non-Crohn's related stuff.

I think also our GP systems work slightly differently, as here even though the GPs hand out the prescriptions, it is the specialists who have ordered them, and I think the GP would be in trouble for refusing to prescribe. You don't have the option of getting the prescription from the specialist, only via your GP. So if my GP refused my meds, I would want to put in an official complaint.

It might be worth having a chat with him, and straight out asking him why he is going against specialist advice, and basically say what you have said here- that you are trialling the mesalamine but have been asked to give it a couple of months, if that doesn't work you will ask about something stronger but in the meantime you and the pain specialist feels you ought to have painkillers. And if talking to your GP about it doesn't work, politely explain that you need a GP that will work with your other doctors and you no longer feel that he is right for you.