This is so very frustrating to read about - very sad that Kelly has to endure this...here are my thoughts and advice.
I am a RN and recall the things we deal with as health care providers.....we all know that there are drug abusers and seekers and we have to be aware of this and the potential for these patients to become addicted by some medications. It is hard to know what is right. Fentanyl patches provide continual doses of pain medication for severe pain and are often used as a last resort for patients who are terminal (such as cancer patients in their end stages) But, since the doctor is a Pain specialist, he likely prescribes them for a variety of patients. Crohn's is probably one of these instances.
I am also a Migraine sufferer. Something I have learned from my migraine forum is that pain specialists (such as the Diamond Clinic) aim to use continual pain medications sparingly and try to give the least possible amount of pain medication and apply other forms of pain control. That is...a Pain Specialist does not necessarily use addictive medications more that other specialists. Nevertheless, it is up to the doctor to determine what his patient needs - not his nurses or office staff!
My Neurologist aims to prevent pain first and foremost but sometimes I need narcotics to abort the migraines. Most of my past Neurologists gave me a small quantity of narcotics to use only when I need them......but I have encountered Neurologists over the years who feel that narcotics should only be administered in the ER. I absolutely dread having to ask for refills, wait until I am in severe pain and to the point where I feel as I am groveling and begging as a real drug seeker will do.....when I tend to be extremely cautious about using my pain meds.
The entry in Kelly's LJ about going two days with NO patch suggests that she is not just trying to stay medicated. She has a painful disease and often NEEDS pain control just to live her life and go to work each day. A woman on the office staff is not qualified to suggest that Kelly is "using too much medication!" The problem is not that Kelly does not work well because she is taking pain medication, she misses work when the pain is too disabling. So taking the medications she needs allows her to function better and be able to go to work, right? The doctor's office wrote the prescription....so it appears that they knew she needed it. It is not Kelly's fault that the prescription was not written correctly!!
I HATE the way medical personnel can sometimes make me as a patient. I am reminded of my days working in a hospital and knowing that I also was taught to be very careful of "drug seekers". I may well have been one of those providers who caused a patient in severe pain to feel the way I now feelI hope not.... as a nurse I wanted to make my patients comfortable and tried to serve as an advocate for them. Now that I deal with doctors with myself as the patient - I have a better attitude. My best Neurologists have been one who had a wife with migraine, and my most recent provider is a migraine sufferer as well.
What I have tried to record are my feelings and observations from both sides....that said, I also feel that this office manager sounds out of line. An office manager is an adminstrative person correct??? What she has given Kelly is MEDICAL advice and this certainly sounds out of line. Kelly is obviously reacting as a person in pain and frustration and I feel that the doctor should be made aware of this behavior of his staff. Reading that the pharmacist also encountered uppity behavior from her is also disturbing.
I would suggest that Kelly schedule a meeting with this doctor and bring someone with her to be there as she explains the problem with the office manager. I really feel that he needs to know and having a second person present will help Kelly to feel less vulnerable, etc.
It is possible also that the doctor LIKES having this "guard dog" in his front office. If he does not seem to understand the way Kelly has been made to feel, then I would suggest finding a more understanding doctor. The danger in this, however, is that changing doctors also reflects on the patient and raises warnings about drug seeking behavior. I hope that talking to the doctor about his office manager will be helpful. It would be terrific if the pharmacist would support her but since he has to deal with this woman often, he may prefer to stay uninvolved
((((HUGS))))) to Kelly....I am so, so sorry that you are having to deal with people like this. Being in pain is frustrating enough and I can only imagine how disheartened she must feel
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