Question About a Recent Doctor Visit

Updated on February 28, 2011
P.C. asks from Sachse, TX
18 answers

Hi ladies. I'm not sure if this is an appropriate subject to bring up here, but I don't know where else to get advice. Here's the situation...a few weeks ago when we had all that ice I slipped on the ice in my driveway and when I went down I put my left hand down to break the fall, which was a bad idea. My wrist, arm, up to my shoulder is still hurting. I went to my doctor (who is very nice) the very next day just to make sure I didn't break anything. He ordered x-rays and said nothing was broken, gave me a sling to wear, prescribed some hydrocodone for my pain (take 4 times a day) and a muscle relaxer. Well since the pain has not gone away yet (almost two weeks later) I called back and apparently my doctor was out due to emergency surgery he had. His medical assistant (who is super nice) said she talked to another doctor in the practice and he said I could come in but all he was going to do is refer me to an orthopedic doctor. My insurance does not cover MRI's (goes toward my deductible) and I simply can not afford one. I went in and explained this to this other doctor and basically the first words out of his mouth when he walked into the room was "i'm not the type of doctor to prescribe pain medicine because people can get hooked on it" I looked at him funny and said "ok" he got up and looked at my arm and noticed my hands were shaking just a little bit (they do that all the time, I think because of an Anti-depressant I take. I didn’t think anything of it because it happens all the time. So he went back to the computer, started looking at my chart and asked me if I was out of the hydrocodone my doctor prescribed (well yeah since he only gave me 28 and told me to take 4 a day!) He looked at the xray results on the computer and asked again why I wouldn’t be able to go to an orthopedic doctor and he said I understand your financial issues but you really should go. No, he doesn’t understand it because I have NO money to go. While he was sitting at the computer he mentioned about two more times how my hands were shaking. Again I didn’t think anything of it. He finally said he would give me some hydrocodone but he only wanted me to take it at night so I could sleep. He also had my doctor’s medical assistant put a brace on my wrist, which really helps but it still hurts.

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So What Happened?

I guess I ran out of room - here is the rest of it...Ok, so it wasn’t until after I left the office and replayed what he said about me shaking (and me working in an orthopedic clinic many years ago and how the doctors would say people would only come to get pain meds) that he was questioning whether I was hooked on pain meds or not! It upset me a lot, the last time I took any pain meds is when I had major dental work almost two years ago! On their website they have a spot to email your doctor. Now that my doctor is back I feel like I should tell him that upset me, because I don’t know what he wrote in my chart and I don’t want my regular doctor thinking I’m hooked on pain meds. I also don’t want to stop seeing my doctor because he is the best doctor I have had in a long time, so I don’t want to make it awkward. What would ya’ll do in my situation? Keep your mouth shut and just let it go or say something to your regular doctor?

More Answers

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L.D.

answers from Las Vegas on

Hydrocodone is highly addictive so I can understand this second doctor wanting to be very cautious about wanting to prescribe it for you a second time. Now you mention that you don't want to go see an orthopedist because the cost of MRIs goes towards your deductible and you don't have the money to pay for it. I still don't understand why you don't want see an orthopedist. An MRI may not be necessary, but if it is to check for ligament damange in your rotator cuff for example, don't you want to get that checked out and treated? I understand about financial hardships but your health and wellbeing are very important. I'm sure that, if necessary, you can work out some kind of payment arrangement with the imaging place that won't cause you that much undue financial hardship.

You have to find out why you are still in a lot of pain from your fall. If you have injured yourself to the point that you require an ongoing prescription for hydrocodone then that is not good. You cannot be hooked on narcotics the rest of your life. Do what you must to treat your arm/wrist/shoulder injury.

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K.P.

answers from New York on

You have had at least two medical professionals suggest that you seek out an orthopedic. I understand that you cannot afford to go, but I would suggest that you go and talk with the billing department about a payment plan. If your hands are shaking, that is not a good thing (could be impacting your neuro system).

As for the drug addiction- this guy didn't know you and think about the scenario as if you were watching it rather than participating in it. You come in with pain, but not willing to see a specialist. You come to him with "the shakes", but don't think you need to see a specialist. People who are addicted to pain meds (not you, but people who are) "doctor hop" so there wouldn't be a "record" with any one physician. Then you ran out of the room when (her perceived) you didn't get what you came for. He has to be cautious and no, you shouldn't make an issue out of it b/c ANY doctor in his position would have be suspicious.

Now that your doctor is back, you could call him and ask to see him again if you are still in pain. While you are there, ask him what the other doctor's impressions were- if there is something suspect in there ask him whether or not it can be removed b/c the other doctor was not your "primary". Address it directly and understand that if a patient they prescribe meds for becomes addicted and in turn engages in illegal or unsafe activities, they will be held accountable unless it is otherwise noted in the patient file.

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M.S.

answers from Dallas on

Why assume that an ortho doc automatically means MRI's? Bring your x-rays with you. You can always call the ortho's office in advance and make sure that they don't automatically require an MRI; if they do, see if you can get a referral to a different one. Also, when my son needed an MRI and insurance wouldn't cover it, his specialist was able to suggest an MRI place that would do one for only $150. I would hope that you could work out a payment plan for a cost as low as that. If there's nothing else the dr's office can do, why not try the ortho, since you're still in pain?

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A.V.

answers from Washington DC on

I'd talk to your regular doc, who has a history and relationship with you. I just called our dentist about something and I am glad I did. Not that it was a huge issue, but it reassured me and he was glad to have feedback from a long-time patient (who now brings her family). What he doesn't know he can't resolve.

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C.H.

answers from Dallas on

Many good responses here but I would stress a few things:

Tehre are other pain drugs between asperin and Hydrocodone. Praise any doctor who tries to prevent you from getting hooked on that.

If you take a prescription strength Advil (4 pills I think), I hope you also know that you must eat a good bit and not lay down for an hour as they can cause serious and permanent stomach and esophageal problems.

Too much Tylenol can cause liver damage.

Too much asperin -- you get the picture.

Your shaking was a big sign and the fact that you didn't tell him about it made him concerned, of course. Too bad he just didn't come out and ask why your hand was shaking. I've never seen antidepressants make a person's hand shake so that needs to be investigated too! One of the worst case scenarios could be Parkinsons!

Write down what you want to tell the doctor. What else can be done. Can you see an orthopedist without an MRI? If you need an MRI, how can you get one the cheapest and with payments.

YOu don't want permanent loss of the use of your arm or wrist, so ask, ask, ask away. (Did no one ever suggest alternating ice/hot treatments. Ask about that. KNow that hairline fractrues don't show up well on x-rays. Ask if you could be treated as if you had a fracture without the MRI. Just ask...

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R.M.

answers from Cumberland on

Payment for an MRI does not have to be made at the time. You may also be able to make payment arrangements that would allow payments over a long period of time. I would hate to hear of someone losing the use of their arm because of lack of funds. Call the specialist and see if he will see you without payment. Two doctors in Washington, DC literally saved my life-and it took me years to pay them back-the money, that is! They knew, upfront that this was the case-and yet they did my surgery/procedures. Good luck!

K.B.

answers from Milwaukee on

It could be pinched nerves or damaged nerves and that can take a while to heal, like a month (maybe longer if serious damage happened like in a bad accident).

There is only so much that ceritan doctors can do so if you are unable to go to whom they suggested there is only so much they can do to help. Being on pain meds is addictive, even if you are still in pain, so that is what this other doctor suggested further testing to see what other damage is done that can not be seen on an x-ray so that they can evaluate and help you out more then what they can tell you now.

It was rude of the other doctor to be so blunt about being hooked on pain meds if you only are going in a second time, he at least could have been nicer/more professional about it. If your normal doctor is back then stick with him, if you want to e-mail your doctor that you would like to do a follow up from your previous visit because you feel that your concerns were not answered/delt with, you could do that otherwise just let it be.

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L.L.

answers from Tyler on

Yes, you absolutely should say something to your regular doctor. The communication between you and your health care provider is incredibly important and necessary for the two of you to insure that you receive the best care he can offer you and provide you with. I wish that you could afford the MRI. I had a break that did not show up on x-ray. I was in excruciating pain before it was discovered. Is the brace keeping your wrist completely immobilized? If not, I would recommend a cast. They tried to put my foot in a brace first, too, while I waited for the MRI results. It wasn't until I went back and got the confirmation of the break and said I was still in unbearable pain that I got a cast and felt relief. I also worry that your injury will not be able to heal properly. Another reason for the cast. Best wishes for a speedy less painful recovery!

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A.C.

answers from Boston on

I had the opposite issue several years back. Couldn't see my regular doc, so I reluctantly saw someone else, I have heart issues in my family, thought I was having a heart attack (yes I should have called an ambulance, but as you know it comes down to $) I had what turned out to be a panic attack, but this doc, whom I had never even met, takes one look at me and assumes I need of all things Prozac. He didn't even bother to check my pulse or blood pressure or anything. I was livid. And not as polite as you seem to have been. I looked him straight in the eye and asked him if he even bothered to look at my chart, because if he had he would know that I resist any meds, even when I probably should take them. Then I asked him if he was getting paid by the makers of Prozac. He just stared at me, like I was purple or something. I told him I wanted a EKG right now, which I got, and then got referred to have a stress test. I think he was glad to be rid of me. I also informed my regular doc, whom I adore, about the situation. She wasn't too pleased that he immediately went to Prozac especially where he didn't do any exam first. Anyhow, my point is talk to your regular doc about what happened, and even if you cant afford it, go to the orthopedic. Most of them will arrange payment plans that fit within a budget, and also ask if they have free care plans. Many times if you come under specific income limits you can get free or low cost care, even if you have insurance. Feel better :)

M.D.

answers from Dallas on

If the doctor's assistant looked at your chart, he could see that you don't regularly take drugs. Since this is bothering you so much, I would say something to your doctor, but for the most part, I'm sure he already knows what type of person you are. He can tell you aren't trying to get more drugs, you hurt. I'm sure he's had lots of patients like you. Maybe the assistant thinks your doctor prescribed too much to you, and sees how it's affecting you and wants you to just take it in the evening, so you won't become addicted.

J.F.

answers from Philadelphia on

honestly I have several family members that all got hooked on pain meds, that arent; anything but hard working parents, it happens all the time, its chemical through no fault of the person, ecspecially when there is legitimate pain, you go from being in pain to feeling normal you come off the meds, and feel worse because now your going from normal to in pain, the meds stop working as much, you take more....addiction started....he should be concerned, not that you are addicted but that you could be if he keeps prescribing you meds, i agree with the others, unlss you have a way to go to physical therapy or an orthopedic specialist, your next visit shoul be on pain management and trying to live with the pain and things you can do until you can afford the specialist...also even though he prescribed you 4 a day doesnt mean you should take 4 a day thats h*** o* your stomach....i'm sorry your in pain.....i seriously am afraid of pain meds and addcition since i';ve seen so many people have issues with it, i refused to take any after mouth surgery and was hit by a drunk driver in a bad accident and am still afriad to deal with pain through meds

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L.R.

answers from Dallas on

I'm sure it hurt your feelings for someone to even consider you might be drug seeking. The Dr. is wise to notice and mention your hand shaking as it can be a symptom of other things. You might consider verifying it's a side effect of the antidepressant. Hydrocodone can be extremely addictive and the longer you take it the more likely your body will think it needs it. Perhaps you could try a different over the counter pain reliever to take the edge off while your body heals.

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L.M.

answers from Norfolk on

some doctors just have a hard time articulating their own limitations. I would e-mail your regular doctor. Include a comment that you feel uncomfortable seeing another doctor who is unfamiliar with you as a patient and may mistake that you are simply seeking pain meds. Emphasize that you want a solution, not just pain management. Ask if there is any course of treatment he can recommend. (Will your insurance cover Physical Therapy?) Tell him if there is absolutely nothing they can do, you will see an Ortho, but don't let the ortho do the MRI until you can afford it. I saw an Ortho for an ankle problem. He did an x-ray and determined there was no need for an MRI. A shot of cortisone and I was outta there.

Best of luck to you.

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K.B.

answers from Dallas on

I understand your concern with money problems, but there are many things including hairline fractures that just don't show up on x-rays. My son also slipped on the ice and landed on his knee. It was very painful and extremely swollen. We had x-rays that showed nothing, so they put a brace on it and gave him crutches. We went to an orthopedic doctor and he did not immediately do an MRI, but when it was not better after two weeks, he did. Found out that my son had a hairline fracture of his knee cap. They immediately put him in a cast from his upper thigh to his ankle. I would talk to the doctor about your finances and see if they can take another set of x-rays or if he can recommend a less expensive place for an MRI. If you have a fracture or some other kind of injury, it could trouble you for the rest of your life if it does not heal properly. If you are uncomfortable with the doctor you have seen, try a different one. We went to the Carrell Clinic, but I think there is also a really good orthopedic place in Rockwall that might be closer for you.

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P.M.

answers from Dallas on

I work for an orthopedic/neurosurgeon's office, the reason he asked for an MRI is to see of there was anything else muscular going on, or to see if anyting was torn, and or looking for fractures...yes, hydrocodone is addicting, and is the first thing they prescribe for pain medicine...Aleve up to 220 mlg is all you can take in a 6 hour period, motrin 800 mlg is all you can take in an 8hr period, what I have heard that works the best is Advil liquid Gel Caps...I think maybe he was looking at something to see if it was something of a surgical nature...I know those things are expensive, but they are KEY...better be safer than sorry....I wpuld call around and check prices for MRI centers...sometimes on a cash basis they will only charge you like 3-400.00...Good Luck

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M.C.

answers from Dallas on

P.,
From the way i read your story it sounds like the doctor that you just saw is actually concerned with your arm. If he made several comments about the shaking in your arm he may feel you have possible nerve damage. I know you say that your arms have always shook but that is really not normal for most people. It could be nerver damage or a neurological issue...this maybe a bigger issue then what you are thinking. I know that you can not afford to pay for the medical doctors or procedures due to deductibles being so high. My suggestion would be get the referral from the doctor. CALL the specialist and explain that you ahve been referred but you do not have any money to pay for it.... they may be able to help you out. I wish you the best of luck and hope the pain will soon go away for your arm.

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C.M.

answers from Dallas on

I would call back and talk to your regular Dr.
My Mom broke her foot leg (or foot/ankle maybe) several years ago. She had X-rays a few times and they kept telling her that it was not broken. About a year later, she had to have an MRI for something else, and the Dr (a different one) asked her when she broke her leg, because she didn't note it on her paperwork. So, it's possible that there is a break that didn't show up on the x-ray. It's also possible that you bruised your bone, which from what I've heard can be even more painful than a break.

T.F.

answers from Dallas on

Your Dr. is concerned about your arm and it shaking. It could be shaking from some nerve damage or something from the fall.

Please, NEVER compromise on safety and health. You obviously NEED to see an orthopedic Dr.

Plano Orthopedic on Plano Parkway in between Preston and the tollway is an excellent office. We have used all of the Dr's there. They do not just hand out pain meds or jump to surgery. Explain your financial situation.

Explain your financial situation. You may be doing more harm than good by ignoring this issue with your arm. Think long term....It could cost you thousands more by ignoring it and then a day will come when you have to address the issue.

Not all breaks show up on a regular xray... Get some help.

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