When I went to my pain specialist on Feb 6, I was feeling good enough about everything in my life that I thought that the possibility of reducing the high dose of narcotics I'm on for my migraines was a very good idea. Start lowering it to see if the migraine pain I've had since 1995 has finally gone away or at least been reduced to where I don't need the extreme dose thaf I've been on for so long.

I have been so stable & functional since the California pain specialist was willing to prescribe the huge dose the beginning of 2003 (5 years now). Before that point, the pain was so horrible I couldn't get out of bed. My dark room with no sound, light, or smells was the only place I could even partially exist & it was just that....existing.. Until then I was so sick, I couldn't live outside of my dark room in my bed with no sound or smell.

When I came to KY, I had to find a new pain specialist & have been to see him 2 times....Feb 6, was the second time. Because he had lost his license for prescribing narcotics....(DEA has come down on KY because of it's previous high rate of prescribing narcotics & is putting a stop to that) he had me go to see a pain psychologist & talk to him to see if he thought there was a justification in prescribing me such a huge dose of narcotics for migraines. The thought in the medical world here is that narcotics don't work on migraines/headaches & they WON'T prescribe narcotics for that.....so I was in a not good place to start with....so I cooperated in every way possible so that they would understand my honest need for narcotics & how functional this high dose has actually made my life. The pain psychologist gave his approvial beyond a shadow of a doubt & so the pain specialist has graciously prescribed them for me.

I thought that by trying to lower the dose would show that I was more than willing to work with them on getting off the meds....even though I know that my teeth problems have to be causing some pain that the meds are covering up (I need all my teeth pulled & oral surgery to remove some boney growth on the inside of my lower jaw). I figured I would be able to find the dose that would now work.

Then came the certified letter from the IRS on Feb 9 & the back taxes that my husband had not communicated to me about for the past 11 months. I found that this stress started twinges of pain behind my eyes every once in a while. Not enough to be a problem, but enough to know that there is something there bothering me. I was finishing up the last of my prescription of fentynal patches & realized that this coming Sunday, I was going to be getting the new prescription of the lower dose. I realize that right now isn't a good time with all the stress to try to lower the dose. I have to be functional to deal with all the things I have to take care of with the IRS. Realizing that my husband actually has a very deminished mental capacity (might be the beginnings of alzheimers, or maybe had a mild stroke sometime in the past year, or maybe he's just the jerk I married that is getting worse with age). Whatever the case, I have to take over handling all the financial issues including getting the refinance of the California house going.

I realized that if the lower dose of the med allows me back into pain & if I end up not being able to function, I would really be in a bad place. Considering that this might be a possibility....I knew it was a mistake to have attempted to lower the dose at this point. If I had known what was about to hit me when I was seeing the pain specialist, I never would have even suggested lowering the dose...but I did.....so what are my options.

I could just go ahead & fill the lower dose & hope that it will be ok & that I won't have any more pain than I have already been experiencing since my anxiety level has climed.

If I end up with increased pain, then I have to call the Dr, set up an appointment (hopefully I could get in on short notice), drive myself the rather long distance to the Dr's office to get the increased dose of 25ug/h for the rest of the month, then the worse part would be to deal with the insurance not wanting to cover the increased dose because they already covered the prescription for the month....so I'm stuck covering (with money I don't have right now) the increased prescription expense.

My other option (which I chose) was to call the Dr's office, explain my situation, & see if he couldn't write the prescription for the higher dose & I would bring in the lower dose prescription & exchange it for the higher dose prescription.....that sounded simple & logical to me.....but things are never simple of logical in the real world. I called the office & left a message with the nurses desk. They called me back & I explained the situation. They talked to the Dr for a few moments explaining what I wanted & told me I would have to make an appointment to see him & he would re-wright the prescription then.

So when could I get the appointment....this week before I needed to fill the prescription?....of course NOT. Couldn't get in until March 12????? This is an emergency!!!!....I need the prescription this week because I run out of the med on Sunday....what about that isn't an ememgency? I was told by the nurse to just deal with the lower dose & if I ended up in pain, then I could call back & they might see me on an emergency appointment & work me in (that's a might).

At that point, I was loosing it...coming unglued...sounding paniced. I know I couldn't have come across very well, knowing how frustrated I was feeling inside. I had to have sounded like a druggie that couldn't get her meds. That was the last thing I wanted to sound like with a new Dr that doesn't like the idea of prescribing that high dose of narcotics, one who in the past had actually lost his license for a short while because of prescribing narcotics (they appologized & he got his license back), & in all cases except for me....WILL NOT prescribe narcotics for migraines/headaches. Here I was, trying to keep in self control & not sound as desparate as I was feeling....but I was getting nowhere with the nurse. I pleaded to talk with the Dr so that I could explain the situation to him. She unwillingly took my number & said that he would call back after hours (inside I was questioning if he would really call back).

I had errands to run & things to......then I looked at the time & it was 5:40pm.....would he call me back or not? I actually got a call from him.....& he was wanting to know what was going on. I was trying hard to keep calm & explain the situation without sounding as desperate as I was feeling inside....praying that he would understand my situation. I tried to let him understand that I wouldn't have suggested lowering the dose if I had known what was being thrown at me by the IRS & the fact that my husband had kept everything from me for almost a year. I had to sounding desperate explaining that I was worried that lowering the dose by that little bit might possibly put me into a position where I couldn't function when I have to be functional to get everything straightened out in my life. Sounding so dependent on the medication that allows me to function in life.....& not willing to take the chance at this point that all might actually be ok & there might be absolutely no problem at all. I also explained that the situation goes beyond the IRS & that I have to take over all the financial dealings because I think this pointed out a serious problem with my husband...possibly the beginnings of alzheimers or a mild stroke....but that I had to be completely functional.

Then he explained that he doesn't have time for situations like this because he is dealing with so many people that are in pain, his appointments are filled & doesn't have time to squeeze these types of situations into his practice. He explained that he doesn't feel good about the fact that I am dependent on the high dose & that he doesn't even prescribe that high dose except that I am the exception because this high dose allows me to be highly functional & that it is obvious to all concerned, that I am not a drug seeking person & don't abuse the medication.

After all of the comments he had about how uncomfortable he is with the situation, he said that he realizes that with all the stress I'm going through that he doesn't need to make me feel any worse. He told me that he understands how stressed I must be in the situation with the IRS & that I am such a cooperative patient that he will make an exception to how he runs his practice & will write the prescription for the higher dose so that I can come in & exchange the lower dose prescription for the higher dose when I come into Lexington on Wednesday. I thanked him, got off the phone & broke down into uncontrolled tears.

It could have just as easily gone the other way where he wouldn't deal with me & wouldn't treat me in the future....but I took a chance & am really blessed that I do have a wonderful pain specialist here in KY. The situation that my husband has put me in goes so far beyond just dealing with the IRS......with every turn in the road, I am having to deal with something else that is affected by the stupid situation he caused. I feel so dependent on the mercy of everyone in my life....the Dr's, the IRS......but I also know that the way I come across with them determines how they treat me.....& I'm trying so hard to not say something wrong or say something the wrong way....things are hard enough to deal with....I don't need to make things harder so I end up putting even more pressure on myself trying to make the least amount of mistakes as possible

I just want to get into bed & cry myself to sleep, but am so stressed, I can't even sleep & it's taking more energy than I have right now to even cry. I need some peace in my life & keep wondering when it will come?

Debbie