Hey, wisewoman, maybe you can do something like print out the Pain Assessment Checklist on the Lyrica site and take that in as a talking point with your doctor? I find if I have "props" to back up what I'm saying it helps me be a bit more assertive.

My doctor keeps trying to put me on stronger asthma meds which I don't want (I want to lose weight instead) and I'm able to stop him cold each time as they have side effect risks I refuse to tolerate (death or depression/suicide :-)

Just telling your doctor what you "want" or will accept/not accept might help. Doctors can be at a loss if things don't work very well so telling them, "I tried that med in the past and don't like/tolerate it well" or, "It hasn't helped me at all in the past, too much breakthrough pain" is helpful information without being particularly obnoxious. Like with most conversations, just stay with "yourself" and your knowledge instead of trying to make the doctor see your point of view. People can't argue very effectively with "I" statements as it's not trying to get them to do anything, it's just telling them about yourself.

I know my health history and my genetics, etc. and not having anyone die before age 74 when I'm only 57 has so far kept me off high blood pressure meds (and it was my great grandfather who died at 74 back in 1928; everyone in my grandparents' generation were mid-80's and my father's sister just turned 87 and my mother's brother will be 96 this November :-)

I make sure I have basic facts about my age-related, chronic problems (genes only get you to age 60 then you're on your own) and after a discussion or two getting to know one another, my doctor is in a "support" role trying to help me help myself with his knowledge rather than trying to force his knowledge on me.