Methadone: A Flicker Of Light In The Dark

Methadone: A Flicker Of Light In The Dark

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 Getting a clinic and/or Doctor working for you, "Informed Consent" and AN UPDATE ON MY CLINIC TRANSFERS (note plural)

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Number of posts : 68
Location : Over the rainbow
Registration date : 2011-10-11

PostSubject: Getting a clinic and/or Doctor working for you, "Informed Consent" and AN UPDATE ON MY CLINIC TRANSFERS (note plural)   Mon Dec 12, 2011 5:43 am

I have been posting on my problems regarding my Methadone clinic and my clinical medical needs for quite a while now and alot has happened since the beginning so I thought I would share the results in hopes to hear how you all feel about it all and in hopes that I have done the right thing. RECAP................I transferred clinics because 1. Rude Ass Nurses. 2. Fear that I was getting ready to be detox/taper because of qtc's. 3. I was not stable but they were making me take a P&T which I knew for sure was going to give them reason to decrease me. Well you ptrsnake were the one that was able to help me. I have done a lot of research on qtc prolongation and Methadone and have an update from my issues just last week that may inspire your wife somewhat she needs to read this and then go in search for a doctor that will allow her right of "INFORMED CONSENT" if she chooses. UPDATE....................... I changed clinics before I got the results to my Peak and Trough because I was sure the only reason they were making me take a mandatory/random P&T was because they were getting ready to take some action on my dose of 160 because my EKG shows qtc issues. I called back to the old clinic and ask if I could pick up a copy of my P&T as soon as they got the results when the director called me back to inform me that I had shown a need for split dosing and increase from my results in my P&T and yes, I could get a copy to give my new clinic. So....upon admission I had told the new doc I had a P&T and wanted an increase because I had been asking for increases but the old clinic was hesitating to give me one because they had been unable on two separate times to draw my blood and finally at their request for a P&T the nurse was able to get blood go figure huh? I did not inform the new doc of my qtc's and I had heard that this clinic hardly ever did EKG's so I was hoping that my EKG's from the old clinic did not follow me and from what I can see to date they never did. BUT ANYWAYS....The grievance on the two nurses I had filed against had been resolved satisfactorily as the nurses were put on contract and one of them quit. The Director called me again actually we kept an ongoing conversation and he had offered me the option to come back to the clinic. I told him very openly and honestly my fears. That 1. I needed to be stabilized and the new clinic had received the P&T but was dragging their feet as I had one 5 mg increase after 3 weeks of asking for one. 2. That I fear because of my qtc's the new clinic may have gotten my EKG's or not but I was scared if I returned to the old clinic they would decrease me or detox/taper me because of my qtc's and he made a promise to me that neither would happen and in fact the doctor had agreed that we needed to do something regarding my P&T results along with my complaints of not being stable. I HATED THIS NEW CLINIC YOU TALK ROGUE CLINIC WELL THIS WAS POSTER CLINIC FOR ROGUE CLINIC. So, I was so tempted to just go back. But, because of your responses and others on this site I was not very trusting so I ask for a meeting with him and the doctor regarding my grievance, clinic transfer, qtc's and increases. And...On Thursday last week, I was fit into a 20 minute admit spot and I went to said meeting not as an admit but apparently this is the only day the doctor comes to the clinic. The meeting lasted almost two hours and I think the whole clinic was in an uproar, but the doctor and director took one issue at a time and we talked them out. The Grievance like I said was satisfied as far as I was concerned but the doctor was appalled at the story and in our meeting he and the director enacted some rules and procedures that will make it a bit more unlikely the nurses will feel they have the right to treat clients like we are drug addicts needing humiliation and bully tactics in and about our dosing arena. Well eventually the conversation went into my need for increasing but my EKG results and the doc pulled all my EKG's and he said truthfully he was concerned about my qtc's. My face went flushed and my heart began to beat very fast and I felt a sense of panic as this conversation is such a sore spot for me that even knowing I was not going to have to deal with his idea of an outcome not in my favor I get panicked at any thought that I may lose my methadone treatment because of qtc's. He saw my reaction and panic before I even opened my mouth and he put his hand on my knee and said hey no worries here we are going to figure this out. (I think maybe he thought I had agreed to be readmitted or something because he was treating me like his patient, which I found comfort in because all of a sudden I saw him connect with me) I broke down at that moment and told him my fears and that Methadone is the only thing (even not stable yet) that has half way worked for me. I told him about being on suboxone ten years ago before suboxone was even well known and how I had no success with that. I told him that I had a lot at stake this time as I had bargained a lot on this time with my family and my husband. I told him that I walk around in relapse mode but because I I keep hoping that I will get the help I need to get stable I have been able to avoid using (except one relapse in June 2011 for one day I used and came in and told) After my breakdown he did a physical and he said my pupils were a good 9 (I guess that means some withdrawal as he acted as if) He said I had clammy skin, Goosebumps, runny nose and he noted watery eyes before the tears so he agreed I did indeed display withdrawals he told me he does not have a lot of confidence in P&T but the 881 for a peak was a good Peak but the 226 Trough showed with the 881 a fast metabolizer if you believe in P&T he goes more on the physical evaluations, but the clinic itself (meaning home clinic) uses P&T so he has to use them too but places no real importance on them. So he sat back down and told me to come sit in the chair beside him and he asks me what I wanted to do? I told him I wanted to be free of cravings and withdrawals. He talked back in forth with me, the head counselor and the director about me being a patient at the other clinic and ask me if I wanted to come back to the clinic and is so he would work to get me free of withdrawals and cravings but I had to commit to a couple of things too as he wants a good outcome too. I immediately began to panic again, but he saw that and grounded me again by telling me that he will not give up on me as a client just because I have a issue that has to be monitored a bit closer than most and he will not decrease me at anytime because he believes in "Informed Consent" and he will allow me to execute that in my treatment there if my qtc's continue to rise, but he thinks maybe we can meet in the middle and for me to be patient but in good time he will have me more stabilized and feeling better. So I agreed to come back to the clinic. At that moment he had the head counselor call and get my dose (MARS Sheet) and level paperwork any other admit work up they needed but to get my MARS Immediately I signed consent and she was gone. I sat there panic that the other clinic was going to be mad etc... WHO CARES sometimes I am my worst enemy. Anyway he asks me to commit to walking everyday and increasing my speed and length every few days until I can walk a mile at a good pace with no breathlessness etc... Drink a lot of water daily..Take special care with my dental hygiene...Try to stop smoking without patches or medicine but if I can't then would I agree to try some medicine etc...???? I said Yes because he made the most sense when he said if we were going to work together in hopes of a good and healthy outcome he needs me to try at least if I can't I can't. He will not drop me as a patient in fact he said we were going to be seeing each other every six weeks until I tell him I am stable. He said he was increasing me 10 mg a week for four weeks with split dosing. I see him on week six and between week four and week six I have a P&T and EKG and when he saw me panic again he said I have to do these because of the clinic but I do not use either to dictate my treatment plan with you. You and I will work together on this. We will sit back down on week six and talk about my results from the increases and if need consider more, but for me to keep educating myself on QTC Prolongation and know that it is something that can be fatal so I need to be very honest with him and myself about the need to go any higher in fact I do not have to take all the increases he has set up for the four weeks if I feel better and when I feel I am stabilized to stop because the lowest dose I can take and be stable is best. I reminded him that I know me and I know if I don't get stable I will end up back on dope and I feel that is just as fatal. He said he understands that and that is his motivation in helping me become stable. Went to shake his hand and he hugged me up to him and said to stop worrying so much that’s doing me a lot of damage and I left feeling like finally I was free of all that worry for two years I had been carrying around. He dosed me that day with my first increase. I got half at the window and half in a bottle with my six take homes for me to divide myself. He told me to play around with my dose maybe holding out as long as I can before second dose for the day or triple dose etc...I hope I have done the right thing by transferring back although I really had no choice. THE OTHER CLINIC SUCKED and the doctor OMG he in 7 weeks gave me two 5 mg increases and I put in seven request. My Counselor was fired apparently so I had no counselor to ask for an increase the last week. etc.....I hope this Doctor really means to help me. I am going to try to do all the things he suggested I try. I feel real positive about it all but I am waiting for something to yank it all away.
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Number of posts : 484
Age : 59
Location : Vermont
Registration date : 2009-03-05

PostSubject: Re: Getting a clinic and/or Doctor working for you, "Informed Consent" and AN UPDATE ON MY CLINIC TRANSFERS (note plural)   Tue Dec 13, 2011 1:07 am

I am glad to hear that everything seems to be working out the way you want/need it to. If you are able to get yourself on the correct dose, that is all that matter here.
Your stability and your recovery without the fear of any retaliation.
I know it was scary for you to go in there especially with everything that you had going through your mind.

"I will let yesterday end so that today can begin"

Never take any online advice over that of a qualified healthcare provider
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Getting a clinic and/or Doctor working for you, "Informed Consent" and AN UPDATE ON MY CLINIC TRANSFERS (note plural)
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