Q. I have Hepatitis C, type 1A diagnosed in 2000 at Stage 2 Grade 3 with my last biopsy in 2002. Over the course of the past 3 years I have gradually become more and more arthritic and as a result began a regular dosage of both Daypro and Vicodin eventually turning to Norco in order to lessen the amount of acetaminophen intake. I have been a part of a long-term clinical trial and have worked very hard to seek as many solutions to my illness’ possible. I’m not idle about my diseases. Recently, I was forced by my insurance program to change doctors. The doctor I had for so many years, I trusted. I feel that if there is something that we could do for me, he has attempted to help find it. He has worked very closely with the doctor leading the clinical trial I’m involved with also. It was going rather well and I was at least stable. Stable meaning, not getting worse, and still able to work a part-time job. When I was forced to change doctors, I began seeing a new doctor. On the first visit, he prescribed the same medications I had been on all along. He referred me out to a rheumatologist also. It turned out that the rheumatologist needed a faxed referral though. I called my new doctor’s office 4x attempting to get them to send the referral and they did not. When my medication ran out, I had to go in for a refill. He flat out refused to refill my pain medication. He said that I didn’t follow through making the appointment with the rheumatologist and this was his reasoning and that he was going to prescribe a drug called Ultram. Now I had attempted to use Ultram in the past only to find that it didn’t help at all and I tried to tell him this. I requested that if he wanted to try something new it was fine, but please ween me from this drug first. Norco isn’t a drug that can just be stopped abruptly after almost 2 years of use. And I really wanted him to help me find something that would work until I could see the rheumatologist. He walked out of the room and did not prescribe anything at all. The next day, my fiance called his office at 11pm to let them know I had to go to the ER as a result. The doctor on call asked my fiance why he was bothering him at 11pm and called him a big jerk. I am very ill. I am not some drug addict running in for my fix. The least I could have expected was to be given instructions on how to ween from the medications. What do I do now? I did go to the ER. I called my insurance, but nothing can be done. The ER gave me 3 days of medication and I have 1 day left now. That was Tuesday. Also, because of getting so ill on Tuesday, I feel as if I cannot get relief at all now. I am in constant pain. I feel like I have no alternatives and I’m going to end up at the hospital again. Can I ween myself with only 1 days medication left? What can I do? I’m really scared.

A. I am very sorry to hear about this situation. Is there any way that you can contact your previous doctor for advice? I know that he is no longer your treating physician and he may not be able to prescribe anything for you but he may be able to assist you by giving you advice or even calling your new doctor and speaking with him directly. In the mean time, while you have no access to pain medication to relieve your pain, go to the emergency room as much as you need to. I would strongly advise looking for a new doctor if you can. Usually, there are at least a few other doctors to choose from within health plans. Perhaps when and if you call your previous doctor for advice, maybe he could recommend a physician in your network that he knows that is good. It is a real shame that you could not have just stayed with your previous doctor. Unfortunately, in this country, health decisions are rarely based on what is best for the patient. Rather, it is whatever works best for the insurance company. I wish you luck and I am sorry that I could not be more assistance to you in your time of real pain. Take care.

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Last reviewed: By John M. Grohol, Psy.D. on 11 Dec 2006