This isn’t easy for me but I would like to share a very upsetting and frustrating experience I have had with a doctor and ua lab results.
A little about me, I suffer from RSD/CRPS, Fibromyalgia, Occipital Neuralgia, I’ve had Thoracic surgery yrs ago which seems to be given me pain also, Cervical disc fusion 2-7, asthma and more. I feel I am a good patient, always following instructions and seeking out new treatments on my own, on the net and through all my Facebook groups. These groups have been extremely helpful in many ways.
I have a PCP, Neurosurgeon, Anesthesiologist for pain blocks, ENT, and Neurologist who treats my pain with some meds and once with Occipital blocks.
For the past year I’ve had sinus face and ear pain so my PCP set me up with a wonderful ENT. Due to the asthma/copd he wanted to do a balloon sinuplasty in office but insurance wouldn’t approve, but they did approve the OP Full in hospital sinuplasty. While waiting for surgery date I was put on 1 Rx of amoxicillin then 2 Rx of Amoxicillin-Clav. Almost 4 weeks of antibiotics.
I visit the neurologist, get my Rx and do a ua. I mention to the lady that I was taking new meds (antibiotics) she says nothing and walks away.
Then the following Saturday I receive a certified letter in the mail. I open it, read it, and just started losing it. The stress brought on a bad asthma attack. Family wanted me to go to the hospital but I refuse. This letter was from the neurologist and said I tested positive for “cocaine”, and that after 6/16 he would no longer treat me as I breeched the pain contract. After I get my breath, I get ANGRY! WTF? I have NEVER EVER use cocaine or any other street drugs. I’m losing it. My family who doesn’t get how we chronic pain patients are being treated by drs, and pharmacist just thought the dr would fix it. We all know that doesn’t happen. You just get kick to the curb and that’s that. Those who know me would have never thought this would happen to “me”.
That night I contacted Pharmacist Steve and Dr Mark Ibsen for their help and knowledge. These two men are the most caring and helpful people who I have the pleasure of meeting through FB. Both explained that labs are NOT 100% accurate AND that there are other drugs/foods that CAN show a FALSE/POSITIVE for cocaine or other illegal drugs. WHAT? I had no idea about this. Their help and info pushed me into fighting to clear me of being red flagged. I spoked to my local pharmacist who was outraged, I called my PCP to request another ua but they didn’t think the dr would accept that. I also saw my ENT who confirmed what Dr Ibsen mention that ENT’s may use a cocaine substance in surgery as it’s a good dilator. (Surgery was after the us) He says he doesn’t use it in surgery but did say the spray used in office is Pontocaine & Tetracaine which was used prior to the ua. He wasn’t sure if these would cause the positive results.
So the following day after I see the ENT I go to this drs office and ask to speak to the dr about these results. First a lady comes out and has the test results & shows me the report. I practically start crying and she says she believes me when I say I never use but…. it’s the metabolites. I still don’t understand and the nurse comes out and says I can do another ua and I give her my ENT meds (only new meds) and all my OTC meds and she says she will call me with the results this week.
During this several day wait in hell I gather up all my meds, write everyone down and list all the OTC meds I have in the house that I may have used. This included vitamins, sinus spray/pills etc…. I go to the pharmacy as Pharmacist Steve suggested and get a printout of several months of everything I’ve been prescribed and then FAX all this to the dr so he would have this first thing Monday morning.
Everyone I spoke to and internet searches ALL said that the amoxicillin COULD produce a FALSE/POSITIVE for cocaine. In my mind that HAD to be the problem as that was the only new med I had taken. Oh the stress & frustration of this! Something like this the Dr SHOULD know this. The dr at the time did not know yet that I had been on amoxicillin or had had surgery. But dam, I’ve seen him for years and never had a positive ua. I would have appreciated a call into the office to discuss this instead of getting a shitty letter that nearly sent me to the hospital stressing out.
As we know, depression is a huge part of chronic pain and I could see this stress sending me down that deep dark hole…. But Pharmacist Steve, Dr Ibsen, and others gave me hope and the strength to fight this stigma.
Today I received a call from the drs office saying that after going over all the information I had faxed and the 2nd ua results the Dr WILL “continue” to see me. No apology of course. I will see him early next month and hope to have a SERIOUS discussion about this. I so understand the drs are under scrutiny by the DEA etc…. but this is no way to treat a long term “good” patient.
At the moment this has left me with the question, do I want to even continue to see this dr? (I liked him because he’s one of the “very few” drs that understand RSD/CRPS as his wife has this terrible disease). Could it happen again to me or someone else who doesn’t have the resources of professionals like I had to see me through this nightmare? I guess I will see him next month and see how the discussion goes.
I share my horrible experience and what I’ve learned hoping it never happens to you too.
Filed under: General Problems
I agree with the person who’d posted that Steve Ariens was helpful in this situation. I, too, was given incorrect test results. It’s confusing, humiliating, frustrating, and…in some cases, hopeless.
I no longer trust ANY doctors-period, as I was given my ua results as well as the results of the test they run AFTER an affirmative finding of whatever you are being accused of taking, using, etc.
Quite honestly, I was in shock when I heard my doctor say, “he doesn’t write for users of street drugs”. In fact, at first, I agreed with him, stupidly saying, “of course not. I wouldn’t, either.” Then, he repeated what he said again…emphasizing ME. I just kept saying, “NO, NO, NO. That isn’t right.”
I ended up being physically removed by his nurse, and
I cried all the way home…and for two weeks following, as I had NO IDEA of how to FIX this error.
FIRST, however, I made an appointment with my GP, who was confused, as well. I researched day and night for almost a year, and couldn’t find ANY help in how to prove myself innocent.
That was in 2015. This will follow me FOREVER, and I can’t help but wonder, if doctors REALLY think about that. He didn’t just accuse me of something, he ruined any chance I had of being properly treated for pain. (I live in a very rural area, and there are but a handful of PM doctors, anyway)
It sounds ridiculous, but I have nightmares because of this experience.
I’ve ALWAYS been brutally honest with my doctors, and had always respected them. No more. I have been to the ER once since this happened, for pneumonia, and the ENTIRE time, I couldn’t help but wonder what preconceived notions the attending physician came in with.
**There WAS apparently, a very small window in which I could have responded to this accusation, and I missed it. That is MY fault for not being able to keep a clear head during this nightmare.
I spend the majority of my life now in my bed.
If this happens to you, DEMAND a blood test, a HAIR test, or WHATEVER you need to PROVE the doctor incorrect. Pay for it out of your own pocket, if you must, but DO IT.
Then, tell the idiot to get bent. Life is TOO short.
Sorry for the rant. It’s still traumatic for me.
im in the same boat n i hope it works out for you guys God bless .im done with this game im a work comp case with crps/ fibro an who knows anymore im a father of 3 somewhat married under 40 years happened in 2011 work comp /wc has wanted me to settle medical i wouldnt a several months back wc forced my pm to stop doing ua’s and wc took over since they have there was 2 months saying i didnt take my clonazapam witch i pay for for this last year n a half out of know where never had that problem before n that second test i stop tacking for that month every vitamen n supplment to make sure that there was no way it couldnt show up well it didnt like i said ,my doc an pharmacist said they needed to check for kloponin there testing for the wrong thing, few months later a ua i came up with a few points over some cut off for a viocden im allegerac its in my file so my dr said an has been pushing every spinal pump shock n frequiency adaptor since i started to see him this is in florida i moved to a warmer climate so i could move anyway took a psyk test for the spinal inplant and no a day goes by back to pm an next thing im told i have cocaine in my system so now what i got crps from working for a living and a docter who placed a contaminated graft jacket an i am the first case ever to have this contaminated flesh placed in a person every single wrong to me placed on me never stoped me fighting or moving but im so tired ptsd from drs to every month fighting for meds to be paid an more but i guess i dont have to worry about that anymore, ive been on the same meds for years never asked for more or early even tho any body with crps knows its will power because the pain never stops
Same thing has happened to me.Without long details,I’d like to add,FALSE POSITIVES are common.A friend of mine is a chemist.He explained to me that when this happens the proper procedure is to send specimen for a second,more expensive but more accurate confirmation test.Doctors of all people should know this,and not turn a patients life into hell without covering all bases.Especially if it is a long term patient that has a good record,and that they know.Is it laziness,incompetence,or lack of knowledge on their part?
My test showed a positive for methadone,even though I do not,nor would I use methadone.After going through the same stress as the author of article,I did my own research since the doc I had at that time was to stressed for time or to lazy to do do so.Ifound that two substances I use have been known to set off false positives for methadone.I use the over the counter sleeping aid Diphenhydramine,and drink Kratom tea,which is legal in my state and 45 others.The combo helps me sleep,and has been safe for me.The doctor that was to incompetent to give me the benefit of the doubt I FIRED!Another doc at same health clinic was assigned to me and is working on this so he can continue the pain meds that help keep me functional with constant pain from disc and spine degenerative disorders.The second doc was compassionate enough to listen to what I described to him was most likely setting off the false positives.He didn’t just look at me like a faceless number,but REALLY listened to me and was able to discern I’m not a substance abuser,and was being truthful with him.
My situation is not yet fully resolved,but I’ve determined if this is the misery they want to cause me,I will taper down and quit using the pain medicine even though it would result in laying on a bed even more than I do now.These medical people do not realize the stress and depression they cause legitimate pain patients when these things occur.
The ua dip tests are often deceiving.The second confirmation test should be REQUIRED and demanded by the patient.Even besides medical patients,many have had jobs jeapordized because of false positives.patient advocates should be aware of this and do something to help the patients.We are patients,not addicts,and deserve the benefit of the doubt,especially when we are known to one doctor over a period of time.
Congratulations on your hard fought victory! Proud of you for standing up for yourself! No patient should be discharged without a face to face discussion with their healthcare provider about the abnormal screen, why it was abnormal, what was going on in the patient’s life that would lead them to use said substance, what else could have possibly caused a false-positive result, AND a confirmatory screen if the patient denies using said substance. Even the CDC and major professional organizations advise against this.
Also note that false negatives are a huge issue for pain patients. These occur when the expected drug is missing and can be caused by metabolic defects, malabsorption issues, or MEDS/SUPPLEMENTS that cause the missing medication to be eliminated faster.
https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
A medscape review of a scientific publication about false positives on drug screening
http://www.medscape.com/viewarticle/726897_2
Horrible. And to me the worst part is the doctor didnt bother to contact the patient before “firing” him. Communication seems to be missing from so many doctor patient interactions
(I just got results of a test and need a biopsy. little thing thyroid but they dont know me or know if I might be cancerphobic, but how did i get the info that I needed a biopsy? From a note posted to their internet portal site.)
Is it that they are not being taught how to interact and speak with patients or are too many of them truly insensitive to their patient needs and what they are experiencing?
If this person;s doc had called they could have squared this away quickly, one way or the other. I understand why the writer now has trust questions about continuing with the doctor.