Firing My Primary Care Physician Today

Good morning: Really unrelated to CPAP but many of you are also taking anti-depressants. I have had severe back pain since last November (disc generation, arthritis, etc) and my Primary put me on Cymbalta 60 mg for pain and Spine Doc on Celebrex 200 mg every day. I also asked him to write me an order for a sleep disorder clinic; this being on my own accord, not his, when I told him I feel I had a sleep disorder; as when my daughter stayed overnight she could hear me snoring like a truck, and this could be a symptom (which turned out it was). Anyways gained 29 pounds in 8 months (and doesn't help sleep apnea either) and we were going on a tapering off process starting 2 weeks ago, from 60 mg every other day, to 30 mg every day, and now every other day, and then every 3 days for 2 weeks and then OFF. It's from the good caring people on this site (who are complete strangers to me) who CARE and have told me that is not the correct way to taper off Cymbalta whether it be for back pain or any other disease.
I have done a lot of research online and they are absolutely 100% correct. Lots of smart intelligent people on here, I will say! I asked my Primary to please write me a script for 20 mg and he said, NO. I think he does not care and is lazy.
49'er, EMS and others on here wrote about compounding pharmacies and turns out I live near one. I wrote him a long email begging him for an order to get these down to 15 mg from the 60's I have, and he did not write back to me. The nurse said he will not use compounding pharmacies. I have an appointment on Aug 20th with Dr. Pundy (psych for a script for lower Cymbalta) but unfortunately he is very expensive for a first-time patient. Time is important because I will be starting the 30 mg every 3 days starting next week. I called his office today and spoke to his nurse and she said she will have him call me at work today.
My point being, there are some wonderful people on here who care more about me, who are strangers, than my Primary Care Physician who has known me personally for 10 years! Thank you!

Hi Luthie2006,

I am so glad to hear you have ditched your PCP. Wow, the arrogance to not even care about tapering a patient safely off of a med and to not refer you to a sleep clinic when you asked for a referral.

Good luck with Dr. Pundy. Hopefully, he will be cooperative in writing the prescriptions you need for compound pharmacy so you can get off of the Cymbalta with as minimal side effects as possible.

49er

Luthie2006 wrote:Good morning: Really unrelated to CPAP but many of you are also taking anti-depressants. I have had severe back pain since last November (disc generation, arthritis, etc) and my Primary put me on Cymbalta 60 mg for pain and Spine Doc on Celebrex 200 mg every day. I also asked him to write me an order for a sleep disorder clinic; this being on my own accord, not his, when I told him I feel I had a sleep disorder; as when my daughter stayed overnight she could hear me snoring like a truck, and this could be a symptom (which turned out it was). Anyways gained 29 pounds in 8 months (and doesn't help sleep apnea either) and we were going on a tapering off process starting 2 weeks ago, from 60 mg every other day, to 30 mg every day, and now every other day, and then every 3 days for 2 weeks and then OFF. It's from the good caring people on this site (who are complete strangers to me) who CARE and have told me that is not the correct way to taper off Cymbalta whether it be for back pain or any other disease.
I have done a lot of research online and they are absolutely 100% correct. Lots of smart intelligent people on here, I will say! I asked my Primary to please write me a script for 20 mg and he said, NO. I think he does not care and is lazy.
49'er, EMS and others on here wrote about compounding pharmacies and turns out I live near one. I wrote him a long email begging him for an order to get these down to 15 mg from the 60's I have, and he did not write back to me. The nurse said he will not use compounding pharmacies. I have an appointment on Aug 20th with Dr. Pundy (psych for a script for lower Cymbalta) but unfortunately he is very expensive for a first-time patient. Time is important because I will be starting the 30 mg every 3 days starting next week. I called his office today and spoke to his nurse and she said she will have him call me at work today.
My point being, there are some wonderful people on here who care more about me, who are strangers, than my Primary Care Physician who has known me personally for 10 years! Thank you!

Luthie2006 wrote:Good morning: Really unrelated to CPAP but many of you are also taking anti-depressants. I have had severe back pain since last November (disc generation, arthritis, etc) and my Primary put me on Cymbalta 60 mg for pain and Spine Doc on Celebrex 200 mg every day. I also asked him to write me an order for a sleep disorder clinic; this being on my own accord, not his, when I told him I feel I had a sleep disorder; as when my daughter stayed overnight she could hear me snoring like a truck, and this could be a symptom (which turned out it was). Anyways gained 29 pounds in 8 months (and doesn't help sleep apnea either) and we were going on a tapering off process starting 2 weeks ago, from 60 mg every other day, to 30 mg every day, and now every other day, and then every 3 days for 2 weeks and then OFF. It's from the good caring people on this site (who are complete strangers to me) who CARE and have told me that is not the correct way to taper off Cymbalta whether it be for back pain or any other disease.
I have done a lot of research online and they are absolutely 100% correct. Lots of smart intelligent people on here, I will say! I asked my Primary to please write me a script for 20 mg and he said, NO. I think he does not care and is lazy.
49'er, EMS and others on here wrote about compounding pharmacies and turns out I live near one. I wrote him a long email begging him for an order to get these down to 15 mg from the 60's I have, and he did not write back to me. The nurse said he will not use compounding pharmacies. I have an appointment on Aug 20th with Dr. Pundy (psych for a script for lower Cymbalta) but unfortunately he is very expensive for a first-time patient. Time is important because I will be starting the 30 mg every 3 days starting next week. I called his office today and spoke to his nurse and she said she will have him call me at work today.
My point being, there are some wonderful people on here who care more about me, who are strangers, than my Primary Care Physician who has known me personally for 10 years! Thank you!

the one to lose.

Comment,

Luthie2006, at this stage in the U.S. you can't treat physicians as dirt. They know each other and talk about you and once your name goes into the "system" as a trouble maker you are then the one to lose.

Luthie2006 wrote:Good morning: Really unrelated to CPAP but many of you are also taking anti-depressants. I have had severe back pain since last November (disc generation, arthritis, etc) and my Primary put me on Cymbalta 60 mg for pain and Spine Doc on Celebrex 200 mg every day. I also asked him to write me an order for a sleep disorder clinic; this being on my own accord, not his, when I told him I feel I had a sleep disorder; as when my daughter stayed overnight she could hear me snoring like a truck, and this could be a symptom (which turned out it was). Anyways gained 29 pounds in 8 months (and doesn't help sleep apnea either) and we were going on a tapering off process starting 2 weeks ago, from 60 mg every other day, to 30 mg every day, and now every other day, and then every 3 days for 2 weeks and then OFF. It's from the good caring people on this site (who are complete strangers to me) who CARE and have told me that is not the correct way to taper off Cymbalta whether it be for back pain or any other disease.
I have done a lot of research online and they are absolutely 100% correct. Lots of smart intelligent people on here, I will say! I asked my Primary to please write me a script for 20 mg and he said, NO. I think he does not care and is lazy.
49'er, EMS and others on here wrote about compounding pharmacies and turns out I live near one. I wrote him a long email begging him for an order to get these down to 15 mg from the 60's I have, and he did not write back to me. The nurse said he will not use compounding pharmacies. I have an appointment on Aug 20th with Dr. Pundy (psych for a script for lower Cymbalta) but unfortunately he is very expensive for a first-time patient. Time is important because I will be starting the 30 mg every 3 days starting next week. I called his office today and spoke to his nurse and she said she will have him call me at work today.
My point being, there are some wonderful people on here who care more about me, who are strangers, than my Primary Care Physician who has known me personally for 10 years! Thank you!

the one to lose.

Comment,

Luthie2006, at this stage in the U.S. you can't treat physicians as dirt. They know each other and talk about you and once your name goes into the "system" as a trouble maker you are then the only loser.

I myself had problems with my lower lumbar spine since 1965. Discs herniations etc. When ever I lifted something wrongly I got the back pain plus radicular Sciatic pain in the legs down to the knees and ankles. I never took those medications that you're talking about. Only bed rest some Tylenols and some muscle relaxants. After a day or two in bed the pain was reduced enough allowing me to go back to the gym and do the weights exercises again. About Steroid epidural which I occasionally got, well, they stopped helping me during the last two decades. Recently I read about a study saying that those corticosteroid epidural injections are no better than plain Lidocaine anesthetic. This is besides the story of several dozens dying in Mass b/c of tainted material by a screwy compounding company there.

A few month ago, in March, I underwent a lower back Spinal Stenosis surgery at Duke/Raleigh hospital done by Carlos Antonius Bagley, MD, a Duke Spine Neurosurgeon specialist. No fusion and no metal hardware. I can post here the exact procedure.

The pain in the back and legs from the spine are gone but instead I have problems with reduced blood circulation in my legs limiting my walking to about 30 minutes and then I need to sit down for a few moments b/c of pain the calves and knees ( Peripheral Arterial Disease {PAD} in my Diabetic legs) . I am working on it now by walking more and more daily. And, I am hoping.

I agree with Avi. I will not even tell my Primary he is not going to be my doctor. I won't be mean, I will just quit him. And you are right, I work at a hospital that he works at too, and is a small medical community even though a very large teaching hospital. The old saying, "Don't Burn your Bridges." I do try to follow that. Since my private insurance pays a lot of $$$ to him, and I PAY a lot to him, and it is the US and fortunately I don't need Obama Care or Medicare, I can choose who I wish. This is not the first time he has been "uncaring" or "lazy". He refused to write an order for an MRI for my back at a pain level of a 10 because he said it is "arthritis." Went to a spine doctor and YES, he was right, it is arthritis, but at least it is more clear w/the MRI as to where the areas and discs are bad. He really didn't care about the sleep apnea thing either. Since I am fortunate to have PPO insurance, I just went myself to a specialist at a sleep disorders clinic in a major teaching hospital (not mine) and got wonderful treatment from them, so much personalization that I bought my sleep clinician a gift card for her thoughtfulness with me. The doctor was wonderful too. Love them!

But thanks Avi. I do agree with you, "don't burn your bridges." Also, 49er, if this "uncaring idiot" will agree to write a script for 20 mg at my local pharmacy, since he refuses to do business at a compounding pharmacy according to his nurse (maybe he doesn't get paid well there) I will settle for the 20 mg at least from 30's. Dr. Pundy is not cheap I heard, and I have a lot of deductible to pay to see him. But the uncaring idiot may not even write me a script for 20 mg. I still do have an appointment with him on 8/20 I may cancel if I can get the 20's from the uncaring idiot. Oh, and he never asked me how I am doing with CPAP treatmennt being fairly new. I figure that's what I have the sleep docs for. Thanks all!

PS Avi, was your procedure artificial discs?

Also, 49er, if this "uncaring idiot" will agree to write a script for 20 mg at my local pharmacy, since he refuses to do business at a compounding pharmacy according to his nurse (maybe he doesn't get paid well there) I will settle for the 20 mg at least from 30's. Dr. Pundy is not cheap I heard, and I have a lot of deductible to pay to see him. But the uncaring idiot may not even write me a script for 20 mg. I still do have an appointment with him on 8/20 I may cancel if I can get the 20's from the uncaring idiot. Oh, and he never asked me how I am doing with CPAP treatmennt being fairly new. I figure that's what I have the sleep docs for. Thanks all!

Hi Luthie2006,

If you're concerned about the cost to see Dr. Pundy, I would make an appointment with this idiot and calmly explain to him why would like to taper the drug more slowly by using a compound pharmacy as you are concerned about adverse affects from tapering too quickly. If you can find some mainstream links backing you up all the better.

The reason why he may be objecting to using the compound pharmacy is many doctors if they have never heard of doing something as in the case of using one, they will have an objection. But in my opinion, if you just hold your ground and state that because you want to taper safely, you would really appreciate it if he would write a prescription for lower doses than 20mg when you are finished at that dose.

Hope this helps.

49er

I try NOT to be a drug expert. What would happen if you cut the 30s in half. It would seem you would have 15s. Walmart has pill cutters for about $4.

Thanks 49er I was just at his office a few weeks ago. I will be lucky if he prescribes the 20 mg commercially available Cymbalta and I will have to figure out how to wean from there, better than at 30's and then "dropping off the hill." He really is uncaring. He really truly believes that the way he is doing it is safe. And if I give him articles, he does not like that. Done that before, and he is the doctor, I am the patient kind of mentality.
I will be very happy if he writes a script for 20 mg. And let's see what happens there. I will not be able to change the idiot's mind to using a compound pharmacy when he does not believe in it. He just won't. I will be lucky if he writes the script for 20's. I will keep you posted.

Luthie2006 wrote:Thanks 49er I was just at his office a few weeks ago. I will be lucky if he prescribes the 20 mg commercially available Cymbalta and I will have to figure out how to wean from there, better than at 30's and then "dropping off the hill." He really is uncaring. He really truly believes that the way he is doing it is safe. And if I give him articles, he does not like that. Done that before, and he is the doctor, I am the patient kind of mentality.
I will be very happy if he writes a script for 20 mg. And let's see what happens there. I will not be able to change the idiot's mind to using a compound pharmacy when he does not believe in it. He just won't. I will be lucky if he writes the script for 20's. I will keep you posted.

That is too bad. I really feel for the tough position you are in.

49er

Luthie2006 wrote: PS Avi, was your procedure artificial discs?

Reply NO. I know about those artificial discs but apparently did not need them. I had a surgical procedure which lasted about an hour and I went home the 2nd day: I was lucky not to need fusion and/or metal hardware. It could have been my age and less activity expected. So the spine needed less support.

As I mentioned above I still claudicate = limp as Claudius Caesar did.

[quote="bwexler"]I try NOT to be a drug expert. What would happen if you cut the 30s in half. It would seem you would have 15s. Walmart has pill cutters for about $4.[/quote

bwexler,

Cymbalta comes in a capsule and can't be cut via a pill cutter. If someone wants to taper it slowly, it has to be done by counting beads or getting the prescription at a compound pharmacy where they make the doses that you can't get at your local drug store.

Not sure what you mean when you say, "you try not to be a drug expert.". Again, the issue is that Luthie's doctor is essentially proposing what is a cold turkey approach to getting off of the Cymbalta. According to an RN I know, also advocating an every other day tapering procedure is putting the body into withdrawal as it needs a consistent dose on a daily basis.

My point is that just because someone has an MD by his/her name doesn't mean we should leave the expertise to them as demonstrated with this situation.

49er

First, wow Avi123: You may not have had hardware in your spine (which is great!) but it still looks like a major procedure to me. I am in the health care field and although not a medical professional, I work with docs and see reports all day long. But it looks like you have come a long way! I can't tell you (and you may know this too) how many countless patients have "failed back surgery." Friends of mine 5 repeated back surgeries and still in pain. So you are very lucky, Avi.
49er, thanks again for your advice. I think the other member just didn't know that Cymbalta only comes in capsules. My gut hunch is the idiot will not even call me at all today at work. I think he will be too "lazy" to "debate" anything with me via phone or in person or just simply not want to. He is right and I am wrong. Apparently either he doesn't give many scripts out for Cymbalta for his patients for back pain or depression, and the ones he does taper off, probably don't complain or didn't have any problems. But hopefully he will call me and give me 20s so I don't have to count beads.
By the way, with the CPAP nasal mask, is it ok to sleep on one's back with sleep apnea? I know that is not a very desirable position to be in, but it's the only comfortable one for me with my back problem. My AHI is 1.8 and my sleep tech said it used to be lower. I have mild apnea.

I fired my PCP a couple months back. Reasons were numerous:

• Office visits where the Dr didn't have any info on my previous tests and asked me what they were. Really?
• No interest at all in the use of CPap. As if the technology does not exist. Was not my PCP when I started.
• Every visit they wanted blood and urine tests regardless if the same had already been done via my Cardiologist.
• Never forwarded on lab tests to Cardiologist, but they always sent the results to her.
• As soon as the visit was over, it was like I physically didn't exist. If I thought of a quick question while checking out, and she was standing there, it was like I was not there.
• Never suggested any routine tests other than blood test in 5 years.

BTW it was not like I said that you are fired, I simply looked for a new PCP and signed up. And have never scheduled a new appointment with the old one.

Wife and mother-in-law have the same Dr and my wife says she is great, but I really don't trust the DR. I think both would get better care with someone new. When I was looking for a new PCP I ran into Dr ratings and the original Dr had one of the worst ratings of any Dr I looked at.

New PCP is fantastic. Very into CPap, interested in how I used it, how long I have used it, how I sleep, ordered a consultation with a Sleep Dr on first appointment to get me up to date on my equipment. Brought up lots of questions about physicals, and other tests that I should have had over the years.

49er, thanks again for your advice. I think the other member just didn't know that Cymbalta only comes in capsules. My gut hunch is the idiot will not even call me at all today at work. I think he will be too "lazy" to "debate" anything with me via phone or in person or just simply not want to. He is right and I am wrong. Apparently either he doesn't give many scripts out for Cymbalta for his patients for back pain or depression, and the ones he does taper off, probably don't complain or didn't have any problems. But hopefully he will call me and give me 20s so I don't have to count beads.
By the way, with the CPAP nasal mask, is it ok to sleep on one's back with sleep apnea? I know that is not a very desirable position to be in, but it's the only comfortable one for me with my back problem. My AHI is 1.8 and my sleep tech said it used to be lower. I have mild apnea.

Hi Luthie,

Good point about bwexler not knowing that Cymbalta only came in capsules.

By the way, I reread the thread I had given you a link to regarding withdrawal in which compounding was mentioned. A doctor said it can't be done so now I am not sure that is even a viable option. But when I compounded Wellbutrin XL, my psychiatrist said the same thing and he turned out to be wrong so who knows. Anyway, hopefully, you can get the 20mg pills.

You can definitely sleep on your back as that is the purpose of having the machine so you can be in the position that is comfortable for you. An AHI of 1.8 is not chopped liver.

49er

Hi Luthie... a couple of things... some which were already mentioned. Since you work in a hospital, I would think it would be rather easy to get the name of a few decent general doctors. At this point, I would interview at least two of them. It's possible you can get a general doctor to help you with your taper. I know several where I live that prescribe as well as help folks taper from ADs. At the very least, your PC is an idiot... which is the best reason to find another doctor.

I had the same surgery as Avi did. Mine was very successful... altho, I too know that surgery doesn't help everyone. It was minimally invasive and I was back to work in a month... could have gone back much sooner but figured I'd take advantage of some time away from work. This was back in 1996, and I can easily say I'm at least 85% better. I waited 13 years to have the surgery b/c I was so scared - for me, big mistake. The pain was so debilitating that I walked with a limp... after surgery, I no longer do that. Not saying surgery is for you... just my experience.

Things a bit crazy at my house but I'm keeping up with your posts. Please continue to let us know how things are going... both with tapering and your back issues. Glad you found us... and yeah... we do care about you and wish you a positive outcome on both issues.