Jumping Through Insurance Hoops!

One of the medications I rely on daily is Tramadol (also known as…Ultram )

It is used to manage(but not eliminate) my pain, and it is classified as a controlled substance. It is not the only medication I am on but it is the only that is classified as a controlled substance.

Until now I have been very lucky. I haven’t had any issues getting my prescriptions filled. I have had my other prescriptions set up on an automatic 90 day refill through a mail service our insurance company uses. As for Tramadol, I live in a small town and both my doctor and pharmacy have always been great about helping me out.

Also, when I was first diagnosed with Fibromyalgia and my other 19 “evil sidekicks” I was taking medication 4x’s a day and at higher dosages but after working on managing my fibromyalgia in other ways and leaving a very stressful job for a very rewarding one I have been able to reduce my dosages as well as only taking them 2x a day.

Over the summer, I was required to go in to see my doctor regarding my medications. I was taking clonazepam to help me stay sleeping during the night.  It worked great! I was told that they wanted me to go off of it and try melatonin or Tylenol/Advil PM. Ironically when they put me on clonazepam they said they were concerned about the damage that can be caused by taking too much Tylenol PM. I have had the recommended sleep study and found I do not have sleep apnea but rather sleep maintenance disorder which means I fall asleep fast wake up in the middle of the night and can not go back to sleep. I practice good sleep maintenance and I am using melatonin and at least for now I am sleeping fairly well. Exhausted all the time but I can easily sleep 12 hours on the weekend. I feel very lucky that I am able to sleep and stop taking one of my medications.

January 1st arrived. A brand new year. A brand new insurance company. Fibromyalgia can cause cognitive problems and I felt good that I had all the procedures down for ordering meds, paying bills and getting reimbursement from flex. Now, everything had changed.

I realized the first hiccup when I went to reorder my medication. The clinic informed me that my prescription had been denied. During the transfer of information someone failed to put me on my husbands insurance.

I knew exactly how many pills I had left and started to panic. I have ran out one time before and had such horrific withdrawal symptoms I could not face that again.

In addition, I had to request from my doctors all new precriptions (once they added me to his insurance) to a new mail service.

After many phone calls, broken promises, 2 tearfilled trips to the clinic and pharmacy I finally had everything straightened out or so I thought.

On the next trip to pick up my prescription I was now told that I had to set up an appointment for a pain management review with my doctor. The law had finally caught up to me as it has so many of my friends over the last couple of years.

It was time for me to sign a pain contract. As my husband said, “you knew this was coming.” He was right (don’t tell him that). I did know that eventually the new laws and crackdown on opiods. I have lost friends who could not stand the pain due to having had all of their medications taken away from them cold turkey.  No matter how many times you read about someone else’s experience unless you have actually gone through the same thing you really don’t get it. I lived in fear for the next 2 weeks of what could happen. Now, I have been with my doctor for 19 years. He knows me. I have a wonderful relationship with him and we have worked together to get me where I am now. However, he did take away my clonazepam so what if he was forced to do the same to the tramadol.

I received the pain contract in the mail. As I read through it nothing surprised me. My fibro friends had told me what theirs said. However, mid-way through it stated that I have to agree to get my medications from one place only. I wasn’t thinking clearly. I thought it was referring to all of my meds and not just the Tramadol. The rules also stated that I can not receive refills after 12:00 on Friday, the weekend or any holidays and only from him. How does that work? If you can’t get the meds until you are going to run out? My doctor doesn’t work Wednesday’s, what if we are going out of town? My mind was spirilling and I did let it get out of control.

My scheduled 40 minute appointment was yesterday.  It lasted 10 minutes.

My story ends happy so if you have been through this I feel I should apologize. I feel guilty that I had a good ending to my story. For now.

Yes, I agreed to the rules of who, when and where I can get my prescriptions and to periodical drug testing. I understand that there are people out there that are using medication illegally. I know that there is a problem of people who do not need the medication using it for recreation. I know that taking away medication or making it harder for those that these medications benefit is not the answer and I believe that those battling with addictions will still get what they are looking for.

I am fortunate. I have a good relationship with my doctor who knows that I am doing many things other than prescription medication to manage my symptoms.  I feel that is half the battle. The other half I feel is standing up for yourself. Not rolling over and letting them completely dictate how you will be taken care of.

I know that it is out of our hands a lot of the time but I do believe we are the captain of the team that works with us to manage our health.


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