Question: Hi, I have chronic pain and have been seeing doctors for it for a number of years. Doctors have tried a number of different medications including Kadian, Avinza, Fent. patches, and Dilaudid (each with break through in between) . I have DJD, multiple bulging dics in the upper and lower spine, pinched nerves and just recently had another MRI done for my doctor to talk with me about. I had only been seeing my doctor once every two months, for a year and a half, but about four months ago I accidently lost a perscription, He was out of town when that happened and I was forced to get by the best way I could, stretching out my medicine. When I went in to see him the following visit, he was upset with me and almost didn't write my perscription and only wrote one for the time he would be in town and had me come back in before he left to go out of town, bringing my bottle in before he would write the next month's perscription. He knows that I have requested that my parent's keep my medication in a safe at their house, at my request, with my father dropping it off each morning for that day, usually. Before that last visit, things were pretty chaotic with a death of a friend, my parents being on vacation, having left just 5 days worth of medicine with me before they left. Also I have no access to their safe. Mother gave me the bottle I asked for quickly, due to a call to come in to doctor's office several days early. I didn't look like I had the correct number of pills so I went in my bathroom looking to see if I could have any in there by mistake. I saw a few that looked like mine, but my eyes are not that great. The pills were counted at the doctor's office and they noticed a shortage. He didn't say how many were missing, but asked me about the ones I found at my house. Because of this, he wrote two months of Ultram. I first finished out the month with 4 pills each day through the 27th of Nov. with no problem. When I took the Ultram, I was in severe pain, only managing, forcing myself to do certain things I had to do, and then laid on ice and heat to rest up and try to numb my pain. I feel that there were either another bottle in the safe or packets that my mother puts my medicine in for each day in the safe that were not accounted for, but my parents are almost 80 and don't want to say they caused the problem. I have never miss used my medicine at any time by taking more than perscribed, or in any other way. The medication that the doctor has had me on for a year and a half is Dilaudid. Please try to sort this out for me and let me know what I can do. I am on Disability for DJD, Chonic pain, and Depression. Disabled and in Pain

Dr. Katlyar, I appreciate your response to my query today. Thank you for your opinion, as well as your suggestions. I always am aware of my weight and stay small to moderate in size so that my pain will not be any worse. I plan to begin some light exercise when my doctor gets me on a medication that works for me. The PT that I have received does not help me much at all. I do not have much to choose from living in the small town that I live in as for as PT's are concerned. I will have taken Ultram for 47 days when I return to my Pain Management Doctor on Monday. The last time I saw the doctor was the middle of November in which I still had enough Dilaudid to last through the 26th day of November. There was certainly no addiction problems with my Chronic Pain medication or I would not been able to handle the 47 days of a medication like Ultram, which I haven't taken in about 25 years, when I was diagnosed with fibromyalgia. It worked at that time in my life, but I didn't have all the medical issues that I have today. Hopefully, my doctor will understand my situation and be able to put me back on my medication that has been working for me. I felt like I was beginning to have at least some quality of life and not the lack of quality of life I am living now, not being able to do things around my house, or visit friends, or go to choir practice at church regularly,church services. I am missing out on so much and at 57, I feel like I am living the life of an 87 year old women. It is extremely depressing, not helping the pain either. That seems to be a vicious cycle - The more pain, the more depression, the more depression, the more pain. I do see a counselor, as well as a doctor that writes my antidepression medication. Am I on the right track? I try hard to read everything I can about my medical problems and stay up to date with things that are being done to help patients, such as myself. Hopefully, Monday will go well and my doctor will be understanding and helpful so that I do not have to go through the difficulty of having to find a new doctor. This is stressful for me. I don't have the stamina since I got off the pain medication that was working. Working to relieve some of my pain. I don't believe that there is anything that will take it all away and I understand that narcotics only cover up the pain, but there is something to be said for masking some of this awful chronic pain that ages a person, that seems to take over our lives, that disables us, and causes so many changes that depress us and keep us from a restful sleep. Pray that I and others like me will be able to live a more meaningful life, without having to constantly worry about the pain we are dealing with and start contributing to society again. Thank you again for answering my concern and I appreciate being allowed to submit this follow up tonight and I wish you well.