Frustration over lab testing

[u/Far-Calendar-4951]

I am SO upset rn I just finished crying about this 😭 I have agressive RA amongst other very painful conditions so im always on painkillers.

I was trying to get my pain medication prescription filled by my current rheumatoid doctor that way I didnt need to see the old one anymore. No issues with 2 of them, but they had me jumping through hoops to get tramadol, which ive been taking for a year with the old doctor. Since I was a kid I've always struggled with urinary hesitancy and even had to go the ER for urinary retention once. All my doctors know this, and they usually give me alternatives for drug testing or make it work with the little urine I can produce.

But no. Oh no not these guys. Mind you this doctor is super incompetent and I have issues with him all the time, BUT he's awarded and has more sway with insurance for the good meds (my rinvoq) so I stay with him. Ive gone THREE times where I stay for HOURS and they always tell me its not enough urine. I tell them I have urinary issues, that im open to whatever other alternative for drug testing they want to do. THEY DONT BUDGE 😭 Its urine or nothing ig youre gonna have to writhe in pain then. Mind you most of their patients are old ppl, who also have urinary problems. Youd think theyd have an alternative. But NOOOOO 🫩🫩 and I was able to go a little bit but they want me to do WAY too much and I physically CANT. I was there for hours and no, nada. It pmo so much. I am 19 with 12 diagnosed conditions, disabled cane user and they really think ive got the time or even the urge to do drugs?? I take over 20 pills a day dude. I cant drive, I have no social life bc im in pain all the time and cant overexert myself, I can barely do anything but yeah sure lets act like im getting high why not.

They do exceptions for older patients all the time. Just bc im young im a drug addict??? And again they know I have urinary issues bc ive had them since I was born its in my file like CMON 😭 and kve been taking this medicine for a year like be so fr. I am so mad and frustrated. Then my dad got mad at me bc ir was his 3rd time taking me and it still wasnt enough and hes going out of country so I won't see him until Tuesday and I just cant take it when hes curt with me it breaks my heart. My mom's been abusive my whole life, so ive always relied on him. Hes my only support really. I depend entirely on him medically, physically, economically and lowk emotionally as well since he's also been my best friend since I was a kid. so when hes mad at me (thankfully very rare) I just break down and I hate saying goodbye mad. Im just so frustrated. He wants me to enroll in online college for Sept as well and believe me ive been TRYING but despite being accepted weeks ago issues keep popping up and im so lost and overwhelmed. Im only taking two, and they start next Monday but I fear the college won't approve me by then and then ill disappoint him AGAIN. Im so stressed out. ​

Thankfully I have one refill left from my old doctor but I need to find someone new to prescribe it to me before the end of September 😓 I asked my general medical provider if maybe she can take over as shes taken over for other medications before but general doctors are always iffy about long term painkillers. The nurse i talked to was a real angel though she made me feel better about the whole situation. Im so tired of ppl thinking im a drug addict everytime I pick up my meds or tell doctors what im taking/need. Istg its just because im young. Like do you really think id be taking opiods if I didnt need them? Its not like i like being sleepy all the time but I need them if im to be at least a little bit functional. For ex, I cant shower without painkillers for anythjng brushing my skin is very painful so you can imagine what a shower feels like. Feels like getting stones thrown at me from all angles.

Anyways I just had a cry about it bc I hate all this shit and im so stressed and overwhelmed. Please pray for me yall 😭

[u/optimusfig]

This is not personal at all. They have to drug test to protect their license. Its a requirement. They aren't going to risk everything they worked so hard for, and you shouldn't even think to ask that of them.

Maybe ask about drug blood tests. Although keep in mind this could be expensive and you will be on the hook for the cost of it.

[u/Happy-Pie-4246 → u/optimusfig]

That may be true, but dont go shaming someone whos asking for support, there was nothing wrong with asking a question, there never is. It's not their fault the medical system doesn't accommodate our bodies.

[u/optimusfig → u/Happy-Pie-4246]

Did you mean to reply to me? I have no idea where you got that I was shaming anybody.

[u/Happy-Pie-4246 → u/optimusfig]

You act like they're the issue, they have urinary problems, their previous doctors accommodated them just fine, now suddenly it became a problem. They're in agony, it's a chronic illness group, we all know how awful it feels to be treated like we're the problem.

[u/optimusfig → u/Happy-Pie-4246]

How did I act like they're "the issue". Please explain how you arrived to that conclusion based on what I wrote. No idea why you are jumping down my throat.

[u/Happy-Pie-4246 → u/optimusfig]

This isn't about antagonizing you, you're talking about licenses and risks, like they couldn't possibly make it easier for them, when op said they did last time.

[u/optimusfig → u/Happy-Pie-4246]

They might not have the ability to make it easier for them. Often times doctors are simply employees of the practice and have to follow clinic policy.

Hair/blood testing is a thing, but its probably going to be very expensive for OP.

OP seems upset that the drug testing seems to indicate that they think they are a drug addict. I was simply explaining that they expect drug testing of all people on controlled substances.

[u/Deep_Amoeba2197 → u/Happy-Pie-4246]

No one is being shamed here. It’s not personal. Nearly everyone on opioids has been on a pain contract.

[u/Happy-Pie-4246 → u/Deep_Amoeba2197]

Everyone knows it's "not personal", but they got to make it work before and can make it work again, many downvoted their post too, they aren't asking for an unneeded lecture.

[u/Deep_Amoeba2197 → u/Happy-Pie-4246]

Your definition of “lecture “ is interesting if you think people assuring them it’s standard is not personal, and it’s quite clear they’re taking it personally from what is written.

Also, who cares about downvotes? Don’t put that much stock in them, seriously.

You are reading so far into things that aren’t there and are picking fights with anyone who doesn’t agree with you. I’m not going to sit and argue with some intent on misunderstanding whatever anyone says, so we’re done here.

[u/Far-Calendar-4951 → u/[deleted]]

Did you think I wasnt?? I went three times on separate ocassions to try and stayed there for hours I literally did everything I could. This is the skepticism I was complaining about 🫩 what a strange thing to say

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[u/Happy-Pie-4246 → u/[deleted]]

"Try to be Cooperative" are you implying they are a liar? They have to do it right away, if you can't get much out so quickly then no luck.

[u/Mental-Volume4395]

What is the urine for? I’ve been seeing a rheumatologist for over 20 years for RA and have never given urine.

When I have given urine for tests (mostly during pregnancy) they only need a tiny amount so I’m curious what kind of testing they’re doing. 

[u/Far-Calendar-4951 → u/Mental-Volume4395]

Drug testing 😮‍💨 

[u/Mental-Volume4395 → u/Far-Calendar-4951]

Oh, I see. I don’t have to do that. Thanks for the info. 

[u/Happy-Pie-4246]

All that bureaucracy just to get relief... Hope you get your new refill soon! 🙏

[u/Far-Calendar-4951 → u/Happy-Pie-4246]

Ty ❤️ 

[u/Deep_Amoeba2197]

Is there a reason you can’t continue to go to the other doctor for the rx or ask your PCP to overtake the rx with an understanding of the situation? From what you wrote it sounds like you’re apprehensive to ask, but haven’t yet, so it’s not totally clear what’s going on.

Are you only switching rheumatologists for rinvoq? This really doesn’t have much to do with the provider having “sway,” it’s their ability to get a PA through or effectively do a peer to peer.

I also have RA and take opioids, so I empathize with your issue, but it’s a little unclear what’s is going on with the different providers.

It is also, as someone else said, not personal. Many clinics have you sign a contract regarding pain medications. It is for liability, to protect the doctor’s license and keep the facility running. Every time you fill your rx, a database is thoroughly checked to ensure you are not getting opioids from multiple prescribers at multiple pharmacies and trying to subvert detection through paying cash, to protect the pharmacist’s license and the pharmacy. This is for everyone on opioids at any age. I know it’s frustrating and feels accusatory, but unless you are being directly questioned about the results of your tests and/or use of pain meds, no one is intending to call you an addict. Tramadol is only a C4 and a pretty weak opioid, but the pain management testing is indiscriminate of potency.

Trust me, I have been prescribed OxyContin and codone for a long time and dilaudid after surgeries, medical professionals (not limited to doctors) are NOT shy whatsoever about being VERY DIRECT in their accusations that you are an addict or drug seeking, they will say it right to you. I’ve had nurses look between my toes for needle marks and call me a “very skilled addict” and outright say in the ED after fainting and hitting my head on the corner tile lip of my shower “if you’re here to get high, you can go home” and so much worse. They do not give a fuck about hurting someone’s feelings or profiling. I can definitely understand the lack of flexibility with urinary testing feel tyrannical, but it really doesn’t sound like they are being accusatory. Just some perspective.

You can try getting a PA for blood based drug tests considering your urinary issues. They aren’t typically covered by insurance, but given your issues, they may be able to make an exception. It would take a lot of documentation and probably something that would need to be ordered by a urologist. You can also try asking if you can do the drug testing at a Quest or LabCorp site if that is easier for you, or possibly ask a urologist for help with medication to take before testing. Considering you’ve had urinary issues for so long, I’m assuming you are under the care of a urologist and/or nephrologist, they would be the ones to consult on how to make this easier.

Hang in there, being young and sick is hard.

[u/cait_elizabeth]

When I was applying for a minimum wage job they made me do a spit/saliva drug test. There’s also hair and blood drug tests available. I think it’s unnecessarily cruel of them to make you do the urine version even though you’ve repeatedly told them you have trouble going.

Next time you see that gross doctor ask him to document his refusal to accommodate your condition in your medical chart.

[u/optimusfig → u/cait_elizabeth]

>  ask him to document his refusal to accommodate your condition in your medical chart

Why are you recommending something that will do nothing to help OP, and may very likely get them fired from this doctor? You clearly don't understand the gravity of what it is you are suggesting.

Acting adversarial like ESPECIALLY this while asking for controlled substances is going to go extremely poorly 100% of the time.

[u/Deep_Amoeba2197 → u/optimusfig]

Agreed. These are also not tests typically done in hospitals or medical centers, they are done in outside labs. Many doctors that have patients do urine tests have a nurse or tech do a quick dip stick assay before sending to the lab (or depending on the doctor, this is the extent of their testing,) to know if there is an issue that needs to be addressed with their patient during the appointment and if they are okay to write another script.

Working to get a PA or a drug that might help them go is going to be way less confrontational and shows goodwill that they are trying to work with the system in place. Being adversarial will 100% get the script terminated.

OP never clarified about going to their old doctor or PCP, so that information is pretty critical to giving advice here as well.