#732813 - 07/22/08 09:44 AM
Not happy w/ my PCP...
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subrosa
Journeyman
Registered: 05/15/08
Posts: 72
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When looking for/switching to a new PCP would I have to go through my insurance co.? Or is it something I can just do w/ little question or concern from Drs or insurance?
When/if I do is it bad form to ask the new Dr for a certain RX even if it's not the one my original PCP wanted me to try?
My reason:
Migraines get me. They do not get me often, but when they do it's long & hard.
My PCP's aware they happen & they've been discussed at annual physicals. We've tried a few RXs: different narcotics & Fioricet -- Fioricet has worked the best for me since high school. I'd like to also add I am against taking an RX daily, thankfully this is one thing my PCP *does* respect.
Recently, at my last physical, my Dr stated he wanted to try something new (blah, blah, blah... I've given way to many boring details, sorry) & prescribed 2 mg hydromorphone.
I'd like to mention here that I've been exclusively breastfeeding my first baby for the past eight months & intend to continue to at least one year. My Dr knows this.
Beginning to see my problem?
Thanks for listening!
Long-winded
(But, the question wouldn't have made much sense otherwise)!!!
Edited by subrosa (07/22/08 09:46 AM)
Edit Reason: Spelling. I'm a perfectionist like that!
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#732870 - 07/22/08 10:34 AM
Re: Not happy w/ my PCP...
[Re: Ballerina59]
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subrosa
Journeyman
Registered: 05/15/08
Posts: 72
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Two, for two, for two. Thanks again to you both!
I figured I'd have to call my Insurance Co., but kind of hoped it didn't come to that. I'll have to prep for the call a couple days in advance due to loser nerves & anxiety.
It's a starting point.
D
hasn't taken her anxiety meds since before the baby either
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#733591 - 07/23/08 09:17 AM
Re: Not happy w/ my PCP...
[Re: Ballerina59]
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subrosa
Journeyman
Registered: 05/15/08
Posts: 72
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Thank you Ms. Ballerina. Though, my loins being rather important to me, I'd prefer they stay unfettered!
I called my current PCP yesterday, he's adamant re: the new med. I'd also like to mention, simply b/c I got a laugh, I also used to get a benzo (baby safe!!!) from him. He advised me the new RX would help alleviate my anxiety/tension (big reason I get the migraines).
Um...
We'll see what happens. I like him, aside from the recent disagreement. It's not like he's a "Dr Feel Good," my DH injured his back lugging an 8 foot sofa up a flight of stairs & was prescribed a muscle relaxer.
We'll see, we'll see, we'll see!
D
debating whether or not to spend $ at Urbanoutfitters today
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#733785 - 07/23/08 01:17 PM
Re: Not happy w/ my PCP...
[Re: recruiterlo]
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TheMoodyBlue
Pooh-Bah
Registered: 11/17/04
Posts: 1265
Loc: LET'S ALL KEEP AUSTIN WEIRD !
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Hydromorphone for a mother breastfeeding? GET A NEW PHYSICIAN AND REPORT THIS HACK! You realize that your baby is also receiving close to the same dose of hydromorphone that you are? The baby could very easily become addicted to this, much like crack babies do when their mothers abuse crack while pregnant and then breastfeeding. Granted, you have a legitimate need to take it, but please either switch to formula or switch to a less addictive medication. This is a bad mix! I don't mean to preach, but this doc either misunderstood that you were breastfeeding an infant or is a complete and utter idiot. Hydromorphone is one of, if not the, most addictive narcotic being prescribed today.
As far as the benzos go, I don't think so. Benzodiazepines are also contraindicated for breast feeding mothers. As big a supporter as I am of natural mother's milk for infants, in this particular set of circumstances I would recommend possibly switching to formula with supplements to help replace what the formula does not provide. A good pediatrician can advise you on how to supplement formula to at least get fairly close to mother's milk, although there is NO synthetic substitute for mother's milk that really gets the job done properly. Mother's breast milk is one of God's most impressive creations. It is perfect nutrition for infants and small children. But, mixed with Benzodiazepines or hydromorphone, it (or for that matter anything mixed with those two) is going to be incredibly dangerous for a newborn, infant or small child. PLEASE BE CAREFUL, and I hope you get some relief from the migraines as well. This situation is a headache in and of itself! 
_________________________
Ego sum in poena, proinde Ego emo
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#734268 - 07/24/08 04:27 AM
Re: Not happy w/ my PCP...
[Re: TheMoodyBlue]
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subrosa
Journeyman
Registered: 05/15/08
Posts: 72
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I should have posted disclaimers all over the place.
I do not take meds every day.
Depending on when I take the med & when I feed I pump & dump. If I half or quarter the meds & take right after a feeding I don't pump (per Pedi oked). I'm not on Valium, which is HIGHLY lipid soluble. Also, I have not once consumed ONE of the hydromorphone pills.
The meds I have/do take were discussed w/ my PCP (for what that's worth), my OB & DD's Pedi. I apologise for typing "baby safe" & should have realised people would want to respond to that more than anything.
My daughter is strong, happy & healthy.
D
would type more but getting a little bit defensive
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#734374 - 07/24/08 08:02 AM
Re: Not happy w/ my PCP...
[Re: subrosa]
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subrosa
Journeyman
Registered: 05/15/08
Posts: 72
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So, I'm not defensive anymore.
I can see how the information I provided came across as not only careless but very dangerous to my little one.
I'd like to assure the good intentioned posters I've weighed benefits & risks w/ my PCP (again, for what it's worth), OB & DD's Pedi. A minute amount of the meds I do (occasionally consume) are transferred through breast milk, I'm fully aware of this & that's why I pump & dump when need be.
One of the reason's I felt comfortable posting on this board was the thought most people here were familiar w/ the kind of pain that renders one useless & pain management. I also thought judgement would not come w/ a heavy hand.
I hope this is still the case.
Thanks
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#735169 - 07/24/08 10:07 PM
Re: Not happy w/ my PCP...
[Re: subrosa]
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Gdgrrl
Member
Registered: 02/19/07
Posts: 164
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I've got to speak up here. My sister was a lactation consultant, and also had occasion to take pain meds for headaches both during her pregnancies and afterwards, while breastfeeding. Those who are so worried may not fully understand the facts.
Meds taken during pregnancy readily cross the placental barrier, but meds taken during lactation are much more filtered, meaning the infant is getting miniscule amounts. It is NOT at all like a 'crack baby' for a nursing mother to take pain meds in reasonable, prescribed dosages. Especially if child-led weaning is practiced, the baby takes in less and less milk as he or she develops. By the time baby is fully weaned, solid food has supplanted mother's milk as the main source of nutrition, and the bit of breastfeeding still done is as more of a source of comfort, or at bedtime, and the milk comprises only a tiny fraction of baby's intake. This means that even the small amounts of medicine that might filter through the milk have been lowered gradually, bit by bit, over time as the baby's nursing patterns decrease.
The amount of pain meds that end up in the baby are no more 'toxic' than they are to the mother whose headaches they alleviate.
After surgical births - Cesarean sections - mothers are often given IV morphine for days, even weeks afterward, and there is no attempt by medical staff to discourage her from breastfeeding. Reasonable caution is taken - the baby is watched to make sure it doesn't seem unduly sleepy or otherwise affected, but pain medicine is certainly not withheld from the mother for fear of harming the baby.
If the nursing mother is mindful of her overall health, eats fresh, healthy food and takes vitamin supplements, gets regular exercise and hydration, a moderate amount of pain meds as needed is not really a danger to her infant. There definitely are many drugs and medicines which shouldn't be used by a pregnant or nursing mother, but I am fairly sure that opiates are not among them.
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#735661 - 07/25/08 02:56 PM
Re: Not happy w/ my PCP...
[Re: Gdgrrl]
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fashana
Enthusiast
Registered: 02/21/07
Posts: 251
Loc: Washington
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Gdgrrl,
Thank you,for the voice of reason 
Everyone should keep in mind that no double blind studies have ever been done on PG or breast feeding women.
The study that was done at the University of WA,in which Fetal Alcohol Syndrome became know,was not really a controlled double blind study. It was more just complied information based on the infants of homeless women.
I am not saying go a head and drink and take whatever drugs you want,but at some point you need to realize that your health and wellbeing are also important,and your Doc just might know what he/she talking about.
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#735763 - 07/25/08 05:05 PM
Re: Not happy w/ my PCP...
[Re: fashana]
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Gdgrrl
Member
Registered: 02/19/07
Posts: 164
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Gdgrrl, Thank you,for the voice of reason Everyone should keep in mind that no double blind studies have ever been done on PG or breast feeding women. The study that was done at the University of WA,in which Fetal Alcohol Syndrome became know,was not really a controlled double blind study. It was more just complied information based on the infants of homeless women. I am not saying go a head and drink and take whatever drugs you want,but at some point you need to realize that your health and wellbeing are also important,and your Doc just might know what he/she talking about.
Thank you, fashana, and Amen to your point above. A mother in pain does not make for ideal circumstances for breastfeeding OR mothering in general, and opiates have been around a long time; if the occasional pain pill taken by the mother was harmful to nursing infants, we would've heard all about it long before now. I'd be a lot more afraid of newfangled antidepressants and other categories of newer drugs having ill effects on both mother and baby.
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#792983 - 10/27/08 05:39 PM
Re: Not happy w/ my PCP...
[Re: RNB007]
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whatsaywhat
Enthusiast
Registered: 07/30/07
Posts: 220
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Think you have a really smart doc, who's taking better care of you than you think...
Floricet contains codeine and a barbiturate.
Barbiturates aren't good for babies, even worse than a benzo, and a Canadian study last year, pointed out that codeine CAN BE TOXIC IN BREASTMILK.
As a result from this, Canadian maternity wards are moving away from using codeine, and give mothers demerol, or other narcotics when Tylenol isn't strong enough.
Hydromorphone isn't toxic or dangerous for a baby (When being given in breastmilk, obviously), and since it's not something you're taking every day, addiction or tolerance shouldn't be a problem.
But basically, you want to switch PCPs, because he want's to give your baby something that isn't toxic instead of the floricet?
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#793052 - 10/27/08 07:31 PM
Re: Not happy w/ my PCP...
[Re: DanielWA]
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whatsaywhat
Enthusiast
Registered: 07/30/07
Posts: 220
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Really? Where I live, there's only the one with codeine, a barb and caffeine...
Wouldn't they be OTC then?
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#793265 - 10/28/08 08:30 AM
Re: Not happy w/ my PCP...
[Re: whatsaywhat]
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martind
Threadhead
Registered: 05/01/08
Posts: 816
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Really? Where I live, there's only the one with codeine, a barb and caffeine...
Wouldn't they be OTC then?
Why would they be OTC if they only contained a "barb and caffeine?"
And where do you live where pharmacies don't stock Fioricet and Fiorinal?
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#793590 - 10/28/08 03:56 PM
Re: Not happy w/ my PCP...
[Re: martind]
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whatsaywhat
Enthusiast
Registered: 07/30/07
Posts: 220
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No, I was replying to the poster, that wrote that they made a version without codeine. I thought they might have pulled the barbs out of it too, and wondered if they made an OTC "Fioricet"
The only Floricet I know has codiene AND a barb in it...
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#793598 - 10/28/08 04:16 PM
Re: Not happy w/ my PCP...
[Re: whatsaywhat]
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DanielWA
Veteran
Registered: 02/27/07
Posts: 601
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Maybe this will help...both need a prescription. Fiorinal and Fiorinal #3 are the exact same as below, except they do not contain the acetaminophen.
FioricetŪ (Butalbital, Acetaminophen, and Caffeine Tablets USP) is supplied in tablet form for oral administration.
Each tablet contains the following active ingredients:
butalbital USP . . . . . . . . . . . .50 mg
acetaminophen USP . . . . . . 325 mg
caffeine USP . . . . . . . . . . . . .40 mg
FioricetŪ with Codeine (butalbital, acetaminophen, caffeine, and codeine phosphate) is supplied in capsule form for oral administration.
Each capsule contains the following active ingredients:
butalbital, USP.......................50 mg
acetaminophen, USP............325 mg
caffeine, USP........................40 mg
codeine phosphate, USP..........30 mg
Butalbital (5-allyl-5-isobutylbarbituric acid) is a short- to intermediate-acting barbiturate.
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