Prescriptions (California)

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Prescriptions (California)

Postby hardluck1 on Mon Mar 23, 2009 5:42 pm

I am under the care of a Chronic Pain Management doctor. The prescriptions he has me on provide some relief however I'm always drowsy and have very little energy.
When an AME does his report does he take these meds into account. I doubt I could perform a job under all these pills. I would probably fall asleep as I do many times each day. I also am on a sleeping pill at night. What effect are all these pills having on my liver and will I be ok in the future? Injured 01/17/00, spinal fusion, both knees replaced and both shoulders rebuilt. I would list the drugs however they are mixed compounds which they do themselves so it's difficult to describe them.
Thet are for nerve pain, muscle relaxants, muscle spasms and general overall pain.

My major question is how much can the liver stand before it fails?
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Re: Prescriptions (California)

Postby art... on Mon Mar 23, 2009 8:19 pm

Hardluck,

The new layout takes some getting used to and this question belongs in another category. Click the below link and scroll down to the IW section. Near the bottom you'll see "Questions and Answers" where this should be posted and once it is, will garner a response.

Good Luck...

http://forums.workcompcentral.com/index.php?sid=6b46c672e9e3d2f5804016b0703ba65c
"Things are more like they are now than they ever were before."---Dwight D. Eisenhower
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Re: Prescriptions (California)

Postby rider001 on Tue Mar 24, 2009 8:19 am

If they are compounded topical creams they should have minimal effects on your liver. If not you should look into trying to get approval for these type of remedies. Coupounded creams are generally not consistent with current treatment guidlines but many patients do find relief with them. The benefit with compounded creams is they target the injured area and since it is absorbed through the largest organ in your body, the skin, it bypasses your liver and other organ. In addition you need much less medication to provide benefit and therefore that translates into less side effects. As always talk with your physician.
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Re: Prescriptions (California)

Postby art... on Tue Mar 24, 2009 9:32 am

Hardluck,

Looks like admin moved this for you so disregard my comment. (It was in "Medical" in the "Professional" group when I replied.)

Rider001 is essentially correct. Although your liver eventually detoxifies everything that runs through your system regardless of entry point, since it is applied locally instead of distributed systemically as with oral meds, the total mg per kg used is much less thus less potential effect on the liver.

As Rider001 noted they are effective. I had ones containing ketamine and one or another of the "...caines" and when applied there was near instant relief. In the long run mine proved impractical as being as sticky as honey they attracted all manner of grime and stuck to clothing, pillows and clothing. Additionally, having injuries to multiple parts made usage more difficult, but for localized pain they can be the ticket.

Later...
"Things are more like they are now than they ever were before."---Dwight D. Eisenhower
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Re: Prescriptions (California)

Postby stevepsca on Wed Mar 25, 2009 7:40 am

My major question is how much can the liver stand before it fails?
It would stand to reason that your PTP could provide ACOEM/MTUS/EBM to back up a request for lab work to determine IF any of your long term medications are affecting any body function.
There should be no problem with showing the 'medical necessity' and 'reasonableness' of such a request.
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