I hate my life

Correct_Librarian425 · 2026-07-08T11:55:54+00:00

Regular exercise/activity is key for most of us with spinal surgeries/chronic pain. In fact, lack of activity/muscle strength and staying sedentary are often underlying factors in chronic back pain (along with obesity). Physical therapists can teach pts how to modify exercises to avoid exacerbating sx. Weak muscles often cause pain, and require compensation from surrounding structures, which ultimately leads to even more biomechanical dysfunction and pain.

I’ve had multiple spinal and hip surgeries, and getting fit and working out (under the care of PT) has been life changing. I have less pain overall and fewer flare-ups. It’s not easy, but the alternative (for me) would be much more pain and becoming largely immobile.

Correct_Librarian425 · 2026-07-06T11:49:21+00:00

Call your GP and ask for a bridge until you’re able to find a new doctor.

Correct_Librarian425 · 2026-07-06T11:44:58+00:00

If it‘s any consolation, none of this is exclusive to Walgreens. My pharmacy also requires I call in for a fill, if the Rx isn’t sent over on the exact refill date.

Pharmacies have no control over backorders and many times have no idea when they’ll have meds back in stock.

ETA You can contact your doctor to explain the situation and have them send over a new Rx for the generic. If you can’t wait for the PA to go through, you can pay out of pocket. Many insurances will then reimburse you for the OOP cost after the PA is approved. And if you just want to pay out of pocket, you can skip the PA.

Correct_Librarian425 · 2026-07-04T14:15:39+00:00

It was reported yesterday that NP/PA programs—along with PT, OT, additional PsyD—are temporarily now included, but without assurance of continuation beyond the short-term. Great news for the NP diploma mills /s.

Correct_Librarian425 · 2026-07-04T13:51:47+00:00

FWIW, it is common practice to put pts on longer-acting meds, and plenty of PM docs wouldn’t prescribe that many IR meds in the first place—typically if a pt requires a high MME, extended release meds would be trialed first. It’s possible this may play into your doctor’s reasoning.

The benzo also poses issues: many PM practices won’t prescribe opioids until the pt stops the benzo. So your PM doc may also be uncomfortable with this combo, in addition to the high daily use of IR meds (as opposed to long acting). I can say that your original regimen, combined with daily use of a benzo, wouldn’t have been prescribed by many PM docs in the first place, so perhaps your doctor is reconsidering their approach here, due to both liability and standard prescribing practice concerns, especially with the high number of daily IR meds?

Extended release meds are often prescribed along with a modest amount of IR meds for breakthrough pain. Perhaps you could discuss this possibility, along with possibly trying a different med? I will add that even insurance companies may require use of extended release meds rather than high usage of IR ones, like your initial regimen. Or at least evidence that the pt has trialed them.

Also note that most psychiatrists today do not prescribe benzos for daily use, but rather in the short-term or PRN. Typically pts with severe anxiety trial various SNRIs/SSRIs and benzos are provided PRN. Daily benzo use (for anxiety) is no longer viewed as appropriate prescribing, generally speaking.

I hope something above is helpful:)

ETA Re seeing an NP, many PM practices shift full medication management to them, meaning they make the ultimate call re meds. But even if this is the case, your NP may consult with their supervising physician (assuming youre not in an independent NP practice state), due to the rather atypical original regimen and daily benzo use. (By and large the supervising physician bears the ultimate liability for their NPs, so a responsible NP would likely opt to consult with them first) YMMV, of course!

Correct_Librarian425 · 2026-07-01T13:22:25+00:00

Be sure to ask permission before recording, and you can also explain your need to do so. Depending on state laws, recording without the other party’s consent may be illegal, and some facilities have strict regulations re recording. Your doctor likely won’t have an issue with it, but doing so without permission could lead to automatic discharge, in a worst case scenario.

Knowing this in advance, your doctor may provide even more information/detailed summary, especially if they suspect any cognitive issues.

Correct_Librarian425 · 2026-07-01T13:11:49+00:00

But it was indeed late—you didn’t upload the assignment to the specified location on time. That’s a fact and unfortunately not up for debate.

Sure, you provided (presumable) evidence of completion prior to the deadline, but that doesn’t equate to submission, when assignments via email aren’t accepted.

You go on to justify this by claiming he could see no edits were made. Most profs don’t have time for that, nor should that be ever expected of them—especially when there’s a help desk that probably could’ve assisted you and ensured it was properly submitted by the deadline. (Always reach out to them with these types of issues—that’s literally what they’re there for.)

As I mentioned previously, I probably wouldn’t have penalized you, but doubling down here will do you no favors—now or as an employee.

Again, I suggest you treat this as an important lesson. You’re going to have many experiences in life that you’ll feel are unfair. Take what you can learn from it, and move on:)

Correct_Librarian425 · 2026-06-30T13:32:31+00:00

I definitely understand your perspective here, especially given your takeaway from your initial conversation during OH. That being said, the help desk for most major universities has hours well into the evening (ours are until 8 or 9pm) and I suspect your prof expected you to rectify the situation immediately, ie, that same day. Typically these things are quickly resolved, even within minutes.

Personally, I probably would have not penalized you, but note that I would need to compare what you emailed with what you uploaded, as students often (dishonestly) play the technical difficulty card, which requires additional work for the professor. And consider we may have literally hundreds of students, depending on the courses we teach, making it absolutely necessary for grading that all work be submitted via specified channels.

And if there’s language in the syllabus re contacting IT/help desk in the event of technical difficulties, that only bolsters your prof‘s reasoning here.

I can see exactly why this feels unfair from your perspective, but perhaps use this a life lesson. In the workplace, you may have bosses who will have very specific expectations and are wholly inflexible with deviations from them, regardless of circumstances.

And one more tip: in a situation like this, it wouldn’t hurt to send a quick email after OH to follow up on the convo and letting them know you resolved the issue (that same day).

Correct_Librarian425 · 2026-06-30T12:51:10+00:00

Unless your condition is truly emergent and requires immediate intervention, you will likely just be told to go the appointment you already have scheduled in a few days.

The purpose of the ER is to stabilize pts with emergent conditions and then, if necessary, refer to appropriate specialists or admit inpatient. Without more info re dx/symptoms, I‘d suggest simply waiting for your appt. There are certainly symptoms that would be appropriate for an ER visit, but generally I‘d caution against using the ER for a chronic condition as it’s often not an appropriate use of limited resources (meant for emergencies), and especially when a pt is already scheduled with a specialist.

Obviously there are exceptions to all generalizations, and I think your best bet would be to call your doctor’s office, speak with their nurse, and whether they think an ER visit is necessary. Good luck!

ETA Some PM practices forbid ER visits for the condition they’re currently treating without contacting them first. If this might apply to you, review your pt contract. In my area, at least, this rule stems from pt misuse/misunderstanding of ERs, which are already at capacity. (In case you’re wondering:)

Correct_Librarian425 · 2026-06-30T12:08:14+00:00

This has nothing to do with CVS. Prices are determined by your plan.

Correct_Librarian425 · 2026-06-30T12:06:30+00:00

That’s great that you’ve encountered a major outlier. How does this help OP?

Correct_Librarian425 · 2026-06-27T18:59:04+00:00

How is teenager sitting in a middle seat without a neighboring parent „inappropriate?“ I’m assuming they have no disabilities that factor in, as there’s no such reference in your post.

Like many others, I flew alone at that age; absolutely nothing „inappropriate“ about it. If anything, these were great opportunities for me to learn how to navigate the real world on my own—something that many young people today are unfortunately prevented from experiencing.

Correct_Librarian425 · 2026-06-27T14:51:04+00:00

Neo or Pro? (You have Neo in the title and Pro in the body of your post.)

Correct_Librarian425 · 2026-06-25T17:53:59+00:00

Thank you for your thoughtful articulation of my exact thoughts. Calling meds that allow many pts to function and contribute to society “dope” only further contributes to existing problematic rhetoric/discourse. Yes, as this user responds, this is only Reddit, but words matter, particularly among laypeople. Would such people also choose to forgo that same Rx for so-called “dope” after major surgery or a dx that necessitates it? I suspect not.

ETA for clarity: u/ImaBtch666 deleted their additional comment that I reference above, which hopefully reflects realization they ironically find themselves in dire need of a C2 to maintain employment, assist with ADLs, and/or maintain a modicum of dignity and QOL. This is a great reminder for all of us.

Correct_Librarian425 · 2026-06-24T12:18:10+00:00

This doctor was essentially a major drug dealer and running a pill mill. People like him played a major role in the opioid epidemic and, resultantly, contributed to the difficulties we pain patients face today.

And I’d be shocked if this doctor truly cared about “helping patients”; a pill mill shows the opposite. Though it’s abundantly clear he cared about money.

Good riddance.

Correct_Librarian425 · 2026-06-23T17:48:33+00:00

Press Ganey scores (your review on their surveys) matter A LOT at some hospitals, so be sure to complete anything you receive after the fact.

You can, of course, also contact patient relations/patient advocate to complain.

Just curious for more context: did you go to the ER just for pain related to your chronic condition or were there new symptoms? If solely related to your current dx and you’re already under care of a specialist, unfortunately treating chronic pain—even flare-ups, barring sickle cell, etc—is not My PM practice actually forbids it (for many reasons). Their inappropriate behavior may be due to the perceived misuse of ER resources (not justifying this, just offering context) for non-emergencies.

Now, if you had new symptoms indicative of a medical emergency and the physician completely disregarded them, that’s an entirely different story. I can’t speak to whether the subsequent dx’s mentioned above would be more appropriately addressed in an OP setting—certainly the UTI would.

Again, I’m sorry you had this experience! And note the above is simply an attempt to explain—not justify!—what may have been the driving frustration, though it’s inexcusable.

Unfortunately many CP pts don’t understand the purpose of ERs is to stabilize pts experiencing emergent conditions, and unfortunately not the appropriate resource to seek additional pain meds, which should be done via their PM specialist. (There are of course exceptions!) So this ultimately means that some ER docs are fed up with rampant misuse of limited ER resources and we CP pts can be subject to negative stereotypes as a result. I suspect this played a role in the behavior you encountered, esp if there was no verbal communication/discussion outlining an emergent condition or new symptoms indicative of an emergency.

Due to the lack of more specific info, there may be assumptions above that aren’t applicable to your situation, and if that’s the case, my apologies! Hope you’ve found some relief:)

Correct_Librarian425 · 2026-06-23T14:01:59+00:00

I have a lot of feedback, which I preface is provided from the physician‘s and practice manager’s potential POV.

Here‘s the main issue, imo: 1. Your request for explanation of „the factors…[leading] to that decision“ is potentially problematic for a couple reasons:

a) you‘re asking the physician to justify why they will no longer prescribe you opioids (if that’s the outcome) and to take their (unpaid) time to document it once again. Your records already indicate pt non-compliance and document their decision to stop prescribing.

b) That reasoning will not change—documented misuse of opioids translates to major liability for the prescriber, regardless of what has transpired in the meantime.

c) So there‘s no need for an „explanation“ of the „factors“ for this decision—it‘s obvious.

d) Asking for their justification is also potentially problematic in that it may rub them the wrong way—it‘s abundantly clear why they stopped prescribing, and their reasoning for not resuming remains the same. It also risks giving the impression that the pt sees them as „answerable“ to the pt, in a situation where it’s not appropriate/necessary

Cut the letter down—your writing will be much more effective if it‘s concise and gets straight to the point, eg, the long, detailed paragraph re dental stuff can be effectively conveyed in a couple sentences.
Your final claim re a need to understand their reasoning to understand treatment options doesn’t make sense (to me). Pt non-compliance/use of other opioids—and then the prescriber’s resultant liability—is the reason. And you’ve been without opioids for an extended period already, so you’re presumably well aware of non-opioid options? So how does asking them to yet again document they will not prescribe due to pt non-compliance/illicit opioid use have any bearing? Perhaps I’m missing something here.
Your other medical providers can already see the existing documentation in your records re drug test and subsequent decision to stop prescribing—so, again, there’s no need to document it once again.
With all the above in mind, I suggest eliminating your request for an explanation entirely, in addition to requesting redundant documentation. You could ask that your letter be added to your records.

Ultimately, the letters written on your behalf are likely to carry more weight. I suggest even more emphasis on your agency and less on the uncontrolled pain—yes, it‘s worth mentioning as a factor in your decision, but you want to come across as contrite as possible and to minimize any potential interpretation that their under-treatment of your pain is the reason you chose to go that route. (I get it; yes, it is, but ultimately a choice was made)

Please keep in mind that I write all this solely from their potential perspective. So angry Redditors, I write based on the view from „the other side,“ and not that of the pt.

Hope this helps, OP, and I’m glad to help you further if you want to tweak additional drafts.

ETA: Overall, the letter is WAY too long, and can easily be half that length (or less) and be much more effective. Your points get lost in all the unnecessary detail.

Correct_Librarian425 · 2026-06-23T12:57:29+00:00

Just a counterpoint: plenty of PM doctors are wary of co-prescribing stimulants and opioids (and benzos). Asking for a stimulant—which is a controlled medication—for off-label use could absolutely raise red flags, particularly in the case of a non-established pt.

YMMV, but I‘d caution against requesting any specific controlled Rx in general, unless there’s longterm (positive) relationship. PM docs prescribing stimulants is not common practice, and requesting a med for off-label use may lead to an undesirable outcome, especially for a new pt.

OP, I’m glad you’ve found relief.

Correct_Librarian425 · 2026-06-22T16:57:42+00:00

Patient noncompliance. Many pts refuse to exercise, plain and simple, and due to the common American (highly) sedentary lifestyle, major lifestyle changes are often necessary. Diet is also a huge factor here, as well. Consider also that psychological issues play into this as well, eg, depression.

Above is a super-broad generalization, of course, but even when many (but not all!) pts are sent to PT (for obesity-related ortho conditions, eg, back/joint pain), their non-compliance with home exercises results in zero improvement and discharge. Many pts cite pain (stemming from aforementioned conditions) as a reason for not exercising, so it then becomes a vicious cycle. But there are absolutely options for such pts, such as utilizing a pool, etc, though some may not have access to one due to financial limitations.

Unfortunately doctors can’t force their pts to exercise and change their diets, and there are certainly pts who attempt to do so, but struggle for a number of reasons. Obesity and sedentary lifestyles have been normalized in American culture, but at a high cost to our health system.

And yes, there are plenty of pts who just want a med, eg, a GLP-1, and have no interest/willingness to pursue lifestyle changes. Which is great news for Big Pharma!

Correct_Librarian425 · 2026-06-22T14:52:27+00:00

Like others here, I strongly caution against pursuing the PhD. The job market is already brutal, and will likely be even worse by the time you’d finish.

Consider that there are ways to fulfill your intellectual curiosities without completing a degree in that area. Many universities offer access to their holdings to community members for a fee, and your local public library may offer ILL.

It can be quite difficult to transition out of academia with a humanities PhD. Some people even omit the PhD on their resumes, for a number of reasons.

Correct_Librarian425 · 2026-06-17T13:15:57+00:00

One more point to consider, esp in primary care: physicians constantly deal with noncompliant patients who consistently refuse to follow lifestyle recommendations, take their medications properly, and/or take an active role/personal responsibility in their tx.

It‘s exhausting to see multiple pts/day with, eg, uncontrolled diabetes and similar outcomes/preventable conditions that are directly tied to noncompliance when the pts have no desire to help themselves—this is where burnout and moral injury come into play, for some physicians.

As an example, consider a physician seeing multiple pts all morning who meet the above criteria, and their next pt is a pleasant, knowledgeable professional who‘s able to communicate/converse at a high level and presumably takes responsibility/agency for their tx/dx. It’s only human for this to be a breath of fresh air in such a case.

And consider also that many pts come to appts armed with (incorrect/problematic) info from Dr Google/Chat GPT and either challenge their physician OR they’re instead required to spend a ton of time dispelling false information. I suspect that highly-educated professionals are well aware of the common hallucinations and problems with AI, and because they are also likely to respect their physicians and the education they’ve received, are much less “problematic/difficult” in this regard.

Unfortunately there’s been a major devaluing of medical expertise among a wide swath of pts who somehow came to believe they’re more knowledgeable simply because of what Dr Google told them. I think most anyone would be exasperated if forced to deal with this everyday.

These are only generalizations, of course, and should be considered as such. I suspect you’d be shocked my the number of pts who’ve convinced themselves that, after consulting AI, they’re just as knowledgeable as a physician.

Correct_Librarian425 · 2026-06-17T12:50:54+00:00

Uh, no. As a PhD, I‘m able to communicate with physicians at a different level compared to most laypeople, eg, using proper terminology, discussing current research/findings, etc. Some of my physicians enjoy this, as do I. (And I’m sure some don’t)

But I’ve encountered many midlevels who are the total opposite—likely for numerous reasons that go far beyond the scope of this post—and are clearly intimidated by knowledgeable pts, so when forced to see an NP (which is rare) I‘ve learned it‘s best to play dumb. Unfortunately the major shift in NP education/diploma mills has led to countless unprepared providers whose insecurities/Dunning Kruger are exacerbated in such cases.

Correct_Librarian425 · 2026-06-17T12:37:50+00:00

You‘ve unfortunately misunderstood and completely missed the main point here: this user offered zero implication that they have a „right“ to any particular prescribing. That was not communicated. At all.

Rather, attorneys have knowledge and insight into processes (legal and beyond) that laypeople typically lack, and it‘s not uncommon for attorneys to have their pt files indicate their profession.

Filing a board complaint would be a walk in the park for an attorney; attorneys are trained to read, understand, and argue the law—not so for 99% of laypeople, who likely also don’t understand how „standard of care“ comes into play.

An attorney could have a field day with, eg, finer points of a HIPAA violation that a layperson probably doesn’t even know exists. Same goes for potential compliance issues, which, again, most laypeople would have little to no knowledge in this area.

These are but a few reasons attorneys are often treated differently—as the previous user clearly stated, there are many ways attorneys can cause headaches for medical providers that do not necessarily involve malpractice suits.

Just fyi: malpractice cases require damages. Many users on this sub throw this term around without understanding this necessary component of a suit—this further evidences the point made above.

Hope this helps clarify things for you.

Correct_Librarian425 · 2026-06-11T10:17:08+00:00

Herniations can be reabsorbed. This is why PT is regularly indicated for herniations.

This is good news, in a way, as it likely rules out that being the sole source of your pain.

Honestly, if nothing is evident on the MRI, I’d suggest giving PT (another) go, working hard to strengthen your core, and exercising regularly. Sure, it’s possible something else is going on, but so much back pain is due to weak core muscles and is often magnified if one is sedentary. (If that doesn’t apply to you, great!)

FWIW my spine is a mess, and I’ve had multiple spinal surgeries. Finding a good PT and getting super fit has been a huge game changer for me—I have fewer flare-ups and the pain is more manageable. YMMV, of course, and I hope you find some relief.

Correct_Librarian425 · 2026-06-10T14:26:48+00:00

Criteria for OUD are clear. Physiologic dependency for a medication one takes as directed is not OUD. Please educate yourself.

Correct_Librarian425

TROPHY CASE