How do I articulate this to my dentist?

[wolfie]

I'm scheduled for some extensive dental work in a couple weeks, and one thing that's fairly common in such cases is for the dentist to prescribe analgesics for afterwards.

Slight problem: The most commonly prescribed "post-treatment" analgesic is Tylenol 3, with 30mg of coedine per tablet. I'm a truck driver. While any legitimately prescribed medication (with documentation) would be treated as a negative on a drug test, all opiates/opiods are a special category - until the patient discontinues use, they are medically disqualified from driving commercially.

ASA/acetominophen/ibuprophen (even in prescription strengths) are fine - it's the entire opiate/opiod family that would be a problem?

How do I get the message across to my dentist that stuff from group "A" is fine, but I can't take stuff from group "B", without looking like a drug seeker (even though drug seekers would WANT group "B", and would make up some excuse that they can't take anything from group "A")? Thanks.

[EricKei]

Bring in a copy of your company's policy, including a list of specific substances that would keep you off of the road -- ideally, in advance. Have whomever is in charge od drug testing call him, if that's what it takes.

[Buzzard]

Most of the medics I've dealt with are fairly understanding of such matters.

Besides, you're asking to NOT have the super-happy-fun drugs. If any medic, outside of certain extreme situations, insists on the opiates... is there something wrong with this guy, or do I not know how bad things are for me?

[wolfie]

Bring in a copy of your company's policy, including a list of specific substances that would keep you off of the road -- ideally, in advance. Have whomever is in charge od drug testing call him, if that's what it takes.

It's not company policy - it's a FMCSA regulation (covers everyone who drives commercially in the U.S. - even though I'm a Canadian, those regs apply to me as soon as I hit the border).

[EricKei]

Then bring a summary version of that. The important thing is that you talk to him about it ahead of time, so he can make arrangements for painkillers you can take without getting into trouble.

[Luna Baby]

You wouldn't/shouldn't be viewed as a drug seeker for asking for the types of meds you've indicated you can take and still work. Those you have listed are readily available OTC here in the states and should pose no real risk unless you have some type of different reaction to them. I have had major dental work and other major surgeries where I've specified that if narcotics are not needed, no need to write an RX for them. I typically stick with ibuprofen/acetaminophen when I need pain control. Only twice did I take the narcotic med and that was the first 2 doses after my hysterectomy. Most doctors/dentists are used to the request you will make as they see all kinds.

[EvilEmpryss]

Simply tell the staff (preferably ahead of time) that you cannot have any opiates/controlled substance/class whatever type medications. Tell them specifically that you do not want any medications that will prevent you from doing your job as a commercial truck driver.

Then take one more step: when they give you the prescription, Google it before you leave the office. Make sure that what they give you won't conflict with your work before you step out of the office. Once you're satisfied with what they're written, you're good to go.

[dalesys]

Thmoke! PHMoke! Fire!
[/Cosby]

[Food Lady]

If it helps, I got a script for vicodin and never needed it. Taking enough ibuprofen and keeping it in my system took care of any discomfort. Maybe you won't need anything stronger than a larger-than-normal dose of ibuprofen. Of course, check with the doc on how many mg you can take at one time, and how many in a 24-hour period. Mine allows me to take double the dose the package says.

[Seshat]

Taking a copy of the regs and evidence that you're a truck driver should be proof enough that you have a more-than-valid reason for your request.

Besides, lots of people are in jobs that mean they can't have opiates/opiods; it can't be an uncommon request. The main reason we (as in humanity) still use them is that they're effective. They just have sucky potential effects and side effects.

[TheSHAD0W]

If it helps, I got a script for vicodin and never needed it. Taking enough ibuprofen and keeping it in my system took care of any discomfort.

Yup. I'm not sure what procedure it is you're in line for, but I've been prescribed Tylenol 3 after root canal work and have never had to take it.

[Seshat]

Also, just because you have a script, doesn't mean you have to use it. Um, for some things. Check with your doctor/pharmacist...

(... hides from our medical community members, who will come down on me like a ton of bricks if I try to suggest not taking antibiotics till the infection is totally, utterly, dead and gone. Nuke the site from orbit, it's the only way to be sure.)

[Sapphire Silk]

Simply tell the staff (preferably ahead of time) that you cannot have any opiates/controlled substance/class whatever type medications. Tell them specifically that you do not want any medications that will prevent you from doing your job as a commercial truck driver.

Then take one more step: when they give you the prescription, Google it before you leave the office. Make sure that what they give you won't conflict with your work before you step out of the office. Once you're satisfied with what they're written, you're good to go.

Wolfie's dentist shouldn't have an issue with him only taking non-narcotics for pain. I'm sure they'll get it.

But the advice to google the med ahead of time is spot on.

I'm allergic to vicodin. I can't take anything with hydrocodone, the active ingredient.

I tell that to an ER doc (can't remember the reason for the visit, kidney stone pain I think). He prescribes Norco. That has hydrocodone in it. I tell the nurse, "I can't take this, I'm allergic." He prescribes Anexia. It also has hydrocodone. I ask to speak to the doctor. With exasperation I tell him, "I am ALLERGIC to Vicodin. The opiate ingredient is HYDROCODONE. I cannot take ANYTHING with HYDROCODONE in it." Yes, I had to spell it out for him like he was an idiot . . . because he was.

He looks at me and says, "Well, what do you want for pain, then?"

*you're the doctor, asshole.* Me: Could we try Percocet? I've never had that before, so it should be OK.

He writes it and sends me on my way.

Ugh.

Of course, I developed an allergy to Percocet as well. I'm also allergic to Demerol. Morphine gives me panic attacks. So I don't have a lot of choices when it comes to pain control

Wolfie: Odds are you'd do very well with Tylenol (acetaminophen/paracetamol) and/or ibuprofen (Motrin). Tylenol is actually excellent for dental pain. Just watch the dosages on Tylenol. Don't take more than 1 gram in four hours, or 4 grams in 24 hours. It can be hard on the liver.

Oh, and be careful about buying Tylenol in Canada. There's a Tylenlol, codeine, caffine mix meant for migrines that's OTC there. You have to get it from the pharmacist usually. But if someone you know offers it to you check the bottle to make sure what they're giving you first. Don't take anything from a friend not in its original bottle.