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anyone had a hemorrhoidectomy?

8,147 Views | 121 Replies | Last: 2 days ago by AgsMyDude
tandy miller
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In reply to rjhtamu • 3:11p, 3/26/26
AG
Okay I get that. This is what I'm having trouble understanding: she initially prescribed what three 100 mg tramadol per day, one every eight hours. Like I said, I found out today that it was not covered by my insurance. I asked my insurance for the formulary and saw that they covered 50 mg tramadol up to 240 pills per 30 days so there was not a difference in efficacy and it was not a matter of insurance coverage when I asked the office to prescribe me basically doubled the number of 50 mg tramadol to get the same dosing as the three 100 mg they flat out said no we won't do it and I cannot understand why.

If they really are bound by dea or whatever to prescribe what they prescribed, that'll be a conversation between the dock and the Board of medical examiners.

It seems Insane to me that while under the care of a doctor for post-surgical recovery my only option for adequate pain management is to pay an exorbitant amount of money in addition to the $4200 that I've already paid and go to an emergency room. Is part of what i paid her for not pain management? Why pay to go somewhere else when ivwe already paid her?


Waiting for medical records so I can submit to board of medical examiners.

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tandy miller
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3:11p, 3/26/26
AG
These are the all of the AMA opinions I feel were violated

  • Do No Harm / Beneficence (AMA 1.1.1 & 9.1.1): Physicians must act in the patient's best interest and provide adequate pain management. Denial of a covered, clinically equivalent alternative caused unnecessary pain.
  • Patient Advocacy / Respect for Rights (AMA 1.2.1 & 1.2.3): Physicians should advocate for access to medically necessary care. Dr. Haubert refused my request for a covered alternative despite clear documentation and guidance from my insurance.
  • Responsibilities in Treating Pain (AMA 9.1.1): Effective management of pain is required. Refusal to provide a clinically appropriate alternative violates this ethical principle.
These are the TMB regulations I feel were violated:

  • 193.11(a) Unprofessional Conduct: Willful neglect of patient needs.
  • 193.11(b)(1) Failure to Maintain Standard of Care: Denying medically appropriate treatment without justification.
  • 193.11(b)(4) Failure to Respond to Patient Needs: Ignoring documented complications (ripped stitches, excruciating pain).
  • 193.11(c) Financial Harm: Forcing unnecessary out-of-pocket expenses when clinically equivalent, insurance-covered alternatives were available.
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tandy miller
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In reply to rjhtamu • 3:16p, 3/26/26
AG
I didn't ask her to prescribe the "stronger stuff".

I asked her to prescribe the exact same medication, 100 mg tramadol every 8 hours. I simply asked her to prescribe the same number of total milligrams in a manner that my insurance would cover.

She said no. I paid 445% of what I would have paid for the same drug in a manner that would have been covered.

If it really is as simple as "no can no, partner" she can simply tell that to the medical board when they come calling. Not my problem anymore and I'm not going to keep fighting with a dr's office to do the right thing.
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rjhtamu
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3:18p, 3/26/26
AG
I can't legally comment on any of the above, but I do tell people to do what they feel they need to do all the time.

I still recommend coming to the ER if you feel like you need better pain control, or even an urgent care (where I happen to be today.)
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rjhtamu
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In reply to tandy miller • 3:19p, 3/26/26
AG
tandy miller said:
I didn't ask her to prescribe the "stronger stuff".

I asked her to prescribe the exact same medication, 100 mg tramadol every 8 hours. I simply asked her to prescribe the same number of total milligrams in a manner that my insurance would cover.

She said no. I paid 445% of what I would have paid for the same drug in a manner that would have been covered.

If it really is as simple as "no can no, partner" she can simply tell that to the medical board when they come calling. Not my problem anymore and I'm not going to keep fighting with a dr's office to do the right thing.


Certainly can understand why you're frustrated and upset of this mess, would have to say I would be too in your shoes.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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tandy miller
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In reply to rjhtamu • 3:22p, 3/26/26
AG
rjhtamu said:
tandy miller said:
I didn't ask her to prescribe the "stronger stuff".

I asked her to prescribe the exact same medication, 100 mg tramadol every 8 hours. I simply asked her to prescribe the same number of total milligrams in a manner that my insurance would cover.

She said no. I paid 445% of what I would have paid for the same drug in a manner that would have been covered.

If it really is as simple as "no can no, partner" she can simply tell that to the medical board when they come calling. Not my problem anymore and I'm not going to keep fighting with a dr's office to do the right thing.


Certainly can understand why you're frustrated and upset of this mess, would have to say I would be too in your shoes.


Not trying to be an ******* but can you think of a reason why a doc wouldn't prescribe the 42 pills of 50 mg (2100 mg total) instead of the 21 pills of 100 mg (2100 mg total)?

I'm genuinely curious as this seems asinine to me.

Also would not be surprised if they dismiss me as a patient. I dont know if they can right now though, as I'm actively under her care with an apt 4/16… I think that would constitute abandonment


I really dont know how any of this works. Im not a dr, just stayed at a holiday inn once and have a rather autistic obsession with the pursuit of perceived justice
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rjhtamu
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3:49p, 3/26/26
AG
The simplest answer (not that it's a great answer) is that they don't have to. When you're dealing with an opiate, a narcotic or other controlled substance, there is a very heavy "pressure" not to prescribe a lot of this stuff any more.

Some places are ok with writing an initial prescription but are "hard no" on refills or new scripts within 30 days after the initial.

Not saying it's right or acceptable. Unfortunately all of the regulatory and "legal" pressure out there is to write for as few and as little as possible right now.
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BlueMiles
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In reply to tandy miller • 3:58p, 3/26/26
AG
Either what rjh said or some kind of misunderstanding.

Hope you are feeling better, soon.
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YouBet
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In reply to rjhtamu • 4:06p, 3/26/26
AG
Which would be wild if she just did III because this surgery is a known 9-10 on the pain scale post op between surgical pain coupled with BM pain.
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rjhtamu
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In reply to YouBet • 4:10p, 3/26/26
AG
YouBet said:
Which would be wild if she just did III because this surgery is a known 9-10 on the pain scale post op between surgical pain coupled with BM pain.

I don't disagree.. Like I said, I work primarily in the ER. I prescribe level II's all the time because a lot of the things I do to people are godawfully painful too.
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tandy miller
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In reply to rjhtamu • 4:15p, 3/26/26
AG
rjhtamu said:
The simplest answer (not that it's a great answer) is that they don't have to. When you're dealing with an opiate, a narcotic or other controlled substance, there is a very heavy "pressure" not to prescribe a lot of this stuff any more.

Some places are ok with writing an initial prescription but are "hard no" on refills or new scripts within 30 days after the initial.


But she was clearly willing to prescribe opioids. Why would a doctor not prescribe the same qty mg in 50 mg tablets? Especially knowing that it was 445% of the cost of the exact same medication? Or, (if it was a qty issue) not prescribe the tramadol ER instead? It was also covered

The "because she doesn't have to" answer is insufficient. Not to mention downright insulting, as it implies she simply didn't switch because she didn't feel like it, not due to any regulatory constraints etc. it also implies that doctors only do "what they have to", nothing more (honestly kinda tracks at this point).


I also can't imagine that she did it simply bc she doesn't have to. Regardless of if a person has to do something or not, there's still a reason why they do it.

For instance; I don't have to return the cart to the corral at HEB. But I do it because it's the right thing to do.

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rjhtamu
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4:28p, 3/26/26
AG
Again, sucks that you're going through this, and I'm sorry that you are.

Having them prescribe a "new" prescription at a different dose/concentration/quantity could still be seen as a refill or a 2nd prescription within 30 days. Some places are just unwilling to do this.
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rjhtamu
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4:31p, 3/26/26
AG
And also please understand that I'm not trying to defend this or condone this behavior or decision, just trying to give you an answer or explanation of how or why it might happen.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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tandy miller
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In reply to rjhtamu • 4:51p, 3/26/26
AG
rjhtamu said:
And also please understand that I'm not trying to defend this or condone this behavior or decision, just trying to give you an answer or explanation of how or why it might happen.


I know you're not, and I'm not trying to be a jerk. I'm sorry if it comes off that way. Genuinely trying to understand.
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tandy miller
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In reply to rjhtamu • 4:53p, 3/26/26
AG
rjhtamu said:
Again, sucks that you're going through this, and I'm sorry that you are.

Having them prescribe a "new" prescription at a different dose/concentration/quantity could still be seen as a refill or a 2nd prescription within 30 days. Some places are just unwilling to do this.


So is the issue writing a refill/new script within 30 days of the original script?
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Absolute
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5:04p, 3/26/26
AG
I have had several surgeries where they refill painkillers multiple times in 30 days. The doctor completely knows that it will happen. Bit of a hassle, but assumed it was because they don't want to give out a large quantity and have a bunch left over. Understandable and acceptable. Honestly never had a doctor give me a hard time about having plenty of pain control as needed by the situation.


Honestly seems like this is a case where she just doesn't care. Which is really terrible.
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rjhtamu
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In reply to tandy miller • 5:20p, 3/26/26
AG
tandy miller said:
rjhtamu said:
Again, sucks that you're going through this, and I'm sorry that you are.

Having them prescribe a "new" prescription at a different dose/concentration/quantity could still be seen as a refill or a 2nd prescription within 30 days. Some places are just unwilling to do this.


So is the issue writing a refill/new script within 30 days of the original script?


It totally could be. Without being in the person's head though, can't truly say.
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tandy miller
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In reply to rjhtamu • 6:01p, 3/26/26
AG
So is it prohibited or just a mitigation of risk? And if writing a refill was an issue I don't think they would have written me a refill.
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rjhtamu
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6:08p, 3/26/26
AG
It's not prohibited. There is no rule or law against it, but some places do make an "internal policy" about it.
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tandy miller
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In reply to rjhtamu • 6:14p, 3/26/26
AG
Seems like covering their own asses is more important than operating in the patients best interest in this instance. Like I said, they were willing to write a script. Just not one for a covered medication.


Even if the coverage exception form I sent to Dr gets approved it's only moving forward. This is the last refill I will need so it does me no good.

**** me I guess. But hey, at least the doctor won't come under scrutiny! What an absolute clown show.

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rjhtamu
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6:16p, 3/26/26
AG
Wish I could be of more help... other than just information. Situation sucks I agree, hope you get to feel better soon. As most have said, first week is worst. Most are "better" after 2 weeks.
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tandy miller
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6:19p, 3/26/26
AG
Fundamentally this comes down to a doctors office not wanting to act in a patients best interest because they likely did not want to subject themselves to scrutiny or be accused of "overprescribing" opiates.

I thought doctors took an oath to act in patients best interest? Knowingly making a patient pay 445% of what a covered substitute would cost just "because you can" is not acting in the patient's best interest, at least in my opinion.
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rjhtamu
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6:32p, 3/26/26
AG
Yes... but keep in mind too that it swings in the other direction too. "Do no harm." Opiates have a proven harm and risk over the past 20+ years. Yes they can be beneficial in the treatment of pain, but the data can't be argued. They have caused significant harm and continue to do so over the past two generations. At the peak of the opioid crisis as many as 300 people were dying a day from opiate related overdoses in this country. It's not that bad currently, but at around 200 per day, it's still horrible.

We're trying to reach a balance in this country currently with safely and adequately treating people's pain, and not leading to a danger cycle of dependency, addiction and abuse. It's not easy and honestly it hasn't been figured out yet.

There is not a perfect solution for this yet.. I will be one of the first in line to celebrate one day when we have better options and solutions for people.
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tandy miller
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In reply to rjhtamu • 6:48p, 3/26/26
AG
rjhtamu said:
Yes... but keep in mind too that it swings in the other direction too. "Do no harm." Opiates have a proven harm and risk over the past 20+ years. Yes they can be beneficial in the treatment of pain, but the data can't be argued. They have caused significant harm and continue to do so over the past two generations. At the peak of the opioid crisis as many as 300 people were dying a day from opiate related overdoses in this country. It's not that bad currently, but at around 200 per day, it's still horrible.

We're trying to reach a balance in this country currently with safely and adequately treating people's pain, and not leading to a danger cycle of dependency, addiction and abuse. It's not easy and honestly it hasn't been figured out yet.

There is not a perfect solution for this yet.. I will be one of the first in line to celebrate one day when we have better options and solutions for people.


I get that. I've seen Painkiller and the Oxy Express. But the fact she prescribed opiates sort of kills the notion that she was overly concerned with opiates harming me
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rjhtamu
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6:55p, 3/26/26
AG
You're not wrong... it's a very difficult area in medicine right now that needs a better solution.

Anyway.. my last post on here for the night. Shift over. Heading home. Hope you get some relief over the next couple of days. It does get better.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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tandy miller
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In reply to rjhtamu • 7:00p, 3/26/26
AG
I appreciate it. I think unless I rip stitches it'll start to get better in the next couple days now that i have meds. I appreciate the insight from the other side. Have a good night
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tandy miller
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9:25a, 3/27/26
AG
Feel like I may be through the worst of it. Feel substantially better than even 24 hrs ago, finally not in constant pain.

Could also just be the tramadol.
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YouBet
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In reply to tandy miller • 9:27a, 3/27/26
AG
tandy miller said:
Feel like I may be through the worst of it. Feel substantially better than even 24 hrs ago, finally not in constant pain.

Could also just be the tramadol.


Actually I think you are right on schedule. I believe I said earlier you should start feeling better by day 8 and going track to OP this looks like day 8 for you.
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AgsMyDude
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In reply to tandy miller • 9:32a, 3/27/26
AG
tandy miller said:
Feel like I may be through the worst of it. Feel substantially better than even 24 hrs ago, finally not in constant pain.

Could also just be the tramadol.


Either way, glad you are feeling better today Tandy
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tandy miller
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In reply to YouBet • 9:37a, 3/27/26
AG
Lol I thought abt that as I was typing my message
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JW
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2:22p, 3/28/26
AG
Cautionary note, look into hemorrhoidal artery embolization, it's a nice alternative to try before jumping to surgery, if you're the right candidate.
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tandy miller
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In reply to JW • 2:33p, 3/28/26
AG
Rubber Band Ligation is also an option. Unfortunately mine were bad enough that RBL wasn't really a viable option.
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BartInLA
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In reply to tandy miller • 3:37p, 3/28/26
Great to hear!
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Dad
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5:05p, 3/28/26
AG
I have prescribed people pain meds before the previous one expired several times over my career and I haven't had any issues with it. For me it has been that pain medication initially prescribed was not effective or caused some sort of allergy or adverse reaction. I'm sure that a time or two these people were lying to me and were drug seekers, but I choose to treat people like they are trustworthy unless they give me a reason not to trust them. I also look everyone up before prescribing in the pharmacy database.
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fav13andac1)c
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6:29p, 3/28/26
AG
I apologize if this is insensitive, but weren't you responsible for some Aggie mojo by staying on the toilet during football games?
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