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Old 11-06-2009, 06:44 PM   #1
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Default I am so angry!

Please stop me from binging right now because I am SOOO upset and angry.

I have sleep apnea and have had it for I'd say about 2 years (or diagnosed at least). I have spoken to my doctor multiple times about fatigue. Recently I was told about a drug called Nuvigil- for people who have sleep apnea and narcolepsy- it helps give you energy during the day and promote "wakefullness." I went to the site and got a one week free trial voucher. I then went to my doctor and asked for her to give me the prescription for the one week. After three days I told her I feel SOO good on this drug- for the first time in a long time I feel awake- please write a prescription for me. I called my insurance and they said to get this prescription my doctor MUST speak to the pre-authorization department and say I have sleep apnea and constant fatigue and need this medication. I told them this this Past Monday knowing I would have enough pills Till Thursday.

Today I did not take the medication because I am out. My husband has his own prescription but I didn't want to take his pills because obviously he needs his supply as well. And today again I am exhausted- I know now that part of my overeating was exhaustion- Today for sure I have overeaten- but I can't sleep 12 hours a day to combat this. Yes I do use a CPAP every night but it's not cutting it.

I call the doctor today because I have heard NOTHING from them and they say "oh we didn't know we had to do this." UM YES YOU DID I CALLED MONDAY! I SPECIFICALLY TOLD YOUR RECEPTIONIST THIS HAD TO BE DONE- I SPECIFICALLY GAVE HER THE PHONE NUMBER AND FAX NUMBER AND MY PRESCRIPTION MEMBER NUMBER...

Needless to say I was very angry and the girl apologized and said she'd get it taken care of ASAP. The girl I spoke to was not the same person from before.

Seriously I am ready to cry and scream and am so upset I literally feel I'm going to vomit- my doctor has been nothing but rude to me the whole time about this medication. I feel that this was done ON PURPOSE because the whole way through my doctor has been resistant about my taking this medication due to the fact she says it's an "addicting" drug. To which I say that's like telling a diabetic person they are addicted to insulin... It's medication- it's FDA approved- it helps- I need it- you are the doctor- prescribe it.

I am currently looking for a new doctor btw.

Thanks for letting me rant out my frustration.
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Old 11-06-2009, 06:51 PM   #2
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I am really sorry this is happening to you and I hope it all gets straightened out soon
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Old 11-06-2009, 07:01 PM   #3
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Default I am angry for you

I sure would encourage you to find a new doc - one who trusts you rather than one who is suspicious of your motives.
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Old 11-06-2009, 07:03 PM   #4
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OMG i know its fustrating but DO NOT EAT ANYTHING THAT WILL SET YOU ON A BINGE ... go for a walk call someone play a video game .. idk if you smoke ... but if you do go do that anything to relax you a little bit if you eat and binge you'll feel guilty and hate yourself for it i know this seems irrational but im kind of on the brink now myself im trying to talk myself down off my binge right now ... but seriously DONT DO IT !!!!! please dont do it. your better than that
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Old 11-06-2009, 07:20 PM   #5
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Don't take this the wrong way, and I don't mean to be rude, but maybe you should do more research on this med. Most docs I know are script happy, so I tend to have respect for the ones that don't like to write scripts for meds they think are worrisome.

Tricking the body into having energy it didn't get from sleep does not sound good and you may have long term complications with not only rhe addicyion aspect, but other things as well.
And really, the fda isn't really a credible agency, they approve anything, sees if anyone gets sick or hurt, then do a recall.
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Old 11-06-2009, 08:09 PM   #6
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Hang in there.
Sometimes the MDs just don't get the human aspect of patient treatment.
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Old 11-06-2009, 08:47 PM   #7
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I hope you feel better =/ sounds really stressful!
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Old 11-06-2009, 09:58 PM   #8
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Quote:
Originally Posted by beerab View Post
To which I say that's like telling a diabetic person they are addicted to insulin...
Not quite. Addiction has a specific meaning in medicine, and that is not it.

A physician who ignores the risks of scheduled (restricted) drugs is not a doctor you want. On the other hand, neither is one who refuses to use them properly.

I do hope you get what you need.
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Old 11-06-2009, 11:02 PM   #9
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I am a physician and I'm actually not familiar with this medication although I know of some others that are probably similar. When was the last time you saw the pulmonologist about your CPAP? Maybe your settings need to be adjusted and that would be a better solution than a drug? I can also tell you that I recently discovered that sleep deprivation is a trigger for me too so I feel your pain. Last time I was on call and didn't get much sleep was the only time since I've been back on plan again that I was tempted to eat carbage someone brought into work.
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Old 11-06-2009, 11:54 PM   #10
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Are you talking about your primary care physician? If so, have you talked to your specialist (the doctor who diagnosed or is treating the sleep apnea and narcolepsy)? Are you seeing a neurologist?


I'm taking provigil, which as I understand it, is basically the same medication as Nuvigil. Nuvigil is an "improvement" in that it is a longer lasting "extended release" formulation. If you speak to your doctor, you may have more luck getting the Provigil prescription (and have to take a second dose during the day) and it also is most likely a somewhat less expensive form of the drug, just because of the "new, improved" status. Often these improvements aren't really improvements so much as a way for pharmaceutical companies can get more money by getting people to switch to the "newest, latest" thing (or as a way to circumvent some of the losses when a drug goes generic).

I don't think "addiction" or even dependence is your biggest concern with this medication - it does have some downsides though. My neurologist (he's a sleep disorder specialist) told me that while it's much less habit-forming and harsh on the body than amphetamines - some people do build a tolerance to it when it's used as a daily med. He recommends that his patients who need it to be able to work, use it every other day (if that works) or at least take weekends off. He recommended to me that I take it to "make a good day better, " not to try to make a bad day good (I do not have narcolepsy however, I have fibromyalgia and a common fibro sleep disorder in that I spend nearly no time in restorative stages of sleep).

I find for me, that it causes rebound fatigue/pain flares of the fibro if I take it more than one days in a row (but again, I don't have narcolepsy, so my situation is a bit different).

I find that the specialists are much more pragmatic about maintaining function. Narcolepsy isn't a fatigue that you can combat with "just a little extra sleep," your brain isn't working right so you DO have to trick it into a more normal energy pattern. But a primary care physician probably isn't going to be well-versed on the necessary treatment protocols for narcolepsy - so they're going to think "stimulant = habit forming." Even an apnea specialist if he or she's a pulmonologist and not a neurologist may not be well versed on the subject.

(I only know as much as I do about narcolepsy, because it's my neurologists favorite subject, and even after we ruled out the diagnosis for me, he's always comparing and contrasting fibromyalgia sleep disorders to narcolepsy).

Good luck.
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Last edited by kaplods; 11-06-2009 at 11:57 PM.
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Old 11-07-2009, 09:18 AM   #11
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If I read the original post correctly, beerab has sleep apnea-not narcolepsy. The drug may be approved to treat both, but sleep apnea is her issue. Did I miss something here? Narcolepsy is an entirely different disorder and is not weight related. The vast majority of sleep disorders specialists are pulmonologists. I'm sorry if I made an incorrect assumption in this case.
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Old 11-08-2009, 02:51 PM   #12
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Nope, it looks like I was the one that made the mistake. I misunderstood and thought the OP had narcolepsy in addition to sleep apnea.

I also had sleep apnea, but after losing only about 40 lbs, the apnea disappeared, but the sleep stage problem persisted (it's very common in fibromyalgia to have sleep stage disturbances, especially in deep sleep - I apparently spend virtually no time in deep REM sleep).

I also have rls and plmd (restless leg syndrome and periodic limb movement disorder - I thrash around something terrible when I sleep - hubby has the bruises to prove it).

Not all sleep studies include an EEG, so OP, you may not know whether or not you have sleep stage disturbances. If you haven't been tested for sleep stage problems (or the rls/pmdd - I don't know if they are always included, I've had a sleep study without the EEG, but I've always had the movement sensors), it's something you might ask your sleep specialist about, especially if after getting your CPAP adjusted you find that you still are experiencing severe fatigue.
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Old 11-08-2009, 03:11 PM   #13
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What is this, Prior Authorization for Drugs Week? My dermatologist recently prescribed me Retin-A for acne because Diferin wasn't working. My prescription plan didn't cover the Retin-A, but they covered the generic, tretinoin. I went to the pharmacy, asked for the generic, and they said, "That will be $75.99." (I normally pay $7.50 for generics.) They called my plan, who said that they needed a prior authorization from the doctor before they'll cover this. Then the pharmacist called the dermatologist's office, who told them that they DON'T DO PRIOR AUTHORIZATIONS, and that I should have been prepared to pay full price. They confirmed this with me, even after I explained the situation.

The frustrating thing is, when I called my prescription plan, they told me that I have no way of knowing when they will require a prior authorization. The woman told me that they may pay for a drug for a year and then suddenly require one.

It almost sent me on a binge, too. I found myself rummaging in the cabinets until I calmed myself down and made myself a cup of tea.
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Old 11-08-2009, 03:11 PM   #14
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I always thought these pills are dangerous. However, maybe you don't have another solution, or you are not well informed about sleep apnea treatments.

Theoretically, if you already have CPAP, you don't need medication. But I see you have a problem with your machine, maybe the pressure is disturbed from the original setting. You should find out what's happening with the CPAP.

I have mild sleep apnea, and I don't use medication or CPAP. I know, I'm lucky 'cause it's a mild disorder. However, I learned from the net that behavioral therapy is effective for some patients with sleep apnea. So I learned some tips from there and is working for me. I sleep every night with a special pillow that helps me to sleep on the side every night. If you have central sleep apnea this pillow are not helpful for you. Search on google "sleep apnea guide.com" and you'll see a site with all the information you need about behavioral therapies. Maybe it will work for you, too.
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Old 11-08-2009, 06:13 PM   #15
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It usually takes more than one day for the drug to leave you system. People are human and humans make mistakes. Your anger was misplaced and you should apologize.
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