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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10243
Experience:  14 years as clinician in the field of Family Practice
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hI. iF MY PARTNER who is a T7 paraplegic has not had a decent

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hI. iF MY PARTNER who is a T7 paraplegic has not had a decent bowel movement in a week and a half AND was in the ER this weekend for autonomic dysreflexia and they gave him an enema/lactolose with hardly any production AND the ER doc said he was not impacted and saw some stool in upper right bowel....where is the stool going? He eats a normal meal and yet no feces? Somethings rotten in Denmark! Please advise.

2) Can a doc write Lyrica-90 day supply WITH refills? Why would a doc not want to put refills even though its going through Pfizer Connection to Care Program.Thanks

Anthony Bray, MD : Hello!
Anthony Bray, MD : with the constipation there are different factors which may explain the scenario...
Anthony Bray, MD : If he has had a LOW RESIDUE diet this would mean that higher percentage if food was being absorbed and do less volume if stool would be produced... If he has no problem with abdominal distention then this could be part of what is going on....
Anthony Bray, MD : if he had X-ray or CT scam of abdomen this would reflect if he had an obstruction, partial obstruction, impaction( the latter I believe you indicated had been ruled out)

very hard to read

Anthony Bray, MD : with him being paraplegic this would of course limit him from normal activity which would otherwise promote normal bowel function...
Anthony Bray, MD : he might benefit from several days of Miralax ( one capful dose in8 ounces water) once a day until results or for about three to five days typically ...

Thanks...go How about Refill question?

Anthony Bray, MD : Senikot S 2 tablets twice a day may help to increase his peristalsis of bowel and may help to relieve the long term problem...
Anthony Bray, MD : With the Lyrica simply take his prescription to his doctor's office and explain the problem. It was probably just an oversight. His doctor should be happy to replace the prescription to fit with his needs . It is not a question of abuse potential here....
Anthony Bray, MD : I will switch to Q and A format! Let me know if you have further questions' best regards!
Anthony Bray, MD : Anthony Bray MD
Customer: replied 3 years ago.

Thanks...that explains alot. Would the miralax and senecot be better than lactolose?


So it is ok to write 90day supply WITH refill for Lyrica? can I ask the doc to write Refill on the script instead of no refill or will he think I am being pushy?Thanks!

Hello again,Either Lactulose or Miralax should work in the short term. Neither of these would be my first choice for long term use for PREVENTION of recurrent constipation however...I would try the Senekot S either way perhaps starting after a few days of either the Lactulose or Miralax.... The Senokot may help to stimulate more normal function of his bowel day to day...If he already has the Lactulose then have him try that next I would say. That would seem to be the most practical...I hope that this helps! Let me know if you have further questions! Best regards!Anthony Bray MDPs yes it is ok to ask for refills on the Lyrica prescription. I can't guarantee the doctor's response however. Often we face insurance issues that alter our usual prescribing habits... That sounds like what has been going on in this case... Generally we try to help with all reasonable requests( not all requests may be reasonable of course) no -- I don't think you are being pushy... It is a simple request... I hope this helps! Take care !!
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Customer: replied 3 years ago.

Yes...thanks...Because he won't put REFILLS it has held up my refill and I have run out. Can I ask for a few days to"bridge the few days" until Pfizer gets my script here from CONNECTION TO CARE. It is not an insurance issue because I get it free.thanks!


Yes you may request a few pills to bridge gap... Pharmacy may help... They may also fax doctor for authorization possible... These days many offices are more responsive to direct communication with pharmacies...

I hope this helps. Good luck in receiving the medication that you need soon! Let me know if I may be of further help!

Best Regards, XXXXX
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Customer: replied 3 years ago.
Hello Doc, my partner had to refill his bactrim script because it was for only 5 days but he missed 2 days waiting for the script and thinks he went back to square one because of that interruption. He thinks he still has the infection because of smelly urine but sine he is paralyzed cannot really KNOW . His urine is always smelly to me because he is "colonized". Any advice? Thanks!
Hello again,

They do have urinalysis strips available now in pharmacies in which you can test at home for infection. I agree that urine odor is hard to gauge as it routinely would have bad odor!

Cloudy urine is a sign of infection...

Otherwise follow up with his doctor if UTI is still suspected but this can wait if he is taking antibiotic... If he has antibiotic now to take then what would be done any differently?? Probably nothing... Have him finish his current antibiotic and then check...

I hope this is helpful! Let me know if you have further questions or discussion. Best Regards,

Anthony Bray MD
Anthony Bray, MD and 4 other Health Specialists are ready to help you