This topic revolves around the challenges faced by someone living with an ileostomy, particularly when it comes to managing pain with prescribed medications. The person in question, a 67-year-old woman, has been dealing with a range of health issues, including chronic pain and complications from her ileostomy. Recently, she encountered a problem where her urine toxicology tests showed no presence of her prescribed hydrocodone, leading her doctor to stop her prescription. Here are some insights and advice that might be helpful:

1. Opioid-prescribing climate:
- Many doctors are reducing or stopping opioid prescriptions, which can make it difficult for patients to get the pain relief they need. It might be necessary to consult specialists for better pain management.

2. Challenge the toxicology results:
- Urine tests can sometimes give false results. If you have an ileostomy, medications might pass through your system too quickly to be detected. Consider asking for more accurate lab tests and contest any incorrect results with your healthcare provider or even the state medical board if needed.

3. Seek different providers:
- It might be beneficial to get a second opinion or switch doctors. Pain-management specialists are often more experienced with complex cases and can offer alternative medication forms that might work better for you.

4. Alternative medication delivery for ostomates:
- Consider using liquid, chewable, or transdermal medications, as they might be absorbed better and show up on tests. Increasing dietary fiber, if possible, might also help slow down your system and improve medication absorption.

5. Non-opioid or complementary options:
- Some people find relief with medical marijuana, though its legality varies. Kratom is another option some have found helpful, but it's important to research its safety and effectiveness. Over-the-counter NSAIDs might also help, but check with your doctor first, especially if you have kidney issues.

6. Self-advocacy:
- It's important to question medical decisions, demand clear explanations, and ensure you receive adequate pain management. Keeping a record of your symptoms and medical interactions can be helpful, and bringing someone with you to appointments might provide additional support.

7. Emotional support:
- Connecting with others who understand your situation can be comforting. Sharing experiences, like tips for managing appliance leaks, can also be beneficial for both you and others in similar situations.