I'm looking for recommendations on short acting pain meds for breakthrough pain. I experience chronic pain which is caused by a perineural cyst, bulging disk and tethering on my cervical spinal cord. My doctors are reluctant to operate as I've already had three cervical laminectomies. I've had in intrathecal pump since 2006 and while it does help (especially my spasms), I am still experiencing some very intense breakthrough pain. From the pump I'm getting 54.02 ?g of Lioresal daily and 4.05 ?g of hydromorphone daily. I can get a bolus of 12.60 ?g of Lioresal and 0.945 ?g of hydromorphone every four hours.
Up until a few months ago, I had been taking 800 ?g of Fentora five times a day for breakthrough pain. Late last year the pain started getting even worse and I had to start taking 30 mg of oxycodone as the Fentora wasn't always doing the job. I had to switch to a different PDP for 2014 and the new plan doesn't cover Fentora so my doctor switched to oxycodone as my primary medication for breakthrough pain, I was taking 30 mg three times a day. The oxycodone alone wasn't helping very much so my doctor also prescribed methadone, 10 mg three times a day but that hasn't been helping much either. I have to go for a pump refill this Thursday and plan to ask my doctor what other medication besides methadone she might recommend (as well as asking for a bolus increase). I'm also throwing that question out to the group.
What do you all take for your breakthrough pain? Anyone else here ever tried Fentora and if so did it help you? I found the Fentora a better medication as it was much faster acting than the others with less side effects. Anyone know what the best replacement for Fentora would be? I have used Actiq in the past but that too is not covered by my drug plan. The only reason my doctor prescribed methadone was because I had mistakenly brought it up and a phone conversation, I meant to ask about morphine. When I got the prescription for methadone, I had it filled as I was desperate to try something different. From what I've read, methadone is better than morphine for treating pain but unfortunately it's not helping me.
Thanks in advance for any info you all can provide.