help on pain meds before doc visit

[jccarolina]

Hi guys.....Long time no see....
I have a quick question before I go to the Doc.
I've been on Fentanyl 50 mcg e 48 hrs., and Morphine 30 mg 3 X a day for over 2 years now and things have to change. He has added Valium 2 mg as needed lately but that’s a no go.
I want to suggest a change on the Morphine and was wondering if you guys had some suggestions on what works better for you? Oxy? Methadone? etc.....

[arndog]

Originally Posted by jccarolina

Hi guys.....Long time no see....
I have a quick question before I go to the Doc.
I've been on Fentanyl 50 mcg e 48 hrs., and Morphine 30 mg 3 X a day for over 2 years now and things have to change. He has added Valium 2 mg as needed lately but that’s a no go.
I want to suggest a change on the Morphine and was wondering if you guys had some suggestions on what works better for you? Oxy? Methadone? etc.....

Hi jccarolina. I have a question. When you say "things have to change", could you explain why? Is it side effects, not adequate pain control? Maybe if you could expound on that it would help me try to answer. Also, why was the Valium a "no go". How do you find the patches?
Are you taking other pain meds like Neurontin, Lyrica, Elavil, or Topomax?
Is your doc a Pain Specialist? Sorry for all the questions and I understand if you don't want to answer them but that helps me understand why you feel things "have to change". I have been living with chronic neuropathic pain for 9 years since my SCI and have been on many different medical regimes and would be happy to through in my 2 cents.......

[jccarolina]

I have a question. When you say "things have to change", could you explain why? Is it side effects, not adequate pain control?{ I'm becoming resistant to the meds that I've been on and they just don’t work as good anymore.} Also, why was the Valium a "no go". {He gave me the Valium because he wont let me have Toridol,“which actually works wonderful”, but is too hard on the body.} How do you find the patches? {I get them from my pain Doc. They do so-so as long as have breakthrough meds.}
Are you taking other pain meds like Neurontin {Yes}, Lyrica, {Use to}, Elavil {Use to}, or Topamax {Yes}?
Is your doc a Pain Specialist? {Yes}
Sorry for all the questions and I understand if you don't want to answer them but that helps me understand why you feel things "have to change". I have been living with chronic neuropathic pain for 9 years since my SCI and have been on many different medical regimes and would be happy to through in my 2 cents.......{ I've been there about the same, started out on Vicodin. }

Anyway I went to see him and we talked and he changed my Morphine to 30mg Oxycontin. I took one about an hr. ago and so far my pain scale has dropped considerably.
Finally. I hope this will last for a while. (A good LONG while).

[Garyis]

JC,

I'm using Fentynal 75 mph- every 72 hours. My insurance won't go for the Fentanyl @ 48 hr. They say the 72 hour change is industry standard.

I also use 10/325 Oxycodone.

Question; how does this 30mg Oxycontin compare to the 10/325 Oxycodone?

I never heard of 30mg Oxycontin. I just read that they come as strong as 80mg! I should ask my doc for some.

Thanks for this bit of info.

[jccarolina]

My doctor apealed the insurance co. and told them I needed 15 a month (e 48 hrs.) and they approved it.
I havent taken Oxycodone so I cant give you a compairison. My scrip isnt tylenol based like the 10/325 is, thats why its 30mgs.
The generic for mine is g-Oxycodone HCL. It's more straight Morphine based.
Ask the Doc though.....

Originally Posted by Garyis

JC,

I'm using Fentynal 75 mph- every 72 hours. My insurance won't go for the Fentanyl @ 48 hr. They say the 72 hour change is industry standard.

I also use 10/325 Oxycodone.

Question; how does this 30mg Oxycontin compare to the 10/325 Oxycodone?

I never heard of 30mg Oxycontin. I just read that they come as strong as 80mg! I should ask my doc for some.

Thanks for this bit of info.

[arndog]

I am not a big fan of the patches, when I was on them, I found that they wore off much soon than expected and I would go into withdrawal symptoms.

I think Oxycontin is a good choice as a long acting opiate. Are you taking 30 mg twice a day, 3 x a day ? The negative about Oxycontin is that it is so expensive but that depends if you have a drug plan. The super cheap alternative that isn't bad is methadone. It has its own problems though (long half life of 50 hours and hard to withdraw from) but that could be said about all these agents.

Are you taking enough Neurontin or do you have room to push the dose? People can take up to 3000 mg of it.

The other question you have to ask is whether you are getting a paradoxical effect from opiates where they actually make you feel worse in between doses. I had that happen and had to take a 'drug holiday', withdraw from the opiates for a month or 3 and I actually felt better for a while.

Could you choose to start up on Elavil 25 mg at night again?

[Sh1wn]

Originally Posted by Garyis

I never heard of 30mg Oxycontin. I just read that they come as strong as 80mg! I should ask my doc for some.

They used to have 160's but I think the government made them stop.

[jccarolina]

[QUOTE=arndog;1396959I] I am not a big fan of the patches, when I was on them, I found that they wore off much soon than expected and I would go into withdrawal symptoms.

I think Oxycontin is a good choice as a long acting opiate. Are you taking 30 mg twice a day, 3 x a day ? {yes, and it's day 2 and my pain scale I would say is about a 1 or 2 and I can live with that easy. Sure beats 7 or 8 where it was sitting at!} The negative about Oxycontin is that it is so expensive but that depends if you have a drug plan. {Thank goodness I do, Extra help from Medicare. 90 pills only cost me $6.30 } The super cheap alternative that isn't bad is methadone. It has its own problems though (long half life of 50 hours and hard to withdraw from) but that could be said about all these agents.

Are you taking enough Neurontin or do you have room to push the dose? People can take up to 3000 mg of it. { I'm up to 900 mg right now. My Rehab Doc suggested upping it if I wanted. }

The other question you have to ask is whether you are getting a paradoxical effect from opiates where they actually make you feel worse in between doses. I had that happen and had to take a 'drug holiday', withdraw from the opiates for a month or 3 and I actually felt better for a while. { I don't think I could do that, I couldn't stand the withdrawals} .

Could you choose to start up on Elavil 25 mg at night again? { Im taking Seraquil 100mg at night right now, up to 200 mg. Along with the Valium 2mg which knocks me out pretty good without making me feel groggy in the AM } [/QUOTE]


oops I goof my first reply

[Garyis]

[QUOTE=arndog;1396959I] I am not a big fan of the patches, when I was on them, I found that they wore off much soon than expected and I would go into withdrawal symptoms.

I go into withdrawal symptoms after 2 -1/2 days. even as soon as 2 days, the withdrawals are mean!!!

I see my doc next week. I'm going for the Oxycontin 30 to start with.

Carolina, you use Neurontin {Yes}, Lyrica, no. I just quit Lyrica after 4 months. Never was sure if they worked or not!

Why Neurotin rather than Lyrica? I thought that they were similar?

"The generic for mine is g-Oxycodone HCL" This is NOT Tylenol? Maybe this is what I ought to try?

Thanks for the info>

I have an RX plan but today after picking up the Patches I went into the doughnut hole

[jccarolina]

I just stayed with the Neurontin because I've been on it so long and I didn't want to fight the Ins. Co over another brand name drug. I've tried the Lyrica but found it to be about as effective as Neurontin.

"I have an RX plan but today after picking up the Patches I went into the doughnut hole."

arndog= if your on a part D plan have you tried to see if you qualify for extra help from Medicare ? Then your scrips will only be $2.50 for Gen and $5.00 for brand and there is NO Doughnut Hole to worry about.