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Managing your medications

William GarzaWilliam Garza TexasPosts: 2,232
edited 06/11/2012 - 8:22 AM in Pain Management
Ive been skating on thin ice. I try to balance being able to think with pain relief.
I take hydrocodone 10/500 x 6-8 a day when i am in breakthrough crisis stage of pain, you know, the stage where ya have to lay down...NOW! my days are like 16 to 18 hours long. I like being able to think somewhat strait...do you?
Ime in school 13 hrs this semester and as you know that means a few hours of sitting, ya buddy, the bum goes numb. !
when i take enough of painkiller to ease the pain somewhat/ it never goes away...nor can i expect it to, i begin to get the drools/slow thinking/muzzy feeling.
I think school is more important than pain right now and accordingly i adjust to the level of pain i will feel. Do any of you put pain on the back burner? coz life dont stop and you dont want to be left behind? Do you tolerate higher pain to get ahead?

or do you value trying to be pain free as possible ...all the time?

where do you stand on this?



  • will definitely suffer higher pain levels if I have to when it comes to my kids. If I have to take them somewhere I do not take meds because I want to be alert when I am driving ( I don't drive unless I have no other choice because I can't turn my head like I need to)....stuff like that. Life does happen and sometimes we have to make adjustments. In a perfect world , none of us would hurt but Lord knows this isn't a perfect world. :(
  • If you need to concentrate take just enough of the med so you can still perform to necessary potential and deal with the pain that is left (it's all a balancing act). If you have too much pain you can't concentrate on anything else. If you take too much pain killer than you cant concentrate correctly. After a while you should get used to the side effect and still get decent pain releif, but the point is to live your life to the fullest and have the pain distraction at a minimum (a balancing act). Sorry can't help anymore.
  • stillhurtin. I could not agree more.
  • My doc just started me on fentanyl patches today. It is a time released pain patch that you wear for 72 hrs.

    Its suppose to get rid of the pain without those "space aged" side effects. Ask your NS or PM about this. Like I said I just started it today while going through withdrawls from hydrocodone.

    I had RF done a week ago and man oh man having a struggle with it. They had me on soma and hydroco every 3 hrs for a week straight...a person can not live like that..or...i refuse to live like that. I pray this patch works because i am like you i have to have pain releif but cant live in lala land just to get releif.

    Good luck and GOD BLESS!!
  • dilaurodilauro ConnecticutPosts: 9,733
    I've often thought about that same situation. As a programmer, I 'should' try to keep my mind as sharp as possible. But I know that when I am on my pain medications, even though I feel totally together and with it, I know I am not as sharp as a tack. So when it comes to big projects or working on something as important as NYPD 911 or Airline Control systems, you do not want to add anything that could create a problem.
    So, during some of my bigger projects, I would lay off some of my pain medications. This was a several years ago and I can tell you that that decision was a mistake! Was I any clearer without the pain medications? Its hard to say because being on the for a long time and just stopping them from time to time is not enough to get them out of your system. But the biggest problem came from having to deal with pain. I can pretty much focus out pain - to an extent, but when I was working full speed and was not taking pain medications, little things started to crop up (toes number, finger tapping,etc) till the pain crept back in. I spent more time fighting to not have pain then I was doing what I should have been doing (Programmer).
    So, for the past year, I have not concerned myself about medications and sharpness. I will do the best I can in what ever I do, and if pain medications get in the way, I try to push out what I can.
    This is such a difficult subject. Its probably a subject that several books could be written about. I know I have volumes of situations to talk about.
    But, you know best what you can do and what you cant do using pain medications
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Taking your medications only when you are in extreme pain has always caused a domino type affect with me. My PM and I talked in length about this because I work for a medical lab and have to be clear headed. What he explained and I discovered first hand is that you need to keep a good baseline level of medication in your system. Lack of medications in your system can cause some of the side affects you have described and possibly start medication withdrawal or the yo-yo affect. This was also why he prescribed me a long acting release medication (Fentanyl Patch) and breakthrough (Oxycodone).

    I'm concerned that you are also taking so many Hydrocodone, that has so much Tylenol and may give you problems with other organs down the line.

    Have you tried the patch? I have found that this particular medicine keeps me more clear headed than the concentrated pill forms. I still have to use a breakthrough medication on a schedule to keep my levels climbing out of control so often.

    So in short it is a balancing act and also a experiment to get the right combination of medications to work for you.

    I have felt your struggle and am currently recovering from SCS implant to help stabilize my pain level so I can go back to work. You are a very intelligent person and I know by reading your posts that you are passionate about your education and don't want to put it off. My suggestion is that you lighten your load and try to reduce your stress. Stress and lack of sleep definitely add to your pain. Doing this may help you to find your balance faster. Your health has to come before anything (sorry even your education) or anyone else. IMHO

    My wish is for all of us to find our balance and a better quality of life. Take care of you.

  • Oriah, you hit on a couple of important points, keeping enough meds in the system to be effective and to prevent the yoyo effect. and yes the docs have taken notice of my liver,i try to keep from killing the liver by staying to the minimum i can, but the breakthrough pain is gotten to the point of tears while i sit. it distresses some of my more sensitive friends, but thats life..you cowboy up and try to work smarter and harder. Mr Dilauro hit it on the head about trying to be sharp. its important that i be as smart as i can,its a personal thing..I need to be of service to my fellow man, and to do that i need education,also the smarter i get the better my fiancial outlook gets!
    I have a need inside to ahh..push. its part of life to me and ive learned to do it well. but no longer the torpedoes be dammed approach that got me here in the first place. To lead you have to do it from the front, not some rear ranking yeller outer(sorry) of platitudes. i do the very best i can day to day, but when spine acts up..it gets frustrating trying to do "life" and thats a story from the past.
    Cambran- I had a run in with a W/C doc a few years ago who labled me as a drugseeking addict. he papered it and just getting treatment became an excersize in patience. i told the sorry cur dog off and he retaliated..oh well..so any time i ask for something stronger..you get the picture.
    i get down coz of one misguided insurance lapdogs assasination of my character,but again oh well...life goes on,so i can try,and most likely will get nothing in return, thats a card ime saving for the future.As for implants etc, the insurance gots me over a barrel and no thank yous from them. according to some desk jocky doctor from the ins co, ime not hurt enough to warrant any other treatments,but they wont release me either. ive been to specialists ready willing and able to do good by me, but it goes right back around to the ins co. ive sought legel representation, but thats another set of hoops to bend over and jump through. as the doc and ombudsman said" i am falling through the cracks of the system coz i was honest,i am unwilling to compromise my character to get what i need, i will not amp up my injuries,crawl into the docs office in crocodile tears, scream in pain at any touch ect.
    so in short the system is broke,and it wont be fixed anytime soon. ive tryed to initiate a civil suit,and again, ime not bad enough to qualify" when will i be? i dont know or care any more, its a defence reflex to keep me from being mad all the time. hope you guys find some balance in your fight!
    chin down
    fist up
    keep swinging!
  • Oh Ranch, I've been doing this medication dance for over a year now and I can tell you that I'm pretty tired of it too. I'm sensitive not only to the meds themselves but to the side effects as well yet have to bear all of it to find pain relief.

    I've finally put my foot down and told my neurologist (who handles my pain managenemt) that I simply didn't want to take the Methadone any longer. She agreed with me. I'm in a fog all of the time and pretty depressed. While it does an okay job at relieving my pain it's not enough to justify the side effects in my book. I'm not much on taking meds every 4 or 6 or 8 hours either because of my sensitivities. Alternatives must be found!

    I wish that I could hang in there with the meds and live that balance, find that comfortable zone that keeps my mind intact while my body remains in working order. So far it's not been within reach. I admire the fact that you can sit in the classroon day after day like you do. It takes a lot of motivation to keep going when it would be so easy to give in to all of it. Talk about Cowboy Up, you sure got it down.

    I agree with Oriah in that you need to find a way to get a better quality sleep. I've read posts of yours that talk about your lack of sleep and we all know that wreaks havoc on the body and the mind. Not sleeping doesn't allow us to handle the stress of our everyday lives either. Have you talked to your doc about ways to help you get more sleep? You may actually feel better physically and have more stamina at school if you can get more rest. There ain't a thing wrong with a nap or two between classes either LOL

    All the best for you. I hope you can find a way to achieve your goals in an easier way.

  • love that name!!!i think i may ask my doc about that. i dont know how or if i can handle morphine. dads on it and it whops on him pretty hard. my prob is two fold. 1. Lack of sleep as many of you all know
    and 2. break through pain.
    I'll start at two... muy pain levels have jacked up to a higher level. Its my fault..ya i push too hard,and that has an effect on no.1. But i have to have a driving force inside or there is no ahh..savor to life, its just a day to day grind until you die. I wont live a life without passions and desires. so hence i laive a semi fulfilled life! what is life without any spice?
    i love to help others, i get a warm fuzzy feeling from the service.
    Ok no1. i think my energy levels are way up despite not having put in a 70+ hour week in 2 years. 20 years of pushing the limits of my endurance may have fixed my level at a certain level???
    i think that may be why i am awake so much...IDK?
    it was a blessing when i wanted to grow a company and i needed the energy to gogogo!
    my thing used to be if it wasnt for eating sleeping or having to take a wee every now and then i could make some money... do you?
    i wish my back was back to normal but it wont..ever so here i sit... dang!
    Its alright though, ime relearning to use the gift of not sleeping to my advantage..maybe. i was in better physical health before and i wasnt tired all the time from the pain battle,so i bounced back.
    ohh well.Donrt worry for me thanks though!
  • Ranch-
    Your father probably doesn't take Avinza. Most other Morphine Sulfate meds will knock you out sometimes but this one is the only one on the market that is a modified release capsule. That means that 10% of the med is released right away and then then the rest is released over a 24 hour period. Little bits at a time. It works great and you just don't get high. So, yeah, ask about it. I am also taking the 15 mg oxy for BT. So you can ask for a BT med to go along with it, actually, you have to have it just in case. You will sleep like a baby too.
  • My dad takes morphine 15 mg tabs. I am going to see doc today and i will ask him bout it. Ya the breakthrough pain level is seemingly getting to be the new norm, so that means the ever spiraling cycle begins anew. ohh well.thanks for the info!
  • Hello Ranch,
    Although our personality type may be stuck in driven, we do have some choice in the task we set ourselves and to some extent plan for failure. I think pain makes us more aware of that time scale and those windows of opportunity are moments of at times manic activity.

    We attempt to perform normally with half the physical and sometimes cerebral capacity through the fog, a golden globe performance, effortless unseen and a revelation to ourselves, never do we let that game face slip, a morphed version of our unrealistic self.

    I have been forced now to pace far more effectively and that frenetic pace necessitates ever increasing medication that I am perpetuating, I may be playing catch-up and the keywords of pain and medication rotate in an ever smaller cycle in circumference. I have tried to evaluate what is missing at these times and perhaps feel detached from myself, distracted or on stand-by, my intention is ready. Nobody can perform effectively with these level of medication and we delude ourselves to think that we can, in the trying is all the hurt and passion we contribute to survive every day, failure or even the thought of it, is not an option.

    Even while doing some activity I deny the inevitability of the pain to come and that has never worked even in my head, let alone physically. That metronomic chant of pain, tick tock, pain pain, my inner voice debating the positives of stopping, while Type A countermands that proposal. The jury is still out in the notion that pacing alone can reduce the occurrence for BT pain to endure, and if the increase of activity causes such pain one may surmise that the reverse would bring some benefit. We may have some control, although BT pain is not all self indulgence, it is akin to flare-ups a mystery of our anatomy. Performance is important in whatever form that takes it give’s us some dignity and inclusion and the encouragement to continue.

    Come the day our psychedelic world is visible to anyone externally we may have some explaining to do, every tablet has accumulative symptoms not in the tiny text and we should acknowledge how well we all do despite taking these volumes, and it is to our credit that we will continue to perform to the best of our ability with symptoms only known to ourselves, that we endure with grace and sheer tenacity.

    As you I need to be switch on for my job, if they only knew, I have an acceptance speech.

    Take care, what a great topic.


  • This is a great discussion and I have a couple comments. For me I have been taking Vicodin ES for about 1 year for nasty lumbar disc issues and on one thing for me I need to keep my dose regular @ 1-2 every 4-6 hours. My pain is usually 4-5 and I can work with no issues (supervisory) If I miss a dose which has happened a few times I suffer pain level shoots to a 7-10 and I go into withdraw lithargic, ect. My PM now wants me to start with a long acting and some of the possibilties we talked about are Methadone, Oxycotin, Fentenyl, and Morphine with the Viodin for breakthru. I would appreciate any feed back on these long acting meds that anyone can share. I am not to interested in the Methadone or Oxy ideas and I am not sure of the others. Just looking for feedback. Thanks in advance Jim
  • I think I can help a bit here. First of all, it is good that your PM Dr is wanting to give you an LA med. (long acting) They work so much better, in my opinion, than immediate release meds do when your in it for the long run. Lets see, you're talking about Methadone which is a really good pain med and long acting med, OC which is simple Oxycodone Hcl., Fentanyl which is Duragesic Patches and also a very long acting med as it seeps into the bloodstream from your skin, and Morphine Sulfate. Just as if I were the patient, I would not at this point stray too far away from where your at and I think that the OC would probably be your best bet with the Hydrocodone for breakthrough. I only say this because the OC is the closest in structure to the Hydrocodone (Vicodin ES) and therefore you would be in the same ball park. Ask your Dr. what he or she thinks about it and let them do the talking because I am no Dr. nor do I ever plan to be one. I just feel that jumping from a 7.5 mg hydrocodone product to Morhine, Methadone or Fentanyl is quite a leap. Think about it and talk to to the Dr. about it. I could be way off base too, but I'm trying to inject some layman's advice.
  • I see My PM next week and we will see what comes of it. Thanks Again
  • Anytime. Thank you and good luck at the Dr. office. I am going on Monday weather permitting, yes I live in Miami and I had to check to see if the Dr. and my pharmacy will be open on Monday. Both will be and I hope this storm slows a bit so I can get in and pick up my meds.
  • jdtrip~*

    I just want to give you my experience as I was once facing your very decision regarding meds. At the time I was on Vicodin HP (10/660) only and my PM offered me MS Contin (long acting morphine) with the Vic's for breakthrough. I take 30mg of the MS Contin twice a day, and now am on Oxycodone 10/325mg for breakthrough because I built up a tolerance to the Vic a year ago or so-as I am now with the morphine, but don't assume that will hold true in your case-I have tolerances to all types of meds. But I didn't have any side effects at all going from just Vicodin, to both Vic and the MS Contin, and was so relieved to find how much better my pain management was. It might be worthwhile for you to give this combination a try if you're not comfortable with the Oxycontin or Fentanyl. Just wanted to give you another experience to think on.

    Best of luck, keep us posted, and as always-take care of you..
  • I dearly hope you can get to the pharmacy and your doc tommorrow! i know the agony of running into bad timing on the part of the weather.I hope ylou escape the worst of the weather out there! take care and good luck!
  • Thanks EMT gone Nutz and Herrball. I will let you know how it goes this Fri. Take Care
  • I mentioned to my pa the morphine sulfate and she kinda wigged! she said something along the lines of they dont handle meds of that class at the clinic and referred me to a p/m...here we go again..as of now the circle will close..again.a pm is why i had to go to the county for help in the first place! all kinds of false accusations and a bucket of bad blood between me and the idiot. ime sorry...the idiot with a medical degree.
    good luck to ya on your appointment!
  • I just want to make a comment about this Morphine Sulfate that I have been on now for a little less than a year. It's called Avinza and in my opinion, it is the by far the best narcotic analgesic that I've ever taken. The amazing thing about this drug is that it actually works for a period of around 24 hours and it has very little if any euphoric highs to it. In other words, you take it, and it seems like you didn't take a narcotic but the pain is gone within the hour and it stays gone for an entire day. So Dilauro, and anyone else out there that has to be focused for a project or for anything else, try talking to your Dr about Avinza. It comes in four different strengths, 30, 60, 90 and 120. It acts on a different receptor therefore it doesn't give you that high that you would get from lets say hydro or oxy. It may only be me, but I think Avinza has saved my quality of life and put it back where it belongs. I take the med everyday around the same time and its like I never took anything because you don't FEEL it. Now I'm not talking about aches and pains pain, I'm talking about pure panic pain. The type of pain you get and you start to freak out because its so severe that you don't know what to do and you panic. That is what I was dealing with until I started taking this drug. By the way, the sleep I get is the best. That's another aspect of this drug. It is Morphine Sulfate and helps you to sleep right straight through the night.
  • I think it's a shame that people have to be put through what you are going through. That's just ridiculous. That's like my Neurosurgeon telling me that he doesn't want to write me any prescriptions for pain meds and that I need to see a PM Dr. He did indeed refer me to one, but that's not the point. Why not let me leave the office with a script for the time that I will be out. Turns out that I was out for about 2 weeks. It could have been worse. Sorry to hear about that whole County thing you're going through. I was able to get to my PM Doc and the pharmacy all before 10 am on Monday. What a relief!!!
  • So, JDTrip, how did it go with the Dr. last week? Are you now taking a long acting med or are back in the same boat? Please let us know what happened.
  • Hi Herrball. I did have my appointment with my PM and I am seeing a in clinic Pyschologist next week to go talk about the proposed course we are thinking. At the clinic I go to before a patient starts long term Opiode treatment we see a Pysc and sign a new long term pain contract which replaces the standard. We tried another Epidural yesterday to see if it would calm the low back down but I have my fingers crossed that it will however the last 3-4 did not help much. Anyway to make a long story short I will see my Doc in 2 weeks and we will probably try his preferred medication MS Contin although I will say he is a very understanding and considerate doctor and I have been seeing him since day 1 which I feel very fortunate to have we kind of eliminated Methodone and looks like we will give either the MS Contin or Oxy a try. Thanks for thinking of my situation and as I have said this is the best board around . I will keep you posted. Thanks and God Bless Jim
  • hiya jdtrip. i hope they treat ya right there at the pm and with the meds. i am gonna hopefully have to sign one soon..hopefully coz of the threat of some pain relief! its been so long that i can only hope its true. luck to ya in the battle against the pain!
    ive been through this! ringer before and i dont mind the hassle as long as there is help coming !
    herrball i talked to a buddy of ine who has taken the avinsa before ,he wasnt happy with the results, but...thats just him! he'se a druggy who is a stain on the system,so i still have hopes for the system to work for me. my body isnt"used" to having opiates heavy in my system, so i have hope for the long lasting effects.
  • To medicate or not to medicate... that is the BIG question. I got a lecture from my friend the other day, how pain meds are not the answer. I KNOW THAT. But I know sometimes they are the "right now" answer. They may not be THE answer, but they are apart of the solution.

    I feel that If cutting back on meds, trying to be more alert for school or work, most likely, you still wont function to the fullest extent. Meaning that you will probably be more focused on your pain, instead of the task you are trying to accomplish. I know when it comes to my job... home making, If I am in pain, it can take hours to do a simple task such as loading the dishwasher. The pain slows me down. It consumes my mind. I dread the thought of sitting in class for hours, trying to concentrate on learning, or passing that exam, when all I could think about is the pain.

    We are in a lose lose situation. The way I see it, why should we have to suffer, if the end result is the same? Obviously there are exceptions, as said above, like driving... there are times when we need to make those decisions for safety sake.
  • Good luck to you Ranchand. I wish you well getting the relief you are seeking. The whole journey for me as I am sure with many takes a whole lot of turns with alot of peaks and valleys. I am very grateful that in my case I trust those that are working with me although at times it seems things can move at a snails pace and with pain that can be very frustrating. So I wish you luck and God Bless. Jim
  • YA its about how to balance. thats the core of the issue, sorry incomunicado this week, but school has me tied in knots lately. its a razors edge ime finding that balance , ias long as i set my foot down on my activity level i can make the week! i dont advise doing this to anybody but i like to push. having to decide to listen to the body and listen to the greater power of mind is an exercize and it is a discipline that can be developed,tempered with a healthy dose of realism and wisdom. pain exists,it is there i acknowlege it,and then i say you have no power over me, it is instinct that makes me bend in accordance to the "nature" of pain. it is not a real fear, only a leftover from the dna string my ancestors left me.
    if you take the power of fear away from pain ...whats left?
    if you overcome your instinct with intelect.. you have conquered the sensation, the "idea" of pain which grows in the mind beyond the actual sence. the fear of pain is a powerful driving force in conditioning of the mind, we are taught to fear, not the injury, but the aftereffects,in any shape form or manner.
    where does this leave me?
    i look at the pain, i accept it..and then move on, with less of the fear of it and more of the strength of knowledge before me, its an ongoing discipline to be exercized everyday, mastering yourself,exceeding yourself!
    that is the essence of pushing, the very "Tao" the way" of defeating the beast a little more everyday at its own game,and thats the goal...to master yourself,your pain, No?
  • RanchieBaby~

    I just want to let you know that you've been on my mind and I'm praying for you to get good, solid pain relief and much improved sleep cycle/quality of sleep. You are such a strong man, so gentle, kind, loving, responsible-you're a wonderful guy and I feel so blessed to have you for a friend, even tho that friendship was formed because we shared this common entity of pain. I truly admire your determination and drive to finish school and to put your best effort into doing so. Unfortunately, my schooling days are done until I can find a way to pay for the classes I need to finish my 2nd degree as I lost my financial aid little over a year ago (been in school too long cause I had to change majors due to my back and they've covered the max hours allotted I guess), but I remember clearly the need to focus and the desire to excel, and you are a true inspiration to us all because of the perseverance you're clearly displaying.

    Having said that, I just want to say one more thing-if you get to the point where you just cannot find a happy marriage between pain control and the ability to focus on your education, please consider a brief break from school. Taking one semester off isn't a huge deal when you look at the grand scheme of things, and like Amanda said, if you're pain is insurmountable then you're not going to do as well academically anyway due to inability to focus, etc. I'm not saying in any way that you should quit school so please don't misunderstand me. I'm just trying to think of what's best for Ranchie and his health, which MUST come first or else you're no good to anybody. You can always get right back into the education aspect once you've attained that controlled pain. It's at least worth consideration.

    I am so very proud of you, as are so many others, and I just thought you that should know. :)

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