Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

the importance of regular pain killer review with your doctor

strakerstraker Posts: 1,851
edited 06/11/2012 - 8:32 AM in Pain Medications
i see my doctor every two months to discus my pain and meds and i have recently changed from 2x40mg to 1x80mg of oxycontin and even though the amount is the same i a m getting better relief with the 80mg tablet.i posted this because i have read that some people on here have ran out of pain killers and feel embarrassed about asking for more drugs and are going through the hell of narcotic withdrawal .well there is no need for it just be honest with your doctor and tell him/her how many pill you require foe adequate pain control and as long as you a re genuine case you should get you medication .your doctor will appreciate that when your original script was issued that over time you will require more pills to get the same relief but if you dont tell him /her that wont know and as a result you will run out .so my advice have regular cont ac with your doctor and be honest no point in telling them that you need 100mg a day when you really take 150mg!


  • I was interested to read this. My fusion was 2-24
    and I have realized I am having much less intense
    pain. I have tapered down to 3 oxycod/apap 5-325, down from 8, then down to 6, then to 4 & now 3
    and think I could have this replaced with something that is not as strong. I still have discomfort and some pain but it's not anything like it was. I think the muscle relaxers are still needed and I've taken them for a long time. I thought I should make an appt with my family dr. who has been prescribing all of my medication and tell him I think I can go to something that is on a lesser level of strength.
    Does that sound like what people do when they start to get better?
  • I'm glad the 80mg tablets are working for you <:P Hopefully it will make a difference and get you some more pain relief. I don't know how you do it each day with all the pain you experience, but we all hope that there will be better days ahead for you.

    Well, I'm having a morphine pump implanted in a couple weeks and I am so grateful that I have this resource available. I am cautiously optimistic that this will be the answer to improving my quality of life. I'm sorry you can't try this out or an SCS because of the extensive scar tissue you have, but I have a good feeling that your doctor will keep working with you and help you stay comfortable as possible. Take care buddy
  • ..be honest no point in telling them that you need 100mg a day when you really take 150mg..
    Call me crazy, but it seems to me that the better route is not to take more pills than you have been prescribed. If the prescription says take 100mg, then you take 100mg - not 150mg.

    If your dosage isn't working, then it's time to discuss it with your doctor. It's not time to increase the dose of your own accord, without prior approval from your physician.

    Why this particular concept is so difficult for people to get a grip on is beyond me... ~X(
  • but your point, it seems to me, is EXACTLY the same one Straker is making. Susan
  • I took your advice and I spoke candidly with my doctor about how terrible I've been doing, and now my meds have been adjusted so that I get better BT pain relief. I hope this will help me out, and I thank you for inspiring me to speak up >:D<
  • That's good to hear! I'm glad you spoke up and the doctor heard you!
  • I called my dr.s office to ask for an appt.
    4 months after my fusion I didn't think I
    absolutely needed something as strong as
    Percoset. But the Dr.s office called back
    and said because it worked so well just
    keep it on hand. They said I could cut one
    in half or if I have a bad day I could take
    up to the limit they gave me per day. The
    nurse said I didn't need to prove anything
    to them - I think I was worried someone
    would think I just wanted pills. I'm glad
    I called though - and that my pain is
    less intense.
  • My Oxycodone 7.5mg was replaced by MS Contin IR 15mg and it should help because I was told it's stronger. Have you ever tried instant release morphine before? Anyway, I hope you're doing better today :H
  • Doctor the other day about this very subject {he is my main source of medical info by the way}.and he said that many of his patients struggle on ...on the original does of medication even when there condition gets worse and they dont go back to the doctors because they are too embarrassed or too ill.so they just increase their meds to cope with the pain .now the doctors know this and if they see that a patient is ordering there scripts {too early} on more than a couple of occasions they will contact the patient and discuss why ?? the main reason is that the patient thinks that they will be in trouble for going through the med too fast ..this is not the case with genuine people in pain.and the doctor will increase as necessary or change meds as required .my doctor knows me very well and he had said if i am in terrible pain to titrate the does up to a given max {max 400mg per 24 hours } for oxycontin {on a healthy adult}..i understand that not everyone has the same relationship as me with there doctor so dont use my example as a given .if you require more meds than you are currently taking then see your doctor {that's what i was trying to say in the original post !!
  • dilaurodilauro ConnecticutPosts: 9,877
    Pain Medication Management is so critical to patients.
    Doesnt matter if you are suffering from Spinal problems or have some other painful disease.
    One of the objectives of medical professionals is to reduce the pain levels in patients and to coordinate various actions to achieve this.
    Narcotic medication is definitely one of these actions.
    And as Straker has pointed out, discussing all of this with your doctor is so very important. But to have two way communications, you first have to establish a trust/confidence relationship. So when the patient comes to a doctor and tells them that the current dose of medications is no longer managing their pain, the doctor takes them seriously and will come up with a plan. It may me increasing the dosage or switching to another type.
    Like Straker I have an excellent relationship with my physiatrist. She is the one that started me on Oxycontin 40m 3x daily, then switching me to lower dosage until I was weaned of the Oxycontin completely. I was still taking Oxycodone IR 5mg for breakthrough pain. Several months later I had a flare up , so she prescribed Opana ER 20mg and Opana regular for breakthrough. I still had almost a month supply of oxycodone, but she just told me to put aside, throw it out, whatever.
    Thats trust.
    Problem is really complicated for two reasons:

    1- Many patients do NOT have a good relationship with their doctor for whatever reason. So, it is difficult to talk to them about your pain levels and need to increase the dose.

    2- Too many abuses of narcotic pain medications. DEA has made it difficult for doctors in the USA to prescribe pain medications. I've talked to my doctor and other doctors that I am friendly with and you would be amazed as to the stories some people tell them in order to get more pain medications.

    Bottom line, as long as you are being honest with yourself regarding pain levels and have been doing
    everything you should to manage your pain and there is still a problem. Then there should be no problem in discussing this with your doctor.

    Last thing a doctor wants to hear though is when a patient comes to them talking about their high pain levels and then tell the doctor they want a certain dose of pain medication. Asking and discussing will probably produce better results then demanding something.
    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
  • This type of delicate relationship cannot exist without trust and respect.

    Hi Straker, I'm so glad that my doctor gave me some leeway with my BT meds- I can take an extra dose when necessary during a pain flare. I was alloted a few extra pills a month to cover me so that I don't run out from taking an emergency dose. How thoughtful is that? I am so grateful, and it is very reassuring to be looked after.

    PS I forgot to thank Wrambler earlier in this post..thanks dude <):)
  • S'O.K....

    :''( ~X( :? 8} :))(

    I understand, no need to thank me O:)
  • I actually did what many have said to do when speaking to your PM about meds: I told him I was still in severe pain about 4 out of 7 days a week (at that time I did not include the constant throbbing hip or neck pain).
    He said:
    you have a choice:
    1. Go on suboxone (here I think he's still thinking I'm hyperalgesic)
    2. Go back on narcotics
    3. Take the non-narcotic pain meds (tramadol, or may as well be nothing)
    4. Be a guinea pig and try this mixture: Effexor and Neurontin. (subtext, what he didn't say: "because I still don't think anything's going to work for you, you are just a guinea pig")

    I really fought with myself on what to do... My NS said neurontin wouldn't work for me, but I really didn't want to go back on narcotics, because what if he was right about the hyperalgesia?

    So, I guess I'm lucky we stumbled on the right med for me, even though the other med (effexor) was a mania producing drug for me... some day this PM will trust me I hope!
  • God I feel like such a dummy!!After reading all the comments I am kicking myself. Decided 4 weeks ago to stop taking so many pills, just kept taking codeine phos. felt really terrible but determined not to get addicted to narcotics-haha Just realised I was already reliant on pills to "get by" and now have less ability to cope with the pain. Thank you for the reminder that good doctors are valuable and that the relationship we have with them can make a huge difference. Will now have to apologise to my lovely doctor who is probably just waiting for me to return begging for a sensible drug regime.Straker I owe you for giving me a shove in the right direction-Thank you - Hugs n' Loves - Paula
  • i have lumbar spinal stenosis with facet syndrome that has been developing for years. i am at a point now where i can only walk short distances pain free.
    i have been taking morphine 30mg daily for a year plus i get 40 oxycodone .5 mg a month for breakthrough. when i went to my GP reporting how much worse the pain has gotten, she said that narcotics do not work on nerve pain and she refused to change or up my dose. why then did they help me for a time? she offered me Gabapentin and after reaching 200mg daily it caused me horrific night terrors. it didn't help the pain either. i do also get periodic spinal injections.
    my condition, at this time, is labeled "inoperable."

    i will be going to a pain clinic but the appointment is months away. i will be seeing a pain psychologist fairly soon.

    i fear that my doctor is wanting to avoid more narcotics out of fear of the DEA knocking on her door or something. perhaps she believes that they do not work for my condition. but i read here that many take them with enough benefit to continue taking them. so here i am feeling guilty for wanting more and i know this shouldn't be so.

    i will be happy to try another anti-seizure in spite of my bad history with them, but isn't it reasonable for her to prescribe a new narcotic or an increase while i am going through so much pain while i wait for other things to happen?


  • some say that narcotics dont work on nerve pain ..but that's like saying that a certain type of TV advert for a certain type on pain pill goes straight to the point on pain! for those with no medical background the think that when they take this pill it will go to the headache or back ache or tooth ache only!! all medication is processed in the liver and its you brain that decides if it can put out the pain ...believe what you will but i would say that long term narcotics USED correctly work very well on CP/IP/..the other gaba type drugs play hell with most people's minds and there waist lines and water works .
  • i am so jealous hearing you folks talk about relief by using a pill. for some reason i don't get relief from by taking methadone, oxycontin, dilaudid, neurontin, lyrica, or cymbalta. most of them just put me into a state of depression. and depression is worse than pain. i'd rather be in a good mood and in pain than depressed. My dr. has no problem prescribing painkillers for me but we just haven't found one that works.
    Anyway straker i agree with you that being honest is the best policy. most drs want to help their patiens and will bend over backwards for you if they feel youre holding up your of the bargain.
  • Moll, I will ask what others have asked me, have they tried Lyrica yet? I know some insurance carriers either don't cover it or you get a huge copay.

    Pete, that stinks that you can take nothing without getting depressed. Pain in and of itself has a depressive effect on most people. I know most people in pain find it hard to be compassionate and caring during the worst times, so I commend you on your ability to always be so, even without pain relief!

  • Some doctors think it does nothing for nerve pain, while others say yes it works but in higher doses. I can't take high doses of Neurontin or antidepressants because it makes me feel really ill, so my doctor tailors my medication according to how well I tolerate them. They may try spinal injections first before increasing the narcotics; it just depends on the doctor and what he thinks is best. I personally think narcotics have a role when it comes to controlling nerve pain, and they work better when combined with nerve pain meds like Lyrica and Cymbalta.
  • oooooooo moll, I hear you. My doctors haven't been able to control my pain either and won't listen to me. You know what works for you, so why won't your doctor at least give you a one month trial? If it doesn't work she can say I told you so, but I suspect it will work because you already know! I think some of the others here are right about how some of our doctors are just skittish about the DEA and your doctor might be one of them.

    My primary would do as little as possible when it came to pain, but it's because she said I am her only chronic pain patient and she doesn't know what to do, so she's sent me to specialists and the darned specialists are the ones skittish about pain meds, so they won't prescribe for me or even give her advice on prescribing pain meds. So we're still at square one. And the worst part is one of these doctors was a pain management specialist, but all he would do is shots in my neck. He's an anesthesiologist by training and I think that's all the idiot knows.

    I'm so tired of being in pain all the time and knowing that no one will help me.
  • dilaurodilauro ConnecticutPosts: 9,877
    it surely wouldn't work for everyone.

    Those that know me know I do not believe medications alone will manage your pain, that is why I am such a believer in the The Blend

    You will hear that narcotics will or will not work on nerve pain, the nerve medications (neurontin, lyrica) will give you nightmares, muscle relaxers can turn you into a zombie, etc, etc

    Then add to this, Well in the beginning I was taking 10mg of XYZ and it managed all my pain, now I might as well be taking a sugar pill. I should ask the doctor for a higher dose

    This goes back to Straker's initial post in this thread. Why it is so important for all patients to meet regularly with their pain management doctors.
    Medications and treatments almost always need to be tweaked after being used for a while.
    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
  • went back to my doctors after fighting to get an appointment that wasn't 2 months away tyneol 3's were not working. she doesn't like to prescribe narcotics so she gave me tramacet. well i have to say it does nothing for my pain but makes me high, i have never been so high in my life! my next appointment isn't for 3 more weeks and I have no idea what to do until then. I still am waiting on an appoinment with a specialist , fingers crossed he has delt with this before and understands what i am going through.

    fusion of the l5 and s1 by birth defect.
  • Finding that correct blend as DiLauro mentions, is never easy and not necessarily the same answer for everyone, our consultant pharmacist said we should take medication be the clock so as to decreases the peaks and troughs of pain and raise the underlying threshold to enable this. If we feel the pain the medication is then less effective that it could have been if we take it sooner.

    We should all periodically review our medication the type volume and strategy we are using and then we may feel we have some control of our own symptoms if at all possible, medication itself is only one aspect of managing chronic pain and we need to try each one to evaluate its effectiveness before dismissing it. Our overall strategy should be one of continual rotation and having found medication that helps it is always a problem changing or adapting. Changing the dose into two tablets that cover a wider period a simple and effective change for the better.

    Good luck John
  • I am currently taking 2 40mg Oxycontin tablets like you used to, and it's 1 every 12 hours. I reread your initial post and am amazed that 1 80mg tablet works all 24 hours for you. If I need to refill it again, that sounds like a good idea to me because it should run cheaper I suspect. I paid $250 for 60 pills. Ouch. What brand do you use? I have the DVA generic ones. They also prescribed oxycodone w/ tylenol 10/325mg for breakthrough pain and I take 1 every 6 hours.

    Anyway, I hope you're doing well today. Take care buddy
  • i used to take 2x40mg of oxycontin twice a day but now i take one 80 mg twice a day same amount but for me the 80mg works better ..i also take 20mg oxynorm 2x20mg 3 times a day or sometimes one 20mg 6 times a day same amount it depends on how bad my pain is .but like i said always consult with your doctor before adjusting your medication {i have had permission to take the 20mg capsule as required up to 6 x20 mg per day ..}
Sign In or Register to comment.