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How long can one stay on oxycodone? Alternatives?

kathyykkathyy Posts: 580
edited 06/11/2012 - 8:41 AM in Pain Medications
Had fusion surgery about 15 months ago. Started seeing a pain management specialist just 4 months after surgery because the pain was at the level of climbing into bed, grabbing my knees and just weeping. Have had 4 esi's and rfa, 3 levels both sides under fusion (L4-L5) area. Use a tens unit and sometimes lidoderm patches help a little.

I'm on Lortab 15 to 20 mgs a day. I go from 8 pm until 12 or 1 the next day without any. Today I just had a caudal esi. Hoping for a little relief.

My first question is - I'd prefer taking an oxycodone without tylenol. Is that available? What do I ask my pm doc to prescribe without tylenol. I take ibuprofen most days so my liver doesn't need the tylenol.

Also, I've been taking Lortab at this level for more than 15 months. How long can one continue on this drug? Sometimes it doesn't help my pain and I have to take 25 mgs. Sometimes just 15 mgs. But never, less than that. I know it is physically addicting. Is there another drug that can be substituted for awhile to minimize the addiction risk?

Finally, what does one do? I know many here have dealt with chronic pain for years. The pain isn't "invented." I hate it and I hate taking drugs for it. But without them I can't make it through a day without staying in bed so my back doesn't have to have any stress on it. Anybody have any suggestions for different options? At this point I'd almost welcome a 2nd surgery if I thought it would help.

Is it normal for docs not to be able to pinpoint the exact source of the pain, ie, hardware vs nerve damage? Thanks in advance for your advice. Kathy
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Comments

  • Oh, Kath, I am so sorry you are having all these problems. Is it the same pain as you were having when you were on the board last year? (I've kind of forgotten the timeline....) Is your doctor telling you he has no idea if it is hardware or nerve damage? Usually there are at least clues if there is a loose screw or something like that.

    Nerve damage is hit or miss to predict. Sometimes the nerve is still compressed when it is assumed it is permanently damaged. Sometimes there is scar tissue entrapping the nerve and sometimes the nerve itself can become scarred. I don't believe there is any way to know that short of examining the nerve during surgery. And nothing can be done about it if it is scarred...at this point in time, anyway. I think this will change in the near future.

    I can't answer your meds questions, but I know others will have a go at it.

    Have you consulted with another spinal surgeon for a different look at your condition?? I'm going in for a 3 level fusion in two weeks. At that point I will know better if mine is permanent nerve damage or if it is compressed....We're obviously hoping for compression caused by instability...but my surgery is kind of experimental.

    Good luck to you, Kathy. Don't give up looking for reasons for your continued pain.

    Gwennie
  • Hi Gwennie. Yes it's the same as last year! I will be extremely interested in your outcome with this upcoming surgery and will (if it's OK) keep you in prayers. I have a referral to a top notch - listed in the top docs in Atlanta - neurosurgeon. Plan on having him look at my old mri and maybe get a new one. The pain doc, from the mri, doesn't think it's scar tissue. The surgeon thinks it must be. Who knows? I'd really like to have more tests to try to pinpoint it.

    I know you've tried so many avenues. I sincerely hope you have some relief. Exactly when is your next surgery? Is it the same surgeon that did your original? Kathy
    gwennie17 said:
    Oh, Kath, I am so sorry you are having all these problems. Is it the same pain as you were having when you were on the board last year? (I've kind of forgotten the timeline....) Is your doctor telling you he has no idea if it is hardware or nerve damage? Usually there are at least clues if there is a loose screw or something like that.

    Nerve damage is hit or miss to predict. Sometimes the nerve is still compressed when it is assumed it is permanently damaged. Sometimes there is scar tissue entrapping the nerve and sometimes the nerve itself can become scarred. I don't believe there is any way to know that short of examining the nerve during surgery. And nothing can be done about it if it is scarred...at this point in time, anyway. I think this will change in the near future.

    I can't answer your meds questions, but I know others will have a go at it.

    Have you consulted with another spinal surgeon for a different look at your condition?? I'm going in for a 3 level fusion in two weeks. At that point I will know better if mine is permanent nerve damage or if it is compressed....We're obviously hoping for compression caused by instability...but my surgery is kind of experimental.

    Good luck to you, Kathy. Don't give up looking for reasons for your continued pain.

    Gwennie
  • dilaurodilauro ConnecticutPosts: 9,714
    I was on Oxycodone for over 3 years. Never had a problem with it, until the pharmacies started to dry up in terms of getting that medication.

    My pain management doctor switched me to Opana 5mg...It basically does the same as my Oxycodone IR 5mg did
    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
  • I hear so many horror stories! I almost feel "guilty" about having to take the stuff. Ron, are you off meds, now? I know you've been through so much but as aa person who is probably looking at long term pain management, I just wondered where you are, now.
    dilauro said:
    I was on Oxycodone for over 3 years. Never had a problem with it, until the pharmacies started to dry up in terms of getting that medication.

    My pain management doctor switched me to Opana 5mg...It basically does the same as my Oxycodone IR 5mg did
  • Hi Kathy

    I've been on oxycontin for nearly 5 years. A few months ago I weaned off it. I only managed a short time of it and the pain was unbearable so I had to go back on.

    In theory you can be on it indefinitely, one of the benefits of opiates (without tylenol or anything added) is that they are not toxic to the organs.

    the big problem of course is tolerance. And that is unavoidable. Unfortunately I now need four times what I used to to get the same amount of relief.

    I would simply explain to your surgeon you have concerns for your liver being on tylenol constantly and ask if he/she can suggest another option. Always best to put it that way than to ask for a med straight out.

    Best,
    Beka
  • My 5 mg. Oxycodone has no tylenol in it. I was on Vicodin for yrs but due to the tylenol I was put on this.
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • Kathy, your story sounds like mine. I had a lumbar fusion 5-08 and i am still in severe pain. they can't pinpoit it. I was just switched from hydrocodone to 15 mgs oxycodone ( no tylenol) 5 per day. It has made a world of difference. I don't want to take drugs forever but I am sick of being in pain, i too have had 4 esi's and the last one the Dr hit the nerve with the neddle(I nearly jumped off the table)
  • dilaurodilauro ConnecticutPosts: 9,714
    medications:

    1- Opana 5mg for Pain
    2- Neurontin 1200mg for Nerve Pain
    3- Soma 350mg 4x day for Muscle spasms

    I am also heading in for complete shoulder replacement surgery soon, so, I am afraid, but I know that the pain medication dosage will soon be going higher
    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
  • Hiya Kathy :)

    I hope your doc's are able to pinpoint your pain so you can get some relief!

    I take oxycodon 15mg every 6 to 12 hours. Usually 2 to 3 a day I'd say. It is with out tylenol. I also konw they make 5mg with out tylenol as well. I was on them awhile back. I also take oxycontin 30mg 3x a day and neurontin 2400mg a day. Have you tried neurontin? I deffinately notice a difference if i'm late with the medication. It is specifically for nerve pain, it started out as an antiseizure med and they they found it's analgesic properties. Sometimes for my 6am dose if i'm still feeling sleepy I'll just take my long acting oxycontin and stool pill and skip the neurontin and bladder meds for an hour or 2 to get some more rest. Although the oxycontin helps the pain, I deffinately notice a difference til I take the neurontin. Maybe that might be something to ask your doctor about.

    Hope all works out :)
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,728
    Look at my reply to your other post. Hydrcodone.
    Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I'm sorry to hear that you are in this type of dilemma that a lot of us here seem to suffer from. I know it's not easy to try to figure out where the pain is coming from, esp if it's from multiple sources. I also continued to have severe pain despite my surgeries and mine comes from scar tissue, nerve damage, severe DDD, etc (as far as I know) :?

    Well, I started off on Norco 10/325mg for BT pain and ended up on Oxycodone 15mg every 6 hours. It was certainly cheaper to pay for 120 straight Oxycodones than 180 Percocets when you take 60mg a day. Anyway, I found it to be stronger than Percocets and it comes in handy when the pain flares up. I also had surgery to put in a Dilaudid pain pump and currently I'm weaning off of Methadone. I know this will be more effective than relying on oral meds and it does however take some time to work things out such as titration.

    I guess I have come to terms with the fact that I'll always have back problems but at least I learned through all my experiences to not give up. There are other treatments out there- they can't get you back to how you were before you hurt your back but they can help you to live life differently and manage the pain. Anything is better than being stuck at home, bedridden and isolated...this is what I tell myself now. Take care Kathyy and I hope that you get all the help and support you need. Hugs, Meydey >:D<
  • You and I are about at the same point. I had my PLIF 2 level on Dec 11,2008. I am still in serious pain. I have a fentanyl patch 100 mcg every 72 hours and also take 30 mg of oxycodone every 4 hours for BT pain. My pain meds have been at the same level since my surgery. And noe they are not cutting the pain.
    I am going to see my Ortho on Tues. He wanted to give it until May to see if having so many surgerys that last 2 years has slowed down my healing. I have been pretty much housebound for the last 2 months and nothing has changed, in fact I think it is worse,or pain meds are wearing off too soon.
    I hope that he can find something to fix. I had another disc that was somewhat compromised, and wasnt fused. I want to figure out if this is the problem. And get it over with. It is a long road, as you well know. You and I and Gwennie, seem to be in the same boat. I hope she gets her surgery, as if it is postponed it would suck.
    As far as the oxycodone, it is a short acting type. You might want to talk to them about something that lasts a little longer for you. Thats where my fentanyl patch comes in. Good Luck, and if I can help, please let me know. Take care, Love Robin
  • You can be put on Oxycodone that doesn't have acetaminophen in it-perhaps mention to your Dr that your concerned about long term effects on the liver? I had to be switched from Percocet 10/325(oxycodone w/tylenol) to Roxicodone 15mg (oxycodone w/o tylenol) because my liver enzymes are high, so yes, you absolutely can get it w/o the acetaminophen in it. (I also had to quit taking ibuprofen, which I had been taking 600mg 3-4 times per day and it did help when adding it to my other meds, but because of the liver enzymes I decided to just deal with the increase in pain from not taking the ibuprofen anymore.) Better than losing liver function, eh? ;-)

    I'm sorry that you still have to deal with pain...more and more people keep joining us here at SH, which shows me that more and more of us are IN pain! That sucks! I wish that I could just take the pain for all of us and then it would just be ONE person in pain!

    I'll keep you in my prayers for some relief and protection for your liver-both my PCP and my Pain Dr agreed completely that we need to protect our livers, so I would think if you asked to be switched to Roxicodone (or something similar) that it wouldn't be a problem since your concern regarding your liver IS a valid concern.

    Keep us posted on your meds, progress, etc., OK? I hope you can speak with your Dr about this soon. Let us know! :-)
  • i used to take percocet 10/325 and i had the same concern about taking tylenol everyday for a long period of time. So my doc switched the med to oxycodone 10mg, the only problem was i tried a couple pharmacies and no one carried it. So they had to special order it and it took a week to get. If your doctor does change your meds ask him if he knows if the pharmacy in your areas carry that med. i had to switch back to the percocet in the end because no one carried it without tylenol, kinda dissapointing.
  • you need your doc to write the Rx in 5mg form. Plain oxycodone only comes in 5mg or 15mg forms, not 10mg. My concern was the excess Tylenol as well from Percocent b/c I took 10/325 every 6 hours for BT pain. My doc changed me from that to 5mg oxycodone (take 2 pills every 6 hours)...so the quanity was high, like 242 per month. Now, recently I had to go up b/d tolerance and went to the 15mg oxy every 6 hours. YOur doc jus needs to be willing to work with what is available.

    It's perfecly fine to ask for something without so much Tylenol b/c it is toxic to the liver. God bless
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