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Just wanna pain med that works!

EmmyEEmmy Posts: 29
edited 06/11/2012 - 8:50 AM in Pain Medications
I have been switched from pain med to pain med so often lately that my head is spinning.

I just started diluid 2mg last night and just like the other meds it works for about an hour and quits. I had just started oxycodone 2 weeks ago and I really did like it but it didn't last very long. I was taking 10 mg 3 times a day. Prior to that I was taking hydrocodone 10/325's 4 times a day.

I told my pm that I thought that if they just upped the dosage on the oxycodone a bit, especially in the morning, that I could get a hold of the pain before it got out of control but instead he puts me on this diluid (sp) 2 mg up to 5 times a day. Its making me loopy and barely touching the pain. Oh why doesn't he take what I say in to account? I feel like he is giving me just enough to chase my pain all day.

Does everyone else have a hard time finding something that works for them?? This is getting to be tiresome and I have been missing work because of the pain as well.


  • dilaurodilauro ConnecticutPosts: 9,827
    Upping the dosage of narcotic pain medications is something that needs to be taken very seriously.

    So many think that if my doctor increased my dosage, I would be fine.

    There is so much more to pain management and control than most people realize.

    The most important thing to do is to work with your doctor, discuss your situation, ask for alternatives.

    Take a peek at: The Blend Here is where I talk about the complete package to pain control.

    So many people feel that if they were given the higher dosage that their pain would go away. That is the furthest from the truth. Pain medications are designed to help control you pain, not eliminate it. Sure, if you were given enough pain medications, you probably would not feel any pain, but then you wouldn't feel anything being a zombie.

    There is a lot of trial and errors to come up with the right mixture of medications to help you.

    Many folks here have been living in chronic pain for many years and fully understand where pain medications fit in and how they are used. One person comes to mind, Jon (terror8396). He lives in chronic pain, fully understands the medications he needs to take and has always continued to work and be fully productive.

    Its not easy, at times it can get depressing, but it is something that we need to do.

    Dont give up, there will be that "Right Blend" for you. Hopefully, that will come sooner than later.
    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 understand that the pain medications are not going to take the pain away completely and that finding the right blend will take time. I am getting frustrated at the process. They flushed my oxycodone when they wrote my script for the diluild (sp)and then yesterday, when I called to say they were not helping the pain, they brought me in flushed the diluid down the toliet and wrote me another script for oxycodone upping it to 40 instead of the 30.

    The pharmacist was totally confused about the whole thing. She said I shouldn't be out even if I were taking 4 a day. I finally confinced her that indeed, my pm doctor had gotten rid of my other meds when he had wrote the new scripts. My insurance company on the other hand was not so understanding and would not pay for it so I payed out of pocket. I don't like the pharmacist is looking at me. We used to have a good relationship but I'm not so sure anymore. Maybe that's all in my mind.

    And then there is the $35 copay everytime I have to go in to have a med change.

    I am new to this pain management so please bear with me.. Emmy

  • I just read your article on The Blend and it was very good. It's great that you have taken the time to share it with everyone.

    I have had all the injections and none helped. I do take effexor for the depression, gabapentin for the nerve pain, baclofen for muscle pain and remeron for sleep and anxiety.

    What I would like to get is massage therapy and I forgot to ask the doctor if he could write me a script for this. I get plenty of exercise and I like to think I eat right. Getting the pain meds right is what I feel I am working on right now.
  • Emmy, once the doctor settles on the right amount of medication that works for you, you should notice a difference. There are many elements in pain management, but prescribing the right amount of pain medication is essential. When starting out, doctors often prescribe in doses far too small to be effective. Hopefully you and your doctor can soon find the best dosage/combination for you - good luck.
  • It's best to give this medication and yourself, some time to adjust. If you continue calling your Dr. and going in he may get frustrated (as well as yourself), and I understand that you are frustrated, but you cannot give up on yourself, your Dr. on the other hand, might look at this in a different light.

    Because you are new to PM you may not understand, but most PMDs do expect us to give these new medications a chance. "They" say that a 7.5 oxycodone is *about* equal to a 10mg hydrocodone, so you have had an increase in your medication. Your Dr. (most likely) is not going to increase your medication again very soon, and it would be in your best interests to give this a good try.. not calling for a change, early refill, or appt change.

    You mentioned that you were put on oxycodone 2 weeks ago, liked it, but it was not lasting long enough. Now you have 4 instead of the 3 that were initially Rx'ed. Hopefully those, along with your other pain relievers are enough to manage your pain for awhile.

    I find it easier when I find things to do that will pass the time, thereby not watching the clock for my next dose. Sometimes I am pleasantly surprised, but usually my pain is the reminder that it is time...still, that's better than sitting there listening to the tick tick tock of the clock on the wall.
  • I did ask my doctor if he had any other patients that were having difficulty finding the right meds and he said he did and that it was no problem with me calling and saying they were not working. This last time I called was because we were approaching the weekend and I did not want to go through the weekend in pain. I usually give it a better chance than I did this time.

    I don't watch the clock, I listen to my pain and let it tell me if its time, and then check the clock to see if its time. I work full time so the time passes rather quickly.

    I am new to the Pain Management but I am not new to pain. I have been dealing with this for over 3 years now. I have had 3 mri's, 2 ESI, trigger point injections, injections to see if I would be a good canidate to have a nerve block and another injection to see if I was a canidate for a old/new procedure. (can't remember the name). I have been to PT, a nutrionist, massage therapy and I'm sure I am forgetting something.

    It's not like I havn't tried a few things and I am not totally stupid when it comes to dealing with doctors as I have delt with quite a few over the last couple of years. I only call it as I feel it, nothing more nothing less.

  • Okay then, but you did mention that you were new to PM and I was honestly only trying to be helpful. I have been dealing with CP for over 25 yrs, and if I feel that I can pass along some advice that *may* help a person, I like to do that.. thinking (in my mind) that I am somehow being of help to that person. I never meant to imply that you were less than intelligent, only that PMDs have ways that are not always (or sometimes at all) the same as our regular Dr(s). I hope that you find the best relief that I'm sure you deserve.
  • It's great that you have a supportive doctor. I'm sorry that you're having trouble with getting the medication doses right. I would wait until your next appointment to tell the doctor if the 40 mg. works well or does not. Even though the doctor said that you can call anytime, I would still wait it out.

    I understand how frustrating it is to have pain all of the time. It is important that they get your doses right, but it does unfortunately take time. If the 40 mg. is not effective, I don't know what your doctor will do. He may move you to a long acting medication, he may move up your oxycodone, or he may not do any increases at all. It depends on the doctor.

    It's a long process in the beginning, but it will get better!
  • with my PM doctors and any med changes, he likes to have the patient wait at least two weeks before making a decision about whether or not it is helpful in managing your pain levels. He also likes to see a reduction in pain levels of 2-3 points on the pain scale. Most pain meds help to some level, maybe not as much as we would like but they do offer some level of pain relief.
    When talking with your pm doctor , maybe saying it relieved my pain xx amount on the pain scale or before taking my medication, I was xx on the pain scale, after taking it , I was at xx level. This gives him a visual representation of the effectiveness of the pain medication and you can also tell him the length of time that you got relief for.
    I don't know what your "normal" pain scale levels are like unmedicated but the pm doctors that I have had have said that a reduction from a 7-5 is what they shoot for. A "5" is pain that can be managed by taking some motrin or advil, along with your pain meds. At least that's what my pm doctors scale says.
  • I apologize to Robin, I know you were just trying to help, so please accept my apoligies.

    I do think that the 4 oxycodone is covering me most of the day, so I will stick with this.

    Off topic. When you switch pain meds and have some left over, what does your doctor do with them? The pharmacy was totally surprised that the doctor tossed them. With me as a witness I might add.
  • I hope you witnessed your Dr. tossing out your leftover medication. This is a controversial subject because it is illegal to dispense our medications to *anyone* other than who they are originally Rx'ed for, that includes your own Dr., unless, as I mentioned above, you actually witnessed him dispensing/discarding of them. Ok..lol, I just re-read and see that you did witness the disposal of your medications.

    This makes a lot of patients angry, because you did pay for those medications and by law they are yours. However, if you are changing medications a lot of Drs don't feel comfortable allowing the patient to have both the new and the "old" med, the old which is no longer useful to the patient for fear the patient may (possibly) make bad choices, ie; extra meds can cause overdose, company(home visitors) can steal them, you could use diversion, etc.

    I'm glad your medication is helping your pain most of the day for now, and I do understand it's a long process. I always remind myself on my bad days of how it felt before I had any relief and that helps me to feel more thankful, even on the days when I don't feel as though I'm having much at all.
  • Hi Emmy

    I can share your frustration with finding the right medications. I've been on my latest round of this for about 5 months now with no real luck. And the side effects have caused lots of new problems.

    It is a slow process trying new meds. My doctor insists on starting with very low doses and speaking with me on the phone each week before I increase. We have a great relationship and discuss the pros and cons of each meds and make a decision together. I've never had him ask for meds back and have to say I am pretty shocked by that. I have never had a doctor do this.

    You mentioned that you have been in pain for several years. What have you been doing to manage the pain before this doctor? Are you just looking for better management of the pain or has your situation changed in some way?

    I'm glad to hear that you are finding some relief. But keep in mind that medications need to be constantly monitored and adjusted under the guidance of your doctor. Your body and your life is constantly changing.
  • Medications are no longer allowed to be flushed down the toilet or put into a sink. EPA ruled against it saying it was polluting waste water. Makes no sense to me since it is diluted anyway. But, drugs can be turned in to specific collection sites. They are regulated by the DEA. I run an ambulance service and we have to send all medications if they expire before we use them to a specific company that correctly disposes of the material.

    I'm not a lawyer or doctor, but I don't think the doctor can make you destroy the drugs in front of them. As has been noted, you paid for them. But, it's also your responsibility that they aren't used for illegal activity or diversion purposes.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • That's right - I forgot about that new ruling against flushing meds down the toilet or drain, but the Dr should not have forgotten. If medications are taken in to the Drs office for disposal they are supposed to be put into the sharps container, witnessed, and signed by two witnesses(the patient being one), usually a nurse is the other witness.

    No, the Dr can't MAKE you bring your medications in to be destroyed, but he can refuse your new Rx without them, and he can DC you for non-compliance of his office policy(s).

    I have never had this happen either. Now that I think about it I don't think I have ever changed medications (opiates or controlled substances) midway through, it has always been at appt. times whenever my Dr has made changes and even then it hasn't happened very often.
  • Emmy,
    I have researched academic PM for twenty years and never seen any evidence that medication alone is the panacea for the pain we endure, accumulative simultaneous strategies, are suggested as the best possible notion for managing pain and the desire to find one medication even at increased volume will not manage our pain sufficiently, we all diminish in function as the volume of medication increases and we have to find our own balance between function and pain relief.

    One would expect any change of medication to be introduced slowly and give sufficient time for any benefit or detriment to be evaluated, finding what works for us as individuals is a very personal, just as treatments or even surgery. Eventually perhaps we all come to some compromise with what works for us and as we change our strategy need to mirror those needs, I have yet to find an adequate overall plan that caters to my needs, the moment I seem to get closer the more advanced that carrot evades me.

    Pain is emotional, imparts frustration anxiety and disorientation, skills and techniques of coping take time to develop, those more able are not in less pain, rather they micro-manage the whole process more effectively. It is not easy waiting in pain for those expectant improvements that sometime do not materialise, did we expect too much, managing pain itself can be an illusive objective, that seemed simple when we set off.

    If we are doing all that is asked of us, we can do no more, for many here recreating who we were is a distant memory, as the new unfamiliar us emerges.

    Take care, we are here to help each other.

  • I applaud you, and hope that someday I can reach that "balance" you obviously already have...very inspiring..
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