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increase in pain meds

alicefiveaalicefive Posts: 4
edited 06/11/2012 - 8:51 AM in Chronic Pain
I am going to my pain clinic tomorrow. I have been on the same dose of meds for over 1 and 1/2 years. I had two surgeries where they removed parts of the discs. The surgery worked for the L4 region but not the thorasic one. I have had the injections 3 times but it never really gave me any relief. I don't have back pain but terrible ribcage/chest pain on the right side. I am on percocet 10/325 4 X per day. It still works very well but the meds just don't last as long. The pain starts coming back after 4 hours. I have intense pain(a 7-8) for about 2 hours before I can take another pill. Has anyone had their percocet increased to this level? Did it make you too loopy? I can't take any other pain meds right now as I don't have prescription coverage and this is all I can afford. My doc wants me to go on a pain patch but every patch I have read about is too expensive, even the generic ones. Any suggestions?


  • If the doc wants you to go on a patch just so you know they should have paper work in the office to help you apply for financial assistance. As far as the percocet and the amount you still have a lot of room to work with it. The issue is getting to much tyelnol in your body. But your not that close at this point and time. Ask your doctor specifically about that. They can also prescribe if need be without any tyelnol in the percocet. But you still have room to work in that med. The doctor can also prescribe a ER med that will last longer so you don't have the highs and lows in the med, as your describing and use the percocet as a break through med to boost the other med.

    Be sure to describe the pain your having to your doctor and let them make the choice as to which way you need to go. You might also look at getting a muscle relaxer to see if that helps out. I am not sure if your using a tens unit but might be something also that will help out. Just be sure to let the doctor do the work. Good luck and keep us posted on how you get along.
  • talk to dr about meds for breakthrough pain. i take oxy 4x's a day and fenatyl lollipops for breakthrough 4x's a day also. breakthrough pain is well known and established when treating chronic pain. your pain dr should know about it unless he is hesitant in writing more narcotic scripts. a lot of people here use meds for breakthrough pain. talk to him about it and also use th e patch, the only problem i had when i was on it is that if i would sweat, it would come off. i tried to tape in on with scotch tape but it did not work. too expensive to through away and it also looks like you take too much. it works well, but if you sweat. watch out.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I'm interested to see what the doctor has to say when you see him/her today. I think you would get better pain coverage if you were taking a long acting pain medication like oxycontin. As Tamtam said, taking a med that gives you longer coverage without the highs and lows that come with a short acting medication like the Percocet you are now using would work best. Recommending the patch (if the doc indeed means the Fentanyl patch) seems like an awfully big step up from the Percocet 10 that you are taking now. Like others have said, you still have room to move if you stay with the Percocet. If I were in your position I would ask my doctor for a long acting pain med with something thrown in for those times when you have an increase in pain between your regular long acting dose. Getting away from the Tylenol is prudent - and as you probably already know, Oxycontin contains the same active ingredient that you are currently taking in the Percocet which is oxycodone. And, of course, the long acting version of oxycodone is oxycontin. Good luck - please let us know how your appointment went today.
  • He upped my percocet to 5X per day(10/325)but I could tell he was reluctant to do that. I think he did it because I cried. I have to go back in a month. He is really pushing an injection to try to control the pain. I had it done before and it lasted less than a day. He is worried about my liver and said he may try ER morphine. I don't understand why he wants to change it as the percocet works. I was pretty upset so I had a hard time understanding what he was trying to get across. When I go back in a month, what questions should I be asking him? I want to take in a list of written questions so I don't forget. Would the morphine be easier on my system? Would I be falling asleep all of the time? I am not sure what to do. I have to work as I am single and have to support myself.
  • The issue with going past 5 percocets is the tylenol in them; most docs really prefer to stick to under 4 for breakthough pain, and would prefer a sustained released med. such as morphine ER or Oxycontin altogether (Oxycontin comes in some low doses - 10 mg, that are supposed to last 8-10 hours). Given that most pain patients are also on muscle relaxers that can affect the liver, he/she has a right to be concerned.
    I went from percocets to morphine and can honestly say the morphine affected my mind/mood, and was much more constipating. (Keep in mind all narcotics affect different people differently). The good thing about morphine ER is the generic is very cheap, whereas there is no such thing as cheap Oxycontin or Fentanyl patch.
  • I agree with the people above who talked about Extended Release medications. I was taking the percocet prn, but like you, they would run out on me (pain coverage), and I couldn't stand the up and down roller coaster I was on each day. I went to ER oxycontin, and it really evened things out for me. I sleep A LOT - on the oxy, I sleep about 10 hours per day. If I get my 10 hrs, I'm usually OK. I also went on the morphine sulphate - I tried it a little while, because oxycontin IS EXPENSIVE, and the morphine was only a $5 copayment (for oxycontin, I have a $60 copayment). After one month, I went back to oxycontin - I'd rather pay the higher copay.

    Morphine - I slept 12 HOURS A DAY - and if I had a bad day and had to take muscle relaxants or whatever, - well the worst was I SLEPT 15 HOURS - and I think I only woke up then because my husband yelled at me! It also gave me cramps - and even on a daily basis, when I slept too long and missed my dose (was late) - Oh man, the withdrawals - I really felt I slipped into the Twilight Zone - I just felt awful!

    But everyone is different, and react differently to meds. But if he's giving you 6 or whatever percocets a day, and you're taking them everyday, I found the extended release Oxycontin was best - like I say, it really evened things out for me. The point I'm trying to make is that Extended release was a big help for me, and try the morphine if you're worried about costs, but morphine was TOO MUCH FOR ME!

    All the best Alice. Also read Ron's "The Blend" - a lot of us take a few different meds for different symptoms (the anxiety and depression can catch up on us over time too, and we have a little something for that - also sleep meds.) What about anti-inflammatories, oral steroids, "nerve meds" (e.g. lyrica, pregalbin, neurontin), muscle relaxers.

    Hope you get things evened out for you soon.
  • I was on oxycotin for a while and I couldn't afford it so they put me on methadone and thats the best thing i've found yet. It's cheap and works better than oxy's. I take 6 methadones, 3 klonipins, and 4 hydrocodones everyday.

    I still have pain but I can handle it most days.
  • and it takes a while for different meds to build up in your system.

    I've only been back on the Butrans patch (I think they're called Fentanyl is the US) for the past 2 weeks (I started on 5 micrograms per hour, then a week later went up to 10mgrs/hour), but I've been back to the doc tonight and will be going on 15 mgs/hour from tomorrow. I take Oramorph liquid for the times when my back is more painful than usual.

    I do understand all the pro's and con's with any medication, but as someone said, the side effects of any medication change with each individual. I wish I could sleep for 10 hours! but it doesn't happen. I'm lucky if I get 2-3 hours before I wake up again.

    I've tried many different medications over the years and these patches seemed to work for me in the past. Also, because they give a small amount each hour they're longer lasting (in my experience) and the patch stays on for one week, which is extremely convenient. When I do return to work (in schools), I don't want to be seen popping pills and don't have the opportunity to do so anyway.

    I'm waiting to have spine injections around May (I thought I'd finished with them when I had the fusion, it's a shame, but there's not much I can do about it), so I need something to keep the pain level down so I have a chance of returning to work and hopefully if the injections work, then I can reduce the patches down to zero!!!

    I really hope your doctors can find a medication, or a combination, that really works well for you. Persevere! I'm sure you'll get there in the end.
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
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