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Update and questions regarding medication

Hi everybody.

Again, sorry I haven't been around - I've been working on dealing with my lumbar issues. In my last update I talked about the pain I was having at L2/3 and L3/4 area with no nerve pain and a missing disc at L1/2. When I saw my surgeon (actually, his PA) he had me try the injections and then said if they didn't work, I'd need to consider a rhizotomy and then on to a 5-lvl fusion.

So at my follow-up after my injections, I actually saw the surgeon and he spent a great deal of time with me, explaining what was happening, going over my MRI and talking about next steps.

First, he put my on oxycontin, which I really didn't want to do, but KarenD explained to me exactly what the surgeon did, that my pain was spiking and my taking Vicodin 10/325 6/day (sometimes 7) was not the way to deal with this unrelenting pain. I tried taking the oxys yesterday while I was at work and after running into a few doorjams, not able to calculate simple mathematical equations and an overall saggy feeling, went back to my Vicodin regiment. I'm off work today and don't go back until Monday, so figure I'll try the oxys over the weekend and see how I do.

That's where my question comes in: does the oxy side effects get better as you take them regularly? I do have the Vics for breakthrough pain, allowed 3 a day, but don't know if I need them yet.

My surgeon also said that he wants to do a 2-lvl fusion at L2/3 and L3/4, not the 5-lvl the PA said. My surgeon said that the L1/2 isnot causing problems at the moment and the fusion is because the L2-4 is very unstable due to spondylolisthesis and the facet problems. It's scheduled for Dec. 18, although I can cancel at any time.

Anyway, sorry for the long post but any suggestions and answers or advice about the oxys would be appreciated. I'm not in a good place right now and am extremely frustrated.

Thanks friends.


  • YEA...I can finally post again!!! I've been trapped the past week or so in this strange limbo of being logged in one second but then not showing it when I came to the boards...have emailed...PM'd....and gotten no response...Sorry to hijack as I came to answer your question but I bet there are others like me having issues:(

    Cath...I'm glad they have move you to a long acting medication as yes...if you were having to take more than 3-4 short acting a day, every day...that is the next step in better pain mgmt. as you aren't chasing the pain all day.

    Is your prescription once every 12 hours or every 8? I personally had great succes with Oxycontin and only had to go off it because I lost my insurance after my divorce and they generic patent ran out...

    With any new medication...there is usually a settling in period with a few side effects like the grogginess or a bit of fog. This should go away in a few weeks.

    My Dr. has always told me to give a new medication at least a month of taking it each day. Obviously this is barring any emergency reactions that need medical attention.

    When I moved to MSContin I had the same thing as you. Along with some nausea...thankfully it all went away and I cannot tell one bit except a lowering of pain level that I take the medicine. With long acting ones you shouldn't feel the rush of pain relief like you do with short acting because it's so slow.

    And I am VERY happy to hear that the actual surgeon is not recommending a 6 level fusion! That would have been insane and only should be done under dire circumstances of someone who is in a terrible accident, lying in the hospital ICU and rushed to surgery....

    And obviously they do not feel any of this is emergent with scheduling so far out in December...that gives a lot of time and with using other modalities every day/week/month from injections, massage, exercise, PT, aqua therapy, acupuncture, TENS unit...etc. There is even a chance that some of it could get better by then!

    Keep in mind that what you read on the boards here or anywhere online are people who are in the percentage of having chronic pain. There are hundreds of thousands of people who have bulging/herniated disc, bone spurs, and all the issues we have that resolve on their own or with non surgical means as well as they don't have the same level of pain...

    I've had 3, two-level, cervical fusions and still have 3 herniations at the lower cervical/thoracic and lumbar region. Along with all the similar diagnosis of spondy, and facet joint disease, etc. But I, along with my surgeon, agree that we will NOT be doing another surgery unless there is direct threat of paralysis.

    Because as you know...the more levels fused...the more pressure it puts on the discs above and below the fusion and can cuase more discs to herniate so it's a catch 22.

    As long as you are being seen by a Board Certified Neurosurgeon/Orthopedic surgeon and have gotten at least 2 opinions from BC surgeons about this surgery...then you can feel comfortable about the surgery. Being Board Certified is key as that means they have more years of experience and training.

    Another thought about the Oxy...make sure that you stay very well hydrated each day and if you dont' have any other medical problems like with kidneys and such...I drink close to 12-14 cups of water each day because narcotics are very dehydrating.

    And I also hope that you don't smoke as this is now known to cause spine problems and can make the recovery from surgrery less likely.

    Along with maintaning a healthy weight which is crucial to your spine and recovery as well.

    I really hope that your transition starts to smooth out with the Oxy and it provides good pain relief for you.

  • I'm on one 10mg every 8 hours, as my surgeon said that he found his patients start losing relief around that time so he switched from every 12 hrs to every 8. He said I will probably end up at 20 3x/day down the road. There is no non-invasive relief in sight, as the spondy is at two levels and severe. He said it wasn't a matter of when I have the surgery, but when.

    I chose the December date due to financial/vacation/time off reasons for recovery. I can use up what vacation/sick I have left this year then on Jan. 1, another 4 weeks of vaca kicks in giving me more time for recovery.

    I thought it was high time I was put on a long acting medication, but the stigma of oxycontin had me worried (we've known people that were highly addicted and would go to great lengths to get just one pill), but with the increasing pain I feel there's no choice.

    I've been on it today and feel remarkably well, just one breakthrough needed this morning after a walk with my little Wally in the park and up some hills. Otherwise, I'm doing well today. I'm amazed at the help this has given me and the lack of spiking pain.

    I'm aware of what goes on on these boards as I've been a member for years and was once an authority member when they existed. But thank you for your thoughtfulness.

    My surgeon is board-certified and fellowship-trained, he's the best. For me, whatever he says goes. He did my 3-lvl cervical fusion and my 1-lvl lumbar surgery but is not eager to jump into surgery. The problem is that my problems stem from a car accident I had over 30 years ago that started my spine collapsing before it finally told me starting with my cervical. It's going at an alarming rate right now, but I also have a very strenuous job that doesn't help much.

    Anyway, thank you for your help and kind words. I really need to get back on here and help others again. I've been wallowing in my own misery for a while and it's high time I stopped. Maybe with this pain relief, it'll be possible to do that again.

  • Thanks for sharing more....It sounds like you have a really good Dr. so that is I'm sure a great relief! I was just concerned about the 6 level part as that sounded very extreme..But I guess that was the PA and not this Dr. so that is good.

    It also sounds really good that this Dr. is willing to go up in dosage and is starting slow which any good pain mgmt. Dr. knows. I'm glad you are feeling good today:)

    I take my long acting medicine (MSContin) every 8 hours as well. Actually I have two prescriptions for 30mg and one for 15mg as some days I take all 90mg and some I can take 75mg if having a lower pain day. And then the OxyIR 5mg for breakthrough...

    Again...I appreciate learning more about you and sounds like you are not new to this type of surgery and have everything all planned out and set!

    I will continue to pray that you keep getting relief from the Oxycontin and the side effects subside. I do know what you mean about this type of medication....If someone had told me 11 years ago I would be on such strong medications like Oxy or Morphine I would have laughed in their face! That medicine was for dying cancer patients in my mind...

    But obviously we have all gotten here from years of pain and surgeries and I am thankful to have a wonderful Neurosurgeon and PM at this point too! Finding great Drs. is half the battle!

    Hope you have a low pain weekend:)

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