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Torn over what to do

I'm currently taking 60 mg of Oxycontin per day. My PM no longer believes in giving meds for breakthrough pain. That's what is putting me down right now! The Oxycontin does okay for most days, but if I over do it, stand too long or sit too long, it flares the pain up considerably.

The NP I see said she would adjust my maintenance drug to something stronger therefore keeping the chances of breakthrough less. Most likely, I will go on Opana next month.

Question - should I ask for a referral to see a different doctor that does prescribe for breakthrough pain for when I need the extra help or stay medicated with stronger drugs all the time?

I'm almost getting to the point where working a full time job and managing my pain is getting hard to do. My employer has already made concessions based on my medication and I'm not sure how much further they will allow.

If my PM would simply change his approach to prescribe for breakthrough pain, it would make things so much easier. I really like his staff and they work with me very well. I will hate changing doctor's, but I'm beginning to think that's what I may need to do.

I've read a lot about Opana and I'm not sure it sounds right for me. I'm only 46 and I'm afraid taking stronger meds at my age is going to be problematic as I get older.

Any thought's?

Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2


  • Keith, Im sorry you are having to go through this. It seems it has been an issue for you for sometime. We had discussed working in the medical field makes it hard dealing with pain meds. I believe if it were me I would try to find someone who would give the breakthrough meds. I can't imagine why a doctor wants you to go to a stronger med so he doesn't have to prescribe a breakthrough med. My brother is 61 and he has been on pain meds for past 12 yrs. and started out on some of stronger meds and now is on a pain pump and pain is not controlled very well most of the time. Just my opinion but I would want to try to stay with my breakthrough meds. What would happen in a few yrs. if you build up a tolerance to strong meds and doc doesn't want to write a Rx for stronger drugs :/ Im sorry and hope whatever you decide works for you.

  • Hi EMS Guy
    I am taking opana. It was origionally rx-ed with the 12hr extended release, but that one scared me too much, you HAVE to READ everything about the ER meds especially opana ER (extended release) This medicine has a serious potential to make you overdose if even one teaspoonful of alcohol is taken, for example a spoonful of cough medicine or a SIP of wine or beer or mixed drink. What happens if you get sick and need cough medicine?

    The ER version of this med scared the bajeebers out of me, so I asked if it could be switched to something different. I went thru a few meds and ended back with opana, but the 5mg no ER It was perscribed 4 times a day, then increased to 10mg 2 times a day. I think it was more helpful taking it 4 times a day vs 2 times a day..nevertheless, my pain levels have not been managed well, and any activity more than just being at home and switching from sitting to standing to laying down, the 10mg will not cover my pain levels if I decide I have to go do errands or have to go to the grocerystore and then try to put groceries away...cooking after that is out of the question after all the walking and just a short grocery list.

    The opana is a decent med if given in the right doses. I do like that it does not make me feel "high" or goofy, and upon the first doses I thought it was going to help pain levels, maybe it needs to be increased to a different level but so far I am not pain free and fear the thought of coming off these meds for fear of pain increasing more than I am aware of being controlled. So far I have only experienced that "high" once when switching to a different muscle relaxer and do not like it at all so this med was for me good at the beginning, I do think I build a tolerance to meds very quickly though. Maybe give it a try before you switch doc's it might be a good thing for you and you just dont know it, I have read many stories of people getting good relief from opana...
  • My PM's APRN didn't change medications. Kept me on what I'm taking, but is going to do a 5 level facet joint injection session in a couple weeks. She did give me a prescription for Oxycodone 7.5 to help me out between now and when they do the shots.

    We both talked about switching me to something stronger and I told her that I'm a little afraid of going on something that strong at only 46 years old. I'm going to have back pain the rest of my life and at the rate were going, were going to run out of options for pain control. She agreed and that's when she recommended doing the facet injections again.

    I've had facet joint injections before. They have always focused on L2-L3, L3-L4. This time, I'm getting shots at L1-S1, both sides. If this doesn't get it, I don't know what will.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Have you discussed trying a patch? I have used a Fentanyl patch for years. I change it every 72hrs. It made a HUGE difference in not dealing with the lows of taking a pill every few hours and controlled the pain much better. You can start on low dosage and see if it works. I have been on same dosage for two years and only recently have thought about changing either dosage or pain med. Good luck and hope you find something that works for you. I was hurt when I was only 48 and have been on pain meds. for 9 yrs.
    L3, L4
    Fibromyalgia,Chronic Fatique
    Severe Osteoporosis
    Undiagnosed Leg pain
  • backache99backache99 Posts: 1,338
    edited 04/13/2013 - 12:01 AM
    you and i are the same age and i take 3x80mg of oxycontin and 6 times 20mg of oxynorm a day ! .i also know someone with the same prescription as me and now we have the problems you fear BOWEL PROBLEMS .all of a sudden mine have stopped working and i am worried sick i see my doctor next Tue .the problem with intractable pain is the medication that many of us are on was meant for terminally ill patients ...so it did not really matter so much if the medication eventually killed them .but i don't want to die and i am sure you don't .i will now have to have some nasty tests done and i will more than likely have to either come off narcotics or drop down a lot ..this will be hell its self ...my advice to you is ..if you can don't go UP the pain meds ladder because coming down from it can make your life hell.i too am torn because i still need pain relief from my spine but i don't know if you have ever had bowel pain ??? its as bad as post op pain . i thought i was going to die about two weeks ago and ended up in hospital .i have since had to have the doctor to my home and i have not been able to eat properly for a week ..Keith do anything you can to avoid ending up in my situation please !! .i have got so much to live for .i am a new granddad i have just bought a new car i have a holiday booked and many more nice things as you would expect to have in early middle age .but unfortunately sometimes we forget that 50years ago a 46 year old man was getting old and it was normal for many to die around 60 nowadays a 60 year old can look as young a 30 .i myself don't look 46 many say late 30s .but however we feel and look our bodies have been put through hell with operations and medication and it dose damage you ..its just that we can't see it ..take care my friend
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • I started out w/ a low dose fentanyl patch. My doc prefers this med because of its low side effects. So far I have not had any side effects from the fent. patch. Other than constipation. Any narcotic you take can and will cause constipation...to the other poster. I too have problems in the L2-3 L3-4 and get horrific stomach pain also. Part I think is from the muscle spasms and the other part is that the muscle relaxers stop the movement of the intestines. SO with any pain med we all need to be taking gentle stool softeners everyday. For me exlax will make me go if I take it 3 days in a row, but the back up from not going is really painful too...add on top of it being a lady w/ monthly problems and the pain levels skyrocket..so do wht ever you can to make sure you can go to the bathroom on your normal schedule, because this increases pain.
    I so dont want to be in a pain management system forever and I dont think they really know all the damage this stuff causes. To me its all poison, just pick what you can tolerate.
    The fentanyl pain patch might be a very good option for you. Like i said I had no side effects from it. Just put it on, on the weekend so you can get a feel for how it will help you. I take soma, fentanyl 50mcg opana 10mg 2x's a day and 2400 of gabapentin divided into 2 doses,
    I do get good pain control for about 2-3 hours w/ the opana and wish he could increase it to 3 or 4 times a day. But at the rate we are going w/ my increases I am gonna run out of options soon.
    Opana comes in different strengths so do some research. I think maybe you might like the opana, no funky "high" feelings for me at all. I still drive even on these meds but am concerned if I get into an accident what will happen???? I know how I react and feel like I still have good reaction times. But cant multitask driving like I used to...lol
    So before you rule out a med, maybe give it a try first. I hope some of my rambling info is of some help to you.
  • My doc was gonna do facet injections on me but changed his mind and offered scs instead. How were the facet injections for you? Did they just diagnose pain or help to reduce pain?? I understand the proceedure is painful also. Can you fill me in on your experiences
  • I've had multiple facet joint infections in the past. They do help out. They've tried doing RFA twice and it didn't really impress me.

    I'm hoping that the injections bring me down to a point where I can come off Oxycontin and stick with Oxycodone PRN. If they don't, I'm not sure what my next step will be.

    I can tell you one thing; extreme weather changes like we are having now is really "F"ing me up! My surgeon said the titanium rods would act like barometers when the weather changes and he wasn't kidding.

    I'm due to get the injections in less than two weeks. I'm hoping the work!

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • RickilalasRRickilalas Posts: 559
    edited 04/13/2013 - 10:12 PM
    Hey bud
    I have read many of your post but did not have much to add. On this thread I would suggest trying the injection for two reasons.one pain relief and two they help with a decision on what is wrong and does show more information as to maybe another procedure to help you out. I have had every injection and Rf done in many places. My injections showed that a SCS would be of help for me. I know not everything works for everybody but its worth trying anything to have a some what normal life.
    Trying to just get by on pain meds does not do us much good as it only mask the issues and give some help for a short time.
    You already know that work is making it worse and will continue to make your spine worse.
    I was a fool and tried for years to work through it and guess what that this does not work. I have to change my meds out a few times a year or they stop helping. I have been up to three narcotics at a time for a long time. A few months ago when I went to Pain management he could tell I was at he end of the road and could not take much more pain and want to stay around.
    My idea to keep working ruined my life for good now. My profile pic shows how compressed me cord was at C6 and C7.
    This was something I did not even know I had a problem with. My pain was my lumbar issues.

    OK my point is if you want to get better or maintain where you are without getting worse its time to think about a easier job or feel the doctors out about SSDI. My doctor had me wait till I was 50 years old because under that it is hard to prove you can not do any work at all. I love it they claim most back issues can be chicken sexers and work a full day doing so.
    I am like you and wanted to keep working which was the worst thing to I ruined what spine I had left and trust me the pain you have now is'nothig to the pain in your future if you if you do anymore damage.
    I am back on the fent patch 75 plus oxy 10s and SOMA 350 to just get by without doing much.I still have pain and a very limited life. Dont wait to long see if a scs may help or maybe even a pain pump which cuts your meds down to about 1/300 of a dose of regular oral meds. Stay on it and just try somethings while you still can. Remember I waited to long and pay the price every day.

    Catch you later
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