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How much is too much...

sonofjorelssonofjorel Posts: 5
edited 06/11/2012 - 8:24 AM in Pain Medications
I have a question on how much is too much pain meds and long term effect. I have been coming on the board for quite a while I don't always post but do a lot of reading and have to say this is the best board I have found.

I have a a herniated disc in my lower back I believe it is the L5-S1 area. My spine is narrowing at the base which pinches the nerves. I have had several shots and also nerve ablation done on six nerves in my lower back. I have been on Lortab 5/500 one pill four times a day for about two years now. I have also been on Flexeril, Skalaxin, Cymbalta & tried Neurontin as well to work with the Lortab. My pain level has started going up and I think it is due to the nerves growing back because it has been about 9 - 10 months since the procedure. My doctor just increased my dosage of the Lortab to two pills four times a day. That is now 10/1000 four times a day. She said she didn't want to go to the Percocet yet because she wanted to maximize the Lortab. She said that my body will build up a tolerance to it and I will need to be on Percocet later and wanted to hold off so I don't build a tolerance to that so soon. I have read on some other threads of some of the other medications out there and my doctor is great about helping my find meds. She never judges me or makes me feel like a druggie. She understands and has help me try several different medications and treatments.

My question is, Is that too much Hydrocone in one day? I know I am getting close to the acetaminophen level for a day. Should I ask for something else with a lower dose of acetaminophen? I have blood work done about every 4 or 5 months to check my liver and kidneys due to the medications.

Thanks again, it is great to have people that are in the same boat as I am. There truly is strength in numbers. It is hard to explain to my wife how it is to live in pain every single day. She asks me am I hurting today, I tell I hurt every minute of every day it is just how much pain I am in but we go on one day at a time.




  • Hi Scott,
    Sorry to hear about all your pain.
    Narcotics are very safe as long as they are taken at the dosage perscribed. Sounds like your Dr is a good one and by getting your levels checked all the time is a A++++ in my book.
    Alot of Drs and or patients forget about that.
    4000 is the max for tylenol intake for 24 hrs. Now hydrocodone based products do now come in 325. Instead of the 500 so mabye something you want to discuss with them.

    Is your dr a surgeon or personal care dr????
    If you havn't seen a surgeon yet I would discuss your situation with them. Especially if you have all these treatments done already and your still in pain.
    The L5 S1 area is very common for injury.
    Has surgery been mentioned at all???

    So anyways I answered your question about tylenol. Let us know if you have been to a neuro for the spine or a ortho spine specialist to get their point of view.

    Hang in there you came to the right spot!!! We are here to support you in anyway we can.
    All advice given is strictly personal as we are not medical professionals.

    Take care and so glad you joined our group!!!
    Terri O:)
  • opiates? Have you considered them. They are great for long term use because they do not effect your organs like the short acting meds. Usually dosing is once or twice a day and most people get great relief from them. Just a suggestion but that does seem like lots of acetaminophen to be putting in to your body. Do you have your liver function checked on a regular basis?
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  • Oxycodone comes in Immediate Release forms that have no Tylenol/Acetaminophen in them at all. It might not be a bad idea to look into the 5, 15 mg and even the 30 mg Oxys. This way, you don't have to deal with the Liver issues. I understand that pretty soon the FDA is fixing to approve a long acting Hydrocodone without the APAP. That would probably help you too.
  • I wonder if I can get my doc to go another route...

    I don't know how easy it is to get on with a pain management doc.
  • Hey Scott,

    I have taken both a long acting med (Oxycontin) and an instant release or breakthrough med (Hydrocodone) for several years. I used to take hydrocodone in the form of vicodin, but since the vicodin version's lowest mg count of APAP is 500mg, my doc switched me to Norco, which is available in 325mg APAP doses.

    The beauty of having a long acting med, like Oxycontin, is that it gives you a more steady release of medication over a longer period of time. (with no APAP) Most patients who are prescribed a LA med, also are given an instant release med to cover any breakthrough pain. My doc is a firm believer that even with the LA meds, we all do things throughout the day to cause spikes or flare-ups in our pain. This is what the BT meds are for. I take mine, only as needed. Some days I might take 2 and some days I might take 4. It all depends on how active I am in the course of a day. (I take the Oxycontin 3x/day)

    Since your doc seems to be quite open minded and obviuosly trusts you to be med compliant, this seems like it might be a good option for you. I know some docs have a particular aversion to Oxycontin, because it's had some really bad press. (Undeserved, in my opinion) But there are other time released meds available too. There are a couple of relatively new ones, one of them being Avinza, which is time released Morphine Sulfate. It is supposed to be a once or twice per day dose. I haven't had any personal experience with it, but there may be others here who have.

    I also give your doc an A+++ for doing routine liver enzymes on you. My doc does them every 6 months or so. I hope you can find a regimine that works well for you and keeps you at the safest APAP levels. You didn't mention whether any new injections are ahead. Is that something your doc is thinking about? I haven't personally had any luck with injections or epidurals. I really envy those who get help from them.

    I wish you the best of luck. Please keep us posted as to your progress, OK? Take care and be well. Mitzi
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  • Hi

    I have been on Vicodin 5/500 3x-4x a day for 10 months now. Thursday I asked my Doc to switch me over to percosets whoice she did.

    From thusday to sunday I went through a mini withdrawal. Even though I was taking the percosets and they were stronger I still really wanted the vicodin. I felt really weird for those 4 days. Anxiety high. Eyes puffy and irritated. Etc. Did I mention I really wanted those vicodin back!!!!!

    My plan is to go back to the Vicodin in 8-10 months when the percoset at the current dosage becomes inadequate. I'm really trying to keep my dosages/usage low for as long as I can.

    Being on 40mg of vicodin a day seems kind of scary to me at this point. I can feel the impact/want/need at 20mg a day.

    Guess we will see how it goes


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