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Hi, my name is Justin and I am new to this forum. I am writing today in hopes of finding other people that have gone through what I am going through and maybe some insight that will help me with some concerns that I have. A long story short....In November of 2009 I injured my lower back. An MRI showed that I had a problem with two discs, one was herniated and one had a bulge. The pain was horrible, it started in my lower back and went down my right leg into my foot. I had already been taking Percocet 7.5/325 (2xday) since 2005 from a surgery that left a great deal of scarring on my chest wall. My doctor raised my dose from 2 a day to 3 a day and sent me to a specialist to have two epidural injections which did not help at all. After this failed to help we decided to ride it out in hopes that the discs would just naturally heal over time. Instead of healing the problem just seemed to get worse but my wife and I were having twins and there was never a good time to stop and focus on finding a solution to the problem. I was avoiding surgery because of all the negative things I have always heard about back surgeries.

Around July 2013 the pain was becoming almost unbearable. The three Percocet a day was becoming tough to get by on and it was very hard to make it last the 30 days. I talked with my doctor about increasing my dose and he said that 3 a day was his limit and he wanted to set me up with a surgeon to discuss options and a pain specialist. The first surgeon I saw would not agree to operate because he thought this had become a permanent problem because of how long I had the herniation. He didn't think a surgery would fix it. The second surgeon I saw thought he could at least make things more manageable and thought operating was worth a shot so I decided to do it. On February 28, 2014 I had a discectomy & decompression. It has been two months since the surgery and I have seen no improvement. If anything the pain has been worse at times than before. Since the surgery my surgeon has prescribed me 8 percocet a day for the first month & 6 a day for the second month. I am now in the process of finding a pain management specialist that I feel good about and this seems to be a very nerve racking thing for me. I have been taking Percocet everyday for at least 8 years because I had to have something to function and do everything that I need to do. I haven't really thought about it until now but I would have to say that I am physically and mentally dependent on this medication, for good reasons but still dependent. It has allowed me to do things that anyone should be able to do, like play with my kids and take care of them. I believe my anxiety comes from knowing that I am about to be with a new doctor (a pain specialist) and I have no idea what I am going to be given to manage this. I just have so many overwhelming thoughts in my head and I don't know what to expect. I keep telling myself that whoever I choose to treat me would surely take into consideration that I have been taking the Percocet for such a long time and if they change my medication it would be something that will not only help me more but also make the transition from Percocet an easy one. I know very little about the long term chronic pain medications and I want this change to be one that is good for me and my family and not one that puts me into some depressed mental state. I am at a point in my life that I am going to have to work so hard just to catch up and get my life back in order so that I can support my family and the thought of this is very overwhelming to me. If anyone could give me some advise that would benefit me I would so greatly appreciate it. I know that there are others out there that have been through far worse situations than mind that can relate to this. I would love to hear what you have to say. Thank you.


  • I'm pretty sure we all have at least a small bit of this anxiety, that we could be cut off from meds at any point and have to not only suffer pain but withdrawals. One thing to comfort, even if you were for whatever reason cut off, you could go to the ER and get help with withdrawals. 2nd when searching for a new Dr. It's important to consider medication but the Dr. may also want you to consider being painkiller free. While this seems like an unreasonable propisition you should at least give it thought. Being on pain medication for so long can mess with your pain tolerance and once you are off pain meds you may find things better off, if they aren't all the more reason that you need to be on meds again.

    As for what meds they would transition you to, it would probably be a long acting med which should help you much more than a short acting one like percocet. I'm on a Butrans patch and I can't recommend it enough as it takes away the hassle of taking so many pain meds and doesnt give you the highs and lows like pills do, just a steady constant release if meds. Also Buprenorphine is much more resilient when it comes to tolerance, I've been on the same dose for over two years with the same pain relief. Although Butrans may not be strong enough for you since probably have a good tolerance already with pain meds, but still there are other patches out there.

    In any case being on Percocet for so long you are probably overdue for a long acting med and probably a switch too, I found oxycodone to be extemely quick tolerance building wise.
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  • in my first post...........especially the top three. The What to expect at your first visit with a PM doctor, it discusses what to bring with you to your first visit and what to expect from that visit and what to ask, and Pain management do's and don'ts.......
    You also need to be prepared that he most likely will NOT write medications for you at the first visit.......even with all of the imaging studies, test results, etc, he may want you to try more conservative treatment options first, and other medications, rather than opiates to see if they in fact do offer some relief...
    He may also want you to try other more conservative therapies first, and may want more recent imaging, or studies, and may want you to undergo a series of injections first, depending on his exam of you. Based on those things, he may or may not want to consider using opiates. He may refer you to another surgeon based on what he sees in the imaging studies.
    Even though you have been on opiates for some time, he may not feel that they are the best option for you, at this point....so it is wise to prepare and be open to trying the suggestions and modalities that he wants you to try.
  • I, too, had a couple of surgeries, both mostly successful, though, but I was still in quite a bit of bit, and knew I always would be. I also just switched to the Butrans patch after having been on Percocet for years.

    I switched to a new pain mgmgt dr. last year, who was recommended by my surgeon, and so he was comfortable writing me prescriptions on my first visit. Then we sat down together and made a plan. I wanted to get off the narcotics as much as possible.

    Also, you should be on other meds to compliment your Percocet. Gabapentin or Lyrica for nerve pain is a staple in most of our pill "diets", and works wonders. Sometimes a good, true muscle relaxer will help. An anti-inflammatory? Anti depressant? You and whatever dr. you end up going to will have to "experiment" to find out what works best for you. But his job, and your goal, should be to control your pain, while giving you functionality, with as little medication as possible.
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