madhatter
01-04-2006, 07:33 AM
Hi group! its been a while,with comp. hearings,I.M.E exams etc. anyway,i was on 60 mg. oxycotin tid,with 15 mg oxycodone 2x a day for breakthrough,last month,my doc. uped my o.c to 80 mg. tid,and said i should need no b.t well,i do,and i have to call for my script today,was wondering if i asked for something like ibprophen 800,or tylonol 500,if that would help[a little] or would that be useless since i'm on 80's tid?Thanks and happy new year to you all!
mad. Forgot,i'm taking nurotin for nerve pain
mad. Forgot,i'm taking nurotin for nerve pain
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Shoreline
01-04-2006, 09:52 AM
Hey MH, I don't really see the point in askng if you can use apap or IBU. I would give it a try so you have smething to report about the usefulness f OTC meds.
I remeber reaing the post where he increased the base and did away with the BT med. It didn't entirely make sense then and still doesn't. Perhaps decreases the number of doses, but if your now impervious too pain thanks to the last ncease, I have some yard work that needs doing. LOL
I know it's really not somethin to laugh at. The first doc that used LA meds on me didn't believe in BT meds, for whatever reason. She wanted us to use one of the methods like Bio-fedback we learned at her clinic to manage BT pain. She would through everything but more oiates at yu before increasing or using BT meds. I could have stayed zonked n the antipsychotcs and anti siezure meds IF that was my goal, but changing a doc belief on BT meds is tough./ Howver apperently the doc does use BT meds at certain doses? Is that bcause someone on 60mgs TID is lees proone to abuse their BT meds? Did I miss that breaking news from the AMA and APS? Sorry it always sems like a struggle.
For all intensive pruposes, IF you were taking 60 mgs TID, THat sustained 30 mgs in your system. Takng one 15 mg Roxi increased your serum level to that which 45 mgs of IR oxy would sustain if given every 4 hours. The new dose, the 80 mg tabs TID sustain 40 mgs in your system with no BT or increase. You wouldn't think 5 mgs would make a huge difference, obviously it does.
I base increase son how well I handle the higer dose during a bolus perriod. Particularly with the pump. If my flow rate is say .20 mgs in the day and .25 at night and I know I handle .25 easily at night, I will switch that to my day time dose and increase the night dose to say .29 at night. This way I have already tried the higher dose before using it as a base dose during the day,and hopefully the night time increase will be enough of a differnce to actually help and reduce BT med use. I use what I have taken previously as a foundation for my request, hwow I tolerated, how it effected me and how effective the dose was as a basis for my request.
I would simply create a PM chart/journal showing how the higher dose has helped where previously you mayhave used BT meds, but also incude the times of day now where it seems your not getting the same relief you were when using the lower base dose and BT meds.
Take care, Dave
I remeber reaing the post where he increased the base and did away with the BT med. It didn't entirely make sense then and still doesn't. Perhaps decreases the number of doses, but if your now impervious too pain thanks to the last ncease, I have some yard work that needs doing. LOL
I know it's really not somethin to laugh at. The first doc that used LA meds on me didn't believe in BT meds, for whatever reason. She wanted us to use one of the methods like Bio-fedback we learned at her clinic to manage BT pain. She would through everything but more oiates at yu before increasing or using BT meds. I could have stayed zonked n the antipsychotcs and anti siezure meds IF that was my goal, but changing a doc belief on BT meds is tough./ Howver apperently the doc does use BT meds at certain doses? Is that bcause someone on 60mgs TID is lees proone to abuse their BT meds? Did I miss that breaking news from the AMA and APS? Sorry it always sems like a struggle.
For all intensive pruposes, IF you were taking 60 mgs TID, THat sustained 30 mgs in your system. Takng one 15 mg Roxi increased your serum level to that which 45 mgs of IR oxy would sustain if given every 4 hours. The new dose, the 80 mg tabs TID sustain 40 mgs in your system with no BT or increase. You wouldn't think 5 mgs would make a huge difference, obviously it does.
I base increase son how well I handle the higer dose during a bolus perriod. Particularly with the pump. If my flow rate is say .20 mgs in the day and .25 at night and I know I handle .25 easily at night, I will switch that to my day time dose and increase the night dose to say .29 at night. This way I have already tried the higher dose before using it as a base dose during the day,and hopefully the night time increase will be enough of a differnce to actually help and reduce BT med use. I use what I have taken previously as a foundation for my request, hwow I tolerated, how it effected me and how effective the dose was as a basis for my request.
I would simply create a PM chart/journal showing how the higher dose has helped where previously you mayhave used BT meds, but also incude the times of day now where it seems your not getting the same relief you were when using the lower base dose and BT meds.
Take care, Dave
madhatter
01-04-2006, 09:58 AM
Thanks dave,and it was good to hear from you,i see my doc. in 15 days,i might suggest going back to 60 mg tid,and 15mg for b.t
catnap
01-04-2006, 12:23 PM
I am having that problem with getting bt meds also. I don't know if asking for tylenol or bute would help because of the liver enzyme increase with these drugs.
Pcp has now increased my la with another 120 mg. of morphine (Avinza) putting me at 360 mgs daily dose. This is still under what I was getting from my last pcp which was 449 mgs.
And get this when the assist went out to get the doc's approval on what to do for me, (this is my 3rd visit) he comes back in and tells me I am now receiving the highest dose opiate of any of his patients. :eek: Really! But then he tells me I am the only patient he has that has been in pm for 10 years. So I am not opiate-naive. What planet did he fly in from? I can only imagine that he must be new to this.
I did find that keeping a diary of my pain helped. Seems like if its written down they don't miss out on any of the important things or maybe they believe your pain is really that bad. Not every little thing just hit the high spots like, what you were doing when you pain level reached 10, what your pain is at rest as opposed to activity, etc. I kept a one page report of what I have experienced in the last two weeks of this med change and handed it to him at my visit yesterday. He did read it and wrote a few things down off of it. Maybe it helped because I did get the increase in my med.
Pcp has now increased my la with another 120 mg. of morphine (Avinza) putting me at 360 mgs daily dose. This is still under what I was getting from my last pcp which was 449 mgs.
And get this when the assist went out to get the doc's approval on what to do for me, (this is my 3rd visit) he comes back in and tells me I am now receiving the highest dose opiate of any of his patients. :eek: Really! But then he tells me I am the only patient he has that has been in pm for 10 years. So I am not opiate-naive. What planet did he fly in from? I can only imagine that he must be new to this.
I did find that keeping a diary of my pain helped. Seems like if its written down they don't miss out on any of the important things or maybe they believe your pain is really that bad. Not every little thing just hit the high spots like, what you were doing when you pain level reached 10, what your pain is at rest as opposed to activity, etc. I kept a one page report of what I have experienced in the last two weeks of this med change and handed it to him at my visit yesterday. He did read it and wrote a few things down off of it. Maybe it helped because I did get the increase in my med.
Josie115
01-04-2006, 09:57 PM
Hi Catnap.. this may sound like a really dumb question and I admit that I'm still fairly new to all of this.. I tried avinza and couldn't tolerate the side effects and..it just didn't work. I am now on 150mcg. of fentanyl. It works. It works really well now that I'm getting the Sandoz instead of the Mylan. I almost think I could back off of it a bit..start tapering down.
Have you tried the patch? Did it not work for you? Would you try it? I have really mixed feelings about all of this. I won't have surgery and from what I can figure out.. no one is really pushing it. I'm doing ok, working, etc. and that's the way I want it..but, does it have to take this strong of stuff? I was on hydrocodone for years. Maybe like 6 yrs. but not very high doses..just the prescribed dose of 4 a day. Never go more than over the prescribed amount. I just think I want off..
You seem like you have alot of experience. What is your thoughts about the patch?
Have you tried the patch? Did it not work for you? Would you try it? I have really mixed feelings about all of this. I won't have surgery and from what I can figure out.. no one is really pushing it. I'm doing ok, working, etc. and that's the way I want it..but, does it have to take this strong of stuff? I was on hydrocodone for years. Maybe like 6 yrs. but not very high doses..just the prescribed dose of 4 a day. Never go more than over the prescribed amount. I just think I want off..
You seem like you have alot of experience. What is your thoughts about the patch?
catnap
01-05-2006, 01:26 PM
Yes to the patch. That is what I had been taking and started in 1998 on a 25, 50, then 75, minus a few years on methadone. I was using the patch 100 mcq q 48 hrs. for 2 years. He thought that was a HIGH dose and was uncomfortable with prescribing it. Now with the avinza change I am almost up to that amount. A 100 mcq patch equals 404 mgs morphine. He is not ready yet to give me any bt meds. With bt meds I was at a dose of 449 mgs. and was doing fairly well. Now after the change I have to say I was doing great.
Switching meds requires a period of adjustment. If I had never had to change to the methadone I would have probably needed an increase to the 150 patch just because of tolerance.
If you believe you could cut done on the dose I would do it, because you are going to need an increase due to building a tolerance of the drug maybe in a few years or more. You might be able to go longer on the same dose. It's difference with everyone How long have you been on this dose and are you able to last every 72 hrs until a change. Fentanyl has less side effects than all of the others. I also liked the patch because if I got sick with a virus and had vomitting it would not matter. Although if you run a high fever you would need to do something different because high temperature causes the drug to release faster.
Switching meds requires a period of adjustment. If I had never had to change to the methadone I would have probably needed an increase to the 150 patch just because of tolerance.
If you believe you could cut done on the dose I would do it, because you are going to need an increase due to building a tolerance of the drug maybe in a few years or more. You might be able to go longer on the same dose. It's difference with everyone How long have you been on this dose and are you able to last every 72 hrs until a change. Fentanyl has less side effects than all of the others. I also liked the patch because if I got sick with a virus and had vomitting it would not matter. Although if you run a high fever you would need to do something different because high temperature causes the drug to release faster.
madhatter
01-05-2006, 09:58 PM
I tried the patch a while ago,[50] I was always tired,even after 30 days,i thought i would aadjust,but didn't.
dango
01-06-2006, 01:15 AM
I DO find that Aleve, Aspirin, or tylenol increases the effectiveness of my meds if I need them to be particularly rugged! Seems to increase longevity also. The reason why I don't use them all of the time? My fragile gut will not tolerate it!
tracer
01-06-2006, 01:37 AM
i use otc meds and they help alot.im on dura patch and norco 10 for bt,but the otc meds make a world of difference.
madhatter
01-06-2006, 09:51 AM
Well,i tried the tylonol 500,and it didn't work,even my pharmacist doubted it would work for me,since i've been taking opiods for the last 3 yrs.I just didn't qant to ask for an opiod b.t sine i'm taking o.c 80 mg tid. It did upset my stomache,ihaven't taking a med with tylonol,ibpro. in a very long time.
some peaple i talk to don't understand how,or why i would need anytrhing for breakthrough
some peaple i talk to don't understand how,or why i would need anytrhing for breakthrough