ozzybug
05-22-2007, 06:10 PM
OK Everyone-
FIRST, I want to say thank you to everyone who lent me support. Thank you so much for your kind words and prayers. It seems they have worked for the time being. My PM doctor did not discontinue the Norco, and he also put me back up to the 7.5/325 mgs I was on before, and here comes the big BUT...
BUT...he gave me a scrip for a 2 week supply, and also wants me to start the Duragesic patch. I was TOTALLY wrong about them thinking Opioid Induced Hyperalgesia is a valid thing. As a matter of fact, in a round about way, he feels it is just scientists making themselves feel "important" by using big words. He said that his studies, and information at hand support the use of opiates, but using ones that give a steady level in your system. He feels that the short acting or IR meds cause an "up & down" effect in the brain (even if the patient doesn't actually feel the "up & down") and that is not really the best form of managing long term chronic pain. He feels that the actual dosing or administration of the opiate is key, and that the key is not doing the up and down thing with IR meds, but by administering the medication and keeping it "steady", thus the Duragesic. He did say that yes, hyperalgesia is real because hyperalgesia means "Hyper" pain, or increased pain, but it isn't necessarily caused by opiates. He said that all chronic pain patients have hyperalgesia, but that doesn't mean it's their medications that are causing it.
Whew- I hope I did ok in explaining in my own words what he explained to me. He was with me for over an hour. I told him I am willing to try the Duragesic even though I feel it may be too strong. I say this because the Norco, in combination with with the Neurontin & Depakote keep my pain levels at a 4-5 range, and to me, that is good pain management. To me, it is more than acceptable because I can function with that level. Anyway, I'm not going to refuse to try it because he is the doctor, and I know if it is not a good fit, he will discontinue it. I just need to give it a fair chance, and am thankful he agreed to start me at a low dose. We are doing the Duragesic 12 mg.
If the Duragesic is a good fit, we can discontinue the Norco, so this is why the 2 week supply of Norco. If the Duragesic is not a good mix, we go to whatever his plan "B" is.
OK guys, I am truly sorry this is such a long post. I just wanted to fill you all in. And thank you once again! I did misunderstand what his PA was talking to me about at our appointment in April when she started talking about hyperalgesia. The doctor explained it in depth to me today.
FIRST, I want to say thank you to everyone who lent me support. Thank you so much for your kind words and prayers. It seems they have worked for the time being. My PM doctor did not discontinue the Norco, and he also put me back up to the 7.5/325 mgs I was on before, and here comes the big BUT...
BUT...he gave me a scrip for a 2 week supply, and also wants me to start the Duragesic patch. I was TOTALLY wrong about them thinking Opioid Induced Hyperalgesia is a valid thing. As a matter of fact, in a round about way, he feels it is just scientists making themselves feel "important" by using big words. He said that his studies, and information at hand support the use of opiates, but using ones that give a steady level in your system. He feels that the short acting or IR meds cause an "up & down" effect in the brain (even if the patient doesn't actually feel the "up & down") and that is not really the best form of managing long term chronic pain. He feels that the actual dosing or administration of the opiate is key, and that the key is not doing the up and down thing with IR meds, but by administering the medication and keeping it "steady", thus the Duragesic. He did say that yes, hyperalgesia is real because hyperalgesia means "Hyper" pain, or increased pain, but it isn't necessarily caused by opiates. He said that all chronic pain patients have hyperalgesia, but that doesn't mean it's their medications that are causing it.
Whew- I hope I did ok in explaining in my own words what he explained to me. He was with me for over an hour. I told him I am willing to try the Duragesic even though I feel it may be too strong. I say this because the Norco, in combination with with the Neurontin & Depakote keep my pain levels at a 4-5 range, and to me, that is good pain management. To me, it is more than acceptable because I can function with that level. Anyway, I'm not going to refuse to try it because he is the doctor, and I know if it is not a good fit, he will discontinue it. I just need to give it a fair chance, and am thankful he agreed to start me at a low dose. We are doing the Duragesic 12 mg.
If the Duragesic is a good fit, we can discontinue the Norco, so this is why the 2 week supply of Norco. If the Duragesic is not a good mix, we go to whatever his plan "B" is.
OK guys, I am truly sorry this is such a long post. I just wanted to fill you all in. And thank you once again! I did misunderstand what his PA was talking to me about at our appointment in April when she started talking about hyperalgesia. The doctor explained it in depth to me today.
Sponsor
Fabrashamx
05-22-2007, 06:21 PM
Ozzy,
Thats great news! Glad to know everything worked out for you. Let us know how you do on the patch.
Have a good day,
Fabby :wave:
Thats great news! Glad to know everything worked out for you. Let us know how you do on the patch.
Have a good day,
Fabby :wave:
BrittleBones
05-22-2007, 08:38 PM
Hi Ozzy - I waited all day for your report and I'm so happy to find that the doc didn't discontinue your meds like you feared! It sounds like he/she is really interested in you as a patient if he/she devoted that much time for the appointment. Good going! You may remember that I just recently started the Duragesic Patch, although at the 100 mcg level. Of course, I had been on stronger oral meds than you've been on. I was taking 120 mg. of methadone with oxycodone 30mg for breakthrough. So far I have to say that I'm getting better pain relief with the patches than I did with the methadone. There is a bit of a "buzz" with the Duragesic that my body needs to get used to. I'm told that it will go away and I can tell it is already much less than when I first started a couple of weeks ago. I didn't have that feeling on the Methadone. However, I really feel more clear headed on the patch. Go figure - Give it a try and like you said, you can always go on to plan B! You take care and all the best sweetie!! KathyMac
butrfligirl28
05-22-2007, 10:01 PM
You made my day Ozzy! I am so happy and relieved for you! :):):) What a weight off huh?
I do however, have some concerns about starting you on a med that you state you do not need. If moving back to the previous dose works for you, why change it? I agree with using long-acting meds, but not when short-acting meds are cutting it.
Just remember, you do not have to be anyone's guinea pig. I know we have alot of pressure to "do what they say" all the time, but you have a voice in this as much, or more than he does.
I wish you all the best!
I do however, have some concerns about starting you on a med that you state you do not need. If moving back to the previous dose works for you, why change it? I agree with using long-acting meds, but not when short-acting meds are cutting it.
Just remember, you do not have to be anyone's guinea pig. I know we have alot of pressure to "do what they say" all the time, but you have a voice in this as much, or more than he does.
I wish you all the best!
captnanny
05-23-2007, 05:03 AM
WHY CAN'T I HAVE DOCTORS LIKE THIS.
I AM STILL IN PAIN AND NOW DEPRESSED FROM THE PAIN,
I added to my post that my doctors will not put me back up on the duragesic. they said with lowering by just 12 should do nothing to me. Well what if i was at a 8-9 before lowering it? WHY CAN'T I GET A PAIM MANAGEMENT PERSON WHO DOES NOT PULL THE RUG OVER MY EYES!!!!!!!1
I AM STILL IN PAIN AND NOW DEPRESSED FROM THE PAIN,
I added to my post that my doctors will not put me back up on the duragesic. they said with lowering by just 12 should do nothing to me. Well what if i was at a 8-9 before lowering it? WHY CAN'T I GET A PAIM MANAGEMENT PERSON WHO DOES NOT PULL THE RUG OVER MY EYES!!!!!!!1
whosit
05-23-2007, 03:26 PM
Wish you the best and let us know how that patch works out for you! I hope everything is ok and you get good relief from the patch. It sounds like your doctor knows what he is talking about and will take good care of you regardless if it work well or not. Good Luck!
Wvrecon432
Wvrecon432