jrod84
03-02-2008, 03:21 PM
Hi all..., I was in a bad car accident in October. I have always had back issues, but after this accident, my MRI showed 3 herniations and one disc almost completeley out of place. I have received 2 epidurals already, and they did not work. My Dr. has me on percocet 10/650. I am at the point where i need to take 3 of them to get any relief. I am a teacher, so I do not take them while at school, and just deal with the pain until I get home. On the weekends, I will take 3 twice a day. I asked my PM dr. if he would change the meds to a lower Tylenol dosage since I was concerned with the amount going through my liver. He said "I don't want you taking that many a day"...I dont either, but it is the only way to get relief, and he will not change it because he says..."let's not get confused, and keep it how it is"...I am just concerned about the amount I am taking....any suggestions???
Thanks:)
Thanks:)
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hessie28
03-02-2008, 05:29 PM
I worried about that too. I was taking it over a year. When I went to pain management the dr. swithched it to just the Oxycodone without Tylenol. She said I did not need the Tylenol. Funny thing is I just got diagnosed with a Fatty Liver. I am overweight but all of a sudden Fatty Liver. I wonder if it is related to all the Tylenol I had in the Oxycodone for so long.
jrod84
03-02-2008, 09:42 PM
Well, I do not want that! I think my question is, I felt kind of strange that I told my Dr. I had to take more than prescribed to get any relief, and when I asked for him to change it to a lower dose of Tylenol, he said no. I just do not understand why he would not be supportive of my concerns with my own health! I am truly looking to get off the medication through therapy and epidurals, whatever works, but I am really concerned about the amount of Tylenol I am taking, and he would not change it for me....Is this normal? Should I go to a different PM dr? My family Dr. , when I mentioned it to him, was pretty much on his side, saying "oh, that sounds weird, he's usually a pretty laid back guy. There must have been a miscommunication..." What should I do?
Executor
03-02-2008, 11:24 PM
In my opinion, you've got a couple of inter-related issues here....First of all, you're safe re: the Tylenol issue. Much of the medical documentation says you can take up to 4000Mg per day, which you're way below. However, your concern is a valid one and is certainly your right to address as a patient. The other poster is correct in that at some point, it would probably be prudent to move to straight Oxycodone.
Just a guess, but the Doc probably doesn't want to script straight Oxycodone because (1) He's probably one of the paranoid Docs who wants to fly below the radar and not script straight Oxy and (2) Probably thinks you'll take less if it has Tylenol in it, especially since you're aware of the situation....Nothing against you personally, but probably does this with everyone.
As to whether or not you should seek another Doc, that's only something you can decide. I will say that there are lots of PM Docs out there that do things differently and you may be able to locate one in your area. However, there may be things about your current Doc that you like and sometimes in life the grass isn't always greener on the other side of the fence....Be careful what you ask for, you may get it.
Lastly, it's important to note that with more and more PM Docs, you have to get a referral to get into their practice....So keep that in mind if you start looking.
Hope all works out for you, and good luck!
Ex
Just a guess, but the Doc probably doesn't want to script straight Oxycodone because (1) He's probably one of the paranoid Docs who wants to fly below the radar and not script straight Oxy and (2) Probably thinks you'll take less if it has Tylenol in it, especially since you're aware of the situation....Nothing against you personally, but probably does this with everyone.
As to whether or not you should seek another Doc, that's only something you can decide. I will say that there are lots of PM Docs out there that do things differently and you may be able to locate one in your area. However, there may be things about your current Doc that you like and sometimes in life the grass isn't always greener on the other side of the fence....Be careful what you ask for, you may get it.
Lastly, it's important to note that with more and more PM Docs, you have to get a referral to get into their practice....So keep that in mind if you start looking.
Hope all works out for you, and good luck!
Ex
cmpgirl
03-03-2008, 11:41 AM
Hey jrod:
I'm probably starting to sound like a broken record to some, but if you find a new PM doc (and I hope you do) It wouldn't be a bad idea to ask about a long acting med such as oxycintin (there are several, but thats what I take). It sounds like you are taking more of the percoset because it's not lasting long enough. Instant release meds usually only work or stay in your system for about 2-3 hours, where a time released/long acting med will slowly release over a period of roughly 8 hours. Instant release are usually prescribed for "breakthrough pain". This method works so much better.
I know that not all docs or all states have the same prescribing rules and regulations, so I don't know if this will be an option for you, but if it is, I can definitely say it changed my life. You'll see that several of us here take these types of meds.
Good luck with everything and keep us posted. cmpgirl:)
I'm probably starting to sound like a broken record to some, but if you find a new PM doc (and I hope you do) It wouldn't be a bad idea to ask about a long acting med such as oxycintin (there are several, but thats what I take). It sounds like you are taking more of the percoset because it's not lasting long enough. Instant release meds usually only work or stay in your system for about 2-3 hours, where a time released/long acting med will slowly release over a period of roughly 8 hours. Instant release are usually prescribed for "breakthrough pain". This method works so much better.
I know that not all docs or all states have the same prescribing rules and regulations, so I don't know if this will be an option for you, but if it is, I can definitely say it changed my life. You'll see that several of us here take these types of meds.
Good luck with everything and keep us posted. cmpgirl:)
ozzybug
03-03-2008, 01:05 PM
If your doctor is opposed to a long acting medication and only wants you taking the percocet, I agree with trying to get him to write for a med that has no tylenol in it as suggested by others. Roxicodone might be an option here as there is no tylenol.
Also, I know Norco has less tylenol in it, but it's not as strong as the Percocet. It's actually hydrocodone.
I'm really sorry you are hurting so bad. Please do talk with your doctor about one of the oxycodones that don't have the tylenonol in it.
Good luck. I'm sending positive thoughts your way!!
Also, I know Norco has less tylenol in it, but it's not as strong as the Percocet. It's actually hydrocodone.
I'm really sorry you are hurting so bad. Please do talk with your doctor about one of the oxycodones that don't have the tylenonol in it.
Good luck. I'm sending positive thoughts your way!!
jrod84
03-03-2008, 04:03 PM
Thanks for all the tips. I know that I do not want to be on Oxycontin, since I have heard so many horror stories! I have gone through two series of epidurals with this PM already. Would it look strange if I switched Dr. in the middle? Like I said, my real concern was that I asked for something to be changed in my medication, because I have a concern, and I was told no.
Again, thanks everyone for all the input!
Again, thanks everyone for all the input!
Wren9
03-03-2008, 04:30 PM
The very first thing my pain doctor did was switch me from Vicodin (hydrocodone with APAP) to Oxy IR (oxycodone 5 mg, no APAP). He said that all that Tylenol (acetaminophen) was no good and that I did not need to be taking it.
From there, we went to something long-acting with a short-acting opioid for breakthru pain.
The oxycodone/APAP formulation with the least amount of APAP is 10/325.
Same thing with hydrocodone/APAP -- the formulation with the least amount of APAP is called Norco 10/325. This is Schedule III, where the oyxocodone preparations are all Schedule II.
You can also get hydrocodone compounded, so that it just contains hydrocodone.
-Wren
From there, we went to something long-acting with a short-acting opioid for breakthru pain.
The oxycodone/APAP formulation with the least amount of APAP is 10/325.
Same thing with hydrocodone/APAP -- the formulation with the least amount of APAP is called Norco 10/325. This is Schedule III, where the oyxocodone preparations are all Schedule II.
You can also get hydrocodone compounded, so that it just contains hydrocodone.
-Wren
brianpain33
03-03-2008, 07:57 PM
I can understand your viewpoint but I can also understand the doctor's viewpoint. The one concern is taking 3 of the 10/650 Percocets at once which is 1950mg of acteminophen at once and usually you should take no more than 1500mg at one time. Did you specifically ask for the Oxycontin or just something else that would work better? I would ask if there would be something long acting (LA) which could be used. There are many choices and these keep the medication at a constant level, there's no acteminophen, and there the tolerance does not grow as fast. Here are some of the LA meds:
1. MS Contin
2. Avinza
3. Kadian
4. fentanyl patch (Duragesic brand)
5. Opana (oxymorphone)
6. Methadone
7. Oxycontin
8. Suboxone
Oh, one more thing Oxycontin is no more addictive than any other narcotic medication. It's just it has been abused more and publicized more which creates fear and misconceptions among patients and doctors. And just think you are already taking the active ingredient in Oxycontin which is oxycodone. It's just that you are taking Percocet which is oxycodone plus acetaminophen.
Brian
1. MS Contin
2. Avinza
3. Kadian
4. fentanyl patch (Duragesic brand)
5. Opana (oxymorphone)
6. Methadone
7. Oxycontin
8. Suboxone
Oh, one more thing Oxycontin is no more addictive than any other narcotic medication. It's just it has been abused more and publicized more which creates fear and misconceptions among patients and doctors. And just think you are already taking the active ingredient in Oxycontin which is oxycodone. It's just that you are taking Percocet which is oxycodone plus acetaminophen.
Brian
jrod84
03-03-2008, 09:12 PM
My actual words were " I need to take 3 at a time for any relief, and I am concerned about the amount of Tylenol." He started to write the scrip, but changed his mind, saying let's not confuse ourselves and keep it the same. Thanks for all the helpful advice....The more I think about it, the more frustrated I am getting that I said I had a health concern about my medication, and he refused to change it for me. It was almost as if he thought I had some alterior motive, but as most of you agreed, it is a valid issue...I think I might ask again, but the problem is my insurance changed, and now I have to give a $20 copay to see him. I don't want to pay the $20 if all he is going to say is no again, and I don't think I should have to feel that way.
Executor
03-03-2008, 11:05 PM
It's understandable that you don't want to pay another co-pay for him to possibly say "no", but at the same time, if you return, it will show him you're serious and he may say "yes." Many times, Docs "test" patients to see how much the can deal with or initially push back for a variety of reasons....Then, if you still have the issue, they change their minds. I'm just speculating, but it sounds as if your Doc just doesn't want to go into the traditional PM meds (like Oxycontin) for political reasons....Keep pushing....Your long term health is worth it. As Brian said, there are sooooo many alternatives in today's PM world for you not to be taken seriously.
Good luck.
Ex
Good luck.
Ex
jrod84
03-04-2008, 09:31 AM
Thanks everyone for the help. I will give it a shot!