Jema X
02-28-2009, 04:09 AM
I take 20mgs of oxy 3 times a day and I think I am getting some withdrawal effects in the 2 hours before my next tablet is due. I start to yawn and my body starts to feel a bit jumpy which makes my pain worse. I know that I am a fast metaboliser, I've had the tests done. In australia bt meds are not given as much as in the US - I get 20 - 30 endone (IR oxy 5mgs) but that's it.
Does anyone experience this? is there anything I can do? I think I'm going to ask for 15mgs four times a day and see if this helps. I've also noticed a significant pain spike 5-6 hours after my last tablet. I've just come down from 70 to 60mgs which was probably silly, I did it because I get sick of the stigma associated with oxy. Oh well, I could go back up but it wouldn't solve my problem. Any advice or others experiences welcome.
Does anyone experience this? is there anything I can do? I think I'm going to ask for 15mgs four times a day and see if this helps. I've also noticed a significant pain spike 5-6 hours after my last tablet. I've just come down from 70 to 60mgs which was probably silly, I did it because I get sick of the stigma associated with oxy. Oh well, I could go back up but it wouldn't solve my problem. Any advice or others experiences welcome.
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10sox
02-28-2009, 06:28 PM
I haven't been on your med, so I cannot really help you much. But I think it is possible that you are experiencing WD's. I know that when I was on my LA med, OpanaER, I would start feeling like CRAP about 2-3 hours before my next dose. I took mine 2x per day. I am now off of it due to GI problems and my pain doctor has doubled up on my vicodin. I can tell when this is wearing off, but it is nothing like what I felt during the hours between the LA med.
I also wanted to share that I beat myself up a lot due to my pain meds. But then I have a day like today where I could not even sit in the car for an hour trip without being in sooooo much pain....AND I was on my meds!!!! I bascially have thrown up the white flag and realize I am not a bad person...just somone living in chronic pain every single day. If you really do need your meds, then take them (under your doctors orders of course).
Good luck and hopefully someone whose been on your med can help you.
10sox
I also wanted to share that I beat myself up a lot due to my pain meds. But then I have a day like today where I could not even sit in the car for an hour trip without being in sooooo much pain....AND I was on my meds!!!! I bascially have thrown up the white flag and realize I am not a bad person...just somone living in chronic pain every single day. If you really do need your meds, then take them (under your doctors orders of course).
Good luck and hopefully someone whose been on your med can help you.
10sox
Jema X
03-01-2009, 12:30 AM
Thanks 10sox, good on you for being brave. I don't feel ashamed, I just get sick of the drs that judge and having to alwys fear going to the ER. It really sucks that we are judged like this. As you say though, quality of life is more important & I can't function without medication. Such is life.
brianpain33
03-01-2009, 04:50 AM
It is definitely a possibility that you are experiencing some withdrawals if you are a fast metabolizer. I guess you could always ask the doc to try you on a different LA medication to see if it makes a difference. As for other people judging you, I believe that us personally judge ourselves the worst. I am a recovering addict and I have to also take pain meds due to the fact that I have chronic pain. I used to fear what other people thought about me. However, I know that I have legitimate pain and as long as I am taking them for legitimate purposes and not taking them to get high then I have nothing to worry about. So try not to let your thinking choose to allow yourself to be in severe pain because you don't deserve that, ok? I believe that you are taking them as prescribed and need them for legitimate pain so keep on with the docs orders.
brian
brian
Jema X
03-01-2009, 05:24 AM
Brian, you r a lovely man. You too have been through a lot - I know that it isn't always easy but you always come through for other. Thank you. I am not an addict but I am dependant on my meds and not just for pain - the wd feeling is scary to e because it reminds me that my pain relief comes at a price. Dependance. I don't get any sort of 'high' from my meds, I did when I was given tramal but that became seretonin syndrome. Scary stuff and enough to scare me off. I've tried most things - fentanyl and oxy work best. I think fentanyl only comes in patch though? And they give me a terrible rash - norspan (buprenophine) patches left me with a scar. We do use fentanyl if I'm in hospital though. I wish that there was something without the ups and downs.
Another question, what do others consider to be acceptable pain? I usually sit around a 6. I class a 10 as when my nerve pain is so bad I can't see and my ribcage spasms - luckily not often! Sometimes I wonder if a 6 is too high? I have trouble concentating on conversatons or sitting still. Just wondering what others think.
Thanks again, I probably shouldn't have said advice 'required', it sounds bossy! :)
Another question, what do others consider to be acceptable pain? I usually sit around a 6. I class a 10 as when my nerve pain is so bad I can't see and my ribcage spasms - luckily not often! Sometimes I wonder if a 6 is too high? I have trouble concentating on conversatons or sitting still. Just wondering what others think.
Thanks again, I probably shouldn't have said advice 'required', it sounds bossy! :)
10sox
03-01-2009, 08:55 AM
Juliet-
I personally think a "6" is too high. Although I HATE that number system, I would consider what you described as too much pain. I believe when the pain interferes with my quality of life....like not being able to sit in a car, or hurts too much that I cannot take my kids to the park, then that is too high.
When my vicodin kicks in, I live at a "4". A "4" to me means that the pain is still there, but I am able to put it in the back of my mind and still function. However, that "4" is only if I am not doing much. If I drive in a car, take a walk, or just about do anything much....it climbs anywhere from a 4 to a 8. (this is on my meds) I just came off my LA medication due to GI issues, so we are in the process of trying to get my pain under better control so I can function better.
This is just my opinion though. There are some days when my tummy is acting up that I can barely handle my "4". I want it to be a ZERO, but I know that is not going to happen.
10sox
I personally think a "6" is too high. Although I HATE that number system, I would consider what you described as too much pain. I believe when the pain interferes with my quality of life....like not being able to sit in a car, or hurts too much that I cannot take my kids to the park, then that is too high.
When my vicodin kicks in, I live at a "4". A "4" to me means that the pain is still there, but I am able to put it in the back of my mind and still function. However, that "4" is only if I am not doing much. If I drive in a car, take a walk, or just about do anything much....it climbs anywhere from a 4 to a 8. (this is on my meds) I just came off my LA medication due to GI issues, so we are in the process of trying to get my pain under better control so I can function better.
This is just my opinion though. There are some days when my tummy is acting up that I can barely handle my "4". I want it to be a ZERO, but I know that is not going to happen.
10sox
Jema X
03-01-2009, 05:10 PM
My partner agrees with you 10sox. I understand that you have a lot of nerve issues too? My pain is 90% nerve pain, 10% back ache. I take neurontin in high doses and I'm supposed to take endep (elavil over there I think?) But it makes me put on weight. It sounds silly but I'm sure that putting on weght makes my breathing worse & it doesn't make me feel great either. I've been thinking of swapping to cymbalta. We shall see. I'm having a fusion in ma & I have the most awesome anaesthetist - he specialises in acute pain manageent. He may have another suggestion to lower my pain but it will probably come in the form of more oxy. It must be so hard 4 you with no LA meds - I fing that after a while endone (IR oxycodone) gives me mood swings. How are you coping? May I ask what your nerve pain is?mine is thoracic, mainly right side and it's simply horrible. Today is a can't get out of bed day, so apologies if I sound down. I might have to take some endone because I have a fair bit 2 get done. I think you're right about the pain scale, my quality of life could be lots better. Thanks 10sox (ps: sorry about long paragraphs, I can only use my phone @ the moment). I hope you have a good day :)
brianpain33
03-01-2009, 08:39 PM
Brian, you r a lovely man. You too have been through a lot - I think fentanyl only comes in patch though? And they give me a terrible rash - bossy! :)
thank you for the complement. the fentanyl does come in other forms like the losenge and a type of sucker(i think that is what they call it). however both of these are very short acting and can be highly addictivie along with raising tolerance. I think there is a form of Dilaudid that is long acting and I don't know if you have been on that before. Have you tried all of the LA meds including:
1.morphine based (Kadian, MSContin)
2. oxymorphone (Opana ER)
3. Methadone
4. Oxycontin
If you have nerve pain then you might want to try other meds that work well for nerve pain including: Cymbalta, Lyrica, Neurontin, and Elavil(amitryptiline). hope you can get on somethine long acting
brian
thank you for the complement. the fentanyl does come in other forms like the losenge and a type of sucker(i think that is what they call it). however both of these are very short acting and can be highly addictivie along with raising tolerance. I think there is a form of Dilaudid that is long acting and I don't know if you have been on that before. Have you tried all of the LA meds including:
1.morphine based (Kadian, MSContin)
2. oxymorphone (Opana ER)
3. Methadone
4. Oxycontin
If you have nerve pain then you might want to try other meds that work well for nerve pain including: Cymbalta, Lyrica, Neurontin, and Elavil(amitryptiline). hope you can get on somethine long acting
brian
Jema X
03-01-2009, 09:08 PM
Thanks Brian, I take oxycontin. LA morphine is out because it makes me go red and a bit twitchy. We don't have hydramorphone (opana?) In austraia. We do have dilaudid, which we call pethedine and it doesn't come in an LA format. I can take it but only short term as it is seretonergic. The oxycontin does work, it's just not perfect (what is!) And only brings my pain down to about a 6. Thanks for all thoughts - the patch is woth considering as they are all slightly different.
I also take paracetamol (acetominophen), mobic, neurontin and endep (elavil). Neurontin helps most out of the lot, then endep.
Thank you, brian :)
I also take paracetamol (acetominophen), mobic, neurontin and endep (elavil). Neurontin helps most out of the lot, then endep.
Thank you, brian :)
Executor
03-01-2009, 11:48 PM
I take 20mgs of oxy 3 times a day and I think I am getting some withdrawal effects in the 2 hours before my next tablet is due. I start to yawn and my body starts to feel a bit jumpy which makes my pain worse. I know that I am a fast metaboliser
Yes, what you are describing are minor WDs:(...In PM this is called "end of dose failure." I would talk to your Doc about this and see what he says. It's not so much about "what" drug you're taking but rather the amt and frequency. For example, a higher dose or more frequent dosing....Either or, would raise your Blood plasma level (BPL). You're on the right track with a lesser amt, but more frequently...This would keep your BPL elevated, especially if you have a fast metabolism.
Therefore, switching meds probably won't do much. If anything, it may make it worse because when Docs transition from one med to another, they are usually very conservative....Especially if it's a med you haven't tried before.
This is exactly why PM is so individualized....Everyone is different. This is also why Docs are prudent with their dosing....Start slow and work up. What may not be enough for one person, could be very detrimental to another.
I would be candid with your PM doc in a professional, non threatening way and see what he says. End of dose failure is fairly common, especially with established PM patients.
Best of luck to you with this.
Regards,
Ex
Yes, what you are describing are minor WDs:(...In PM this is called "end of dose failure." I would talk to your Doc about this and see what he says. It's not so much about "what" drug you're taking but rather the amt and frequency. For example, a higher dose or more frequent dosing....Either or, would raise your Blood plasma level (BPL). You're on the right track with a lesser amt, but more frequently...This would keep your BPL elevated, especially if you have a fast metabolism.
Therefore, switching meds probably won't do much. If anything, it may make it worse because when Docs transition from one med to another, they are usually very conservative....Especially if it's a med you haven't tried before.
This is exactly why PM is so individualized....Everyone is different. This is also why Docs are prudent with their dosing....Start slow and work up. What may not be enough for one person, could be very detrimental to another.
I would be candid with your PM doc in a professional, non threatening way and see what he says. End of dose failure is fairly common, especially with established PM patients.
Best of luck to you with this.
Regards,
Ex
Jema X
03-02-2009, 02:31 AM
Thanks Ex, when I was tested because of my intolerance to drugs such as tramal, stemetil, phenergan, maxalon & others (I get akasthesia) - the specialist psychiatrist did blood and pet testing & found that I metabolise between 30 to 50% faster. Having the proof helps - guess but it doesn't seem to mean much to my pm. Luckily (because I have to have surgery, or unluckily!) I will be seeing my anaesthetist who specialises in acute pain and complex management. Until then, I'll ask my gp 2 change me to 15mgs 4 times a day - that shouldn't be too threatening as no dose change. I exercise as much as/more than I should trying to chase an endorphin high & I think this also increases plasma highs...but also faster washout. Thanks for reassuring me about not changing drug though, I always appreciate your input.
Many thanks, Juliet
Many thanks, Juliet
Executor
03-02-2009, 12:39 PM
Thanks for reassuring me about not changing drug though, I always appreciate your input.
Glad I could help. Best of luck to you.
Regards,
Ex
Glad I could help. Best of luck to you.
Regards,
Ex
10sox
03-02-2009, 01:08 PM
Juliet-
Sorry you are having a bad pain day again. Your pain sounds very similar to mine. I had my L5-S1 disc herniate 2x (due to DDD) and it crushed my nerves so badly, that my surgeons said they'd never seen a piece that large break off. For now, my back is stablilized (the discs that is) but the nerves were damaged so badly, that I am in soooo much nerve pain. I always say my back hurts 10% and my leg/buttocks 90%.
The pain is this horrible ache that gets stronger and stronger as the day goes on. It is so hard to describe. I guess like a toothache in my bones, is the best way I can describe it.
The only thing that helps me is epidural injections. I am due to have on at the end of the month. They only last a month or so, but I'll take it!!! I am only allowed to have 3 per year.
As for medications, this is what I have tried:
Lyrica (did nothing for pain, and made me WAY too sleepy)
Cymbalta (did nothing but cause terrible insomnia..took it in the am too)
OpanaER (helped a bit with the pain, but caused horrible GI problems)
Tramadol (did nothing)
Skelexin (sp??....caused horrible GI pains)
Neurontin (currently on this...was on 2400mg daily, but too sleepy. Now on 1200mg.,,I dont think it does anything but makes me sleep at night)
Hydrocodone (currently on this, takes the edge off a bit)
So, that's about my story. I have been told there is nothing but a spinal cord stimulator for me. But, I have a 2 and 4 yr old at home, and no help (besides my husband who works all day). I need to wait a couple years for them to get a little older before I can think about this. Plus, I am praying I can get the pain under control with meds.
Please keep us updated and let us know how you're doing.
Lisa
Sorry you are having a bad pain day again. Your pain sounds very similar to mine. I had my L5-S1 disc herniate 2x (due to DDD) and it crushed my nerves so badly, that my surgeons said they'd never seen a piece that large break off. For now, my back is stablilized (the discs that is) but the nerves were damaged so badly, that I am in soooo much nerve pain. I always say my back hurts 10% and my leg/buttocks 90%.
The pain is this horrible ache that gets stronger and stronger as the day goes on. It is so hard to describe. I guess like a toothache in my bones, is the best way I can describe it.
The only thing that helps me is epidural injections. I am due to have on at the end of the month. They only last a month or so, but I'll take it!!! I am only allowed to have 3 per year.
As for medications, this is what I have tried:
Lyrica (did nothing for pain, and made me WAY too sleepy)
Cymbalta (did nothing but cause terrible insomnia..took it in the am too)
OpanaER (helped a bit with the pain, but caused horrible GI problems)
Tramadol (did nothing)
Skelexin (sp??....caused horrible GI pains)
Neurontin (currently on this...was on 2400mg daily, but too sleepy. Now on 1200mg.,,I dont think it does anything but makes me sleep at night)
Hydrocodone (currently on this, takes the edge off a bit)
So, that's about my story. I have been told there is nothing but a spinal cord stimulator for me. But, I have a 2 and 4 yr old at home, and no help (besides my husband who works all day). I need to wait a couple years for them to get a little older before I can think about this. Plus, I am praying I can get the pain under control with meds.
Please keep us updated and let us know how you're doing.
Lisa
Jema X
03-02-2009, 05:02 PM
Thank you, lisa, your post made me feel better - but sad because I know how all consuming nerve pain is. I hate that I can't concentrate by the time 12 comes around!
I applaud you for keeping on going - you have kids so you have to but I know of many people with bone and nerve pain that just don't really try anymore. Not that I can blame them,getting up sucks, but going to bed and trying to sleep is worse! Ah well, e will get through, lisa. These boards help a great deal.
I take the same as you, neurontin but 2400. I had to build up slowly from 1200 but I'm so glad I did. Lyrica is less sedating but often less effective for those of us with nerve pain - some sedation is helpful. I take oxy, as you knowand I'm so sorry you can't take LA meds. Can you use a patch? After my liver surgerymy stomach was terrible so we used fentanyl.
I want to have kids soon but it scares me. Do you think you'll have another? That's probably the last thing on your mind!
I can't have an epidural because of my thoracic damage unfortunately - I do have an awesome anaesthetist who looks after me for surgery or if I end up in hospital (I make them call him) and he adds ketamine to the fentanyl for post op or acute pain. It sounds mad but it disassociates me from the nerve pain and turns it down a bit. Hallucinations are the main side effect (along withj some good ones, like keeping your bp up a bi) but it's not too bad. This could be something you could look at, just a thought. He specialises in acute pain, so he is comfortable adding in some different drugs, I'm lucky to have him - I just wish he managed me!
What are you thinking about SCS? My pm is pushing for it but I've got a fusion in may, so that's my excuse. I'm really not sure about it.
I've written an essay. Thank you, Lisa, you're a star :)
I applaud you for keeping on going - you have kids so you have to but I know of many people with bone and nerve pain that just don't really try anymore. Not that I can blame them,getting up sucks, but going to bed and trying to sleep is worse! Ah well, e will get through, lisa. These boards help a great deal.
I take the same as you, neurontin but 2400. I had to build up slowly from 1200 but I'm so glad I did. Lyrica is less sedating but often less effective for those of us with nerve pain - some sedation is helpful. I take oxy, as you knowand I'm so sorry you can't take LA meds. Can you use a patch? After my liver surgerymy stomach was terrible so we used fentanyl.
I want to have kids soon but it scares me. Do you think you'll have another? That's probably the last thing on your mind!
I can't have an epidural because of my thoracic damage unfortunately - I do have an awesome anaesthetist who looks after me for surgery or if I end up in hospital (I make them call him) and he adds ketamine to the fentanyl for post op or acute pain. It sounds mad but it disassociates me from the nerve pain and turns it down a bit. Hallucinations are the main side effect (along withj some good ones, like keeping your bp up a bi) but it's not too bad. This could be something you could look at, just a thought. He specialises in acute pain, so he is comfortable adding in some different drugs, I'm lucky to have him - I just wish he managed me!
What are you thinking about SCS? My pm is pushing for it but I've got a fusion in may, so that's my excuse. I'm really not sure about it.
I've written an essay. Thank you, Lisa, you're a star :)
brianpain33
03-04-2009, 06:09 PM
As for medications, this is what I have tried:
Lyrica (did nothing for pain, and made me WAY too sleepy)
Cymbalta (did nothing but cause terrible insomnia..took it in the am too)
OpanaER (helped a bit with the pain, but caused horrible GI problems)
Tramadol (did nothing)
Skelexin (sp??....caused horrible GI pains)
Neurontin (currently on this...was on 2400mg daily, but too sleepy. Now on 1200mg.,,I dont think it does anything but makes me sleep at night)
Hydrocodone (currently on this, takes the edge off a bit)
Lisa
Lisa,
Have you ever tried the fentanyl patch(Duragesic is the name brand). That is the one thing that did help to get my pain under control. Of course you would start out with the smallest dose and go up from there. You might want to ask your doc about it.
brian
Lyrica (did nothing for pain, and made me WAY too sleepy)
Cymbalta (did nothing but cause terrible insomnia..took it in the am too)
OpanaER (helped a bit with the pain, but caused horrible GI problems)
Tramadol (did nothing)
Skelexin (sp??....caused horrible GI pains)
Neurontin (currently on this...was on 2400mg daily, but too sleepy. Now on 1200mg.,,I dont think it does anything but makes me sleep at night)
Hydrocodone (currently on this, takes the edge off a bit)
Lisa
Lisa,
Have you ever tried the fentanyl patch(Duragesic is the name brand). That is the one thing that did help to get my pain under control. Of course you would start out with the smallest dose and go up from there. You might want to ask your doc about it.
brian
TitaniumJen
03-05-2009, 07:58 PM
Juliet,
I have had 4 spine surgeries (L5,6 discectomy, C5,6 foraminotomy, C5,6,7 Fusion, L4,5,SI Fusion). All surgeries took place within an 18 month period. I have been on pain management now for almost 3 years since these surgeries. I have taken every pain medication and cocktail you can imagine until it took a year and a half to find something that finally works. Oxy made me feel awful and shaky as well and the WD's can be excrutiating. I asked for a lower dose opiate (Norco) because I did not want to take so much acitominopen (as I had been on Lortabs for a long time after Oxy) but he combined it with the fentynal patch. I also take Soma as a muscle relaxer. These three together seem to keep the pain tolerable. Nothing will ever take the pain away completely. But they will make pain tolerable to live a somewhat "normal" life. Maybe you could ask for a lower dose opiate with the patch and see how it works for you. Just a suggestion. I wish you the best. Feel better.
Jen
I take 20mgs of oxy 3 times a day and I think I am getting some withdrawal effects in the 2 hours before my next tablet is due. I start to yawn and my body starts to feel a bit jumpy which makes my pain worse. I know that I am a fast metaboliser, I've had the tests done. In australia bt meds are not given as much as in the US - I get 20 - 30 endone (IR oxy 5mgs) but that's it.
Does anyone experience this? is there anything I can do? I think I'm going to ask for 15mgs four times a day and see if this helps. I've also noticed a significant pain spike 5-6 hours after my last tablet. I've just come down from 70 to 60mgs which was probably silly, I did it because I get sick of the stigma associated with oxy. Oh well, I could go back up but it wouldn't solve my problem. Any advice or others experiences welcome.
I have had 4 spine surgeries (L5,6 discectomy, C5,6 foraminotomy, C5,6,7 Fusion, L4,5,SI Fusion). All surgeries took place within an 18 month period. I have been on pain management now for almost 3 years since these surgeries. I have taken every pain medication and cocktail you can imagine until it took a year and a half to find something that finally works. Oxy made me feel awful and shaky as well and the WD's can be excrutiating. I asked for a lower dose opiate (Norco) because I did not want to take so much acitominopen (as I had been on Lortabs for a long time after Oxy) but he combined it with the fentynal patch. I also take Soma as a muscle relaxer. These three together seem to keep the pain tolerable. Nothing will ever take the pain away completely. But they will make pain tolerable to live a somewhat "normal" life. Maybe you could ask for a lower dose opiate with the patch and see how it works for you. Just a suggestion. I wish you the best. Feel better.
Jen
I take 20mgs of oxy 3 times a day and I think I am getting some withdrawal effects in the 2 hours before my next tablet is due. I start to yawn and my body starts to feel a bit jumpy which makes my pain worse. I know that I am a fast metaboliser, I've had the tests done. In australia bt meds are not given as much as in the US - I get 20 - 30 endone (IR oxy 5mgs) but that's it.
Does anyone experience this? is there anything I can do? I think I'm going to ask for 15mgs four times a day and see if this helps. I've also noticed a significant pain spike 5-6 hours after my last tablet. I've just come down from 70 to 60mgs which was probably silly, I did it because I get sick of the stigma associated with oxy. Oh well, I could go back up but it wouldn't solve my problem. Any advice or others experiences welcome.
Jema X
03-05-2009, 09:31 PM
Thanks Jen, I'm definitely going to look into that. I quite like fentanyl as it doesn't make me feel any different. The only prob is that I don't think we have fentayl patches in aus. We also don't have hydrocodine. I'm going to find out though after first swappining to less oxycontin 4 times a day. I apprecate ur advice, your history isn't unlike mine though -'ve only had thoracic surgery and a couple of abdominals - imy cervical fusion is going to be the last surgery I ever have - I hope :) I hope things go well for you, you've been through a lot. Juliet