Hi, I am Sammi, I have 3 children and alot of pain. I have schrolisis that is mild and a leg length discrepency that has causes severe hip pain. I finally found a dr that is taking care of my pain ok. She has me on lortab 5-500 4x daily and naproxen2xdayily. I have been using the lortab for about 2 months constant \. I found that the lortab is not working like it should. It doesent bring my pain down but to like a 6 or 7 and it doesent last that long maybe and hour and half.
I am afraid if I tell her this she is going to think I am abusing my medicine and not give me anymore. I would rather take what she gives me and say nothing than complain and her giving me nothing. Do you think it is too early for a tolerance?
Should I wait and ask on my next appointment? I have one tomorrow but don't know if I should mention it. It is a pain class and she will be wrighting my refills.
Let me know what you think
Sam

Hi there, and welcome to the board. :wave:

You are not imagining things with the increased tolerance. It is bound to happen with regular use. It is the nature of the med, and if your pain requires you to take them on a regular basis, it would be unusual to NOT notice the tolerance issue.

Of course I am not a doctor, but I don't think it would be wrong to be honest and mention this to your doc. Don't tell her you want a stronger med, or more dosing, but just tell her exactly what you told us in this post...that it isn't working as good. Tell her the pain scale estimation of where you are now. Giving a doctor a pain diary is also a good idea, tracking a week of med usage and pain scale estimations every couple hours. If you want any help on building a pain diary, let me know and I'll give you more info.

I wouldn't ask your questions in front of a pain class, just because you never know who these other people might be, and your doctor might not want to tell you in front of them that she is willing to up your script, because they would expect the same and might not have your same situation. Definitely talk in private. (I'm fairly certain you probably planned to do this anyway.)

Don't be scared to ask for the relief you need. If she is not willing to help your pain, then consider seeing a doctor who will. We shouldn't have to be scared to ask for our needs to be met, and it is VERY understandable in this society why we have to be scared, with all the abuse going on. Put it in terms of telling her the problem, and letting her suggest the solution (which will hopefully be to tell you that you can take 2 tabs, or change to something long-acting). Never make the suggestion to take more, or to suggest a certain drug. They always flag this as someone drug-seeking....They never take this as you knowing yourself well, and doing your homework. Sad, I know.

Anyhow, if there is anything I can do to help, please feel free to ask!

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Sara

Sara is right, I tryed stopping my pain meds a month agobecause I was afraid if I didnt I would be addicted all my life and that scared me alot, so I just stopped without telling my doc or anything but after two weeks off all I could do was lay up in the bed on heat so I finally called and went to see my doc and I flat out told him that I made a mistake and I wanted to start my oxycontin again and I told him how many I needed to take and he had no problem giving it to me, now I take oxy 4 times a day and percocet 4 times a day too, but I still hurt but just not as bad!

There are different views on tolerance to narcotic painkillers. Some medical professionals say that tolerance starts with the first use of narcotic painkillers while others say tolerance starts after a few days or weeks of use.

I have been using Duragesic (patches containing fentanyl, an opioid or narcotic painkiller) for a year and I am not tolerant to fentanyl yet. This medication still works very well for me.

Talk with your doctor and explain her what has been going on with your pain management. If she is knowledgeable and caring, she will be willing to work with you. She will also accept that tolerance might happen with narcotic painkillers.

Sometimes, a narcotic painkiller stops giving pain relief not because the person using it has grown tolerant to it but because the condition causing pain has worsened. I hope this is not the case for you. Again, talk with your doctor and ask her about this.

Hi and welcome.
What I did for my doc was take a tablet and write down when you got up what you took, how long it lasted and pain level. I did this everyday til I went back to see her and that was how we found what I needed in control for the pain.
Just tell her how you feel. She will understand.
Good luck
Kari

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Cronic pain from tendonitous in right elbow 1996, left elbow 1998, shoulder pain within that time, neck pain the hole time. Docs would not give pain meds because of cronic pain and would not help. Could not take tha pain anymore 2003. Until I went to welfare and ran up $$ for med covarage.

Have a good day.
Kari

Hi Sami, Tolerance to pain meds will happen to some degree. The first sign is the length of time in which you get relief. You are also more likely to become tolerant to short acting meds faster than long acting meds. I'm not on a low dose of meds but I have been on the same dose for several years after titrating to an effective dose.

I'm not sure why a PM doc would keep you on short acting meds so long in addition to harmful NSAIDS unless part of your problem is inflammation that can't be reduced. Like OA or RA. There are certainly better anti-inflamatories than Naprosyn that are less harmful to your stomache.

I agree you need to be honest about the relief you are getting. It may be time for long acting meds if they can't manage your pain with other means. Perhaps your doc has used this combination because she expects you to make a recovery and at some point the meds won't be needed.

I know scholiosis isn't going to go away but the doc knows you have managed up to a few months ago without meds and had children without the need for meds so she may be hoping that through PT and other means they can return you to that pre debilitated state you were once in.

Having children certainly effects the abdominal muscles and I'm sure strengthening them back to the pre baby state would help although it's easier said then done.

One device I would purchase is a Theraball, you know those big balls they have you excercise on at PT. They are great for strenghtening your core muscles and developing stability and balance, kids love to play on them too. I've been through 3 already but they do help and aren't expensive and results can be seen quite quickly after just a short perriod of time.

The doc can't read minds though and she needs you to report any progress or regression you are experiencing. Do you have an orthotic device to level out your gate. Making your legs the same length? Sometimes the obvious is overlooked. There are also manipulations and stretches that can help with the difference in length of your legs. Just having you SI joints out of whack could account for the difference in the length of your legs.

You need to be your own advocate and if things aren't being adressed then you need to ask about options to help with these problems and your level of pain. Asking if there are any other options certainly comes across better than asking for specific long acting meds. Good luck, Shore