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Old 03-02-2004, 08:10 AM   #1
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Feel "strung out" byend of day/panic attacks

Hi All,

I'm wondering if anybody else has this problem...here's what I take for my pain:

4:30 am 20mg oxycontin
7:00 am 1.5 5/500 vicodin
10-10:30 am 20 mg oxycontin
12:30-1 pm 1.5 5/500 vicodin
4:00 pm 20 mg oxycontin

This regimine controls my pain enough to let me work....by the time I get home I'm wiped out and can't do much of anything.

By about 2 pm I feel kind of "strung out" wierd like wired but tired. Almost at feeling like I'm on the verge of a panic attack at which time I take 1/2 a 1 mg xanax.

Does anybody else have this problem? I know that oxy/opiates can make some people hyper...wondering if I'm having that side effect.

Also, every morning when I wake up I have an immediate panic attack...even if I take a two hour nap during the day I wake up and all these thoughts pour into my head, my pain is always there (lots of stress mainly with my uncaring work...I work 45 hours a week and it's still not enough...had to have my doc write a note limiting me to 45 hours can you believe it )

Thanks in advance for any info on these two issues you may have.

Wishing all as pain free a day as possible!
Angela

 
Old 03-02-2004, 01:27 PM   #2
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Last edited by barteel; 06-17-2004 at 05:44 PM.

 
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Old 03-02-2004, 01:34 PM   #3
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Re: Feel "strung out" byend of day/panic attacks

Thanks for your replies...

Meredith...I'm SURE your're right!!!! I AM very stressed...

Jonny...yes it does get better w/first morning dose, but I also take 1/2 of a 1 mg xanax first thing in the morning too....in the afternoon I feel like I've taken one of those illegal stimulant drugs many of us tried when we were younger (I'm 38..been there, done that, grew up... )

Just kind of out of sorts, grinding my teeth a lot more than usual...(I grind my teeth all the time). I've been feeling this way for a while although not when I first started the pain meds about six months ago, so I guess it's been about two months that I've been feeling like this.

Thanks again for your replies
Angela

 
Old 03-02-2004, 08:37 PM   #4
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Re: Feel "strung out" byend of day/panic attacks

If it were the meds, I would say you would have noticed it a lot sooner. My guess is you are stressed to the max. Have you tried taking the zanax twice a day, rather than once? Make one dose a bedtime dose. Perhaps that would help you relax better during sleep which would cut down on the pain when first awakening and might, just might allow you to wake up without that panicky feeling. I get the impression that you are juggling a lot of balls right now and need to make time for yourself.
Carol

 
Old 03-03-2004, 06:38 PM   #5
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Re: Feel "strung out" byend of day/panic attacks

For me, it's the meds. Though I do have depression, I've never suffered from anxiety since I started taking pain meds. In the morning since it's been a while since my last dose, the anxiety is present. It's a horrible butterflies in the stomach feel. I know if I tend to reduce my dosage of Hydrocodone or go too long, it comes back. I try to take .5 of Xanax, but it doesn't help a whole lot. The only thing that makes it go away is the pain medicine. I hate the fact it controls my body so much.

 
Old 03-04-2004, 09:46 AM   #6
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Re: Feel "strung out" byend of day/panic attacks

Hey Glenda, I think it's the timing of your meds, You are certainly not experiencing withdrawal when you are taking 3 doses of OxyC within a 12 hour period.You might in the morning when your serum level has completely bottomed out because you stacked all your pain meds in a 12 hour period

OxyC has two releases, The first release is at 1.5 hours and the second at about 6 hours, By dosing every 6 hours you are creating a large amount of overlap which virtually doubles your dose and drives your tolerance through the roof and then bottoms out when you have to wait 12 hours for your next dose..

This is certainly not the way the med was intended to be taken and although it doesn't last 12 hours for many people, Taking another dose every 6 hours when OxyC has a release at 1.5 hours and at 6 hours you pretty much double the serum level when you redose even before the second release of OxyContin has occurred. You end up doubling your serum levels plus take BT meds which is what is causing these symptoms

If the anxiety is from the opiates, It can likely be managed by dosing properly and not dosing to achieve the highest serum level possible while your at work. What your doing is not safe. Addicts call it stacking where you dose upon dose upon dose until you reach the maximum possible serum level from your meds, then it drops to virtually nothing by 4am, you feel like crap and have to start the whole process over again including the need for BT meds that are now part of your regimen and no longer being used for BT pain.

The scary part is that if you do this while on relatively low doses of opiates what's going to happen if the doc increases your meds. Higher spikes, more anxiety and a greater chance of ending up in the ER overdosed. Then your family sues the doc for prescribing such a dangerous med when it was the way you took it that caused the problem.

It's your choice to take as prescribed or continue the stacking which will just crank your tolerance up to the point of only getting minimal relief when your serum level is at it's highest during the periods of overlap and BT med.

The same anxiety you may associate with withdrawal is also a sign of too much medication taken in to short a time frame. Oxy is well known for increased energy from the histamine release, so is hydro. You even have break through medicine built into your 6 hour dosing schedule. Why?

TID or 3 times a day means every 8 hours, not every 6. The huge spike from doubling your dose and adding BT meds could be a warning that you are over medicated and your body is telling you there is a problem.

Anxiety symptoms like shortness of breath, shakiness and sweating are also signs of OD. There is no reason to take the meds way you do and I imagine your doc would have a cow if he knew how you were taking them.

BT meds aren't breakthrough meds anymore if you take the same amount every day at the same time. It's just part of your daily routine designed to create the highest serum level possible. Your body is telling you something is wrong and it shouldn't take an ER trip to see what the problem is. It's pretty obvious your not taking the meds correctly and you need to start correcting this before you land in the ER.

If you do end up in the ER because of misusing your meds, PM docs can get pretty testy about not following directions and displaying signs of addiction by stacking dose upon dose upon dose of the medication he entrusted you with. What you are experiencing is not an anxiety attack, it's a warning to use your meds correctly. Not everyone is so lucky as to get a warning.

My suggestion is to try to level out your serum level to see if it reduces the feelings of anxiety, By getting on an 8 hour dosing schedule and using the BT meds as BT meds, not when the clock strikes 7:too and 12:30. You will feel better and have a smoother serum level and the BT meds will be effective when you actually need them.

The way you are taking your meds now more than doubles the potency the doc intended for you to take. You may not have even been aware that addicts have a term for what your doing "stacking" But I'd bet the bank your doc knows what stacking is and it's a sure way to loose your docs trust and risk your own health by doing it.

If you save your BT meds for actual break through pain you may actually have the means to manage break through pain rather than just using the hydro to boost the OxyC to an even higher level. I would feel like crap too if I took my meds in this manner.

I'm looking at your schedule again and it's so obvious why you feel bad. You have a period of almost doubling the strength from overlap each time you dose at the 6th hour. From that last dose of Oxy it's just down hill as far as serum level till the next day when you start the stacking process all over again. That's why you feel so rotten when you wake up and have to start your dosing day at 4am.

I'm sorry if this wasn't what you wanted or expected to hear but what your doing is dangerous and you are misusing every med the doc has entrusted you with and looking for relief from to much opiate by taking Xanax, that's not real smart. Try to correct the problems before the only way to correct them is in detox or your spouse and kids join the Oxykills website and bandwagon. Oxy doesn't kill, misusing it does.
Good luck, Shore

 
Old 03-04-2004, 10:07 AM   #7
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Re: Feel "strung out" byend of day/panic attacks

Thanks Shore...I was hoping you'd respond.

You're right...I never heard of "stacking". I'm not trying to be an addict I'm just always in pain and trying to get thru the day at work. I did not know about how the oxy was released...it's a scary thought that I am taking another one right when the second "burst" is happening. I just wanted to be able to make it thru the day at work. As I write this I am in tears because I never thought of myself as an addict. I pretty new to this pain management stuff and just wanted to feel better.

Gosh I feel stupid.

I understand that many folks are sue happy. I can assure you that I LOVE my doc (he's my regular doc...not a PM doc). And if something were to happen that was my own fault (even tho I didn't know before your post) I would never let anyone go after him....it's not his fault.

Starting right now (when I usually take another oxy) I'm going to wait the full 8 hours.

Shore, thank you for your frank answer.

Angela

One more thought....the reason I was taking the meds on that schedule, including the b/t meds was because I thought they were keeping my pain away. I guess I misunderstood how to take b/t meds.

thanks again

Last edited by GlindaWitch; 03-04-2004 at 11:54 AM.

 
Old 03-05-2004, 10:38 AM   #8
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Re: Feel "strung out" byend of day/panic attacks

Hey Glenda, My intent was not to make you cry but to warn you that your actions are tilting toward abuse rather than proper use. Both Contins, MS and Oxy use the same double bump release. A 20 mg OxyC basically sustains 10mgs of oxy in your system for 8-12 hours.

The purpose of BT meds is for pain tha breaks through your long acting med. If you take the same amount at the same time every day, It really doesn't leave you with any means to manage actual increased pain from over doing it, injuries, or other incedental increases in pain like barametric pressure. Docs intrust us with BT meds as a way to keep us out of ER's where CP patients are treated terribly.

I knew your dose was relatively low so I didn't really think your intent was to catch a buzz at work by stacking your meds, I imagine you were just tryng to make the most out of them in a way that seemed to make sense. Doubling the strength of a 20mg oxy isn't near as dangerous as doubling the strength of a 40mg OxyC.

So be careful and I'll bet by smoothing out your serum level you will feel better in general. If in fact you do need an increase and the 20's don't manage your pain while taken corectly an increase may be in order but please don't overlap a higher strength pill.

You should be fine once on a proper dosing schedule, It will also make mornings much easier when you aren't waking early without any meds in your system.
Good luck and Take care, Shore

 
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