So frustrated! - Pain Management Message Board

Madison30 · 08-16-2004, 08:43 PM

Hi there....

Use to be REC but i've recently moved from Illinois to Indiana so i haven't been on in quite a while and i have a new name. I see a lot of new faces on here!

So needless to say i have a new PM doc and it's not going so well already. My old PM doc had me on oxycontin 20mg.3x's/day and 10mg percocet for BT and i was on that for about 6mo. and it was working great but at my first visit my new one was very short with me and quite frankly acted as if i was annoying him by taking up his precious time. He told me he thought it was an awful combination and said he was switching me to Duragesic 50mcg every 72hrs.

My MRI was repeated and it showed that L4-L5 where i had surgery to decompress looked as if a re-rupture was iminent and 2 levels above that had medium herniations and tears in the annulus and ligaments as well as bone spurs.

He prescribed exactly 10 to last me 30days......heaven forbid he give me an extra 1 or 2 for a beginner. Needless to say they worked well for 2days and on the 3rd day i was in agony and sicker than a dog from withdrawal symptoms. I was taping them down with medical tape and bandaides and everything i could think of and they were still falling off. I called the office 2 times and finallly the 3rd time my husband had to go off on the nurse to get anyone to pay attention.

So the patch was all he gave me because he said they don't believe in BT meds at their practice so i had nothing to fall back on.

Went back in on friday and he put me on Kadian 60mg. 2x's/day and man is that stuff hard to find. Makes me incredibly sleepy but seems to be helping well with the pain. Since he doesn't prescribe BT meds i'm still having to take about 2400mg. of ibuprofen to get by, does anyone know what's the max you can take on a daily basis?

I was so excited about starting with a new PM doc because things weren't going so well with my last one but this one doesn't really seem to care much at all.

Anyone have any experience with Kadian?

Thanks for listening

Kissa · 08-17-2004, 07:20 AM

Some doctors regardless of speciality give you that feeling that you are wasting his precious time, it is usually those types of doctors I never see again.
You said you moved, any chance of finding another pm? I'd give this one at least a few months try, maybe he was having a busy or bad day and the next few times you see him you won't get the same impression.

I'm not familiar with the Kadian name but according to their website it is a morphine sulfate so I'm guessing it's similiar to or the same as MS contin just a different name and is supposed to last up to 24 hours where as MS Contin lasts or is supposed to last only 12. It lasts more like 8 tops. Apparently Kadian has a polymer shell on each "grain" of medication within the capsule, which is the reason it can last up to the 24 hours. It comes in capsules instead of pill form like MS contin and interesting enough they suggest you use a sprinkle method, open up pill pour on food, for those who have problems swallowing pills.

I take only 30 mg 3 times a day of the MS Contin in generic pill form. And it made me sick at first but that passed after the first few days and now I just can't sleep well, see my post regarding BT frequency. The initial groggyness I had passed after about a week as well. I still get short spurts of it but it is most likely related to me not sleeping properly and not the meds so much.

Give the meds a little time, your body will adjust or should adjust for you.

As far as ibuprofen goes here's what the FDA has to say:
The approved OTC daily dose of ibuprofen (1200 mg/day) is 37.5% of the maximum daily prescription dose (3200 mg); the OTC dosing regimen of 200 mg to 400 mg has been shown to provide very effective analgesia and is designed to allow for flexibility in dosing where necessary

you are pushing towards the 3200mg so I'd be careful on that. Almost every place I looked highly reccomends staying at or below the 1200mg daily. It can cause stomache and intestinal problems.

Good luck let us know how the med works out

madhatter · 08-17-2004, 07:20 AM

delete delete

erfan · 08-17-2004, 11:04 PM

As I recall from what Shoreline said, Kadian is NOT like MS Contin. While a 60mg MS Contine releases 30 mg of morphine at about the 45 minute mark and another 30mg at the 6 hour mark, KADIAN releases the entire contents of the pill over a 24 hour period. Thus, a 60 mg KADIAN would release 2.5 mg/hour or equivalent to taking 10mg every 4 hours.

If I'm wrong, someone correct me.

Kissa · 08-18-2004, 06:58 AM

You are correct, however the base ingredient is the same, morphine.
I think why it does that is because as I noted each individual grain of medication is coated with the polymer and there for dissolves or is released over time instead of the timed release.