Hi...my name is Jen, I've been reading these boards for a bit...I've really learned a lot from all you guys. I just had a quick question about pain meds...can someone tell me what the next step up from Lorcet 10s would be? Also, how do they compare to Vicodin? I've been on Lorcets for a year now and they are not touching the pain anymore. I'm a student and considering leaving school because it's just unbearable now...I'm only 20 but I've been diagnosed with compression fractures in T6-T8, herniated L3-L4, and L4-L5, arthritis and bone spurs and also Scheurmanns Disease. NEver had an accident or injury, it just came on all of the sudden when I was 18, and the pain has only gotten worse. Now my left hand is going numb constantly. My back grinds so loudly you can hear it all the way across the room. And I am totally at a loss. I have no idea what to do now. I have tried everything. Has anyone here ever had a SCS for thoracic pain? I'm really curious to know how well it works. I would do anything at this point but I'm not even sure if that's an option for me. anyway, thanks. God bless you guys! Hope everyone is doing ok.
~Jen~
Hi Jen, 10mgsof hydrop is the most hydrocodone you can get in any merketed hrodocodone /tylenol combination You could decrease the amount of apap witha med called Norco it comes in 10/325 but as far as the differences between Vicodin, Lortab, Anexia, Norco or any generic is simply the portion of hydro and the portion of apap
To go to something stronger you would need to go to a class 2 med that contains oxy, morphine, dilaudid or methadone
The rconversion rate from hydrocodone to oxycodone is roughly 10mg of hydro is equal to 7.5 mgs of oxy. So even the 5 mg percocet isn't neccesarrily stronger when you compare strength mg to mg.
If 10 mgs of Hydro and whatever amount of apap isn't working the next step would be to go to something equivelent or slightly stronger than 10 mgs of hydro. If your using this long term you really want to use as little apap as possible. Percocet 10/325 would be stronger
Oxycodone also comes in pure form with no apap, in 5 mg, 15 mg, and 30 mg. They also make a liquid version of oxycodone called oxyfast/Oxydose and Roxicodone intensinol. It comes in 2 strengths, 5mg per ml or 20mg per ml. With a metered dropper you can dose any amount of you find you need. If 12 mgs works, it's easier to measure with the dropper.
If you used another med like morphine, you first step would be morphine sulphate 15mgs or Dilaudid 2mg
Here is a list of all the hydro/apap combinations and how supplied. There is a generic or name brand for every one.
HYDROCODONE BITARTRATE APAP TABLETS 5/325 mg 100s CIII
HYDROCODONE BITARTRATE APAP TABLETS 5/325 mg 100s CIII
Hey Jen, Going from hydrocodone to somthing as invasive as an SCS is insane IMO. Howw about PM doc or clinic. Is your pain radiating nerve pain or pain mainly in the spine. If it's not radiating nerve pain or "radiculopothy" the SCS wouldn't work but would make the manufacturer and the surgeon about 50K. I would be looking for PM doc and try some other modalities before anything as extreme as an SCS. You insurance may even insist you try something else before doning anything as extreme as an mimplant that has to be repeplaced every 3-5 years for the rest of your life when the battery dies.
I think because your younfg your being steered away from a lifetime of dependence on opiates but dpendence is so different than addiction it's amazing even docs use the word addicted rather than dependent. If your taking an opiate 24/7 you become dependent, that simply means if you stop clold turkey you experience abstinance syndrome, "withdrawal" Addiction is apsychologica problem and characterized with destructive behavior and psychological need for meds. If meds impropve the quality of your life and improve funtion that's not addiction.
There are also modalities other than opiates that can be tried. Compression fractures heal, If they don't and you have bone loss of more than 30% there is something called Kyphoplasty , where they inject a bone glue that seals the fractures and infltrates the bone and restores vertebral height. There are just so many other methods to manage pain before jumping to an SCS it makes no sense at all to even be considering it untill you have exhausted every recource to manage the pain and improve function.
It may take seeing a dozen different PM docs over the next few years to truly find what works for you, but once you have the SCS and it can't manage your entire spine, just a specific nerve root. So where would they use it, herniated discs in lumbar, your thoracic area, what nerve root would they attach it too. You would need several diagnostic nerve blocks to determine where the greatest pain is and those same diagnostic blocks can be used to to do olonger lasting nerve blocks or ablation of the nerve itself "destoying the nerve chemically or with radio frequency" if your having radiculopothy.
Surgeons cut, the scs is another surgery, but surgeons only manage post op pain. If this is a surgeon, once the SCS is implanted and you find it only helps with one very specific area, he's then going to send you to pain management to try everthing you should have tried prior to having the scs implanted.
Please run from that doc that thinks an SCS is an answer at this point and one that knows the difference between addiction and physical dependence.
Hang in there, Dave
Good luck, Dave
Hi Dave
Thank you so much for all the info, I really appreciate it. It was really helpful. So the SCS will only help pain that is radiating and won't do anything at all for actual pain in the spine? I have radiating pain down my legs, both of them, from the discs, but my major concern is the thoracic pain. that's what is killing me. I have done everything possible in the last 2 1/2 years to get this under control...physical therapy, chiro, ESIs, pain clinics, even did one of those stupid pain management programs for 6 weeks. My problem is really that doctors never want to prescribe anything because "I'm so young", meanwhile, I cant even live or enjoy my life and may have to drop out of school...I just don;t get it. Even at the pain management they wouldn't prescribe it, I finally had to have my GP prescribe, and that took a long time.
The last few surgeons I have seen have told me that the only option now really is a thoracic fusion, but I really don't want to go there, at least until I absolutely have to. I'm just scared of the rest of my life. I guess I'm just looking for something, anything other than a fusion, that will help me somehow. anyway, thanks again!
~Jen~
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