Hello, it has been 5 months or so since i've made a post, I suffer from severe chronic pelvic pain which is been going on for almost 3 yrs now. I have been on a lot of different drugs and have had tons of test done in the past I am currently on 90mg tid of morphine switched over from 40mg tid of oxycontin and before that 50mcg of duregesic q 2 days with 25mg of elavil at bedtime and many different short acting opoids, antisezure meds antiiflammatories,antidepressants,muscle relaxers and every thing else that is used in combination for pain relief.The morphine I am finding does not cover my pain at all compared to the oxycontin and the duregesic wasn't much either as I always had a lot of breakthrough pain with it.morphine I find makes me feel very sick, but none of the other opoids i was on did including demerol,oxycodone,dilaudid,pentazozine(t alwin),fentanyl,codiene,opium&belladonna ,etc.
My pm doc gave me a drug called clopramide to prevent the sickness and it does help, but the morphine is not giving me any relief at all is that normal because it is double the amount of the oxy I was previously taking which covered my pain much better! But my doc just wanted to try a different drug on me instead of upping the oxy to 50mg tid from 40mg tid,
He said if the morphine continues to not work he would probably put me back on an oxycodone based drug, where I live there is this specialty compounding pharmacy which compounds a capsule with oxycodone as the base, I am not sure what else is in it or how it would last as a long acting drug?? it is a every 8 hrs capsule, but I do know they add cayenne or ginger in an atempt to prevent snorting the drug. A good friend of mine is on this capsule 100mg tid because his doc feels more confident in prescribing it over the real oxycontin, but this friend is finding that it does not last 8 hrs as the real oxycontin does not last the 12 hrs like it is suppose to, one advantage I do know about it is and that is the doseing can be upped by whatever is needed. Which makes me wonder if it is basically like an immediate release drug or if something else is added into the mixture within the capsule to make it long acting? The other option is hydromorph contin which I do not believe is available in the USA yet so I don't know if anybody would know much about it??
I suppose methadone could be another one as well that I could try, methadone does not seem to be used as much in Canada for pain or not in my area which is Moncton, NewBrunswick it is almost exclusively for opoid addicts. I am not really sure how hydromorph contin works either never heard much about it?, I know it is a long acting dilaudid type capsule coming in strengths up to 32mg a capsule. Also I don't know much about methadone either? Anyway I sure hope something can be done so I can start getting some sleep at night and be SOME WHAT pain free again or have a doc just find out what is causing my pain. The pain is deep in my pelvis which reffers pain to my testicles and that is whwre it is unbearable! Anyway I hope somebody can give me some input if they would (shoreline) or who ever wants to, thanks very much and I hope everybody has a pain free night!!
I'm sorry you are in so much pain, Shawn. It sounds like you have tried almost everything. I'm wondering if it is just that the doctor has not put you on a high enough dose to stop the pain. If he keeps switching low doses of drugs, what is the point? I'd say ask for whatever drug you tolerated the best, and ask for a high enough dose to get pain control. If you have never had pain control of course nothing works!
I was the same way when I first started on meds. Nothing worked, because I was in a terrible amount of pain, and I needed a terrible amount of medication. I didn't know that. Maybe you should change doctors. If the one you have is not giving you enough medication to stop the pain, he is just torturing you and wasting your time.
It is not about finding a magic drug: they all work basically the same. It is about taking enough and often enough to stop the cycle of pain.
Hi Shawn, Actually different opiaites do work better on different types of pain.
Everyone reponse is going to be difeferent but generally, methadone works better on neuro panin, Oxycodone works better on visceral pain. Because different opiates bind to different opiate receptors the response can be very dramatic from one to the other. They all bind to some common receptors but The class of synthetic opiates called Keto opiates "oxycodone,Oxymorphone, Hydromorphone and Hydrocodone" Do bind to receptors that opiates derived drectly from opium like Morphine, codiene and Heroin are very dfifferent from synthetics. The opiates in the class of Fenntanyl are fentanyl, suffentanyl, affecntanyl and carfentanyl do bind to receptors Morphne doesn't touch.
Methadone is in a class with levodromoran and darvon used in darvecet are another class and bind to receprors others don't. The laws in Canada are dfferent and ifa doc must have a special licence to prescribe methadone, whether it's for detox/maint or for chronic pain. But it is an option. You guys up north have asome meds we don't have available like Hydromorphcontin but Purdue has come out with a more tamperresistant longer lasting"24 hour"version called Palidine which shoukld be available in the US in the next few months. It already has FDA aporval.
Swithcing from Oxy to MSContin, you would need more mgs because mg to mg, Oxycodone is stronger than morphine, some charts say it's 50% stronger some say it's 100% stronger. It's important not to get wrapped into what a chart suggest the conversion s, they are simply guides to get patients into the ballpark without OD and without causing withdrawal. Synthetics also tends to be less harsh on the stomach and don't cause as much initial sedatiuon, so needing more mg to create the same or better anelgesia is pretty normal.
It's just a matter of trial and error untill you find the right med, the right dose and the right dosing schedule.
keep at it, report honestly with your doc and if yorur doc seems to have mental limits on his dosing, it may be time to change docs. When it comes down to it, what difference does it make if you take 300mgs a day or 600 mgs a day unless the side effects prevent you from increasing. But keep at it and don't except less than you know what they can do for you.
There are also adjunt meds that can improve the action of the meds you take. One of the latest is Nemanda but it's apotent NMDA blocking agent that should help with with pain threshold, pain tolerance and neuropathic pain.
The right doc will knopw of adjunct meds and will be willing to work with you on the dosage. Take care, Dave
Shawn, sounds to me like you have taken just about everything. I am totally "empathetic" to the pain you are having!! But what has really hit me is what is "causing" this terrible pain you are experiencing?? It sounds like you have been given all the pain meds. but have they done anything to find out where the source of your pain is coming from?? It could be something very serious. Pain is a symptom of something wrong! This concerns me...sounds like you need to find a doctor that can diagnois a problem rather than just prescribing you all those pain meds. Of course you know that all the meds. you have been taking are addictive and that those meds. just "mask" something that is truly wrong! Good Luck, S