OxyContin? - Pain Management Message Board

erfan · 08-13-2005, 08:30 PM

I have been on the Duragesic 75 mcg patch for 1 month. Prior to that, I was on the 50 mcg for 1 month and prior to THAT I was on 100 mg MSCOntin BID. My BT med is 30mg Roxi.

I do not feel any great relief from the patch. I'm a little worried about gpoing up to 100 mcg because right now I feel like I'm on the cusp of some of the side effects.

The Roxicodone works great. Does that mean that OxyContin would would work better?

The climate for OXYC is so poor right now that I don't think that it might be a choice.

To refresh, I have 4 levels of Herniation, Stenosis, Sclerosis and thecal sac impingement.

Another thing is that previously, all of my pain has been on the left side. Now, i am beginning to get sciatica on the right side alomng with the same pain in the thecal sac. What could THAT mean?

Shoreline · 08-14-2005, 09:26 PM

Hey Allen, I wish there was a cut and dry answer, The logic makes sense, but some docs flat out won't prescribe OC. The don't use it any my group of docs but do everything lese.

If you do go that way, Your tolerance to Roxi will be part of the dosing equation too, so that means starting faily high. Personally if this is what I wanted to try, I would switc your BT med away from OC. It wil simply addd to your tolrance of oxycodone and you wouldn't benefit from hitting multiple receptors . MSIR would probably be the better choice but that's Just MO.

Personally, I've seen more rapid tolerance issues with oxy, but that may be simply because it was nitially a frtont line drug, if they couldn't get it right they titrated a bit to much before switcing to a new med. There could be many reasons why I see folks impressed by 20 mgs twice a day and taking 80 3 time a day a year later. Unrealistic expectations, tryng to maintain O pain, With the leg pain it;'s going to make it even harfer wto maintain and except that nerve pain is simply different tha other types of.

I'm sure there are plenty of folks that think it's a life saver and to them and all the others it is. All ou can do is give it a try and you have some other things to compare in the back of your mind. IF you see tolerance devloping too quickly I think you know it's better to loook at a diffeent med than put your doc on the line prescribing hndreds of 80's a month. He would much rat5her prescrbe 15 or 20 100ughg patches than 240mg oxyC a month. But whatever works bets. The only absolute is a BT meds from a different class will bind to receptors your base med doesn't and likely give you better relief.

Sorry to hear about the bilateral radiculopthy, that really confuses docs, didn't they tell you that only one leg is supposed to hurt.

It sounds like time for more tests, a meylogram/CT will show what's going on without scattering from hardware.

Good luck and keep us posted. Dave

erfan · 08-14-2005, 10:59 PM

Thanks for the reply, Dave. no, the emphasis has always been on the left side because that was where all the pain was. Now, it is almost like a mirror image of the pain on the right side.

I originally started with MSIR and switched to the Roxi. The Roxis work great which is why I thought the OxyContin might be the way to go for the LA. I do need to go up on the patch, but I'm afraid because with the 75's the side effects are a little worrisome. I know I should give it more time. I've read you enough to know

I guess I will see about the 100 mcg because I can tell you that the 75's are not cutting it!

Today was a rough day. Changing day for the patch. Even after the change, I had a bad time at dinner and then did a little food shopping. Feel a bit better now.

Hope your having a great weekend!

Alan

76Owls · 08-14-2005, 11:20 PM

hey there ~ sorry to hear about your pain. I too have suffered from the bilateral radiculotrophy (sp?) pain starting on my 5th year now. I have had many tests, including the EMG, which showed alot of nerve damage. Since you mentioned the sciatic nerve issues, have they put you on anything like Neurontin? I started out on 600mgs twice a day and gradually worked up to 3600 mgs a day...which is the max. That helped for awhile with the severe sciatica, but it did cause weight gain, which is not good for patients with back pain. The extra weight just makes the back work harder to carry around the extra weight. I also kept having the Oxycontin doses increased. This became dangerous, as I was becoming a walking zombie...and all the time I was still in pain.

What was the point?
I finally got hooked up with a WONDERFUL pain management specialist doctor who worked for a long time to come up with the right combination of pain meds to keep me more comfortable. He was also concerned with my emotional state of being, which no other doctor seemed to care about. It really is like a death in the family when you (I) lost the use of part of my body. Anyway, I also had a Medtronic spinal cord stimulator surgically implanted along my spine to help with the back pain, as well as the leg pain from the sciatica. The stimulator is like a 'tens unit' or massaging vibrator on the inside of your body, right on top of your back bone. It has electrodes that can send currents throughout different parts of my back and legs to help control the pain. It's wonderful!!!

Although, while this helped take away about 60% of my pain, the other 40% was still a major issue, so my doctor did a series of "shots" called "Facet Nerve Blocks". These basically burned the nerves in a particular part of my back &/or legs. The trial shots worked very well for my right side, but not my left. I only had the right side permanently done...and I think the results were fantastic. The good doctor said the nerves will grow back in about 3-4 years, and by then, they may or may not remember that they were in pain.

At least I will get several years of help before the nerves grow back. Anyway, you should ask for a specialized pain management doctor in your area any questions that you may have...and possibly one that works with Medtronic products. You could look up www.Medtronic.com to check out some of their other options. Any good qualified pain management doctor should be able to help you with any questions too. I know they also work with worker's comp patients if that applies to you. It does to me, and I have had great care...even here in Texas where they are in the process of revamping the WC system. Good luck on your research.

Don't get stuck in the trap of thinking that only medicine will help. I had a doctor that just did that...and while he tried to keep me out of pain, he just kept upping the dosages of my meds. I was on way too much meds to function anymore

...and that does not include working either. I am classified as disabled now. Good luck to you.