Just come from my doctor appt. an he made a change in my breakthru med. from Percocet to the Oxycodone.He said he wants me to get away from the tylonol in the perc. but has anyone found the the Percocet just work better?I know it's the same amount of pain med minus the tylonol an I told my doctor I quess I could just take a tylonol with them an he said that was up to me but as my doctor he didn't want to have his name giving me the Percocets.I have taken them for over 2 years @ 3 aday for breakthru along with 3 Oxycontin.I can see his point just wondering if I'm the only one who finds the Perc. works better.My medicine isn't working as well an we may have to increase or change which is my biggest fear.it took so long to finally get some pain relief but after 2 years I have built a tolerence to it I guess.I will need pain meds rest of my life an so afraid of one day nothing will help my pain.This process has went on over 10 years with me starting out on darvon an I really fight any increases.My doctor says not to worry that we have plenty of other options when that time comes but what I read about for severe pain is the Oxy or Methodone.I would welcome any reponses from other's who are on high doses of pain meds an what helps them the best.Thanks babycakes I take 80mg Oxycontin 3day an he is allowing me up to 8 of the 5mg oxycodone day for breakthru.I know it sounds like alot an thats what scares me about my future.
Hi Babycakes, The thing with BT meds is if you use them every day at the max amount to supplement a dose of LA meds that's simply too low or ineffective. When you actually need something for an incraease in pain "break through pain", Those same 8 5mg oxy's aren't going to be any more effective than any other day you take them at the max dose. Meaning if you take 8 a day whether you need it or not just to increase the effectiveness of the LA med,they become part of your daily routine, what are you going to use when you have a true flair? The med you take for months prior to a major flair even if it's something minor like a fall, a weather change or overdoing any activity you have nothing stronger to take than you took every day for months prior to needing something additional.
I look at BT meds as a way to keep out of the ER, as a way to prevent calling my doc after hours or for an emergency apt. If you take them just to increase the effectiveness of the OxyC, those BT meds just become part of your regular routine.
If you have the ability to get by taking one or two doses, which is what the proper dose of LA med should leave you needing, you would have the means to manage additional BT pain. IF only 2 or 3 tabs a day become part of the routine, you will still have something extra you can take if you need it for BT pain or pain relaed to an activity. Otherwise you may as well just increase your dose of oxyC and reserve the use of BT meds for BT pain.
The general rule for OxyC and BT meds is if you need BT meds more than twice a day, your oxy dose should be reevaluated. Otherwise your getting no benefit of a long acting med as far as freeing you from clock watching and the ups and downs of SA meds. Having to dose 6-8 times a day when we have meds that last anywhere from 8 hours to 48 hours defeats the purpose of using a LA med other than to get to high doses. The idea of LA meds is to move on with life so you don't have to dwell on when is your next dose and when can you take another pill.
Combining the two "LA and SA" as part of your normal regemin, even if you take 2 oxy 4 times a day, your stll taking 7 doses of pain meds a day along with the other meds used to treat chronic pain. It becomes more of a situation of when aren't you taking something for pain rather than forgetting about the clock, forgetting about staying out too long and more importantly avoiding the ups and downs that short acting meds create. If you only feel good when you have the max amount of meds in you at all time, something is wrong with the dosing of your LA med and then you feel wrotten when the SA med wears off and your back to where the LA med meaves you.
Confusing pan relief and the feeling SA meds produce is a big pitfall you want to try to avoid. Feeling the need to take something every 4 hours can be as much a psychological factor as an actual need and then your tip toeing along a fine line between dependence and addiction.
If your going to take apap in adition to the Oxy just keep your apap intake at or below 2000 mgs per day. There is nothng wrong with still using a couple tylenol for a headache. Just because it takes X amount of opiate to manage a CP condition, it doesn't mean apap looses it's ability to reduce a fever, relieve a headache or other incedental aches and pains.
Good luck and if your doc is willing to work with your LA med, I really see more harm in taking lots of BT meds rather than increasing your base dose of LA meds so you don't have to live in 3 hour increments waiting for your next dose of whatever form of oxycodone your taking. Heck, why not just save all that money on oxyC and use BT meds around the clock, they don't do that because it's a crappy way to manage chronic pain, but it can become a habbit we get used to thinking we need a to take something or something has to make it better and the more often the better it must be.
Some docs don't use BT meds at all, some docs see BT medsthe same way I do, They have given you the mans to manage extra pain so what are you doing going to the ER or calling on weekends or adjusting monthly apts to get you in early to accomadate an increase in pain.
Obvioulsy they can't increase everytime you have BT pain, if the max dose of BT meds become part of your dalily routine, that's the only option your leaving your doc. Which may end your relationship with the doc because they know if they give you 4 pills a day you would take all 4 or if he gives you 12 you would take all 12, how many doses of SA meds would satisfy someone that hasn't broken the 3-4 hour cycle and what benefit is shown by using these meds if you can't break a 4 hour dosing cycle with meds specifiaclly designed to do this. Using them correctly is just as important as not running out early as far as compliance goes.
Take care, Dave
Thanks for the replys an Yes this is what my doctor talked about yesterday,the fact I may need to have my Oxy increased,He has allowed me up to 8 oxycodone for breakthru now but what started happening was every nite I have been waking up in horrible pain an I would try my best to wait until time for next dose,this is with the Perc. so I just asked him if I could maybe have one more Perc. to take then,,so he agreed with what your saying about fact I'm not getting enough pain relief from my LT Oxycontin dose an so he may increase the LT.I think he would have yesterday but I wasn't ready because I have made over 2 years on this dosage but he said I have built up tolerence an thats part of dealing with pain mtg.I appreciate the wise advice I have recieved an it makes me feel better to know I'm far from alone in this fight to try an have a painfree day.Thanks babycakes