Hello, I am 56 and being treated by a pain management specialist due to severe DDD that is inoperable. The pain, which is in my lower back and shoots down my leg, is constant. It gets worse with certain activities (stooping down to clean, standing for more than 5 mins., etc.) but is always there at some level. I have been on Percocet for several years -- current dose is 7.5/325, which has been prescribed for BT pain. I typically don't need them til afternoon/evening, and I normally take about 3 a day. The doctor has tried several different non-narcotic meds to try to manage the pain (amitryptiline, Cymbalta), which I had to stop due to side effects. We then tried Kadian, a long-acting morphine, which made me nauseous. I'm now on Oxycontin, 20 mg. twice a day, plus Percocet for BT pain. As far as I can tell, the Oxycontin's not doing anything. I feel the same amount of pain that I did when I wasn't on any long-acting meds. I'm still taking the same number of Percs a day so it hasn't helped me reduce the need for BT meds.
My question is -- shouldn't the Oxy be doing SOMETHING? Is the dose that I'm taking considered a 'normal' dose or is it low? (I am female, 5'7" and weigh 140, if that makes a difference.) I know he doesn't want me to be popping Percs all the time, but if I still have pain, I don't have much choice. I thought Oxy was supposed to be one of the most effective pain relievers out there. I don't feel any different. What do you think? If the Oxy's not doing anything, maybe I should go off it, what's the point...
He also mentioned a fentanyl patch, but I chose the Oxycontin because the patch sounded like a hassle to apply plus it would show when wearing certain clothes. Would this be more effective than the Oxy?
I really am becoming very dejected that even the most powerful narcotics aren't bringing me any relief.
Have a couple of questions for you. Has your pain doc tried any cotail mixes for your meds? There are some that do better with muscle relaxors, headache meds, beta blockers, xanax with certain combinations only if your doc would agree might help you .
Also with your diagnostic test and results did you ever get refered to a rhumatologist? If there is diblitating disk damage then i would be willing to bet joint damage ) nerve damage could be happening as well and may be cascading.
Pain comes from all areas and not all pain meds is right for different kinds of pain. I am also conserned that nada was given for possible nerve damage with that diagnosis.
While i am tickled you are getting some help and have a pm doc, i would still suggest going to see a rhumatologist to see if their approach can help you stop joint damage and what their ideas might be on handeling long term of this thing.
I wish you answers luck and most of all relief please take care of yourself and know you are not alone.
I was on oxi for 2 1/2 years and it worked for me to a point. my PM dr has me on Kadian now. 60mg twice a day. Yes, it does make you nausea. But I also take something for that. The Kadian seems to work fine. I've tried the patch, and actually I'd like to be on just that. You can hide the patch so it doesn't show. Nice thing about the patch, is that you don't have to replace it for three days. Less pills to take.
Also, my dr mentioned to me that oxi has it's highs and lows. It gives you a boost first and then wears out. With the kadian, its supposed to be a even flow. At least that's what my PM dr. says.
To answer the questions above -- my PM doctor tried a combo of amitryptiline/Cymbalta (made me too tired), then Cymbalta alone (had some side effect I can't remember, then went through withdrawal coming off it), then Kadian (made me nauseous and the anti-nausea med made me too tired). Also he wanted me to try Pamelor (nortriptyline) but I'm actually afraid to try it for fear of the side effects -- I obviously am extremely sensitive to mostly everything. All of those anti-depressants were supposed to help with nerve pain. I haven't seen a rheumatologist but I don't really know what he/she could do other than what's been tried already.
I haven't noticed a lessening of pain with any of these drugs, including Kadian (morphine) and Oxycontin. The Percocet takes the edge off but the pain is still there. If the pain is severe, I have to load up on the Percocet, but then I am buzzed and plus start feeling sick. I just wonder why the Oxycontin doesn't take the pain away...is the dose not enough, or is this type of pain not helped by Oxycontin....
You said [i think] the percs. work better than the oxycotin.Percs. have the narcotic oxycodone,oxycotin have the same narcotic[oxycodone] the difference is oxycotin is time-released,and also,oxycotin doesn't have all that tylonol in them.The way oxycotin works,a 20mg oxycotin will release 10mg of oxycodone the first hr,and 10 mg the 6th hr. a 40 mg oxycotin-20 mg of oxycodone the first hr,the other 20 mg. the 6th hr.Many peaple[including myself] complain that oxycotin doesn't last 12 hrs,that the maker[perdue] says it does,and most doc. know this,and will perscribe them tid[3x a day] I take 80 mg of oxycotin tid[3x a day] wich releases 40 mg first hr,40 mg. 6th hr. iI tried the patch,but i was always tired,and had problems with them staying on.Goodluck,let us know how you make out.
Late in the fall of 2004 my pain was as you described and I was taking both Oxycontin and something for breakthrough as well as muscle Relaxers. My pain was unbearable, I think because my body had developed a big tolerance to the oral meds over a period of years. I was offered a 7 day trial of a Codman Morpine pump after my spinal fusion L5/S1 that supplies a constant supply of morphine delivered via a cathedar slightly under your skin to the intrecal space of your spinal column. The medicine since it applied directly to the affected area and it is not having to be metabolised and filtered by all of your organs . With all of the oral meds I was taking no amount was sufficient in controling my pain nor could the doctor legally prescribe more. I went through a 7 day trial and the pump gave me really good pain relief with very few if any side effects. I take as little oral meds now as I can, and feel so much better. It is not a CURE ALL 100%, I do live with pain everyday and will probably have to the rest of my life, it is that or be a zombie and have no life. The pump allows me to feel like I am back with the living if you know what I mean. I take only oral meds on the worst of worst days, by doing this I don't develope a great tolerance and the orals work on the real bad days like a climate change, or from prolong sitting or possibly I slept wrong or twisted the wrong way. I hope this helps you out. Check into the Spinal Stimulator as well, I was never offered it or knew anything about it prior to the pump> The pump was my last resort and I am glad that I choose it. Hope you can find the help that you need fast and are feeling better soon. Jeff
I feel for you. But what sticks out to me, is that you only mention seeing a pain doc - not a team helping you manage your condition. The trend now is to employ yes, a pain managament doc for meds, blocks, injections, etc, but, also, a psysiatrist, a sports medicine psychologist,clinical hypnotist, nutritionist, PT, OT, fitness instructor, Reiki,etc.- a team approach that looks at the whole person. I would suggest checking out university centers close to you to see what is offered - it will be worth the trip.
Nothing is worse than popping pills all day long. Eventually your body builds up a tolerance, requiring higher dosing or switching, it is a vicious cycle.
I have a chronic debilitating illness. I was told by a prominant NYC physician that there was nothing he could do for me except give me another pill. He was WRONG. I now am walking, exercising, happy, yes, IN PAIN, but functional. I employ all of the above techniques that I mention. It is WORK, but like anything in life that is work, is is worth it! I still require meds, but now I am in control of my life, not the illness or the medications.
Good luck to you
I'm very sorry to hear you are in so much pain. I was at the same place you are a few years ago. Severe DDD in 3 discs and inoperable. Oxycontin wasn't doing much at all for the pain and my breakthrough meds were only half way helping. After much discussion with my PM doc I had a morphine pump implanted. I'm young (30's) and was facing a lifetime of pain control, so this was a good option for me. I'm still unable to walk/stand/sit for long periods, can't work, etc., but my pain is controlled somewhat better if I'm careful.
There is also a Spinal Cord Stimulator (basically an implanted TENS unit) that I have heard works very well for some people (Jerry Lewis has one). Please know there are options for you. I am not advocating running out and having a pump implanted or a stimulator. They both are life long commitments. But after you have exhausted ALL of your options, they can be extremely beneficial in terms of pain control.