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Old 11-04-2006, 11:08 AM   #1
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Question How much ultram is TOO MUCH ??

Hi all !! I have a question concerning Ultram. I returned to the doctor's this week being fed up with the pain . I have been to 8 doctor's in the last 12 months and they all say the same but no one as of yet knows how to treat me. I am as of now waiting for Cleveland Clinic to call (if they can't find a treatment no one will ) anyway back to my question. My doctor said in the meantime while waiting to find a doctor who may be able to help me he will do all that he can to keep me going. My PM doctor left this area last month and my regular doctor said to just come to him because he can do the same thing with my meds. I have been taking 2 -50 mg. of Ultram every six hours. They don't help much but they do take the edge off. So I asked my doctor if maybe I could try more of a dosage. (All doctor's want to put me on the Fetanol Patch , a few doctor's also recommended Morphein. I have refused all of these) My doctor said he would help me if I ever felt I needed to get off of the Ultram but in the mean time I should take more to try to relieve the pain. He suggested to take at least 4- 50mg. every 4 hours and if that's not enough he wouldn't care if I upped it even more . I am now taking 3-50mg. every 4 hours and I have seen little difference. My question is HOW MUCH WOULD BE TOO MUCH ?? I can understand he wants me to take enough for the pain to be relieved but I am afraid I could take too many and possibly die of an overdose. If anyone out there has an knowledge on Ultram I would love to hear from you in the mean time I send my best wishes to all my fellow partners in pain.

 
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Old 11-04-2006, 12:37 PM   #2
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Re: How much ultram is TOO MUCH ??

why are you opposed to trying morphine? i would not recommend trying the fentanyl patch until you are tolerant to opioids. you may also want to ask about methadone. i have heard of good results with that and it is long-acting from what i understand.

i am on the fentanyl patch now and have had good results. i had been on hydrocodone and oxycodone for nearly two years before moving on to the patch. i now use oxycodone (without the tylenol) for BT pain.

don't be afraid to take strong medications, even opioids, if you are really in pain. pain should be treated and treated adequately. you may become dependent, but that doesn't mean you are addicted. those are two different things. one doctor once told me, when i was worried about this, too, that if i could feel a buzz or high with a medication than it was too strong and to go down a level and i could easily regulate what my body needed. i have never felt that "high or buzz" people sometimes report. i guess the medication just goes straight to the pain.
good luck!

 
Old 11-04-2006, 01:14 PM   #3
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Re: How much ultram is TOO MUCH ??

Thanks for replying Mrsswank !! I had spinal fusion in 2000 and was on oxycotin while recovering at home and I was not in my normal mind, I don't remember much and what I did do I had to be watched. I had also taken percs before only to still have the pain but have alittle buzz with it. I guess what I am saying is I do not want to feel the least bit 'out of it' . My youngest child is 16 and I just am afraid if I try the stronger meds I will look back some day and not remember her teen years at all (although some parents might think that is a great idea, lol) I had one doctor recommend Morphine pills and 3 other tell me they are so happy I didn't get them filled. I am willing to try every pain pill first before I have to give in to the 'big meds' . I just want something that will make me able to lead a somewhat normal life without the feeling of being 'high' I know with moderation this can be accomplished with the more potent meds but I am trying first not to have to go that direction even though my pain is not being touched by what I am taking now. I have never been a person to take any meds even cold remedies and now I see am heading the complete opposite way. The ultram that I am taking make me still feel like my head is clear and my family agrees that I seem to be ok, I just wish it could work better for me . Along with the ultram I also take zanaflex (muscle relaxer ) and ambian cr for sleep (which I recommend highly for those who can not sleep because of pain ) . I am just so frightened to take the next step, my fear is not the dependancy because I am sure my doctor would help me there but I am frightened of just not being myself. In a perfect world there would be a pill that would take all our pains away until then I will climb the ladder of meds slowly (and painfully). But these boards help alot if not just venting but also the great advice by people that have been there!

 
Old 11-04-2006, 04:08 PM   #4
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Re: How much ultram is TOO MUCH ??

so, are you taking the pills for postfusion pain? first of all, i found no relief from my spasms with zanaflex, but have gotten more relief from soma, so that may be a bit of help. also, have you tried the lidoderm patch?

 
Old 11-04-2006, 08:51 PM   #5
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Re: How much ultram is TOO MUCH ??

Actually my fusion went well and I was better than ever after the lengthy recovery time.I went back to my very stremuous job. I had to give up my job of 20 years this past January because now six years later I am dealing with something totally new. I (for some reason)have no cartidge between my pubic bones (this is extremely rare, and very painful) then while I have been trying to get some help and relief from this I now found out from a mylogram I have a degenerated disc right above my original fusion.(this is also extremely painful ) So I am practically bone on bone in two places in my body and so far no doctor has suggested any type of surgery so for now all I can try to do is treat the extreme pain. Yes I do take zanaflex as directed and I have found little relief from it except if I don't take it at night my mornings are much more painful. My life has really changed dramatically in the past year. I no longer work, my husband now works two full time jobs, I can no longer do the things I use to do plus all I do is go to more doctors and take more drugs. But I actually am not complaining,yes my life right now is not looking good but I know it could be much worse..therefore I take one day at a time and take nothing for granted..............but it sure would be nice to be painfree if only for 3 hours !!

 
Old 11-04-2006, 10:01 PM   #6
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Re: How much ultram is TOO MUCH ??

Queeneeee....Your doctor told you that you could take 4-Ultram 50mg every four hours. Would that be like 4 at 6am, 4 at 10am, 4 at 2pm, 4 at 6pm, and 4 at 10pm (making a total of 20 tabs a day) or around the clock? I take Ultram, 2 every 4 hours and it doesn't seem to be enough to take the edge off anymore, although my doctor says I can take more, but like you I am scared to take more in fear of overdose or something. All I want is the edge to be taken off and to be able to get through each day. I take Ambien as well, it is a wonderful thing. Thanks for the info!

 
Old 11-04-2006, 11:00 PM   #7
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Re: How much ultram is TOO MUCH ??

Yes Chef Elizabeth..my doctor had me taking 2 -50 mg every 6 hours . Now he changed it and said I could take 4-50 mg. every 4 hours. He even said I could take more if needed. I don't quite understand it because like you I am afraid it may hurt me , maybe not now but maybe in the long run. He said not to worry when I need to stop them he will help me and it will be no problem. I have taken 4 -50 mg around the clock for 3 days now. I really don't see alot of difference... I am hoping it will help once it's at it theraputic level. Yes ambian cr is my favorite bed time buddy !! Without it I am up all night in terrible pain. With the ambian I sleep without ever awakening throughout the night. Good luck to you and to our livers ......I just wanted to add I went without my ultram for 48 hours (missed the drug store on the weekend) and the pain was worse then ever, which means they do work for me and I did have withdrawal symptoms which I didn't realize then but thanks to this board I now know that is what I went through... it wasn't fun !!

 
Old 11-05-2006, 01:16 AM   #8
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Re: How much ultram is TOO MUCH ??

I am not quite sure why suffering is better than living a less painful life if meds are required. You can start on a very low dose of morphine or methadone, keep a pain diary especially monitoring your psychological well being.Living with less pain can give you your life BACK..... You worry about your family, but wouldn't they be ecstatic to see you living a more comfortable life? Pain Management is not a test to see who can go longest without "hard" meds.Keep an open mind, listen to folks on the board since they are great resources and have been thru many,many different scenarios.

Ginger Snap

 
Old 11-05-2006, 08:25 AM   #9
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Re: How much ultram is TOO MUCH ??

Hi Queneee - Just a quick note about how much Ultram is too much Ultram. I was taking Ultram in the doses that your doctor is recommending. I began experiencing some very strange auditory "hallucinations". Please don't laugh! If I was exposed to any kind of loud, sustained noise, like a truck passing by or a lawn mower in my front yard, I could hear classical orchestrations and band music! These weren't songs that I had ever heard before....these were Mozart, Bach, etc.-sounding compositions coming right out of my head!! This went on for about 7 days and it scared the beejeebers out of me!!! It was the most ***zare side effect or over-dose effect I have ever experienced with a medication. I spoke to my doctor who recommended that I either lower the dose, or stop taking it if it wasn't really helping (which it wasn't). I went to the literature on Ultram and did find that there is a notation about auditory symptoms as a side-effect. In addition to the Musak-effect, I felt like a total zombie on that much Ultram. I switched to oxycodone and found it to be much more effective in treating my pain. I'm glad that chapter in my search for pain relief is over, although I do miss a good John Philip Sousa march now and then!! KathyMac

Last edited by BrittleBones; 11-05-2006 at 08:27 AM.

 
Old 11-05-2006, 01:24 PM   #10
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Re: How much ultram is TOO MUCH ??

Queene

I just want to mention someting to you. Do not buy into the "if the CC can't find out what's wrong with no one will". While the CC is a fine organization they are well known for one thing, hearts. When you start talking back, bones, joints and more then forget it, they are no different than any other hospital. I've been misdiagnosed by them 3 times for bone and genetic conditions. They are not the best hospital there is. They get their name due to the incredible heart work they do and because the Cleveland Browns players visit their sports department. It in no way reflects how the rest of the actual hospital works.

If you are willing to come to Cleveland then I highely suggest you forget about CC and head to University Hospital System instead. Their Chief in the bone/arthritis department is one of the best there is around. They are well known for back problems (while your's are the hips) and other joint problems. In fact most individuals I know who have these types of problems end up at University only after CC has failed to even help them.

Please consider this and please do not buy into famous name. If you want a doctor who will do the best that he or she can with your condition I do believe University will service you better.

Additionaly there's a doctor who did my hip replacement that is world renowned and definately cutting edge and very knowledgeable about rare conditions. He is from the CC system but doesn't work at the CC, he works for a satellite hospital they bought. The Hospital is Luthern. The doctor is Bernard Stulburg. He is top in his field and is one of the most respected hip/knee/back joint doctor around. He is the go to guy that all hospitals here refer patients to. His care is outstanding and he's very well versed.

You might actually want to consider calling him or his office and see if perhaps there's something they can do to help you. I do feel that this is your best option. He is also in the Cleveland area.

I wouldn't fear being on stronger medications. It may just very well end up there's nothing they can outside of some sort of surgery. Your body adjusts to medications over time and you don't feel that rush or high feeling. Medications like Percocet and Oxy are known for the rush or high they give which is why they are so often sought out by drug seekers. But medications like Methadone you never feel that high. It's also rare, at least for me, to feel that type of feeling with morphine either. I think you'd do well either with morphine or methadone.

I am on the timed released Morphine and yes I feel a little bit of a lift when it first releases and again when it does, but it lasts for maybe 15 mintues at the most. After that I'm totally normal and you'd never guess in a million years that I have been on Morphine. I do not feel in the years that I have been a pain management patient that I've really ever been in a fog and missed out on anything important in my life or the life of my family.

You will of course need to start with low doses and the goal of course is the least amount of meds for maximum relief. Discuss the other meds with your doctor and give them a chance at least. A day is going to come when Ultram does nothing for you at all and it seems you're nearing that point anyhow. Going back on Percs or Oxy (which are basically the same med, one without tylenol is all) probably isn't a good idea because of how they make you feel but the others will most likely give you better relief with less side effects.

Good luck
Barbie
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Old 11-05-2006, 09:22 PM   #11
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Re: How much ultram is TOO MUCH ??

Queeneeee...what kind of withdrawl symptoms did you experience from Ultram?
I wonder why there are withdrawl issues with Ultram and not with Ambien?
I have been on Ambien for a few years now, and a few times I have been without it and never experienced any withdrawl symptoms (except not sleeping of course).

 
Old 11-07-2006, 12:42 AM   #12
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Re: How much ultram is TOO MUCH ??

400mg per day of tramadol is generaly considered the maximum.

However, you can boost the effect by adding acetaminophen (1gm 4 times a day) or/and ibuprofen (400mg 4 times a day) to the tramadol regime.

 
Old 11-08-2006, 01:57 AM   #13
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Re: How much ultram is TOO MUCH ??

The patient data included with my prescriptions of Ultram specified: "Do not exceed 400MG per day." Online inquiries about the drug result in the same answer. Also, my doctor explained to me that the toxicity threshold for Ultram rises dramatically at doses even slightly over 400MG in a day.

Please check your patient drug data sheet, put in a call too your pharmacist (that's what they are trained for), and check that your doc was not refering to a NSAID or some other confusion was involved.

I find it difficult to imagine a doctor writing or a pharmacy releasing so many hundreds of doses on one prescription.

TC

 
Old 11-08-2006, 08:59 AM   #14
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Re: How much ultram is TOO MUCH ??

Quote:
Originally Posted by Queenneeee
I (for some reason)have no cartidge between my pubic bones (this is extremely rare, and very painful)
oh, i sympathize. i didn't have exactly this, but with my last pregnancy the cartilage tore and the pubic bones separated - just turning in bed at night was excrutiating, movement of any type, i would crawl to the bathroom. horrible! i finally got some relief with a chiropractor with expertise in this area and handling pregnancies. are they sure there is no cartilage and it isn't just torn? with proper realignment, it will heal on its own, otherwise it still just stay that way.

i am so sorry for your pain.

as for the above-fusion degeneration, i was told this was common with fusions, as it puts extra stress on the disc above it. i am sorry you are having so much pain with it. i have congenital DDD and i know how uncomfortable it is. i have been bone on bone (fused one level and artificial disc above it to prevent rapid deterioration and domino effect above) and know what it is like. UGH!

 
Old 11-08-2006, 09:48 AM   #15
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Re: How much ultram is TOO MUCH ??

Queenee,

The ultram dosage seems quite high,trying something different may help the pain level and give you some relief before getting into the Cleveland Clinic.

I have had 2 prior lumbar surgeries and I seen a DR at the CC and he was a real wack job.The second neurosurgeon was great very professional and straight forthcoming .My 2 surgeries have failed and has left me with additional thoracic problems.The first surgeon wanted to remove the titanium disks and rods and just totally fuse the entire lumbar spine.The second surgeon stated that the possibility of total paralysis was to great to take that chance.Which I knew.The neuro surgeon that done my second surgery attemted to remove the cages and found out the are lying on the spinal canal and the rods were put in to releive all the pressure from the spine caused by the cages.

The CC is a fine state of the art hospital known for there heart clinic,but there are exceptional DRs in other departments then they have there handful of quacks.I also see a neuromuscular specialist and I go to the MS mellon institute once a year for my MS.Their pain management clinic is great.

I really hope that a DR there or at another institute can get you the help you need.Living in extreme pain is a disorder in itself.

I have also found that chiropractor care if its a good one can provide some relief.

Best wishes to you

Toni

 
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