issues with mom again - Pain Management Message Board

ffb · 01-02-2007, 11:22 PM

I hope you all remember my post a few weeks back, I was the one with the teenagers that took my moms meds. Well that situation is completely controlled. The meds are now at my husbands office in their safe. I take jer meds over each evening for the following day. That seems to work well, except the occasional very bad day and I have to take her extra.
Well I followed your advice and it has been working. My mom was the 65 yr with many medical problems needing pain meds, etc
She is now taking meds for Diabetes, HBP, Heart, and pain.
Her pain meds and meds for depression and anxiety are as follows:
40 mg oxy...2 daily
5 mg oxy IR..as needed
4 mg Xanax daily
3 zanaflex
2 flexiril
cymbalta
wellbutrin

She has an appt with her primary care dr this next week. I have many concerns to bring to her attention and would like to go in with a game plan. This dr a very popular with the elderly in our local area and it very hard to get hold of if not during your regular appt so you must take advantage of the entire 5 mon she will give to us. But she is very good dr and at this point in my moms life, she can't switch drs.
Anyway, the Oxy 40 is not enough and the IR for BT is not doing anything, might as well be eating M&M's. What can I ask for the dr to add for the breakthru pain, or should she take 30 mg 3 times daily for better pain control? Also, her anxiety and panic attacks are progressing, she will hardly venture out of her house. Only to go to her regular beauty appt, 1/2 mile away from her home. Is she at her max with the xanax, what about the xanax XR, does it work better. Is xanax better than valium. She has been on the same dose of xanax for almost 20 yrs. Also, all the muscle relaxants that she is taking, isn't that an awful lot for someone to need to be able to sleep at night. Isn't there something else we can try?
I know this is alot to digest but I really need some good advise and I know this is exactly where I can get it.
Thanks,
Dee

RetiredDirector · 01-03-2007, 02:30 PM

Hi Dee: When you see the doctor, there are a couple things you can ask about. First of all, three time a day (TID) is used a lot for Oxycontin. 40 mg is not that high of a dose, especially if she's been on it for a while and it sounds like she has. You could ask for a increase to 40 mg TID on the Oxy and also possibly an increase in the dose. We don't want to put Mom under the table, so you'll have to judge how much she could handle. Usually, if there is a need for the BT meds to be increased, it means the base med is not doing the job and needs to be increased. When I was taking Oxy, I eventually got up to 160 mg TID. I also had Oxy IR for BT, either 15 or 30 mg.

As far as the Oxy IR for BT, you can discuss with the doc about upping that, if she really needs more. It comes in 5, 15, and 30 mg doses, so maybe she is needing more. Remember though, BT shouldn't be used as a substitute for the base med, Oxycontin.

Anti-Anxiety is a little harder as to what could be done. If she's been on Xanx for almost 20 years, maybe a change would do the trick. Personally, being a CP patient, my doctor put me on Lexapro, 10 mgs first thing. I have since gone to 20 mg, but maybe Mom needs a change.

Sleep is really hard too, because many of us in pain need something and I happen to find Ambien works very well for me. I take either Ambien, 10 mg. or the Ambien CR, 12 mg for sleep. If I need to be up at a certain time and it might be a shorter night and I'll be getting less than eight hours, I just take the 10 mg Ambien. I have even taken a half, when flying and want to sleep for about five hours on a red eye flight.

Good luck and I hope I've been able to help a little.