ozzybug

OK Everyone-
FIRST, I want to say thank you to everyone who lent me support. Thank you so much for your kind words and prayers. It seems they have worked for the time being. My PM doctor did not discontinue the Norco, and he also put me back up to the 7.5/325 mgs I was on before, and here comes the big BUT...

BUT...he gave me a scrip for a 2 week supply, and also wants me to start the Duragesic patch. I was TOTALLY wrong about them thinking Opioid Induced Hyperalgesia is a valid thing. As a matter of fact, in a round about way, he feels it is just scientists making themselves feel "important" by using big words. He said that his studies, and information at hand support the use of opiates, but using ones that give a steady level in your system. He feels that the short acting or IR meds cause an "up & down" effect in the brain (even if the patient doesn't actually feel the "up & down") and that is not really the best form of managing long term chronic pain. He feels that the actual dosing or administration of the opiate is key, and that the key is not doing the up and down thing with IR meds, but by administering the medication and keeping it "steady", thus the Duragesic. He did say that yes, hyperalgesia is real because hyperalgesia means "Hyper" pain, or increased pain, but it isn't necessarily caused by opiates. He said that all chronic pain patients have hyperalgesia, but that doesn't mean it's their medications that are causing it.

Whew- I hope I did ok in explaining in my own words what he explained to me. He was with me for over an hour. I told him I am willing to try the Duragesic even though I feel it may be too strong. I say this because the Norco, in combination with with the Neurontin & Depakote keep my pain levels at a 4-5 range, and to me, that is good pain management. To me, it is more than acceptable because I can function with that level. Anyway, I'm not going to refuse to try it because he is the doctor, and I know if it is not a good fit, he will discontinue it. I just need to give it a fair chance, and am thankful he agreed to start me at a low dose. We are doing the Duragesic 12 mg.

If the Duragesic is a good fit, we can discontinue the Norco, so this is why the 2 week supply of Norco. If the Duragesic is not a good mix, we go to whatever his plan "B" is.

OK guys, I am truly sorry this is such a long post. I just wanted to fill you all in. And thank you once again! I did misunderstand what his PA was talking to me about at our appointment in April when she started talking about hyperalgesia. The doctor explained it in depth to me today.