I would like to know what is the next step up from taking 120 15mg oxycodone a month. They stopped working about 2 months into it (b/c I saw a pain dr before my current one) so I have a tolerance. With the old dr I was on 15 mg oxy, 10 mg methadone and 90 soma/ mon... this dr RXs me 120 15 mg oxy a mon and just put me on Xanaflex 4mg 2x day which did work but made me hallicinate and stopped working after a few weeks. I thought about asking for fentanyl but didnt know if that was the next step medication wise.....(he is also doing procedures...
Hi Mel! Before talking about "the next step" as far as meds go, can you tell us a little about what the pain is you are dealing with? So much of what might help you is dependent on your condition and what is causing the pain. If you can give a little more detail, I think folks will respond quicker and with better answers. It's easy to say that the next step is 30mg oxycodone tabs or 20 mgs of methadone instead of what you are taking, but medicine isn't always the answer. Please elaborate. Thanks - KathyMac
Thanks for the response. I have been in one motorcycle accident ( flipped over the hood of a car) and 5 car accidents and 2 sporting accidents. the last one was jan 10 2007, I fell asleep and ran off the intersate/ hit a tree at 85+ mph. The hosp did not keep me in , they released me to my parents even though I was unconscious for 3 days at home in bed.I have 3 herniated discs in my neck and 2 in my lumbar, the doctor put arthropathy and degenerative disc disease, and TMJ in his report ( I snuck a look). I am afraid to ask my doctor what all my diagnoisis are, I saw a list and those are only four of the 12 (!) I counted. Also I have a SEVERE carpal tunnel syndrom bilaterally (?). My pain dr is doing RFL ON my NECK since the he did the shots and then will do my low back , and after that refer me to get my Carpal tunnel taken care of... I want to get off pills and caneasily, I have before even though I build up tolerance. my body builds up tolerances quickly to even antibiotics. I just want a med that will help in the meantime.....and I have tried physical therapy and all that goes along w/ it, it doesnt help.
Oh yea, I forgot to say I am only 23. (I know, I know, the "partying" age, but I dont use the RXs recreationally, dont smoke cigs, drink , and Do not use recreational drugs.
I just feel like I have done something bad in my life to have been caused such bad pain and starting to think I cant get down to a pain level "0".
ANY input is nice, hope all of you are feeling well.
Last edited by myhearthurts; 06-26-2007 at 01:06 PM.
Sometimes the solution is found in how one approaches the problem. My dr would not diagnose your current troubles as "meds no longer work." Rather she would say that the pain has increased, and then go looking for reasons why. The effectiveness of the meds would be just one of many possibilities. More often the problem is found in progression of disease - something has gotten worse, and you have a long list to consider.
Many of us have been fortunate to find solutions w/o having to increase meds, which in the end is in your best interest. Looking for (increased or different) meds to solve the problem can get you the unfortunate drug seeker label as well. Let the dr check you out and check all possibilities.
Yea my "freiond" already assume I am an "abuser: since my pain is getting worse.You did make a good point. My dr said my "disease" will spread over more of my spine and to the other joints that a compinsating. Alot of it radiates so its hard to tell if it from the same source or a different one.
Wow!! Have you had alot of bad luck or run into alot of bad drivers or??????? That is alot of accidents for being only 23!! Sounds awful.
The one thing that is glaring out from your second post is where you say;
"I just feel like I have done something bad in my life to have been caused such bad pain and starting to think I cant get down to a pain level "0"."
The 'expectations' of a good pain management Dr. should be to get the pain level down to a 3 or a 4. The quickest way to build up tolerance is to medicate with the goal being to get your pain level down to a zero.
I'd ask the PM Dr. if he/she expects you to be bothered by one or more of the 12 things you saw in your file for the rest of your life or if they think that you will heal enough to get off all pain meds.. Or even if they expect you to be on them for more than a couple more months. If so they should have you on something that is long acting, like the patch or methadone, or one of the long acting morphine preps. like Kadian, MS Contin etc.. Short acting meds. generally will cause your tolerance to rise faster than long acting ones..
I wouldn't give up on the physical therapy either. You never know, you might not have found someone who is really good yet.
thats exactly right! The oxycodone does not last long enough and build up tolerance too fast. I tried methadone and it was horrible!... I was thinking about asking about a patch but dont know what else there is other than fentanyl. Morphine seems to work slightly better (in the past I took it but still didnt last long). I dont know how much stronger the fentanyl patch is or anything about othe pain killers at all and I am afraid to ask my doctor nad tell him the oxycodone just doesnt work like it used to.
If I could find some education on that stuff or reference then Id feel better going to him...I feel like a dog with its tail between its legs because everyone is telling me (even my friends) that people on pain meds are junkies and I feel even worse now.
Im sorry for posting this. I just think its been causing a slight deppression too,
thanks again for any info
oh and sometimes I am not even at a 3-4, sometime I cant get out of bed but try to force myself to stay mobile.
Last edited by myhearthurts; 06-28-2007 at 12:04 PM.
You don't need to apologize for anything, that's what the boards are here for!!!!
I was on the patch for a while and loved it. Fortunately I didn't need to stay on anything daily so I switched but for some people it is great!!
Have you tried the long acting morphines?? Or were you on the MSIR (short acting version).
When you ask for the next 'step up', that is a hard question to answer because while one medication (oxycodone) may be stronger mg. to mg. compared to morphine, that doesn't mean it will work better for you. Methadone is quite a bit stronger than oxycodone but it might not work as well for you.
You also have to factor in your Dr. Some are quite comfortable Rx'ing any med. they think will work best whle some Dr.'s, no matter what, just don't Rx some medications. For whatever reason.
Don't be afraid to ask any questions. Hopefully someone else may have more to add. The knowledge here is fantastic!!
I used to be on 15 (?) mg of methadone 4 x day, 15 mg of oxycodone 4xday and 350(?) mg of soma 3 x day. then I switched doctors and amd on 15 mg oxycodone 4 x day and just put me on 4 mg zanaflex 2x day... I think the reason the medication is not working as well is that he started doing facet joint injections and at 1st it feels good then it hurts worse than it did before. He is doing it cause he wanted to see if I would be a canidate for radio frequency lesioning and I am. I think he is going to finally do it this month and hopefully it wont make it hurt... Anyway, what are longer lasting medications than oxycodone (the small green ones)?
i would go up to the 30 mg of oxys. there is a great difference. I have tried everything and i have stuck with that dosage and mgg for two years. The patch has lots of limitations , such as you cant be out in the hot weather that often or in the sun etc etc or else the medication from the patch can disolve in your body faster . I have never taken the patch and that is the only thing I have not tried because of the limitations but some ppl say it works like a charm! good luc
thanks for the advice. Sorry it took so long to reply, I had lost (or had it stolen) the whole bottle of my Oxys and had to wait a week to get them filled again... Needless to say the reason I havent replied was cause I was really sick.
Oh and I was wondering if there was anything (other than Methadone) with a longer half life than oxys.
Last edited by myhearthurts; 07-10-2007 at 01:36 PM.
Directly after my spinal fusion surgery, I was put on 7.5 mg of oxycodone, and given the fentanyl patches. For me, the pills worked better than the patches did, for the most part the patches made no real difference.
My only advice is what worked for me. I had spinal fusion surgery in late April. Before the surgery I was on vicodin, but for a month and a half after the surgery I was on oxycodone. Until I was growing very tolerant of it, then I figured I would go back to Vicodin, even tho oxy might be stronger, the vicodin had been out of my system for a while and I would be less tolerant to it than the oxy. I suggested this to my doctor and he said ok, and I've been on it ever since and it works fine.