Major med change, did I do the right thing? - Pain Management Message Board

Kissa · 08-11-2007, 01:17 PM

Hi all! I hope you all are having a reduced pain day today!

My PM made a massive medication change last week, of course this decision was totally mine and now I'm not sure if I did the right thing.

The scenario is that ever since last year and my hip revision my morphine leves have been going up. I started having severe problems with vomiting, severe urinary retention and the like. My doc switched me from MSC to Kadian. Ironically this simple change in release mechanisms really caused huge issues. I was sleeping at least 12 - 18 hours per day. I was a total zombie for the last several months. The nausea and vomiting went away but I couldn't keep my eyes open.

Since June we've played with dosage and dropped me to 150mg a day, 50mg 3xs daily, still no help. My pain levels increased to beyond belief. I've been on methadone and the patch, avinza and others to no avail. MSC seemed to always be the best and have been on it nearly 4 years but my body could no longer tolerate it.

Out of sheer frustration on both my part and the doctors not knowing what to do a radical decision was made, I went back on Vicodin. Huge shock but was totally at my wits and sleeping all day not feeling in control of my life anymore.

Things are not as bad as I expected the most irritating part is it feels like I have RLS (restless leg syndrome) in my entire body. I'm clock watching, about hour 3 my body begins to feel numb and creepy crawly.

Here's the huge surprise though, my pain levels are actually in control!! How can I go from 200mg to mere vicodin and less pain? I'm astonished and honestly wonder if there isn't something to the one theory about meds making pain increased. I would of NEVER thought it possible had this not happened to me. I simply just dont understand how a decrease, massive one at that would actually decrease my pain. I'm not complaining though.

My question here I guess is more or less has anyone experienced the RLS feeling in their entire body and what do I do? It's been 6 days now. My bowels are wreaking havok I tell ya, my colitis is not liking the change that's for sure. I can live with it but I can't stand this creepy crawly feeling inside my entire body. I'm going insane!

I take both flexeril and Bacolofen which aren't even affecting this horrid feeling in my body. Research indicated it is a sign of withdrawals but I'd think it would be slowing by now, instead today it's been horrendous and getting worse by the minute it seems.

Part of me just wants to call the doc and go back on the MSC but after extreme weight loss and other big problems I'm scared and I'm tired of being chained to these meds. I've exhausted most LA resources and certain LA meds my doctor refuses to prescribe.

I'm wondering if this feeling ever goes away or should I see a nuerologist? Could the LA meds been maskign a more severe problem? I do have a long history of RLS but haven't had a problem in years since being on LA meds and never during the day or shall I say really rarely... I'm so frustrated guys.

Thanks for letting me vent
Barbie

Wren9 · 08-11-2007, 01:31 PM

Hi Barbie,

This definitely sounds like withdrawals to me. The all over RLS feeling...the diarrhea...classic withdrawals. And no surprise since you were on all these high levels of long-acting meds and switched to, as you said, mere vicodin.

I had a lot of the same symptoms on Kadian, including severe urinary hesitancy. I hated it. I also had constipation, tiredness, sleeping all the time, and stopped menstruating

I was switched to Oxycontin, and what a relief. WAY fewer side effects -- I can pee again and don't feel like I have to "go" all the time.

BUT, I am having more mood problems now.

It's always something it seems -- no free lunch.

I loved methadone, but it made me gain weight. Otherwise, it was amazing.

The only thing I haven't tried is the patch (Duragesic). Well, I haven't tried the pump either.

You mentioned a lot of long-acting meds, except for Oxycontin. How do you do on oxycodone? Is that what you meant that your doctor would not try certain things?

How much vicodin are you taking? I would worry about liver toxicity with too much tyelnol (APAP). The safest bet -- least APAP -- is Norco 10/325 -- which contains 10 mg hydrocodone and 325 mg APAP. Compare this to regular-strenth vicodin, which contains 5 mg hydrocodone and 500 mg APAP.

Did you know that you can get hydrocodone compounded, so that all it contains in hydrocodone, no tylenol. Or you could get it compounded to contain just a little bit of APAP, or even to contain ibuprofen, although I am not sure if this would interfere with the Vicoprofen patent. And you can even get it compounded to be long-acting. I think there is a member here who has done that.

I too preferred hydrocodone to other meds I have tried so I see where you are coming from.

I forgot to mention that you should start to feel better pretty soon. Drink a lot of beverages including something like gatorade or watered down apple juice (cold-filtered). The first week of w/ds is the worst. How often are you taking the vicodin? Cuz I am worried you will continue to experience w/ds at the end of one dose before you take the next -- and you will continue to "clock-watch" as you put it -- and that is no way to live.

But the worst w'ds will go away soon. Eat healthy, exercise if you can, even if you don't feel like it, especially if you don't feel like it. Exercise, massage, meditation, prayer, listening to music, reading a good book -- all of these things raise endorphins and will help your endorphins start working faster.

I have gone thru this same thing before and I found that benzos helped more than anything -- klonopin, ativan, something like that. Will your doctor prescribe a benzo just during this time?

-Wren

babs17 · 08-11-2007, 09:03 PM

Questions for both of you...the Urinary Hesitancy...did you notice that when you felt this "hesitancy", that you also had facial swelling? Any relation there? And the urine retnetion...is that 'always" or "comes and goes"?

butrfligirl28 · 08-12-2007, 07:14 AM

Hi Barbie,

I agree with Wren that this sounds like withdrawal. It stinks, but will go away with time. I would talk to your doctor. Maybe you can increase the Vicodin until it gets better? I am so glad that your pain is better since the switch! I know things are hairy now, but in the long run, this is a very good thing. Now that you are back on the Vicodin only, you have so many more options available to you. Maybe the doctor can prescibe something for the RLS symptoms to get you through the withdrawals. I would call my doctor AND my pharmacist and find out what your options are.

I pray that you feel better soon! I had heard about opiod induced hyperalgesia, but haven't spoke with anyone that actually experienced it. I actually hoped at one time that I was suffering from it, but when I reduced my meds, my pain got much worse, not much better.

I think once you are through the withdrawal symptoms, you will feel much better.

Your Friend,

Amanda

Wren9 · 08-13-2007, 05:53 PM

babs, with regard to the urinary hesitancy, it was always there, but was worse when my opiate levels were higher. I'm not sure about facial swelling. But in order to "make urine" I had to push/strain just to produce a few drops and that gave me headaches. Do you have a problem with urinary hesitancy too?

Barbie, how are you feeling?

-Wren