Oxycodone ER - Pain Management Message Board

ms_west · 12-05-2007, 05:33 PM

I recently had spine surgery 1 week ago. Prior to surgery I was on 10-325 mg percocet 3 x per day. Since surgery Oxycodone ER was added 20 mg. 2 x daily with 10-325 percocet as breakthru every 4 hours. I have had to take every dose of breakthru.

I don't want to appear stupid but I do have a couple of questions:

1) the fact of having to take the breakthru every 4 hours is it correct to assume that the oxycodone is not working for me or is an inadequate dose?
I realize part of the reason I am requiring so much medication is because of the surgical incision and manipulation of the nerves during decompression and removal of bone spurs which has resulted in increased pain levels.

2) I am shocked that this med has not made me tired in the slightest. It is like I am wide awake. Before surgery the percocet would make me feel exhausted - now I am taking this oxycondone along with the percocet and I am wide awake. Could this be a side effect?

3) Did a search on the board and realized that I have the TEVA brand and that this was supposed to be going away and most patients did not receive relief with it. MAybe this is why I am requiring so many breakthru meds? When is the TEVA brand going away?

4) I am so worried about being on this long term which may be a possibility due to my severe back problems. I am allergic to dillaudid and morphine so I am very limited with pain medication. Can anyone offer any words of wisdom or advice about the addiction/dependence issues written all over the web about this medication?

Thank you in advance for your responses.

brianpain33 · 12-05-2007, 06:22 PM

I would have to say that needing every one of your doses of BT is because you are in some serious pain. Just be careful not to take more of the BT medication than needed. Also, once the pain starts to level off and come down (which hopefully it will), then you will need to titrate down on the doses. Hopefully you won't need to be taking all of the medication that you are taking right now for very long. The longer you do take that high dose just realize you may go through some withdrawal when you start to titrate down. I wouldn't worry about the addiction issue just be extremely careful to only take the BT medication "as needed".

As for one of your other questions about being more awake when you are taking the straight oxycodone. This happened to me as well when I was taking the exact same dose. When my doc switched me and I was taking less percocet and starting taking the long acting oxycodone, he told me that I would probably have less sedation. That's all I have for now and I pray that things were successful with the surgery. Keep us posted

Brian

BrittleBones · 12-05-2007, 06:48 PM

Hi Pepper - please remind me what the surgery was again? I know you said removal of bone spurs....where were they? what levels? how many? etc. I have had many spinal surgeries and I can honestly say that my requirements for more medication ran a good 6 weeks post operatively. Of course the kind of surgery you had...the extent of the incisions, maniupulations of nerves, etc., will have a big impact on how long you will need the extra Oxy. How long did the doc say you would be in pain following surgery? I wouldn't worry too much about the dependance issue - you will quite naturally be concerned about it, but as your pain lessens you will be taking less breakthrough med and if the doctor is worth his/her degree, they will taper you off slowly. As far as being wide awake...all I can say is that the first 10 years that I had occasion to take percocet (off and on ... not as a chronic pain patient) it kept me full of energy...wide awake....and feeling like I could run a marathon. But since I've been a chronic pain patient, the oxycodone leaves me tired, lethargic, etc. I know that there are quite a few synthetic narcotics that have the opposite effect on the body than would be expected. I also believe that you can change the reaction you have to certain medications as time goes on. Memere (K'Mac)

ms_west · 12-05-2007, 07:04 PM

Quick Summary of my History:

1982 - fusion s1/s2
1982 to 2004 Lived a normal happy pain free life
2004 Heard a pop in back and everything felt stuck for about 5 minutes
May 2006 Laminectomy L5/S1 for stenosis, decompression and removal of bone spurs
Feb 2007 Fusion with Hardware L5/S1 - Vertebrae unstable due to laminectomy

Last Weeks Surgery

Nov 28 th 2007 - Revision Surgery L5/S1, Laminectomy L3 and L4, Removal of bone spurs at L4, Hardware Removal on right side, Added BMP to L5/S1, and nerve root work at L4, L5, S1. He was hoping to be able to insert a cage into L5 but there was not enough room. He feels an abdominal plate may need to be inserted at a later date.

I feel like a 43 year old trapped in a 90 year old body.

We are hopeful that this surgery will relieve my pain but I was told it was no guarantee.

I have taken my meds as directed. There is no way I would ever jepordize being terminated - I have been with inadequate pain control in the past and lets just say I don't want to go there or ever risk it.

Should I try to stretch the meds out 6 hours? I have tried but the pain starts getting out of control. I have been on these meds since last Wednesday. I see my surgeon tomorrow and will discuss this with him.

BrittleBones · 12-05-2007, 07:11 PM

Hi again Pepper ..just read your last note. My goodness...I think you are way undermedicated for the amount of surgery you've just undergone!!! I'd be screaming for something stronger if I were you!!! Call and ask if you can increase the amount of oxy you are taking. You can easily go up on the dose without much of a worry - of course you would need to get the ok first from the surgeon. I just can't believe you are getting ANY relief on what you are taking. Memere