Vacation - Pain Management Message Board

Aver00 · 12-07-2007, 10:57 AM

Okay, I know I have belabored this point BUT back to the vacation - if I were to taper, I would feel bad most of the time and especially when I do a new taper, now I know if I go cold turkey I will have horrible withdrawals - I have never had a w/d symptom so I do not know how bad this would be - it makes sense to me to only have physical w/d symptoms for 3-4 days rather than every month for a year - there has to be more to this - I have Crohn's disease, breast cancer (6yr survivor), anklosing spondylitis, and a generally messed up lumbar spine - I am really frightened to do anything that will cause physical symptoms - I am not a total wimp, I was a flight nurse for the
military and gone through some awful things in my life but I am having a hard time with this one - it seems so self inflicting - I want to try and lower my dose - I take oxy 140 three times a day with norco for b/t and I believe I could take it down from a pain standpoint - I have started on Remicade and it is a miracle????????? Should I leave well enough alone??? Tks Aver

also have hypertension, diabetes, and am taking Cymbalta 120mg

BrittleBones · 12-07-2007, 05:47 PM

Hi Aver - let me get this right....are you saying that you are on *** mgs. of oxycodone a day with Norco for breakthrough pain? If this is really the correct dose I would BEG you not to discontinue your meds cold-turkey!! I can assure you that you would feel like throwing yourself in front of a fast moving metro bus!! Why don't you talk to the doctor about switching to Methadone at this point? You are certainly pushing the limit on the oxycodone and folks who are taking methadone (I was one for years) don't seem to need the kind of increase in dosage as patients taking other opiates. Is there a particular reason why you have to return to taking the oxy after your "vacation"? You could also try the patch. But I fear that I am repeating what others have already told you in previous posts. You are going to be one tough cookie if you can get through a cold turkey withdrawal from all that oxy!!! Please consider your options carefully Aver before making any decision about terminating your meds. Good luck - Memere

Aver00 · 12-07-2007, 06:05 PM

Thank you thank you thank you - just what I needed to hear - would you taper before the switch to methadone - If I taper down the oxy then maybe I could switch because I fear this is long term, like forever thank you again and I will definitely not go cold turkey - I guess no one understood how much rx I am taking and I am totaly ignorant about w/d and did not know the dosage made that big of a difference Aver

Aver00 · 12-08-2007, 09:13 PM

I am going to attempt to go this week without using any b/t medicine and if I can do that then I can begin to work on lowering my oxy - unless someone thinks I should try dropping one of my 40mg oxy - i take 3 40's a day and
3 80"s of oxy a day - I do have a lot of pain but I feel like I need to start learning to live with it instead of the constant medicating - I know you all feel this way but I just wish I had a normal life, pain free like my friends
wah wah wah poor me Aver

Shoreline · 12-09-2007, 04:26 AM

Hi Aver, Memere is right, cold turkey would be a rough way to do it, But it also doesn't have to take a year to taper. More than likely you could shave 20 mgs a day from one of the doses every 4-6 days and may not feel a thing untill you have dropped down to 25-30% of your previous dose. Starting with the BT meds makessense but you realy may be surprised how you can decrease quite a but before you hit a wall and your body rebels. Basically you would ned your doc to supply with with a greater number of 20 mg pils and slowly remove 20 mgs from one dose out of the day and do that every 4-5 days and it's very likely you can make a considerable drop before you hit a wall and really start to feel uncomfy in any way.

If you just derease by 1 norco a day every few days your really going to extend this out and feel worse, longer. If you cut the norco out completely, all your losing is 10 mgs of hydro every 4 hours and and still takinkig remaining oxy ***** sustains 70 mgs of oxy in your system with the 140 TID dosing. Oxyc sustains half it's dose. Removing the norco woud be like a 10- 15% drop in your total serum level and often if your drops are less than 20% you may not even notice it if your getting that much relief from the new med. Basicaly find a a happy medium between cold turkey and taking a year to discontinue opiates.After 4 or 5 days of no BT.

Then you start removing 20 mgs from one of those 3 doses and every 4-5 days remove another 20 mgs from a different dose. So it would look something like day5 you go to 140-120-140, Day 10 you drop to 120-120-140, Day 15 your at 120-120-120, Day 20 120-100-120. If that's to slow drop 2 doses by 20 mgs every 5 days so you go to something like 120-140-120. next 120-120-100, next 100-100-100. You could actually make the drops every 3 days untill you hi a wall where you body tells you to slow down. and then slow it down to 20 mgs less every 5 daysys instead of every 3. There are lots of ways to smoothly reduce your daily dose as long as you give your body some time at the lessser dose to adjust.
Good luck and never let fear of withdrawal keep you taking a med you may not need. That's what methadone maint is for.
Good luck, Dave