PM Communication - Pain Management Message Board

ms_west · 03-04-2008, 03:04 PM

My doctor has me on oxycontin with percocet as breakthru. He has asked last month if I could try to take one tablet per day breakthru and wrote my script for 30 tablets per month. I did not say anything and underneath I thought this would not work but I wanted to be compilant and give it a try.

I emailed him earlier in the month because my sciatica nerve flared up while I was in the hot tub asking to take more than 1 possibly 2 or even 3 if needed. He told me to take the least amount possible per day but no more than 3 per day. I took 2 and sometimes 3 for 4 days then went back to my normal dose of 1 per day if needed. Now my back is flared up again....do you think it is okay to take the higher amount again or should I email him again.

I will exceed 30 tablets this month and will need another script. Do you think that will be a problem because the bottle said one per day?

I have also found it a struggle to only take one tablet of the breakthru a day but I have muddled thru it. Should I let him know this or wait until my appt in 2 1/2 weeks.

I feel bad because I have had to email him twice this month. Is it normal to communicate this often with your pm or do you think I am bugging the man to much? I just don't want to bother him to much but on the same line I don't want to do anything to have him question me or violate my pain contract.

brianpain33 · 03-04-2008, 03:29 PM

hi dietdrpepper:

I have a question for you. What dose of the Oxycontin are you taking and how often are you taking it? If he really does want you to take as little BT med as possible then logically it would seem that you might have to up the LA med (Oxycontin in your case). I know it doesn't make much sense and you would think the opposite would be the case. But, if he doesn't have any problem prescribing the Oxycontin then you gotta do what is necessary to get your pain under control. I would e-mail him and tell him exactly what your pain level is averaging on a scale of 1-10. Tell him you are having a hard time coping at this level. If you have a good relationship, then ask about increasing the Oxycontin. Let us know what happens.

Brian

ms_west · 03-04-2008, 03:36 PM

Hi, I take 40 mg. 3 x per day of the oxy. On my last visit, he talked about reducing my dose of oxy. He really does not like it but my surgeon put me on it then dropped me at 3 weeks post op. He has also talked about switching me to the methadone everytime I visit him so I doubt that he will increase my dose.

brianpain33 · 03-04-2008, 03:55 PM

Quote:

Originally Posted by 123dietdrpepper

He has also talked about switching me to the methadone everytime I visit him so I doubt that he will increase my dose.

What is the hangup about not going on the Methadone? Have you ever tried it before? If it is going to work better at controlling your pain then it would be the better choice. I tried it once and itched like crazy and couldn't take it for more than a few days. But, as you well know, it has been seen as the "magic bullet" of pain meds for many people on here. I think you really should just ahead and try it out. I know the "stigma" concerning Methadone but just think you are on Oxycontin and you know the "stigma" concerning it in the news and among doctors. I know just how hard it is to overcome stigmas or to switch to a new medication that you don't know what kind of side effects you will have, or you might have worse pain in the beginning until the dose is at the right point. If you do start the Methadone, I would definitely suggest e-mailing him every 3-5 days if the dose is not working out and he can adjust it accordingly. Good luck.

Brian

ms_west · 03-04-2008, 06:02 PM

Thank you Brian. I hestiate to have my meds changed because this is the second month my pain has been controlled in over a year. I also have never been on methadone and have a tendency to have major reactions. I am allergic to morphine, neurotin, dillaudid, keflex, pencillian, elavil, and palemor.

As far as the stigma goes, no problem here.