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Old 05-03-2008, 07:37 AM   #1
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Question Darvocet or Hydrocodone and more Questions ???



Hi everyone, hope all is well. I have a question regarding Darvocet and Hydrocodone. Can anyone help me with the comparison? I have looking on the internet and can't find any comparisons. How does one Darvocet 100/650 compare to Hydrocone? How many Darvocets would it take to equal a 10mg Hydro? I am curious because my Ortho doctor gave me a script for Darvocet yesterday. I have been on Ultram 50mg off and on for a while and find they don't work as well anymore. I know Darvocet is supposedly a very weak drug.
My MRI showed a torn meniscus, lots of fluid and that my kneecap is tracking to the side on the bone and not in the groove like it should. But insted of surgery (again) he want's me to start Celebrex and PT 3 times a week ?.?.? I don't know how well our insurance will pay for PT. If it's (what I think) $30 copay a visit I can't afford to do it. I guess I'll cross that bridge next week.

Thanks for any help in advance.

 
Old 05-03-2008, 09:42 AM   #2
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Re: Darvocet or Hydrocodone and more Questions ???

i am kind of just wondering why your ortho does not want to actually do a surgery on you at this point? it would be a pretty simple arthoscopic procedure. has he bothered to even aspirate the accumulating fluid for you? i too had a torn menicus along with alot of other knee issues. the torn meniscus actually occured while i was already waiting to have the other knee problems fixed. it really is not that big of a deal for him to do for you. that alone would help with your pain and possibly even take it completely away for you too. do you have some other medical issue that would make this a high risk or something? i am just a bit confused as to why he is continuing to ignore such a simple fix for you thats all. have you ever sought out another ortho for a second opinion? he could have at least aspirated out that fluid for you. that alone does help with pain and swelling.

i really don't know how the darvocet would compare as far as how many pills would equate that level of coverage but my concern is in trying to do that you may have to take ALOT of tylenol since darvocet if i remember right has like 650 mgs of it? you are right,it IS a very weak level of narcotic,like a schedule five i believe? it does seem to work much better than some other narcotics tho for more inflammatory type pain. not too sure just why but it does. the thing is,as long as that menicus stays torn and unrepaired,that inflammation just wont go away for you and you will continue to have this going on,ya know?

i am just kind of suprised at your orthos take on this and why he simply cannot take like a half an hour in an OR and fix it. like i said,its a simple arthro prodedure. i cannot even fathom a good reason from his end as to why he is just letting you continue to have to suffer and deal with this? did he explain anything to you about the reason for not doing it for you? honestly,if there is no medical reason on your end to actually have to hold off on this,it just really needs to be done. i would defintiely seek out another ortho if i were you,if that is possible. he is just letting you continue to suffer very uneedlessly ya know?

the thing is is our knees are a load bearing area/joint and when anything is actually damaged in the knees,the feet or even the hip areas,it can create that certain level of weakening and make you more susceptable to further inury in just letting this go without fixing it. the knees and the feet suffer the most in just simple walking. its alot of force with every step that right now is getting placed upon a damaged knee for you.

honestly LMP, if he cannot offer you what you really need done right now(the logical thing??),i would really seek out someone who will. instead of feeding you more meds he should be fixing the problem so you dont HAVE to take more meds ya know? you just deserve much better treatment than you are currently getting. you are hurting and this is just the right thing to do.

the way he is treating this really sounds more like what you would be doig AFTER doing a surgery that still left you in pain,you know what i mean? its just not going to get better without surgical repair being done,so i really am wondering just what he is waiting for here,and i am sure you are as well? i would either just tell him i want this fixed or move onto a much more caring ortho who will just do the right thing for you.

sorry i really couldn't answer your main question LMP,but honestly,i do feel for you. you do need this fixed surgically soon. i wish you lots of luck in getting this all better. he just should not be putting you thru this when its so simple to repair ya know? please keep me posted as to how you are doing. take care,Marcia

just reread your post and saw the part about the PT possibly being done? i would NOT got there if i were you hon. that will NOT help your type of problem that actually just needs surgical repair. if anything it would possibly create an even more painful situation by imflamming things even more,and possibly creating an even worse injury. please don;t EVEN go there right now,for your own sake. he just needs to fix this problem himself.
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

Last edited by feelbad; 05-03-2008 at 09:49 AM. Reason: more info

 
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Old 05-03-2008, 10:06 AM   #3
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Re: Darvocet or Hydrocodone and more Questions ???

I thought it was just me, when I read about the PT. I haven't had a torn meniscus, but my brother did, years ago, and all I could think was that PT would be like adding salt to the wound, so to speak. Thanks Marcia, for clarifying. LMP, I wouldn't go to PT either. Sounds like a recipe for disaster.

As far as the Darvocet vs Hydro goes, I'm no expert on meds either, but I do know that I've often heard of Darvocet being compared to baby aspirin, in terms of the narcotic pain med scale. I did not know it had anti-inflam qualities, though, so maybe this is why he prescribed it. He also may be uncomfortable prescribing anything more potent. Many docs are, as we've read here so many times.

Best of luck and I would agree with Marcia about maybe seeing a different ortho. It makes no sense to not treat the injury, when there is a surgery that can. God Bless, cmpgirl

 
Old 05-03-2008, 11:29 AM   #4
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Re: Darvocet or Hydrocodone and more Questions ???

I agree with Marcia :::waving at Marcia and Cmp

I am amazed he would prescribe an outdated med like darvocet, it is not a good pain killer, and there are many many more effective anti inflammatory meds out there, even naproxin and advil are better, and those are over the counter.

I would ask him why he is not choosing to be more assertive with resolving this for you, and in the meantime, could he put you on a better med!

Good luck and hang in there, I suffer from knee pain sometimes, it is the worst, you have my sympathy.

Hugs, Fabby

 
Old 05-03-2008, 11:39 AM   #5
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Re: Darvocet or Hydrocodone and more Questions ???

The chart I usually use shows that 30mg of hydrocodone is equivalent to 130-200mg of propoxyphene. Referring to the starting dose of lortab, 5mg of hydrocodone would equal 21.67mg-33.33mg of darvocet and the doses of darvocet that are generally prescribed are 50mg or 100mg. Statistically speaking, darvocet 50mg is more potent than 5mg of hydrocodone, about the same as 7.5mg of hydrocodone and less potent than 10mg. 100mg of propoxyphene is more potent than any dose of hydrocodone.

Fundamentally, the problem with these charts is that in some cases, they use "ranges"....Like they do for the propoxyphene. Well, 130-300mg is one big range!

Furthermore, it doesn't necessarily mean it's the same for everyone. If the Darvocet isn't working, I would tell the Doc.

Hope this helps.

Ex

 
Old 05-03-2008, 12:39 PM   #6
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Re: Darvocet or Hydrocodone and more Questions ???

So Executor: You're saying that a 100/650 Darvocet is equal to 2-7.5mg Hydrocodone. How can that even be possible. I took one of the Darvocet's yesterday, two more today and I might as well have taken Tylenol. Gosh, wish I would of known, I would have saved my money .

As far as the Ortho doc. He did surgery on the knee March '06 and it did not help 1%. He said at that time the knee would have to be replaced in 3-5 years because of severe infection and inflammation and the knee was in general bad shape. He is the nicest man but I feel as though he does not help me at all. He wants to shoot the knee full of cortisone as often as he can and has prescribed Ultram and now Darvocet. I feel like I'm getting nowhere with him and he has never mentioned the knee replacement since the surgery. He came out of my surgery and told my husband and mother about the knee and the replacement to come. But, to this day he has not brought it up again. I looked into another Ortho doc close by who said he would see me, evaluate me but would not take over treatment....no reason was given. The office worker I spoke to said he was very leary of taking over any other doc's patient that had already been operated on.

 
Old 05-03-2008, 02:32 PM   #7
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Re: Darvocet or Hydrocodone and more Questions ???

Quote:
Originally Posted by Luvmypugs View Post
[FONT="Tahoma"][COLOR="DarkOrchid"]

Hi everyone, hope all is well. I have a question regarding Darvocet and Hydrocodone. Can anyone help me with the comparison? I have looking on the internet and can't find any comparisons. How does one Darvocet 100/650 compare to Hydrocone? How many Darvocets would it take to equal a 10mg Hydro? I am curious because my Ortho doctor gave me a script for Darvocet yesterday. I have been on Ultram 50mg off and on for a while and find they don't work as well anymore. I know Darvocet is supposedly a very weak drug.
Propoxyphene is related somewhat to demerol, both of which produce unhelpful metabolites. This is the main reason that neither are used much any more. Besides that, it is fairly weak, and many respond unfavorably to it. What I don't get is the progression from Ultram to Darvocet?

Quote:
Originally Posted by Luvmypugs View Post
My MRI showed a torn meniscus, lots of fluid and that my kneecap is tracking to the side on the bone and not in the groove like it should. But insted of surgery (again) he want's me to start Celebrex and PT 3 times a week ?.?.?
I'm sorry you are having to go through this. I know all too well how it is. I was born with the outer groove underdeveloped and suffered dislocating kneecaps all through my early years, lasting 'til 1981. Maybe my experience can be of help, especially why PT is really a good idea.

My knees are the reason why I'm in PM, and have been since the mid 90's. I started with surgeries in 1969 to adjust the muscles and tendons to stop my knee caps from tracking to the outside, very similar to your problem. Only my knees would actually dislocate which was horrifically painful. Since I was only in Jr. High at the time, they had to avoid the bones as they were still growing. So both knees were operated on at the same time. It was successful for a few years until the dislocations started again, along with arthritis.

Both knees were reconstructed in 1978 and 1981 respectively. Total knee replacements were experimental at the time and I was too young for that anyway. This ended the dislocations, but the damage from the arthritis and the sports had already cause permanent damage. Since then I have had numerous procedures to clean-up the joints and one to adjust the length of my right tibia which added some spacing between the lower and upper leg bones, to help reduce bone-on-bone grinding since all meniscus had disappeared years before. It is now SOP to have patients endure PT before any knee surgeries to strengthen the joint and muscles for surgery and recovery.

I believe the doc is ordering PT to strengthen the muscle group at the lower-inside end of your quadricepts to help pull the kneecap more inward when your upper leg muscles tighten. This actually does work but it takes strength and help from a pro to learn how to activate and work that muscle.

I believe the new surgeon is simply refusing to get involved in the previous doc's botched job. I find many surgeons do not want to get into fixing what other surgeon's screw up. They can't know who you're going to sue when the fix job doesn't take.

After a certain age meniscus can no longer be repaired surgically. It really is a good idea to try and strengthen the leg muscles through PT. If you can get the patella to track properly this way then you can wait that much longer before venturing into total knee replacement. Most of the better orthopedic surgeons no longer do clean-up surgeries. As obvious as it sounds to get in there and remove the excess fluid and floating particles, statistics show that these kind of surgeries provide no real long-term benefit. My last such surgery was in the middle 90's and they just won't do this again. I actually wish I could get one more clean-up, since I've got some bony particles that are getting caught in the space created by teh loss of meniscus which causes lots of sharp pain and brings me to my knees literally from the pain.

Celebrex is an outstanding anti-inflammatory. Take it if you can. I'm allergic to all drugs that contain sulfa so I can;t take it. I wish I could.

Best of Luck!

steve

Last edited by forginon; 05-03-2008 at 02:39 PM.

 
Old 05-03-2008, 07:57 PM   #8
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Re: Darvocet or Hydrocodone and more Questions ???

I was being a bit sarcastic towards your doc.

In my opinion Ultram is equal to or slightly stronger than darvocet. So, in reality, darvocet seems a step backward, but clearly no 'progress' from Ultram.

I would have expected vicodin up to its 10mg strength or percocet at the high end.

I don't see his prescribing making sense.

Sorry if my post was confusing.

steve

 
Old 05-03-2008, 09:42 PM   #9
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Re: Darvocet or Hydrocodone and more Questions ???

Quote:
Originally Posted by Luvmypugs View Post
So Executor: You're saying that a 100/650 Darvocet is equal to 2-7.5mg Hydrocodone. How can that even be possible. I took one of the Darvocet's yesterday, two more today and I might as well have taken Tylenol. Gosh, wish I would of known, I would have saved my money .
No...I'm saying that one 100mg of Darvocet is stronger than any one dose of Hydro @ any strength. Statistically speaking, a 50 Darvocet is roughly equal to a 7.5 of Hydro. A 100 Darvocet is stronger than a 10mg Hydro. However, not all meds work the same in all people.

I would communicate with your Doc that the Darvocet isn't working.

Ex

 
Old 05-03-2008, 09:51 PM   #10
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Re: Darvocet or Hydrocodone and more Questions ???

My mom's GP for years was a realtively nice man, but way behind in the medical field. He had a very full patient load, because he had been around for years and everyone knew or grew up with his kids, etc. Unfortunately, every time I would go to the pharmacy to get a script filled for mom, I'd end up coming home empty handed.

The pharmacist would always tell me that they either didn't stock "that" drug anymore or, the insurance company wouldn't cover it, because it was considered obsolete. The man knew nothing about newer meds and I don't think he ever allowed a pharm rep in his office.

Sounds like maybe your ortho is one of those types of doctors. I don't know. He may just be behind in terms of what's available for pain now. I finally convinced mom to switch docs, in her later years, but this doc kept practicing til he was 80. I don't know how he kept the practice going.

Are there any orthos within a decent drive from you, who wouldn't be afraid to step on another doc's toes? I just don't know if this one is best for what you need right now.

Take care and I hope you can get some relief from someone. I'm sorry if I missed something earlier in the post, but what about your GP? Do you think he/she would write for your pain? God Bless, cmpgirl

 
Old 05-04-2008, 07:19 AM   #11
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Re: Darvocet or Hydrocodone and more Questions ???

hey steve, sorry for what you have had to endure with the knees. i just wnated to mention something. before my father had both knees actually replaced,it was wayyy too painful to even try to endure basic "PT" so he started going to 'the club' and using the hot tub to just do very basic bicycle excercises everyday? and wow,what a difference he had towards recovery time just by doing this one excercise in that hot tub. it really helps to do any knee excercises in a heated tub. he was out of the rehab hospital way before they expected him to be both times with each knee. they said he had great muscle tone by the time the surgeries came up.

LMP,if they are actually going to send you to any type of PT with that knee the way it is,i would request some level of this same type of aquatic/heat type of therepy. it made PT much more tolerable and strengthened my dads knees really well. it sounds like if you really just sat down with your surgeon and actually discussed good PM that he would most likely change the meds for you. if not,hon, i don;t think he is quite as caring as you think. seriously,if he actually knows how bad this is,he should be doing more for you. the darvocet with what you have going on in there is just way too low to really "do' anything for you from what you have stated. just communicate your true needs to him. i would also bring up that knee replacemnet again and see what he says. it could solve alot of your problems. just a thought. he should just be really caring about your suffering,thats all. find out your options for any therepys that wont exascerbate the knee and what you can do to really help with the pain. i do wish you luck with this hon,Marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 05-04-2008, 07:30 AM   #12
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Re: Darvocet or Hydrocodone and more Questions ???


Thanks all of you for your advice and suggestions. Marcia: Thanks for the suggestion about the hot tub/heat therapy. I really don't understand why he wants me to do PT when I can barely stoop down and get back up, it's like gritty sandpaper and it hurts!! He has been less than helpful since the surgery. All he's done is Cortisone over and over and Ultram. The Cortisone seems to help for about a week and then back to square one. I have a lot of functions coming up, trips, vacation etc. and I can't imagine trying to do all the traveling, walking etc. with my knee this way but there is no way I could do a surgery on it before the end of June. I just want some relief, you would think that 2 years of complaining, coming to see the doc (at $50 a visit), cortisone shots etc. would give this Doctor a clue that I'm not just about the drugs ....but something other than Ultram or Darvocet (yuck) would be nice. Take care all!!

 
Old 05-05-2008, 07:22 AM   #13
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Re: Darvocet or Hydrocodone and more Questions ???

you REALLY do need some help here hon,with good PM AND a possible surgery just to clear that gritty(chondromalacia) crap from the knee and to fix that meniscus. you are walking around with an actual tear in there and it is wreaking havoc in that knee and creating more "gritty' stuff with every step. i am really shocked at his additude here really.

tho alot of orthos are reluctant to take on another surgeons patients once surgery has actually been done(went thru this with my c spine and NS too)there ARE orthos out there who really will help you with this. i think he has for some stupid reason,given up on you with no intention of going back in there. but if you DO indeed need a knee replacement,or even partial,another ortho wouldn't be so reluctant with that coming into the equation just becasue everything would be removed from the last docs 'surgery',you know what i mean?

you just really DO need to obtain that second opinion as to what options you have here and what treatment plans are availiable for you(or what could actually be just plain fixable). there is another place that you could go that is usually alot easier to see someone else after a surgery and thats a university type teaching hospital? these places take on alot of already had the surgery and failed type patients without too much problem. this is what i ended up doing after two surgeies on my c spine actually caused impingment in my c 7 nerve root and my stupid NS kind of blew me off? it really was sick.

he somehow managed to actually impinge my c7 nerve root with the pedicule screw that went into that vertebrae when placing the hardware. not only impinged,but actually 'looped" it around it somehow and it was solidly impinged. i went to the U of MN here in MN just to get some help and thats when i also found out my cavernoma in my cord had also bled twice and not two NS ever told me it did. this place saved my sorry butt from total paralyzation that would have occured with the every next bleed. big nightmare believe me. but they ahd no problem taking me on there and i know alot of other people who have gone this route when their surgeons either screwed them up even more or they started acting like yours is to you. you just deserve to have treatment and help from your surgeon hon.

what you have going on in there just really needs attention or it will continue to decline and things will get much worse for you. some things can be fixed from what you have stated. that menicus is pretty simple, the chondro(i had this too, badly)needs to be scraped and cleared,and it would alleviate some of that constant inflammation in there that is the base of your pain. you could have whats called crepitus in there too from the way you described the "gritty" feel. this is tiny bits of bone floating around in that fluid. or possible bone on bone situation which is a very highly inflammatory condition to be in.

you just really need that second opinion from another ortho if this one refuses to even help you with the pain he left you in in an appropriate way. it IS possible to do if you go to the right places or orthos. if you approach this from a 'possible knee replacement" angle,it would also be a bit easier to see another one too. thats kind of up to you. how long ago was the last MRI done?

i would start trying to find another ortho for this hon since he has already made his decision about any surgery being done on you and will not take you on thru a simple surgery that could possibly help alot with at least your pain situation. i really cannot imagine,unless he was planning to do surgery,that PT in your case would help too overly much,and could make a bad situation much worse since you DO have an actual injury in there ya know? this also what you need to find out from another ortho too. you just don't have to suffer with this when there are ways to actually get to a much more caring and probably much more knowledgable ortho surgeon. you should at least be getting that pain more appropriately treated. maybe seeking out a PM would help while this gets sorted out. they could also help you get to another ortho. just a suggestion for you.

if a referral comes from a PM to another ortho,that would really help you alot in getting the attention this knee deserves. you just really need to know with 100% certainty what it that is going on in there and what your real true options are here and you wont get that from your current ortho,so you have to attack this from another angle to just get your real needs met. believe me, i have been there. sorry i couldn't offer you better help hon. but you DO deserve better than you are getting right now,thats for certain. i do hope you can find better help with this. either demand that your current ortho just do the right thing for you or move on. cuz your not going to get what you need from this guy,he pretty much already showed you that. good luck LMP,marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
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