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Old 05-17-2008, 09:05 PM   #1
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kim46 HB User
I have a question re LA meds, please, thank you

For all of you on this board, I think of you all daily - particularly when I have a super bad day.

I'll try to keep this as brief as possible but I need to give you an open and honest overview.

My husband (of 30 years) and I suffered from infertility after wasted years trying artificial insemination. At age 40 we were referred to an IVF clinic and I can't say enough wonderful things about our Reproductive Endocrinologist. He diagned a blocked tube and moderate/severe endo for me and an issue with my husband. I couldn't continue into the City to see very expensive doctors and my PCP (now former) treated me for migraines, endo and the lovely peri symptoms. I received 100 Vidodin HP about every 6 weeks to 2 months. I rarely saw "my" PCP - I mainly say his partner (younger and quite helpful). My former PCP and my new PCP (the partner) broke up and I'm now with the younger PCP. I've always provided full disclosure to every doctor I've had via new patient information sheets and/or keeping my PCP updated during innocuous visits for bronchitis, etc. In May of 2006 my back went out. I was changing the sheets on the bed and was in agony. When my husband got home I went to a back doctor. I worked for 25 years in 1 job and when my daughter arrived I moved to a "part-time" (about 45 hours weekly) hourly in a finance area. I would spasm up and have to pull over to the side of the road until the spasm passed - once for over 1 hour. I told my now former PCP with updates from May 2006 until April 2008. I put a letter in his file from my back doctor that he was treating me with physical therapy and 10 mg of Percocet to be taken as needed (in addition to the Vicodin I received every 6-8 weeks from my PCP.

So my insurance send a letter (new insurance) to all my docs as they want me to take generic. The letter listed every med I have taken for the last 4 months (this has been going on for many years, eg endo).

I'm happy with my new PCP (whom I've know for 7 years anyway) but my back specialist will be the only doctor prescribing narcotics (off topic but this whole nightmare caused me migraines, 3 nights without sleep and two weeks with about 2 hours of sleep).

My *issue* - I was taking about 3 10 mg Vicodin daily plus 3 10 mg percocet. I talked to the phycial therapist at the office about getting off the continued usage of tylenol (6 years) and that I would ask the specialist if he would switch me to a long acting drug with percocet or vicodin for break through pain.

Like all of you I just want quality of life which has been fleeting the last 2 years and bringing me down very low when I have so much to be happy about. Sure bad things have happened - I have lost loved ones. That said, I'm usually optimistic person. I have always, always taken my medicine as prescribed.

I'll raise the LA medicine with him and then let him make the suggestion of what one he would prefer. For those who use LA meds, what do you think works best for you. From the reading I've been doing for 2 years the Oxycontin seems right for me as I have no issue with the percocet expect they wear off quickly. At this time in my journey, I've only gone up slightly (in my opinion) re narcotics meds. From 30 mg Vicodin to about 50-60 vicodin and Percocet in 6 years.

I was going to suggest, once I hear him out, 20 mg of Oxycontin 2 times daily with 60 10 mg IR pills to last 30 days (total intake would be no more than 60 mg of Percocet; 40 mg in Oxycontin and 20 mg in Percocet per month.

I'm so sorry this turned into a book but I trust your judgement and experience.
Thanks in advance

Last edited by kim46; 05-17-2008 at 09:45 PM. Reason: Too long - repetative - shortened and fixed spelling

 
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Old 05-17-2008, 11:17 PM   #2
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cmpgirl HB User
Re: I have a question re LA meds, please, thank you

I absolutely agree with what Juliet said. I think you need to make a more round-about approach with the LA med. Docs today are sooooo suspiscious. They tend to want to be the one to bring it up.

I would just let him know what you have been Rx'd up to this point. Also tell him what therapies, etc. you have tried that didn't help and any that did. Let him know that the current meds make you feel like you are never getting any real relief, like a roller coaster of up and down all day, and then ask if there is anything that can be done to help with that. Period. I think it's a much better approach.

I also think that with a LA med, you probably won't need 6 BT a day. They really do give you better overall coverage and generally decrease the need for more BT.

Good luck and let us know how it goes. Take care, CMP

 
Old 05-18-2008, 09:18 AM   #3
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Re: I have a question re LA meds, please, thank you

60 Oxys IR for 30 days is only 2 per day, which isn't that much. It would be a good compliment to OC.

However, instead of going in and asking for specific drugs and qtys, I would talk to him about going on a LA med in general and let him decide which is best...If he throws something out that you don't like, you could object and say something like "are there any other choices"?

As far as BT meds....Qty and strength....Again, I'd take the same approach...Tell him you like some meds for BT each month and let him decide. He'll probably give you at least 60, if not more.

Honestly, I think the subtle approach would work much better. But, you know your Doc best, so do what you think is right. I think your main problem from what I've read is the "ups and downs" of all the shorting acting meds in and out of your system.

Good luck.

Ex

 
Old 05-18-2008, 10:44 AM   #4
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forginon HB User
Re: I have a question re LA meds, please, thank you

Tara,

You're doing the right thing by going after long acting meds. So much better for a smoother delivery and less times when you feel no relief at all.

As everyone else has written, let the doc decide. Asking for specific drugs and quantities is probably the worst thing to do. You can easily say that oxycodone has been good for you for relief, and could he prescribe one for LA and another for BT? That would be about as specific as I would get. Since he's already prescribing oxycodone for you, this shouldn't come off as at all suspicious.

Best of Luck.

steve

 
Old 05-18-2008, 01:13 PM   #5
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kim46 HB User
Re: I have a question re LA meds, please, thank you

Thanks. I did mention to the PT that I perhaps a LA med would provide better/longer relief and he said talk to the doctor when I'm next in which is Tuesday.

I'll go with the flow and I'll keep you posted, thank you for your replies they are appreciated.

 
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