Need Advice About Changing Meds~ - Pain Management Message Board

IZZY'SMOM · 05-19-2008, 04:56 PM

Hi everyone~
Im home, and exhausted. Thank you for all of the well wishes, and I did well, but not my best, at all.
For those of you who know me, Im on the patch 12's, 15 mg. LA hydro 4x daily, 10 mg hydro 4-6 Xdaily, and its just NOT working any more.
Im going to call my doc and ask if I can try oxycodone compound instead of the patch or one of the hydros.
What are your thoughts? Also, Im afraid to ask for a specific med, b/c Im afraid to look like Im demanding or wanting just that med. but after all of my thinking, and Ive tried oxy before, I think its my best bet.
This combo isnt working for me, even if Id doulble the hydro doses OR the patch. I think having the two hydros and the low patch dose isnt doing anything for me any more.
BUT, IM afraid he will tell me I need a pain holiday. God, Im so sick of worrying about that all of the time.
Thanks for everyone, support...sorry I havent replied sooner, Im really tired and hurting after all of the wet weather in Jersey, and having to start over because of the rain was really a bummer~
xoxoxox,
IZZY'SMOM

forginon · 05-19-2008, 05:03 PM

Izzy,

pain Holidays are not necessary if your doc is willing to employ opioid rotation. As I understand it, opioid rotation works just as well at addressing tolerance and finding relief. Research says that we don't become fully tolerant to all opioids just because we develop tolerance to one of them. It's called incomplete cross tolerance. One of the best meds to use in opioid rotation is methadone. One can go from 600mg daily morphine to 80mg daily methadone very successfully. After being on the methadone for awhile, then rotate to something else, or back to the original med.

Gotta go - if you have questions just ask - my carpool ride is here.

steve

IZZY'SMOM · 05-19-2008, 05:34 PM

I tried methadone once, amd it was horrid for me...Ill never touch it again. Thanks Steve~
I need to go, my son is waiting for me to golf with him, but Ill check back later on. God, I just want to crawl into bed...this was the worst ever.
xoxoxox,
IZZY'SMOM

aussiejono · 05-19-2008, 05:48 PM

Why the insistance on a compounded med, any reason you couldnt use OxyContin, MS Contin, Kapanol or Paladrone as a LA med?

Could you add Celebrex 200mg twice a day to your regime, it can add significantly to th releif without adding to the side effects.

Executor · 05-19-2008, 06:19 PM

Hey Izz.....Here are my thoughts:

(1) Compounded Oxycodone won't have the true long acting mechanism. While the gel they use in the capsule will slow absorption, it won't be long acting. Thus, if you are set on Oxy, I would go with OC. The absence of a true LA med may only compound your problem(s).

(2) The patch may not be working properly because you may be too active for it. I dare say that you work up a lot of natural body heat, and the patch is probably releasing med way too fast. Also, the 12 patch isn't very strong, and given your level of pain, you're probably under medicated from a LA med standpoint. The whole purpose of a LA med is to elevate your BPL. The 12 has only recently been added to the patch line up and is mainly used for tapering and moderate dose increases. Very few use it as a stand alone LA med.

(3) You say that doubling up on the patch isn't working. The patch isn't designed to be a quick fix....The literature says it takes several consecutive application changes to properly elevate your BPL. Additionally, if you have periodically put an extra one on, it may actually make things worse because your levels go up & down which puts your body under stress.

(4) Unless I'm missing something, you basically have four LA choices....The patch, OC, Methadone, and Opana. Given your activity level, I'm thinking OC or Opana would be best. If OC, you would probably need 3 X or maybe even 4 X day. I've heard great things about Opana and am thinking of trying it myself. Those I've talked to who use it all say it works much better than OC and lasts much longer.

(5) I'm with Steve in that I probably wouldn't ask for a specific med. Instead, I would tell your Doc the patch isn't working due to your activity level and would like to try something in a pill form. If he suggests Methadone, then you could object given your previous history. Then, that only leaves OC or Opana. Once he offers up one or the other, I would tell him that your concerned that the standard 2 X day doesn't work for many, and given your activity level, your body would burn through meds even faster. So, could you try 3 X? Asking for 4 X wouldn't be prudent @ this point, so I'd wait until you try 3 X first.

Hope all this helps.

Ex