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Old 07-20-2008, 05:01 AM   #1
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Steve can you help ?

Hi Steve just wondering if you could help me, I know it is just a guide, and I would just appreciate you looking over the following and maybe see where I could get better relief with the meds I am taking. I have found a huge difference with my meds since taking them every 6 hours. But I dont have any breakthru painKillers that some of you mention from time to time.

I take in Total 60mg of Oxycontin
every 6 hours 20mg X 3
Amytriptylene 70mg Total.
take 25mg in the morning and then 6 hours later 10mg and then 35mg at Night.

The reason I was only taking 10mg during the day was they tend to make me sleepy, but now I have got used to the 10mg in the daytime i feel I could up it.

Steve I dont know if it is the Amytriptlyene that is helping me more as i noticed a better improvement when I went on it. Had been taking the Oxy for a number of weeks beforehand and the biggest improvement was when i took the Amytriptlyene with it. Whether it is the combination of the two drugs or the Amytriptlyne on its own I dont know. That is the total of what I am taking. I know the Amytriptylene is an antidepressant but it is also used to block the pain signals and this is what we aretrying to achieve. I dont know what dosage I should be on as this was left up to me to see what I could tolerate. I am due to phone in my prescription this week so I can get him to up the dosage if I need to. I would just value your opinion on it. I know we posted before about this but it was to just get me started taking it every 6 hours which now I am. (PM doesnt want me to !! but its my pain !!)
You know how frustrated I am and I am just wondering if painkillers would help
and give me that extra bit.............. thanks Steve.

Round1

 
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Old 07-20-2008, 11:55 AM   #2
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Re: Steve can you help ?

Round1,

I just read your post and am off to pick up my son and then get the vacation washed off of my car. When I get back I promise to dig into this and do my best to help. OK?

Be back in a bit...

steve

 
Old 07-20-2008, 12:57 PM   #3
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Re: Steve can you help ?

Round1,

I sure hope we can get you some better pain relief. You have been struggling for so long. Have things improved in Ireland weather-wise? Does that affect your pain level?

Back to business...

There are many drugs that can either help or hinder how oxycontin (oxy) works. It just so happens that the way amitriptyline (ami) is broken down in the liver, and the liver enzymes it effects actually makes the oxy stronger. Other ADs like Prozac can serve to hinder oxy's pain relief mechanism, depending on the person. For you, the combination of the two delivers better pain relief than if you took either one alone, or at widely different times.

Regarding your oxy - The way you wrote it I can't tell for sure how much you are taking. If the base dose is 20mg, every six hours would total 80mg daily, that's 4 times per day. Right? If it's 20mgx3 every 6 hours, then that would be 240mg daily (that's 60mg x 4). Or does the "every 6 hours" mean "awake hours" and then you take none during the 8 "sleep hours?" If you would clarify that would help.

If your schedule is truly every 6 hours during 18 awake hours, then no meds during the 8 sleep hours, then I can see a problem with the waking period - when you wake up. I would expect that waking up could be a difficult time.

But I'd like to wait until you clarify the oxy schedule before saying more because it'll make a critical difference.

steve

 
Old 07-20-2008, 02:25 PM   #4
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Re: Steve can you help ?

Not to butt in but I think she meant 20mg 3x a day for a total of 60mg.

Correct me if I'm wrong. Just trying to help.
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Old 07-20-2008, 02:31 PM   #5
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Re: Steve can you help ?

I think so too, but I want to be sure before I post more.

People usually consider the time between doses as a pretty firm number. Patients watch the clock sometimes, or set timers as reminders. And she was fairly firm on the 6 hours number in a couple of places. If it is 6 hours, then she has a fairly large range of time uncovered since there are four 6 hour periods in the 24 hour day, and something needs to be done to account for the remaining 8 hours.

steve

 
Old 07-20-2008, 03:15 PM   #6
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Re: Steve can you help ?

Sorry to have kept you waiting, managed to get the laptop of my husband who was checking out the tour de france......


Steve, thank you for taking the time to help, and my timing is possibly wrong as you have a lot of things to do after the holiday. Well i hope you enjoyed and has refreshed all the family.

Okay, now I can see you shaking your head at this. See, some mornings I might wake at 7am and would start then, but it might be 10 O'clock another morning. I take the meds every 6 hours when i am awake. But if I go to bed say at 11pm and dont wake till 7am or 9am, that is when I start to take them.

But the surprising thing is I am better in the morning than anyother part of the day. If I have to go or do something it has to be morning. Afternoons used to be so so bad until I started to take the meds every 6 hours
So I know there is alot of time there where I dont have cover but once I am lying down I am fine, and I dont have trouble sleeping, or stiffness getting out of the bed in the morning.

"awake hours" and then you take none during the 8 "sleep hours?" If you would clarify that would help. Yep, that is correct, but it could be a 10 hour sleep sometimes.

I know you are possibly saying to keep the levels up and not to be paying catch-up during the day, but I was trying to do is take the most of the meds while I am awake as they seem to benefit me more during the day. But if you think by keeping a constant level would be a better way to go ..... ?

So making a long story longer !!!! every 6hours that I am awake I take, and yes a long period during the night not covered by meds.

Also just one think to bear in mind that my PM does not agree with the 6hours and said they last 12 !!!! right we kind of know different, and by changing has made such a difference. So I cant really up up the dosage to much at the moment I am ringing in for 60mg of Oxy in 20mgs and 10mgs.
as I am meant to be taking 30mg every 12 hours.

Sorry if this is rambling on ........... Well you asked about the weather, well it didnt rain much today, today we had abit of sun and very windy..... still need a jumper or jacket !!!! so yes the worst July in history I think for rain so far this summer !!!! - Dont really find it affects me.... more the extreme cold for me just makes me stiff as a poker......... and I go around hugging the hot water bottle

Again steve, thank you so much for taking the time to help with this. I just feel I have more to get out of this........... and I really feel if changing has made a difference to me, there has to be more.......please God. Yes like us all I am sick of the pain.

You made me laugh about washing the car ! that is something like my husband would do......... or before my back trouble and we would be heading off on a long trip the car would have to get washed before we go...... why I dont know because it used to get destroyed on some of the trips !!.

It is 11.15 pm here so I will log on in the morning, and dont worry if you dont have the time Steve, whenever you can. Thanks Again.......... I will stand you a big Pint(s) of Guinness on your trip to Ireland. Take care...Round1

 
Old 07-20-2008, 03:18 PM   #7
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Re: Steve can you help ?

I took so long in posting that reply Ex has said it !!! keeping the levels up !. Normally for me I find the meds kick in after 30min........so maybe I am just playing catchup then.......... but I cant see a way to stretch 60mg over 24hours when I was on 10mg I felt nothing at all.............................

 
Old 07-20-2008, 03:47 PM   #8
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Re: Steve can you help ?

Quote:
Originally Posted by Round1 View Post
I took so long in posting that reply Ex has said it !!! keeping the levels up !. Normally for me I find the meds kick in after 30min........so maybe I am just playing catchup then.......... but I cant see a way to stretch 60mg over 24hours when I was on 10mg I felt nothing at all.............................
I know you specifically requested Steve, but thought I'd just throw a quickie response in there. Again, I do think consistent BPL is critical. I think you probably are playing catch up during the day and that's where you've been having problems.....Even if you feel ok upon waking.

For example, I have found that taking my LA med right @ bedtime really helps....Because one's metabolism is very slow during sleep, the med can usually carry you through without too much trouble. Then, upon waking, the combination of the other LA doses and BT meds, take care of the rest.

Hope you feel better.

Ex

 
Old 07-20-2008, 06:35 PM   #9
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Re: Steve can you help ?

Round1,

I agree completely with Ex's last post. I also take my night-time dose right before going to bed.

And I used to be just like you - not wanting to be medicated while asleep. But I learned over time that by taking my meds every 8 hours instead of every 6 hours, I was better covered for pain during my precious daytime hours. It just plain worked.

So my recommendation would be to take your oxy 20mg every 8 hours, and, at the same times, take your amitriptilyne. I'm not sure how to advise you regarding dosing the ami, but I would think you could take two similar doses upon waking, then also for the second dose, then a larger amount for the bedtime dose if you prefer. Because of the synergistic advantage of taking the oxy together with the ami, please take them together.

I would encourage you to give this a try Round1. Even if it's a little hard at first, see if you can adjust. If not, you haven't lost anything and can return to how you're doing it now.

steve

 
Old 07-20-2008, 07:11 PM   #10
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Re: Steve can you help ?

Round1, I just wanted to jump in and say that I have had great success taking my oxycontin in 20mg doses, every 6 (out of 24) hours. I never sleep more than 6 hours at night so it isn't usually an issue for me. But I agree with Ex and Steve that a dose right before bed and right when you wake, is an excellent method of maintaining consistant pain coverage. Even if you tend to sleep 7 or 8 hours, there will still be a higher BPL through the night. I know Pepper has mentioned that she will set her alarm so that she can get 4 doses in a 24 hour period.

Hope you can find a schedule/routine that works for you. Hugs, CMP/MM

 
Old 07-20-2008, 08:33 PM   #11
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Re: Steve can you help ?

Yep, I am the 4 a.m. alarm girl. And FYI it does make a major difference for me. If I don't take the meds spread out every 6 hours, my pain levels jump to 9/10's. That 2 times a day dose does not work for me either. If I went to bed at 10 and took my meds then and did not take meds until 8 am, I might as well plan on staying in pj's for the day. My pain is all messed up. So every morning at 4, you know what I am doing.

 
Old 07-21-2008, 06:08 AM   #12
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Re: Steve can you help ?

Hi thanks,

I just phoned by Dr. and asked if I could up the amytriptlyne, when he is renewing my prescription. Thank you all for helping, and I know I put the post of to Steve, but anyone that can help i am gratefull so dont feel you shouldnt reply.

I did try the eight hour, but then I found the 6 hour better as I needed to have a better time in the morning and afternoon, and I found that come the 6hours I really needed some relief. I remember trying it at 8am and then 4pm and I was just so sore. Then found the 6 hours just so much better. But my problem now being is trying to make a 60mg dosage go into 24hours, that is why i didnt take at night. I dont think I can phone for an extra 20mg... as he believes I am taking 30mg in the am, and 30mg in the pm. 12 hours apart !! Taking a 10mg and a 5mg (which is available here) I dont think that will do much for my pain over 8 hours..

Do you think I should get the dosage up if I can? Are is there so other painkiller you would suggest that would cover me better to take then with the 10mg and 5mg of Oxycontin?

I hope that all makes sense. Thanks everyone, and all help is greatly appreciated.

Round1

 
Old 07-21-2008, 06:51 AM   #13
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Re: Steve can you help ?

Round1....This is just my humble opinion, but I think another 20mg total of oxycontin per day would be a big help. This would allow for 20mg every 6 hours. If he needs to think that you are taking it at 40mg a.m. and 40mg p.m., then so be it. It really all washes out in the end. I actually think this would allow you to remain at the same dose of ami per day. Unless, of course, you feel that your current dose of ami is not cutting it.

Has he said that he has a problem with increasing the oxy? I just know that this new schedule has made a huge difference for me. My PM doc has no problem with how I dose the meds, as long as I don't excede the max/day of 80mg. I guess I just don't understand why yours is being so rigid. Maybe he doesn't have as much experience with oxy and wants to stick to the manufacturer's recommendation. It could be because he wants to make sure that his records can not be questioned, in case of an audit by whatever governing authority you have in Ireland. (like our DEA)

Whatever it is that happens, I wish you the best of luck. I would just love to see you have the opportunity to have the best overall pain coverage, in whatever way you can. Take care and have a good rest of today. Hugs, CMP/MM

 
Old 07-21-2008, 10:23 AM   #14
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Re: Steve can you help ?

I have to agree with cmpgirl.

Another 20mg would serve you well. Could you just ask to add 10mg to the prescribed 30mg AM dose, and 10mg to the prescribed 30mg nighttime dose?

steve

 
Old 07-21-2008, 11:24 AM   #15
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Re: Steve can you help ?

Thanks guys, yes I have been thinking along those lines aswell, since I couldnt log in for most of the day, kept getting error reports !!!. Anyway as I said I phoned by Dr. about increasing the amytriptlyne not daring to mention the oxycontin, and he wants to discuss it, so make an appointment, or ask to make an appointment with my Pain Management Specialists.

cMPgirl, I think you are right about not having the experience with the oxycontin as he said to me that he has very few people on it.... He also said that he thinks the 30mg should hit it for me, he is very ridget in his views, and of course his attitude that "he knows best " I am not due a visit to the PM yet, but I think it might be worth a visit to the Dr. rather than pay 150.00 euro for PM to say NO. My dr. would be better.

So if I could just get the extra 20mg sorted it really could do alot for me.
Thanks all for your help. cmpGirl, what BT painkillers do you take then during the day besides your oxycontin?

Round1

 
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