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Old 07-23-2009, 09:42 PM   #1
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How much is too much hydrocodone?

Hi everyone -- I am 23 years old and have been consistently been taking hydrocodone since I was 18. It started with ovarian cyst problems but after getting those surgically removed I developed very bad sciatic nerve pain and have been suffering from that for 4 years.

It says take as needed -- but I try to keep it down to no more than 3 a day. But since I have been taking these pills for such a long time and almost every day for the past year --I wonder if this is harmful. It helps my pain some but not much, but because I will take any relief I can get I rely heavily on them. Another worry is that I also have been diagnosed with polycystic kidney disease recently and have been told hydrocodone is safe with this? But I take soo much of it. I'm just kind of worried and wonder if anyone knows how much is too much. Thanks so much for reading!

 
Old 07-24-2009, 05:15 AM   #2
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Re: How much is too much hydrocodone?

i only know a small amount about Hydrocodone.
In liquid form (eg: cough syrups) there is a tiny amount of Hydrocodone so even drinking a whole bottle will not cause an overdose. Hydrocodone is also addictive. Have you consulted your doctor about the kidney problems because it is recommended to avoid hydrocodone unless advised by a doctor.
Normally daily consumption should not exceed 40 Milligrams. If you think you have overdosed these are the signs :
respiratory depression; extreme somnolence; blue, clammy, or cold skin; narrowed or widened pupils; bradycardia; coma; seizures; cardiac arrest. Obviously dial for a paramedic is any occur.

Sorry my knowledge is limited. Hope it gives you an idea though

 
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Old 07-24-2009, 06:06 AM   #3
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Re: How much is too much hydrocodone?

the one thing that would help you the most right now would be to see what can actually be done for the pain generator itself. have they ever done an MRI on that lower back area just to really see what is affecting that sciatic nerve? that would be one thing to try here. areas of pain within our spines for various reasons can actually be brought down to a much more tolerable level using injections of steriods, trying different "types" of meds other than narcotics since they can work much more effectively on nerve type pain too. but with PKD, you really do need to try and stay away from NSAIDS. thats what i was told by my neph after my PKD diagnosis(its just much harder on the kidneys). at least you found yours very very early. mine was not Dxed til i was about 40 years old. did not have a clue i even had it. is your liver also affected like mine is or just your kidneys and the other cysts?

are your kindneys actually enlarged at this stage or are they still pretty much within the normal size yet? the one thing you do just have to keep in mind here with just having PKD at all? your kidneys will continue to enlarge as more poplycysts develop and push away the healthy tissue. its still there but the cysts just grow and displace that healthy tissue. that is the biggest reason the labs wont change til you are usually in your upper thirties to forties. i am 48 and all my liver and kidney labs are still amazingly within all norms, despite both kidenys being covered inside and out with humongus cysts and them being almost four times their norm in size, but i know that willchange sooner vs later.

finding out whether or not you actually have ANY cystic development within the actual muscles in there too can matter alot. i have two seperate polycysts that somehow migrated over from the left kidney and into the psoas muscle. what side is your sciatic pain on the R or the L? the left kidney actually kind of 'saddles" that paoas muscle so the left is much more likely to have this occur. sheer size of affected organs can also start pressing onto certain nerves and cause problems as well. this is why you really do need to find out what IS simply affecting the sciatic.

while alot of this usually occurs as you age and the kidneys enlarge over time, depending upon many different factors, they could be already enlarging to the point of affecting other organs, muscle and nerves too, and also vascular structures within organs as well.

as far as taking hydro based meds,it is okay with PKD. the one thing tho to really watch is the overall tylenol intake. if you are only taking three a day you should have no problems with that. but like i mentioned above, there are other ways other than just using narcotics that could also manage your pain too. you just have to try different types of meds and therepies to really see what works for your particular pain process. just finding out for certain that this is even the sciatic nerve itself being affected at all or some level of the PKD playing a part in this would help to try and treat it appropriately. i can tell you just from my own psoas muscle cysts, it can and does at times feel alot like sciatica since that muscle just happens to be located within that very same area. just obtaining that MRI would really be a good idea, for alot of reasons.

just how did you find out you even had PKD? who else in your family has this? have they fully checked out all other addominal areas/organs just for possible cystic development? they CAN show up in just about any organ in there. if you have any other PKD questions you can catch me in the kidney boards. Marcia
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3-22-01,herniated C-6-7
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9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 07-24-2009, 06:07 AM   #4
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Re: How much is too much hydrocodone?

Quote:
Originally Posted by iamtooyoung View Post
I'm just kind of worried and wonder if anyone knows how much is too much. Thanks so much for reading!
Welcome to Healthboards. Many here have a lot of experiences thus, can help in a variety of ways.

Your question is a very tough one....There are upper end "limits" out there, particularly for Tylenol. However, on the narcotic side (Hydro), there is much debate about how much is too much.

For example, I've seen articles that suggest that there is virtually no upper limit with many pain meds....Regarding tolerance. However, for those patients who take massive qtys, they've been taking those meds for years....Sometimes decades, and the buildup has been over a very, very long time.

This whole concept also depends on one's individual condition, pain, and the particular theories and concepts practiced by one's participating physician. There are many different types of pain meds out there, some being long acting (LA), that are available for your physician to use.

The first step is to have a Dr determine if one's pain is long term, or chronic, and if so, then develop a plan for long term PM. Given your particular medical situation, including your kidney issues, a Doc would probably devise a plan specifically for you. My guess is that it sounds like your pain is more long term oriented and there's probably little reason to be using Tylenol based products.

My recommendation would be to get referred to an official pain clinic, if you're not in one already. This way, all the concepts I just discussed can be adequately addressed. There is nothing wrong with GPs treating pain, but as with any speciality, pain mgt Docs are the foremost experts out there.

Best of luck to you.

Regards,

Ex

 
Old 07-24-2009, 06:11 AM   #5
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Re: How much is too much hydrocodone?

Hi-

I have been on hydrocodone for a while and just recently switched to Oxycodone. I was switched because the problem with hydrocodone is Tylenol (acetaminophen) that is in it. I don't know what type of hydrocodone your taking but it can range from 500-325mg per pill. A person is only supposed to have less than 4,000 mg of acetaminophen per day (and recent developments by the FDA are suggesting that even that may be too much). I was taking Norco which is hydrocodone with 325 mg of Tylenol. I was taking 8 of those per day. The doctor said I needed to switch to something without Tylenol because that much would eventually start damaging the liver. I know the kidneys are in the same system as the liver but I am not sure how much they are affected. If you are only taking 3 a day even if you have the 500mg kind that's only 1500 mg which is well bellow the recommended daily allowance but if you have kidney problems ANY Tylenol might be harmful. You really should get with your doctor and voice these concerns. There are other pain meds without Tylenol...or even hydrocodone without- like Vicoprofen which is hydrocodone with ibuprofen (Advil) mixed in without the acetaminophen.

Well anyway, I hope that answers your question somewhat. I definitely wish you good luck in getting some of the relief we all are searching for living with chronic pain.
B.

Last edited by Brosiah; 07-24-2009 at 06:18 AM. Reason: typos

 
Old 07-24-2009, 10:43 PM   #6
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Re: How much is too much hydrocodone?

Wow, thank you all so much for your input. To specify -- I have been taking Hydrocodone/APAP 5MG/325 MG for about 6 years and rely heavily on it.

I actually expressed my pain management concerns to the nephrologist (kidney dr) and they said I am fine as long as I avoid ibuprofen! So I gave all my ibuprofrin away and have been taking a lot of hydrocodone and Tylenol pm. Now I'm scared seeing multiple people saying this is bad for kidneys. I know the Tylenol is harmful for the liver long-term but my understanding was ibuprofen is the thing to avoid if you have kidney problems????

And as far as trying to find the cause of my pain-- it's been a huge struggle for a long time. I have had many MRIs, ultrasounds, xrays.. done on my spine/back. And that's actually how the cysts on my kidneys were found. The MRI found "insignificant" ruptured discs on my lower spine and I visited a neurosurgeon who basically just told me to continue physical therapy which wasn't helping me anyway. I just used 'sciatica' as a very general term but I am pretty sure it's either piriformis syndrome or sacroiliac. I have been so determined to get relief any way I can -- I went to physical therapy for a year, stretched when I was able, got custom arches from a podiatrist (one of my legs is longer than the other and my hips aren't aligned properly), stayed at a healthy weight/did core exercises. I want to try a chiropractor next and also am interested in injections. I will take any relief I can get because I literally can not move most days and can't live like this. The hydrocodone takes such a tiny sliver of pain off so I tend to take 2 a day. I also can't sleep at night at all and the hydrocodone has lost the drowsiness effect on me because I used it so much so I also take Tylenol PM. I am now thinking about asking my Dr. for sleeping pills such as Ambien -- but again, will this be bad for my PKD? It's like if I try to help my excrutiating pain my other problem with my kidneys will be negatively impacted.

I didn't even know there was such a thing as a pain clinic. I will ask my doctor about this. I am at a doctor or specialist literally just about every week so hopefully they can help clear up some of my medication worries as well.

 
Old 07-25-2009, 03:36 AM   #7
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Re: How much is too much hydrocodone?

If you've specifically asked your specialist about your meds, then I would rely on that information. They know best.

In terms of your pain and etc., I think what you need to do is somehow find out (if you don't know already) if your pain is determined to be "chronic" or not. If so, then it is not expected to improve much, if at all. Conversely, "acute" pain is temporary and is expected to improve. If chronic, then, it would be in your best interest to get a plan together addressing your long term care....And a pain clinic may or may not be the best for you.

What you are describing in terms of the meds losing their effectiveness is quite normal. It's called "tolerance." And, I'm sorry to say that it will only get worse. Thus, it's very normal, and in fact, expected......For meds to need to be increased, either in qty, strength, or both. This is part of the "plan" I was referring to. There is no need to suffer needlessly because there are a whole slew of meds out there that can address this issue. Over time, most CPers usually creep up in their meds....In strength and qty. For example, it's not that unusual to see a long term pain person on major amounts of meds....Enough that one would think would kill a cow, but in reality, is the minimum needed for a high tolerance person.

I would first talk to your Doc about all of this, and then go from there. He or she may very well be able to treat you long term.

Lastly, regarding your sleep issues and Tylenol PM....It's simply Tylenol packaged with an antihistimine. If you don't feel you need the Tylenol, just take the antihistimine itself (OTC) and avoid the Tylenol. This way you could even take a bit more without having to increase your Tylenol. In fact, your overall Tylenol use would decrease.

Best of luck to you and please let me know if I can be of any assistance.

Regards,

Ex

 
Old 07-25-2009, 09:52 AM   #8
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Re: How much is too much hydrocodone?

i would LOVE to know just what an 'insignificant ruptured disc" actually is??? every rupture within discs is ususally pretty significant in nature at least to the degree that it can simply produce pain and symptoms. its that simple. alot also depends upon just what the released crap inside that ruptured disc is also impacting(the nucleous of the disc itself). if you also have ANY level of actual stenosis going on down there as well, it could very easily create pain since a nerve root would be involved and impinging from at least time to time.

just how long ago was that MRI done that found the disc issue? time does impact spinal issues as they usually become worse over time and not better. it may be worth your time to obtain another opinion from an ortho surgeon here to just see what they feel may be going on. do you yourself actually ahve copies of all of the testing results? if not, get them from anyone who has laid hands on you and any and all test results, just so YOU have these for your own medical files. it helps alot to have this stuff and it also allows YOU to simply read thru them for yourself to see what you were and were not actually told was found in that summary at the very end? many many, espescially specialists just do NOT tell every patient about everything that actually showed up on any given rad report. they will only tell you what they 'feel" is pertinent to what you are dealing with. many many people find out even years after an MRI when they have to get their records or just see that report that even sifgnificant findings that showed a real problem or condtion were simply not told to them. this has happened to me too. its kind of a sick thing to do to patients but this does go on out there.

another thing you just have to keep in mind is that what you actually get told is even a problem by any real specialist is dependant solely upon their own level of knowledge and experience with it. i had a hemangioma gowing inside of my spinal cord that three different actual neurosurgeons gave me like three totally differing opinions on, solely dependant upon 'their" actual level of experience with them. the first two did not know anywhere near what my third opinion did and he was the head of neurosurgery at the U of MN for over thirty years. that was the one i went with only becasue he was the only one who could truely answer the questions i had, and just knew like everything about them since he had treated or monitored well over hundreds of patients with them in their cords and their brains. experience is the key.

as ex told you about the meds? go with what your actual neph tells you. your neph was right on target about any NSAIDS, they should be avoided only because they are extensively metabolized within the kidneys among other things. that really was the only true limitation i was given too when my PKD was found and i needed pain control. hydrocodone is fine with PKD type of kidney disease. you have to actually understand what PKD is and does to really know how function will be affected. it much more heavily affects the actual tissue by displacement than it does direct function, which is very different than most types of actual kidney diseases. i am assuming that your kidney and liver functions are still well within the norm range if this is 'just' PKD we are talking here? at your age, it will normally take many many more years before actual kidney function becomes impaired in any real way shape or form. that is only due to the fact that you still actually have all the healthy kidney tissue right there,i ts just "displaced" when a new cyst decides to simply 'move in'. so it would normally in most cases not change your functions till you hit up into the late 30s if ONLY your kidneys are involved, but if cystic spread occurs like within your liver too, for some insane reason, it actually stays longer(i am 48 with VERY enlarged kidneys fully cystic and as of may, everything is still the norm with the kidneys. and i do have extensive liver involvment too). i do think it has something to do with the cysts just being spread out much more so the kidneys, tho they are replacating cysts heavily, are not 'as" impacted. it is just a really really insane type of kidney disease, trust me. the more research i have done and finding out other peoples courses with this too, the crazier it really actually gets.

if you are just dealing with pain that you cannot control,seeing a good pain management doc would be ideal for you to start with right now. they can just offer you o many different ways of managing all of your pain gnerators that most docs simply cannot offer you. but any PM has to also be working with your neph just to make certain you are not being potentially being Rxed any nephrotoxic meds. my ony concern with the hydro would be that tylenol that most people just really do not need in some cases. a good PM would be able to help you with this. but it would be worh at least seeing a PM for an eval to see what they would or could offer you. you simply will, after time passes, really start to feel the impact of the enlarging kidneys as they create direct and indirect pressure and compression upon themselves and other organs too. it just goes with this type of kidney disease unfortunetly. also, any real stretching of that surrounding kidney capsule will also cause pain. its just sensitive and a much different surrounding covering than any other organ in our bodies. its 'encapsulated' in an almost shell like covering where other organs are not. this pain is NOT going to overwhelm you like kidney stone pain or something of that level, its more achyness with little sharper pings of pain than anything else,espescially in the earlier years. that does change with enlargement when you get to be my age tho. but depending upon other areas that get impacted will also kind of dictate what it is you will actually feel too.

but at this point i would make certain to gather up all and any real test results and keep getting them from here on out,espescially labs done for comparrison. and see about getting that second opinion from an ortho instead of another neuro just to see how they see this. and if the pain is simply that bad, seek out at least that eval from a real pain doc who can see you for things like injections of various types too, not that you have to be an actual PM patient? i saw my eventual PM many years ago for severe pain under my shoulderblade casued by huge trigger points just being under it. this was 'just" a referal by my primary to the clinic just for injections only. unfortunetly life changed on me and i am now an actual PM patient. you just really need to find out for certain what that insignificant disc herniation is all about and how it could be impacting you and casuing your pain. after that, it will kind of dictate itself. how have your blood pressures been for you?


by the by here,i would actually do what ex suggested with regards to not doing the added tylenol thing by using the PM type for sleep? with what you are already taking, you just do not really need that much more tylenol added, that hydro should be fine for your actual pain. just using benedryl is what would do the real work here with that. i used to use that to help me sleep too before i was on the valium for my spasticity. now that simply works for me much better. please keep us posted on things, 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 07-30-2009, 08:07 PM   #9
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Re: How much is too much hydrocodone?

Thank you all again so much -- I will definitely ask my Dr. about getting into a pain clinic. And yes, when I heard my ruptured disc was 'insignificant' I wanted to scream. What else could possibly be causing me such unbearable pain?! I was seeing the best neurologist at the University of Wisconsin hospital too -- very highly recommended. My physical therapist thought this was insane as well, she was sure I had a herniated disc. Hopefully a pain clinic will help determine if I do indeed have disc problems.

My first MRI for my spine was taken January of this year (that's when the kidney cysts were accidentally discovered and they concluded with this I had 9 cysts on my kidneys and had PKD.)

Then I had an ultrasound of my kidneys. This came back as saying I have only 3 cysts total.

Then I had an MRI specifically for the kidneys and also had the dye injected. I get a call today from the kidney clinic saying I still have cysts but it "probably isn't PKD".

What makes a person have a bunch of cysts on their kidneys but it's not PKD? I don't get it! How can my MRIs and ultrasound differ so dramatically?

I'm also just still so afraid of cysts being in my body. I have suffered from ovarian cysts rupturing since I was 18 and it was hell. I ended up having to get one of my ovaries and fallopian tubes completely removed along with a large cyst. Can kidney cysts rupture and be as painful as this? Has anyone here had kidney cysts removed? Is there such a thing as a cysty person? I'm pretty sure I can feel my kidney cysts -- it's not painful but I would say it's definitely uncomfortable and feels like pressure. How do people deal with this?

Thanks again sooo much for all your detailed responses -- I trust people with experience now more than doctors. Thank you

 
Old 07-31-2009, 07:19 AM   #10
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Re: How much is too much hydrocodone?

what actually determines whether or not PKD actually is PKD or 'just' simple cysts is how they actually appar and how the react over time kind of thing? you are still very young to fully 'see' how the cysts will form and eventually grow together? my son is 22 and he does have it like i do, BUT his cysts are more like yours are at this point. one thing that just happens over time is the much smaller cysts that start our seperate, eventually attatch and join together. they kind of look like 'bubbles"? just how they glob onto each other? that is the more indicative Dx of PKD. you just could have had what WERE seperate cysts actually join together too so it would sort of reduce the overall number of them but create at least one or two bigger ones? do you know what i mean?

one huge thing you need to find out is your family history. most ADPKD(autosomal dominant PKD)patients actually inherit this from one parent who has to have the gene and in most cases, also has to have the actual disease present. tho in our familys particular presentation of this, tho both my sister and i did get this crap from my mom and her side of the family, she herself has only one simple cyst in one kidney. which essentially means that she does not actually 'have" it? this is just freaking out our neph right now since it does go againt just what adpkd actually is. but i most definitely have this, my sister and my youngest son too. very bizarre type of kidney disease let me tell ya. does anyone in your family on either side actually have kidney or liver problems? any history of brain aneurysm or chronic UTIs? hig blood pressure? these are just possible issues that can come along for the ride with having PKD. you just really need to do some digging and find some things out since more than likely other family members would have this to some degree too, espescially one of your parents. a simple ultrasound is what is the norm for standard testing for PKD. PKD just shows itself really well upon ultrasound.

the old 'cutoff' age for getting tested and seeing what is actually there or not in any patient that is younger actually used to be 16. it was said if a child of a PKD parent did not actually show the more characheristic globs of cysts, or had more than one cyst show up in at least one kidney by then that they probably did not have it. well that changed again to like age 20, and now it s actually age 30 believe it or not. our oldest son had showed one cyst in each kidney back in 99 when our other son became sick and we all had to be tested. we were told based on that, that oldest son did NOT have it. now we really don't know for certain only because of the new changes in the age thing. so it would appear based upon what was actually found in your kidneys, that this is indeed indicative of actually having PKD. like i said,things just look a bit different at the younger age you are when it s found. time changes that in a very big way.

like i mentioned to you before, i did not have a freaking clue that i had this til around age 40. by that time there was pretty extensive cystic involvement in both kidneys(also very overly enlarged) and also cysts in my liver. but labs still great. my latest US i had(we do this once a year to monitor all things abdominal now)everything is much more extensive and i also now have a 36mm cyst on my R ovary which is new and one kind of on top of my gallbladder. i already knew about that psoas muscle stuff years ago.

i seriously would do much more research on ADPKD, and just really read up on this stuff. it really can play out in some very crazy ways as i have been finding out. i would for now, look very deep ino your own family history and possibly have your mom and dad also obtain an ultrasound since this just IS the most commonly inherited type of kidney disease out there that many many people just do not have a clue they even have because those labs wont change til the damage usually becomes pretty extensive. despite very extensive damage in my kidneys and liver, my labs STILL as of two months ago look fantastic, with no labs even close to being out of normal ranges yet. it jut really does freak the crap outta me knowing wha i see in my US and having those types of labs still. but this is how this type of kidney disease actually plays out.this would also be a possible reason that either your mom or dad could also actualy have this too and simply have great labs still. so it would be "assumed" wthout having that needed ultrasound being done that they have great undamaged non cystic types of kidneys too.just obtaining that US is how they actually Dx this in most cases, you simply cannot go by lab work with this type of kidney disease, ever. and cysts CAN form in just about ANY actual abdominal organ you have when you actually have PKD. so you could end up with some in some pretty odd places like mine have done too.

what will occur with those cysts as you get older, or even by age 30 will show more of what is actually going on with them. but what you are showing now, IS what shows up in the younger patients. they actually have narrowed down the true chromosome at ths point where it sits which would show it if you really needed that definitive Dx. i do believe it is chrom 16? but since there really is not alot you can do to really "treat" this type of disease process(it does NOT have a cure yet) since it simply IS a ongoing and progressive one. all you can really do is try and keep your BPs under good control, try and avoid any extra salt, which can affect other things besides BPs and just monitor where new cysts could be forming with that yearly US being done. and just listening to what your actual neph says is or is not okay for you personally.


but you do really need to find out just what could be causing pain from that herniation here too. seeing a good PM can help identify whether or not that disc is producing pain by doing certain types of testing. usually like a discogram or one of many other types of tests they do there too. if you can obtain that actal MRI they did that showed tht disc hernation and just post what the findings were in that summary at the very end here, that would help TONS in just seeing how his was described by the interpretting radiologist and any other possible pain generators around it like bone spurs or even stenosis. those findings can also produce pain, trust me on that one. something is causing this that simply needs to be sort of tracked back to the base or generator. but i would speak with your primary about referring you to a good pain management facility for just testing done or as a pain patient. if you have any other questions for me,just hollar. i did clear out my inbox this morning. i did not know it was actually full til i recieved a mail from HB telling me and you tried to send me a PM. so you can resend that PM if you want now, sorry. 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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