I'm so sorry about the pain you're experiencing. It does sound you are at the point where a Long-Acting medication would be most beneficial. It sounds likes your body is building a tolerance to the Hydrocodone and the pain relief isn't as effective as it once was. My PM Doctor has me on the Fentanyl Patch and I also take the Hydrocodone 10/325 as needed for breakthrough pain. I have found the patch to be very beneficial and has made a difference where my pain is concerned.
Prior to starting the patch in Aug/09, my pain was really having a huge impact on my ability to function and carry through my daily responsibilities and the Hydrocodone just wasn't cutting it. I would literally wake up in the morning exhausted because of the pain I would have through the night and getting up and moving in the morning was a major challenge, until I would take the Hydrocodone just moving was difficult. One of the biggest differences I have noticed with the patch is that it provides consistent pain relief in that I sleep a lot better and wake-up close to pain-free (no waiting for the Hydrocodone to take effect). I still am prescribed the Hydrocodone for breakthrough pain (but I am taking a lot less than before). So, I would definitely discuss with your Doctor the possibility of trying the patch and also being prescribed the Hydrocodone for breakthrough pain. If the patch works for you like it has for me, you should be able to take less Hydrocodone in a day - which will be a good thing in the long-run. I have loved the patch, because I basically put it on and then don't have to worry about it for 3 days until I change my patch, so it has been very effective for me and I love the idea of taking less pills.
I think a discussion with your Doctor is definitely worth while. Keep us posted on what you find out.
~ Fiona Jo