I see what you are saying David. The doctor can write 4 times a day and the pharmacists has some leeway to interpert. My doctor puts down the full # of pills.
You are not crazy, many people take b/t every day. In fact it is part of their regime. I think there are good reasons to do this. Like the patch is bumpy or you have a daily pain surge. Or you need more but don't want to go up to the next patch size. David often says that mixing opiates is helpful.
I do wonder if so many are on so much b/t medication because their docs won't up their base dose. For me, the whole idea of long-acting medication was to get away from the ups and downs and additives of the short-acting b/t drugs. I would rather have enough base medication for most days and use b/t for emergencies. But that is me and I get rebound headaches from the short-acting stuff. Plus I find I get tolerant to it fast.
My perference aside, it is extremely common to be on it all the time. It is reasonble to bring it up. You sound nervous about how your doctor will react if you need a refill at the end of the month. Regardless of what that wrote on the bottle, they said use it for really bad pain. In which case they may not be expecting you to ask for refill at the end of the month.
I hear the fear in your words. I remember being nervous about asking for my monthly refills. Generally, I would say if they wrote it for a month, then you can use it. Perhaps it would be safer to let this guy know before you move to every day.
Sounds like they have under-estimated what you need on a normal day. So perhaps he will up your patch or say just take the Narco. Would that you did not have to panic about having the converstation.
Good luck. It is normal to prescribe b/t drugs for every day. I can't tell if this guy will be cool, but you are not asking for anything unusual.
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Bone spurs and degeration c1-6; radiculopahy; Pain in shoulders, neck and arms
Leg pain (l5, L4) - probably spine related
Migraines
MS Contin, Valium, Neurontin and Soma
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