Stronger meds - Pain Management Message Board

lgriffincsa · 07-08-2003, 11:07 PM

To those who are taking Oxycontin for cronic pain. I hope y'all dont mind me asking this question. I would like some details as to how your Dr. started you on Oxycontin. I have DDD, a bulge at L4-L5 and L5-S1. My Ortho. sent me to a PM dr. because he did not think I was a good candidate for surgery at this time. My PM Dr. has me on percocet 7.5/325. He insisted a undergo a Discogram, which I did today, and the results comfirmed a tear at L4/L5, which is what is causing my pain. The percocet do not do an adaquate job at controling my pain, which I have pointed out to my PM Dr. twice before I had the DG. He really has taken a lets wait and see what the DG tells us attitude. I have taken Oxycontin in the past, and it (20mg. 2 times per day) did an excellent job at controlling mh pain. Before the DG, my PM Dr. was insisting on some form of surgery to releive my pain. I am taking my Orho.'s advice to not have surgery at this time. I would like to know what I need to do/say to have my PM prescribe this med. to me? Thanks for the advise.

HikingFan · 07-08-2003, 11:31 PM

Hi there

I hate to sound pessimistic, but I think that you will run into trouble asking for this drug by name. It has had so much bad hype in the media, that any doctor will get suspicious if you ask for it, no matter how valid your reason. In my experience I have found that dr's in general do not like you "telling" them what you want, even if it is backed by a valid reason and solid research. And to suggest a jump from a fairly moderate narcotic (you are taking 7.5 percs, right?) to something much stronger will trigger suspicion.

I am not doubting that your pain is legitimate, so please don't take it that way! I just know that many PM docs are going to run the gammet of medications before jumping to something so strong. Maybe try telling them that you need something not only stronger, but something that lasts longer. I was on Norco (which is vicodin, but has less tylenol, 10/325) and I was sick of taking it every 6 hours, so I requested something stronger, and longer lasting, and they gave me oramorph (sustained release morphine). Unfortunately, I am not happy with it, because since it is long lasting, I feel drugged all the time. I am going to ask to step back down to the norco next time I see my doc. At least with the norco, it works instantly when you need it, and wears off in a few hours, whereas with the SRmorphine, it takes 1.5hour to kick in, and then makes me tired for the next 8 hours.

Sorry I can't be more helpful, but I really think you will get into a bind if you ask for oxycontin by name. Especially since your doctor sounds super-conservative.
Best of luck to you!!!!!

lgriffincsa · 07-09-2003, 01:04 AM

Hikeingfan,
I want to thankyou for your candor. I had the same estimation of the possible outcome if I were to ask for a med by name. I have asked for something that lasts longer and was stronger, I even voiced my concerns about the amount of APAP that I injest daily. My ortho started me on 5mg percocet. My 1st visit with the PM Dr. I told him it didnt control my pain. He increased me to 7.5mg percocet. After 1 month of taking this, I had another appt. with him, to discuss my DG.He had already given me a refill prescription at my last visit. I told him again that the medicine didnt work very well, nor last very long. I admitted to him that I was taking twice the prescribed dosage, and that I was about to run out. I told him that I had 2 days of meds left on a script that was supposed to last for another week. We talked about my APAP intake, which at present is 2600mg per day. He wasn't concerned with those amounts, and gave me an analogy that even though I had heard of people getting ran over in a grocerystore parking lot, I still was willing to take the risk of going grocery shopping because I needed the food; just like there are risks of liver damage with high levels of APAP, I need the pain releif, so the risk is worth it, in his eyes. To shorten the story, He changed the refill date on my script so that I could have it filled a week in advance. He didnt question me, scold me or anything. I just think it is odd that he is aware of #1 I am taking twice the prescribed dose to get any releif, and #2 he is not concerned about the APAP levels. Like I said earlier, I just had the DG today, and again I will run out of meds 1 week before I am supposed to. I have to call his office in the next day or 2 at the most, to get another refill. I see him again on the 22nd of this month for a followup on my DG. I was hopeing that you or someone else could give me some advice about pointing out the ovious to my Dr. (I need longer lasting, stronger meds)since my efforts have failed. Maybe he will be more open to suggestions now that he has his beloved DG results in hand, whereas in his own words, "All I know right now is that I have a paitent with a backache". I guess I should again stress my concerns over my APAP intake, and stear clear of making any specific requests for meds, even though I know they work as needed for my condition. Thanks for listening.

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1998-Major rear-end colision
1998-mid2000-Chiropractic care
2000-mid2002-Pain level increased drasticly. No insurance, took a combo of every OTC painreleiver imaginable.
2002-MRI/ L3/L4 and L4/L5 annular bulging; DDD L4-5 and L5-S1
2003 February- Orthopeadic Spinal Surgeon said not a candidate for surgery,Percocet 5/325 every 6 hrs.
2003 June-1 month at PM clinic, Percocet 7.5/325 every 4 hrs. PM wants to discogram, fusion or IDET.
I can function/work for 3-4 hrs per day/ 2/3 days per week with current meds. I beleive I could function/work normal hours with stronger, timereleased meds. Surgery is NOT an option at this time.

chriztene · 07-09-2003, 03:55 AM

Griffin,

It sounds as though your doctor isnt comfortable with prescribing the longer acting meds and some doctors arent.

You might have to be referred to pain management. The first thing the pm doctor wanted to do was take me off of the percosets and put me on a longer acting med without all the tylenol. I am still allowed the percosets for break thru.

The pm doctor even stated the long acting med manages the pain better and you dont have those ups and downs as you do when taking the instant release. (percosets)

It sounds like you have said all the right things...You might keep stating you really do not like all the tylenol and you have read on the internet about the longer acting meds and 'ask' him what he thinks about trying that route..

Best Wishes,

Chriztene

TDHZ28 · 07-09-2003, 09:50 AM

Has it been made apparent or discussed that you will need to stay on long acting meds and no other treatment will work? I ask because that is usually when they will go to the oxy or morphine meds. When they can document that this is all this patient can do at this point. If they think your pain will heal and not be long lasting they don't wanna gt you on meds that they will have to taper you off of. The short acting meds, like percocet are really just for short pain episodes. Ask him "do you think I will always need pain meds, and if so what can we go to that is long acting and not hurt my liver?" If he has other plans to treat you he wont want to get you on a med that will be hard to come off of. In my case, the percocet 10/325 6x day wasnt working, so they said, ok you will be on narcotics for all your life and here are your choices, I chose oxy/w/oxyir. I went from 40mgs twice a day to 80mgs 3x day. I have great relief. I had a hard time each time they increased it, but now I am adjusted and doing better. Good luck and I hope it all works out well, I didnt mean to sound preachy but I've been in this PM mess long enough to know how they work and think. It all depends on your personal pain situation and your Dr.'s treatment beliefs. Take care, THERESA

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pain from cervical radiculopathy, spondy, permanent nerve damage, c5/6 buldging dics, DDD,nerve root lesions, anxiety.depression from chronic pain or vice versa. current meds,oxycontin 2 40's twice a day, oxyir for B/T, xanax, paxil, estratest, synthroid, phenergran.