Change or what? - Pain Management Message Board

catman1313 · 07-10-2003, 05:17 PM

The other day I put up a question on Actiq. I was told by Shoreline it was the last line of medication before IV drugs. What I don’t understand is, “don’t meds work different on different people”? I have never talked to my pain management doctor about Morphine, diluadid, methadone, etc… he told me that the Actiq is for break-though pain only and did not think I would build up tolerance to it as fast.
I take 2- 800mg a day (If the pain is really bad I sometimes cheat and take 3) I don’t always take the whole sucker (Actiq) either. I am prescribed 28 a month.
I am 38yo, male suffering from chronic migraines, cluster headaches, and keep a constant headache that ranges from a 1-7 on my pain scale and never goes away. I have been this way for seven years since I was in a tornado seven years ago and my head and face were crushed. I had total reconstruction done on my face and head. I had a brain injury and a small part was removed along with my left eye.
I am taking oxy 20mg 3 x a day Percocet 7.5mg 3 times a day I also have a nerve block given in the back of my head every 3 to 4 weeks. The nerve block helps keep the migraines down but they come back and the level of the headache increases after about 2 weeks. My PM does not want to burn up the nerve by giving me too many too quick so he keeps the shots at every 3rd to forth week. I am also taking Zomig and Imitrex as needed. I am on a few other drugs to keep stress down and to be able to sleep.
As I said I keep a headache 24/7 and have migraines with cluster headaches.
OK back to my question.
Should I ask him to change me to something different if Actiq is the last line or is it?
I am just wondering.
Actiq works great but will I build up a resistance to it after a while and really be in trouble?
I don't know if I should ask him for a different treatment?
I don't like playing the hit and miss game with my meds but I don't want build up tolerance to the drugs either.

mokita · 07-11-2003, 06:52 PM

Why don't you just discuss what you've heard here and see what your doctor has to say? Do you trust him/her? This is not something to take lightly.... if you're concerned, you should state those concerns.

I hope the best for you!

Karen

------------------
9/22/00 24 hour labor, baby posterior, left tailbone killing me
12/00 MRI - PCP said nothing amiss - but, had to begin taking vicodin
2/8/02 - 2nd baby born after long, painful pregnancy, weight gain didn't help
2000-11/02 various PT + pain meds
11/02 Referred to Neuro
3/03 NEW MRI - shows slight bulge L3-L4,slight DDD, neural foramen involved, Superior aspect S1 and L5 Nerve root involvement -Neuro Refers to PM for ESI
3/03 PM Doc orders ESI
3/21,4/1,4/8 - ESI's no help
5/9 - Discogram - shows Tear L4 w/ significant leak onto nerves, DDD
Performing doc oversedated, False Negative (pm doc & I agree)
New Consult w/ Dept Head Cleveland Clinic 7/8 to discuss possible new discogram/IDET candidacy
7/8-Doc ordered Facet Joint nerve block for 7/29 to rule out/identify as pain generator. If not, new discogram.
Also, thinks tailbone prob is dif issue - wants x-ray - THOUGHT I had one - didn't!! They are ordering.

Jack Beanstalk · 07-11-2003, 09:40 PM

I think he may have meant the Fentanyl patch,as it contains probably the most powerful Opiate prescribed.Fentanyl patches allow the drug to enter directly into the body,bypassing the stomach and digetive system.Fentanyl is Rxed by micrograms as it is so strong,100 times more so than Morphine.Acqtic is oral fentanyl.You can ask your doc if he,s thinking along those lines,but there are still several options left for you ,Catman,so don,t fret!Jack Beanstalk

catman1313 · 07-12-2003, 12:40 PM

Jack Beanstalk thanks I was a lillle nervious thinking that I could be at the end of my pain med. rope. I plan to talk it over with my pm doctor when I see him again right now I am talking with his nurse-practicener(sp.he is the one giving me the nerve blocks and med. refills.
Thanks

Autumn Angel · 07-12-2003, 01:22 PM

Thanks Jack I was clueless as to that this med was lol.
Catman...I have chronic headaches as well and for a time I was given Dilaudid 2mg to take just at bedtime since that and mornings were my worst times because I am a night grinder. It did help alot. He just added it to my regular med schedule. I was on Oxycontin 20mg twice a day plus percocet 5mg/325mg for BT 4 times a day so I just cut out the 4th perc at bedtime and took the dilaudid instead. Considering what you have been through the 4mg Dilaudid might be better for you if thats what you decide. Here in Canada they have Hydromorphone Contin the time released Dilaudid I was never on that but it would have been my next step if I wouldnt have learned how to do other things to manage my pain. I detoxed off the Oxycontin because I couldnt afford it anymore I was only on it 3 months and I quit the dilaudid too. I am now just on the Percocet 2 tabs 4 times a day and I am trying to taper down on them too. Depending on the day I can get by with 6 a day.
I hope you find something that helps you..My prayers are with you. God bless.
Autumn.