PM dr. has me confused - Pain Management Message Board

lgriffincsa · 08-28-2003, 03:49 PM

I am posting back after my dr.'s appt. today. I was on Oxycontin 10mg, 3X per day, with percocet 7.5 for breakthru. My dr. changed me to Oxycontin 20mg, 2X perday, and has me on Keppra, 2X per day. I dont know about the percocet for breakthru. I was taking it, and it was from a different dr. My PM knows this. I have a refill for the percs due on Sept 5th. I dont know if its ok to fill it. Does anyone know anything about the Keppra? I read it is for seizures! I dont have seizures. Apparantly, it for people with epilepsy, thats not me. Also, my dr. wants to do a series of 3 epidural injections. I told him that I have already had 2, and they didnt help. Matter of a fact, the 2nd one made me worse. What should I do about this? The Oxycontin alone, without the Keppra, controls my pain enough, with an occasional percocet (2 times per day) for breakthru). Please advise what do you think about my situation. Thanks

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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.
08JULY2003-Had Discogram, comfirmed pain comming from L4-L5 disc.Followup confirms tear at L4/L5, pushing on a nerve.
JULY2003-Duragesic patch, had allergic reaction, switched to Norco. Norco provides no releif. Dr. wants me to have IDET. NOPE!!
14AUG2003- New PM Dr. switched me to Oxycontin, with percocet for breakthru untill my dose is stable. Scheduled for EMG. Thank God for this Dr.
I can only work for 3-4 hrs per day/ 2/3 days per week with current meds. I think this will inprove when I am on a stable dose of my meds; real soon I hope.
Surgery is NOT an option at this time.

Autumn Angel · 08-28-2003, 06:59 PM

Hi there well I am glad you got a med increase...as for the Keppra or whatever you called it...it may be a seizure med but it will help you if you have nerve pain. My PM wanted me on Neurontin which is also for seizures and I wish to God I could take it but my plan wont cover it because I dont have an actual seizure disorder. Hope this helps you some.
Autumn.

Shoreline · 08-29-2003, 10:18 AM

Hey griff, Off label use of meds is common in just about every medical specialty. The use of anti seizure meds to treat nerve pain is an off label use but many PM docs believe that the anti seizure meds have the ability to interupt the pain signal and lesson your pain.

Anti seizure meds have been used for at least the last 5 years I have been involved in PM. If your pain is not nerve related such as radiculopothy or neuropothy it's not likely the Keppra will help other than act as somwhat of a sedative which this action alone may increase the effectiveness of opiates.

Personally I would not fill a class 11 script from another doctor now that you have a PM doc prescribing opiates for your problem. Having more than one doc prescribing class 11 meds for the same problem can be construed as doctor shopping which is not only illegal but a good way to loose both docs trust and make finding a new doc even harder. A handful of percs isn't worth risking having your pain not treated at all.IMO Good luck, Shore

lgriffincsa · 09-01-2003, 12:48 AM

Thanks for the replies guys. Shoreline, you are absolutly right about the percs. I will ask my new doc about it before I have them filled. I am also stopping the keppra. It seems to make me anxious, and I stumble around alot. I feel like I forget where my feet are. I took one this am when I got up, after 8 hours of sleep, (man I havent done that in years)! Within 20min. of taking the keppra, I was on the couch and I slept from 9 am until 4 oclock! I wont be much good to anyone if this continues. For now, I will just take my Oxycontin, and when I see my doc again I will ask him about breakthru meds. I will also try for 8 hrs doseing on the OxyC, since it seems to wear off by 7 or 8 hrs. I dont know if its because I am so active now, and sweat it out, or if this is normal. He had me on 10 mg every 8 hrs, but that didnt control my pain well enough. Anyway, thanks for the advice, I will take it. Have a great day.

------------------
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.
08JULY2003-Had Discogram, comfirmed pain comming from L4-L5 disc.Followup confirms tear at L4/L5, pushing on a nerve.
JULY2003-Duragesic patch, had allergic reaction, switched to Norco. Norco provides no releif. Dr. wants me to have IDET. NOPE!!
14AUG2003- New PM Dr. switched me to Oxycontin, with percocet for breakthru untill my dose is stable. Scheduled for EMG. Thank God for this Dr.
I can only work for 3-4 hrs per day/ 2/3 days per week with current meds. I think this will inprove when I am on a stable dose of my meds; real soon I hope.
Surgery is NOT an option at this time.