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Old 05-25-2011, 02:09 PM   #1
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Oxy/OxyIR questions. Help, please?

Hi,

Iím new to this site, so please excuse this post if this type of question has been asked before. I recently was released from the hospital 2 weeks ago. I was in there for 2 weeks due to my ulcerative colitis and horrific pain (2nd time being hospitalized for this). I met with a pain management doctor and was switched to oxycontin 20mg 2x daily, oxy IR 20mg for breakthough pain (for a while I had to take it every 4 hours around the clock) and Neurotin 200mg 3x daily, but I have reduced that to once a day due to the side effects. {I was on the fetynal .75mcg patch, IV dilauded 1-2mg every 4-6hrs, and Percocet 10mg every 8hrs as needed.} The pain doctor thought the first would be a better combination. All is this is very new to me (the UC, horrible pain, and pain management.) I have been on the fetynal/dilauded/Percocet combo before when I was hospitalized my first time; it seemed to work quite well. My pain goes away when my flare up is gone, but while my disease is active, the pain is not pleasant. Thankfully, itís starting to diminishÖ at least I think so, because Iím rarely having to use the Oxy IR (this has become a recent thing).

I have my first appointment with my pain management doctor (outside of the hospital setting) June 1st. I am hoping that he is going to try to cut back on my dosages and eventually get me off these narcotics. I have a few questions I was hoping some people could help me with. I want to go to my appointment prepared and asking the questions I need to ask.

1. If weaned off correctly, what are the withdraw symptoms like? How long do they last?
2. How do they wean you off what I am currently on?
3. What are the WD symptoms like for Oxy IR since I have been the one who has cut back on taking it.

My pain is obviously still there, but itís not as debilitating as before. Yes, I have done reading from other sites about WDís and other symptoms; I was just hoping for some answers from people that have actually experienced this or something similar. Any advice, answers or help would be greatly appreciated. Thank you for taking the time to read this.
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Old 05-25-2011, 03:10 PM   #2
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Re: Oxy/OxyIR questions. Help, please?

Hi there..

Welcome to the boards...

Quick first question...I'm not aware of Oxy IR being a 20mg pill? Or are you saying it's 20mg for the whole day in 5 mg doses? If it's Roxicodone it comes in 5, 15 and 30mg...So I'm confused on what you are taking and the dosage..

Now..the answers to your questions are

1)if the Dr. is helping you wean down on the medication...you shouldn't have any real withdrawal symptoms...maybe some diarrhea...but a good Dr. will have you going slow enough that you should be able to adjust accordingly and that might not even happen either..

2) No one here is a Dr. so we can't give you proper taper down schedule...that will be something your Dr. provides to you..

3)Again..you shouldn't feel any withdrawals from properly weaning down with your Dr.s help..

I've had 3 fusion surgeries...and after my first one..I was on a pretty high dose of medicine and they slowly tapered me down until I wasn't taking anything at all for a good few years until my next issue with my neck..

The 'horror' stories that you hear from people are either people who are taking too much of their medications and then run out each month before their next prescription...or from people who are addicted to their meds and again..are taking them in huge amounts and going from that to nothing all the time...or...from having a terrible Dr. at a pain clinic who's practice closes down and they are stuck with nothing...in the latter example...I would have someone go to the ER to get assistance to get some medicine until they find a new DR..

So..they whole point is that you should be very comfortable and work with your Dr. every step of the way..and if you start to have any symptoms...tell them and they will have you hold at that level and go more slowly...

Any time we can take less medicine because our pain is better...it's a wonderful time so I'm happy to hear that you can do this!...

 
Old 05-25-2011, 04:04 PM   #3
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Re: Oxy/OxyIR questions. Help, please?

Hi,
Sorry to hear of your fusion surgeries. Does not sound like something I would want to experience! But seems like youíve gotten through things pretty well. I hope all your issues are better.

Thank you for your time. In regards to the Oxy IR, itís 5mg. I was taking 4 of them every 4-6 hrs around the clock.

I appreciate your answers. Iím very relieved to know that I may experience minimal WDís. I was worried about the ďhorrorĒ stories you mentioned in your response. I know no one can give out proper tapering advice or things like that, I just wanted to be as prepared for my appointment (and just in general) as I can be.

Your response has definitely eased my apprehensions of coming off these pain medications and seeing a pain management doctor.

Thanks!
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Old 05-25-2011, 05:35 PM   #4
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Re: Oxy/OxyIR questions. Help, please?

Ahh...thanks for the clarification on the OxyIR...I take the 5mg as my breakthrough medication so that's why I was curious thinking there was a 20mg..LOL...

I hope that all goes well at your appt. It sounds like a good and caring Dr. as he has you medicated well to cover the pain that you had...so hopefully he will be just as good at helping you tirate down..

Feel free to discuss your concern with him about withdrawals..

Are you thinking that you are now pain free with the UC and won't need any meds? Or are you just trying to find your 'new normal' and keep going down until you have an amount that covers your pain which is less than it was...

I don't know enough about UC..I'm sorry that you have this and it caused the hospital stay...I hope that doesn't have to happen again!

I still live with a lot of pain with all the scar tissue pulling on the muscles and nerves..as well as other bad discs because of the pressure it puts from being fused on two levels...I take MSContin for my extended med and then the OxyIR for the breakthrough when needed...I also use a muscle relaxer from time to time...but since this is chronic situation...I try to stay on the lowest dosage possible over the last years to keep my tolerance level down...I also walk each day for 30 min...do yoga..aqua therapy...acupuncture...use other means as well as my medicine to help with the pain..It's still a 5-7 depending on the day...

Thanks for asking..

Please keep us posted on how things go at your appt.

 
Old 05-25-2011, 06:22 PM   #5
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Re: Oxy/OxyIR questions. Help, please?

Wow, sorry to hear the extent of your situation . A constant 5-7 level of painÖ canít imagine. Itís good though that youíre doing other things to help with pain than just loading yourself full of medication. Someone recommended to me acupuncture. How does that work for you; does it help your pain? Once my flare is over I plan on starting some sort of yoga regime.

Do you find that the Oxy IR works well for you? Have you been taking it long? Sometimes I find it just doesnít cut it for me. Real frustrating. I guess another issue to discuss with the pain doctor.

As for my UC, I am still experiencing pain (because my disease is currently active)Ö just not the excruciating pain I had during my lovely hospital visit. However, once my flare is over, the pain goes away; therefore, I will no longer need to take narcotics. I just donít know how long this flare, or any flare for that matter, will last. So far itís been a little over a month; I hope it subsides soon.
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Old 05-25-2011, 10:13 PM   #6
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Re: Oxy/OxyIR questions. Help, please?

1. If weaned off correctly, what are the withdraw symptoms like? How long do they last?
2. How do they wean you off what I am currently on?
3. What are the WD symptoms like for Oxy IR since I have been the one who has cut back on taking it.

My pain is obviously still there, but itís not as debilitating as before. Yes, I have done reading from other sites about WDís and other symptoms; I was just hoping for some answers from people that have actually experienced this or something similar. Any advice, answers or help would be greatly appreciated. Thank you for taking the time to read this.


Hi Lindy,
Sorry you have had such a difficult time recently but am glad that things are slowly getting better. To answer your questions, withdrawal symptoms should be minimal if your doctor provides you with a taper plan .
Withdrawal symptoms don't happen for everyone, and it is rather individual. Some will experience many symptoms, some others, only a few and some , none at all. It depends primarily on the half life of the medications that we are taking and if we are following a tapering plan provided for us by the doctor or if we are stopping all at once, known as "cold turkey". For most of us, except for methadone or suboxone users, this is what we would experience if we suddenly stopped taking our medications.
This is the standard opiate withdrawal symptom list that the majority of us would experience in the event that there is a sudden stoppage of our pain medications.


ēOpioid withdrawal for pain management patients with no tapering plan:
◦Patients experiencing opioid withdrawal can usually provide an accurate history of their usual dose, of the timing of their last dose, and of any other current symptoms. The clinical problem is in differentiating symptoms associated with opiate withdrawal from symptoms that may reflect an underlying medical illness.
◦In general, opioid withdrawal does not directly cause life-threatening symptoms, seizures, or delirium.
◦Opioid withdrawal syndrome may resemble a severe flu-like illness. The syndrome is characterized by rhinorrhea, sneezing, yawning, lacrimation, abdominal cramping, leg cramping, piloerection (gooseflesh), nausea, vomiting, diarrhea, and dilated pupils.
◦Altered mental status, disorientation, hallucinations, and seizures, which are characteristic of DT, are not seen in opioid withdrawal.
◦The half-life of the opioid causing withdrawal syndrome determines the onset and duration of symptoms. For example, heroin and methadone withdrawal symptoms peak in 36-72 hours and 72-96 hours, respectively, and may last for 7-10 days and at least 14 days, respectively.

In a proper taper plan, given to you by your doctor, you most probably wouldn't experience many if any of these. In the tapering plan, your doctor would take all of opiate pain medications that you are taking and add them to figure out your daily dosage- then he would have you reduce that daily amount by a percentage of your total daily dose , for a few days , and then have you reduce the new daily amount again for a few more days, and so on and so on, until you were at the lowest dose and then have you take that lowest dose for a few days and then stop....done properly, any withdrawal that you might feel should be minimal, if you have any at all. It can take you a month or more , depending on how fast your doctor wants to taper you and if you feel comfortable doing that. If you do experience any difficulty, be sure to call him and discuss it with him and together you can make a decision to stay at one level for another day or so before going to the next step down.
Don't read or believe all of the horror stories on the internet that you will find regarding tapering off pain medications. Withdrawal for someone abusing opiates or other drugs, versus a properly done taper plan are two different universes apart. Most all of the "withdrawal" stories you will read have not been done with a proper taper , planned and overseen by your PM doctor, and have more to do with the abuse of the medications, addiction and psychological addiction as well as physical , versus a gradual discontinuation of opiate therapy for pain treatment. They are entirely two different things and don't even come close to being the same or similar.
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Old 05-26-2011, 06:05 AM   #7
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Re: Oxy/OxyIR questions. Help, please?

Back,
Thank you so much for all the information you have provided. Everyone I have encountered on here has been more than gracious in providing guidance and answers. You've been extremely helpful. I definitely feel more comfortable knowing this information and for my visit come the 1st.

I appreciate you taking the time to write all of that. It's comforting to know that if tapering is done correctly, WD's should be minimal
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