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Old 09-08-2011, 02:21 PM   #1
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hydrocodone no longer working well, whats the next step?

Im 33 with severe psoriatic arthritis. Im taking enbrel once a week and 15 mg of hydrocodone. Its not working very well anymore and i was swiched to 5mg of oxycodone. The oxy did not work so dr. said to try 10mg of the oxycodone and i got minimum relief. The hydrocodone works much better then the oxy. I just dont understand why? I've been trying to reach my dr. for 5 days now with no call back. When i do get in touch with him what can i suggest to help me get the most pain relief that lasts longer? Im new to this disease and i have to work beings im a single mom. The hydro worked great for 6 months but now i just dont know what to do. Is there anyone whos had this experience or anyone that can suggest other pain management options?

 
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Old 09-09-2011, 10:45 AM   #2
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Re: hydrocodone no longer working well, whats the next step?

Yep, that's basically called "tolerance" and it happens to almost anyone taking a narcotic. What's also common is the hydro working for you and oxy working for me. Some of this stuff is hit or miss and requires constant communication with your doctor. It sounds like you may need to stay on the hydro and just up the dosage until something else is figured out. Good Luck!

 
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Old 09-09-2011, 09:50 PM   #3
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Re: hydrocodone no longer working well, whats the next step?

does anyone out there have psoriatic arthritis? I was diagnosed just over 6 months ago. My doc says its gonna get better, but im really starting to wonder. Its been getting worse, im on a cane full time now with mainly severe pain and swelling on my right knee, ankle and middle back. I dont know how else to explain to the dr. how much pain and stiffnedd im having in the evening, its so hard to get comfortable enough to fall asleep. The oxycodone doesnt work at all!! so all i have are 6 10mgs of hydro for the whole day. Im really loosing faith in my pm doc but there are no others. He just keeps saying it will get better. Can anyone suggest something that works for you, that i can pass onto the doc and how to make him listen and understand that im miserable and exhausted. The hydro works ok in the day but by 2-4 while im trying to finish working i just want to get away from my body. Theres gotta be some way to make him understand...please help?

 
Old 09-10-2011, 07:58 PM   #4
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Re: hydrocodone no longer working well, whats the next step?

I don't have the exact same thing as you, but I have pretty severe arthritis in my hips, knees and ankles due to a Degenerative Cartilage Disease, I have lots of swelling, stiffness and blood clots in my legs.

A couple things I can recommend, heat is always good for relaxing stiff joints, soaking in hot baths, or a heating pad or moisture heat pad. The disposable heat wraps that you can get at the pharmacy work well on knees. You say your PM says, "it will get better" does he say what attributes to this? Your taking a short acting pain med right now, have you considered moving to a long acting med that works continuously for longer periods of time? Ex. would be oxycontin, morphine, etc. Have you tried any anti-inflammatory meds, these usually help in conjunction with the pain meds, arthritic conditions in general are not usually controlled by narcotics alone.

These are a few things you might try....the other suggestion I guess is to discuss any additional therapies with your PM....generally successful pain management is gained by using multiple therapies and medications...Ex. Physical Therapy, Joint Injections, Acupuncture, etc.

I wish you well, let us know if you and your doc come up with a different answer.

kat

 
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Old 09-10-2011, 08:03 PM   #5
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Re: hydrocodone no longer working well, whats the next step?

Firefli,

One other thing I forgot to mention...I use a topical arthritis gel called Voltaren Gel, it's prescription.....works very well for the stiffness and swelling.

kat

 
Old 09-11-2011, 10:37 AM   #6
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Re: hydrocodone no longer working well, whats the next step?

Oxycodone did nothing for me either. I couldnt understand why? It's stronger, it seems to work for so many other people, why not me? I've been on hydro for a couple of years now and am becoming tolerant, like you, so I recently tried dilauidid (didnt work) and oxy (didnt work). I asked if I could just stay on the norco for a few more months before trying somehting new again. It's hard, physically and mentally, trying new meds. Norco doesnt work great, but it's better than nothing, and I can function on it. I take eight 10mgs a day, which is what my PM said is the maximum safe amount. I wonder if you could ask for more pills?

btw, I have tendinitis. Everywhere, pretty much.

 
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Old 09-11-2011, 02:26 PM   #7
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Re: hydrocodone no longer working well, whats the next step?

thank u so much for ur reply! im taking enbrel injections every 4 days plus now prednisone in evenings. Im so new to this and dont know the right things to say to make him understand that i do need a long acting pain med. I tried percocet but it didnt work at all. I stay on a heating pad while home. I have medicaid and can only have physical therapy for so many sessions a year, usually 3-4 months a year. If i could just get this pain under control i could live again. I havent been able to walk at all this week cause it hurts too bad. I just need to know the right things to say to the doc, i get so emotional when im there trying to explain how bad this hurts and i just dont know how to make him listen...how do i get him to hear me?

 
Old 09-12-2011, 07:20 AM   #8
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Re: hydrocodone no longer working well, whats the next step?

You mention that you get emotional when speaking with your doctor. Often patients have trouble expressing their pain to their doctor. Too often they are speaking in very general terms like "I hurt so much I can't stand it."

If you put yourself in the PM doc's shoes, and hear this all day long, you can begin to understand how it loses its impact. I think you will get further with the doctor if you make an attempt at documenting HOW your pain affects you.

Try keeping a pain journal. It doesn't have to be very detailed. Just jot down how you go about your day, when you take your medications, when the pain starts to really wear you down, etc. You need to convey the idea that you are trying your best to function as a working mom, and that you are trying to find a solution to deal with the pain so you can get through the day. You might ask if there might be a different combination of medications that you could try, because what you are using is only working for part of the day (or whatever the situation is....).

Try to be more specific. Don't go in and just use adjectives and speak emotionally. You need to show him thoughtfully and factually that the meds are not getting the job done.

 
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Old 09-12-2011, 03:04 PM   #9
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Re: hydrocodone no longer working well, whats the next step?

thank u so much, now that makes sense to me! Thamk u i dont know why i didnt think of it! Wow! Thank u!!

 
Old 09-13-2011, 10:11 PM   #10
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Re: hydrocodone no longer working well, whats the next step?

Try adding Celebrex 200mg twice a day to the current regimen - in inflamatory arthritis, antiinflamatories are often better at releiving the pain than narcotics...... you'd probably take the celebrex regularly, and take the hydrocodone as needed.

Alternatively, you could try a long acting narcotic such as oxycontin or ms contin twice a day, with or without celebrex
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Old 09-19-2011, 10:37 PM   #11
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Re: hydrocodone no longer working well, whats the next step?

One way to gently ask for a long acting opiate is to say something like: I get relief from my hydrocodone but in between doses my pain spikes up. Is there anything that can give me consistent relief all day?

 
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Old 09-20-2011, 12:22 AM   #12
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Re: hydrocodone no longer working well, whats the next step?

Quote:
Originally Posted by PorcelainChild View Post
One way to gently ask for a long acting opiate is to say something like: I get relief from my hydrocodone but in between doses my pain spikes up. Is there anything that can give me consistent relief all day?
Thats a great way to put it!

 
Old 09-20-2011, 04:15 PM   #13
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Re: hydrocodone no longer working well, whats the next step?

thanks very much!!! ill take any suggestions i can get!

 
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Old 10-01-2011, 09:27 AM   #14
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Re: hydrocodone no longer working well, whats the next step?

hi,i also have chronic lower back pian.Doc started me off on loritab hydrocodone 10mg 240 per month,then went to perk 5mg,then to oxcycotin.Have been on en since 2002 and have become addicted to them plus my tolerance had built up drasticly.Every person is different and respond diffrently,hang in there i would ask for higher mg of hydrocodone if thats what works for you.The sad truth is these great medical advances dont apply to chronic pain people,we have been left behind and its sad.Good luck i feel and understand your pain.

 
Old 10-08-2011, 11:49 AM   #15
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Cool Re: hydrocodone no longer working well, whats the next step?

If the doctor tried straight oxy w/o ametaphetamine I'd suggest a long acting medication like fentanyl patch (25mcgm, 50 or 100 tops) or ms-contin 12-hr continuous release in various strengths along with either the plain oxycodone w/o tylenol or roxycodone which is 30mg oxycodone or hydromorphone 2,4mg for breakthrough medication. Good luck and Godspeed

Last edited by moderator2; 10-09-2011 at 04:52 AM.

 
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