MScontin to oxycontin to ??

[Streetcar]

I'm going to try and make this short (yeah right) but still give enough info so you can see where I'm coming from.

Two years ago I had major surgery and the incisions became infected causing three nueromas which are acting like pain generators. Without any pain meds at all I have 15" of scar tissue that constantly feel the same as they did 5 days post-op . Before getting into PM, drs tried me on Nuerontin w/ vicodin. The neurontin worked great for the pain but the side effects were completely intolerable. When my vicodin useage started getting to close to the max daily amount my PCP sent me to PM. Started on MScontin 15Mg q8h and MSIR 15Mg x2 PRN for BT med. Pm dr also tried me on Zonagen (sp?) which falls into the same category as Neurontin and had the same side effects, so that was a no-go. Tried a couple of nerve blocks without much benefit. At about the same time my diverticulitis returned and PM dr was going to up my MScontin to 30Mg q8h with Msir 30Mg x2 BT meds but because of my diverticular problems and the fact that the MScontin REALLY kept me constipated he switcthed over to Oxycontin 20Mg q8h with Oxycodone 10Mg (really 2 5Mgs) x2 PRN for BT meds. The Oxy is providing adequate relief but It is driving me nutso. I always feel super tense and uptight and it seems like I can never relax so I'd like to switch to something different, if possible. I just don't know what might be a logical next step and at what doseage. Let me add, that once the diverticular problems calm down I would like to resume trying some of the other non-narcotic meds that are being used for PM and backing off of the opiates/opiods.

Does anybody have any experience with what works/doesn't work for their neuropathic pain and also what might be the next logical opiate in this case? I'm going to be seeing my PM dr tomorrow afternoon and i'd kinda like to know which direction the appt might go once I bring up the dislike of the Oxy.

Tahnks for the help and be comfortable!

[twisten]

I don't know anything about drugs used for nerve pain. As for opiates though I would suggest talking with your doctor about the duragesic patch. It doesn't enter our GI sytems at all so the issue of constipation and your diverticulitis should be helped with this med. Hopefully someone else will come along to give you more info on it.

[Phlox]

Ive noticed that since being changed to Oxycontin, Ive been more irritable lately...but Im still wondering if its because of the problem with it not lasting to provide relief the full 12 hours, or the Oxy itself. Ive had other days where the different meds I was on wasnt stopping the pain, but that didnt make me feel as 'irritable' as Ive been lately.

When you say "its driving me nutso", what symptoms are you experiencing, and how does it make you feel? Just wondering if its similar to the same agitation Ive been feeling, if thats normal even for the first month or two with Oxycontin, or if its really just the fact that Ive been putting some home projects off because I dont want the pain to get any worse than it already is, since this doesnt seem as effective for me as the "weaker" SA meds were. Strange, how these meds work so differently from one person to the next!

[Streetcar]

Hey Phlox!

"Nutso"...It's kind of hard to describe but I always feel "driven", like I HAVE to do one more thing, whatever that may be at the time before I can sit down for few moments and rest my body. I think that it's what is referred to as "wired" but I'm not really sure what that is either but I've talked to some ex-methamphetamine user at the clinic and that's what they called it. I've also noticed that in the eveningwhile preparing dinner that I'm extreemly tense which is something new for me. The tension I mean, not fixing dinner. I notice that all the muscles in my upper back are just tied into knots. My PM dr Rx'd me some muscle relaxers for that reason and they do seem to help somewhat. I don't know any other way to describe it other than I absolutely can't seem to relax for a few minutes and by the end of the day I'm exhausted from being so darn tense all day. Since I taking the Oxy 3x daily the coverage is good so I'm not irrateable from the pain.

[Streetcar]

Hey Twisten!

thanks for the reply, I'll mention the patches and see what the doc thinks in light of trying to get the opiates down to as small an amount as possible. I will say though, that starting PM and viewing this board, that my preception of opiates has changed and is longer the big bugaboo that it once was to me.