Before deciding what drug to take, I think you've got to go back to square one and evaluate your individual situation. Taking pain meds is a "cost / benefit ratio." Does the "cost" of taking them outweigh the "benefit"? Or, does the "benefit" outweigh the "cost"? Only you can answer this question....Depending on what type of pain you have & etc.
If the answer is that the cost outweighs the benefits, then you need to come up with some type of non drug alternative. You don't provide any details about your situation, so I can't offer any help.
If the benefit outweighs the cost, then you'll need to sit down with your Doc and decide what type of drug you'll need to take and the LT implications. Ultimately, most PM patients are on drugs for life, so picking one over the other will be a necessary evil. Also, if you sub one for the other, you'll still need to take something (assuming you take this route) so I wouldn't get caught up in the fact of the matter.
The one thing you don't mention is whether the Doc is recommending the short acting Ultram or the long acting? He may want to put you on the LA med in order to level you out and stop the "ups and downs" of the hyrdros. After awhile on hyrdros, they don't work as well (or as long) so you need to take more (qty) and more often, for them to work. If this is the case, then the Ultram LA would probably work well.
Hope this helps and good luck.
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