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    Old 02-04-2007, 05:48 PM   #1
    mamakitkat
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    Medication Vacation???

    Hi Everyone,
    I'm new to this board, ususally post on the back problems board. I was told by my Dr. that since I dont' want to graduate to oxcy or morphine that I can try to lessen my meds and struggle thru a short meds vacation so my current dosage will still be effective once I start back up again. Has anyone ever heard of this and does it really help for any legnth of time, I dont' want to do this and then like a month later still meed stronger meds. I'm on ES Vocodin every 6-8 hrs (usually take 1 1/2 not 1) alternate with percocet, 2700 mg. neurontin a day, flexiril 10mg 3-4 times a day and 20mg pamalor at bedtime.

    I have been on these meds for over a yr. now and am starting to require larger doses to get the same pain relief. I do have a appt. to see a PM on 3/1/07, just hoping to bide my time until I see him.

    Thanks in advance!

    God Bless

    Carol
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    Old 02-05-2007, 12:06 PM   #2
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    Re: Medication Vacation???

    Hi Carol...I've heard of a med vacation and it's been discussed several times on this board over the years. You might want to do a search for it and find some old posts. I think those of us who have been on pain meds for some time have, for the most part the same or similar opinions about it. I don't mean to speak for others, but in my opinion, med vacations are mostly a waste of time. You put yourself in the position of coming off your meds and then the pain of going without for a certain length of time and then you resume your medication. I think most people find in a short period of time, they are right back where they were when they began the vacation.

    I can attest to the fact, that it does work that way. In the past I have been on Hydrocodone for an injury and took it for a period of time. When I no longer needed it, I went off the Hydro and then down the road I think I got shingles and had to go back on the Hydro. It wasn't long and I was increasing the dose and I was right where I was before.

    You can certainly give it a try, but in my opinion, it doesn't work in the long run. You will be putting yourself through all the discomfort for basically nothing. Why are you against going up to a stronger med, if you need it?

     
    Old 02-05-2007, 09:39 PM   #3
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    Re: Medication Vacation???

    Hi Director,
    Thanks so much for the info, I kinda figured that was how it would go. My spine dr. suggested this but was reluctant to put it into action since I was seeing a PM dr. on 3/1, spine dr. thinks PM will lean towards SCS or morphine pump since there is no surgery options anymore.

    I have a high tolerance to drugs & alcohol and really dont' want to go up the ladder of pain killers too fast. I'm only 45 and worry about the toll it will take on my body long term. I'm already almost maxed out on the neurontin, am having digestive issues with the percocet. Morphine, at least orally, doesn't do much for me after about 20 minutes. IV dilaudid worked well when in hospital along with the IV steroids, but that is the only things that take the pain away at about an 80% success rate.

    I'm really trying to weigh my options before I get to PM dr. so I can be well informed when he brings up my options.

    Again, Thanks!

    God Bless

    Carol
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    Old 02-06-2007, 10:17 AM   #4
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    Re: Medication Vacation???

    Hey Carol: I just had a couple questions I wanted to ask. What did you mean you were having "digestive problems" with Percoset? Also, you mentioned an 80% success rate at taking the pain away. Let me know what you meant and I might be able to answer some of the questions you might have.

     
    Old 02-06-2007, 11:44 AM   #5
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    Re: Medication Vacation???

    I have done a med "vacation" before with some success but it was the worst experience physically of my life. I was on 80mg/day of methadone for multiply ruptured disc in lumbar and thoracic regions.

    I tapered down to nothing in about 4 days and then went with out any pain medication for 2 weeks. As I said, physically it was terrible because you are dealing with withdrawal and increased pain from your primary problem. There were nights of no sleep and restless legs constantly.

    After the two week period I was on 25 microgram patch. It has been over 2 years since this vacation (I am not sure why the use that term) and I have slowly worked back up to the levels of meds I was on and will probably need another vacation in the next couple of months.

    Hope this helps. Extremely hard but worth it.

     
    Old 02-06-2007, 12:33 PM   #6
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    Re: Medication Vacation???

    Quote:
    Originally Posted by macdog View Post
    I have done a med "vacation" before with some success but it was the worst experience physically of my life. I was on 80mg/day of methadone for multiply ruptured disc in lumbar and thoracic regions.

    I tapered down to nothing in about 4 days and then went with out any pain medication for 2 weeks. As I said, physically it was terrible because you are dealing with withdrawal and increased pain from your primary problem. There were nights of no sleep and restless legs constantly.

    After the two week period I was on 25 microgram patch. It has been over 2 years since this vacation (I am not sure why the use that term) and I have slowly worked back up to the levels of meds I was on and will probably need another vacation in the next couple of months.

    Hope this helps. Extremely hard but worth it.
    I'm just curious as to how this is "worth it". To me a vacation doesn't equal intolerable pain, no sleep, and two weeks or more of pure he** only to find that later in perhaps a month or two I'm in the exact same position as I was before I went on "vacation". Not having been there, I don't understand the value of it. I'd rather my vacation be in Cabo or Sunny Bahamas. lol!

    I'm being somewhat facetious here, but I'm truely curious as to the benefits of this "vacation". Exactly what ARE the benefits?

    Wishing everyone as much of painfree day as is possible!

    bgsigns

     
    Old 02-06-2007, 01:50 PM   #7
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    Re: Medication Vacation???

    If you are in a position where your current medication is working less and less, you could keeping on going in that direction or take a couple of weeks in order to start at a relatively low dose of narcotics.

    It is opportunity cost. It took me about 2-3 year the first time to reach the height of what my doctor was willing to prescribe. I took the holiday and it has been another 2-3 years of building up tolerance and uping my meds to the point where it may be time to take another vacation.

    To me it is worth it if while on meds I can go to work in order to feed my family and feel semi normal. I have a high metabolism and tend to build up a tolerance fairly quickly. Some people will go much longer on a maintained dose.

    For now this will have to work as surgery is not an option and I am still relatively young.

     
    Old 02-06-2007, 03:15 PM   #8
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    Re: Medication Vacation???

    While medication vacation does work it's not the best way to addresstolerance. opiate roation is how this is done in pain clinics.

    But the reason I am responding is to ask you all to question the wisdom of what you are doing with long term reliance on short acting opiate combination agents, specifically those containing acetominophen, given the emerging scientific medical data on long term low dose acetominophne and it;'s link to hypertension and end stage reanl failure. I believe these products will likely come off the market soon and suggest you look into it.

    A study from Brigham Womens' Hospital, a major Harvard research insitution, published summer of 2006 was truly frightening in it's message to women about even one or two tylenols (acetominophen) a day. you may have heard about it.

    Pain doctors would consider Vicodin and percoet as far more dangerous meds than long acting morphine, fentanyl etc. in context

     
    Old 02-06-2007, 06:21 PM   #9
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    Re: Medication Vacation???

    Quote:
    opiate roation is how this is done in pain clinics.
    It's funny you mention this, my doctor did excatly this at my appointment today. He switched me from Lortab to Percocet for BT pain. But I'm on relatively low doses still. I have surgery upcoming in May. I'm on 12mcg Duragesic Patch, and was using the Lortab (and now Percocet) for BT 3x a day. Lortab was 10mg, Percocet is 7.5. Originally I was on a 25 mcg Patch and came down to a 12mcg. So my pain is fairly well controlled at these levels and I'm able to work etc. thank goodness. Taking a break in the Summer to have the surgery (I'm having a Double fusion) and hoping that I can finally be free of all the meds after that.

    Thanks for the clarification. I was trying to avoid the surgery too, but I can't keep going at the rate I am. My pain tolerance is high, and I fight a lot to keep going mostly because I have issues with not wanting all the meds in my system, but realistically know I can't handle the pain and function too. I've been going through this since Aug of 2004. Had surgery in 12/04 and it was very successful, but I basically disintegrated the same disc and ruptured two levels above that one cleaning up after Hurricane Katrina. Sometime life just hits ya coming and going.

     
    Old 02-06-2007, 08:49 PM   #10
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    Re: Medication Vacation???

    I think it's great bgsigns that you helped out after Katrina but you really should take care of yourself, I guess that is obvious with your present condition. I think all chronic pain patients tend to WANT to do all we can and our very best but have to concede to the fact that we CANT do what we used to. I really hope all goes well with your future surgery. Be realistic about the meds so if you still need meds you wont be too bummed about it, I know because I felt the same way about my surgery (thought it be the end of the meds) I really pushed for surgery because of all the cruel unfair treatment I got regarding the meds, the surgery went well but there still are other problems with my spine so I still need meds its a real bummer but a fact, I should have known when told by a doc 4 yrs ago that no matter what my degenerative discs will only get worse. Remember be cautious in your activities and take care of yourself.
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    Old 02-07-2007, 04:06 AM   #11
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    Re: Medication Vacation???

    Thanks for your reply Jaydee...

    After the storm I realized that I was still not able to mop, sweep, vacuum, etc, but given the dire conditions of what we went thru, it never occured to me I couldn't RAKE. It's the same freakin' movement. LOL. I just wasn't even thinking. I realized it about 5 minutes into the task, but, it was already too late. I live right off the beach, so the devestation was horrid, and most of us were in overdrive anyway. Like I said, I knew right away that I had done the wrong thing. My hubbs was in emergency response, so he was working 15+ hour days getting the infrastructure back up along the coast, and in my frustration of watching the neighbors get their lives back in order after about a month, I just couldn't handle seeing my home and yard the EXACT same way it was the day after the storm. It was just such an awful reminder of what had happened. So, yeah, not thinking, and almost in anger, I picked up the rake, and had at it!

    I am trying to be more realistic now. I do realize that I may still have to take meds even after my surgery!! My PM doc is one that offers all services including PsychoTherapy, and I have taken advantage of therapy to try and deal with my expectations of myself. I do still remain optimistic, but hope that my coping mechanisms are stronger if indeed the surgery does not allow me to become totally med free. I do realize that at my age (47 soon) I can't continue to live my life in the amount of pain that I was dealing with on a daily basis, and still try to lead a productive life. Unfortunately, I HAVE to work, (don't most of us? lol) and actually think my work allows me to focus my energies on something OTHER than the miserable pain that creeps in. I figure I'm gonna be in pain regardless of where my body happens to be at any given time, home, work etc... and for now, that works for me. Hoping to keep it that way as long as possible. Good luck to you! Sending hugs to all.

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