Discussions that mention morphine

Pain Management board

Hi C&C I can tell you what would be more afordable. the 420 bucks worth of OxyC can be replaced with 20 bucks worth of methadone, meth is a pain med and stocked in pharmaceies. Addicts go to a clinic to get their single daily dose administered in a controlled environment. Meth is 3-4 tmes stronger than oxyC and rediclously cheaper. It also helps with nerve pain. As far as BT meds, Dilaudid is very cheap and so is plain morphine tablets. I can get 120 4mg dilaudid or 120 30mg morphine for under 30 bucks by shopping around and using Sams club or Walmart or Costco. There is no reason your doc can't help you control the expenses with the right meds.

It sounds like they are on the road to surgery but the more medication they take now the harder it will be to manage there post op pain. It really shouldn't be harder, It just works out that way because Orthos and neuros who 10 years ago would do 6 level fusions and prescribe 2 5mg percs every 4 hours haven't been trained in pain management and don't have to deal with tolerance to meds. My last surgery was a 6 level fusion, I had a 6 level disco pror to it, and there was no such thing as 10 mg percocet or 30mg roxicodone or any doc willing to prescribe OxyContin.

What she's presently taking is twice as strong as what I came home after the last surgery with 12 screws and 8 rods in my spine. Surgeons see you, manage some pain prior to surgery and slowly discontnue the meds after their succesful surgery. They are all succesful untill you prove otherwise.

The goal of pain management, even in the most severe cases is a 50% reduction of pain. Not to numb someone to the point where they can continue hard labor or stand 12 hours on a bad back or put you in la-la land if your disabled and unable to work. If they are still working, stop, take medical leave or FMLA or disability if they have it. Time off will do more for there pain than an increase every month and won't have the dependnecy on high doses of opiate consequences.

If someone is looking for 100% relief from meds, they would need high doses increased every 7 days to continue to stay zonked and pain free. The idea is to make it tolerable, not to obliterate it. If there condition requires surgery, than they need to be at home, not tryng to suck it up and continue on as if they doen't have a problem. The higher the dose is now, prior to surgery, may really cause them to suffer post surgically when you need a higher dose than you have taken previously.

Nobody is letting her suffer if someone is prescribng 120 mgs of oxy a day. But there expectations don't sound realistic. If someone is suicidal over there situation, there is likely more to it than pain, and they need psychological counseling. Depression and chronic pain go hand in hand, the lost abilities, the financial problems, the lost hopes and dreams. But if they haven't had surgery, nobody should be condeming them to a life of suicidal levels of pain.

Ask to move things up, speed up the process if you can. If a person chooses not to have surgery at christmas time because it wasn't conveinant, the doc isn't going to consider there pain suicidal if surgery has to be conveinant. There is never a good time to be out of work or have surgry.

There are shrinks and counselors that work with PM docs that help patients understand the goal of PM isn't to be able to stick your hand in the fire and grin. They can help and tech some of the relaxation techniques and give them someone to talk to that isn't tired of the complaints. As great as any spouse is, eventually it gets old for them too.

I really don't want to be harsh but prior to 96 when oxycontin hit the market the best she would be geting now is #2 5mg percs every 4 hours and the docs would be scratching their head for a post op pain med and would just suffer imensely untill they began to heal. They will get IV meds in the hospital but I wouldn't really expect to come home on twice the dose they are on now.

The idea of surgery is to relieve the pain, after the initial pain from surgery the pain should deminish, so they don't want to create a moster problem where they have to figure out how to get someone off 240mgs of oxyC a day in order to see how well the surgery worked. You do become physically dependnet, so some withdrawal is expected, but docs really aren't great at managing withdrawal or tapers.

Each and every surgery I had, the doc decided when I didn't need meds anymore, I had no input, It didn't matter what I said and if you complain enough they will reccomend sending the patent to rehab to detox or back to PM where the meds simply continue due to dependnece, rather than need. Yes pain goes up if you discontinue meds abruptly after surgery, but most folks survive and that's there feeling.

Weeks or a month or two prior to surgery is not the time to jack your tolerance up so high nothng works post op, that's as good as it gets.

After 3 surgries, 2 sets of broken hardware and years on oral meds or nothing at all, I had a morphine pump implanted 6 months ago, a succesful pump is one that relieves 50% of your pain. I got out of bed 2 days ago for the first time in 11 years without having to take oral pan meds. I'm thrilled with 50% reduction in pain. I still couldn't work if they trippled my dose, but I can function and have to much to live for.

Nothing moves fast in the medical comuity unless your dieing or will be paralyzed. I have even had docs tell me nobody ever died from pain. I did have a heart attack at the age of 36, but I didn't die. But if you are concerned about depression or suicide, you need to find them a counselor and they may get added pain relief from antidepressants they use to treat depression and anxiety. AntiD's are usually the first line med when it comes to pain management.

You can try acupuncture, ask for a TENS unit, try TINS, Learn relaxaton techniques like Biofeedback, self hypnosis, guided imagery and yoga. Get back into PT untill surgery so they are in the best shape possble gong into surgery.

But a doctor foolish enough to numb someone that needs surgery so that they can continue to work when they shouldn't be, or try to enjoy the holidays when it's not possible, Isn't doing your partner a favor and is puttng his licence on the line in a futile effort to manage pain for someone with unrealistic expectations. If your partner hasn't slowed down or stopped activity, it sounds like it's time. It doesn't make sense that someone would rather kill themself than take a few months off work when time off will likely do more than an increase if they are still working. Otherwise, work on moving things up to get them relief from surgery if needed. But there could be a huge price to pay for increasing now when it comes time for post surgery pain control.

Good luck, Dave
Methadone is really the answer then, to ease the financial burden. It has a stigma attched to those that don't understand chronic pain or pain mnagement, but it's the only pain med that will touch nerve pain without going to extrordinaryily high doses. I'm disabled and there are no script beni's for medicare. untill 06, the discount cards are a joke, I can get better prices by paying cash at the right store.

I will certainly pray for her and since she is home, make sure she's not overdoing things to prepare for christmas or whatever your holiday may be. I do the cooking and know what's it's like. I rarely eat after having spent hours in the kitchen because I just hurt too much.

It's really not that anyone takes pleasure in seeing her suffer, it sounds like they are doing the best they can. Neurontin isn't cheap either, there are some other older anticonvulsants like dilantin which are very cheap that may be an alternative for the nerve pain or radiculopoty. IF the stigma of meth would prevent her from dropping her cost 400%, there isn't much else I could suggest.

If she's not getting relief from OxyC which has a bad rap for rapid tolerance the other alternative that may save a hundred bucks or so is generic MSContin, long acting morphine. The insurance thing is tough. and so is the lost work. It cost us our home, our credit and almost the marriage. Just let her know your in for the long haul and try to make her comfy. But if increasing oxyC produces no positive efect it's hard to justify the use, so a change sounds like it's in order. OxyC is about the most expensive LA med there is.

Every opiate has it's similarities and it's own unique properties. Oxy works well on Visceral pain like post surgical pain, but I found meth and morphine work better on crsushing spine pain.

I know it's hard when you have been independent for a long time to ask for help, but if she's disabled and your not presently marred and can somehow exclude your income from the housefhold income she would qulaify for medicaid, a state versin of medicare that covers everything including scripts. People on social security disabilty have no benefits for scripts other than diabetetes and breathing problems.

Your right about looking at a 50k surgery for a fusion, that's in the ballpark. My last one was extremely long and the surgeons bill alone for 11 hours was 33k, add in anesthesiology, the hosiptal, the pre op labs and you easily looking at 50k. Medicaid also has something called spend down. Even if you don't qualify at the tme you apply if you reach a calculated number as far as unpaid medical bills and present script costs these things are considered too when reconsidering her eligability. If you have children the household limit drops lower.

If your not married, you can set up a temp residence and leave for the sake of getting her benfits. I'm just talkng about how things look on paper to deminish the household income. But they do look at bank statements which means convertaing to a cash way of life and not running money she can't acount for through an acount they can check.

I just went through the process after my wife was layed off due to her medcal condition. It's degrading to have to ask for assistance, but that's why it's there and obviously the sytem is being worked if there is a single mom somehow feeding 4 kids on less than 580 a week wearing a 400 dollar coach hand bag. You have to do what you have to do, but the longer you put off a CP issue that could be corrected the less likely that the surgery that would have corected the problem will be effective and she may still be left in pain due to pain imprinting which is part of the gateway theory of pain.

Have you talked to hopital social workers to see what they can do to help you get this surgery done and hopefully relieve some pain. I also started on OxyC and never found relief so we changed meds, I had lost insurance and methadone was a miracle and a life saver as far as cost and pain relief. It has propeties that oxy and morphine don't have. It blocks the NMDA receptor which controls tolerance, pain threshold and also helps with neuropathic pain.

I realy am being honsest about post op pain control when you go into a surgery taking more meds than a surgeon would ever prescribe, It creates all kinds of problems and her pain mnagement doc needs to be involved in her post op meds so they aren't throwing rediclously weak meds at a patient that is tolerant to 5 times what they are offering.

It's a crap situation and I do have great emepthay havig traveled this road for 11 years but there are answers aside from simply increasing the oxy and negative consequences of doing so. There aresadjunct meds and other meds to try that aren't as expensive as OxyC. There are meds that work better on nerve pain than oxyC and conveying the situation in a way the hospital social worker or the pain management docs understand will also help. If she's been home and unable to work for ths long, obviously something needs to be done.

I thnk many of us have thought about chercking out just to be done with the pain, You have to dig deep and find somethng that keeps you going. My little brother commited uicide at 24 and that retty much took that opton away from me once I saw how it effected everyone from my parents to his wife to myself and my other brother. It's an act of desperationn that's not thougfht out. Stay with her, be suportive and do what youhave to to get er the benifits of th probno work she needs. There really is no reason to keep tossin 400 bucks on Oxy out the window simply because of the stigma of methadone. A pharamcist knows your not an addict when you pick up a script, they don't give qaddicts a one month supply to go off and do with as they wish. If you have to tell people what she'e on and your worried about stigma, use the brand name whch is dolophne when describing her present meds. Nobody knows what Dolpophne is other tha folks in PM. t's mnerely Name brand meth made by LILLY. The generic version are extremely cheap, pennies a pill.

I wish I had an answer, my neighbor is going through the same thig, he has obvious problems that even I can see in an MRI, but hasn't found a doc that is willing to start him down the road of back surgewry which can lead to more or leads to a life of CP. At 29, they just don't want to do this and 2 weeks ago they flat cut him off when he has a disc impinging 1/4 of his spinal cord and another that's so dehydrated bone is touching bone. But he's not willing to be sliced either.

So his optons are live with it, go through the conventional pain mnagement programs hat don't use opiates or find a doc willing to prescribe and try to mask it as he goes through more PT and more procedures. Eventually he won't be able to mask it and will have to have surgery or be condemnded to a life of intractable pain forever. Which makes no sense with a virgin back and an obviously fixable problem.

If the problem is progressive and she is deterioratng, That's why monthly increases aren't helping but at the rate she's going she may end up on such a high dose of oxy any surgeon willing to operate will want the patient detoxed prior to surgery or will simply DC the meds very quickly after surgery which isn't to humane either.

Good luck and if you have questions about different procedures or meds, Folks can give that advice, but if the problem flat out needs to be fixed, all the meds in the world won't give her 100% relief.

Take care, Dave