Discussions that mention morphine

Pain Management board


Hi Jag, My doc used t o write me 3 seperate scripts for my base meds and BT meds, It actually is legal, btut the DEA doesn't like it and cracked down on it biig time. My doc has been working with them to apease them and now they are saying you can write a 90 day supply, but tehey felt writing 3 scripts at one time was just a way of wrorking a loophole. In my state a lass 11 script is good for 90 days frm the day it's written and the doc put fill on or after dates on each script exactly 30 days apart. It demanded compliance but the DEA didn't like it and I this prtactice change last year from California to VA .

I'm sure a few still do it their own way and if he's following your states laws, He's not bound to follow every new policy the DEA thinks of that has no legal backing. The fear is that if docs don't comply with whatever the DEA wants, even an audit of a docs prescribing practices effectively shuts the doc down and sends every patient into withdrawal during that audit if they happen to be due a refill and need a script that week or two it takes. The doc can't write a script for a patient when he doesn't have the chart.

So although the DEA works without the benefit of a law to back their policies, they have the teeth to enforce any policy change they want. As far as seeing a doc, He should at least be re-evaluated eery 6 months. I understand some patients are stable, but it's not good care if the doc isn't seeing the whites of eyes ever.

My wife was taking LA morphine and had a car accident, rather than increasing her morphine they switched her to methadone. She did get better relief, but she slept all the time. I'm the one that's disabled and starting feeling like a single parent. After 4 months of it, I was tired and pointed out the drastic change since switching meds. It would be a shame to leave because he reacted poorly to a med, but he has to be willing to work on changing meds if his reaction is this severe. They can certainly replace the meth with more oxy or another opiate from another family. The advantage of using multiple opiates is the slight difference from one to the other covers more receptors, but he can accomplish the same thing by discontinuing the meth and using the patch or using morphine. SO he really does have options.

Another thing to consider is the psychology f of it all. In the beginning there was a point where I was intentionally pushing my wife away because I thought she deserved better and was young enough to move on and start a new life. It's just something the other half starts thinking when they don't feel they are contributing.

Even though his doc wrote a book, doesn't mean he is on the right meds. I doubt the doc knows he sleeps all day and stays up all night. I wold bet he minimizes the sleep in the day and complains about not sleeping at night, that's how you end up on high doses of meds to induce sleep. But if you do away with what's causing the sleep during the day, people will eventually sleep once they are tired enough.

I'm very empathetic to what the spouses go through, but it does seem silly to eave because he's having a bad reaction to a med but is too afraid of an increase in pain to be willing to change meds. But the goal of pain management is to restore function, not relieve all his pain. Without restored function, it's hard t justify nothing more than home anesthesia.. Please do as others have suggested and talk with his doc about his level of function. It's not that your trying to make him live with more pain, your trying to find the right combination of meds with expectable side effects.

Do ya'll have children. children can be a great motivator to just be able to participate in some way in heir life. Things are out of hand as far as side effects and I can't imagine a doc saying that sleeping all day is acceptable. If his normal routine is just a med check with a nurse or nurse practitioner, schedule an Eval or consult with the doc. He's obviously not complaining about he drowsiness and if that could be changed he may wake up a little and have to face the decision not to pursue any other means than meds to manage his pain.

I doubt his PM doc would discharge him if he went to see a acupuncturist or saw a PM psychologist to learn self hypnosis, guided imagry, bio feedback, yoga breathing techniques or just to deal with his new issues. If I hadn't spent years trying every other method to manage pain and the meds hadn't been the last option, my wife and family would have serious concerns abut the choices I was making and what I considered acceptable side effects.

I've had 3 back surgeries fail, the last 2 were fusions and Ihe last one was a fusion to replace a failed fusion and broke hardware that stretches from L1 to S1. Now I have 12 screws, 8 rods and an intrathecal pump but I want to feel like a man and contribute n some way. It took years of trial and error and it's a continuos process to remain functional and explore his options.
I was bed ridden at one time too. Things can change.

The dose of dilaudid I receive through my pump probably makes his dose look small, but meds delivered to the spine don't cause the cognitive problems he's experiencing unless you go overboard. I could crank things up to the point of sleeping all day but what gives my life meaning is taking care of my daughter, contributing around the house which pretty much means I do all the cooking ,cleaning and shopping.

It takes me 2 hours to do what my wife can knock out in 20 minutes, but I at least feel like I'm contributing in some way. It kicks the crap out of me to do it but I need to feel like I'm doing something. All these things play into the self worth issues when someone's life has been drastically altered. If he has nobody to talk to about it, I guess sleeping is an alternative, but not one he has to choose and one with a huge price.

I'm sure back problems and the meds also effect intimacy but it doesn’t have to be that way unless he has major nerve damage and even then, Intimacy means a lot of things to a lot of people. Just going to bed together is a start.

Good luck, Dave
[FONT=Comic Sans MS]I can say that Failed Back Syndrome is really the WORST because that is my diagnosis ALSO. However, my Doc--who is a Physiatrist who ONLY does Pain Managment--would NEVER have me on basically VICODEN at the same time as the harder core meds. I ALSO take METHDONE as it is the BEST pain reliever for neuropathic, unremitting pain. I came OFF my MSCONTIN as I was goin UP on my dose of the Methadone. I can recall at one point I was on like 45mg of both and had the nods so bad I'd fall asleep sitting on the toilet and wake up 3 hours later w/my legs numb, OR face down on my computer keyboard and I'm surprised I didn't ruin it drooling on it! I take psychiatric meds for bopolar disorder and I'm certain it makes me sleepier than I would be if I wasn't on the Methadone. The problem is--when I was on the MORPHINE I developed this craving for more, more, more--and lots of anxiety around my dosing. I actually was UNAWARE I'd taken so much "extra" 'til I got to the end of the month and had to split my doses for a week! THAT'S part of the reason for Methadone. You get off the other stuff and stop the cravings that inevitably develop w/long term exposure to opiates!

I am SO SORRY about what's happened w/your hubby. A good marriage doesn't deserve to be devastated by poor Pain Management techniques. He's probably TERRIFIED to go to another Doc--as they might leave him HANGING, detoxing! Maybe THAT'S what you could talk about!

Hugs--
Mya[/FONT]