Discussions that mention morphine

Pain Management board

Last week at my monthly PM visit I was told that I would no longer get the MSIR (instant release? morphine) that I take for breakthrough pain along with MS Contin. He said that it was not just me; they are doing this to everyone. He said that if you give people 60 pills they take them all, and if you give them 90 they take them all. I said that it is difficult not to take medication if you have pain and you have the medication. He agreed with me but he didn't seem to care.

He did say that since the last 2 diagnostic injections gave me some relief in my neck and upper back (right side only) that I need to schedule the Radio Frequency procedure to kill the nerve. (I started going there due to pain in my neck and upper back, both sides and lower back and hips.) If that does work I will still have pain everywhere else.

I had just finished telling him that I was experiencing new pain in my knees and feet and my jaw pain was getting worse. I let him know that my jaw was locking and I had to force it open to eat so I was going to see a specialist later that week. Since I was diagnosed with RA and DJD (along with AS and FM) I assume that these are part of the package.

By the time I saw the Oral and Maxillofacil Dr I had experienced a severe headache with pain in my jaw, face and ears for more than a week. The new Dr confirmed that it was TMJ (from the very loud cracking sound) and the plan is to have an MRI and get a splint made for my jaw. Surgery may be necessary but we won't know until after the MRI and some time with the splint. I asked him what I should do in the mean time about the headache and he said that he couldn’t give me anything because of the PM. I told him about the no breakthrough med policy and he said that he couldn't do anything unless I stopped going to PM.

I called the PM office that afternoon and left a message telling them about the severe headache and the additional diagnoses. That was Friday and they have not called back yet.

Do you think that they are trying to get ride of me? or are they trying to stop the pain medication and just do injections and kill off all of the offending nerves? Should I try to find another Dr before they get rid of me? Or am I imagining things that I shouldn't worry about? I would appreciate any input or advice, thanks.

Pookeysmom: I agree with what's been said by Jon, Dave and Tina about the amount of your medication and some of the procedures your doc wants you to have done. It sounds to me that your base med (MS Contin) dose is too low. I remember you said your doc thought it was too high now, but I don't agree. There's really no ceiling for LA meds, it's what the patient can tolerate as far as any possible side effects. There are other forms of Morphine he could switch you to if that med isn't doing the job. You could go with Kadian for instance, with 12 hour dosing. It just sounds to me like you doctor is a little conservative when it comes to prescribing your meds and doesn't want to bump you up. I guess you could suggest a switch to something else to him or maybe even look for someone new. Don't cut you ties with your current doc until you have something else set up and you know the new doctor will continue your meds.

When I was on Oxycontin (which is stronger than MS Contin) I was taking 160 mg TID. You're taking 180 mg a day and I was taking 420 mg of Oxy a day. I just mention this to show you there isn't cut-off point on these medications. We've had people on these boards that were taking over 600 mg of Morphine a day.

I guess you need to discuss this with your doctor and see what you can work out. Good luck and keep us updated.