Discussions that mention morphine

Pain Management board

Mike, I have a follow-up coming up soon. I might ask for something other than the fentanyl because it doesn't seem to be working all that well. I was taking 10mg hydros TID for BT but they did nothing for me, so I told my previous doc to forget the norco. I know dilaudid worked well in the hospital, but I've never had it in pill form. I hate to request medication, but I am against hydro and oxy because I hate the rollercoaster effect. I don't know whether to ask for an increase on the fentanyl and add a BT, such as dilaudid or to ask to be switched from the fentanyl to something like meth or morphine. I'd rather the doc make the suggestions, but I like to go in with an idea of what might work since its no fun having minimal pain control. If I make a suggestion, say fentanyl 50mcg with a BT dilaudid (dose amount?) or go off fentanyl and over to meth 10mg TID or morphine (MS Contin) 30mg TID. I would be interested in changing from fentanyl because my body absorbs the fent quite fast and the initial 12hrs is OK, but the 24-48hr mark is marginal. On 72hr dosing, my body was going through w/ds on that third day. I'm now on 48hr schedule, but I think I would be able to manage a smoother and more continous dose with a pill. The toughest thing for me in this whole PM deal is how to get a steady level of meds. The oxys were absolutely torture, never going back there. The fentanyl still has a rollercoaster effect, although its easier to handle on 48hr dosing. Now I am ready to look for something that can smooth it out even more so I don't have to be so distracted by the ups and downs. Hopefully someone can give some advice here because I think I am getting really close after years of battling these meds to finally find an even ground.