Hi Dee, 75 mgs of morphine really isn't that much stronger than 70 mgs of hydrocodone. Morphine is just the gold standard to which other pain meds are compared in strength. Oxycodone is stronger than morphine by about 50% mg to mg, Dilaudid is 3-7 times stronger, meth is 3-10 times stronger than morphine. The only ceiling you would hit is the amount of tylenol in hydrocodone products.
There is a chance that after 3 months and using them only when the pain is severe that you would get some relief for a while, It may be only be weeks before you need more that the safe amount due to tylenol or it may take months or years. It just depends on how frequently you use the med. They do make a low dose tylenol and hydro combination called Norco which is available as a generic.
Sleeping the days away isn't really what they shoot for as far as increasing the quality of your life. I understand most spinal tumors are benign, but you still need continued follow up and the time may come when it needs to be removed. I imagine you haven't had it /them removed due to potential risks, but when they start causing neurlologic impairment "bladder, bowel disfunction, loss of refelexes,etc" then the benefits of further damage to those nerves starts to outweigh the risk of surgery. Honestly if you think you could get buy with taking meds 3-4 days a week and skipping days in between, you maybe able to put it off needing an increase for a while, but if you have nerve impingement, the longer that goes on, the less likely surgery will relieve the pain caused by the impingement due to pain imprinting and the gateway theory.
I certainly wouldn't suffer when Hydro would have to work better than OTC meds untill you reach a point where you have to treat the problem more agressively. If you get to where you can only manage if your sedated most of the day, then quality of life is the bigger issue and that may make the risk of surgery worthwhile. How many years does anyone want to spend sleeping from dose after dose of meds?
I guess decades pass for addicts, but when dependence is the only issue, those are tough years to rationalize an existance where you can't function. There are also pyshcological factiors involved in treating chronic pain and knowing you have tumors on your spine that may progress. Understanding the goal of PM isn't to iradicate all pain, it's to allow you to function when you couldn't otherwise. Sleeping all day in't really functioning and learning to accept you have to live with some pain is just part of being a PM patient. Those that shoot for complete relief will end up crossing the line and landing on the other side of dependence. I would say yes, seek treatment. If hydro is what the doc uses, it's not going to turn you into an addict unless your taking it to deal with the emotional pain of being disabled or to numb yourslef from the pain of your life not turning out the way you wanted or expected. The meds won't relieve all pain without puttting you back in bed and needing ever increasing doses to do it.
Nobody expects to become disabled, so it's alot to deal with. A counselor, psychologis or psychiatrist would be someone you can tell the things that might upset or scare your family and friends. It's normal to feel depresseed, but it's not normal to act on it. If you have someone you can talk to and anyone in the medical field has a mind you can pick is only a plus.
An addict would use their DX as an excuse for unexctable behavior, where someone looking to function to their best ability is going to get sick of sleeping their life away as it falls apart around them. You just have to find a medium between over medicated and able to function to the best of your ability. Some days won't be good days, but anything stronger than apap will help for a while. For now it sounds like you can expect things to ease off after a flair. It's when things don't ease off and the bad days become constant you need to look at things more agressively.
Your not lacking medical insurance so a 30 mile drive really is a small price to pay if the pain is disabling. There are programs for the disabled as mentioned by others that will get you where you need to be. You just have to look into what your city or county offer and who to contact to get the ball rolling.
Personalyy I don't see the harm in using short acting meds if you have days when you are pain free or OTC meds manage it. Taking LA meds 24 /7 on days you don't have pain makes any med less effective when you take it when you do need it.
I would talk to the new doc and likely he will tell you when things reach a point when can't manage with hydro he will have to refer you to a specialist. Only your use can be used as a predictor as to how long you will get relief from a med before becoming tolerant and having to exceeed your a docs orders to get relief. You want to be upront with the new doc and if/when you reach that point let him know it's time rather than destroying a trust relationship by simply self medicating. If he thinks you have a problem with hydro, he may refer you to a PM doc that doesn't use opiates and uses differen't methods. That history of abuse can come back to haunt you even if the pain is very real. Even being a patient of a doc that was prosocuted can have a negative effect on his patients.
Take care, Dave