Hey all: I guess, and this is just my opinion, that med dosing depends on:
1) The patients condition. Musculoskeletal pain, nerve pain, joint inflamation, etc.
2) The patients tolerance to pain. Everybody feels pain differently. What might be a pain level of 2 for one patient, could be a pain level of 8 to someone else.
3)The patients tolerance to meds. Not everyone responds the same to every med. Some do very well with organic morphine and have few side effects. Others may only be able to tolerate synthetic (such as Oxycontin) because of side effects (that would be me)
4) And this is the big one. The patients expectation of said medication in terms of pain relief. Some patients realize that if they are chronic they may only reasonably have an expectation of living and functioning at about a 4-5 on the pain scale. Others expect to have, either no pain at all, or a maximum of 1-2 on the pain scale in order to feel they are at a functional level.
This is why so many people are taking so many different meds and having very different results. Very few people achieve the same relief from the same med regimine. That, again in my opinion, is why PM docs have the most difficult and confusing specialty there is. Throw in the DEA, the pharmaceutical companies and the insurance companies and the result is what we talk about and share here on the boards every day.
I know that with my conditions (I have a few) the meds I am taking right now are working for me. It didn't get that way overnight though. I've had several med and dosing changes over the years, due to ineffectiveness, tolerance, and worsening of my conditions. I also realize that I have a PM who works with me to tailor my treatment to my needs. Before coming to these boards I just thought most CPers did. I never realized how lucky I was.
Sorry this was so long, but I've had a lot of down time lately to think about these things (trust me, that can be dangerous :D) and when I read through this thread, I realized just how much we all struggle to accept, understand, and utilize our pain management. No wonder we all have so much to talk about here everyday!!
I just want to add that I think the world of all of you, and you have all been a very big part of my sanity and my solice, especially in the last few weeks. Thank you all, so much for your kindness, knowledge and support. God Bless, cmpgirl :angel: