Discussions that mention tylenol

Pain Management board


Hi there,

I agree with Bake/Pray that you have to be careful and just ask for just specific medicines sometimes and let the Dr. use his expertise in helping you with your pain. This is NOT to say that you shouldn't tell him about your upset tummy, but from what it sounds like, you are sensitive to most medicines like I am. That's just something I have to unfortunately live with and be very careful about having it with food, carrying crackers with me at all times, TONS of chewable Rolaids that are in my purse, kitchen, car, etc.....Again, not saying that you should always keep an eye on your tummy and keep track, with the Dr. on how much Acetamenophin (sp?) you are taking for your liver.....and make sure you don't develop an ulcer..... But again, ALL medicines have some side effects and it's really trial and error with which one's have good pain mgmt....(getting to a 4-5 for me personally is FANTASTIC!!!) and living and managing the upset tummy, fatigue, etc...that comes with the chronic pain package....

I don't think it's realistic that you will find a medicine that makes you feel all happy, energetic, warm and fuzzy, with no side effects whatsover....it's just the degree of "yuck" effects with taking such strong narcotics.....and then praying and working with your Dr. to get your level down to an acceptable level for pain and then managing and changing your lifestyle, eating habits, sleeping habits, work, life, etc. to really live a good and happy life WITH the pain....

You mention that Oxycodone didn't make you feel good...what exactly did you mean by that?.....Oxycontin is oxycodone without the Tylenol added.....

Also, I agree with others that you really have to give the medicine much more time to get used to it....a month is actually a good amount of time as I'm sure your Dr. will tell you to really work out the major "kinks" and side effects to decide what you can deal with....

You said that you stopped taking the Dilaudid and it hasn't even been 7 days on that....It might start to look bad if you keep only taking the medicine your Dr. is prescribing you for less than a week and keep asking for the next stronger thing....Again,,,,not that you don't NEED something stronger....but as we all know here with Chronic Pain....we have to really watch everything we do because in our world...we are guilty until proven innocent....it's just the lay of the land.....

So, unless you had the most awful experience ever with severe heart issues, throwing up constantly and not getting any food or water down for a day or two.....it's really not a good enough reason to stop taking a med just because it makes you naseaus...there are other meds that your Dr. can prescribe if necessary or OTC medicine that I take to help with your tummy issues and deal with it better...


You said that you take Vicoden for BT...so if that is not making you too sick then I would suggest asking for a long acting medicine with the same property of Hydrocodone....since it would be the exact same medicine minus the tylenol....

It took me awhile to find the right combination (meds plus lifestyle) to get to a 4-5 on the pain scale along with my 3rd major fusion surgery for my neck ( they went in through the front and the back this time)...and keeping healthy with my food choices, yoga, exercise, sleep, PT, stress management, drinking lots of water, etc.....

The medicine I take...after 3 surgeries in 4 years and all of the above non medicine things, is Oxycontin 20mg, one every 8 hours...Percocet 7.5/325 one to two every 4-6 hours but never more than 8 a day to keep my tylenol in check...Robaxin as my muscle relaxer, and Cymbalta for nerve pain and then Ambien to help with sleep when needed....
As Shoreline as others will say too, you also have to show your Dr. what else you are doing to manage your pain that doesn't include medicine and work with him to find a TOTAL BODY/MIND plan that will work for you instead of just asking for medicine after medicine so that you can be a participant in your pain management along with your Dr...

BTW...have you done PT, injections, shots, traction, surgery, or anything yet to maybe help fix some of the herniations? Just curious....

Hope that this can help some and that I don't come across harsh but want to be honest about what it can "look" like as you qouted in your post, sometimes when we just ask for certain meds....

I really wish you luck in finding a great pain mgmt. plan that can help you live the best life possible and I'm sure you will great some wonderful advice from others on this board as they have been so helpful to me...

Blessings,
Ingrid
A couple of points bear comment;

First: the exvtended release oxycontin will almosts certainly not cause the same type of stomach upset that the immediate release preparation does. THis is due to the fact that the nausea associated with opiates is triggerred by the surge of opiate hitting the bloodstream and crossing into the brain. Since this does not occur with the CONTIN- prep it is very well tolerated , generally the best tolerated opiate on the market.

Second is the erroneous and very dangerous idea that ONLY taking a 5-6 or so tylenol or percocet or vicodin per day is safe. It is definetely not safe alkthough it is true thaat it wont harm your liver at that doseage.. To say that one takes no more than 8 percocet per day in order to "keep my Tylenol is check" is a dangerous misconception of the current medical knowledge.

The recent peer reviewed studies unequivacably demonstrate that even 1-2 tylenol ( 325-650 mg acetominophen) per day, when taken on a regualr basis for long time oeriods, is associated with the rapid development of hypertension in previoulsy well middle age women, and would be expected to lead to end stage renal failure. ( They had to actually stop the study as 98 % of the healthy woman developed hypertension after just a dew months. ) I suggest you research the link, for your own health if for no other reason. Simiar findings for men are just emergin and also impicate all of the NSAIDS for similar reasons

The third comment is that the expert consensus of pain specialists, and the recommedation of governing and oversite agencies, is that when the decision is made to treat chronic pain with opiates that ir should be with extended release preparations at sufficient strength that a "breakthrough" medication, ( or rescue dose ) is needed obly very infrequently. THe regular use of short acting opiates in the short termin chronic pain is useful in determining the ultimated extended release dose.

One of the hallmarks of the illigitimate opiate dispensing doctor is when he or she writes for an artificially low dose of an extended release prep and an inordinately large number of short acting preps so that these may be diverted to the street trade. THe classic example is oxycontin 20 mg three times per day ( it's a tweleve hour drug ????) and 200 - 300 Vicodines or percocets "for breakthrough pain" . WHen patients are on this type of regimen it is also very suspect.
I feel that I need to respond directly to OM28 since you seem to be quoting things from my post and do not appreciate you saying that anything that is prescribed by my Dr. is innapropriate. I work with my Spinal Sugeon and Pain Dr. from one of the most well know Spine Institutes in the US and this regimen has been specifically put together based on my lifestyle as a missionary.

First off, the amount of "up to 8 a day" for the Percocet for B/T pain that I take is perfectly acceptable for me....my lifestyle. I am a missionary and travel every month around the US and Africa helping Katrina victims and other natural disasters as well as children suffering from AIDS and poverty. My regimen to be able to take fast acting medicine in certain situations throughout the day when needed is absolutely fine. My Dr. and I test my liver functions every 6 months and I have never had an issue. I just had my 3rd major neck fusion in Nov. and have a wonderful Dr. who helps me with a total LIFE plan where I eat healthy, don't smoke, don't drink, get appropriate sleep, go to therapy to help living with chronic pain, exercise, yoga, Physical Therapy, etc...

Yes, many times a Dr. will up the long acting medicine to reduce the number of B/T medicine but because of the nature of my travel and work, I have it to be on a lower dose Oxy and then be able to take B/T when needed and doing something strenous or being able to handle a 14 hour flight to Africa...So the prescription written for "up to 8 a day" gives me a lot of flexibility to take 1-8 (in a 24 period...not 8 at a time), depending on the severity of pain/activity that given day so I can stay in a 4-5 pain level range. My prescription is specifically written for 1-2 every 4-6 hours....and no more than 8 in a 24 hour period....they are 7.5/325's....so not the strongest nor the highest for the tylenol but is perfectly SAFE ( as long as you monitor liver functions and don't add other lifestyle or medicines that effect your liver)....Many people are on much more higher doses, totally, than I am, as well as much less....That is why we should all find a Dr. who will treat us as individuals, (not a cookie cutter plan) and what is going to work for us in our lives....

So to suggest that anything that I am doing is "suspect" is not something someone who doesn't know a thing about me and does not really understand the medicince that he/she is talking about.

Oxycontin is probably prescrbed MORE often every 8 hours than 12 since they discovered long ago that it really does not last for the 12 hours. So this is a VERY common practice and suggest that you read many other posts including Shorelines about the fact that this particular medicine is prescribed this way all the time and is not "suspect"....

I really don't want to cause any problems here but get upset when someone is attacking my own personal regimen when they don't know what they are speaking about...

I was posting to the original person to say that you have to be VERY careful about asking for specific medicine....I did not criticize that poster about who they are but responded to their specific questions about how to deal with a pain Dr.....I also spoke about that you have to do many other things in your life to help with your own pain mgmt. besides medication and find a Dr., like mine, who helps with a total body/mind plan. I also said that you should always give medicine much more time to let your body/tummy adjust and that you may never find the perfect medicine that doesn't have uncomfortable side effects and that's why I carry crackers/Rolaids, etc....

Again, I don't want to cause a problem but felt it necessary to respond since you are saying incorrect things about medicine in general as well as what my specific regimen is that is perfectly fine....for me....not for everyone....I would never recommend as much Tylenol for someone who drinks...even socially...which could harm their liver.....

You also say that Oxycontin won't cause tummy issues but that is not true either.....I am sensitive to any medicine...period...even my vitamins I have to take with food....so that is not true to say they won't have any issues with taking that....again...everyone is different and react differently to every type of medicine...that's why it's trial and error and working WITH your Dr. to find the medicines that HELP with pain (not take it all away) and have the LEAST amount of "yuck" side effects....


Please be more careful about criticizing what a person is taking when your knowledge about Oxy or Percocet is incorrect. To also say that my Dr. is doing anything illigitmate or illegal with my particular plan is extremely rude and un called for....

I totally agree with Butrfligirl28 about QUALITY of LIFE and talking to your Dr. about that and what you want to achieve in your life and what your goals are....We have to be realistic that with our surgeries, chronic pain and meds that we have to adapt to what we were doing before all of this came about...but to live with LESS pain and be happy and joyful is something to strive for...I am a strong proponent of adding a depression medication and seeking therapy to help us with this since it's a definite life change to LIVE with chronic pain...but that's the key word...live life to the fullest we can:):)


Blessings,
Ingrid
OK, so I went today and told the doc that the dilaudid upset my stomach and caused vomiting. I obviously can not take morphine. He prescribed me some kind of patches that you wear for 3 days and tylenol 3's for B/T. I've been taking vicoden for 5 years every day. I don't see how tylenol 3's are going to bring me relief. I did not sugggest any meds. I will try these patches and the tylenol for the next 2 weeks, and if they don't work - then it's back to the drawing board. I must admit that I'm very frustrated at this point, and kind of bummed out.

He is my doc and knows what's best for me, and I want to try everything he says to do without saying no. I gotta tell ya, I do not want these patches, but if they work than great. I'm thinking they must be stronger that's why he went down to tylenol 3's, but I'm not optomistic at all.

So right now I'm very upset and feel like I should've kept my mouth shut like I always did and just grinned and beared it. Worst case scenario is they don't work, the B/T isn't enough and he has to try something else. I'm so upset. I need relief now.

Any comments? Anybody on patches? I can't read the writing, but think they are duragesic 50 something. Why tylenol 3? Am I underestimating this?
Hey there,

I know that others like Shoreline can give you the dosage and strength amount but the Duragesic patches are very strong and since he went straight from the 25 to the 50mcg strength then he is looking to definitely help you with your pain. Tylenol 3's are a strange B/T but my guess is he is thinking that the jump to the Duragesic should keep your pain at a low level.

The patches are wonderful for keeping medicine in your system at all times....They do, however, take a few days to really start kicking in so please give it some time...There are lots of people on this board that are on the patches so they can give you better advice since I have such a sensitive stomach that I cannot take them....

So the good news is that he did prescribe something that should help maintian pain control much better than the pills....so I do feel he is trying to help you...

Please don't feel that you shouldn't have said anything to him about the Dilaudid and give the Duragesic a fair try...If they don't work after about a month or so, then you can go back in and try again. That's the unfortunate part about chronic pain is it's really the trial and error with all the medicines...I know it's frustrating and you just want RELIEF...but so glad that you came here to tell us how it went today..

I, too, have gone through too many to count, of combonations of meds to finally get to where I am today...So PLEASE hang in there....keep coming here for advice and I'm sure others will chime in to talk about the Duragesic to help you....

Blessings,
Ingrid