Hi Pam,
Since you have decided against methadone, May I offer some advice on OxyContin dosing?
I was on it for 2.5 yrs up to 120mg daily. I think if you take it more evenly spaced out, even though I know you don't like to take all that is scripted to you. Perhaps take the 20mg 3x a day spaced out every 8 hrs. I think you may get more even relief.

I initially found when I first took it, it was scripted only twice a day(I started at 20 mg twice a day) and the pain coverage NEVER lasted 12 hrs. I told my doc and he gave it to me 3x a day and said a lot of folks need it 3x a day. When I only took it 2 x a day, I felt very unwell for the last couple of hrs of that 12 hrs., a bit nauseous and headaches, a general malaise yet very anxious and pinchy feeling, it almost felt like a mini withdrawal. Maybe that is what is happening with you?

I know you don't like to take that much due to your perforated bowel issue and certainly that is scary but, you need to be at your most clear headed when you meet with the NS. I also hope someone helpful and knowledgeable is attending the appt with you...it is really helpful and knowing you, you will go with a list of questions and concerns.

I can't recall if fiber is a difficult issue with you but I control opiate induced constipation with prunes or Yakima fruit paste. Certainly the prunes are easiest, I get them in a ziplock pouch and eat several spaced throughout the day, totaling about 6 daily.

These decisions are all so intense and stressful...you have my sympathy. I suggest you focus on pain relief first and then, deal with return to work because you are not going to return to work without getting the pain under control.

When I read your story and what you have endured I think, how does this dear woman ever get enough relief to get any sleep at all. Every moment of shut eye must be blessed relief for you. Last week as I was awaiting facet joint injections for migraine/disc issues my pain was brutal and no amount of my regular pain meds were touching it and sleep was non-existent. I had my doc give me Elavil(amitriptiline sp?) which is an anti- dep often used for pain which just knocks me out. I literally knocked myself out for the 3 days prior to my facet joint injections with Elavil...just got up to use the bathroom. My family was kind enough to help me out through this ordeal, bringing me food and handling all household issues.

I wish you the best Pam...it sounds like you are covering all the bases. Be kind to yourself, I was also the professional caring family member that everyone leaned on....it is your time to lean on them now...that is what family and love is all about. I know how hard it is to give up the " I can handle it all" mentality...it took me years to accept help and realize, I can only do what I can do. Once I accepted that, it was cathartic.
All the best, D.