I am going to a Pain Mgment Dr on April 9th '08. I would like to be put on Morphine Sulfate and Oxycodone. The level I need is at least 3-100mg Morphine and 6-8 15mg Oxycodone or 6-30mg. I could also use something for sleep like Amitriptyline. That works well for me. I wonder if anyone here takes that med for Lyme and Fibro pain? If so, how does it work for you? I take it now.

My mom died and before she died she gave me her meds because I couldn't get any help. Now that's the level I take and I'm finally been recommended to a Pain Dr. I'm going to tell him the truth but I wanted opinions on the meds for these diseases. What else do you take out there?

I know the dr will yell at me for what I did but I was desperate. I have NEVER taken one illegal drug or prescription not for me but my PCP is a jerk and I couldn't take it any longer. My PCP was giving me 1 7.5 mg hydrocodone a day...ONE!!!! I cried to him about my pain, the level it was at. I begged for any kind of long term meds, he called Pain management a joke and said I was too young (I'm 34). I told him I have no life and I've been a lousy mother (in my eyes) for a few years. I was the fun mom who played everyday and now never. He didn't care.

My mom started me off at a low dose but I worked up to this level quick. I still feel pain at this level but I can get out of bed, play some, and get stuff done that I couldn't a few mths ago. If I have a Dr that will help me, raise me when needed, and listen, I feel my life can come back somewhat.

Any recommendations who how to tell the Dr what I've done with meds? I need him to believe the level I'm at only I don't have any bottles, or a way to show him what I take. He will draw blood at my 1st visit but I could go another 30 days before seeing him. Also, I don't want him to think I'm seeking drugs because I'm an addict or selling it. I have documentation of Lyme, Fibro, chronic UTI's, Adhesions, cysts on ovary (right one gone from cysts) The pain I feel is from the Lyme the most. The Ovary and adhesions hurt the worst during my period or hard bowel movement but they are tolerable on their own....just not with every thing else going on.

I'm scared to death of this Dr's appt. I want help at the level I need it and I need him to believe in me and trust me. I know trust takes time though. Has anyone tried Lyrica? Any suggestions on that? Any help at all would be greatly appreciated. BTW, the fentayl patch...I like the pain relief but I am highly allergic to the adhesion stuff.

And I refuse to EVER take Oxycontin!! My huby was on that for a car accident and he hated it completely. I won't touch it and this Dr doesn't deal with that anyway. Please help!! Thanks so much! Take care

Wow, some story. I wrote you an long answer, but decided to delete it. Not knowing your pain med doc, he might refuse to treat you. The pain med docs around here are beyond paranoid about what you did.

Don't get me wrong, I understand how you felt, but you may have complicated your life a lot.

I would emphasize the degree of pain and lack of compassion by the PCP. Same as I had. I can tell you the pain med docs around here think 180mg of Avinza is a horrendous amount of morphine.

It has ruined my memory and ability to process information well. BUT every human body is different. You might do ok on 400mg. Was it Kadian you used?

Oxycodone is fast relief for me. What frustrates me to this day is that morphine does not help a toothache. It does not stop the pain when I shut a drawer on my hand.

IF you are used to 400mg a day -- whew....you have to tell the pain med doc so he can help you get the dosage down.

UNDERSTAND IT IS PAIN MANAGEMENT, NOT 100% PAIN FREE.
It took me 3 or 4 months to figure that one out. Do you have a choice in pain med docs or is it an HMO?

You have a valid point and sometimes we have to do something to get our PCP to understand our level of pain. I took about a dozen Vicodin in one day. Mine accused me of abusing the drug and I told him to back up, if he had prescribed the correct meds, one pill would have been enough. He thought about it and sent me to a real pain med doc.

Best wishes Kristin, you really need to be careful though, the side effects can be bad too. Loss of memory, ability to think like you used to ... constipation can leave you in a lot of pain.

If you want more details, you can PM me....Dave

Wow that is a lot of meds!! I would be very shocked if a pain dr will give you that. Mine wont go over 40 mg of oxy at a time. I dont think they will give you both oxy and morphine together unless you are on your death bed. It sounds like you have bulit up a pretty good tolerance to opiates. I would never want to tell someone to be untruthful just because it is so hard to find apain dr especially at our age but in your case the dr just might flag you as a seeker. I might would just go in and tell him how bad your hurting and let him go from there. I hope you find the relief you are searching for.

I agree, the worst thing you can do it tell a doc that you have a high tolerance to pain meds. You would be much better off to just tell how bad the pain is, let him prescribe something and if it doesn't work call him a few days later and tell him its not working and ask him to call in a new prescription for you. Once they flag you as someone seeking drugs you might never get any help from any doctor again. Your first visit to a new doc can make or break how they treat you. Be very careful what you say or you can end up paying for it for the rest of your life.

Jerry

I just had oral surgery where they cut a section of the roof of your mouth off (or maybe the scrape it off?) but I am on Avinza and a lot of Oxycodone A lot.

Something screwed me up again. I can't dispose of bodily waste like I did before. My memory is getting worse. I started my old log up again so I can remember how many morphine capsules I took and so on.

I can't say this loud enough .... study the McGill Pain Chart and learn how to express yourself. When I talked in those terms my doctors seemed to ..... I don't know... relate to me better?

Good luck with it, let us know what they say. Also, you better read up on Class II drugs if you are on a 2 week vacation and need a refill.

Also, see what YOUR doctor's policy is for you needing meds. Go to the ER? Call the dr. at 2am? I was told it is important to know what the office policy was because I could get stuck with an ER bill $$$$$. Take care

Am not sure how to answer, but generally if you go to the doc asking for strong narcotics, they will decline. Doctors generally do not want to be told what medicine to give you. Mine however just seems to dole out the ones I do not want and will not give me the one I want. I ask for Demerol, he gives me Dilaudid. I ask for Demerol he gives me Fenanyl. I really do not like Fenanyl, it is eighty times stronger than morphine. Dilaudid is only eight times strong than morphine but I cannot sleep taking that drug. Only when I mix it with Percocet can I go to sleep. The new pain doc I just started going to gave me Flector patches. Seems decent, unfortunately the patch needs to be much larger. It's cost is much better than Fenanyl, $4.33 as opposed to $25.20 a patch. Back to the subject, asking a doctor for narcotics without prior history, their response is that you are searching for drugs, for a habit. This is what they are taught in medical school. You see this all the time in the ER. Let me think awhile on the response. Fruit

Hi,Tell the Pain MD the truth,if they find out your not telling the truth theyll database you and youll be on street drugs. These MD's are experts on Pain Management and many are members of Partners in Pain,a nationwide group of doctors whos belief is that no one should suffer in pain. A heads up,the Fentenyl you used was it generic? ONLY get Duragesic for several reasons...they are better,the adhesive is better and less alergic,if so,place the patch on a different site of the body..its been a wonder drug after 18 years of disability..Good Luck!

Dear Kristin --

I joined so that I could reply to your post. I see, however, that you wrote it one month ago, so who knows what's happened by now? April 9 is past and gone, but I'd like to be able to help in any event.

It's hard to tell, without asking you some questions, whether you suffer from intractable pain, sometimes referred to by the specialists as "IP." INTRACTABLE PAIN takes away all quality of life. It's as though one slammed an entire hand in the car door and the pain, instead of lessening and going away within five to fifteen minutes as it usually would, stays. It hurts and hurts, just as much as when you slammed the door on your hand and you were jumping up and down and yelping maybe and maybe saying some words that weren't too polite, or crying. This kind of pain keeps you from eating, sleeping, intelligent conversation, reading, watching TV, housework, paid work -- in general, as I've said, IP disables all quality of life. There is NOTHING in the sufferer's world at all, nothing except pain.

This is the kind of pain experienced by many patients with advanced cancer (although some cancer patients experience little pain at all) In addition, it's the kind of pain suffered by those with kidney stones, pancreatitis, interstitial cystitis, certain back conditions, late-stage labor (though temporarily) and a number of other non-cancerous maladies. Some with diseases far less threatening than cancer have pain that is far worse than any caused by cancer.

Though I am not an MD, I belong to a group of pain specialists and I have done a great deal of work with sick people, both those who have pain and those who suffer from other conditions. I can tell you this, and you should do your best to get it across to the doctor you're seeing, whether or not you have started with him: there are exceedingly few who can stay alive for more than a few weeks with any kind of untreated intractable pain. I do not know whether you suffer from such pain, but if you do, it is absolutely imperative that the physician you're seeing understands the dread suffering of IP, and that he treats you accordingly.

Many who have written thus far have told you that you're taking "a lot....too much....an astounding load of opiates" <WRONG Word!> and so on. That's nonsense. You're taking what you're taking. The amount of meds you take depends upon the amount of meds it takes to control your pain. In addition, it depends upon how tolerant your body has become to opioids <not "opiates">

There is nothing wrong with developing tolerance, by the way, and almost anyone who takes opiods in any amount for more than a few days will develop a certain tolerance, meaning that they need more medicine to control the pain. Tolerance, from meds taken to control true pain is a physical phenomenon, caused by your body. Tolerance from opioids or other drugs taken for the fun of it is a psychological phenomenon. Big difference here: the pain patient wants more medicine to control the pain; the addict wants more "medicine" for more enjoyment, or a higher high. The trouble here is that the addict finally -- or soon -- gets no more enjoyment from his pain meds than does the chronic pain patient or the cancer patients. All he gets is maintenance, or avoidance of the pain of withdrawal.

Doctors today are terrified of prescribing because too many young people, from grade-schoolers to college students, and adults too, are raiding the family medicine cabinet, or they're picking out the local internists, pretending to have some disease (usually back problems) getting the meds, and then distributing them among their friends, taking them for the high, or selling them -- or all the above and more. Sometimes, even those for whom opiates are legitimately prescribed are taking a portion of their monthly allowance and selling the rest.

Doctors have good reason to be afraid because the DEA, or other agencies of the government or law enforcement are constantly looking for some MD victim to investigate. An investigation by the DEA alone can bring a doctor down, cost him his license to prescribe controlled meds; thereby his profession. Or things (sure enough) can get worse and law enforcement can cost the doctor his home, every penny he has, and often, his family and his last friend. And at rock bottom, he (and certain she as well) can end up in prison for years, sometimes for life, simply because there are folk out there who have a quota, need to investigate so many doctors per month, and zero in on those who appear to be prescribing too many pills.

Another way that law enforcement can turn a doctor into a captive is to discover a patient who has died with a belly-full of opioids. The patient might have died as a passenger in an automobile accident, but if he died with opioids in his system, the medical examiner will often as not write "drug-related-death" on the Certificate and all that's left is for the feds -- or whoever is hunting -- is to find out who prescribed those drugs. As soon as possible afterward, they move in on the doctor, take his records, pull his license and, often as not, slam him into jail. It's legal, as well, for the Police to call everything in the doctor's bank account "drug money" and take that as well. And where does that leave him? -- sans the wherewithal to hire a decent lawyer. That's where. I know two physicians who committed suicide after the DEA moved in.

Most doctors learned all this in medical school and learned to be properly terrified of treating sufferers who may die of their pain, but I know many who learned it the hard way -- by going to jail, by having their licenses pulled, and so on. Only a few make it back to the kind of practice they enjoyed previously. But a very few do make it back; even so, they usually refuse to prescribe opioids of any kind, ever again, for any reason.

There are hunches. But there is no way of proving that a patient is in pain. And there is no way of proving that someone is NOT in pain. There are exceedingly few doctors who have the nerve -- or the nobility -- to prescribe for you at all, and there also are the "interventional pain specialists," who could easly prescribe opioids for you, but will not do so because there is no money in it. They would far rather move in with their long needles with treatments that can cost thousands of dollars per procedure, their excuse being that opioids are harmful to anyone who takes them. That's dead wrong. Plenty of people who were moaning in their beds in the past have taken opioids, large doses of opioids, and gone back to functional working lives.

None of this gives you carte blanche; therefore, if you are given an ongoing dose of drugs for your pain, please try to get along on as low a dose as possible. The price is simply too high. It's wrong that the price is so high, but that's just the way it is, thanks to an hysterical bunch of lawmakers who have been ruining the lives of the suffering and those who would help them since 1914. If you want to know more, Google the Lindemann Library, the DRC, or just start with "Chronic Pain" and do some heavy reading online and elsewhere.

The Price has not only to do with Big Brother, but with the medicines themselves. Opioids can mess up your gastrointestinal system very nicely, though anyone who tells you that they'll interfere with your thought processes, render you unable to drive and so on, knows not whereof they speak. If you honestly need narcotic pain medicines, you will become accustomed to them within a few days and the morphine or oxycodone you're taking -- and even the Oxycontin -- will take away the pain; otherwise, it will have approximately the same effect as eating a handful of jelllybeans.

"Narcotics" is a pejorative word, by the way; it's best to use "opioids" instead. Opioids are constipating; they will ruin a smile that cost you a year's salary within that many months -- twelve or so -- and you'll be constantly afraid of what will happen if your doctor retires, gets sick, dies, has a baby (this would be a She) or moves away and leaves you with no one to prescribe in his place. This has happened to me twice and it was not pretty.

Not remotely am I going to try to tell you what you need to do. To tell you the truth, I no longer know what you need to do, and we have the addicts who misued Oxycontin, along with the DEA to thank for that. I just wanted to give you a few facts, and though I cannot possibly give you an adequate education about pain meds in a single letter, I can hope that you're more aware of what you're facing.

For now, I hope that your visit in April went well; I'd be interested to hear about your visit, and I wish for you kind, understanding doctors and relief from your pain.

Sincerely,
Abigail

Your response might have been intended for Kristen but I gained a great deal of insight from it.

I recently started on Kadian and have mixed feelings on it as I have had to increase the dosage three times in as many months. Your post has taken away some of my hesitation in continuing this therapy.

Thank you very much.

Interesting msg.

I just wanted to add something that I find hard to understand.

I have tried Kadian, for me it did not work as well as Avinza. I also had blood tests done to see how long the two meds worked. Neither were 24 hours (as Avinza was advertising at the time I started it. I got roughly 12 hours before it was gone.)

Oxycodone. Aprial 10th I had oral surgery. I drank drano at 3 yr old and had false teeth shortly thereafter. I was told I would have gum and teeth problems as I got older. I am 62.

After they took the skin off the roof of my mouth and sewed it to my gums, I was in some pain. THEN I had many days with between 3 and 5 different "toothaches" (if singular can be written as plural while implying plural .... I took Oxycodone.
I talked to my Pain Med doctor's nurse, who has seen me for many months. She said fine, we can double your oxycodone dosage for a couple or three weeks. The teeth hurt pretty bad, and the other parts weren't any joy either. Around May 1st everyone seemed to feel I had another problem. They found I needed a root canal. May 9th they did the root canal, and by the way, your jaw is infected, along with the soft tissue. They put me on heavy antibiotics and within a week or so I felt much better.

THAT is the background. Around May 1st my Medic Alert dog alerted and I woke up, finding her licking my face. May 5th, I was still on 45-90mg of Oxycodone a day, depending on how much pain I was in. On May 5th my wife was alerted by my Medic Alert dog that I was not breathing or not breathing "right".
With a friend and my wife trying (he is a retired professional Life Guard), he told me to squeeze his hand and I did. I could not remember how to wake up. I knew they were there. Finally, he put my head back, checked for clear airways and they put me on my M9 oxygen bottle. Titrated at 2LPM. I did not respond. I was breathing so shallow I was not activating it. They changed it to continuous flow and I finally woke up. It took them 30 minutes to wake me. Fast forward about a week and my Medic Alert Dog alerted again. My Ventilator hose, with oxygen inputs, had broken in two. My wife found me, checked the print outs and I was off the ventilator and oxygen for over an hour. I could not wake up again. I had NOT taken Oxycodone in a few days, but they are thinking the residual from taking so much over 30 days may have contributed.

I normally don't use it every day. And when I do it is 30mg a day maximum. OK, 45mg once or twice.

Two nights ago, Restless Legs Syndrome struck with a vengence.
I had tried cutting back on the 900mg of Neurontin I take each day. I am trying to find a maint. level. I had friends in from out of state and I was supposed to take them sight seeing the next day. I took 7.5 mg of Oxycodone to nail the RLS and it did it again. When I checked my print out the next day, I was in solid apnea for about 30-40 minutes when I got back on the Ventilator. The machine initiated a lot of the breaths, most I guess.

7.5mg of Oxycodone did that. BTW, I have CCHS, since birth.
My CNS does not tell me to breathe all the time. I was on my right side when my wife and Medic Alert dog found me in bed.
I was not responsive, so she reconnected the machine (and oxygen) to me and I soon came around. Two years ago I did not have this problem. A year ago I did not have this problem with Oxycodone. 6 months ago I did not have it, but I used quite a bit (for me) for a month and this started happening.

I am a bit confused because I was told you can take Oxycodone 4 times a day (total of 60mg a day for me). I thought I understood it was good for about 4-6 hours.

I wonder what the chances are I have accumulated Oxycodone in my system? I understand every single body is different. BTW, my Avinza is down from 180mg a day to 30-60mg a day. I want the lowest possible dosage I can take. My memory ... is a memory. Pretty bad. Short term is not there at all. I can be talking to you and if a person walks by, I look at them and turn back to you, I won't know what we were talking about.

I saw one of the best Neurologist's in our area this morning, expecting a miracle, and did not get it. He locked in on RLS but tested me for several things in the office, then told me if the Neurontin is working in such small doses, take it. The whole 900mg a day. THAT IS a small dosage. CCHS is a Pulmonary problem. WHAT??????????????????????????????

My Pulmonologist is aggressively attacking CCHS and some other problems, but CCHS is the brain and CNS. Go figure.

SO -- Does Oxycodone accumulate? I read it is 3 to 4 times stronger (oral) than Morphine. I guess I will be VERY careful with the Oxycodone. YOU watch your intakes too.