I am so sorry to hear this, Debi. I know all too well what uncontrolled pain is like and begging doctors to listen. I am so fortunate to have one that listens now and helps me reach my goals.

What is most disappointing is that according to what I found online in comparison charts, your dose of BuTrans is equivalent to 40 mg ER of Morphine, not 15 mg. Did you by chance ask him what the equivalent was, just to be sure? After all, not all online info is correct. I can't imagine why they would not dose you with an equivalent dose of another medication...just doesn't make sense.

Is there another doctor you can see in the meantime...for another opinion about dosing and/or other options? This guy doesn't seem to be very concerned about your level of pain. I would also ask him (or someone else) about using Fentanyl patch. I know you want to stay away from patches with the pool, but I use a Tegaderm covering over my patch and it NEVER comes off or even starts to lift off after repeated showers, so I don't think the pool would affect it. I can tell you that Fentanyl is highly effective for nerve pain...much more so than BuTrans. So it's worth a try. My pain mgmt doctor was the one that told me how effective Fentanyl is for nerve pain so I tried it and was super happy with the results...without ANY side-effects.

Take a few deep breaths and think about your options over the weekend. Then get on the phone Monday morning and go for it...whether it's a new doctor, or asking about Fentanyl, or considering the Methadone (which does have a lot of potential side-effects).

Please know that we are all hoping you'll have a better weekend and get a better plan next week. keep us updated!!

Debi,

I too am sorry to hear that the doctor does not seem to want to cooperate much with you to try to find some way of lowering your pain levels.

In the past several months I have been on Methadone, Fentanyl patch, MS Contin and now taking all of those out of my regimen since none of them gave good results. I did ok on the Fentanyl but only when on the 50mcg/hr patch along with 4-5 10-325 mg percocets throughout the day. Neither the doctor nor I felt that it was a good idea to keep at that. The Methadone actually helped the most, but gave me breathing problems and irregular heart beat. MS Contin at 30 mg 4x daily gave me absolutely no relief. For all those reasons, we are tapering off of all my meds and starting from scratch.

I hope you and your doctor can make some kind of decision. I know how hard it can be to not be able to do much of anything because of the amount of pain you are in, or how much it will cause your pain to increase if you do end up doing something.

Whatever your choice is, I wanted to at least come over to this section of neurotalk and give you a little of my support. You have given so much to me over the past several months, I wanted to do the same for you.

en bloc and Alaina....I'm still so upset I can hardly think straight.

Feel like I might explode into a million pieces.

My son has been in and out all day checking on me. Bless him.

en bloc....I weight 200 lbs and am 5'6" or 5'7" and have always had a high tolerance to drugs and even novacaine (sp?) when having a tooth filled.

I just need to try and get through this first phase of whatever I'm going through and I know I'll be in a better place mentally.

Thank you both for your messages and your caring.

Debi

We are all here for you to give whatever emotional support we can. Rough times will come and go, but a good friend is always there for you.

Debi, I am so sad to read this. I don't feel like he has given the morphine a chance at such a low dose. I really did feel 100% better when we got to the 30 mg three times a day. Until he has tried this I don't feel like you should have to give up on the morphine,
Like you I am not a small person. I weigh more than you after the past few months of being non weight bearing, but I am 6'2". Now that my toe has healed I need to stop snacking and get some exercise.
There are these arbitrary standards where bells and alarms go off when you get over 100 mg per day of morphine equivalents , but you are no where near this. My doctor has said he can't go up any more, he is just a family doctor, but this is working well for me. I am getting weaker as expected but the pain is controlled.
I have read good things about methadone but it does have more side effects than morphine as mentioned and most importantly I don't think he has given the morphine a fair trial at a strong enough dose. You have had some success with it, it seems logical to stay with it.
Telling you to do less when you feel good is strange when the whole point is to get you back on your feet. You shouldn't overdo things, or have to feel like if you are only going to get one good day you have to pack everything in, but I thought quality of life was the whole point of pain management.
I am so sorry that you are having to deal with this frustration when the answer may be so close and so simple.
I went from 15 mg x 3 to 30 mg x 2 than up to three times a day because it wasn't covering 12 hours. He must know that you can do this. There is a 20 mg but it is much more expensive.
I hope you get more help soon.

Susanne,
I fully agree with you about using the Morphine 30mg's three times a day, along with Oxycodone for break thru pain.

Debi,
I just can't understand this doctor only giving 15mg's to someone that was actually on a higher dose with the patch. It doesn't make sense. While you may like this doctor; it appears he is too reluctant to prescribe enough to cover your pain. I understand not wanting to change doctors; but he does not seem to have your best interest in allowing you to lead a more productive life.

FYI:
I take the Oxycontin ER at regular intervals throughout the day as well as Oxycondone for break thru. I do take the two together in the morning before I get out of bed.(I never looked at this as double dosing.) I have my alarm set in plenty of time for meds to kick in before getting out of bed to begin my day.

Debi, prayers for a less painful day for you.


Gerry

Hey y'all....hope everyone is having a good day

My pain ranges from 6 to 8 resting and goes past 10 if I try to do anything. I was off my feet all day yesterday, picked up my grandson from school (2 blocks away) and drove him by his house (1 mile away) before going home. Not much driving. Came home and got off my feet again. I then helped Christina cook dinner.....on my feet about 30 minutes and that's all it took. I was up and down all night long with my feet, hands and arms and legs doing that deep aching thing.

Enough is enough. Going to write down what we need to discuss and my daughter is going with me. She has seen me everyday since my last visit to my PM dr and she's worried about me. Was so thankful when she told me that and I'm sure you can all understand needing/wanting that verification from someone/anyone !

If he still refuses to raise my 15 mg ER morphine I will agree to go on the methadone (that he suggested last visit) but only if he will raise the dosage if the minimum doesn't work.

That's all I know to do at this point without changing PM dr's. I still am upset that I won't be able to see if an increase to 30 mg ER morphine might help.

He also offered to put me back on the BuTrans and don't get me wrong....I was a heck of a lot better on that than what I'm dealing with now BUT....he knows I'm looking for something that MIGHT work better, be cheaper and not be a patch.

I just think there might be something out there that will get me to the point I was with the BuTrans and possibly better.

As we all know.....we don't know until we try !

Thanks all for your support....very much appreciated

Debi

Dear Debi,

How soon can you get in to see your PM?

March 24th.....2 weeks from today.

I didn't ask the pharmacist about the conversion rate which another poster said was 40 mg of morphine and I'm on 15 mg....but he did say the 15 mg is the lowest dose of ER and it goes up to 100 mg !

To say this is very frustrating is an understatement ! He's always been so helpful to me. All he said was that the 30 mg ER morphine is too strong for me...how the heck does he know ? The 15 mg sure isn't working.

Thanks my sweet friend

Debi

Dear Debi,

I REALLY think your PM needs to justify his statement. For "some", a higher dosage "MAY" be too strong as I am sure it would be for ME since I am VERY sensitive to pain meds. But not everyone is created the same and each person varies in their tolerance to meds.

At the very least, he should allow you to TRY a higher dosage and see how it affects you before just shutting the door on that option.

You said it, "How does he know?" until he allows you to try it.

If he fears you would overdose, then there are ways to handle that possibility.

I strongly recommend you press him on his response and make him EXPLAIN his rationale for his statement.

It is hard to "confront" a doc but you are entitled to answers and explanations.

Just my 2 cents on the matter.

From the peanut gallery that knows nothing.