Re: Help with Pain Meds

[Guest guest]

> rumblefish wrote:

> HI. I've been taking MS CONTIN for past weeks. started out on 15mg 3 x a day.

and nothing. then went up to 30 mg and nothing.

Medications work differently on different people. Some respond to Morphine and

some don't. I didn't respond to anything, all the way up to Methadone. I don't

know why but nothing worked on my type of pain and that is why I don't take

anything now. Why take something if it doesn't work. But there are so many pain

meds out there they should be able to find something for you. If something

doesn't work tell the doctor so you can try something else until you can

tolerate the pain.

No pill will ever take all of the pain away but they should make you comfortable

enough to function. Hang in there, you'll find something.

Darlyene

[Guest guest]

Hi there!

I take both Oxycontin (80 mgs/day), Oxycodone (90 mgs/day) and Gabapentin (2400

mgs/day) for the RSD pain in my foot and ankle.

I've tried a lot of different meds since getting CRPS/RSD. It's a difficult

disease to treat because everyone is different and responds to medications

differently.

I was also on methadone for nearly a year. ly, that was the best med for

pain control that I've ever been on. I had problems with the side effects which

seemed to worsen over time. But should the situation with my current meds change

then I would consider going back on methadone. It's very important to titrate up

slowly with methadone and work very closely with your pain management doctor.

These are all strong meds.

Please keep us informed as to how you're doing and what's working for you

Hugs,

Carol

[Guest guest]

Hello Rumblefish:

I've been on everything you mention in your email at one time or another. They

each affected me differently. For breakthrough pain, Oxycodone was best, but

many doctor's these days are very reluctant

to prescribe it over a long term because of the government.MS Contin didn't do

much for me, likely because I was prescribed a low dosage.

I did take Opana but the headaches I got from it were worse than the neck pain.

I am currently taking what my Dr. said is a relatively new pain medication.

It's called Nucynta. It comes in various dosages. The only side-effect that's

bothered me with taking it so far ( took me awhile to figure out I needed to cut

each tablet in half instead of taking a whole one every four hours ) is it " can "

make me jittery, however it is very effective in controlling the pain.I hope

this helps.

Good Luck,

Keavan

[Guest guest]

Wow Carol,

My pain mgmt. doctor refuses to prescribe anything stronger than Oxycodone. I

have a lot of foot pain with little or no relief. It's very frustrating.

Hugs? I would say kisses but I don't know you (lol).

Thanks for sharing,

[Guest guest]

>Rumblefish wrote:

>does morphine have a different effect on people?

Yes like everything else (I assume). My husband took it when he was in pain and

it worked better than anything. I took it and it had no effect on my pain. Who

knows why, lol

[Guest guest]

> Keavan wrote:

>

> I've been on everything you mention in your email at one time or another.

They each affected me differently. For breakthrough pain, Oxycodone was best,

but many doctor's these days are very reluctant to prescribe it over a long

term because of the government.MS Contin didn't do much for me, likely because I

was prescribed a low dosage.

>

> I did take Opana but the headaches I got from it were worse than the neck

pain. I am currently taking what my Dr. said is a relatively new pain

medication. It's called Nucynta. It comes in various dosages. The only

side-effect that's bothered me with taking it so far ( took me awhile to figure

out I needed to cut each tablet in half instead of taking a whole one every four

hours ) is it " can " make me jittery, however it is very effective in controlling

the pain.I hope this helps.

Keavan,

I understand what you mean, the dosages for Avinza, a timed Morphine, is talked

about in the insert of 360mg and the 3600 mg (up to) and I have seen nurses look

at my dosages and freak out not understanding it is for a 24hour period and the

other concern that some of the state guidelines state that dosages above 120mg

are not guaranteed safe. So a Doctor could tell me he wanted to adhere to best

practices and only prescribe 120 mg. I only take this now, because I titered

myself down but have break thru medication I have to take, so what's the

difference.

So you have the AMDG Agency Medical Directors Groups, advising dosages to

Doctors that are " best practices " but the Doctors do not have to adhere to them

but you have medication monitoring systems, so if you get a Doctor that is

trying to lessen your dose or " nervous " about the dosage amount, this is the

reason.

Even in the AMDG guidelines for Washington state, it says that they advise 120

mg of Morphine but here is a question of the guidelines and their answer:

(June 2010)

How do you know what doses are safe? There is no clearly defined a safe– opioid

dose. The guideline does not say that a dose above 120 mg/day of morphine

equivalents is necessarily unsafe, nor that doses below this are guaranteed to

be safe. Instead, the guideline recommends assessment of risk and benefit of

opioid use for chronic non-cancer pain. Careful attention is urged for doses

above 120 mg morphine equivalents per day if pain and function have not improved

So the insurance companies are also getting this information and they monitor

pain patients " other than cancer " . Now there in itself is a discrimination, some

intractable pain patients can have pain worse than cancer patients and not get

pain medication to control their pain because of these advertisements.

I almost had problems getting my insurance to pay for the Actiq (Gently) for

breakthrough pain but my Doctor had to fill out a form and justify my pain, but

if I had Cancer, I could have it no problems.

Doctors must follow state and federal laws so that is why you have Doctor's not

wanting to get cited or arrested.

This site has database of the state laws : http://www.opioidrisk.com/node/577

: http://www.painpolicy.wisc.edu/domestic/diversion.htm does what is listed

below and explains this system that monitors pharmacies and flags and reports

suspicious prescriptions to the DEA or state.

This website provides updated information about the status and trends of PMPs in

the United States. As of late 2006, 27 states had adopted PMPs to monitor the

prescribing of certain controlled substances and detect illicit prescribing and

dispensing. Typically, PMPs collect prescribing and dispensing data from

pharmacies, conduct reviews and analyses of the data, and make it available

under certain circumstances to regulatory and law enforcement agencies, as well

as practitioners.

I did not mean to get off on this track, Keavan, but I started reading about

this last year and realized the problems Doctors and Pharmacies face. This is

the fact that Doctors start you on lowest doses and have a set limit in their

mind rather than your pain.

Thank Goodness, I have a pain management Doctor that understands intractable

pain. I hope you new medication works. You can see why saying medication rather

that drugs is prudent as " drug " might mean drug addiction and medication

addiction or saying I am on this medication seems less threatening.

Bennie

[Guest guest]

You're so sweet, .

My PM doc is really awesome! He also does the epidural injections in my back

when the DDD flares up. But I can live with the back pain most of the time. My

docs say that back surgery is the only thing that would offer me long-term pain

relief in my back. But there's a good chance that the RSD in my foot/ankle will

spread to my back with surgery. The surgeon I talked to said that he wouldn't

touch me due to the RSD. I agree with him! It's the RSD in my foot that causes

such horrid pain 24/7. But hearing that is nothing new to anyone here! It's so

great having support for you all. I've had some rough days lately and am

spending a lot of time laying down with my foot elevated.

My doc prescribed Fentanyl lollipops for when the pain is so bad that I'm ready

to head to the ER. My insurance will " cover " the Fentanyl, after a

merry-go-round to get approved since I don't have cancer, I " only " have RSD in

my foot/ankle. My copay is $30 PER PILL!!

Thankfully, I will have been on disability for 2 years on July 1st so I'll start

on Medicare! I did quite a bit of looking around and finally signed up for the

Medicare Advantage plan with Secure Horizons. This will save us around

$200/month since I'll no longer be paying such astronomical insurance premiums.

The $115 for Medicare will be deducted from my monthly disability payment!

Hugs,

Carol

> wrote:

> My pain mgmt. doctor refuses to prescribe anything stronger than Oxycodone. I

have a lot of foot pain with little or no relief. It's very frustrating.