Re: out of oxycodone/Gabapentin

[Guest guest]

I agree with Bennie, Gabapentin does give you that memory fog feeling which I

don't care for.  My new Oregon insurance won't give me oxycodone which did help

me before my insurance changed.  I have nerve pain and have a limp when I walk

(sciatica) also.  My doctor is trying me on Gabapentin 300 mgs twice a day. 

 

Note:  If I go somewhere I will not take that medicine until I am on my way home

and do not really have to be clear headed....sad to say.  I really can't say for

sure if it is doing me any good yet though.  I guess I will keep using it for

awhile to see if it works as it is still new to me.  I do not want to go up in

mgs yet because withdrawals can be hard I hear.

 

Hang in there Kitty, keep us up on things, ok?

 

gentle hugs, Coleen

>Bennie wrote:

Kitty,

Gabapentin is known for giving " memory fog "

[Guest guest]

I have had nerve pain down my left leg for 20 years. I see a pain doctor, he

tried to get the wire in for a stim, but couldn't. So for 4 years, I have been

on 900 mgs of gabapentin 2 times a day and 1200 at bedtime. Along with 2 other

drugs. When I talk about it or have my attention drawn to it is the only time I

think about it now. It no longer controls me as it did for so long. My

depression is better, because of this. I have a cage plus rods in my back.

Rosie in Iowa

Coleen wrote:

I agree with Bennie, Gabapentin does give you that memory fog feeling which I

don't care for.

[Guest guest]

Coleen wrote:

> I agree with Bennie, Gabapentin does give you that memory fog feeling which I

don't care for. My new Oregon insurance won't give me oxycodone which did help

me before my insurance changed.

Hi Coleen

Generic Oxycodone is quite inexpensive. You may be able to afford it

without your insurance. I've found that several medications are actually

very low priced. Phone around to a few pharmacies. Let them know your

insurance doesn't cover it. You may find quite a reasonable price.

Also, those free discount cards for lower costs for meds actually work.

Ask the pharmacists what discount cards are available and where to get

them.

I read your comment about trying to lose some weight. It all boils down

to calories in - calories out. If you're eating more calories than you

are burning, you'll gain weight. I kept a list for a while of

everything that went in my mouth. That including tasting things as I

was cooking them. It's amazing how the calories add up.

I'm a chocoholic too. I finally decided that I could have one rich

chocolate treat per week. I chose my favourite microwave brownie recipe

and instead of using all the butter it calls for, I cut it in half with

unsweetened apple sauce. Still makes a great brownie. From the time I

start making it until it's cooked and the dishes are done is about 10

minutes. 15 minutes if I poke along. I get my chocolate fix and it's

quick, tasty, and not much mess to clean up.

With a little shake of cinnamon added, the leftover applesauce makes a

tasty, low cal treat.

Lyndi

[Guest guest]

thank you to everyone who responded. things are ok. not great, but better than

expected.

I woke up early this morning and immediately had a sense of

dread/sadness/depression. I have no idea why. if I had a nightmare I don't

remember. Might be from lowering my Gabapentin or stopping the oxycodone.

Anyway, the feeling has hung with me all day so I'm distracting myself with a

Law and Order marathon. Also super achey so I'd be lying around anyway.

I did call my physiatrist to see if i could get an earlier appointment but no

go. just need to make it to Thursday. I am prescribed a large amount of

Gabapentin (4200 mgs.) and a relatively low amount of Oxycodone (don't feel

comfortable disclosing that). I can't take Oxycontin as I have absorbtion

issues. Whether I take oxycodone or oxycontin they only last in my system 2 hrs.

Honestly, I don't think my doctors are uneducated or bad doctors per se. The

stigma attached to narcotics here is bad. Sometimes I think of moving down South

because I know how much " looser " they are with prescriptions. Hey, if junkies

are getting scripts there so should I.

, you have put it in my head that I should actually be going up on the

oxycodone and I will try to broach the subject. I wonder if there is a point at

which I would be pain free?

[Guest guest]

Now that is one of the best questions ever ' Will I ever get to that point of

being pain free?' Im sure everyone that has Fms and other pain sydromes ask

themselves that question every day. I have always been a pusher of my body so

have a tendancy to push it and end up in a day or two of pain to much to bear, I

take my little oxycodone 5 mg and my combo headache pills and lay on my body

vibe pad and hope it will get to the point I can get up an move around soon.

[Guest guest]

Louisiana is a bit more loose than TN. The opiate use is making headlines

and I find doctors all over are cracking down.

Ellen in TN

> Kitty wrote:

> Sometimes I think of moving down South because I know how much " looser " they

are with prescriptions

[Guest guest]

I can't believe your insurance refuses to pay for generic oxycodone. My

insurance pays $50/month for 150 30mg pills. Oxycodone isn't as cheap as

methadone, but it is still relatively inexpensive.

Did your doctor request prior authorization? Or, send a letter of medical

necessity.

Steve M in PA, age 22

" I know pain. You think you can handle it and one day you can't. And when that

happens, you either find reason to go on, or you don't. " -House MD

> Coleen wrote:

> My new Oregon insurance won't give me oxycodone which did help me before my

insurance changed.

[Guest guest]

Hi Lyndi,

 

I hate to ask but aren't you the same Lyndi that was/is on the kickbutts or

something like that group?  A group for quitting smoking?  I am still not

smoking and it is probably partly because I live with a non smoker, my s.o.,

plus it hurts my back when I cough.  How are you doing?

 

Also, I don't believe I knew there was a generic to oxycodone, gosh, it has been

so long it seems since I was taking those.  What is the generic, or I can try

and look them up.  I do tend to get frustrated easier sometimes.  I have been

putting up with chronic pain or all these years.  I just don't go out much.  I

do go around our place here slowly and carefully in case my sciatic decides to

act up which it has in the past and hurts like heck.  So I do walk/limp around

some <smile>

 

Thank you for the eating ideas.  I have been chewing bubble gum a lot, I like to

pop bubbles, and I think it is driving my s.o. crazy so I pop them quietly. We

live in a 30 ft 5th wheel trailer so it gets a little difficult when it is cold

outside and we are in our own spaces. Living room &  upstairs bedroom are our

two getaways.  I lie on the bed with 2 pillows between my legs now as my

sciatica gave me fits the other day, seriously. Scary.  Getting better now.  I

will ask the doctor about MRI tomorrow and if I qualify.  I will probably have

to find out myself as that is what she usually says.  Why can't they tell you

what your insurance will do.  I know, because they have too many patients and no

time and also do not want to be liable for the information they give you.  

 

Thanks Lyndi for everything, gotta go for now, gentle hugs, Coleen 

ps. am I in a memory fog or clue me in on generic oxycodone, thank you Dear.   

> Lyndi wrote:

> Generic Oxycodone is quite inexpensive. 

[Guest guest]

 

Also, my doctor is not a pain management doctor. The Oregon Health Plan Plus has

changed a bit and I also live on the southern Oregon coast.  I would probably

get better assistance if I moved inland and closer to a big city. 

 

I went to a different doctor's office before Oregon's health insurance changed. 

That was a few years ago.  I was presccribed oxycodone 5 mgs.  At least I could

move around in less pain and do a few more things.  Now I just manage.  My legs

drive me crazy with pain sometimes.  That is why she prescribed gabapentin

300mgs. twice a day.  I do not take it if I go out because of the memory fog. I

did not like methodone. 

 

I am on OHP Plus, (DOCS).  I am on Medicaid.  They have really been careful

about giving out opiates.  I need something done for my back pain.  Maybe the

vitamins will help.  My doctor is new here and needs to learn more about patient

help.  She goes from one patient to the next all day.  She says they prefer less

paperwork now so they write few prescriptions.  Instead, the doctor has you call

your Pharmacy and have them fax your doctor with the prescription you need. 

I like the old fashioned way with the rx script in my hand.

 

Yes,  I was paying like $13 for my oxycodone years ago.  I still have to find

out about this generic oxycodone. There must be an email here about it.

 

for now, take care, Coleen

 

> Steve M wrote:

> I can't believe your insurance refuses to pay for generic oxycodone. My

insurance pays $50/month for 150 30mg pills. Oxycodone isn't as cheap as

methadone, but it is still relatively inexpensive.

[Guest guest]

I thought oxycodone was the generic

> Coleen wrote:

> I still have to find out about this generic oxycodone.

[Guest guest]

> Lyndi wrote:

> Generic Oxycodone is quite inexpensive. You may be able to afford it without

your insurance. I've found that several medications are actually very low

priced. Phone around to a few pharmacies. Let them know your Insurance doesn't

cover it. You may find quite a reasonable price. Also, those free discount

cards for lower costs for meds actually work. Ask the pharmacists what discount

cards are available and where to get them.

All,

Gabapentin also causes that hormonal type weight gain like lyrica does and they

both have the same chemical composition, I just don't gain as much as I do from

Lyrical.

I get those fat fingers and swelling with Gabapentin but not as much as Lyrica

did for me, I gained thirty pounds in one month (it is not liquid swelling that

you can pee off) and it took eight months to get it off.

Topomax which is not as effective causes weight loss and I have taken that and

it did help but was not as effective.

As far as getting payment for your medication, each manufacture has an

assistance program

Address: c/o Express Scripts SDS

PO Box 66547

St. Louis, MO 63166-6547

Phone: 1- Provider Phone:

Fax: Website: Program Website

ELIGIBILITY

Eligibility Info:

• Patients must not have insurance coverage and meet program income guidelines

which are not disclosed.

• Any patient who is denied assistance may submit an appeal, including patients

with insurance, those who qualify for Medicare Part D but did not enroll and

patients who are in the Medicare Part D coverage gap.

https://www.rxhope.com/pap/info/paplist.aspx?drugid=1887 & fieldtype=drugid has a

link to apply online and this is their information:

Purdue Pharma Patient Assistance Program

PO Box 66547

St. Louis, MO 63166-6547

Phone :

Fax: n/a

Eligibility > The patient must have no insurance and have an income at or below

200% of the Federal Poverty Level. The patient must also be a US resident. Who

Can Apply > The doctor/doctor's office should call for an application. Required

> The doctor must fill out a section, sign the application and attach a

prescription.The patient must fill out a section, sign the application and

attach proof of income and proof of residency. Supply > Up to a 30-day supply

Ship To > Patient's home Note > The doctor/doctor's office should call for an

application. Includes Support for This Drug

NOTE: Linked drugs are available for Prescribers to Apply Online now.

Click drug logo or drug name to start online application.

I hope this helps and your Doctor should know of assistance programs as the

pharmaceutical representatives come around all the time and should have that

information also. When I sold medical supplies I had to compete with the reps

and they were always young, good looking, and really short shakers and I was

older, heavier, and wore pant suits but I could answer medical questions

better(I am kidding here) better than them.

I love Lyndi's recipe and I got some of the same recipes and we made mashed

potatoes out of cauliflower and use butter buds (a powder),cottage cheese in

lasagna and other cheese recipes, and applesauce for sweeteners.

Hope you get help Coleen. Let us know what you find out. Bennie

[Guest guest]

> Kitty wrote:

> Honestly, I don't think my doctors are uneducated or bad doctors per se. The

stigma attached to narcotics here is bad. Sometimes I think of moving down South

because I know how much " looser " they are with prescriptions. Hey, if junkies

are getting scripts there so should I.

Kitty,

Dun ta Dun DA repeat, my favorite song of Law and Order, I am fanatic and I miss

Lenny's quips so much, he was one in a million. Did you not talk to you Doctor's

Nurse and tell her what is going on ? My Doctor's Nurse takes messages and

tries to assist. Wow, you do take a large amount of Gabapentin and I imagine

you are having some of the side effects.

Have you thought of doing a short term pain dairy so your Doctor can see your

pain levels and the medications response? I feel that handing a written account

to a Doctor and asking them to place it in your medical records prompts them to

be more receptive to your requests. American Pain Foundation has a great pain

notebook.

Below is the information on it and some other publications that can help such as

dealing with your Doctors. Check it out and let me know what you think and Good

Luck on your appointment.

Also, there is actually no level for opioid that are considered to be " too much "

but Doctors choose in their head. Morphine is 1600 mg per day but new state laws

in Washington state and Arizona and other states are considering because a group

of Medical Directors suggested best practices is that it should be 120 mg per

day so I could not take the additional amounts I was given if I lived there and

ironically Oregon states you can get " double prescriptions " to kill yourself if

you want to. Kinda reversed, isn't it. Bennie

Bennie

•

• [PDF]

The Target Chronic Pain Notebook - American Pain Foundation

www.painfoundation.org/learn/publications/files/TargetNotebook.pdfSimilar

File Format: PDF/Adobe Acrobat - Quick View

Founded in 1997, the American Pain Foundation (APF) is the nation's leading ...

This easy-to-use Pain Notebook was created to help you record your pain ...

• Publications - American Pain Foundation

www.painfoundation.org/learn/publications/Cached - Similar

The Pain Notebook helps you maintain a record of your pain and communicate your

experiences. It's extremely useful when discussing levels of pain, response ...

[Guest guest]

> S wrote:

> Now that is one of the best questions ever ' Will I ever get to that point of

being pain free?' Im sure everyone that has Fms and other pain syndromes ask

themselves that question every day. I have always been a pusher of my body so

have a tendency to push it and end up in a day or two of pain to much to bear, I

take my little oxycodone 5 mg and my combo headache pills and lay on my body

vibe pad and hope it will get to the point I can get up an move around soon.

All,

The Intractable Pain Patient's Handbook for Survival by Dr. Forest Tenants

discusses pain enhancers you can take to make your pain medication more

effective and is a good read.

See below for link:

The Intractable Pain Patient's Handbook for Survival

pain-topics.org/pdf/IntractablePainSurvival.pdfSimilar

File Format: PDF/Adobe Acrobat - Quick View

This Handbook was written to provide intractable pain patients and their loved

ones.

I copied some of the exerts that explain some ways to help reduce pain (Notice

the Vitamin D).

Consequently, IP patients must develop a program to prevent tooth decay and

osteoporosis. Here are measures you must take to best reduce the severity of

tooth decay and osteoporosis:

1. Keep your pain controlled so that your pulse, blood pressure, and hormone,

blood levels are normal.

2. Brush and/or floss teeth daily and rinse often with a mouth wash. Vigorous,

periodic, dental cleaning by your dentist may help.

3. Reduce sugars in your diet, particularly drinks that contain carbohydrates

(sugars). Follow the reducing diet shown in this Handbook if you are overweight.

4. Take these supplements daily: Calcium – 1000 to 1200mg Vitamin D – 600 units

Magnesium – 500mg

POTENTIATORS: WHAT ARE THEY AND HOW TO USE THEM

The term " potentiator " is one used by physicians and pharmacists to indicate

that one medical agent makes another more " potent. " Here, we are talking about

agents that make opioids act stronger and last longer. Potentiators allow less

opioid to be used and lessen their complications. In this day and age of cost

cutting most IP patients will have to learn to use potentiators because

insurance plans will not pay for the most effective opioids.

Additionally, when you wish to decrease your opioids or attempt to withdraw, you

will need to use a lot of potentiators. Common agents which potentiate opioids

and which are commercially placed in some opioids are: Caffeine, Aspirin,

Acetaminophen, and Ibuprofen. For example, Vicodin®, Percocet®, and Darvocet®

contain acetaminophen. Fiorinal® contains caffeine and aspirin. Vicoprofen®

contains ibupro- fen.

Other agents including some muscle relaxants and stimulants potentiate opioids.

IP patients should take a variety of potentiators to determine which ones make

your opioid more effective. IP patients must especially learn to take a

potentiator with their breakthrough opioids since a potentiator can help break a

flare. Here is a partial list of some potentiators which may boost your

breakthrough opioid:

Caffeine Tablet Dexedrine Acetaminophen Phentermine Midrin® Aspirin

You should systematically try potentiators one at a time to determine how best

to control breakthrough pain without the benefit of expensive commercial opioid

preparations such as fentanyl (Actiq® or Fen- tora®).

THE TYLENOL® PROBLEM

Tylenol® is acetaminophen. It is an effective opioid potentiator, and it is

found in many popular opioid formulations (see Table).

As long as patients do not take over about 4000mg a day of acetaminophen, it is

safe to take. Acetaminophen daily dosages above 4000mg a day may cause liver or

kidney toxicity. The maximal dose of Norco®, for example, is 12 tablets a day.

IP patients should know which opioid-acetaminophen combination works for them.

The combination agents are relatively safe and inexpensive as long as the 4000mg

a day level is not exceeded. When a IP patient wishes to reduce or withdraw from

Step Two opioids they should switch from a pure opioid drug such as

hydromorphone (Dilaudid®), Oxycodone (OxyContin®), or methadone (Dolophine®) to

a Step One opioid that contains acetaminophen.

DIET: PROTEIN IS YOUR BEST FRIEND

Protein is comprised of about 25 different amino acids. The body takes amino

acids and uses them individually or in a grouping (i.e. molecule) for various

pain control functions. For example, endorphin, which is the body's natural pain

reliever, is a grouping of about 17 of the 25 amino acids. There are at least 6

single amino acids that the body uses for specific functions to control pain.

Shown here is a Table of these, because IP patients must eat some protein foods

to obtain enough amino acids for the body to effectively control pain. Do not

expect your prescription opioids and other medications to work very well if you

do not take in enough protein or amino acid supplements. Amino acids can be

purchased in most any health food store or through catalogs.

Please note the above list does not include vegetables or nuts. Why? While some

vegetables and nuts contain as much as 30% protein, they will not, by

themselves, suffice to meet the amino acid requirements of an IP patient.

Early morning is the most important time of day to eat protein. If you prime

your body with protein early in the day, you give your body enough amino acids

to allow your opioids and other medications to optimally work. Early morning

protein is also a key to weight control. Simply put, you must prime your body

each morning with protein. You should consume protein within 2 hours after you

awake each morning.

What if you just cannot stand protein foods or eating early in the morning? Get

over it. Think of early morning protein as a medicine; not food. Forget the

taste – go for the medicinal value. As a substitute or partial substitute for

protein foods, you can obtain the amino acids you require by using protein

powders, capsules, or drinks which you can purchase from about any pharmacy or

health food store. Just make sure you take them early each morning.

Another thing to consider is cholesterol and triglycerides. Sugars, starches,

and fats are all converted by the body to cholesterol and triglycerides. While

the fat in beef or bacon will raise triglycerides there is little fat in chicken

or fish. The cholesterol in eggs is dissolved by stomach acid, so the scare over

eggs causing your cholesterol to rise is a myth. Poor pain control raises your

cholesterol and triglycerides be- cause severe pain causes the adrenal glands to

secrete excess cortisol. Although research is early, the high levels of

cholesterol and triglycerides found in IP patients undoubtedly causes heart and

stroke complications.

SINGLE AMINO ACID

Gamma Amino Butyric Acid Glycine Taurine Phenylalanine & Tyrosine

Tryptophan

PAIN CONTROL FUNCTION

Prevents pain transmission along nerves. Activates pain control in the spinal

cord. Activates pain control centers (receptors) in brain and spinal cord.

Produces adrenalin, noradrenalin, and dopamine that control stress, and provides

energy, fights fatigue, and prevents depression.

Produces serotonin which promotes sleep, enhances self-esteem, and prevents

depression.

PROTEIN FOODS

An IP patient needs to eat some protein 3 times a day. Here is a list of protein

foods which is defined as over 50% protein by weight:

Chicken Turkey Cheese Pork Lamb Eggs

Beef Fish / Seafood Cottage Cheese

There is also a section on a weight reduction diet and other support issues. I

hope you take the time to read it and let me know what you think. I read and re

read it often. Bennie

[Guest guest]

> Ellen wrote:

> Louisiana is a bit more loose than TN. The opiate use is making headlines and

I find doctors all over are cracking down.

>> Kitty wrote:

>> Sometimes I think of moving down South because I know how much " looser " they

are with prescriptions

All,

Check out the State Pain Laws, especially Washington states and the laws they

recently past going into effect this year. Limits dosages on opioids on non

cancer patients and I think this is discriminatory as I believe I hurt as bad as

cancer patients and I make this remark with no disrespect to cancer patients and

my Doctor tends to agree and I don't think the pain scale states pain is only

valid in cancer patients. If so, why do they even ask non cancer patients their

pain level. It makes no sense. Bennie

[Guest guest]

Good point, Bennie!

> Bennie wrote:

> Check out the State Pain Laws, especially Washington states and the laws they

recently past going into effect this year. Limits dosages on opioids on non

cancer patients and I think this is discriminatory as I believe I hurt as bad as

cancer patients and I make this remark with no disrespect to cancer patients and

my Doctor tends to agree and I don't think the pain scale states pain is only

valid in cancer patients.

[Guest guest]

I took NO disrespect from your statement and I don't think any

reasonable person should either. You are ABSOLUTELY CORRECT,

non-cancer pain patients are discriminated against. Nerve pain

disordered, like RSD/CRPS are MORE PAINFUL that cancer pain.

I've had fibromyalgia since childhood (toddler) and developed cancer

pain in recent years. I thank god that I am able to get the treatment

that I do. My doctor (PCP) was willing to put me on Duragesic patches

for my fibromyalgia pain after I had a bad reaction to MSContin. That

was after a year and a half of being on hydrocodone and oxycodone

(switched between the two). No one would help me with my pain (or

headaches) as a child or a teen, but they prescribed me Vicodin for

the first time WITHIN a week of my turning 18. Not only that, but THEY

SUGGESTED IT. I'm lucky that the pain wasn't 24/7 until I was almost

19. When I got a break from the pain, it was A LOT easier to deal

with, even without treatment (I tried EVERY non-pharmaceutical

treatment and non-opioid treatment to no avail ).

My pain management doctor actually focuses A LOT more on my

Fibromyalgia pain than my cancer pain, but he specializes in

Fibromyalgia, CRPS/RSD, nerve pain, and other NON-cancer pain. I'm

really lucky to have him.

If I didn't have cancer, I wouldn't have access to Actiq, which is the

ONLY thing that helps when I have a significant pain flare. Without

cancer, I don't think I'd be able to keep living like this. It is

incredibly unfair that Actiq (and it's generic OTFC), Fentora,

Onsolis, Lazanda (nasal spray), and Abstral are only approved for

cancer pain. Many doctors used to prescribe them off-label, but now

generic Actiq costs $30/lozenge. BRAND name Actiq started out UNDER

$5/lozenge when it was introduced. When the manufacturer jacked up the

price (fentanyl citrate has no real competition, no other drug works

as fast or is as stronger, other fentanyl prodicts are the only real

competition). My PM doctor told me that Cephalon applied for 20-30

indications for Actiq and the FDA would only approve it for cancer

pain, which was not that big of a deal, until insurance companies

refused to pay for off-label use. Every other opioid is approved for

" pain " , I have NO IDEA why Actiq was limited to " cancer pain " . Sorry

for my mini-rant, but I do feel that it ties into what you said.

BTW- untreated pain can and does cause brain damage and shrinkage, so

the next time someone tries to tell you to just deal with it, remember

that. Also, once pain is untreated for one year, the way your brain

receives and interprets pain is PERMANENTLY altered and becomes its

own source of pain.

Steve M in PA

Cancer (brain) Patient with childhood Fibromyalgia

All,

Check out the State Pain Laws, especially Washington states and the

laws they recently past going into effect this year. Limits dosages on

opioids on non cancer patients and I think this is discriminatory as I

believe I hurt as bad as cancer patients and I make this remark with

no disrespect to cancer patients and my Doctor tends to agree and I

don't think the pain scale states pain is only valid in cancer

patients. If so, why do they even ask non cancer patients their pain

level. It makes no sense. Bennie

[Guest guest]

You can see the hysteria playing out in your daily newspaper about

prescription drug abuse. The problem, of course, is that pain patients taking

these drugs (Vicodin, Oxycontin, etc.) are being tarred with the same brush as

these miscreants who are out there robbing and hurting people, driving while

high and holding up pharmacies. We've had a few high-profile cases here on Long

Island recently that were just tragic.

I feel as badly about these incidents as anyone else, but I can't help being

reminded of Prohibition by the way the press covers these stories. Tighten up

restrictions on access to pain medication all you want - that alone is not going

to stop criminals from holding up pharmacies! By definition, criminals don't

follow the law.

I don't want people abusing drugs or becoming addicts, either, but I do not

believe that the solution is to demonize the drugs themselves.

> > Bennie wrote:

> > Check out the State Pain Laws, especially Washington states and the

> laws they recently past going into effect this year. Limits dosages on

> opioids on non cancer patients and I think this is discriminatory as I

> believe I hurt as bad as cancer patients and I make this remark with

> no disrespect to cancer patients and my Doctor tends to agree and I

> don't think the pain scale states pain is only valid in cancer patients.

[Guest guest]

You've got that right!

Will you run for office???

Ellen in TN

> L wrote:

> You can see the hysteria playing out in your daily newspaper about

> prescription drug abuse.

[Guest guest]

This is what happened to me. My doc cut me from roxicodone to morphine, a

50% drop. And then further cut the number of pills by 25%. Meanwhile my mri

showed that I went from bulging disc and spinal stenosis on 3 levels to 4

levels of bulging discs and spinal stenosis. I am in constant pain all of

the time and I feel locked in to this doctor.

[Guest guest]

You indicate that you feel locked into your doctor. Are there others available?

Can you bring someone that sees you in pain to go with you to your next

appointment?

I went to my sister's doctor and told him how I had to rescue her from that the

deli counter at Wat-Mart. She had a back spasm and called me to get her.

Have you tried keeping a pain log? If you keep track of the type of pain -

burning, dull, stabbing etc. and severity one to ten on pain scale, as well as

triggers and what alleviates in forms of Rx, therapy, ice, heat, etc. that may

give the doctor a concrete document to cover his butt.

I find doctors reluctant to prescribe because they are afraid of retribution if

something were to happen to you.

I personally would not feel trapped to one doctor. Not getting proper treatment

is akin to abuse in my humble opinion.

If my options were limited, then I would be honest and tell him/her that I

wanted a second opinion because I felt I was in too much pain for too many days.

I would put it in writing to both doctors so it doesn't appear you are doctor

shopping in order to get drugs.

This is USA and we have the right to seek proper medical attention.

When I had to switch doctors on a temporary basis, I documented exactly why I

had no problem switching.

Ellen in TN

[Guest guest]

I agree 150%! I hate it when others make comments on pain meds cause addiction.

I try and educate them to the proper function of medications. Technically any

medication can become addicting if the person comes to believe that they can not

function without it and they can. The difference I explain is that chronic pain

patients do not take the medications too escape life harshness. They take it to

help keep the pain at a manageable level so they can participate in life.

I can see the surprise in their eyes when they hear that. Ignorance breeds

fear. Fear breeds attempts to irrationally control a situation and poor

choices. We need to educate doctors as well as others. If for no other reason

than to keep open the opportunity to have pain medication as a treatment choice.

Wishing all a manageable day. hugs, Tami

> wrote:

> I don't want people abusing drugs or becoming addicts, either, but I do not

believe that the solution is to demonize the drugs themselves.

[Guest guest]

Scary, isn't it? Don't you sometimes (OK, OFTEN) feel like you're

personally in the cross-hairs with the current painkillers-are-evil

mentality that is so pervasive today?

There's a prescription database in New York that is run by the state

that is designed to catch people who doctor-shop for prescriptions, or who go to

different pharmacies either with forged prescriptions or fake names. One of the

problems with it, according to a fairly recent local newspaper story, is that

most doctors don't use it. One of them was quoted as saying (and I paraphrase)

that the database is hard to use and that it is not updated frequently enough to

be useful. The slant of the story, especially if you just read the headline, was

that it was the doctors who were at fault for not using it. While that may be a

part of the problem, it's equally likely that a large part of the problem is

exactly what that one doctor said. So find out exactly why most doctors are not

using it and make it better!

And guess what - it still won't stop bad people from doing bad things in any

case. I would hazard a guess that aguy robbing a pharmacy for

Oxycodone is not greatly concerned with a database. Criminals exist -

get used to it. You can minimize crime, but eliminating it is a pipe dream.

There are no easy answers, but the current " war on drugs " CLEARLY is not

working. When you read about these drug cartels and how they murder and cause

all sorts of mayhem, doesn't it remind you of all the stories you've read and

all the TV shows you've seen about the rise of organized crime in the 1920s? If

alcohol had not been made illegal by the 18th amendment, the whole foundation of

these criminal enterprises would not have existed and organized crime would not

have grown in scope to the size it has. And now we're replaying the whole story

all over again and insisting that somehow things will work out differently this

time. Oh yeah, how so? As has been said, " Insanity is doing the same thing in

the same way and expecting a different outcome. " As has also been said, the road

to you-know-where is paved with good intentions.

And all this from a guy who went through adolescence in the '60s and has NEVER

used ANY recreational drugs EVER.

Not running for office, but my 2 cents anyway

> Ellen wrote:

> Will you run for office???

[Guest guest]

wrote:

> Scary, isn't it? Don't you sometimes (OK, OFTEN) feel like you're

> personally in the cross-hairs with the current painkillers-are-evil

> mentality that is so pervasive today?

I so completely agree. When my Internist sent me to the pain

management (ha ha) doctor for my Crohn's flare up, the pain management

nurse entered all my drugs into the computer and next to them under

the reason for taking them wrote " pain " . I take over a dozen pills a

day for my heart and Crohn's disease and only one for pain.

The computer form listing my " pain drugs " was forwarded to the state.

I spoke with the doctor about it and he said not to worry, that they

could tell that I wasn't abusing my nitroglycerin or things. I told my

Internist, who had prescribed the meds for heart and Crohn's and he

almost released me from his care. Can you believe this nonsense?

I'm still waiting for the narcotics people to bang our front door in

because of the heart and Crohn's gut meds I'm on - and the one, 50 mg

tablet of Tramadol I take 4 times daily.

The USA law makers have gone a little crazy over this stuff, in my opinion.

Every time I get my tramadol refilled, I have to get " counseling " from the

pharmacist where she asks me why I'm taking it, have I tried getting off, have I

tried something over the counter, all this other silliness in front of other

patients who are waiting in line for their interrogation by the narco squad

pharmacist.

Jeanne B in Georgia

[Guest guest]

That is insane! Ultram (tramadol) is not even a controlled substance.

It isn't even a true opioid. It is primarily an anti-depressant.

Opioids like morphine (CII), codeine (CIII), oxycodone (CII),

hydrocodone (CIII), fentanyl (CII), and hydromorphone (CII) act

primarily on the mu-opioid receptors.

Methadone (CII) is a full µ-opioid (aka mu-opioid) receptor agonist,

acts on the kappa opioid receptors, and acts on NMDA.

Ultram (tramadol) (Rx) strongly inhibits serotonin reuptake (like

SSRIs), moderately acts on norepinephrine, and weakly acts on opioid

receptors.

Nucynta (tapentadol) (CII) strongly acts on norepinephrine, moderately

acts on opioid receptors, and weakly acts on serotonin.

It is insane to ask someone why they aren't using a non-opioid

medication when they are taking a drug that has almost no opioid

activity. What do they do when you need oxycodone, Duragesic , or

Actiq? I can't believe that a pharmacist counsels you for EVERY

prescription. Do all pharmacies in Georgia do this?

Note: Since tramadol (Ultram) and tapentadol (Nucynta) act on

serotonin, they (especially tramadol) can cause serotonin syndrome

when combined with SSRIs (i.e. fluoxetine [Prozac], paroxetine

[Paxil], sertraline [Zoloft], citalopram [Celexa], escitalopram

[Lexapro], etc) and SSNRIs (i.e. duloxetine [Cymbalta], venlafaxine

[Effexor], desvenlafaxine [Pristiq]). Unfortunately, MANY doctors have

NO IDEA that tramadol is a strong serotonin drug and dangerously

prescribe it with SSRIs and SNRIs without so much as warning there

patients of the possible reaction. If anyone is taking tramadol with

an SSRI or SNRI, please make sure you know the warning signs of

serotonin syndrome and you may want to discuss the possible reaction

with your doctor.

Steve M in PA

>Jeanne B in GA wrote:

The USA law makers have gone a little crazy over this stuff, in my

opinion. Every time I get my tramadol refilled, I have to get

" counseling " from the pharmacist where she asks me why I'm taking it,

have I tried getting off, have I tried something over the counter, all

this other silliness in front of other patients who are waiting in

line for their interrogation by the narco squad pharmacist.

[Guest guest]

Holy cats, Steve M! I had no idea about Tramadol. Oh my gosh. The

kathunk you just heard was me hitting my head on the keyboard.

I'm pretty sure it isn't one of those laws pharmacists are much

adhering to because son is on some major drugs for multiple spinal

fractures without getting lectured. Also positive my doctor hasn't a

clue that tramadol isn't a true opiod because of things he's said

before like already reaching my limit (50 mg 4X daily).

Makes me feel like an addict when the pharmacist insists on going over

all the drugs I get (Asacol, lasix, ranexa, imdural, atenelon,

nitroglycerin, and on and on for Crohn's and heart silliness) while

the rest of the people in line listen so eagerly.

I wish I understood why the government is so involved with our medical

care that our doctors are terrified to actually help us with the pain.

The times I've actually had some relief from the pain I was able to

actually DO things I enjoy, like baking bread, walking the dogs and

working in my big garden. For a while there, I actually thought that

maybe I was an addict because when I got to the last of my 4 days

worth of percocet I cut the dose in half just to try and stretch it

out so I could do more. Then the next day when the pain was back - oh

well, all of you know how that is. You go from being a capable person

who can do what you love or want to do or need to do to someone who

walks like shards of glass are poking you everywhere.

God knows I'd never tell my doctor this because it would only verify

his contention that I'm taking the tramadol because of some need for

it other than pain. The pharmacist would be even worse.

Maybe it will get to the point that if we take pain meds (or wannabe

pain meds), we'll need a court hearing and have to wear a big A for

addict mark on our clothing. I wonder if we'll get our pictures put on

milk cartons - " Here is what will happen to you if you use anything

stronger than the great god Tylenol! "

Just a silly thought, but has anyone else wondered how many

congressmen and senators are getting money from McNeil labs (makers of

Tylenol)?

Yeah, I'm crazy.

Thank you so very much, Steve. It honestly helped.

Jeanne B in GA

> That is insane! Ultram (tramadol) is not even a controlled substance.

> It isn't even a true opioid. It is primarily an anti-depressant.

>> Ultram (tramadol) (Rx) strongly inhibits serotonin reuptake (like

> SSRIs), moderately acts on norepinephrine, and weakly acts on opioid

> receptors.