Re: Frustration and Ultram to Bob

[Guest guest]

Dear Bob,

You said that you're already using 100 mgs. duragesic with percocet for

breakthrough, about 6 percocet a day. Has your doctor been willing to try

any other meds for breakthrough, such as morphine or oyxcodone? Is he

willing to try that or does he want all of that to be done at the pain clinic?

I was on a 50 mgs. duragesic patch with up to 80 mgs. percocet for

breakthrough. I'd been taking percocet for the last two and a half years and it

seemed that I'd just reached the point that it wasn't doing enough for me. So

then my doctor switched me to 20 mgs. oxycontin every 12 hours, with the 50

mgs. duragesic patch and 5 mgs. oxycodone IR for breakthrough. That didn't

work, the breakthrough meds still weren't doing anything and I was having

daily occurances of severe breakthrough pain.

When I went to the new pain management clinic, the doctor there said that it

wasn't standard practice to prescribe two different long release medications,

like the duragesic and the oxycontin, that it would be better to increase the

dosage on whichever of the two that seemed to be working the best for me.

So he made the decision to increase the duragesic patch up to 75 mgs., and

switched me to morphine, 15 mgs. for breakthrough. I was still having

occasional breakthrough and when I did, the 15 mgs. of morphine wasn't

stopping it. So now he's upped the morphine to 30 mgs, up to 3 times a day.

I've found that I haven't needed to take this much though, I seem to be able

to get by with just one dose of 30 mgs. morphine for BT, the increase in the

duragesic seems to be working well.

Any chance that your doctor could try an increase in your duragesic up to 125

mgs before he sends you to the wolves? Trying to get the patches to work

for 4 days is futile. Although they are designed to last for 72 hours, I find

that

they start to diminish late on the end of day 2. By day 3 they are not as

effective as the first day. Additionally, the residual effect of the medication

from the patch only stays in your system 17 hours or less after 72 hours. So

coverage for a 4th day just isn't there. I've found a lot of other people that

say that they really only get 48 hours of effective coverage with the duragesic.

I do notice a reduction in their effectiveness on day 3, but have been able to

tolerate it.

Ultram can be effective for some people, and I do know of several people that

use it, but they are usually just diagnosed and not in advanced stages of CP.

It doesn't seem to be that effective for anyone with more severe damage.

One question I didn't understand, were you asking whether there was a

connection with steroids and CP, or diabetes and CP? I don't know about the

steroids, I've not had any experience with them. But undoubtedly, yes, there

is a connection between diabetes and CP.

I still think, and this is just my opinion, that if you aren't getting the help

you

need with your current doctor, that you need to find another one. It might be

easier to find another job if you were feeling better. And you won't be feeling

better until you get the treatment you need to keep you out of pain and able

to function effectively.

With hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina

SC & SE Regional Rep.

PAI, Intl.

http://www.pancassociation.org/anthology.htm#Heidi

Note: All comments or advice are personal opinion only, and

should not be

substituted for professional medical consultation.