Mike - pain med answers, maybe

[Guest guest]

Hi Mike,

I also end up writing a book so we are in good company I hope!

As far as the med thing......my understanding is that there is no

threshold on pain meds dosage....that if a lower dose stops

working you can always go up....and that if you increase slowly

like this that the bad side effects become tolerable (like the

respiratory depression). From what I have read, those that are

slowly titrated up can tolerate doses of meds that a naive patient

(someone who hasn't had narcotics) would die from. So

theoretically, there is no upper limit....Now in practice, I am not

sure how that works. I would think that there would come a point

where it is too much. But I also now that there are changes that

can be made with drug combinations or taking a drug holiday or

even undergoing detoxification by going into an induced coma

can all " reset " the bodies response to a narcotic. So I guess that

there are probably ways to address life-long need for pain meds

without hitting the ceiling.

As far as needing to keep your medicine use under your

control...that is a reasonable expectation. My pain doc gives me

the immediate release oxycodone as opposed to the extended

release OxyContin just for that reason. Yes I am on round the

clock meds and at times I think the OxyContin would be more

appropriate but having when I take the meds and how much that

I take under my control gives me some sense that I am in charge

of the disease....not it, me. So, it would seem that your

personality meshes with the idea of having some control over

things. Although I have to admit the idea of taking a pill and

putting the whole pain thing on the back burner has its

advantages too. I think it would help me stop my obsessive

inner dialog about how much pain I have....should I take a pill

now or will it go away soon......if I take a pill now, then I can't take

an extra one to eat supper, or sleep through the night.....those

kind of thoughts that drive me insane........ Always a balancing act

I guess and one that can change day to day......

Laurie