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Mike - myths about pain medication tolerance

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Mike,

I'm not trying to offend you, but I would like to point out something that we

were told by a very experienced Pain Management Doctor at the University of

Indiana at the PAI 2003 Symposium. This PM doctor said that if the patient

was on the correct type and dosage of pain medication to treat their pain, that

increases in dosage over long periods of time would NOT be necessary. In

other words, hypothethically, if the patient's pain level was a 6, and 10 mgs.

of Oxycontin taken every 12 hours caused sufficient relief for that person, that

the patient could continue on this same dosage forever. It's only when the

patient's pain levels increase, that an increase in the drug dosage is

neccessary. He said that it was a myth that patients would build up a

tolerance to the medication and need an increase....IF the correct dosage

and type is used for the correct pain level.

Of course, we have all found that certain medications work better for us than

others, and what works best for me, may not work for you half as well. I'd

have to say that I agree with this doctor's assessment, since I've been on the

same dosage of duragesic for 12 months and have not needed an increase.

In fact, right now I'm cutting down by 25 mgs., and that's been successful.

The only reason I increased my dosage a year ago was because I was

experiencing much higher levels of pain.

Knowing whether this was true was a concern for me, because I was

wondering what would happen in the future. I was on 75 mgs., did that mean

that in ten years I need 500 mgs. to treat the same level of pain? So I

brought the subject up again with the Pancreatologist that I had an

appointment with at the Mayo Clinic in ville last October. I asked if it

were true that if the dosage was correct for the pain level would I be able to

stay on the same dosage forever, or would I build up a tolerance to the

mediction and need an increase? I also asked if it would harm me to have to

stay on the duragesic patch for the rest of my life. The doctor told me that

what I'd been told in Indianapolis was true - if the dosage is correct for the

level of pain, then no adjustments would be necessary. He said that what the

problem was, was that many doctors are afraid of the FDA restrictions on

prescribing, or of over-medicating, or they don't understand the medications

well enough to know the correct amounts to use, so they have a tendency to

under-medicate their patients. And that by doing so, the patients were

repeatedly requiring higher doses just to reach a functioning level.

His answer to my second question concerning whether it would harm me to

have to use a duragesic for the rest of my life was NO. He said that as long

as I had the pain at a level where it was that day, it would cause me more

physical and emotional harm to NOT to be properly medicated, and that I

could stay on the patches for the rest of my life, if nececessary, without harm.

You're probably asking yourself, that if all this is true, then why is she

sitting

here telling me that she's in the process of cutting back on her meds? Why

bother, if she's not afraid of building up tolerance, or of long term harm? The

reason I'm doing this now is two-fold. First of all, I haven't been

experiencing

the higher levels of pain these past few months that I was a year ago, so I

don't feel that I need as much medication. Secondly, if I can get my pain

medication down to a minimum dosage amount, when I DO have another

acute attack, I'll have a lot of leeway and be able to use much lower amounts

to get relief. This way a lot less will do a lot more.

Thanks for letting me explain my thoughts on this. You don't have to agree

with me, okay? We can still be friends and have different opinions....lol! I

just

wanted to explain to you, and to the others, what I learned at last year's

Symposium, especially since we've had so much discussion this week on pain

medications.

BTW, as you just saw, I love to talk and ramble on just as much as you do! In

the past, when it was just me and my pre-school grandson here alone all day

and all night four days a week, I would practically drive my husband out of the

house that first night he got home, with non-stop chatter! If you're the one

home with your children all day long now, man.....I know what you're talking

about! It was so bad that I was carrying on such long conversations with the

telemarketer's that they'd making excuses to get off the phone and once they

did, they'd NEVER call our number back! :-)

With love, hope and prayers,

Heidi

Heidi H. Griffeth

Bluffton, SC

South Carolina State Rep.

South Eastern Regional Rep., PAI

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

Note: All comments or advice are from personal experiences or opinion only,

and should not be a substitute for consultation with your medical professional.

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