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mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/10/2008 7:56 AM (GMT -7)   
Hi Everyone,
I was taking Oxycontin for almost two years after my first back surgery in 2006. It worked pretty well at controlling the mechanical pain that I was still having and along with the Lyrica kept the pain levels around a 7 instead of a constant 9. I had to have a second surgery in August of 2007 and was finding in the months before that the Oxycontin seemed to loose it's effectiveness. We increased the dosage a few times to a total of 40 mg three times a day and an additional 5-10 mg of IR Oxycodone for breakthrough and it still wasn't working as well as it once had.
After talking to my PM, we decided to try Opana, since it's supposed to be stronger than Oxycontin, and hoped that I would get back down to a lower dose over the course of a day, with improved pain relief. We've had to adjust the dose a few times and I am currently at 40 mg of Opana ER twice a day and 5 mg of Opana IR three times a day and it's not working very well at all. In fact, after about 8 hours, the pain relief is almost non existant, even with staggering the breakthrough Opana so that I am taking that during the last 4 hours before it is time for the ER.....I don't want to keep increasing the dosage, hoping that it will work better.
On top of all of that, my PM just left the practice to move back to Puerto Rico with his family. So I will be seeing a new PM in a few weeks for my appointment.
I am at a loss as to what to do. Go up again in the Opana hoping that it will kick in at some point, or change medications all together, but to what?
Anyway, thanks for listening and if you have any suggestions, I'm open to hearing them.
Sandi confused

PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13473
   Posted 1/11/2008 12:45 PM (GMT -7)   
Oh my goodness, looking at your surgery list on that back is enough to make anyone hurt. By any chance does your dr have you on a good muscle relaxer. If not please ask for one. I have learned that pain meds do nothing for muscle spasm and you have to have that going on as well. That can sure add to your pain level. I was nearly out of my mind with pain in my lower back, I have an implanted pain pump. I was given an increase and I also have Dilaudid oral for BT pain but it just did not seem to touch the pain. So,k I took one of my muscle relaxers, I was floored how much it helped. You most likely have alot of spasms with all that hardware. I do hope you get some relief quick. Susie


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/11/2008 7:39 PM (GMT -7)   
Thanks Susie. I was on zanaflex after the first surgery but they changed that over to Baclofen. I am at 15 mg three times a day for the muscle spasms as well. I am just really disappointed in the Opana and can't figure out what to try next. I really hoped that I would be able to go a short acting pain killer and be able to take that only as needed, but that was not even on the table after going off the Oxycontin.
I took Dilaudid after both surgeries and it seemed to help some which is why my PM thought that the Opana would work well.
Ah well, I guess that I will find out what we are going to do after I see the new PM later on this month.
I would settle for a nice 4-5 at this point. After over two years of this constant pain, I'm getting tired of living with this level of pain all of the time.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


TinaK
Regular Member


Date Joined Mar 2003
Total Posts : 396
   Posted 1/12/2008 1:50 PM (GMT -7)   
I switched from methadone 40mg x three a day to Opana ER 20mg x 2 a day about 7 months ago. After three days, I called my PM doctor because it only lasted about 6 hrs. I was also taking hydrocodone 10mg x 3 for breakthru pain. He switched me to 20mg every 8 hrs. and that seemed to do the trick. I have since moved up to 30mg. x 3 on the Opana ER and oxycodone for the breakthru pain. I have been on that dose for about 3 months now and am very pleased with it. So as usual it took some time to get the doses right and the right combination. My PM doctor preferred not to go with the Opana IR as he said that a different med for breakthru pain usually worked better. I am not sure why. I like the Opana because I don't have as many side effects with it as I did with the methadone. Good luck on your journey. I hope you find some relief soon!
Tina


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/12/2008 10:53 PM (GMT -7)   
Hi Tina,
I noticed that the Opana seems to stop working after about 6-7 hours too. I thought that I was loosing my mind but I'm glad to know that I'm not.
Maybe we should try 8 hour dosing with the ER and increasing the IR and see if that works better.
I just don't like switching meds around, try, increase, try increase.......I keep hoping to be able to function somewhat on a low dose too, but I am coming to realize that low doses aren't going to work and a prn medication is not going to be in my future either.
My PM also said that there are less side effects with Opana and I have to agree with him on that. I haven't had much to deal with other than the nausea at first but the phenerghan takes care of that.
I even sleep better with the Opana than I ever did with the Oxycontin.
Ah well, I guess I'll find out what his suggestions are when I see the new PM on the 26th I think is the date.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


sweething72
New Member


Date Joined Nov 2007
Total Posts : 5
   Posted 1/13/2008 6:30 AM (GMT -7)   
hi there,
i dont know when this was posted but i am now replying. Go back to the other meds. Opana is not working for you. I am on hydrocodone along with avinza (morphine) for my back and the avinza does not work for me at all. My doc is gonna switch me but not before taking a toxicology urine. I was kinda offended but did it anyway. Go back to the other meds , the opana is not working for you. If you are feeling all the pain then that tells you right there. good luck and i hope it works out with your new pm.
Michele

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/13/2008 3:17 PM (GMT -7)   
Thanks, I do believe we are going to have to change to something else.
I am not going to continue on meds that obviously are not providing any decent pain relief. I wanted to give it a fair chance once we got to a moderate dosage, and it seems that we are at one that I should be getting at least a decent amount of pain relief from, so when I see the new PM , we will have to discuss where to go from here.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


Circa1988
Regular Member


Date Joined Aug 2007
Total Posts : 90
   Posted 1/15/2008 4:35 AM (GMT -7)   
You could also try methadone or morphine (MS-contin) and see if they help. Methadone leaves many people with a much clearer head than other pain-killers which is a plus. I just figured I would throw those two out there since no one mentioned them.

Good luck getting your pain under control

Circa

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/15/2008 12:50 PM (GMT -7)   
We tried Methadone a short time ago, but I think we went up too fast in the dosing, because it made me inordinately tired and sleepy. I really dislike that feeling.
I haven't tried MS Contin but when I see my new PM next week, we will be having a talk about what to do pain med wise. I'm open to trying the Methadone again, and will ask that we go slower and hope that the dopiness subsides if we do.....
Maybe he'll have some suggestions.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


Circa1988
Regular Member


Date Joined Aug 2007
Total Posts : 90
   Posted 1/16/2008 8:51 PM (GMT -7)   
How long did you stay on it before you quit? When I started Methadone it made me very, very sleepy also, practically so tired that all I did was lay in bed (not really, I went to school some, and I did a bit of stuff, but as soon as I got home it was right back to bed and I slept probably around 12-16hrs a day). I asked how long you stayed on it because, though like I said, it made me very tired when I started, that gradually started to go away after a couple weeks and after about 2 months I was doing much better. I am now at college full time, though I do still sleep quite a bit more than your average college student (I go to bed around 11-12 at night as opposed to many of my friends who go to sleep at 2-4 in the morning every night). I have read that this is a very common reaction with Methadone, also I was only on 15mgs daily (5mg three times per day), and I had previously been taking 8mg of Dilaudid every day, so it is not as if I was taking a large dose. I think it just makes people very tired when they start, however it does not cause the usual 'high', or foggy head and confusion that most other opioids cause, even when I first started. It just made me very tired. Of course perhaps I would have tried a different med when it was making me that tired except that my doctor said it was the only one he was willing to prescribe. I think this is because of my young age and the fact that I am in college, the doctor was concerned about people stealing my meds from me or me becoming addicted to them. This brings up another plus of Methadone, it is less likely to cause psychological addiction than other opioids, though it does cause a nasty physical dependence that apparently has longer but less intense W/Ds than most opioids for some people. Maybe the biggest plus to Methadone is that some people claim that they do not gain a tolerance to it once they reach a certain dose that works for them, or more often, that tolerance grows more slowly than with other opioids. There is also a lot of scientific evidence to support these claims as well. All in all, methadone can be a very good pain med for some people.

There is one other medication that might help you. I read a post written about it somewhere by someone who is prescribed it for pain, it is a medication called Levorphanol. Unfortunately, there is a good chance your doctor will not have even heard of it, much less consider prescribing it. This is because it is rarely prescribed in the US for some reason, however, in Europe apparently it is prescribed somewhat more frequently. It is another med with a very long half-life like methadone so it lasts a long time but does not have to be in Extended Release pills (which cause fluctuations in the level of medicine in the bloodstream). Apparently it is similar to methadone but without as many negative side effects. It might be worth a try to mention this to your doctor and see what he says, maybe print something about it off of a reputable website with a bit of info so that he doesn't just think you are making something up if he hasn't heard of it (doctors sometimes have that God complex you know).

I almost forgot, you can also try fentanyl patches. I didnt see a mention of them anywhere in this post. They supposedly last 3 days before you have to switch to a new one, though some people feel like they stop working after 2 days. You should definitely ask about those unless you tried them already.

Hope this is all helpful info and good luck finding a med that helps you.

Post Edited (Circa1988) : 1/16/2008 9:00:58 PM (GMT-7)


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/17/2008 9:00 AM (GMT -7)   
I was on it about a week and maybe a couple of days. Like I said, I think that we went too high , too fast with it. I went from 150 mg of Oxycontin to 60 mg of methadone a day. I started dozing off with little forwarning, and with small kids, it's not a good thing.
I discussed it with my PM and he decided to stop using that and go back to the Oxy until we tried the Opana.
I will talk with the new PM and see if he thinks that we should go back and try again. At this point, I just want some decent pain relief. It's been a long almost two months.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13473
   Posted 1/17/2008 6:32 PM (GMT -7)   
Mrs I think I would see more about adjusting the Opana doseage rather than going off and trying something else. At least give it a shot since you are already on it and on a low dose. I am with you, I hated the trying & switching thing when I took oral meds. With my pain pump I have not had to go thru all of that and I sure don't miss it. My hardest thing with my pump was getting the doseage where it needed to be and once we did it was so much better. Good luck. Susie


Circa1988
Regular Member


Date Joined Aug 2007
Total Posts : 90
   Posted 1/17/2008 6:52 PM (GMT -7)   
I would definitely ask your doc about fentanyl patches, some people swear by them. The drug is also very different in structure from most of the other drugs you have been on so maybe it will have a different, more effective pain killing effect for you. The way the drug is put into the bloodstream (trandermally, through the skin by the patch) is also very different and gives very steady levels of the drug in the bloodstream supposedly. Perhaps it will be more effective than the other medications you have been trying. Most of all, listen to what your doctor has to say, he knows more about you and your situation (medically speaking), as well as much more about how to treat pain than anyone here (I assume). Make suggestions and ask questions, but if he believes that something in particular is most likely to help you than I would do it, in my opinion it's always best to trust the Dr.'s judgment rather than second guess it based on some time reading the web, he has after trained for this very thing for 8-9 years plus all the experience he has had in practice. Of course first you have to find a doctor that you trust. That is just my piece.

I really hope that you can find a med that gives you the ideal combo that all pain sufferer's seek, freedom from pain without sacrificing functionality. Good luck at your appt.
Circa

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/17/2008 7:21 PM (GMT -7)   
Thanks Susie. One of the reasons to use Opana was that it is supposed to be much stronger than oxycontin so we were hoping to be able to use less to get better relief. The conversions for it are ____mg of oxy x .50 to get a dosage of Opanam so we should have been able to get adequate relief at 75 mg total dose a day on Opana, right now, I am at 40 mg bid and 5 mg tid and still not anywhere near adequate relief. I also have to take phenerghan to settle my stomach when taking the 40 mg pills.......I should be getting at least partial effective relief at this point. I could rationalize not getting adequate relief at the lower doses as we titrated up but by now, I was expecting at least some decent pain relief.
We'll see what he has to say when I see him Thursday of this coming week.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 1/17/2008 7:24 PM (GMT -7)   
Hi Circa,
I will see what his recommendations are. Thankfully, he is supposed to have decent listening skills, so I'll see what his recommendations are, I don't want to feel doped up, but need relief at this point too.
There has to be some thing that we can do that will do both of those things. Maybe I am just being unrealistic when it comes to wanting to keep the mg's down and expecting better relief.....that's a possibility too.
Thank you all for your help,
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..

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