What dosage should i ask for?

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Khupe
New Member


Date Joined Oct 2007
Total Posts : 13
   Posted 10/14/2007 2:28 AM (GMT -7)   
I had been taking luratab 7.5's for a good while , getting 60x per month. Then i changed to percocet 7.5/325's 60x a month and the doctor and i talked about upping my med's , he said he would prolly put me at 90-120 10/325 perc's and i told him i didnt like the acetaminophin in the first place , so if i get 10's anyhow could i switch to a long acting or extended release formula ( oxycontin ) he agreed and he said we would talk it out at the next appointment. But he will most likely give me 10's and i dont think upping it the 2.5 milligram's will help much more , even though they will be ER formula's. As i been researching people with my conditions and dosage's from patient reviews , do u think he would get pissed off if i asked to start out on a little higher dose like , instead of a 10mg oxy 3 times daily , a 20mg or something to that effect. Basicly it boils down to i dont want to ''*****foot'' around with my pain , id like to get it under control and im wondering if he will think im crazy for not wanting months of undertreatment to find my optimal dose to give me my quality of life?
 
Please leave me some comments thanks , karol :)

Chutz
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Date Joined Jan 2005
Total Posts : 9090
   Posted 10/14/2007 12:05 PM (GMT -7)   
Hi Karol,

Sounds like you do have a good doc to work with. One thing to consider is 'asking' for levels of pain medications. Some doctors start to think you may be a 'drug seeker' even tho you're not. That's a decision you have to make since you are the one who knows your doc.

What you might do is keep a pain journal. Every day write down, several times during the day, your level of pain from 1-10, what you took, did it work, any exercise or activities...you get the picture. That way he can see for himself if your level of med is working or not. If 10mg won't cover it it will be obvious to him....I would hope. ;-) Or you can point out where your toughest pain issues are. Engage him in a discussion about the level of med and it's effectiveness instead of outright asking for it. Just trying to avoid any problems down the road.

Hugs,
Chutz
Co-Mod Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, collapsed disk, dermatitis herpetiformus, osteo arthritis in spine and other locations.
***************

The only difference between genius and stupidity is that genius has it's limits. Albert Einstein: (1879-1955)


Khupe
New Member


Date Joined Oct 2007
Total Posts : 13
   Posted 10/14/2007 9:26 PM (GMT -7)   
i know i dont mean to seem that way , i just dont want it to be months before i can get to a level that actually helps.

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 10/14/2007 11:11 PM (GMT -7)   

Hello and I agree with Chutz re asking for larger doses.  You are on a lot of narcotic now.  Have you ever been to a pain clinic to seek options versus so much drug?

The more you take of the meds the more your tolerance builds and you can only go so high with the oral meds.  Also you seem familiar with the side effects of the meds. It is good to know your meds.

I am only giving you fyi here as your the one who knows your pain best.

I hope you and your Physician can work this out to get your pain under control

Gentle Hugs


Respectfully
Kitt
Moderator Anxiety ~ Panic Disorders
*~* Not a mental health professional at all *~*
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Khupe
New Member


Date Joined Oct 2007
Total Posts : 13
   Posted 10/15/2007 8:59 AM (GMT -7)   
Well with such a wide variety of problem's , i won't be able to find a ''cure'' by any mean's , as i have a diabetic son i have to work. There is no choice in that , so it boils down to either hurt like hell and want to jump off a cliff or be on high powered med's to have a better quality of life while im here. As far as being on alot of narcotic's i really dont understand what u mean by that as there is no ceiling effect with opiate's and the oral dose med's do cap out on a certain dose , but there isnt a cap to the amount u can take to relieve the pain depending on how u handle the side effect's ( i.e how much sedation and or resp depression etc) and just because im looking for what i see as a small increase in narcotic's doesn't mean i havent seeked any other alternitive's in the past as i have went off of narcotic's ( my choice ) to seek other method's of relief. But truth be told it all failed , horribly i might add. I tried medications such as lyrica and cymbalta for my pain ( the nuero part of my pain) and the side effect's i gotta say are mind blowing in how many there are 25-35 i know of. Simply put , i have to live , work , play and have a life as these medication's are the ONLY thing that actually work's. As to options i would enjoy more detail as what u mean by that and i currently take 60x 7.5/325 that's 15mg/650tylenol a day i do not see that as high dose , if anything im pseudowithdrawing inbetween doses making the pain worse from undertreatment , which is why im asking for the increase and i do understand the risk's and all side effects as i been studying my med's so much since the first tylenol i ever put in my mouth. I do not take anything without 1-4 week's research first. thanks for your comment's and i didnt mean to sound rude in any way if i did.

Please leave more comments , karol :)

Khupe
New Member


Date Joined Oct 2007
Total Posts : 13
   Posted 10/17/2007 7:40 AM (GMT -7)   
lol , i appreciate what u mean by that but, i dont speak to them the same way i talk in post's. I'm not that null , not yet anyhow and i do understand each case is different. But i do not wish to spend 1-5 years to make it to a relieving dose is all im saying. I do take into consideration side effect's etc sedation and what not, but as far as i know u wont get much sedation if its actually killing the pain signal's , hense when u are taking to much u seem to be more sedated. I know there is a top's as to how much they put u on , but i just want a useful dose , one thats not sending me into psuedo withdraws and or undertreating as far as i feel.

Would they limit u to how much heart medication needed to keep u stable , no. I just want a better quality of life without spending the other half of my life trying to get it. My doctor is unlike most ive seen because he appriciates me being so outspoken , i have no fear of the word's ( drug-seeker) etc , cause i know im not seeking them for a high , but for relief and relief alone. I worked in a pharmacy the last 3 years of my life , and i do understand the up's and down's to the meds that work for me. I just want relief , period.

Gramps i appreciate your comments as your's are usually some of the most helpful , karol

As far as being grateful for the switch is debatable , as u shouldnt have to kiss your doc's feet just to inch along like a snail to ''eventually'' get the proper relief. Relief is owed to u as a patient if u ask me :)

maddy29
New Member


Date Joined Jun 2007
Total Posts : 18
   Posted 10/20/2007 4:30 AM (GMT -7)   

Hello Karol,

I have had chronic pain due to internal bleeding leaving me w/adhesions along my stomach & intestinal lining.

I am in constant chronic pain, esp, when i eat or sit for long periods of time.

I dont think anyone should be in pain. My pain doc, started me at 250mg of Morphine,& Lyrica 75mg/day which was too much, so he lowerd the dosage.

My doc, worked from the highest dose for my height wieght & amount of pain according to the pain chart, which was for me 9.9 all the time.

After 5yrs of this, I decided to deal w/my pain in other ways, i was of no use to anyone in the cond, i was in while on the pain meds, aside from the actual pain itself.

I now am on Tramadol, & T#3's, i can function,think, & do things much more clearly than being on all those narc,drugs.

I have my bad days, very bad days, & thats when i phone my doc, & say im having a bad pain day, so i will be taking 6-8 T#3's today or next few days, then go back to my 4/day.

Doc has no problem, as long as i keep him updated & am truly honest w/him & myself about how much pain i am really in & how much is this med, going to make the just the pain better or my ability to function better as well.

Pain is the bodies way of letting yu know something is wrong. Once yu know however, then its up to you to do the right thing & really think about how is pain right now going to effect me mentally,& physically down the road of life.

Do i want to scarf down narcs, & die of liver failure at an earlly age, or do i want to try & walk,phone my best friend or lay down or maybe watch a comedy, when im in pain the last thing i want to see or hear is anything about it.

I want the exact opposite, try it, yu may find yourself in less pain than would ever have expected.

Maddie


maddy29
New Member


Date Joined Jun 2007
Total Posts : 18
   Posted 10/20/2007 4:37 AM (GMT -7)   
Sorry if i messed up your name, i thought it was Karol, its
Khupe,
Which ever yu are i do apologize if i got your name wrong.
 
Maddie

Khupe
New Member


Date Joined Oct 2007
Total Posts : 13
   Posted 10/24/2007 12:22 AM (GMT -7)   
well , i dont want to scarf them. As i want 1-3 hi dose , possibly some breakthru med's and that's all by hi dose i just mean reasonble for my weight/height. To the liver damage , i dont think it's no where as bad when u dont have the acetaminophin and or nsaid's mixed with them , someone correct me if im wrong. I told my doc i didnt want to get hi doses of tylenol due to recent findings on long term use damage.
 
karol
 
 

CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 10/24/2007 1:19 AM (GMT -7)   

Hey Khupe,

Welcome to the Chronic Pain Forum.   I hope it will be useful to you.

I am disabled, and have chronic pain from a number of different health problems.  I know the ins and outs of dealing with doctors regarding the treatment of chronic pain, and you are talking a little too big for your britches.  Theoretically, patients with chronic pain are entitled to adequate treatment/medication to give them a decent quality of life.  Unfortunately, because the medical community is under so much pressure to limit the prescribing of narcotic/opiate medications, many people with chronic pain are not being treated sufficiently to have a decent quality of life.  You are darn lucky that you have a doctor that doesn't seem to fear prescribing adequate medication.  Do your research, but be very careful discussing dosages with your doctor.  A patient that voices extensive knowledge of pain medications can send a red flag up to the doctor that their need for pain medication may not be strictly medicinal.  You may think you are OK on not being seen as a "drug seeker", but that label can pop up at any time, and it can haunt you for a long time.  Once a member of the medical community questions your motives, the horse is out of the barn, and there is nothing you can do about it.  It's not fair, but it's true.

In most long term health problems, the standard treatment is to start with a low dose of medication and work up.  It may take a while to reach an appropriate dosage, you can't jump up high and work your way down, because side effects are much more likely to occur, and starting with a high dosage of a narcotic/opiate medication, you may not be functioning enough to realize there is a problem.  I know how foggy I get when taking a strong dose of pain medication.  I'm a happy camper, but I can't function worth a darn, and certainly wouldn't complain at all about being so fuzzy.  It wouldn't occur to me in that state.  However, you can work your way up, over time, to a ceiling dosage of a specific medication, to the point where you no longer get adequate relief.  Thus, you must escalate to a stronger medication.

A couple of statements you made in different posts just don't make any sense.  You stated that you didn't want to spend 1 to 5 yrs to find a correct dosage.  Where the heck did you come up with that time frame?  I think you just pulled that number out of the sky, as I've never seen any time frame in any documentation to that effect.  Likewise, you said that you never start any medication without researching it for 1 to 4 weeks.  That statement makes no sense at all to me.  First, ask your doctor about what he is prescribing.  Second, if you have any additional questions, ask your pharmacist, or read the information provided when you fill the prescription.  Last but not least, just look it up on a medical search engine like WebMD.  This shouldn't take you more than about a day.  If your doctor wants you to take a medication, double-check the sources and start taking the medication.  There is no reason to procrastinate up to a month.

The last thing that has me puzzled is your negative attitude toward tylenol.  What's up with that?  Granted, taking a high amount over a long period of time can be bad for your liver, but the amount you were quoting being prescribed were minimal.  What's the problem with the tylenol?

Your posts are really strongly worded, but maybe you should review them a little more closely before submitting them.  Also, using capital letters and punctuation correctly really helps other posters understand what you are trying to say, and allow them to respond to your posts more accurately.  Just an observation.

Hope things go well for you.  Let us know how you are doing.

Leigh Ann cool


Basic info:
  • On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ 
  • Divorced, 42, no children
  • Surgeries: Gastric Bypass, Gallbladder Removed (followed by a week in the hospital for a Blood Clot), Impacted Kidney Stone Removed, Broken Ankle, Major Dental work(four molars pulled, multiple cavities, root canals) 
  • Current Meds: Lexapro, Klonopin, Wellbutrin, Stadol Nasal Spray, Lortab, Trazadone, Buspar, Nexium, Tramadol, Phenergan, PROHIBITED FROM ALL NSAIDS
  • Current Problem: Internal Bleeding, possible ulcer in location of Gastric Bypass
 
"The weather is here, I wish you were beautiful."
                                             - Jimmy Buffett
 
 


maddy29
New Member


Date Joined Jun 2007
Total Posts : 18
   Posted 10/25/2007 1:25 PM (GMT -7)   

Hello Khupe,

I hope u dont feel that the folks on here are against yu. ive read through the e mails, ive been where yu are at now.

If at the very least please know we all here want to hear or see yu write that pain is under control.

I agree that yu shouldnt do all that research about meds,ive found that the pharmacist not the docs, know more about the meds, than anyone.

For extra info. go online & look it up.  I wouldnt give much credit to what the government has or FDA has to say about Tylenol, its been around for well a long time, & only now their finding what they think are problems.

Im near 40ish & have been on tylenol since high school when my migraines first began. When i tried to get any other meds of course i was a suspected "drug seeker", & i was because i was in horrible pain.

Then i met a wonderful doc, in Chicago who trusts me because i see him every 3mo. i phone him if my pain is worse or even if its been better.

I keep in contact & dont push the issue i keep him informed on how im feeling & how or if my life has improved on the meds, he has prescribed.

Funny thing is he is always concernd at what my pharmacist thinks about what he is prescribing, i know why, though i have made many friends at my pharmacy & they all about me & my med issues ect.

I guess the point is keep your doc,informed they work for yu, but if they dont know or understand your needs or what yu do w/your life to help them enable yu a better quality of life then i would find another doc.

I wish yu the very best of luck & hope yu keep us informed on how your doing?

Maddie

 


Captainjman
New Member


Date Joined Nov 2012
Total Posts : 3
   Posted 11/25/2012 3:14 AM (GMT -7)   
I need help finding a doctor in Chicago that is willing to titrate my opiate medications properly - someone not afraid of helping new patients. I want to work and the meds I have now are not enough to work - just to lay down and not move relatively under control 3-4/10. Can your doctor help? Are you a doctor that can help? Do you know of a specialist loot afraid to prescribe ?

My current doctor is not comfortable giving more - he is doing me a favor as is. He is only my general practitioner.

So many anti-opiate docs out there - thank you DEA - and thank you drug abusers for making these medications virtually impossible to get for those of us who need them - just so you can get high.

Northern burb of Chicago
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