I have been on just about every pain medication that there is to date, and at various dosages as well.
Oxycontin takes a few days to build to a steady blood plasma level, since it is an extended release medication, it releases a certain amount of the 40 mg per hour over the intended course of 12 hours. As far as if it is considered a high dose, I have to agree with everything that Mom said about comparing doses with someone else. The tolerance issues , metabolism issues etc make it difficult at best to compare what dose you are on to what someone else might be.
Fentanyl is considered the top of the line in the pain medication lineup. It comes in a patch, and now most of the designs have the fentanyl in the adhesive , rather than in a gel matrix that they used to be in. It seems that the adhesive now helps also with the skin reaction problems. I have had those in the past and so far this time, I haven't had one reaction to it. Thankfully.
Lidocaine is a topical anesthetic as Mom explained and those patches can be cut into different shapes and put in areas that are painful. You put them on the painful areas and can leave them on for up to 12 hours and then take them off.
There are a lot of other medications between oxycodone/oxycontin and fentanyl for you to try, before having to head to the fentanyl route.
Like all medications, some will work well for you and others won't, and it really depends on our individual makeups that will dictate that. My best suggestion is to give each medication at least a month before deciding it is or is not working for you. And if needed to give it at least one dosage adjustment if the original dose isn't working. You'd be surprised how many times I have tried a medication and found that at the initial dose, it didn't seem to do much, but after a dosage adjustment, it worked much better.
Most of the time, when doctors change a medication from one to another, there is a reduction in the dosage of the new medication, made by the doctor due to what is called cross tolerance issues. For example, if you are going from oxycodone to a morphine derived medication, they will figure out the new dosage and reduce it by anywhere between 10-25% depending on the new medication for cross tolerance, instead of a straight conversion from medication to another. The reason behind this , is that the new medication may work better at relieving the pain, but at a lower dose and the idea is to keep the dosages down to minimize tolerance problems.
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..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too