RFA today and addition of Oxy IR question

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Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 12/9/2010 8:08 PM (GMT -6)   
Hello All,
I have come to you all again for info on a "new" med my PM prescribed to me today.   eyes   I had my RFA and literally yelled out in pain during the procedure and then cried all the way to the car.  It was soooooo painful for me.  The PM says it's because my muscles are so inflamed and I can't use NSAIDS or Steroids or even some of the numbing meds.  cry  
None the less, he refused to increase my Dialudid from (2 mg) 4 times per day and added Oxy IR (5mg) 4 x day as breakthrough.  He says we can up that one if it helps without problems, but that the dilaudid is so strong a med that he doesn't want to up it any.  I also take Ultracet x 4 per day, Xanax CR (3mg), ambien 20 mg at night, BP meds Coreg 2 x a day, a BP/Water Pill (Torsemide) 2 x a day, fenofibrate, HGH .2 mg, aspirin, vitamins A, B-12, & D, Calcium, Magnesium, Prevacid 30 mg x2 per day, Nystatin 1 x day, & Mycolog as needed for serious yeast overgrowth. smhair
My question (and reason for providing such detailed information) is about adding the Oxy IR 5 mg.  I don't know anything about this med at all.  I checked out Mayo and found some information and of course it "should not" be taken with many of my other meds, however, the PM knows exactly what I take and in what amounts and combinations. sad
Do any of you use the Oxy IR?  Are there any side effects that you have with this med?  If you have taken Oxy IR and Dilaudid at the same time, was there a problem?  What about with the Ultracet or Xanax?  confused
I hate to ask such specific information, but I have soooooo many meds and soooooo many med allergies and sensitivities that I'm a little scared about adding this new med.  I'm also a little confused about the problem increasing the Dilaudid to a higher dosage yet giving another similar drug that "we can increase without a problem if it works and we need to".  It just seems strange to me and I don't understand. rolleyes
Any info would be greatly appreciated.
Also, any prayers about the RFA working woudl be greatly appreciated too.  It helped so much last time, but that was a year ago and I really need a pain break for a while.  This procedure is so hard on me, but my best friend has almost no pain with hers and even says she can't tell where they put the needles after it is over.  She's also knocked out for hers and yet I'm as sore as if I fell on an electrified ice pick. shocked shakehead shocked
Thanks for any advice my HW family. confused
Retired Mom

Regular Member

Date Joined Aug 2010
Total Posts : 215
   Posted 12/9/2010 9:47 PM (GMT -6)   
Good Evening RM,

First off, I hope your breakthrough medication provides you with some additional relief. I think it will but at 5mgs, I wouldn't expect a night and day difference. Regardless, you should get a little more relief and even a single drop on the pain scale can be like removing a knife from the back.

The IR formula lasts up to 6 hours, but depending on your metabolism and body process, relief sometimes only lasts for 4 hours so if your dosing says 1 tablet every 6 hours, keep in mind that some people can have increased pain between hours 4 and 6 due to the medication wearing off. I've heard some people claim it lasts 7 hours so it really depends on your metabolism.

Oxy IR is a great tool. Its slightly more potent milligram per milligram than morphine orally and is well absorbed and fairly quick acting. It might not be a bad thing that your doc decided to go with a second pain reliever because Oxy IR hits certain receptors called Kappa Opioid receptors in addition to the Mu Opioid that both hydroM and Oxy hit. Therefore there is some cross-tolerance but not total corss-tolerance. However, it should be noted that tolerance to oxy's pain relief abilities builds up quicker than weaker medications like codeine, but if its not used arround the clock, this should not be much of an issue since it takes round the clock dosing to typically increase tolerance to a short acting medication like oxy IR.

As far as interactions with other meds, I think you should do a consult with your local pharmacist, and possibly get the opinions of 2 or 3 different ones since you will be using multiple pain medications. My humble recommendation would be taking the Oxy IR atleast 1 hour apart from your HydroM dosing. This might help to keep the medication from hitting your system to hard. However 5mgs is a low dose and you should be just fine. Personally, I would not recommend mixing all 3 of your pain meds together. The Oxy is about 2 to 3 times stronger than tramadol, so for breakthrough pain, I would avoid the tramadol and focus on the IR and HM.
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures have decreased the severity of pain by about 1/3rd. Was on Nucynta (tapentadol 50mgs) for several months, but due to a decrease in pain, I now used Tylenol #3 with Codeine and .5 mg Klonopin. Go ahead and laugh but the Codeine works well ;)

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Date Joined Oct 2008
Total Posts : 2024
   Posted 12/10/2010 5:25 AM (GMT -6)   
So sorry for all your suffering RM!! My prayers are with you always!!

Can you tell me how they do RFA. I don't know anything about that. Sure sounds painful.

Regarding all your meds. the best bet is to go over everything with your pharmacist. They will know all the drug interactions etc.

I hope you can have some pain relief soon as I know you are suffering so much.

Please keep us up to date on how you are doing.


One day at a time!!

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Date Joined Feb 2003
Total Posts : 16789
   Posted 12/10/2010 1:21 PM (GMT -6)   
RM I am sorry that your dr would not consider increasing the Dilaudid. You know my prior PM dr had me on 2 mg for BT pain and after one script of it I accepted no more because it was like taking nothing. My current PM dr was shocked he offered such a low dose and she was not aware it even came in 2mg. My neighbor is an RN and we had talked about it not working and he said it was not surprising when you consider people are given 10mg all the time in shots of it. I imagine since it gives you some relief you are sensitive to it which is a good thing for you. I have 8mg now you know and if it is too much at times I can break it in half with my PM's drs approval. There are times when I need the full 8mg though. I do not have to take my BT meds every day, it just depends on how the day is going. I do hope the other medication will give you more relief I think you would be wise not to take it with the other meds until you know how you will react with it. Another good web site for medication is Drugs.com, they offer lots of info on meds too. Hope your RF works well this time too.

Take care.
Moderator Chronic Pain Forum

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Date Joined Nov 2007
Total Posts : 6795
   Posted 12/10/2010 2:02 PM (GMT -6)   
Hi, Retiredmom,
I'm trying to post more often and saw your thread up on top and wanted to just add my wishes that your RFA helps with your pain, although I know it can take awhile (I think - I've never had one - they could never locate a nerve precisely enough to do it). I think I remember reading others here who have had them don't always get immediate relief. It's sometimes disheartening when we hear of people whose procedures and surgeries work almost magically, and ours don't - but give it time.

I can't speak to any of your other meds, or to the mix of them (as others have mentioned, a good pharmacist can be a great help - not the techs but the pharmacist, especially one who knows your meds, as well as a good PM doc) but I do take Oxy IR 10 mg - usually only once/day, as a substitute for my percocet. My new PM, who is great, gave it to me to use prn as a way of keeping the amount of tylenol I get (which is in the percocet, my main pain med) down. For me, the Oxy IR doesn't work as well as the percocet, but that's probably because the tylenol does help, but since my pain worsens as the day goes on, my first dose of the day I take an Oxy IR 10mg instead of percocet, and then take percocet starting later in the day. I find the IR only lasts about 3 hrs tops, sometimes not even that. My cousin is a pharmacist, and she said that's about standard; my doctor actually has the Rx written for every 3 hrs, and said I could take it that often (within limits - I try to limit the overall amount of oxycodone I get each day so as to slow down any tolerance development, although I haven't had a problem with that so far) as long as I substituted it for percocet doses. It goes without saying I have a great PM who knows and trusts me, so I have both meds available, although he does keep track of refill requests (fine with me).

So my experience is that the Oxy IR 10mg does not last 6 hrs, but as we all know each of us is different, and with all your other meds I have no idea how it will mix or be metabolized. My personal opinion is that the 5mg won't be that strong of a med, but that's simply based on my own experience.

Good luck with the RFA!


Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 12/10/2010 5:23 PM (GMT -6)   
Hello All,

Thank you so much for your info and kind words. Today has been HORRIBLE on the pain scale and when the PM office called to check on me, I mentioned that the script is written to be filled only on the 17th, so I can't even try the new med....they were less than understanding and told me they were sure it was because he wanted to keep me on the same med schedule. I KNOW he did not write the extra wording on the top in a different pen color. It was a woman's handwriting and certainly no Dr's handwriting. So I guess I have to suffer for a while longer. I still feel like somebody used ice picks with electric fence wire to do this RFA. My friend says she has no problems at all, so something has to be way different during the procedures. I sincerely hope nobody else hurts like this, but I have heard of some others having the same pain after the procedure.

Thanks for the info on the oxy. I "tried" to ask a pharmacist/or tech...not sure what she is, at the pharmacy where my husband has to get his reflux med. It's a long story, but he has to use that one for the rebate card to work and I can only use my personal pharmacy to get my meds. When I asked her what oxy IR was, she said oxycontin......that's NOT what Mayo says, so I think this lady needs a little more education. She acted like I was out drug searching or something and I told her I was just looking for info because it had been prescribe to me by PM and I am under pain contract so I don't get it there. What led to the question was asking about how much Tylonol I could safely take during a day and she says no more than 8 pills (ugggghhhh......excuse me, there are different doses of the med). I tried to explain that my Tylonol was 325, as part of my ultracet, and she freaked that I might be taking too much of the tramadol. I gave up!!!! I'll ask my own pharmacist as soon as I can get the chance and I'll just have to increase my regular meds slightly until I can get this pain under control. I have plenty left over from past prescriptions when I have taken less than the normal dose because I could handle the pain better that day. I NEVER want to be left in a situation where I can't get my meds refilled on time and have to do without. I NEVER want to go through any kind of withdrawal, so caution is the name of the game for me.

I would like to address all of you wonderful people individually, but I have to go now and won't be back (likely) until Sunday. I'm taking lots of movies and a warming blanket and everything under the sun to make a comfortable weekend. I'm really NOT up to going anywhere, but family duty calls and I'll just huddle up somewhere and rest while the others do their thing.

I wish you all a low pain weekend and again thank you for your kindess and support.
Retired Mom

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 12/11/2010 6:33 PM (GMT -6)   
Well I guess it's obvious that I came home early. I just couldn't do it another day.....the pain was too much. I so wish I could have started the oxy IR to see if it would help. I'm sick of hurting and this is so painful. Why is it so painful for some and not for others????? I just don't understand.

I can feel some of the nerve pain starting to let go and ease in the facet joints themselves, but the muscles are so inflamed and spasms are constant. I have done nothing but keep a heating pad on my back for most of the weekend and I'm worn out. My daughter came home with me and my husband stayed for the rest of the night. He'll be home in the morning as soon as he gets everything straightened up. I love him, but I'm glad his buddy is going next weekend and he can relax away from home without me being a drag. At least he was able to spend some quality time with my daughter this weekend:)
Retired Mom

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 12/12/2010 11:05 AM (GMT -6)   
retiredmom, I'm so sorry to hear your not feeling well either, and fully understand what it is like. It's awful!....and then to keep hanging to what little hope we have just seems to make it worse.

I had to just shake my head when you asked the pharmacist tech about the OXY IR and the answer she gave you. It reminded me of a trick question I was asked several years ago while attending a local collage. Cant remember who asked it, student or teacher, but the question was..."what do they call a student studying to be a DR, who finishes at the bottom of their class with the lowest passing grade point?" The answer is a DR! smhair ....and not a very good one at that. Some times I wished they would make professionals in the health profession wear their grade point average out where we can see them. smilewinkgrin That might simplify things!

I did take Oxy IR for a very short time, and I believe it was the 5mg. It did nothing for me at all, and I took the bottle back to the PM and tossed it to the receptionist. You should have seen the look on their faces! She said "No one brings back unused pain meds"

I hope your Dr gets this all straightened out, and not anytime too soon either. I feel bad for you.


Veteran Member

Date Joined Aug 2006
Total Posts : 9664
   Posted 12/12/2010 12:15 PM (GMT -6)   
I hated the rfa procedures, sure hope you can get relief soon...
make sure your icing the site for the first 24 hours...
when they did the rfa on my neck it left my neck so sore and stiff for
over three months, it felt like I had something on my neck
and I wanted to tear it off. I think it might be time to look at getting
a new pm doctor. It doesn't seem right that your script
would have two different inks on it, seems fishy to me..
Hope you can get a low pain day soon...
healing hugz and well wishes...

Veteran Member

Date Joined Apr 2009
Total Posts : 856
   Posted 12/12/2010 12:23 PM (GMT -6)   
Dear RetiredMom,
I haven't been posting as much, but I have been reading a bit here every day.
I'm so sorry that you're having so much pain. Oxy IR is very effective for me, but I take a higher dose. That's really ashame that your PM office won't let you fill it until the 17th. That doesn't make sense to me at all.

Whenever I call my doctor, I ask for the doctor to call me back. If they ask what it is about, I tell them that I just really need to talk to the doctor or I'll tell them that I only want to discuss it with the doctor. They never seem to mind letting the doctor call me. I used to find that things would get lost in translation so doing it this way works best for me.

I hope that you're pain goes down and that you get rest.



Retired Mom
Veteran Member

Date Joined Feb 2010
Total Posts : 1753
   Posted 12/12/2010 1:36 PM (GMT -6)   
Thanks guys,

I thought the multiple inks were fishy too, but there are actually four different ones on this script...one for the regular meds, one for the added Oxy, one a the top with the fill on date in big letters and then the Dr's signature. Of course they make a copy of all the scripts, so their will not be a problem in that area. I do think the PM is pretty good and he has honestly been the only one to do ANYTHING for me painwise, so I will likely be keeping him. The only other choice I am aware of is over two hours away, which is alot to drive and alot to ask of someone else when I can't drive or when I have to have procedures.

I have so many allergies and sensitivities (as may of you do) and 'breaking in' a new Dr is a challenge. I always look like a drug seeker to start with and then they seem to let the guard down after I have been seing them a while. My PCP will write anything I ask for (with the exception of PM, since I'm under contract) and she will still give a shot if she feels I need it....despite my protest about not getting shots from her when my PM is controlling Pain Meds. She just documents and goes on, so I try NEVER to get in that situation. She's become more like a friend over the years and I feel I can trust her with almost anything. Same goes for my psychiatrist. I've been with him for two years and I have to admit that he has helped me so many times I cannot count. He's great with meds and making sure they don't cross-over with each other. He's very honest and open and I like him very much. I started seeing him after a serious work issue that caused my PSTD to go out of control. Since then, the PTSD is much better. I keep seeing hime because he makes logical sense of things when I can't always see what is best. I would recommend him to anyone. It's also like that with my endo, but he is a no-nonsense guy and straight to the point. He's good at his job and I like him very much.

I just wish the PM could understand (and perhaps he does). I just keep hoping that he's looking for a way to help and trying to work with the lovely regulations put on him by gov't.

Again, thank you all!
Retired Mom

Regular Member

Date Joined Dec 2010
Total Posts : 80
   Posted 12/14/2010 10:16 PM (GMT -6)   
Is RFA (radial frequency injections)? I get radial frequency injections but my PM gives me an iv with sedation so I don't feel anything. I was just wondering if that is the same injections that I get. They are painful.


Retired Mom
Veteran Member

Date Joined Feb 2010
Total Posts : 1753
   Posted 12/15/2010 6:39 AM (GMT -6)   
It's ablation (sp?). That's where they burn the nerves. I have a friend who feels nothing too. Her husband is like I am, so I guess it's all in the Dr, the sedation, and the patient.....who knows???? medical procedures are like meds...each one is unique to the person getting it. :)

I hope you continue to have good results with yours and that they continue to be less painful.

Merry Christmas!
Retired Mom

Regular Member

Date Joined Dec 2010
Total Posts : 80
   Posted 12/15/2010 1:26 PM (GMT -6)   
I get radial frequency which is freezing the nerves. They sedate us and I never remember getting the injections. Hope you are feeling better. My injections only last for about 2 months and my insurance won't let me get another for 5 months.

Your are right about the procedures being unique to each one of us.

Merry Christmas to you and your family!


Regular Member

Date Joined Feb 2007
Total Posts : 98
   Posted 12/15/2010 8:34 PM (GMT -6)   
(((Hugs to all))) I have had much experience with the RFA, RFNA, RA a procedure by many names. I have had it both the thermal version and the pulsed version.  I am lucky my doctor found the right nerve group.  I am able to get one year of high level relief.  I too only get it with IV sedation and have been advised to ICE it for a few days as heat actually causes inflamation and can raise pain levels and create more swelling in tissues that are already inflamed from the procedure.  For me I am sore for the first week, then I notice the pain levels drop so by the fourth week, gone.  So in my opinion if you get the chance to try this procedure, what do you have to loose?  I realize that could be financial impacts, I relate as my insurance company covers the thermal version, but not the pulsed.  Which is silly since the pulsed version comes with less colateral damage.  I have been told that it severs the nerve at a lower temp so it does not destroy surrounding nerves and possibly create scar tissue as repeated thermal versions could in some cases.  I tried to pay out of pocket for the pulsed version, but I had to go with the thermal the last go round (Aug 10). 
I wish they could develop the silver bullet that is a fixall for all.  It is so sad to see this suffering, when the procedures or meds work for some, but not all.  When it becomes a constant struggle to just function.  Peace to all of you in high levels of pain. Susie
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