I personally wouldn't come clean with your doc, most docs get irritated when their patients don't follow their recommendations, especially with narcotics. You also run the risk of him cutting you off. I quit some medications and my doctor got nasty with me. I'm sticking to narcotics and had quit the anti-convulsants, anti-depressants. I've noticed it has made no difference on my level of pain being without the often off-label medications for nerve pain. Anyways, it's been my experience that doctors can get nasty, and they also don't want to lose their license by having a patient who they perceive abuses medication.
I noticed he's prescribed oxy-IRs, assuming this is the Instant release of Oxy's, then they would only last six hours; and, your doc is missing the point in prescribing long lasting medication for your condition which is obviously chronic. What you need to discuss is getting on long-acting, slow release narcotics. The type of oxy's which I think would be better for you are called Oxycontin - Oxycodone HCL CR (Cr for continuous release). They are typically prescribed twice a day, lasting 12 hours per dose. Some people have a faster metabolism, my doctor has prescribed every 6 hours. The medication will be more effective in your body than spiking with the quick fixes. I think you may also have luck with a lower dose as since it's slow release, you won't have withdrawl effects. Withdrawing can result in the need of even more narcotics as you're battling not only the pain, but also the withdrawl effects. Anyways, I find it's important to be very careful about
the message one gives to pain management specialists. There's a doctor, Dr. Tennant, who writes great articles on how to communicate with pain specialists and what kinds of medicines, supplements are out there to help dampen the pain. Here's his site...http://foresttennant.com/pain_management_patient_self_help.html
Also, when you take the oxycontin, make sure you take it with a protein like with dinner, as it will metabolize better in your system. Some medicines are flushed through, which could be happening if you take it on an empty stomach or without enough of a meal to break it down. Sometimes I find it helps to stage it, I take 20mg with dinner, then an additional 20mg with a protein snack an hour later, etc until I get relief.
Well, if I were in your shoes, instead of asking for more, as for longer lasting (the continuous release) saying you do get pain relief but it seems like a roller coaster as your pain spikes sometimes during the day (and night if you sleep more than 6 hours). With a script
of 180mg, oxycontin comes in 60mg and 80mg, so he'll give you a few of those. You could also ask for a small amount of breakthrough pain killers (ie your IRs) for when you stress your back, like if you have to drive a long distance to visit someone once a week. Most pain specialists prescribe one long acting and one short acting. Focus on describing your pain instead of asking for more. He may even have other suggestions like heat or a better mattress.
Good luck with your conversation and getting your pain under control!
p.s. I don't think you're an addict, just desperate for consistent pain relief. We've all been there at one point in our journey
Post Edited (Sue123) : 1/13/2012 3:29:24 PM (GMT-7)