This is just an incidental anecdote, but I assume others here can relate to it.
I keep my daily pills (Ultram ER, Verapamil, multivitamin) in a weekly pill organizer beside my bed. The first thing I do every morning is take that day's pills.
Somehow, on Wednesday I forgot to take my pills. That has happened perhaps three times since I started taking meds daily, years ago. I realized this only last night when I started to refill the organizer for the upcoming week.
Fortunately, my heart didn't give me any trouble, but Wednesday was a very bad pain day. I had attributed it to it being a cold day, my doing the shopping, and then spending most of the afternoon cooking a chicken soup from scratch (I added lemongrass to the recipe this time -- yum).
Well, I was chasing pain all day. I took 10mg hydrocodone in the morning, then another 5mg around noon. I was quite sore after returning from the supermarket around 3pm and at some point between then and 5pm, as I was going from one stage of the soup prep to the next, I took 10mg of oxycodone -- I was in agony from chopping.
The soup was great, but I had no appetite. At 8pm, I was still in tons of pain and so pulled out my Nucynta, from over a year ago, as other opioids wire me and this one would give me the best shot at getting to sleep.
I believe that was the first time I took 3 BT doses in one day. But one thing it does suggest, given that I forgot my Ultram ER, is that however insufficient, it is still making a difference.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray