My new med regimen

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cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 926
   Posted 3/23/2012 2:43 PM (GMT -6)   
Hi All,

It is my third day on the new regimen my PM wanted me to follow. For almost a year now, I've been asking to add another time-release opioid, either on top of or replacing my Ultram ER.

My PM has said no, since I don't use enough BT medication. He has been encouraging me to use more and I did start over the past three months. But I did my best to keep the doses down, and went 3-5 days per month without BT meds, opting often just to stay in bed through the day, and generally taking as little as possible.

At this appointment, he and his new PA asked that I just try taking 20-30mg of hydrocodone every day, at set times.

So, I decided to take 15mg late morning and 15mg late afternoon (I might pull back to 10 and 10 or 10 and 15 depending upon pain levels).

Although it used to make me a bit hyper, surprisingly, it is now making me a bit more sluggish, but not too bad -- and one good thing is that I was able to go out with my wife today for lunch.

Meals are usually agony for me since I can't lean forward even a few degrees. Thus we've stopped going out for meals, though that is something we used to really enjoy. But we went out today to a new mexican restaurant and we both realized in the middle of the meal that I was causally leaning forward as I ate.

By the end of the meal, my back was hurting some, but not the overwhelming pain I'm used to. At home, I would often lie down for a bit during dinner since I couldn't make it all the way through, or I would right after dinner, have to lie down for a few hours. But with the new regimen: Ultram ER 300mg (as usual) plus 2x15mg of hydrocodone daily, I'm seeing a difference.

Sadly, it looks like I have to finally give up on my militant efforts to limit the buildup of tolerance, but I am definitely doing better (for now). I'm also going in for more trigger point injections next week, btw, and am going to start looking into other options, such as nerve ablation.
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 & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 3/23/2012 3:31 PM (GMT -6)   
…I go through the same thing when eating out, as sitting puts the most strain on the lumbar spine. If I know we are going out to eat, I will often take a BT med so that I can at least enjoy myself to a degree.

I'm not sure what all med's you are on, but the 20mg to 30mg a day is really a low dose for most CP patients. How do you feel around bedtime?…and do you take any med's then….maybe a half a pill? I tend to break my Percocet's in half these days, and that seems to help some. Mornings are the worst though!

I hope you continue to have good luck with the new regimen, and understand the reluctance to keep upping the dose of the BT med's and ride the roller-coaster each day.

SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward."

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 926
   Posted 3/23/2012 5:22 PM (GMT -6)   
HI SE,

It is difficult for me to think of 20-30mg of hydrocodone every day as a low dose. I've been in pain now for over seven years and until about two years ago, held to a rule that I could only take one BT med a day and can't take BT meds two days in a row. So, I militantly fought to slow down the rise of tolerance and also make sure I don't become chemically dependent. During the bad days, I would just stay in bed or one way or another, limit myself.

Looking at my records, it was about this time in 2010 when my PM convinced me to take an extra 1/2 a hydrocodone if I was in pain later in the day and eventually, after just too many bad days in a row, gave up on my other rule. So, it is still quite weird for me to take hydrocodone every day, never mind 30mg.

But the past few days have been great. I've done so much around the house (repainted three areas that needed some touching up, replaced some sprinkler heads and installed a new timer, cleaned up leaves, repaired a bit of guttering, etc. etc.). And as noted above, went out for lunch with my wife. We're planning on a nice dinner out tomorrow.

When I wake up, the pain is mild -- usually I wake up o.k. unless it is cold and damp or I slept in a bad position. So today I took my first dose of hydrocodone around 11am and took my second around 5pm -- after I started to get into pain from moving our stove (it was a bit askew).

So far in the evenings, I've been o.k. and haven't needed any oxycodone. That's another victory since I would like to save them for just the worst days, which before Wednesday, were coming too frequently.

I haven't done any writing since Tuesday as I've been too busy with chores, taxes, insurance hassles, etc.. But I hope that the hydrocodone doesn't impair my focus when I finally get back to it.
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 & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

flower123
Veteran Member


Date Joined Apr 2009
Total Posts : 856
   Posted 3/24/2012 4:30 AM (GMT -6)   
I'm glad you're getting some relief, and happy that you were able to do more. I understand wanting to control tolerance. I have been on the same dose now for years. Some CP patients find an effective dose and stay on it for years, without moving up at all.

I agree with SE...your dose seems very low for a CP patient.

I hope that you continue to get relief, and I'm glad that you've decided to take it every day instead of waiting it out. That would have caused me to be miserable, and my pain would be out of control if I took my medication that way. It sounds like you have a doctor who is on your side as well, which is wonderful.

Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 3/24/2012 8:19 AM (GMT -6)   
I have to commend you Cogito!….I think at times, it may be easy to have the desire of having our med's upped when were in so much pain. At the moment I'm at the same dose or less than you, but am really paying a price for it. I'm hoping that this non-narcotic med (Gabapentin) will eventually lessen my pain, but so far, I have not had a whole lot of luck with it. At first I thought it was working, but the last few days, I have been disappointed. However, the dose I'm on is a starting point, and its a very low dose (300mg x4)….but I will see my Dr at my next script refill…as he wants to monitor my progress or lack thereof as we look for something that will work better.

I myself requested the Gabapentin, and he has balked at this for over a year now, but he has been showing signs and hinting around about the high dose of Oxycodone products I have been taking. I believe I have been on them way too long as well, and have told him about this for quite some time. It seems to be a battle, and of course we are the ones who suffer, because of these Dr's fears. I understand what is going on around this country has the Dr's nervous, but at the same time…when a patient has an arm load of MRI's and test to show the cause of our pain, you would think Dr's would be able to treat a patient without worrying what the DEA is doing in their office.

Sorry if I have strayed of subject here! LOL ….I hope you can stay on the lower dose of your pain med's and understand your thoughts on it. I think it's the wish of every good pain patient, and hope you do not have to suffer too much doing so. Good luck to you.

SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward."

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 926
   Posted 3/25/2012 8:40 PM (GMT -6)   
I'm just amazed...

This is day 5 on the new regimen. Today I took my Ultram ER and 15mg of hydrocodone when I finally got out of bed around 11am (I was up until about 4am reading). After lunch, we went out to look at a house (our second day looking at what is on the market) and then I got to work. I worked sitting upright for a few hours, then went to the store to buy some exterior paint samples and painted a few feet with each at the back of the house. I was a bit sore and took another 15mg of hydrocodone, now my standard late-afternoon dose. We then had dinner and after dinner, I spent 4 hours writing, sitting upright again.

I'm a bit sore, especially my hip, but my back feels more like a background ache and stiffness rather than the fierce burning, stabbing mid-back gnawing/clenching upper back. I still feel very awkward about taking 30mg in a day, but it sure makes a huge difference.

One question -- my PM won't write any refills for Hydrocodone, but I thought that Schedule III meds could have refills. At this rate of use, I'll need a new 90-pill script every month, which means I'll have to call ahead and pick one up every month. Is that what others do who take Hydrocodone? I assume it has to be the case with Schedule II meds, but why can't I get refills for Schedule III? Just office policy?

Post Edited (cogito) : 3/26/2012 3:58:50 PM (GMT-6)


Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 3/27/2012 11:11 PM (GMT -6)   
Cogito,

I'm glad to hear that your new med regimen seems to be working.... I know you were resistant to the extra jump up on your BT meds - but I'm just glad it seems to be helping. That's great news.

Re: your refills - yes, you can get refills on Class III meds. I'm thinking that it just may be office policy?

--Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask
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