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Posted 4/17/2008 11:40 PM (GMT 0)
This may sound stupid but I don't understand it so I'm going to ask it anyway.

 

My pc dr is also my pm dr.  I am on Fentanyl 75mcg & oxycodone 5mg for breakthrough breakthrough pain.  A friend of mine just picked up my Rx.  My oxycodone 5mg reads: take 1-2 pills every 6-8hrs, #60 pills for the month.  The dr tells me to only take 1 pill every 12hrs as needed.  I called and spoke with his nurse who in turn spoke with dr.  She told me he said to disregard what the directions said on his Rx and the Rx bottle take my meds the way he had told me.  I asked why he didn't write it for every 12hrs?  She didn't have an answer other "do what the dr says".  I just don't understand why he writes one thing and tells me to do something else.

 

Does this make sense to anyone out there? eyes

Posted 4/18/2008 1:01 AM (GMT 0)
Hi LassieLuv!
You won't believe this, but the exact same situation happened to me yesterday when I called my doc's nurse for a refill on my dilaudid. On the container it reads "Take 1 tablet every 6 hrs, as needed" so that's what I've been doing, as my iliac hip crest bone marrow site for the fusion has really been hurting. When I saw the doc 3 weeks ago, I had been taking only 2 per day, which was all I needed then...but this last week, b/c of the increase in pain, i have been taking them AS THEY ARE RX'D ON THE BOTTLE...1 every 6 hrs....so I called for a refill,so as not run out. They are really helping & I tolerate them well (we tried a lot of other stuff that made me sick,etc so he suggested this & it works well for me)

So she said the same thing to me: "Don't go by what's on the bottle--you told him you were only taking 2, so just do that." !!!

I asked her the SAME question: "Why did he write "1 every 6 hrs" then???!"

She was very short w/ me & said: "We're going to re-write your refill." But she didn't say WHAT!! (Dilaudid is an opioid & needs a written RX, so they mail it to me. ) "But it will be worded differently." And then she doesn't tell me HOW it will be "worded". I'm thinking: "Take 1 table every week, as needed" LOL! I asked her about the difference and she didn't have an answer either! (Maybe they are sisters! )

Lass, it makes no sense to me either! What are the directions on the bottle FOR if not to be followed?! And the "as needed" part, to me, would be PRN, take the dose AS YOU NEED TO.... as in, if you need more frequent relief (but not more than 1 every 6, which I haven't been anyway) you should take them, as needed, or why would he have RX'd them that way in the 1st place?

Anyone else out there able to figure this out? I have no clue! But a lot of pain tonight!

Ach!!

Lassie, take care! Thanks for bringing this up! I hope we're not alone in this one!

~Lakeside
Posted 4/18/2008 1:02 AM (GMT 0)
My Percs (5/325 mg) read one every 6 hours and the MD knows if I need it for BT I take two at a time, in fact, he had told me verbally I can take two every four hours when things are bad.  MD said it's written that way for "big brother"--don't want anybody thinkin MD's are over-prescribing, only the minimum necessity.

Posted 4/18/2008 10:38 AM (GMT 0)
BigLucy - I understand what you are saying about "big brother" but my situation is the opposite. The Dr. is writing mine for MORE than what I am supposed to take. So what my Dr is writing is over-priscribing on the Rx and is telling me to take LESS than that.

Lakeside - can't believe we're in the same boat. Sometime I just don't know what to expect. I am beginning to wonder about other non-pain scripts; should I take them as directed or what?

Wishing you both a tolerable day!
Posted 4/18/2008 1:47 PM (GMT 0)
Under, exactly! And Lass, exactly@ As with your RX, my doc's instructions were for MORE than I was taking! According to his RX, "1 every 6 hrs" I would have "permission" to take 4 w/in 24 hrs, assuming I was awake(!) to take 1 during the night, which thank God, I'm usually able to sleep.

So, yes, WHY do they RX more than you need (based on what you tell them you are taking when your pain is less) but then tell you to NOT take the written RX'd amount?! Why didn't he just (if he only wanted me to stick to 2 a day) write: " Take 1 tablet every 12 hrs"---but then he adds: "As needed" which would mean just that...."1 every 6 hrs as needed" to me would = a minimum of 1 every 6 hrs, but up to 3 a day IF NEEDED...

Well, this AM I just took 2 advil (she said that's OK now to use a NSAID, as I'm 3 months out & the fusion is starting) but even when I asked her if I could sub some Advil for the dilaudid, she said " Just don't take TOO MUCH!" And this is for REAL pain, from a very painful surgery & I am not just "using" them to pass the time....in fact, I'd really rather NOT use them, as they do have some (tolerable yet annoying ) side-effects.


Thanks everyone for listening! And Bus, I agree: those of us who are in actual pain and really need the actual relief are being held hostage by those who use these very helpful meds for recreational purposes, etc. Something other than punnishing US needs to be done to curtail that mis-use by those who abuse very effective meds for those of us who use them judiciously and conscientiously.

On to the ice pack! Have a "well as can be expected" pain-level day, all!

~Lakeside
Posted 4/18/2008 5:10 PM (GMT 0)
Wow, Gramps!
Thank you for explaining that! Yes, the effect, of my dilaudid, (& it IS very effective at first) does "wear off" in about 4-5 hrs, but until this dumb hip crest started to hurt, they were doing the job nicely for my hardware site discomfort, which was more dull and less acute. Which IS what I told him (two weeks ago) & I WAS honest: "Yes, I take them about every 6 hrs, but some days I only need 2 of them" Wrong thing to say, huh! The truth, tho, back then, a few weeks ago. YIKES! So when my hip crest started to hurt more, I looked on the bottle & read it again: "Take 1 tablet by mouth every 6 hours AS NEEDED" So I took MORE b/c that's what he had RX'd....even tho I didn't need that much when he RX'd it.....!!

Well, I just got the new script from him in today's mail & from what I can decode (Latin & poor handwriting) I think it now reads" Take 1 tablet by mouth efery 12 AS NEEDED." Still the "AS NEEDED" part....but here's where I might be misinterpreting it...does that mean ONLY every 12 hrs, as needed (only 2 in 24 hrs) or every 12 hrs AS NEEDED, as in MORE than 2 within a 24-hr period??

He gave me 60 pills & I see him May 21. I still have a weeks' worth left, so I'll just about be out of them when I see him in May. Truly, I WANT to stop them, as they do have some odd effects when you decrease the dose: hot flashes, muscle cramps, some sweating. But it's not bad & the most I ever took was 3 a day. So yes, I will sub the Advil for my AM dose & only use them around Noon and then bedtime, as by the end of the day, I hurt more. And that would comply w/ his "new" RX to take them only 2'xs a day, staying about 12 hrs apart, as I usually go to bed about 11:30PM.

WHY does no one ever really explain all this to us? And oh, I almost forgot: my original RX, when I came home right after my fusion & the pain was soooo bad, he'd written "Take 1-2 tablets every 4-6 hours, as needed." I never ever took that many! I am only 115# and that much would have knocked me into next Tuesday! I think I wrote down in my pain journal that I dd take 6 TOTAL tabs those first few weeks home, but then I titrated myself down b/c they were making me nauseated. But going by what you'r saying, then, originally I would have had the "permission" to take (this would be the max) 12 a day!! Holy cow!!

Thanks again Gramps & everyone else! I will now take a "legal" dilaudid, watch my dumb soap ("Days" is getting really depressing! Yuk!) and head for my afternoon nap, enjoying a brief, effective respite from the jack-hammering in my hip bone! Geeze Louise, what we endure!

~LAkeside
Posted 4/18/2008 5:46 PM (GMT 0)
Thanks guys - I didn't realize this was such a wide-spread situation. It really burns my butt too when I hear of the people who want to buy / sell pain meds for recreational use. I am not a "drug seeker"; I am just looking for some REAL Rx pain relief. It seem that after seeing the same Dr for almost 8yrs, he would be a little more compassionate after all that I have been through. I don't know what other kind of pts he sees or hears about concerning pain med issues but he should take each case individually. We are not all out there getting "high". We are just trying to live as normal of a life we can with CP.
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