morphine sulfate ER to replace Oxycontin? HELP!

Hello, everyone. I am sorry if I violate any of the posting rules in this post, but this is my first time so please forgive me. I am 29 and have a severely fractured tailbone. They think I broke it having my son in January, 2010 but didn't notice it until I fell in the end of October, 2010. That's when the REAL pain began...

I have a good PCP who is a wonderful man but I am just so frustrated every single day. He's sent me to a neurologist who gave me pain meds and said I'd probably have to have the whole tailbone removed but didn't know of any doctors that did the surgery anymore. She sent me for an injection into the sacrococcygeal joint, and the doctor doing the injection yelled out "WHOA!" when the Xray image of my tailbone came onto the screen that was guiding the injection. He said that he'd only seen one other tailbone like mine (he was in his 60s) and that there was no way the the injection would work (but, of course, he gave the injection anyway...). That didn't work.

I had an appointment with an orthopedic surgeon who called me personally after he saw my films to say the break was too severe and he didn't treat cases like mine. I saw another orthopedic surgeon who told me that there was nothing he could do except prescribe narcotics and maybe it would get better in 10 years (10 YEARS WITH PAIN LIKE THIS????!!!!!!). I see a new orthopedic surgeon next week.

I see a chiropractor and take lots of fish oils. I started glucosamine chondroitin today and got a prescription for yoga which I start tomorrow. I take OxyContin 40 mg twice a day and oxycodone every 4 hours. The OxyContin is so expensive and the insurance company told me in order to save money I should switch to morphine sulfate ER. I can not BELIEVE that the insurance company PHONE OPERATOR is now telling me what drugs to take! I have always trusted the medical industry until now, when something has gone wrong with me. I am a trainer and nutritionist and I believe in mind-body healing. Sorry that I have posted all this information, but I am new here and wanted to give a background.

So that's my big question - will the morphine sulfate ER work as well as the OxyContin? What about being tired? I have a little boy and I can't be out of it all the time. Is there anything else that works JUST AS WELL as OxyContin and is cheaper? I'm so sick of altering my life around this darn pain. Please HELP if you have any input. Also, I am in the Pittsburgh area. Thank you.

Hi Sick...

Welcome to the forum and it's wonderful to meet you! Wow, you sure do have some misery to look forward to and I'm so sorry. Every time I meet a new member with such incredible pain it breaks my heart...but I love meeting and sharing my experience and any knowledge I've gained if it can help others.

I've been on Oxycontin for many years and have switched to MS Contin (morphine sulfate ER) twice and both times the insurance companies costs and attitudes were the main reason. This year alone I changed 3 of my main medications due to insurance costs. For one, a 3 month supply was costing me $40. With the new plan my husband's employee chose that copay is now just under $1000 for the same number of pills. No way do I have that kind of money! Plus the oxycontin jumped up again. But the added reason I switch for good this time is the looks and a nasty comment I received at our local pharmacy. This is not a chain type pharmacy but a locally owned store that's part of our community, where everyone knows everyone and the owner always gives everyone the lowest prices he can possibly do. (People come from over an hour away just to buy their prescriptions there.) Last year when the oxycontin rumors were of low supply, I went down to get my monthly supply. The best and sweetest pharmacy tech, whom I've known for years, looked at me and said "That medicine is supposed to be for cancer patients!" Did she think I was prescribing it for myself? It was my doctor's idea to best control my pain and I hate the stuff...in fact I hate all pain meds, except! that they do work and without them I would have no life at all. But her comment, in front of a store full of people, was the last straw along with the insurance upping my copay again.

I so agree with you about those darn insurance companies doing the prescribing. On many occasions of the years I was told that I either don't need a particular medication the doc prescribed or I don't need as much as he prescribed. He and I both are believers in the least amount to get the job done. There's no 'good feeling', 'buzz' or 'high' from pain medications when you are using them for chronic pain. (there are studies to back that up but it's another topic)

So, if a medication does what you need it to do I see no reason not to change for cost purposes alone. All medications work differently for each of us but if I were you I'd give it a try. Just ask your doctor if it doesn't work out if you can go back. It might take a period of adjustment but for me...I'm doing OK on the MS Contin. You will be taking what seems like a higher dose but it takes more morphine to equal the relief power of the oxycontin. I think it's about 50% more since it's a "weaker" medication.

Hope something here is helpful and please keep in touch..OK?

Greetings dear sick-, I agree with all others on the switch from one medication to the other.  I have been on 60mg mscontin extended release for almost 4 years, I myself will be asking for an increase in my dosage not the mg.  I also take percocet for breakthrough which is 10mg when needed, I have not made it through one month in 4 months without running out of the percocets.  So I will be getting an increase in again the amount not the mg.

I feel so fortunate to not have the insurance (pharmacy anyway) problems so many suffer with.  I will say the one thing medicare has is great options for pharmacy, you have to read carefully everytime that book comes out (once a year) but it is worth it.

So sorry for all you trials, its bad enough to feel bad without having to argue with people who no nothing about what you are going thru.

I hope you feel better soon, insist on getting the help you need.  Everyone has a boss, start moving up that ladder, someone will take note if you get to close to the top, or hopefully before you get to close to the top.  Even they have a boss.

Sending gentle hugs your so glad you found this forum, it has helped me in ways I never thought possible.

Thank you all so much for your caring and compassion. I see now that I didn't mention the full reason why I have to switch. The insurance company only has a $2500 outpatient annual limit and when I hit it that is IT, I'm on my own. Well, with checking out different doctors, MRIs, X-rays, Brand-name (OxyContin) medication, and some infertility treatment earlier this year, that maximum has been hit and then some! Luckily for me, the year starts over June 1st; but I want to be much more careful in the amount of time I use it all up this time around.

So, unfortunately, switching medications is one of the best and most responsible things for me to do for my family. We have a wonderful 16-month-old baby boy who we waited and prayed for after much loss, and I know I shouldn't feel this way, but I feel a lot of guilt about the money I have been spending to care for this situation. I am so thankful that by the time I realized that I had reached my maximum it was only about $3,000 after that out of our own pockets - so it's not the end of the world, it could have been a LOT more. I am a lot more hopeful now knowing that there is a much more affordably-priced option out there, with which you all have had positive experiences; and thank GOD that the insurance starts over June 1st! Now I just wish I'd found it sooner! Oh well, there's no looking back now...

HEre are the answers to some of your questions:

My PCP (Primary Care Physician) is my prescribing doctor. I have not seen a PM, but I am not actually sure because I had to sign a contract and entered a "pain management program" at my PCP's office. So I think maybe that means HE can provide pain care? He has always been very supportive and hasn't had a problem prescribing meds - I never even asked him outright for any. We just tried different options and when I was on oxycodone every 4 hours he switched me into the program and after the 1st month was over and not much improvement he prescribed the OxyContin 20mg with 5mg oxycodone for breakthrough pain. Then it went to 40mg OxyContin with the same oxycodone for BT pain.

I did know from some previous nursing experience that morphine is not as strong as oxycodone and that, theoretically, if I am taking a total of 80mg of OxyContin/day that I should be starting out with 120mg of morphine sulfate ER. I checked the prices on 60mg morphine tablets twice a day using the "price-a-drug" tool on the insurance website and that is a much easier pill to swallow (no pun intended, haha).

Thank you all again so much for your advice. I'm just a little nervous about making a switch. I'll definitely keep you posted on any changes. I see the PCP and plan on delivering the insurance news on Tuesday which means that is probably the day I will switch to the morphine. I see the spine specialist orthopedic surgeon on Thursday. I am even almost a little excited to try the other meds now and have some hope that maybe it will even work a little better (trying to keep a positive attitude). It has been very nice meeting you and I look forward to sharing some better news in the future!

Good reply Snow!

I was going to mention "Methadone"...and I believe it is one of the cheapest pain med's of all listed here, but I also wanted to note that is can be difficult to get started on, and down right horrible to wean off of,
especially if you're PM or PCD doesn't know what their doing. Also if you're PM has a bad habit of being late with scripts, then the withdrawals can be down right brutal. However, everyone is different and it might be a very good fit for you.

It is worth mentioning, that many members on "Methadone" have had excellent luck with it, and seems to be a very effective med in combating chronic pain.

My Insurance Company pushed this med as a possible treatment for me, as they were balking at paying for the increase of Oxycontin. My good PCD went to bat for me, and after several fax's, won a favorable resolve from them to pay for the increase of my Oxy.

Good luck to you Sick! ....and please do visit with us again. Once you sign in on the dotted line here...you're family!

SE

Snowbunny21 said: "And a reminder to use other tools to help with the pain like exercise that you can tolerate each day...yoga/stretching...acupuncture...injections...cognitive behavioral therapy...use of non narcotic meds like antidepressants or nerve pain meds...or muscle relaxers...trying to get a normal night's sleep if possible...etc.."

Since I am a trainer and nutritionist (although I am not working right now though this), I am doing everything holistic under the SUN to feel better. I juice in the morning - EVERY morning - for back pain relief (a blend of a ton of broccoli, spinach, carrots, 1 lemon (with the peel), 1 green apple, and the reserved water from soaking rolled oats for 15 minutes. I also exercise daily, even if it's just very brisk housework or a stroll through the neighborhood with my son.

In addition, I see my chiropractor once a week. I buy my daily muti-vitamin packs through him and take them religiously, along with 300mg of DHA 3 times a day and 600mg at bedtime. He also gave me Glucosamine/Chondroitin 300/300mg twice a day. I also asked my PCP doctor for a prescription for yoga and joined a yoga place. I go for an hour 3-4 times a week. While I'm there, I think of it as physical therapy and not exercise so that I don't start trying all the hard poses and just stick to what stretches/strengthens my back and feels good.

As far as acupuncture, I don't think I would like to try that. I do have a prescription for massage so I add that into my medical bills as well, including some reflexology. All of it feels good while it's happening, but no lasting relief.

As far as injections, I wrote in my first post that my PCP "sent me to a neurologist who gave me pain meds and said I'd probably have to have the whole tailbone removed but didn't know of any doctors that did the surgery anymore. She sent me for an injection into the sacrococcygeal joint, and the doctor doing the injection yelled out "WHOA!" when the Xray image of my tailbone came onto the screen that was guiding the injection. He said that he'd only seen one other tailbone like mine (he was in his 60s) and that there was no way the the injection would work (but, of course, he gave the injection anyway...). That didn't work." So I won't be getting any more of those!!!

I did used to a psychologist (who worked with my PCP to prescribe recommended meds) for therapy and just recently stopped. He and I were satisfied that I was on a good track and finally leveled out on some ADD medicine after much denial and trial of anti-depressant/anxiety medicines. Plus, even if I wanted to continue with him, again comes in the problems I am having with my annual insurance. I was on some muscle relaxers in December and January... I'm not sure I remember why we stopped them now that you mention them. I will have to check my insurance website for prices and then ask my PCP at our visit on Tuesday.

I also just realized I should probably check out a new sleeping medication. I have been on zolpidem CR 6.25mg (generic Ambien CR) and even that's a little expensive so I should check the website about that, too. Although, if I get back on a muscle relaxer I wouldn't need a sleeping medication anyway...

Also, as far as methadone goes, maybe it is my ignorance and newness to the pain drug thing, but the very mention of it terrifies me. Even still, it probably wouldn't be a good option for me because my doctor often IS late with scripts like you mentioned and I certainly don't want withdrawals. With my baby boy, I can't have that sort of thing happening... Mommy's to 17-month-olds don't get sick days! :(

Well, you gave me a lot to think about. I'll keep you posted if any of the holistic stuff kicks in. Because of my profession, I have always believed in mind-body healing, but God is testing me now! I won't quit trying as long as I can take it. I always remind myself of my clients and what I always said to the ones that were moms. "You can do this. This is nothing! You're a mom!" It was true, even if they didn't believe me. The moms were always the toughest people. Well, now I am a mom and I can be that tough, too! (At least, that's what I keep telling myself...)

Thanks again. :)

Welcome to the forum, ladysea.

This is a really old thread. It would be helpful if you'd start your own so more people would read it. Use the "post new topic" button at the top and bottom of the page.

I'll give you a reply when you get this done. I've had a little experience with my tailbone.